WBRT after methotrexate for CNS lymphoma

Lancet Oncology:

A randomized trial is reported comparing MTX alone to MTX with WBRT for responders with primary CNS lymphoma. Designed as a non-inferiority trial for progression-free survival, it failed to meet it's endpoint, however, it is observed that the toxicity associated with WBRT in not insignificant. This mirrors the approach taken at Duke currently, of the selective use of WBRT after MTX, with care taken to limit exposure to those at highest risk of toxicity (particularly those >60 years of age). Of course in the non-responders, the worst toxicity is going to be progressive disease without further treatment.

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[Articles] High-dose methotrexate with or without whole brain radiotherapy for primary CNS lymphoma (G-PCNSL-SG-1): a phase 3, randomised, non-inferiority trial: "No significant difference in overall survival was recorded when whole brain radiotherapy was omitted from first-line chemotherapy in patients with newly diagnosed primary CNS lymphoma, but our primary hypothesis was not proven. The progression-free survival benefit afforded by whole brain radiotherapy has to be weighed against the increased risk of neurotoxicity in long-term survivors."

the "Bolla" trial of long term ADT updated

Lancet Oncology:

The "Bolla" trial of Long Term ADT for prostate cancer is updated, with the DFS and OS benefit confirmed out to 10 years. What is also reassuring in this update is that the cardiovascular mortality was not increased with LHRH agonists.

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[Articles] External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randomised study: "In patients with prostate cancer with high metastatic risk, immediate androgen suppression with an LHRH agonist given during and for 3 years after external irradiation improves 10-year disease-free and overall survival without increasing late cardiovascular toxicity."

HPV subtypes for cervical cancer worldwide

Lancet Oncology:

A large report of the prevalence of HPV subtypes causing cervical cancer is published, again confirming HPV 16, 18, 31, and 33 as the primary actors. Interestingly, it also highlights HPV 45, and the prevalence of HPV in cervical adenocarcinomas.

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[Articles] Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study: "To our knowledge, this study is the largest assessment of HPV genotypes to date. HPV types 16, 18, 31, 33, 35, 45, 52, and 58 should be given priority when the cross-protective effects of current vaccines are assessed, and for formulation of recommendations for the use of second-generation polyvalent HPV vaccines. Our results also suggest that type-specific high-risk HPV-DNA-based screening tests and protocols should focus on HPV types 16, 18, and 45."