A Better Smartphone App for Quitting Smoking
What’s new A smoking cessation smartphone app based on acceptance and commitment therapy is more effective at helping smokers quit than the National Cancer Institute’s QuitGuide app, which is based on smoking cessation clinical practice guidelines, according to a study published September 21 in JAMA Internal Medicine. Research details Researchers from Fred Hutchinson Comprehensive Cancer Center in Seattle compared 1,214 smokers who used the acceptance and commitment therapy (ACT) smartphone app and 1,201 who used the QuitGuide app. After 30 days of follow-up, the study showed that the ACT app was almost 1.5 times more effective in helping smokers quit compared with the other app — with a 28.2 percent quit rate versus 21.1 percent. Why it matters Smartphone apps have long been discussed as a potentially useful tool to help smokers quit, but there has been limited data on how well they work, the authors note. The study suggests that the cessation techniques used in the ACT app may provide a more effective approach to quitting. This approach teaches skills to help smokers to accept and deal with urges to smoke while the QuitGuide app teaches smokers to avoid urges. RELATED: How Wildfire Smoke Affects Your Health and How to Protect Yourself
Some Acid Reflux Drugs Could Interfere With Effectiveness of Tecentriq
What’s new Proton pump inhibitors, a category of drugs used to treat acid reflux, may lead to worse cancer outcomes in patients with urothelial (bladder) cancer who are taking the immunotherapy drug Tecentriq (atezolizumab), according to a study published September 15 in Clinical Cancer Research. Research details Researchers from Flinders University in Adelaide, Australia, looked at how proton pump inhibitors (PPIs) such as Prilosec (omeprazole), and Prevacid (lansoprazole) impacted the survival of 429 patients with urothelial cancer. These patients are typically treated with Tecentriq or chemotherapy. The study found that patients receiving Tecentriq who used PPIs had a 68 percent greater risk of death, a 47 percent greater risk of disease progression, and a 54 percent lower objective response rate than those who did not use PPIs. Why it matters The study shows that PPIs can be overused or used inappropriately in patients with cancer, the authors say. Recent research shows the drugs can disrupt the gut microbiome, which can cause changes in immune system function. “There is growing concern that an altered gut microbiome could negatively impact the efficacy of immune checkpoint inhibitors,” says the lead author of the paper, Ashley Hopkins, PhD, of Flinders University. “Given that approximately 30 percent of cancer patients use PPIs, often for extended time periods, there is an urgent need to determine if PPIs influence the efficacy of immune checkpoint inhibitors.” Currently five immune checkpoint inhibitors are approved in the United States for the treatment of urothelial cancer, according to Dr. Hopkins. Combination Immunotherapy May Help Patients With Advanced Prostate Cancer What’s new The combination of the drugs Yervoy (ipilmumab) and Opdivo (nivolumab) appears to benefit some patients with metastatic, castration-resistant prostate cancer, according to research published September 10 in the journal Cancer Cell. Castration-resistant prostate cancer is cancer that no longer responds to hormone therapy, a common treatment for prostate cancer. Research details Researchers studied 90 men with metastatic castration-resistant prostate cancer who received the combination therapy. One group of men had previously received chemotherapy while the other group had not. In the patients with no previous chemotherapy, the response rate was 25 percent while the median overall survival rate was 19 months. In the post-chemotherapy group, the overall response rate was 10 percent and median overall survival was 15.2 months. Four patients achieved a complete response, meaning the cancer completely disappeared. More than 42 percent of patients had serious adverse events related to the treatment, such as diarrhea, pneumonitis, and colitis. Why it matters Metastatic castration-resistant prostate cancer typically does not respond well to immunotherapy medications. The treatment may be effective because the two immunotherapy drugs act differently. Yervoy is an anti-CTLA-4 drug, while Opdivo is an anti-PD-1 therapy. “Historically, prostate cancer has been very resistant to checkpoint inhibitors,” says the study’s principal investigator, Padmanee Sharma, MD, PhD, a professor of genitourinary medical oncology and immunology at MD Anderson Cancer Center. “These results suggest that a combination approach may be a useful strategy for treating these patients,” Dr. Sharma says. The results of the study have led to an expanded clinical trial aimed at reducing treatment-related adverse events. RELATED: Nonmetastatic Castration-Resistant Prostate Cancer: Two New Treatment Options Have Changed the Way It’s Managed
Report Details Racial Disparities in Cancer
What’s new Black Americans have had the highest overall cancer death rate of any racial or ethnic group in the United States for more than four decades, according to the inaugural Cancer Disparities Progress Report, released September 16 by the American Association for Cancer Research (AACR) and published on its website. Research details The report draws on previous research to analyze cancer outcomes by racial and ethnic groups. In addition to the high mortality toll among Black Americans, the report found that Hispanics have the lowest colorectal cancer screening rates while Native Americans and Alaska Natives have the lowest breast cancer screening rates. The report also showed racial and ethnic minorities are “severely under-represented” in clinical trials. The authors note that the COVID-19 pandemic has sharpened some of the disparities in care. Overall, however, progress is being made in closing disparity gaps, such as through efforts to ensure equal access to standard-of-care cancer treatments. Why it matters The report details the disparities in cancer outcomes among various racial and ethnic groups in the United States and describes areas of progress in closing those disparities. The authors noted that a range of complex and interrelated factors lead to disparities in cancer care, but that systemic racism directly influences many of the factors that result in disparity. RELATED: COVID-19 Pandemic May Worsen Colorectal Cancer Screening Disparities
E-cigarettes Don’t Help Smokers Quit
What’s new Two new analyses of e-cigarette use show the products do not help smokers quit and may increase the chances that smokers become addicted to vaping. The analyses were published September 2 in PLoS One and on July 27 in the American Journal of Epidemiology. Research details The PLoS One study included 2,770 daily smokers who reported trying to quit. During the first follow-up year (in 2014–15, before nicotine salt technology became common in e-cigarettes), 23.5 percent used e-cigarettes to help with their quit attempt. At the second follow-up, one year later, 9.6 percent of e-cigarette users had stopped smoking compared with 9.5 percent who did not use e-cigarettes and 10.2 percent who’d used neither e-cigarettes or pharmaceutical aids. The AJE study looked at 2,535 daily and nondaily smokers, of whom 17 percent used e-cigarettes to help them quit smoking. That study also found no evidence that e-cigarettes helped with cessation. Why it matters The study is important because some people believe e-cigarettes will help them quit smoking. “In these analyses, we carefully matched each smoker who used e-cigarettes as a cessation aid with up to two similar smokers who tried to quit without using e-cigarettes,” says Karen Messer, PhD, a professor of family medicine and public health, the director of biostatistics at the UC San Diego Moores Cancer Center, and a senior author on both papers. “Our results suggest that these smokers would have been just as successful in quitting smoking without the use of e-cigarettes. [And] without the use of e-cigarettes they would have been more successful in breaking their nicotine dependence,” Dr. Messer says. RELATED: How Vaping May Raise Coronavirus Risk
High-Intensity Focused Ultrasound Effective for Some Men With Prostate Cancer
What’s new A treatment known as focal (or targeted) high-intensity focused ultrasound (HIFU) ablation is an effective alternative to surgery or radiation for some prostate cancer patients, according to research published in the October issue of the Journal of Urology. Research details Researchers at Keck Medicine of USC looked at data from 100 men who had HIFU between 2015 to 2019. The study showed that 90 percent of the HIFU patients did not require radiation afterward. About 73 percent of the patients had treatment that was considered successful, meaning they did not have clinically significant cancer recurrence, metastasis, or the need for additional treatment, and they did not die as a result of their tumor. There were no serious side effects or complications associated with HIFU, such as sexual dysfunction or incontinence. Why it matters HIFU is a newer treatment that uses a focused ultrasound beam to heat prostate tissue and destroy it. It was approved by the FDA for prostate cancer ablation in 2015. The procedure is conducted on an outpatient basis and takes about two hours. The study is the largest to examine outcomes of HIFU as a primary prostate cancer treatment. HIFU carries a lower risk of complications. “This positive data empowers urologists to use focal HIFU ablation to effectively address prostate cancer without the intrinsic side effects of radical treatments,” says Andre Abreu, MD, a urologic surgeon with Keck Medicine and the first author of the study. Dr. Abreu is also an assistant professor of clinical urology and radiology at the Keck School of Medicine in Los Angeles. RELATED: Chemotherapy and Prostate Cancer: A First Choice for Treating Metastatic Prostate Cancer
Immunotherapy Can Cause Adverse Events in Multiple Organs
What’s new Side effects linked to cancer immunotherapies can impact more than one organ in a single patient, according to research published in the September issue of JNCCN — Journal of the National Comprehensive Cancer Network. Research details Researchers in Australia evaluated the incidence and patterns of adverse events in patients in four non-small-cell lung cancer trials who were treated with the immunotherapy drug Tecentriq (atezolizumab). They found that, among 1,548 patients, 27 percent had at least one adverse event and 5.4 percent had multi-organ adverse events. The skin, endocrine, neurological, and pulmonary systems were the most common organ systems affected. The patients who had multi-organ side effects tended to have them sequentially, not at the same time. Most of the side effects were successfully managed without disrupting cancer treatment. Why it matters Knowledge is still emerging on the range and impact of immunotherapy side effects, the authors note. There is a particular need to understand the patterns related to multi-organ adverse events. “Multi-organ (immunotherapy-related adverse events) are under-recognized, under-reported, and their pathophysiology is poorly understood,” says the lead researcher, Ganessan Kichenadasse, MBBS, a medical oncologist at the Flinders Centre for Innovation in Cancer at Flinders University, in Bedford Park, Australia. “We need a concerted international effort to improve our understanding and help identify predisposing factors and prevention strategies,” says Dr. Kichenadasse. RELATED: What Is Non-Small-Cell Lung Cancer? Symptoms, Stages, Treatment, and More
Chemotherapy and Radiation Is the Best Treatment for Some Patients With Gliomas
What’s new Chemotherapy after radiation therapy is more effective than radiation therapy alone in some patients with high-risk, low-grade glioma cancer, which occurs in the brain and spinal cord, and specific genetic mutations, according to a study published recently in the Journal of Clinical Oncology. Research details Scientists enrolled 116 high-risk patients with low-grade, grade 2 glioma tumors into one of two treatment arms: radiation alone or radiation and chemotherapy. The patients were further characterized by gene mutations (known as IDH-mutant/non-codeleted and IDH-mutant/codeleted) linked to the cancer. Treatment with radiation followed by chemotherapy was linked to longer progression-free survival and overall survival in patients with genetic mutations There was no difference in survival with the addition of chemotherapy in patients with the IDH-wild-type mutation. Why it matters The new study should result in changes in practice in how high-risk, low-grade glioma patients with IDH1/2 mutations are managed, the authors say. RELATED: What Is Glioblastoma? Symptoms, Causes, Diagnosis, Treatment, and Prevention
Some at High Risk for Colon Cancer Aren’t Aware They Need Frequent Follow-Up
What’s new More than a quarter of people who are at high risk for colorectal cancer (based on a history of polyps) are unaware that they need more frequent colonoscopies, according to a study published August 28 in the Journal of Gastroenterology and Digestive Systems. Research details Scientists from Florida Atlantic University Charles E. Schmidt College of Medicine in Boca Raton looked at data from 2013 to 2017 to explore colonoscopy adherence among 84 high-risk patients. They found that 28.6 percent of the patients were unaware that they needed repeat colonoscopies. Of those patients, 16.6 percent were unaware that three-year intervals are normally recommended, and 12 percent were not aware they required follow-up surveillance at all. Why it matters People who have a history of developing colorectal polyps are at higher risk for colorectal cancer compared with people without a history of polyps. Many of these high-risk patients should undergo frequent colonoscopy. If proper colonoscopy recommendations were followed, the rates of both disease incidence and death would likely decline, the authors say. RELATED: Chadwick Boseman’s Death Highlights Changing Trends in Colorectal Cancer
