In NEJM this week, a team of US researchers reports a study comparing the efficacy of radical prostatectomy versus observation for reducing mortality in patients with localized prostate cancer. The team randomly assigned 731 men with localized prostate cancer to either the radical prostatectomy or observation group — after a median follow-up of 10 years, 47 percent of the men assigned to the radical prostatectomy group had died, compared to 49.9 percent of the men in the observation group. "The effect of treatment on all-cause and prostate-cancer mortality did not differ according to age, race, coexisting conditions, self-reported performance status, or histologic features of the tumor," the authors write. "Radical prostatectomy was associated with reduced all-cause mortality among men with a PSA value greater than 10 ng per milliliter and possibly among those with intermediate-risk or high-risk tumors."
In Lancet Oncology, researchers at the University of Texas MD Anderson Cancer Center report a prospective study of circulating tumor cells in non-metastatic breast cancer. The team collected data on CTCs collected from 302 chemotherapy-naïve patients with stage one to stage three breast cancer, at time of surgery. They identified one or more CTCs in 24 percent of the patients, and found that detection of one or more CTCs correlated with decreased progression-free survival and decreased overall survival. "These results suggest that assessment of circulating tumor cells might provide important prognostic information in these patients," the team adds.
Also in Lancet Oncology, a second team of MD Anderson researchers collaborated with researchers from New Jersey and Puerto Rico in a trial of rituximab combined with lenalidomide to treat relapsed or refractory mantle-cell lymphoma. In phase one of the study, patients were given lenalidomide and rituximab, while in phase two they were given rituximab and the maximum tolerated dose of lenalidomide. Among the 44 patients in the second phase of the trial, 16 had a complete response and nine had a partial response. "The median progression-free survival was 11.1 months, and the median overall survival was 24.3 months," the team writes. "Oral lenalidomide plus rituximab is well tolerated and effective for patients with relapsed or refractory MCL."