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Plasma Proteome–Based Test for First-Line Treatment Selection in Metastatic Non–Small Cell Lung Cancer

FCS medical oncologist and hematologist Ernesto Bustinza-Linares, MD has co-authored an abstract published in the American Society of Clinical Oncology Journal, JCO Precision Oncology, that uncovers a new testing method to determine personalized care options for patients with metastatic non-small cell lung cancer (NSCLC). The abstract’s authors address the limitations of existing guidelines that recommend checkpoint immunotherapy, sometimes in combination with chemotherapy, for treating NSCLC, which often discounts patient variability and immune factors. The findings from the study show that by incorporating additional plasma proteome-based testing, combined with the standard protein inhibitor testing, clear differences in patient outcomes were observed after applying targeted treatments based on the testing results.

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PACE: A Randomized Phase II Study of Fulvestrant, Palbociclib, and Avelumab After Progression on Cyclin-Dependent Kinase 4/6 Inhibitor and Aromatase Inhibitor for Hormone Receptor–Positive/Human Epidermal Growth Factor Receptor–Negative Metastatic Breast Cancer

Findings from the PACE study show that the addition of Palbociclib to Fulvestrant was not better than Fulvestrant alone, and the addition of Avelumab to Fulvestrant improved and nearly doubled the PFS. This is compelling and should be studied further for our patients with HR+ HER2- MBC.

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Hypoxia-Directed Treatment of Human Papillomavirus–Related Oropharyngeal Carcinoma

Interesting study where HPV+ head/neck cancer patients were assessed with a unique PET/CT with F-fluoromisonidazole, which assesses hypoxia in tissue. If, after two weeks of chemoradiation, the tumor became hypoxic, the patients were allowed to have chemotherapy alone while nonresponders went on to complete chemoradiation. At two years of follow-up, both arms were equivalent. There is more and more interest in how to safely de-escalate HPV+ head/neck cancer patients, but still, none have shown this can be done without compromising outcomes; this may be worth following to see if this works out.

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A Cell-free DNA Blood-Based Test for Colorectal Cancer Screening

Colorectal cancer screening by peripheral blood testing? This cell-free DNA assay had an 83% sensitivity and 90% specificity for advanced neoplasia. However, the issue is that this does not detect precancerous lesions well. Colonoscopy has its obvious advantages as it can both diagnose colorectal cancer as well as eradicate precancerous lesions.

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