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Humoral Responses Against SARS-CoV-2 and Variants of Concern After mRNA Vaccines in Patients With Non-Hodgkin Lymphoma and Chronic Lymphocytic Leukemia

Nice study from Emory quantifying the increased risk of infection in this vulnerable group.  These patients should remain vigilant in today’s environment and be considered for pre-exposure prophylaxis where available, in addition to staying up to date with vaccinations and follow-up boosters.   Even in untreated patients, titers were 11-fold lower than healthy vaccinees, confirming the disease causes an inherent immunodeficiency to COVID19.

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The Future of Home and Community Care

This article provides a sweeping historical and modern day perspective on the care delivery ecosystem beyond the four walls of a hospital. While site of care (hospital, community, home, remote, etc.), and its appropriateness / value remains a hot topic of debate, there is no questioning that ultimately the best interests of the patient should govern where care is received / delivered. For oncology/hematology patients, safe, convenient and high quality / low cost care is best received in community settings, like here at Florida Cancer Specialists & Research Institute.

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Five-Year Outcomes of FOLFIRINOX vs Gemcitabine as Adjuvant Therapy for Pancreatic Cancer

Long term results on adjuvant FOLFIRINOX vs Gem in adjuvant pancreatic cancer.  Although the survival benefit is quite significant (OS 53.5 vs 35.5 months respectively), I think the tell-tale numbers are the 5 year DFS being 26.1 vs 19%.  The modest 7% curative benefit of triplet vs single agent chemotherapy highlights the difficulty in managing this disease and the continued need for investment in GI clinical trials.

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CNS prophylaxis for diffuse large B-cell lymphoma

This is a nice historical accounting of this sometimes-challenging paradigm. No randomized, prospective trials exist to guide practice management.  The question in clinic is often, when to use prophylaxis and when not? The CNS-IPI is the best scoring system validated in the Rituximab era.  This did not account for double/triple hit genetics, ABC subtypes or sites of disease (gonads, >3 sites).  A high score or any of these groups are generally those that benefit the most from CNS-prophylaxis. The field has moved away from IT-MTX therapy to HD-IV-MTX since most secondary CNSL is parenchymal in nature. Most relapses occur at months 6-9 so sooner is probably better in terms of timing.

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Chest CT scan plus x-ray versus chest x-ray for the follow-up of completely resected non-small-cell lung cancer (IFCT-0302): a multicentre, open-label, randomised, phase 3 trial

How can you not love these nationalized country studies that make you question foundational oncologic principals; prudence of surveillance CT’s in this case? Thought provoking in the least.  No OS or DFS benefit of CT+CXR vs CXR alone! However some benefit was likely present in higher stage groups, and I doubt this will change practice in the US.

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Pembrolizumab versus placebo as post-nephrectomy adjuvant therapy for clear cell renal cell carcinoma (KEYNOTE-564): 30-month follow-up analysis of a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial

Pembrolizumab remains the only adjuvant option for high risk RCC after curative surgery. The OS curves seem to be beginning to separate and hope to be positive with longer f/u.  The ongoing Durvalumab + Tremilumumab will be an interesting adjuvant study for RCC when the results are available.

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