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Plant-Based and Ketogenic Diets As Diverging Paths to Address Cancer – A Review

This is a frequent question we get in community oncology – is there a diet that the reduces risk of cancer? In my opinion, the data are strong (although no numerous randomized/prospective trials are available) insofar as Mediterranean or caloric-restricted diets in decreasing inflammation, insulin and other growth-factor levels. I generally recommend mostly a  plant-based or Mediterranean diet, with decreased exposure to alcohol and at minimum 3 hours of exercise per week. This article is interesting in reviewing the pathophysiology of neoplastic cell growth and interaction with food intake.

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Olaparib With or Without Cediranib Versus Platinum-Based Chemotherapy in Recurrent Platinum-Sensitive Ovarian Cancer (NRG-GY004): A Randomized, Open-Label, Phase III Trial

The study was designed to evaluate the possibility of avoiding chemotherapy in the setting of platinum-sensitive relapsed ovarian cancer. However, chemotherapy was superior to Olaparib/cediranib  and Olaparib alone. In addition, cost and duration of therapy of Olaparib-based therapy are likely more and longer respectively as compared to chemotherapy.

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OVARIO phase II trial of combination niraparib plus bevacizumab maintenance therapy in advanced ovarian cancer following first-line platinum-based chemotherapy with bevacizumab

FCS hematologist and medical oncologist Gail Wright, MD, FACP, FCCP co-authored a recent phase II study assessing the safety and efficacy of niraparib + bevacizumab as a first-line maintenance therapy for patients with newly diagnosed advanced ovarian cancer. The promising results found the majority to be progression-free in the first 18 months.

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Primary Retroperitoneal Lymph Node Dissection for Patients With Pathologic Stage II Nonseminomatous Germ Cell Tumor—N1, N2, and N3 Disease: Is Adjuvant Chemotherapy Necessary?

Very interesting study. High-risk histology and lymphovascular invasion which are relatively common will be good markers for adjuvant chemotherapy. Morbidity and complications for RPLND may be higher in lower volume centers. At least this study brings further data for patients who are unwilling or severely concerned about receiving chemotherapy.

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Teclistamab in Relapsed or Refractory Multiple Myeloma

The Bi-specific antibody era has started full-force with impressive results and reasonable toxicities, in different hematological neoplasms. Community oncology adoption of Bi-specific antibody will be successful, once standard operating procedures are in place, and multidisciplinary training takes place insofar as management of CRS.  I am optimistic as to the uptake of this class of drugs in 1-2 years, pending payer coverage issues.

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