Diffuse large B-cell lymphoma (DLBCL) poses a challenge in hematology given its varied symptoms, and the complex interplay between disease and treatment effects on health-related quality of life (HRQoL). The phase 3 POLARIX study demonstrated superior progression-free survival and a similar safety profile with polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) vs R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) in patients with previously untreated DLBCL. Here, we evaluate HRQoL through patient-reported outcome (PRO) instruments to fully characterize the patient experience in the POLARIX study. Changes from baseline in HRQoL, lymphoma symptoms, and gastrointestinal (GI) symptoms were assessed, as well as incidence and severity of common symptoms by PROs vs clinician-reported adverse events (AEs). Baseline characteristics of PRO-evaluable patients (N = 874) were consistent. Comparison between PROs and clinician-reported AEs revealed a notable discordance; patients generally reported a higher incidence of symptoms than clinicians, emphasizing the need for patient-centric tools to accurately capture the patient experience. Both treatments exhibited rapid and sustained improvements in HRQoL and lymphoma symptoms, with the most substantial improvements seen in global health status/QoL, lymphoma symptoms, fatigue, role, emotional, and social functioning. GI symptoms (diarrhea, constipation, nausea, and vomiting) were generally similar between treatment arms and returned to baseline levels after treatment completion. These HRQoL data underscore the complementarity of PROs, as an adjunct to clinician-reported AEs, in evaluating the efficacy and tolerability of new treatments, including Pola-R-CHP, which may represent a new benchmark for patient-reported HRQoL in previously untreated DLBCL. This trial was registered at www.clinicaltrials.gov as NCT03274492.
Maybe I’m biased as chair of the VBC, but this study showed that all subtypes of SACT use were associated with markers of poorer-quality EOL care.
Guidelines for post-mastectomy radiation include patients who received neoadjuvant therapy, with or without residual disease after treatment. A good topic to review.
This study reviewed the effects of using novel agents (immunotherapy and targeted therapy) in patients at the end of life (EOL), based on the perception that these therapies may be less toxic than chemotherapy. Adjusted odds of high health service utilization and hospital death were more than twofold greater among patients receiving systemic anticancer therapy (SACT) at the EOL compared to those receiving none.
This study analyzed prescribing patterns for oncology drugs granted FDA Accelerated Approval (AA) versus those later converted to Regular Approval (RA) using data from over 63,000 patients with advanced solid tumors. Prescribing of AA drugs increased sharply—by an average of 23 percentage points—immediately after AA, while conversion to RA led to only a minimal further increase. Off-label use of AA drugs, either in earlier lines of therapy or in biomarker-negative patients, was rare. The findings suggest that oncologists rapidly adopt AA drugs into practice, often without waiting for confirmatory evidence required for RA. In summary, AA status drives substantial and immediate uptake of oncology drugs, highlighting the importance of timely confirmatory trials to ensure clinical benefit.
The article demonstrates that multi-omics research in tumor immunotherapy has grown rapidly since 2019, with China leading in publication volume but showing limited international collaboration. Early research focused on immune checkpoint blockade, while recent trends emphasize machine learning, multi-omics integration, and lncRNA, reflecting a shift toward predictive modeling and biomarker discovery. Multi-omics approaches have enabled the development of immune infiltration-based prognostic models and identified metabolic and spatial biomarkers, such as oxidative phosphorylation in melanoma and ENPP1 in Ewing sarcoma, which may guide therapeutic strategies. Overall, the study provides a systematic framework for tracking technological convergence and emerging frontiers, highlighting the need for longitudinal omics monitoring, AI-driven integration, and enhanced international collaboration to optimize precision-driven tumor immunotherapy.