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Reduced/No Dexamethasone With Netupitant/Palonosetron and Olanzapine for Chemotherapy‑Induced Nausea/Vomiting in Highly Emetogenic Chemotherapy: Phase III Noninferiority Trial

This is a practical, easy-to-adopt result. In 644 patients on highly emetogenic chemotherapy, all getting NEPA plus olanzapine, a single 6 mg day-1 dex dose or no dex at all was noninferior to the standard 4-day course (complete response 72%, 72%, and 70%), with clearly less insomnia, hiccups, anxiety, and reflux. The day-1-only arm is the sweet spot, since going fully dex-free cost some early nausea control over days 1 to 3 before catching up. Caveats: it was open-label, only 6% were on concurrent immunotherapy, and the high-dose cisplatin subgroup was small, but for most of our HEC patients, olanzapine plus one day of dex looks like plenty.

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Mindfulness and Tai Chi for Cancer Health (MATCH) Study: Primary Outcomes of a Preference-Based Multisite Randomized Comparative Effectiveness Trial

The MATCH study was a large, pragmatic, preference-based, multisite RCT comparing Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ) in distressed cancer survivors. Both MBCR and TCQ significantly improved mood disturbance (POMS TMD) compared to waitlist, with the largest effect size for MBCR vs waitlist (0.44) and a significant reduction for TCQ vs waitlist (estimate –5.13; 95% CI, –9.44 to –1.23; P = .01). MBCR had the greatest impact on tension, anger, and vigor, while TCQ was most effective for anger, depression, and vigor; subgroup analysis showed women benefited more from MBCR, and younger or advanced-stage patients benefited more from TCQ. In short, both MBCR and TCQ are viable, evidence-based options for improving mood in our cancer survivors, and it doesn’t seem to matter whether patients choose their intervention or are randomized—everyone does better than waitlist. These are probably underutilized in our communities and more widely available than appreciated.

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Abelacimab versus Rivaroxaban in Patients with Atrial Fibrillation

This new subcutaneous anticoagulant, abelacimab, binds to the inactive form of FXI and blocks its activation by FXII. This drug seems significantly safer than DOAC’s in terms of bleeding risk. So much so that the study was stopped early due to a greater-than-expected reduction in bleeding events in the study arm. I hope this drug is also going to be studied for the treatment of VTE.

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