Cancer Clinical Trials Rebound After COVID-19 Setbacks

While the onset of the COVID-19 pandemic significantly disrupted cancer clinical trials, both patient participation and the number of trials have rebounded to exceed pre-pandemic levels, according to a study published this week in Annals of Oncology. The study analyzed clinical trials at the Dana-Farber Cancer Institute in Boston and the Tisch Cancer Institute in New York City between December 2019 and June 2021 to note changes in patient enrollment and the number of new trials. During the initial months of the pandemic (March to May 2020), new patient accrual decreased by 46% compared with December 2019 to February 2020, while the number of new trials dropped by 23.6%. Those setbacks, however, were erased in the first half of 2021. From March to May 2021, the number of participants rose 2.7% above pre-pandemic levels, while the number of new trials increased by 30.4%. “This shows that cancer centres are able to adapt to the COVID-19-related disruptions in clinical trial activities, which is crucial if we are to achieve better and novel therapeutic options for patients with cancer,” Chris Labaki, one of the study’s authors and a research fellow at Dana-Farber, said in a news release from the European Society of Medical Oncology.

Early Treatment of Anal Lesions Reduced Cancer Risk for People With HIV

Treating precancerous anal lesions reduced the risk of developing anal cancer in people with HIV by more than 50%, according to a study published this week in the New England Journal of Medicine. In the randomized phase III trial, people 35 and older with HIV were screened for high-grade squamous intraepithelial lesions (HSIL), which are precancerous lesions typically caused by HPV that can develop into anal cancer. Of the 4,459 people with HSIL, half were randomly assigned to receive treatment, while the remainder received no treatment and active monitoring, which is the current standard of care. After approximately two years, nine patients in the treatment group had developed anal cancer compared with 21 in the active monitoring group—showing a 57% reduction in anal cancer risk. “We found for the first time that treatment of anal HSIL is effective in reducing the incidence of anal cancer,” lead author Joel Palefsky, an infectious disease expert at  the University of California, San Francisco, said in a MedPage Today article. The study authors said the results show HSIL screening and treatment should be standard care for people 35 and older with HIV.

Diabetes Leads to Worse Long-Term Outcomes for Metastatic Breast Cancer Patients

People with metastatic breast cancer who also had diabetes had worse long-term survival than patients without diabetes, despite having similar outcomes during the initial years after diagnosis, according to a study presented June 12 at the Endocrine Society 2022 meeting in Atlanta. The study matched 244 patients who had both metastatic breast cancer and diabetes with an equal number of patients with breast cancer alone. After two years, the same percentage of patients in both groups had begun a second-line breast cancer treatment, and overall survival at five years was similar (54% for those with diabetes vs. 56% for those without). Among a subgroup of patients who survived eight years, however, survival at year 10 was 87% for those without diabetes compared with 67% for those with diabetes. “In the first five years, glycemic control may not be a major contributor to mortality or cancer progression in most individuals with metastatic breast cancer,” Y.M. Melody Cheung, the study’s lead author and an endocrinology fellow at Brigham and Women’s Hospital in Boston, said in a Healio article. “However, specifically in long-term survivors, diabetes and poor glycemic control were indeed associated with worse survival.”