Oncology roundup: HIV vaccine given in trial; and more

The first dose of HIV mRNA vaccine is given; septic shock is linked to mortality in blood cancer patients; and more oncology news featured this week on DocWire…

This week: RNAM vaccine against HIV; septic shock and blood cancer; and more

Every week on DocWire News, the editors bring you the latest news in oncology and cancer research. In case you missed it, here are this week’s top headlines:

Keep reading for the breakdown of these top stories.

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HIV mRNA vaccine given in trial

Vaccines have been given to the first volunteers in a Phase 1 trial of the experimental HIV vaccine Moderna, the company said.

The vaccine uses mRNA technology – similar to that used in breakthrough COVID-19 vaccines – to deliver HIV-specific antigens that could trigger an immune response against the virus that causes AIDS, the company said in a press release on the trial.

“At Moderna, we believe that mRNA offers a unique opportunity to address critical unmet public health needs around the world,” said Stephen Hoge, MD, president of Moderna, in a company press release. “We believe that advancing this HIV vaccine program in partnership with IAVI and Scripps Research is an important step in our mission to realize the potential of mRNA to improve human health.”

Moderna partnered with IAVI, a nonprofit scientific research organization, for the trial at four sites in the United States: George Washington University School of Medicine, Hope Clinic of Emory Vaccine Center, Fred Hutchinson Cancer Research Center and the University of Texas. Health Sciences Center in San Antonio.

“We are extremely excited to advance this new direction in HIV vaccine design with Moderna’s mRNA platform,” said Mark Feinberg, MD, President and CEO of IAVI, in a statement. “The search for an HIV vaccine has been long and difficult, and having new tools in terms of immunogens and platforms could be the key to rapidly advancing towards an effective and urgently needed HIV vaccine. We are grateful to all of our partners and in particular to the Bill & Melinda Gates Foundation for funding this trial.

The trial will follow 56 HIV-negative adults to determine the safety and effectiveness of the vaccine. Forty-eight of the volunteers will receive at least one dose of the primary vaccine, and 32 will also receive a booster version. The remaining eight participants will receive the booster shot alone.

First vaccines given in Moderna’s mRNA-based HIV vaccine trial

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Septic shock linked to mortality in blood cancer

For patients with hematological malignancies, septic shock is associated with high mortality rates and poor 90-day survival, according to a study published in the January issue of the Journal of the National Comprehensive Cancer Network.

Nirmala K. Manjappachar, MD, of the University of Texas MD Anderson Cancer Center in Houston, and colleagues describe short-term outcomes and independent predictors of 28-day mortality in adults with hematological malignancies and shock septic. Data were included for 459 hematologic patients with septic shock admitted to the intensive care unit from April 2016 to March 2019.

The researchers found that 23.7% of the patients had received a hematopoietic stem cell transplant. Non-survivors had a higher Charlson comorbidity index, longer length of stay before ICU admission, and greater disease severity at diagnosis and throughout the course of treatment. hospitalization. At 28 days, the mortality rate was 67.8% and increased with increasing sequential assessment score for organ failure on admission, respiratory failure, and peak lactate ( odds ratios [ORs], 1.11, 3.12, and 1.16, respectively). Lower 28-day mortality was observed in association with the administration of aminoglycosides (OR, 0.42), serum albumin (OR, 0.51) and granulocyte colony-stimulating factor (OR, 0.40). In 81.6% of patients, life-sustaining limitations were present at the time of death. Overall, 19.4% of patients were alive after 90 days.

“We need to develop preventive strategies to reduce infection rates in patients with blood cancers and promote early detection of sepsis before it progresses to septic shock,” a co-author said in a statement.

Septic shock linked to mortality in hematological malignancies

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Overdiagnosis of lung cancer with screening of non-smokers

According to a study published online Jan. 18 in JAMA Internal Medicine, low-dose computed tomography (LDCT) screening of most nonsmoking Asian women is associated with significant overdiagnosis of early-stage lung cancer.

Wayne Gao, Ph.D., of Taipei Medical University in Taiwan, and colleagues used data from the Taiwan Cancer Registry to identify women diagnosed with lung cancer between 2004 and 2018. The association of the incidence of lung cancer with the promotion of screening in a non-smoking population was evaluated.

The researchers found that after the introduction of LDCT screening, the incidence of early-stage lung cancer (stages 0 to I) in women increased more than sixfold, from 2.3 to 14.4 per 100 000 inhabitants. For advanced lung cancer (stages II to IV), no change in incidence was observed (absolute difference, 0.6; 95% confidence interval, -0.5 to 1.7) . Virtually any additional cancers detected represent overdiagnosis, the authors said, because early-stage cancers were not accompanied by a concomitant decline in late-stage cancers. Mortality remained stable, but five-year survival more than doubled from 2004 to 2013, due to increased detection of early-stage indolent lung cancers.

“Unless randomized trials can demonstrate some value for low-risk groups, LDCT screening should remain targeted only to heavy smokers,” the authors write.

Non-smoker screening may increase lung cancer overdiagnosis and false survival rates

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Metastasis rate in cutaneous SCC

Metastases develop in about 2% of cutaneous squamous cell carcinomas (cSCC), according to a study published in the February issue of the Journal of the American Academy of Dermatology.

Selin Tokez, from the Erasmus MC Cancer Institute in Rotterdam, the Netherlands, and colleagues examined the cumulative incidence and disease-specific survival of patients with metastatic cSCC (mcSCC) in the Dutch population. Data were included for 11,137 patients with a first cSCC in 2007 or 2008, with a median follow-up of 9.1 years.

The researchers found that metastases developed in 1.9% of patients, with a median time to metastasis of 1.5 years. Risk factors for metastasis included age (adjusted hazard ratio, 1.03), male gender (adjusted hazard ratio, 1.7), and immunosuppression (adjusted hazard ratios: 5.0 and 2, 7 for organ recipient and hematological malignancy, respectively). For patients with mcSCC, the five-year disease-specific survival was 79.1%.

“We showed that the majority of metastases occur within four years and that this risk is higher with male gender, age and immunosuppression,” the authors write. “Individual risk prediction models need to include these characteristics of high-risk patients in order to tailor follow-up care to subgroups of patients with cSCC at increased risk of mcSCC among the large patient group primarily at low risk of cSCC. »

Metastases occur in approximately 2% of cutaneous SCCs

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