February 11 2022
The NRG Publications Committee hosted the Scientific Session at #NRG2022, showcasing recent research results and trials.
Patricia A. Ganz, MD, discussed the quality-of-life results of OlympiA (NSABP B-55), a phase III trial for adjuvant olaparib after neoadjuvant chemotherapy in patients with germline BRCA1/2 mutations and high-risk HER-2 negative early breast cancer. The interim analysis of this study demonstrated statistically significant invasive disease-free survival benefit from olaparib after a median follow-up of 2.5 years (published in the New England Journal of Medicine in 2021), however, overall survival did not reach the pre-specified interim analysis significance threshold. The QOL assessment for OlympiA indicated that olaparib was overall well-tolerated as an additional adjuvant therapy and one year of olaparib does not meaningfully affect recovery after standard-of-care neoadjuvant therapy.
Spring Kong, MD, reviewed the results of NRG-RTOG 1106/ACRIN 6697 for standard versus adaptive (mid-treatment PET-based) chemoradiotherapy for stage 3 non-small cell lung cancer and the comparison of these results to the NRG-RTOG 0617 study of non-personalized radiotherapy (RT) dose escalation.
Daniel Krauss, MD, overviewed the results of the NRG-RTOG 0815 trial for dose escalated radiotherapy (RT) alone or combine with short-term total androgen suppression (TAS) for men with intermediate risk prostate cancer. At a median of 6.3 years, the addition of short-term androgen deprivation (STAD) did not improve overall survival, however, it did not result in reduction in PSA failure, distant metastasis (DM), initiation of salvage therapy, and prostate cancer-specific mortality. Benefits in PSA failure and DM rates persisted for patients irrespective of number of risk factors, ACE-27 score, and primary Gleason pattern. Advantages would need to be weighed against a modest increase in acute adverse events and the results of the accompanying patient reported outcomes analysis.
Benjamin Movsas, MD, also focused his presentation on NRG-RTOG 0815, however, he delved into the patient-reported outcomes (PROs) of the trial. The PROs analysis concluded that the addition of TAS to dose-escalated RT demonstrated clinically meaningful declines in EPIC hormonal and sexual domains when compared to RT alone. These PRO results were short-lived with no clinically meaningful differences between arms in hormonal and sexual domains by one year after treatment start. Lastly, there were no clinically meaningful differences between arms for PROMIS-fatigue and EPIC bowel/urinary scores.
Jeanne Carter, PhD, reviewed NRG-GOG 0244, the Lymphedema and Gynecologic cancer (LeG) study on the impact of lower-extremity lymphedema (LLE) on quality of life, psychological adjustment, physical disability, and function. Findings from the trial indicate that LLE symptoms have a significant negative impact on the quality of life, daily activities, and self-image of patients and Dr. Carter expressed a need for more clinical intervention trials to prevent and manage this chronic condition after gynecologic cancer surgery.
Linda Mileshkin, MD overviewed the OUTBACK Trial (ANZGOG 0902, RTOG 1174, NRG 0274) comparing adjuvant chemotherapy following chemo-radiation to chemo-radiation alone as a primary treatment for locally advanced cervical cancer. Results from the trial demonstrated no improvement in overall survival or progression-free survival with the addition of adjuvant chemotherapy following cisplatin-based chemo-radiation. Dr. Mileshkin expressed future research should focus on adjuvant therapies that may be more tolerable and effective when given after standard therapy for this patient population.