ICC 2023 saw many interesting and exciting abstracts. Few of the award winning studies have been selected for their novelty and clinical impact for a special showcase by ISMPO.
Administering 3 weekly cisplatin is challenging in the India. The authors are attempting to provide an efficacious alternative. The study was a phase II open label, randomized trial in patients undergoing definitive chemoradiation. One arm was given standard 3 weekly cisplatin administered as 50mg/m2 on day 1 and 2 while the interventional arm received weekly carboplatin at AUC 1.5 and capecitabine 850mg/m2 on days of radiation. Coprimary end points were overall response rate and progression free survival. The study abstract reported similar ORR and PFS at a median follow up of 12 months. The experimental arm had fever grade 3 toxicities and treatment interruptions. Further phase III trials will be able to confirm and establish addition of capecitabine to carboplatin as a safer alternative to 3 weekly cisplatin.
Lung Cancer is significant public health problem and is the most frequent cause of cancer related mortality. The authors propose that cancer mortality may reduce if lung cancer is diagnosed in early stages. In a joint effort with Assam Cancer Care Foundation, Astra Zeneca and qure.ai, a unique AI qxR was deployed. There was a questionnaire based screening done for all patients. Those meeting criteria for screening were sent for CXR deployed with qXR. The deep machine learning assessed for suspicious nodules. Patients with abnormal CXR were sent for HRCT which also used qXR. Of the 5036 patients screened, 164 patients underwent an CXR and 20 abnormal nodules were detected. 2 patients of lung cancer were diagnosed. The study highlights the need for effective screening strategies and demonstrates how AI can be adapted to address issues of public health. A larger scale validation of qXR or similar technology may improve the capabilities of CXR to screen for early lung cancer.
Obesity and insulin resistance are well known risk factors for cancer. This prospective study evaluated the prognostic ability of insulin resistance on achieving pathological response to neoadjuvant therapy across all subsets of breast cancer. 74 non-diabetic women with locally advanced breast cancer were enrolled and 51 women met criteria for insulin resistance. Nearly 86 % of women with insulin resistance had poor pathological response while 95.6% of patients without insulin resistance achieved good pathological response.