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Women With Intermediate-risk Breast Cancer May Not Need Radiation

Radiation has long been a mainstay of early-stage breast cancer treatment, but oncologists have been reevaluating which patients need to receive this therapy. People at high risk for recurrence typically undergo radiation following a mastectomy, but those with a low recurrence risk usually can forgo radiation and avoid its side effects, like skin changes and swelling. Now, a study published in the New England Journal of Medicine has found women with intermediate-risk breast cancer can also skip postmastectomy radiation without raising their risk for recurrence, the New York Times reported. The phase III clinical trial included 1,607 women with intermediate-risk breast cancer who had undergone a mastectomy, lymph node surgery and systemic therapy. About half of the participants received chest-wall radiation, while the others did not. After a median follow-up of 9.6 years, 81.4% of the radiation group was alive compared with 81.9% of those who did not receive radiation. Researchers found recurrences in the chest wall specifically were somewhat higher without radiation, affecting 1.1% of the radiation group and 2.5% of those who skipped radiation “We’ve now shown that with contemporary anticancer treatments, the risk of recurrence is very, very low—sufficiently low to avoid radiotherapy in most patients,” Ian Kunkler, the study’s lead author and a clinical oncologist at Edinburgh Cancer Centre in Scotland, told the Times.

Bispecific, Chemotherapy Combination Helps Control Esophageal Cancer

The combination of a bispecific antibody and chemotherapy helped control disease progression in people with advanced esophageal cancer, according to a study published in the Journal for ImmunoTherapy of Cancer. The current standard first-line treatment for esophageal squamous cell carcinoma (ESCC) is immunotherapy with a PD-1 or PD-L1 inhibitor plus chemotherapy. However, not all people with the disease have long-term responses to this combination, so researchers are trying to identify additional treatment options, Targeted Oncology reported. In a phase II clinical trial, 43 people with advanced or metastatic ESCC received the bispecific antibody cadonilimab, which targets the proteins PD-1 and CTLA-4, along with chemotherapy. Participants survived without disease progression for about 7 months. Researchers found 81.4% of patients saw their cancer significantly shrink or completely disappear as a result of the treatment, which they noted is higher than the 69.3% to 72.1% seen in phase III clinical trials of a PD-1/PD-L1 inhibitor plus chemotherapy in ESCC. Slightly more than half of participants reported severe side effects that required medical attention, including low sodium levels and depletion of white blood cells that help fight infection.

Colorectal Cancer Screenings Rise Among Younger Adults

Following changes to screening recommendations, colonoscopies have jumped nearly tenfold among people ages 45 to 49, according to a study published in JAMA Network Open. Previously, guidelines had suggested people ages 50 to 75 have a colonoscopy every 10 years to screen for colorectal cancer. As more adults younger than 50 developed the disease, the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) lowered the recommended starting age to 45 in 2018 and 2021, respectively, MedPage Today reported. With the changes, approximately 20 million more Americans became eligible for screening. To evaluate the impact of the guideline updates, researchers looked at 7.8 million colonoscopies performed in people ages 45 to 75 at 1,350 U.S. hospitals between 2016 and 2024. Based on when the ACS and the USPSTF updated their recommendations, researchers divided the results into three time periods: 2016 to 2018, 2018 to 2021 and 2021 to 2023. They found 1,578 people ages 45 to 49 per month had a colonoscopy from 2016 to 2018. That figure increased to 16,534 per month from 2021 to 2023—a nearly tenfold increase. “These trends suggest that guideline adoption is translating into action at the system level—a positive sign that expanded eligibility and coordinated implementation are helping close longstanding screening gaps,” Alyssa H. Harris, a study author and a researcher at the health care performance improvement company Vizient, told MedPage Today.