The risk of mortality from multiple primary cancers in colorectal cancer survivors: analysis of data from the South Australian Cancer Registry.

Purpose: Colorectal cancer (CRC) survivors face an increased risk of multiple primary cancers (MPCs), but evidence on MPC-related mortality is limited.

Methods: Using data from the South Australian Cancer Registry (1982-2017), this retrospective study analysed CRC survivors diagnosed with MPCs, defined as distinct primary cancers arising ≥ 2 months after CRC diagnosis. Causes of death were categorised as index CRC, MPC, or non-cancer related.

Risk Factors of Multiple Primary Cancers Among Colorectal Cancer Survivors.

: Colorectal cancer (CRC) is the most common cancer and the leading cause of cancer-related death globally. While survival improved, CRC patients face the risk of subsequent multiple primary cancers (MPCs). This study aimed to determine the incidence and identify risk factors associated with metachronous MPCs among CRC survivors.

Development and Real-World Evaluation of a Statewide Mainstream Model of Germline Genetic Testing for BRCA1/2 and Mismatch Repair Gene Variants (Lynch Syndrome).

Purpose: To develop and evaluate an evidence-based mainstream germline genetic testing model to support cancer treatment including the BRCA1/BRCA2 and mismatch repair (MMR) genes across South Australia.

Methods: Participatory action research (PAR) and implementation science principles were used to guide the development of the statewide mainstream pathway. To support the implementation of the mainstream pathway, genetic testing packages for clinicians and consumer support materials have been developed, and an education program has been delivered to clinicians.

Patient-reported outcome thresholds and their associations with survival, adverse events, and quality of life in a pooled analysis of breast cancer trials.

Researchers at the EORTC recently recommended clinical thresholds for the QLQ-C30 to facilitate actionable insights in clinical practice. We evaluate the distribution of these thresholds and associations with outcomes in breast cancer. Data were pooled from two early-stage and six advanced-stage breast cancer trials.

Incidence, Risk and Trends of Multiple Primary Cancers in Patients With Colorectal Cancer: Evidence From the South Australian Cancer Registry.

Background: Colorectal cancer (CRC) is the fourth most diagnosed cancer in Australia. With advancements in treatment and an increase in survival rates, CRC survivors face an elevated risk of developing multiple primary cancers (MPCs), presenting a clinical challenge. Therefore, this study aimed to estimate the incidence, trend and risk of MPCs after a diagnosis of CRC in the South Australian population.

Generative AI's healthcare professional role creep: a cross-sectional evaluation of publicly accessible, customised health-related GPTs.

Introduction: Generative artificial intelligence (AI) is advancing rapidly; an important consideration is the public's increasing ability to customise foundational AI models to create publicly accessible applications tailored for specific tasks. This study aims to evaluate the accessibility and functionality descriptions of customised GPTs on the OpenAI GPT store that provide health-related information or assistance to patients and healthcare professionals.

Methods: We conducted a cross-sectional observational study of the OpenAI GPT store from September 2 to 6, 2024, to identify publicly accessible customised GPTs with health-related functions.

Aligning kidney function assessment in patients with cancer to global practices in internal medicine.

Unlabelled: The kidney disease: Improving Global Outcomes (KDIGO) guideline recommends assessing kidney function using glomerular filtration rate (GFR) either through direct measurement or through estimation (eGFR) and describes a standardised classification of reduced kidney function. KDIGO guidelines have been adopted by most internal medicine specialities for the assessment and classification of kidney function, but not by cancer medicine. The development of the International Consensus Guideline on Anticancer Drug Dosing in Kidney Dysfunction (ADDIKD) aims to overcome the perceived challenges with KDIGO recommendations by describing their utility in patients with cancer.

Integrating International Consensus Guidelines for Anticancer Drug Dosing in Kidney Dysfunction (ADDIKD) into everyday practice.

Unlabelled: Part 2 of the International Consensus Guideline on Anticancer Drug Dosing in Kidney Dysfunction (ADDIKD) offers drug-specific consensus recommendations based on both evidence and practical experience. These recommendations build upon the kidney function assessment and classification guidelines established in Part 1 of ADDIKD. Here we illustrate how dosing recommendations differ between ADDIKD and existing guidance for four commonly used drugs: methotrexate, cisplatin, carboplatin and nivolumab.

Predictive and Prognostic Significance of Patient-Reported Outcomes for Survival and Adverse Events in Daratumumab-Treated Multiple Myeloma.

Objectives: Patient-reported outcomes (PROs), including physical function, have predictive potential for survival but remain underexplored in multiple myeloma (MM). This study evaluates the predictive and prognostic value of PROs for treatment outcomes in MM patients on daratumumab-based therapy and evaluates physical function versus ECOG Performance Status as a potential treatment-effect modifier.

Methods: Data was pooled from randomized trials (MAIA, POLLUX, CASTOR) that collected pretreatment PROs using EORTC QLQ-C30.

Evaluation of hyperprogressive disease with atezolizumab plus bevacizumab for hepatocellular carcinoma: A secondary analysis of the IMbrave150 trial.

The use of Immune checkpoint inhibitors (ICIs) as monotherapy for patients with hepatocellular carcinoma (HCC) has been associated with an increased risk of hyperprogressive disease (HPD), the occurrence of which carries a poor prognosis. However, it is unknown whether contemporary frontline treatment with the combination of atezolizumab and bevacizumab causes significant HPD. This study conducted a secondary analysis of patient-level data from the IMbrave150 randomized controlled trial of atezolizumab plus bevacizumab versus sorafenib for frontline treatment of HCC.

Medicinal CANnabis (CBD/THC) to prevent the symptoms and side effects of chemotherapy in people with advanced CANcer (CANCAN): protocol for a phase II, randomised, double-blind, placebo-controlled trial.

Introduction: Many chemotherapy agents used to treat advanced cancer are inherently mucotoxic, causing breakdown of the gastrointestinal mucosa (gastrointestinal mucositis (GI-M)) and lead to a constellation of secondary complications including diarrhoea, malnutrition, anorexia, pain, fatigue and sleep disturbances. These symptoms are usually managed individually, leading to polypharmacy and its associated risks. The endocannabinoid system regulates numerous biological and behavioural processes associated with chemotherapy side effects, suggesting its modulation could control these symptoms.

Generative AI chatbots for reliable cancer information: Evaluating web-search, multilingual, and reference capabilities of emerging large language models.

Recent advancements in large language models (LLMs) enable real-time web search, improved referencing, and multilingual support, yet ensuring they provide safe health information remains crucial. This perspective evaluates seven publicly accessible LLMs-ChatGPT, Co-Pilot, Gemini, MetaAI, Claude, Grok, Perplexity-on three simple cancer-related queries across eight languages (336 responses: English, French, Chinese, Thai, Hindi, Nepali, Vietnamese, and Arabic). None of the 42 English responses contained clinically meaningful hallucinations, whereas 7 of 294 non-English responses did.

Tumour Mutational Burden and Immune Checkpoint Inhibitor Response in Non-small Cell Lung Cancer: A Continuous Modelling Approach.

Background: Tumour mutational burden (TMB) is an established biomarker for patients treated with immune checkpoint inhibitors (ICIs). The optimal TMB cut-off is uncertain. It is also uncertain whether there is a sharp TMB threshold or a more graduated change in clinical outcomes as TMB increases.

CDK9 inhibition inhibits multiple oncogenic transcriptional and epigenetic pathways in prostate cancer.

Background: Cyclin-dependent kinase 9 (CDK9) stimulates oncogenic transcriptional pathways in cancer and CDK9 inhibitors have emerged as promising therapeutic candidates.

Methods: The activity of an orally bioavailable CDK9 inhibitor, CDKI-73, was evaluated in prostate cancer cell lines, a xenograft mouse model, and patient-derived tumor explants and organoids. Expression of CDK9 was evaluated in clinical specimens by mining public datasets and immunohistochemistry.

, and : methylated DNA biomarkers for detection of pan-gastrointestinal adenocarcinomas.

Introduction: Methylated circulating tumour DNA (ctDNA) blood tests for (COLVERA) and (Epi proColon) are used to detect colorectal cancer (CRC). However, there are no ctDNA assays approved for other gastrointestinal adenocarcinomas. We aimed to characterize and methylation in different gastrointestinal adenocarcinoma and non-gastrointestinal tumours to determine if these validated CRC biomarkers might be useful for pan-gastrointestinal adenocarcinoma detection.

Oncolytic virotherapy stimulates anti‑tumor immune response and demonstrates activity in advanced sarcoma: Report of two cases.

Sarcoma is derived from mesenchymal neoplasms and has numerous subtypes, accounting for 1% of all adult malignancies and 15% of childhood malignancies. The prognosis of metastatic or recurrent sarcoma remains poor. The current study presents two cases of sarcoma enrolled in a phase I dose escalation trial for solid tumor, who had previously failed all standard therapies.

A lack of association between BMI and chemoimmunotherapy efficacy in advanced non-small cell lung cancer: Secondary analysis of the IMpower150 and IMpower130 clinical trials.

Background: Multiple studies have indicated that patients with high body mass index (BMI) may have favourable survival outcomes following treatment with an immune checkpoint inhibitor (ICI). However, this evidence is limited by several factors, notably the minimal evidence from randomised controlled trials (RCTs), the use of categorised BMI with inconsistent cut point definitions, and minimal investigation of contemporary combination ICI therapy. Moreover, whether overweight and obese patients gain a larger benefit from contemporary frontline chemoimmunotherapy in non-small cell lung cancer (NSCLC) is unclear.

Current safeguards, risk mitigation, and transparency measures of large language models against the generation of health disinformation: repeated cross sectional analysis.

Objectives: To evaluate the effectiveness of safeguards to prevent large language models (LLMs) from being misused to generate health disinformation, and to evaluate the transparency of artificial intelligence (AI) developers regarding their risk mitigation processes against observed vulnerabilities.

Design: Repeated cross sectional analysis.

Setting: Publicly accessible LLMs.

Medication-based Comorbidity Measures and Prostate Cancer Treatment Selection.

Introduction: We aimed to assess the association between comorbidities and prostate cancer management.

Patients And Methods: We studied 12,603 South Australian men diagnosed with prostate cancer between 2003 and 2019. Comorbidity was measured one year prior to prostate cancer diagnosis using a medication-based comorbidity index (Rx-Risk).

Clinical and functional outcomes for risk-appropriate treatments for prostate cancer.

Objectives: To describe real-world clinical and functional outcomes in an Australian cohort of men with localised prostate cancer according to treatment type and risk category.

Subjects And Methods: Men diagnosed from 2008 to 2018 who were enrolled in South Australian Prostate Cancer Clinical Outcomes Collaborative registry-a multi-institutional prospective clinical registry-were studied. The main outcome measures were overall survival, cancer-specific survival, decline in functional outcomes, biochemical recurrence and transition to active treatment following active surveillance.