Immune checkpoints refer to the plethora of inhibitory pathways that are crucial to maintaining self-tolerance. Tumour cells induce immune checkpoints to evade immunosurveillance. This Review discusses the progress in targeting immune checkpoints, the considerations for combinatorial therapy and the potential for additional immune-checkpoint targets.

/pdf/the-blockade-of-immune-checkpoints-in-cancer-immunotherapy-j2cp4ba5s9.pdf

The blockade of immune checkpoints in cancer immunotherapy

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)62167-9.pdf

Frailty in elderly people

http://www.bloodmed.com/contentimage/guidelines/3182.pdf

Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute–Working Group 1996 guidelines

Bevacizumab plus Irinotecan,Fluorouracil,and Leucovorin for Metastatic Colorectal Cancer

Purpose
The LUX-Lung 3 study investigated the efficacy of chemotherapy compared with afatinib, a selective, orally bioavailable ErbB family blocker that irreversibly blocks signaling from epidermal growth factor receptor (EGFR/ErbB1), human epidermal growth factor receptor 2 (HER2/ErbB2), and ErbB4 and has wide-spectrum preclinical activity against EGFR mutations. A phase II study of afatinib in EGFR mutation-positive lung adenocarcinoma demonstrated high response rates and progression-free survival (PFS).

Patients and Methods
In this phase III study, eligible patients with stage IIIB/IV lung adenocarcinoma were screened for EGFR mutations. Mutation-positive patients were stratified by mutation type (exon 19 deletion, L858R, or other) and race (Asian or non-Asian) before two-to-one random assignment to 40 mg afatinib per day or up to six cycles of cisplatin plus pemetrexed chemotherapy at standard doses every 21 days. The primary end point was PFS by independent review. Secondary end points included tumor response, overall survival, adverse events, and patient-reported outcomes (PROs).

Results
A total of 1,269 patients were screened, and 345 were randomly assigned to treatment. Median PFS was 11.1 months for afatinib and 6.9 months for chemotherapy (hazard ratio [HR], 0.58; 95% CI, 0.43 to 0.78; P = .001). Median PFS among those with exon 19 deletions and L858R EGFR mutations (n = 308) was 13.6 months for afatinib and 6.9 months for chemotherapy (HR, 0.47; 95% CI, 0.34 to 0.65; P = .001). The most common treatmentrelated adverse events were diarrhea, rash/acne, and stomatitis for afatinib and nausea, fatigue, and decreased appetite for chemotherapy. PROs favored afatinib, with better control of cough, dyspnea, and pain.

Conclusion
Afatinib is associated with prolongation of PFS when compared with standard doublet chemotherapy in patients with advanced lung adenocarcinoma and EGFR mutations.

Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations

The oncology field, like many others, is digitalizing rapidly, a phenomenon that may have been accelerated by the COVID-19 pandemic. This movement is creating opportunities and challenges. Another rapidly developing change is the aging of the global population; because cancer is a disease of aging, there is a need for health systems to adapt to taking care of such patients. In this article, we address how these innovative technologies can be leveraged to improve the care of older patients with cancer beyond academic centers, such as in underserved areas and low- and middle-income countries. We review how digital technologies can be used to enhance the follow-up of patients in low- and middle-income countries. We also tackle the issue of training a global workforce to treat cancer in an aging population and how to leverage innovations in this matter. Finally, we review opportunities to expand the usefulness of big data and machine learning beyond academic centers to support private practices and underserved areas.

Global Aging and Cancer: Advancing Care Through Innovation.

Assessment of the external validity of the National Comprehensive Cancer Network (NCCN) guidelines for pancreatic ductal adenocarcinoma in a population of older patients aged 70 years and older.

Outcomes in Older Adults (age ≥ 70) with Acute Myeloid Leukemia Based on Choice of Frontline Treatment for Proliferative or Non-Proliferative Phenotype

Martine Extermann

Papers

Global Aging and Cancer: Advancing Care Through Innovation.

Assessment of the external validity of the National Comprehensive Cancer Network (NCCN) guidelines for pancreatic ductal adenocarcinoma in a population of older patients aged 70 years and older.

Outcomes in Older Adults (age ≥ 70) with Acute Myeloid Leukemia Based on Choice of Frontline Treatment for Proliferative or Non-Proliferative Phenotype

Integrating geriatric screening in the clinical setting with the saop-3: recommendations for screening older adults undergoing cancer treatments

Integrating geriatric screening in the clinical setting: Recommendations for older adult oncology patients.