Key clinical point: Radiation segmentectomy shows high efficacy with a low high-grade adverse event rate in patients with unresectable very early- to early-stage hepatocellular carcinoma (HCC) at unfavorable locations for ablation.

Major finding: Initial target lesion complete and partial response rates were 83% and 17%, respectively, whereas the initial objective and sustained complete response rates were 100% and 90%, respectively. Grade 3 leukopenia and thrombocytopenia were observed in 14% and 7% of patients, respectively, whereas no grade 4 events were observed.

Study details: Findings are from a prospective, single-center study, RASER, that included 29 adult patients with unresectable, solitary, very early- to early-stage HCC (diameter ≤ 3 cm) at a location unsuitable for ablation and no metastasis or macrovascular invasion.

Disclosures: The study was sponsored by Boston Scientific. Some authors declared being on the medical advisory board of or receiving grant support or consulting fees from various sources, including Boston Scientific.

Source: Kim E et al. Radiation segmentectomy for curative intent of unresectable very early to early stage hepatocellular carcinoma (RASER): a single-centre, single-arm study. Lancet Gastroenterol Hepatol. 2022 (May 23). Doi: 10.1016/S2468-1253(22)00091-7

Key clinical point: Radiation segmentectomy shows high efficacy with a low high-grade adverse event rate in patients with unresectable very early- to early-stage hepatocellular carcinoma (HCC) at unfavorable locations for ablation.

Major finding: Initial target lesion complete and partial response rates were 83% and 17%, respectively, whereas the initial objective and sustained complete response rates were 100% and 90%, respectively. Grade 3 leukopenia and thrombocytopenia were observed in 14% and 7% of patients, respectively, whereas no grade 4 events were observed.

Study details: Findings are from a prospective, single-center study, RASER, that included 29 adult patients with unresectable, solitary, very early- to early-stage HCC (diameter ≤ 3 cm) at a location unsuitable for ablation and no metastasis or macrovascular invasion.

Disclosures: The study was sponsored by Boston Scientific. Some authors declared being on the medical advisory board of or receiving grant support or consulting fees from various sources, including Boston Scientific.

Source: Kim E et al. Radiation segmentectomy for curative intent of unresectable very early to early stage hepatocellular carcinoma (RASER): a single-centre, single-arm study. Lancet Gastroenterol Hepatol. 2022 (May 23). Doi: 10.1016/S2468-1253(22)00091-7

Key clinical point: Radiation segmentectomy shows high efficacy with a low high-grade adverse event rate in patients with unresectable very early- to early-stage hepatocellular carcinoma (HCC) at unfavorable locations for ablation.

Major finding: Initial target lesion complete and partial response rates were 83% and 17%, respectively, whereas the initial objective and sustained complete response rates were 100% and 90%, respectively. Grade 3 leukopenia and thrombocytopenia were observed in 14% and 7% of patients, respectively, whereas no grade 4 events were observed.

Study details: Findings are from a prospective, single-center study, RASER, that included 29 adult patients with unresectable, solitary, very early- to early-stage HCC (diameter ≤ 3 cm) at a location unsuitable for ablation and no metastasis or macrovascular invasion.

Disclosures: The study was sponsored by Boston Scientific. Some authors declared being on the medical advisory board of or receiving grant support or consulting fees from various sources, including Boston Scientific.

Source: Kim E et al. Radiation segmentectomy for curative intent of unresectable very early to early stage hepatocellular carcinoma (RASER): a single-centre, single-arm study. Lancet Gastroenterol Hepatol. 2022 (May 23). Doi: 10.1016/S2468-1253(22)00091-7

Key clinical point: In estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) neoadjuvant chemotherapy (NAC) should be considered to enable axillary conservation in patients aged <50 years with Ki67 ≥20%.

Major finding: Both Ki67 ≥20% (adjusted odds ratio [aOR] 2.60; P = .04) and age <50 years (aOR 2.44; P = .01) were significant independent predictors of nodal pathological complete response (pCR). Younger patients (<50 years) had a higher nodal pCR when Ki67 index was ≥20% vs. <20% (35.8% vs. 14.3%; P = .02), whereas older patients (≥50 years) had an extremely low nodal pCR when Ki67 was <20% vs. ≥20% (2.6% vs. 21%; P = .008).

Study details: This study included 315 patients with node-positive, stage I-III, ER+/HER2− BC who were treated with NAC followed by surgery.

Disclosures: This work was partly supported by the National Institutes of Health Mayo Clinic Breast SPORE grant. Dr. Goetz and Dr. Boughey declared having research collaboration and receiving grants, funding, personal fees, or consulting fees from several sources.

Source: Boughey JC et al. Neoadjuvant chemotherapy and nodal response rates in luminal breast cancer: effects of age and tumor Ki67. Ann Surg Oncol. 2022 (May 15). Doi: 10.1245/s10434-022-11871-z

Key clinical point: In estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) neoadjuvant chemotherapy (NAC) should be considered to enable axillary conservation in patients aged <50 years with Ki67 ≥20%.

Major finding: Both Ki67 ≥20% (adjusted odds ratio [aOR] 2.60; P = .04) and age <50 years (aOR 2.44; P = .01) were significant independent predictors of nodal pathological complete response (pCR). Younger patients (<50 years) had a higher nodal pCR when Ki67 index was ≥20% vs. <20% (35.8% vs. 14.3%; P = .02), whereas older patients (≥50 years) had an extremely low nodal pCR when Ki67 was <20% vs. ≥20% (2.6% vs. 21%; P = .008).

Study details: This study included 315 patients with node-positive, stage I-III, ER+/HER2− BC who were treated with NAC followed by surgery.

Disclosures: This work was partly supported by the National Institutes of Health Mayo Clinic Breast SPORE grant. Dr. Goetz and Dr. Boughey declared having research collaboration and receiving grants, funding, personal fees, or consulting fees from several sources.

Source: Boughey JC et al. Neoadjuvant chemotherapy and nodal response rates in luminal breast cancer: effects of age and tumor Ki67. Ann Surg Oncol. 2022 (May 15). Doi: 10.1245/s10434-022-11871-z

Key clinical point: In estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) neoadjuvant chemotherapy (NAC) should be considered to enable axillary conservation in patients aged <50 years with Ki67 ≥20%.

Major finding: Both Ki67 ≥20% (adjusted odds ratio [aOR] 2.60; P = .04) and age <50 years (aOR 2.44; P = .01) were significant independent predictors of nodal pathological complete response (pCR). Younger patients (<50 years) had a higher nodal pCR when Ki67 index was ≥20% vs. <20% (35.8% vs. 14.3%; P = .02), whereas older patients (≥50 years) had an extremely low nodal pCR when Ki67 was <20% vs. ≥20% (2.6% vs. 21%; P = .008).

Study details: This study included 315 patients with node-positive, stage I-III, ER+/HER2− BC who were treated with NAC followed by surgery.

Disclosures: This work was partly supported by the National Institutes of Health Mayo Clinic Breast SPORE grant. Dr. Goetz and Dr. Boughey declared having research collaboration and receiving grants, funding, personal fees, or consulting fees from several sources.

Source: Boughey JC et al. Neoadjuvant chemotherapy and nodal response rates in luminal breast cancer: effects of age and tumor Ki67. Ann Surg Oncol. 2022 (May 15). Doi: 10.1245/s10434-022-11871-z

Key clinical point: Patients with breast cancer (BC) treated with standard chemotherapy during pregnancy show comparable prognosis to young nonpregnant patients with BC, supporting chemotherapy initiation in pregnant women with BC as indicated.

Major finding: Median follow-up was 66.3 months. Disease-free survival (hazard ratio [HR] 1.024; P = .830) and overall survival (HR 1.082; P = .592) were not significantly different between pregnant and nonpregnant patients receiving chemotherapy.

Study details: Findings are from a large cohort study including 2081 nonpregnant women aged <45 years and 662 pregnant women, all of whom were diagnosed with stage I-III BC and received standard chemotherapy.

Disclosures: This study was funded by German Breast Group and other sources. Some authors declared receiving grants, honoraria, personal fees, or speaking fees from several sources.

Source: Amant F et al. Outcome of breast cancer patients treated with chemotherapy during pregnancy compared with non-pregnant controls. Eur J Cancer. 2022;170:54-63 (May 17). Doi: 10.1016/j.ejca.2022.04.014

Key clinical point: Patients with breast cancer (BC) treated with standard chemotherapy during pregnancy show comparable prognosis to young nonpregnant patients with BC, supporting chemotherapy initiation in pregnant women with BC as indicated.

Major finding: Median follow-up was 66.3 months. Disease-free survival (hazard ratio [HR] 1.024; P = .830) and overall survival (HR 1.082; P = .592) were not significantly different between pregnant and nonpregnant patients receiving chemotherapy.

Study details: Findings are from a large cohort study including 2081 nonpregnant women aged <45 years and 662 pregnant women, all of whom were diagnosed with stage I-III BC and received standard chemotherapy.

Disclosures: This study was funded by German Breast Group and other sources. Some authors declared receiving grants, honoraria, personal fees, or speaking fees from several sources.

Source: Amant F et al. Outcome of breast cancer patients treated with chemotherapy during pregnancy compared with non-pregnant controls. Eur J Cancer. 2022;170:54-63 (May 17). Doi: 10.1016/j.ejca.2022.04.014

Key clinical point: Patients with breast cancer (BC) treated with standard chemotherapy during pregnancy show comparable prognosis to young nonpregnant patients with BC, supporting chemotherapy initiation in pregnant women with BC as indicated.

Major finding: Median follow-up was 66.3 months. Disease-free survival (hazard ratio [HR] 1.024; P = .830) and overall survival (HR 1.082; P = .592) were not significantly different between pregnant and nonpregnant patients receiving chemotherapy.

Study details: Findings are from a large cohort study including 2081 nonpregnant women aged <45 years and 662 pregnant women, all of whom were diagnosed with stage I-III BC and received standard chemotherapy.

Disclosures: This study was funded by German Breast Group and other sources. Some authors declared receiving grants, honoraria, personal fees, or speaking fees from several sources.

Source: Amant F et al. Outcome of breast cancer patients treated with chemotherapy during pregnancy compared with non-pregnant controls. Eur J Cancer. 2022;170:54-63 (May 17). Doi: 10.1016/j.ejca.2022.04.014

Key clinical point: Male-origin infertility was associated with an increased risk for breast cancer (BC) in men.

Major finding: Risk for BC was significantly higher in men diagnosed with infertility (odds ratio [OR] 2.03; P = .01), those diagnosed with infertility or low sperm count (OR 2.17; P = .004), and those who had not fathered any children (OR 1.50; P < .001).

Study details: Findings are from a case-control study including 1998 men diagnosed with in situ or invasive BC at <80 years of age and 1597 matched male controls.

Disclosures: This study was supported by Breast Cancer Now, formerly Breakthrough Breast Cancer, and the John Tridgell family. The authors declared no conflicts of interest.

Source: Swerdlow AJ et al. Infertility and risk of breast cancer in men: a national case–control study in England and Wales. Breast Cancer Res. 2022;24:29 (May 17). Doi: 10.1186/s13058-022-01517-z

Key clinical point: Male-origin infertility was associated with an increased risk for breast cancer (BC) in men.

Major finding: Risk for BC was significantly higher in men diagnosed with infertility (odds ratio [OR] 2.03; P = .01), those diagnosed with infertility or low sperm count (OR 2.17; P = .004), and those who had not fathered any children (OR 1.50; P < .001).

Study details: Findings are from a case-control study including 1998 men diagnosed with in situ or invasive BC at <80 years of age and 1597 matched male controls.

Disclosures: This study was supported by Breast Cancer Now, formerly Breakthrough Breast Cancer, and the John Tridgell family. The authors declared no conflicts of interest.

Source: Swerdlow AJ et al. Infertility and risk of breast cancer in men: a national case–control study in England and Wales. Breast Cancer Res. 2022;24:29 (May 17). Doi: 10.1186/s13058-022-01517-z

Key clinical point: Male-origin infertility was associated with an increased risk for breast cancer (BC) in men.

Major finding: Risk for BC was significantly higher in men diagnosed with infertility (odds ratio [OR] 2.03; P = .01), those diagnosed with infertility or low sperm count (OR 2.17; P = .004), and those who had not fathered any children (OR 1.50; P < .001).

Study details: Findings are from a case-control study including 1998 men diagnosed with in situ or invasive BC at <80 years of age and 1597 matched male controls.

Disclosures: This study was supported by Breast Cancer Now, formerly Breakthrough Breast Cancer, and the John Tridgell family. The authors declared no conflicts of interest.

Source: Swerdlow AJ et al. Infertility and risk of breast cancer in men: a national case–control study in England and Wales. Breast Cancer Res. 2022;24:29 (May 17). Doi: 10.1186/s13058-022-01517-z

Chemotherapy, now streaming at just $15.99 a month!

It’s a lazy Sunday and you flip on Netflix, looking for something new to watch. There’s an almost-overwhelming number of shows out there, but right at the top of the recommended list is something that strikes your fancy right away. The algorithm behind the scenes is doing its job well, winnowing the universe of content right down to the few things you’ll find relevant, based on what you’ve watched and liked in the past.

rawpixel

Now, the almighty content algorithm is coming for something a little more useful than binge watching obscure 80s sitcoms: cancer treatment.

By plugging the fully sequenced genomes of nearly 10,000 patients with 33 different types of cancer into an algorithm powered by the same sort of artificial intelligence used by Netflix, researchers from London and San Diego found 21 common faults in the chromosomes of tumors, which they called copy number signatures. While cancer is a complex disease, when faults occur in those copy number signatures, the results were similar across the board. If X genetic defect occurs within a tumor, Y result will happen, even across cancer types. For example, tumors whose chromosomes had shattered and reformed had by far the worst disease outcomes.

The eventual hope is that, just as Netflix can predict what you’ll want to watch based on what you’ve already seen, oncologists will be able to predict the course of a cancer, based on the tumor’s early genetic traits, and get ahead of future genetic degradation to prevent the worst outcomes. A sort of “Oh, your tumor has enjoyed The Office. Might we suggest a treatment of 30 Rock” situation. Further research will be required to determine whether or not the cancer algorithm can get us part 2 of “Stranger Things 4” a week early.
 

Pay criminals, cut crime?

What is the best method for punishing those who commit wrongdoing? Fines? Jail time? Actually, no. A recent study says that financial compensation works best.

In other words, pay them for their actions. Really.

wakila/Getty Images

Psychologist Tage S. Rai, PhD, of the University of California, San Diego, Rady School of Management, found that people who hurt others or commit crimes are actually doing it because they think it’s the right thing to do. The results of this study say play at the angle of their morality. When that’s compromised, the offender is less likely to do it again.

Four different experiments were conducted using an online economics game with nearly 1,500 participants. Dr. Rai found that providing a monetary bonus for inflicting a punishment on a third party within the game cut the participants’ willingness to do it again by 50%.

“People punish others to signal their own goodness and receiving compensation might make it seem as though they’re driven by greed rather than justice,” he said.

The big deterrent, though, was negative judgment from peers. People in the study were even more hesitant to inflict harm and gain a profit if they thought they were going to be judged for it.

So maybe the answer to cutting crime isn’t as simple as slapping on a fine. It’s slapping on shame and paying them for it.
 

A conspiracy of chronobiologic proportions

The Golden State Warriors just won the NBA championship – that much is true – but we’ve got some news that you didn’t get from ESPN. The kind of news that their “partners” from the NBA didn’t want them to report. Unlike most conspiracy theories, however, this one has some science behind it.

PxHere

In this case, science in the form of a study published in Frontiers in Physiology says that jet lag had a greater effect on the Boston Celtics than it did on the Warriors.

“Eastward travel – where the destination time is later than the origin time – requires the athlete to shorten their day (known as a phase advance). During phase advance, athletes often struggle to fall asleep at an earlier bedtime, leading to sleep loss and, consequently, potential impaired physiological performance and motivation the next day,” senior author Elise Facer-Childs, PhD, of Monash University, Melbourne, said in written statement.

Dr. Facer-Childs and associates took a very close look at 10 seasons’ worth of NBA games – 11,481 games, to be exact – and found “that eastward (but not westward) jet lag was associated with impaired performance for home (but not away) teams.” The existence of a pro-Western bias against teams that traveled eastward for their home games was clear:

• The chance of winning for eastern teams was reduced by 6.0%.
• They grabbed 1.3 fewer rebounds per game.
• Their field goal percentage was 1.2% lower.

And here’s the final nail in the conspiracy coffin: The NBA knew about the jet lag effect and changed the schedule of the finals in 2014 in a way that makes it worse. Before that, the higher-seeded team got two home games, then the lower-seeded team had three at home, followed by two more at the home of the higher seed. Now it’s a 2-2-1-1-1 arrangement that leads to more travel and, of course, more jet lag.

The study was published during the championship series, so the investigators suggested that the Celtics “might benefit from chronobiology-informed strategies designed to mitigate eastward jet lag symptomatology.”

So there you have it, sports fans/conspiracy theorists: You can’t chase Steph Curry around the court for 48 minutes without the right chronobiology-informed strategy. Everyone knows that.
 

Being hungry can alter your ‘type’

Fasting and being hungry can be a dangerous mix for becoming “hangry” and irritable, but did you know being hungry can also affect your attraction to other people?

©stevanovicigor/thinkstockphotos.com

Evidence has shown that being hungry can affect important things such as decision-making, memory, cognition, and function. It might affect decision-making in the sense that those six tacos at Taco Bell might win out over grilled chicken breast and veggies at home, but can hunger make you think that the person you just swiped right on isn’t really your type after all?

We’ll leave that up to Valentina Cazzato of Liverpool (England) John Moores University and associates, whose study involved 44 people, of whom 21 were women in their early 20s. The participants were shown computer-generated images of men and women of different sizes. The same background was used for each picture and all the expressions of the models were neutral. Participants were asked to rate each image on how much they liked it. One study was done on participants who had been fasting for 12 hours, and the second was done on those who had just eaten something.

The subjects generally preferred slim models over more rounded ones, but not after fasting. When they were hungry, they found the round human bodies and faces more attractive. So, yes, it’s definitely possible that hunger can alter your attraction to others.

“Future work might seek to elucidate the relationship between physiological states of hunger and shifts in appreciation of the human bodies and whether this relationship might be mediated by individual traits associated with to beholder’s body adiposity,” said researchers.

Chemotherapy, now streaming at just $15.99 a month!

It’s a lazy Sunday and you flip on Netflix, looking for something new to watch. There’s an almost-overwhelming number of shows out there, but right at the top of the recommended list is something that strikes your fancy right away. The algorithm behind the scenes is doing its job well, winnowing the universe of content right down to the few things you’ll find relevant, based on what you’ve watched and liked in the past.

rawpixel

Now, the almighty content algorithm is coming for something a little more useful than binge watching obscure 80s sitcoms: cancer treatment.

By plugging the fully sequenced genomes of nearly 10,000 patients with 33 different types of cancer into an algorithm powered by the same sort of artificial intelligence used by Netflix, researchers from London and San Diego found 21 common faults in the chromosomes of tumors, which they called copy number signatures. While cancer is a complex disease, when faults occur in those copy number signatures, the results were similar across the board. If X genetic defect occurs within a tumor, Y result will happen, even across cancer types. For example, tumors whose chromosomes had shattered and reformed had by far the worst disease outcomes.

The eventual hope is that, just as Netflix can predict what you’ll want to watch based on what you’ve already seen, oncologists will be able to predict the course of a cancer, based on the tumor’s early genetic traits, and get ahead of future genetic degradation to prevent the worst outcomes. A sort of “Oh, your tumor has enjoyed The Office. Might we suggest a treatment of 30 Rock” situation. Further research will be required to determine whether or not the cancer algorithm can get us part 2 of “Stranger Things 4” a week early.
 

Pay criminals, cut crime?

What is the best method for punishing those who commit wrongdoing? Fines? Jail time? Actually, no. A recent study says that financial compensation works best.

In other words, pay them for their actions. Really.

wakila/Getty Images

Psychologist Tage S. Rai, PhD, of the University of California, San Diego, Rady School of Management, found that people who hurt others or commit crimes are actually doing it because they think it’s the right thing to do. The results of this study say play at the angle of their morality. When that’s compromised, the offender is less likely to do it again.

Four different experiments were conducted using an online economics game with nearly 1,500 participants. Dr. Rai found that providing a monetary bonus for inflicting a punishment on a third party within the game cut the participants’ willingness to do it again by 50%.

“People punish others to signal their own goodness and receiving compensation might make it seem as though they’re driven by greed rather than justice,” he said.

The big deterrent, though, was negative judgment from peers. People in the study were even more hesitant to inflict harm and gain a profit if they thought they were going to be judged for it.

So maybe the answer to cutting crime isn’t as simple as slapping on a fine. It’s slapping on shame and paying them for it.
 

A conspiracy of chronobiologic proportions

The Golden State Warriors just won the NBA championship – that much is true – but we’ve got some news that you didn’t get from ESPN. The kind of news that their “partners” from the NBA didn’t want them to report. Unlike most conspiracy theories, however, this one has some science behind it.

PxHere

In this case, science in the form of a study published in Frontiers in Physiology says that jet lag had a greater effect on the Boston Celtics than it did on the Warriors.

“Eastward travel – where the destination time is later than the origin time – requires the athlete to shorten their day (known as a phase advance). During phase advance, athletes often struggle to fall asleep at an earlier bedtime, leading to sleep loss and, consequently, potential impaired physiological performance and motivation the next day,” senior author Elise Facer-Childs, PhD, of Monash University, Melbourne, said in written statement.

Dr. Facer-Childs and associates took a very close look at 10 seasons’ worth of NBA games – 11,481 games, to be exact – and found “that eastward (but not westward) jet lag was associated with impaired performance for home (but not away) teams.” The existence of a pro-Western bias against teams that traveled eastward for their home games was clear:

• The chance of winning for eastern teams was reduced by 6.0%.
• They grabbed 1.3 fewer rebounds per game.
• Their field goal percentage was 1.2% lower.

And here’s the final nail in the conspiracy coffin: The NBA knew about the jet lag effect and changed the schedule of the finals in 2014 in a way that makes it worse. Before that, the higher-seeded team got two home games, then the lower-seeded team had three at home, followed by two more at the home of the higher seed. Now it’s a 2-2-1-1-1 arrangement that leads to more travel and, of course, more jet lag.

The study was published during the championship series, so the investigators suggested that the Celtics “might benefit from chronobiology-informed strategies designed to mitigate eastward jet lag symptomatology.”

So there you have it, sports fans/conspiracy theorists: You can’t chase Steph Curry around the court for 48 minutes without the right chronobiology-informed strategy. Everyone knows that.
 

Being hungry can alter your ‘type’

Fasting and being hungry can be a dangerous mix for becoming “hangry” and irritable, but did you know being hungry can also affect your attraction to other people?

©stevanovicigor/thinkstockphotos.com

Evidence has shown that being hungry can affect important things such as decision-making, memory, cognition, and function. It might affect decision-making in the sense that those six tacos at Taco Bell might win out over grilled chicken breast and veggies at home, but can hunger make you think that the person you just swiped right on isn’t really your type after all?

We’ll leave that up to Valentina Cazzato of Liverpool (England) John Moores University and associates, whose study involved 44 people, of whom 21 were women in their early 20s. The participants were shown computer-generated images of men and women of different sizes. The same background was used for each picture and all the expressions of the models were neutral. Participants were asked to rate each image on how much they liked it. One study was done on participants who had been fasting for 12 hours, and the second was done on those who had just eaten something.

The subjects generally preferred slim models over more rounded ones, but not after fasting. When they were hungry, they found the round human bodies and faces more attractive. So, yes, it’s definitely possible that hunger can alter your attraction to others.

“Future work might seek to elucidate the relationship between physiological states of hunger and shifts in appreciation of the human bodies and whether this relationship might be mediated by individual traits associated with to beholder’s body adiposity,” said researchers.

Chemotherapy, now streaming at just $15.99 a month!

It’s a lazy Sunday and you flip on Netflix, looking for something new to watch. There’s an almost-overwhelming number of shows out there, but right at the top of the recommended list is something that strikes your fancy right away. The algorithm behind the scenes is doing its job well, winnowing the universe of content right down to the few things you’ll find relevant, based on what you’ve watched and liked in the past.

rawpixel

Now, the almighty content algorithm is coming for something a little more useful than binge watching obscure 80s sitcoms: cancer treatment.

By plugging the fully sequenced genomes of nearly 10,000 patients with 33 different types of cancer into an algorithm powered by the same sort of artificial intelligence used by Netflix, researchers from London and San Diego found 21 common faults in the chromosomes of tumors, which they called copy number signatures. While cancer is a complex disease, when faults occur in those copy number signatures, the results were similar across the board. If X genetic defect occurs within a tumor, Y result will happen, even across cancer types. For example, tumors whose chromosomes had shattered and reformed had by far the worst disease outcomes.

The eventual hope is that, just as Netflix can predict what you’ll want to watch based on what you’ve already seen, oncologists will be able to predict the course of a cancer, based on the tumor’s early genetic traits, and get ahead of future genetic degradation to prevent the worst outcomes. A sort of “Oh, your tumor has enjoyed The Office. Might we suggest a treatment of 30 Rock” situation. Further research will be required to determine whether or not the cancer algorithm can get us part 2 of “Stranger Things 4” a week early.
 

Pay criminals, cut crime?

What is the best method for punishing those who commit wrongdoing? Fines? Jail time? Actually, no. A recent study says that financial compensation works best.

In other words, pay them for their actions. Really.

wakila/Getty Images

Psychologist Tage S. Rai, PhD, of the University of California, San Diego, Rady School of Management, found that people who hurt others or commit crimes are actually doing it because they think it’s the right thing to do. The results of this study say play at the angle of their morality. When that’s compromised, the offender is less likely to do it again.

Four different experiments were conducted using an online economics game with nearly 1,500 participants. Dr. Rai found that providing a monetary bonus for inflicting a punishment on a third party within the game cut the participants’ willingness to do it again by 50%.

“People punish others to signal their own goodness and receiving compensation might make it seem as though they’re driven by greed rather than justice,” he said.

The big deterrent, though, was negative judgment from peers. People in the study were even more hesitant to inflict harm and gain a profit if they thought they were going to be judged for it.

So maybe the answer to cutting crime isn’t as simple as slapping on a fine. It’s slapping on shame and paying them for it.
 

A conspiracy of chronobiologic proportions

The Golden State Warriors just won the NBA championship – that much is true – but we’ve got some news that you didn’t get from ESPN. The kind of news that their “partners” from the NBA didn’t want them to report. Unlike most conspiracy theories, however, this one has some science behind it.

PxHere

In this case, science in the form of a study published in Frontiers in Physiology says that jet lag had a greater effect on the Boston Celtics than it did on the Warriors.

“Eastward travel – where the destination time is later than the origin time – requires the athlete to shorten their day (known as a phase advance). During phase advance, athletes often struggle to fall asleep at an earlier bedtime, leading to sleep loss and, consequently, potential impaired physiological performance and motivation the next day,” senior author Elise Facer-Childs, PhD, of Monash University, Melbourne, said in written statement.

Dr. Facer-Childs and associates took a very close look at 10 seasons’ worth of NBA games – 11,481 games, to be exact – and found “that eastward (but not westward) jet lag was associated with impaired performance for home (but not away) teams.” The existence of a pro-Western bias against teams that traveled eastward for their home games was clear:

• The chance of winning for eastern teams was reduced by 6.0%.
• They grabbed 1.3 fewer rebounds per game.
• Their field goal percentage was 1.2% lower.

And here’s the final nail in the conspiracy coffin: The NBA knew about the jet lag effect and changed the schedule of the finals in 2014 in a way that makes it worse. Before that, the higher-seeded team got two home games, then the lower-seeded team had three at home, followed by two more at the home of the higher seed. Now it’s a 2-2-1-1-1 arrangement that leads to more travel and, of course, more jet lag.

The study was published during the championship series, so the investigators suggested that the Celtics “might benefit from chronobiology-informed strategies designed to mitigate eastward jet lag symptomatology.”

So there you have it, sports fans/conspiracy theorists: You can’t chase Steph Curry around the court for 48 minutes without the right chronobiology-informed strategy. Everyone knows that.
 

Being hungry can alter your ‘type’

Fasting and being hungry can be a dangerous mix for becoming “hangry” and irritable, but did you know being hungry can also affect your attraction to other people?

©stevanovicigor/thinkstockphotos.com

Evidence has shown that being hungry can affect important things such as decision-making, memory, cognition, and function. It might affect decision-making in the sense that those six tacos at Taco Bell might win out over grilled chicken breast and veggies at home, but can hunger make you think that the person you just swiped right on isn’t really your type after all?

We’ll leave that up to Valentina Cazzato of Liverpool (England) John Moores University and associates, whose study involved 44 people, of whom 21 were women in their early 20s. The participants were shown computer-generated images of men and women of different sizes. The same background was used for each picture and all the expressions of the models were neutral. Participants were asked to rate each image on how much they liked it. One study was done on participants who had been fasting for 12 hours, and the second was done on those who had just eaten something.

The subjects generally preferred slim models over more rounded ones, but not after fasting. When they were hungry, they found the round human bodies and faces more attractive. So, yes, it’s definitely possible that hunger can alter your attraction to others.

“Future work might seek to elucidate the relationship between physiological states of hunger and shifts in appreciation of the human bodies and whether this relationship might be mediated by individual traits associated with to beholder’s body adiposity,” said researchers.

Key clinical point: Patients who received adjuvant radiotherapy for breast cancer (BC) experienced a significant reduction in radiation-induced dermatitis (RID) incidence and severity after the prophylactic use of epigallocatechin-3-gallate (EGCG) solution.

Major finding: Incidence rates of grade ≥2 RID (50.5% vs. 72.2%; P = .008), the mean RID index of patients (5.22 vs. 6.21; P < .001), and RID-related symptoms, such as pain (P = .03), burning sensation (P = .001), itching (P < .001), and tenderness (P = .002), were significantly lower in the EGCG vs. placebo group. No severe EGCG solution/placebo-related adverse events were observed.

Study details: Findings are from a double-blind, phase 2 study including 165 women with histologically confirmed BC who received postoperative radiotherapy and were randomly assigned to receive EGCG solution or placebo.

Disclosures: Z Zhou, J Yu, and H Zhao received funding from the National Natural Science Foundation of China, Jinan Science and Technology Plan Project, and other sources. The authors declared no conflicts of interest.

Source: Zhao H et al. Efficacy of epigallocatechin-3-gallate in preventing dermatitis in patients with breast cancer receiving postoperative radiotherapy: A double-blind, placebo-controlled, phase 2 randomized clinical trial. JAMA Dermatol. 2022 (Jun 1). Doi: 10.1001/jamadermatol.2022.1736

Key clinical point: Patients who received adjuvant radiotherapy for breast cancer (BC) experienced a significant reduction in radiation-induced dermatitis (RID) incidence and severity after the prophylactic use of epigallocatechin-3-gallate (EGCG) solution.

Major finding: Incidence rates of grade ≥2 RID (50.5% vs. 72.2%; P = .008), the mean RID index of patients (5.22 vs. 6.21; P < .001), and RID-related symptoms, such as pain (P = .03), burning sensation (P = .001), itching (P < .001), and tenderness (P = .002), were significantly lower in the EGCG vs. placebo group. No severe EGCG solution/placebo-related adverse events were observed.

Study details: Findings are from a double-blind, phase 2 study including 165 women with histologically confirmed BC who received postoperative radiotherapy and were randomly assigned to receive EGCG solution or placebo.

Disclosures: Z Zhou, J Yu, and H Zhao received funding from the National Natural Science Foundation of China, Jinan Science and Technology Plan Project, and other sources. The authors declared no conflicts of interest.

Source: Zhao H et al. Efficacy of epigallocatechin-3-gallate in preventing dermatitis in patients with breast cancer receiving postoperative radiotherapy: A double-blind, placebo-controlled, phase 2 randomized clinical trial. JAMA Dermatol. 2022 (Jun 1). Doi: 10.1001/jamadermatol.2022.1736

Key clinical point: Patients who received adjuvant radiotherapy for breast cancer (BC) experienced a significant reduction in radiation-induced dermatitis (RID) incidence and severity after the prophylactic use of epigallocatechin-3-gallate (EGCG) solution.

Major finding: Incidence rates of grade ≥2 RID (50.5% vs. 72.2%; P = .008), the mean RID index of patients (5.22 vs. 6.21; P < .001), and RID-related symptoms, such as pain (P = .03), burning sensation (P = .001), itching (P < .001), and tenderness (P = .002), were significantly lower in the EGCG vs. placebo group. No severe EGCG solution/placebo-related adverse events were observed.

Study details: Findings are from a double-blind, phase 2 study including 165 women with histologically confirmed BC who received postoperative radiotherapy and were randomly assigned to receive EGCG solution or placebo.

Disclosures: Z Zhou, J Yu, and H Zhao received funding from the National Natural Science Foundation of China, Jinan Science and Technology Plan Project, and other sources. The authors declared no conflicts of interest.

Source: Zhao H et al. Efficacy of epigallocatechin-3-gallate in preventing dermatitis in patients with breast cancer receiving postoperative radiotherapy: A double-blind, placebo-controlled, phase 2 randomized clinical trial. JAMA Dermatol. 2022 (Jun 1). Doi: 10.1001/jamadermatol.2022.1736

Key clinical point: Etirinotecan pegol failed to prolong survival compared with chemotherapy in patients with metastatic breast cancer (BC) and stable pretreated brain metastases (BM).

Major finding: The median overall survival (hazard ratio [HR] 0.90; P = .60) and median progression-free survival for non-central nervous system (CNS; HR 0.72; P = .18) or CNS (HR 0.59; P = .07) metastases were similar in the etirinotecan pegol and chemotherapy groups, with overall safety profiles of the two treatments being largely comparable.

Study details: Findings are from the phase 3 ATTAIN study including 178 patients with metastatic BC and a history of stable pretreated BM who were randomly assigned to receive etirinotecan pegol or chemotherapy.

Disclosures: This study was funded by Nektar Therapeutics. Dr. Hoch and Dr. Tagliaferri declared being employees of Nektar Therapeutics, and the other authors reported ties with several sources, including Nektar Therapeutics.

Source: Tripathy D et al. Treatment with etirinotecan pegol for patients with metastatic breast cancer and brain metastases: Final results from the phase 3 ATTAIN randomized clinical trial. JAMA Oncol. 2022 (May 12). Doi: 10.1001/jamaoncol.2022.0514

Key clinical point: Etirinotecan pegol failed to prolong survival compared with chemotherapy in patients with metastatic breast cancer (BC) and stable pretreated brain metastases (BM).

Major finding: The median overall survival (hazard ratio [HR] 0.90; P = .60) and median progression-free survival for non-central nervous system (CNS; HR 0.72; P = .18) or CNS (HR 0.59; P = .07) metastases were similar in the etirinotecan pegol and chemotherapy groups, with overall safety profiles of the two treatments being largely comparable.

Study details: Findings are from the phase 3 ATTAIN study including 178 patients with metastatic BC and a history of stable pretreated BM who were randomly assigned to receive etirinotecan pegol or chemotherapy.

Disclosures: This study was funded by Nektar Therapeutics. Dr. Hoch and Dr. Tagliaferri declared being employees of Nektar Therapeutics, and the other authors reported ties with several sources, including Nektar Therapeutics.

Source: Tripathy D et al. Treatment with etirinotecan pegol for patients with metastatic breast cancer and brain metastases: Final results from the phase 3 ATTAIN randomized clinical trial. JAMA Oncol. 2022 (May 12). Doi: 10.1001/jamaoncol.2022.0514

Key clinical point: Etirinotecan pegol failed to prolong survival compared with chemotherapy in patients with metastatic breast cancer (BC) and stable pretreated brain metastases (BM).

Major finding: The median overall survival (hazard ratio [HR] 0.90; P = .60) and median progression-free survival for non-central nervous system (CNS; HR 0.72; P = .18) or CNS (HR 0.59; P = .07) metastases were similar in the etirinotecan pegol and chemotherapy groups, with overall safety profiles of the two treatments being largely comparable.

Study details: Findings are from the phase 3 ATTAIN study including 178 patients with metastatic BC and a history of stable pretreated BM who were randomly assigned to receive etirinotecan pegol or chemotherapy.

Disclosures: This study was funded by Nektar Therapeutics. Dr. Hoch and Dr. Tagliaferri declared being employees of Nektar Therapeutics, and the other authors reported ties with several sources, including Nektar Therapeutics.

Source: Tripathy D et al. Treatment with etirinotecan pegol for patients with metastatic breast cancer and brain metastases: Final results from the phase 3 ATTAIN randomized clinical trial. JAMA Oncol. 2022 (May 12). Doi: 10.1001/jamaoncol.2022.0514

Key clinical point: Adjuvant breast intensity-modulated radiotherapy (IMRT) in the prone vs. supine position was less toxic in women with large breast size and early-stage breast cancer (BC) who underwent breast-conserving surgery (BCS).

Major finding: IMRT in the supine vs. prone position was significantly associated with higher rates of desquamation anywhere in the breast and grade 3 desquamation in the overall cohort (odds ratio [OR] 1.78; P = .002, and OR 2.09; P < .001, respectively) and among women receiving extended fractionation (OR 1.92 and OR 2.76, respectively; both P < .001). The quality of life outcomes were similar between both treatment arms.

Study details: This phase 3 study included 357 women with large breast size and early-stage BC who underwent BCS and were randomly assigned to receive adjuvant IMRT in the supine or prone position.

Disclosures: This study was supported by Canadian Cancer Society. Dr. Rakovitch declared receiving grants and personal fees from some sources, and Dr. Pignol declared being employed by Accuray Inc.

Source: Vesprini D et al. Effect of supine vs prone breast radiotherapy on acute toxic effects of the skin among women with large breast size: A randomized clinical trial. JAMA Oncol. 2022 (May 26). Doi: 10.1001/jamaoncol.2022.1479

Key clinical point: Adjuvant breast intensity-modulated radiotherapy (IMRT) in the prone vs. supine position was less toxic in women with large breast size and early-stage breast cancer (BC) who underwent breast-conserving surgery (BCS).

Major finding: IMRT in the supine vs. prone position was significantly associated with higher rates of desquamation anywhere in the breast and grade 3 desquamation in the overall cohort (odds ratio [OR] 1.78; P = .002, and OR 2.09; P < .001, respectively) and among women receiving extended fractionation (OR 1.92 and OR 2.76, respectively; both P < .001). The quality of life outcomes were similar between both treatment arms.

Study details: This phase 3 study included 357 women with large breast size and early-stage BC who underwent BCS and were randomly assigned to receive adjuvant IMRT in the supine or prone position.

Disclosures: This study was supported by Canadian Cancer Society. Dr. Rakovitch declared receiving grants and personal fees from some sources, and Dr. Pignol declared being employed by Accuray Inc.

Source: Vesprini D et al. Effect of supine vs prone breast radiotherapy on acute toxic effects of the skin among women with large breast size: A randomized clinical trial. JAMA Oncol. 2022 (May 26). Doi: 10.1001/jamaoncol.2022.1479

Key clinical point: Adjuvant breast intensity-modulated radiotherapy (IMRT) in the prone vs. supine position was less toxic in women with large breast size and early-stage breast cancer (BC) who underwent breast-conserving surgery (BCS).

Major finding: IMRT in the supine vs. prone position was significantly associated with higher rates of desquamation anywhere in the breast and grade 3 desquamation in the overall cohort (odds ratio [OR] 1.78; P = .002, and OR 2.09; P < .001, respectively) and among women receiving extended fractionation (OR 1.92 and OR 2.76, respectively; both P < .001). The quality of life outcomes were similar between both treatment arms.

Study details: This phase 3 study included 357 women with large breast size and early-stage BC who underwent BCS and were randomly assigned to receive adjuvant IMRT in the supine or prone position.

Disclosures: This study was supported by Canadian Cancer Society. Dr. Rakovitch declared receiving grants and personal fees from some sources, and Dr. Pignol declared being employed by Accuray Inc.

Source: Vesprini D et al. Effect of supine vs prone breast radiotherapy on acute toxic effects of the skin among women with large breast size: A randomized clinical trial. JAMA Oncol. 2022 (May 26). Doi: 10.1001/jamaoncol.2022.1479

Key clinical point: Elacestrant significantly improved progression-free survival (PFS) compared with standard-of-care (SOC) endocrine monotherapy in previously treated patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (BC) with a manageable safety.

Major finding: Elacestrant vs. SOC prolonged PFS in the overall cohort (hazard ratio [HR] 0.70; P = .002) and in patients with estrogen receptor 1 mutation (HR 0.55; P = .0005). Grade 3/4 adverse events occurred in 27.0% vs. 20.5% of patients receiving elacestrant vs. SOC therapy, respectively.

Study details: Findings are from the phase 3 EMERALD study including 477 patients with ER+/HER2− metastatic BC who progressed after the first- or second-line treatment with endocrine therapy + cyclin-dependent kinase 4/6 inhibitor and ≤1 rounds of chemotherapy treatment and were randomly assigned to receive elacestrant or SOC endocrine monotherapy.

Disclosures: This study was sponsored by Radius Health, Inc. The authors declared owning stock options or patents, receiving research funding, travel, accommodation expenses, or honoraria from, or serving as consultants, advisors, and in speakers’ bureaus for several sources, including Radius Health.

Source: Bidard FC et al. Elacestrant (oral selective estrogen receptor degrader) versus standard endocrine therapy for estrogen receptor–positive, human epidermal growth factor receptor 2–negative advanced breast cancer: Results from the randomized phase III EMERALD Trial. J Clin Oncol. 2022 (May 18). Doi: 10.1200/JCO.22.00338

Key clinical point: Elacestrant significantly improved progression-free survival (PFS) compared with standard-of-care (SOC) endocrine monotherapy in previously treated patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (BC) with a manageable safety.

Major finding: Elacestrant vs. SOC prolonged PFS in the overall cohort (hazard ratio [HR] 0.70; P = .002) and in patients with estrogen receptor 1 mutation (HR 0.55; P = .0005). Grade 3/4 adverse events occurred in 27.0% vs. 20.5% of patients receiving elacestrant vs. SOC therapy, respectively.

Study details: Findings are from the phase 3 EMERALD study including 477 patients with ER+/HER2− metastatic BC who progressed after the first- or second-line treatment with endocrine therapy + cyclin-dependent kinase 4/6 inhibitor and ≤1 rounds of chemotherapy treatment and were randomly assigned to receive elacestrant or SOC endocrine monotherapy.

Disclosures: This study was sponsored by Radius Health, Inc. The authors declared owning stock options or patents, receiving research funding, travel, accommodation expenses, or honoraria from, or serving as consultants, advisors, and in speakers’ bureaus for several sources, including Radius Health.

Source: Bidard FC et al. Elacestrant (oral selective estrogen receptor degrader) versus standard endocrine therapy for estrogen receptor–positive, human epidermal growth factor receptor 2–negative advanced breast cancer: Results from the randomized phase III EMERALD Trial. J Clin Oncol. 2022 (May 18). Doi: 10.1200/JCO.22.00338

Key clinical point: Elacestrant significantly improved progression-free survival (PFS) compared with standard-of-care (SOC) endocrine monotherapy in previously treated patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (BC) with a manageable safety.

Major finding: Elacestrant vs. SOC prolonged PFS in the overall cohort (hazard ratio [HR] 0.70; P = .002) and in patients with estrogen receptor 1 mutation (HR 0.55; P = .0005). Grade 3/4 adverse events occurred in 27.0% vs. 20.5% of patients receiving elacestrant vs. SOC therapy, respectively.

Study details: Findings are from the phase 3 EMERALD study including 477 patients with ER+/HER2− metastatic BC who progressed after the first- or second-line treatment with endocrine therapy + cyclin-dependent kinase 4/6 inhibitor and ≤1 rounds of chemotherapy treatment and were randomly assigned to receive elacestrant or SOC endocrine monotherapy.

Disclosures: This study was sponsored by Radius Health, Inc. The authors declared owning stock options or patents, receiving research funding, travel, accommodation expenses, or honoraria from, or serving as consultants, advisors, and in speakers’ bureaus for several sources, including Radius Health.

Source: Bidard FC et al. Elacestrant (oral selective estrogen receptor degrader) versus standard endocrine therapy for estrogen receptor–positive, human epidermal growth factor receptor 2–negative advanced breast cancer: Results from the randomized phase III EMERALD Trial. J Clin Oncol. 2022 (May 18). Doi: 10.1200/JCO.22.00338

Key clinical point: In patients with high-risk operable breast cancer (BC) and without diabetes, adding metformin to standard BC treatment did not improve the invasive disease-free survival (iDFS) rate, regardless of estrogen receptor/progesterone receptor (ER/PgR) status.

Major finding: The incidence rates of iDFS events were similar between the metformin and placebo groups in patients with ER/PgR+ BC (2.78 vs. 2.74 per 100 patient-years; P = .93) and ER/PgR− BC (3.58 vs. 3.60 per 100 patient-years; P = .92). Grade ≥3 nonhematological adverse events were more frequent in the metformin vs. placebo group (21.5% vs. 17.5%; P = .003).

Study details: Findings are from the phase 3 MA.32 study including 3649 patients with high-risk operable BC and without diabetes who were randomly assigned to receive metformin or placebo after undergoing complete resection.

Disclosures: This study was funded by the Canadian Cancer Society Research Institute and other sources. The authors declared serving on advisory boards, as consultants, or were employees or received grants, nonfinancial support, or travel expenses from several sources.

Source: Goodwin PJ et al. Effect of metformin vs placebo on invasive disease–free survival in patients with breast cancer: The MA.32 Randomized Clinical Trial. JAMA. 2022;327(20):1963–1973 (May 24). Doi: 10.1001/jama.2022.6147

Key clinical point: In patients with high-risk operable breast cancer (BC) and without diabetes, adding metformin to standard BC treatment did not improve the invasive disease-free survival (iDFS) rate, regardless of estrogen receptor/progesterone receptor (ER/PgR) status.

Major finding: The incidence rates of iDFS events were similar between the metformin and placebo groups in patients with ER/PgR+ BC (2.78 vs. 2.74 per 100 patient-years; P = .93) and ER/PgR− BC (3.58 vs. 3.60 per 100 patient-years; P = .92). Grade ≥3 nonhematological adverse events were more frequent in the metformin vs. placebo group (21.5% vs. 17.5%; P = .003).

Study details: Findings are from the phase 3 MA.32 study including 3649 patients with high-risk operable BC and without diabetes who were randomly assigned to receive metformin or placebo after undergoing complete resection.

Disclosures: This study was funded by the Canadian Cancer Society Research Institute and other sources. The authors declared serving on advisory boards, as consultants, or were employees or received grants, nonfinancial support, or travel expenses from several sources.

Source: Goodwin PJ et al. Effect of metformin vs placebo on invasive disease–free survival in patients with breast cancer: The MA.32 Randomized Clinical Trial. JAMA. 2022;327(20):1963–1973 (May 24). Doi: 10.1001/jama.2022.6147

Key clinical point: In patients with high-risk operable breast cancer (BC) and without diabetes, adding metformin to standard BC treatment did not improve the invasive disease-free survival (iDFS) rate, regardless of estrogen receptor/progesterone receptor (ER/PgR) status.

Major finding: The incidence rates of iDFS events were similar between the metformin and placebo groups in patients with ER/PgR+ BC (2.78 vs. 2.74 per 100 patient-years; P = .93) and ER/PgR− BC (3.58 vs. 3.60 per 100 patient-years; P = .92). Grade ≥3 nonhematological adverse events were more frequent in the metformin vs. placebo group (21.5% vs. 17.5%; P = .003).

Study details: Findings are from the phase 3 MA.32 study including 3649 patients with high-risk operable BC and without diabetes who were randomly assigned to receive metformin or placebo after undergoing complete resection.

Disclosures: This study was funded by the Canadian Cancer Society Research Institute and other sources. The authors declared serving on advisory boards, as consultants, or were employees or received grants, nonfinancial support, or travel expenses from several sources.

Source: Goodwin PJ et al. Effect of metformin vs placebo on invasive disease–free survival in patients with breast cancer: The MA.32 Randomized Clinical Trial. JAMA. 2022;327(20):1963–1973 (May 24). Doi: 10.1001/jama.2022.6147