Weekly symptom monitoring in lung cancer tracked five months of extra median survival

The edition in brief

A quieter oncology day with four findings worth the time. In the SYMPRO-Lung stepped-wedge cluster-randomised trial across 14 Dutch centres, 446 patients with stage I–IV lung cancer completed weekly online symptom assessments for a year or received standard care; at a median 50 months, median overall survival was 26 months with monitoring against 21 without, hazard ratio 0.80 (95% CI 0.63–1.00, p=0.049), with no significant difference in progression-free survival (0.86, 0.70–1.07). This is a post-hoc survival analysis of a trial whose primary endpoint was quality of life. A meta-analysis of 11 case-control studies covering 8,606 melanoma patients and 17,953 controls found the germline MITF E318K variant in 2.1% of patients and 0.8% of controls, giving an odds ratio for melanoma of 2.55 (95% CI 1.90–3.43), stronger in multiple primary melanoma and strongly enriched in those with more than 200 naevi; reported associations with renal cancer and phaeochromocytoma were unreplicated. Pooling eight studies in 7,494 women, PAX1/JAM3 dual-gene methylation testing detected CIN2 or worse with sensitivity 0.81 (0.73–0.88) and specificity 0.95 (0.94–0.96). A three-arm phase 3 trial in 108 breast cancer survivors found self-acupressure improved a fatigue–sleep–depression symptom cluster against both sham and usual care, with the separation from sham emerging mainly at 19 weeks. And an NEJM review sets out the diverging epidemiology of oesophageal adenocarcinoma and squamous-cell carcinoma, the latter still dominant outside high-income Western countries.