The edition · Oncology
A multicancer blood test did not reduce late-stage cancer after three screening rounds in 142,000 people
NHS-Galleri, the first large randomised trial of a multicancer early-detection test, missed its primary endpoint. Also: STRIDE plus lenvatinib with TACE lengthened progression-free survival in intermediate HCC, long-course chemoradiotherapy preserved more rectums than short-course, ovarian function returned in under half after breast cancer chemotherapy, and an everolimus supplement.
The edition in brief
In the NHS-Galleri trial in England, 142,250 people aged 50-77 were randomised to multicancer early-detection blood testing plus usual care or usual care alone; after three annual rounds, stage III-IV cancer incidence across 12 cancers did not differ (IRR 1.03, 0.92-1.14), though stage IV incidence was lower with borderline significance (IRR 0.86, 0.74-1.00). In EMERALD-3, durvalumab plus tremelimumab and lenvatinib with TACE extended median progression-free survival from 9.8 to 13.0 months in embolisation-eligible hepatocellular carcinoma (HR 0.70), without a significant overall survival difference so far and with more serious adverse events. In STAR-TREC, among patients choosing organ preservation for early rectal cancer, 12-month TME-free survival was 78.5% with long-course chemoradiotherapy against 60.6% with short-course radiotherapy. A meta-analysis of 34 studies found ovarian function recovered in 30% of premenopausal women by 12 months and 43% by 5 years after breast cancer chemotherapy. The FDA recorded a supplement to Novartis's everolimus (Zortress) application; its content is not stated.
EMERALD-3: immunotherapy plus lenvatinib with TACE extended progression-free survival in intermediate HCC
Adding STRIDE, with or without lenvatinib, to TACE lengthened progression-free survival in intermediate HCC, but overall survival is not yet improved and toxicity is high.
Rectal cancer organ preservation: long-course chemoradiotherapy kept more patients free of surgery than short-course
For small early rectal cancers where the patient wants organ preservation, prefer long-course chemoradiotherapy over short-course radiotherapy.
After breast cancer chemotherapy, ovarian function returned in under half of premenopausal women by five years
Counsel premenopausal women before breast cancer chemotherapy that ovarian function returns in fewer than half by five years, and refer for fertility preservation first.
FDA: supplement recorded for Novartis's everolimus (Zortress)
An administrative FDA supplement to the transplant brand of everolimus; no change to cancer prescribing.
A negative screening test is not a reason to ignore symptoms
Investigate symptoms regardless of a recent negative screening result.
NHS-Galleri: a multicancer blood test did not reduce stage III-IV cancer after three annual rounds
Do not recommend multicancer early-detection blood tests for screening; in the first large trial they did not reduce late-stage cancer, and established screening should continue.
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