The correlation between chronic sinonasal inflammation and nasopharyngeal carcinoma

In a recent systematic review and meta-analysis, the presence of chronic sinonasal inflammation shows a significant correlation with nasopharyngeal carcinoma. Findings of this study were documented in the American Journal of Otolaryngology.

This meta-analysis involved a comprehensive search of four international databases from 1^st January 1973 to 28^th March 2022 for studies addressing sinonasal inflammation and NPC in adults (greater than 18 years old). Case-control, cohort, or cross-sectional studies were included that explored the association between a prior history of sinonasal inflammation and the risk of developing NPC. The incidence of nasopharyngeal carcinoma (NPC) in patients with prior sinonasal inflammation is the outcome.

A total of eight studies, comprising 8,245 individuals diagnosed with NPC and 1,036,087 individuals without NPC, were examined. The overall odds ratio for developing NPC following sinonasal inflammation was found to be 1.81 (95% confidence interval 1.73-1.89). Chronic rhinosinusitis (CRS) exhibited a stronger association with an increased risk of NPC, with an odds ratio of 1.78 (95% confidence interval: 1.68-1.90), in comparison to allergic rhinitis (AR) (odds ratio of 1.60; 95% confidence interval: 1.52-1.68).

Thus, it can be concluded that chronic sinonasal inflammation is strongly linked to nasopharyngeal carcinoma. It is important to thoroughly examine the cause-and-effect relationship and the potential effects of targeted screening using large-scale prospective studies.

Continuous PEGasparaginase dosing regimen decreases hypersensitivity reactions in children with acute lymphoblastic leukemia

A recent study showed that a continuous dosing regimen of PEGasparaginase (PEGasp) can effectively prevent the formation of antibody and reduce the risk of hypersensitivity reactions. These findings were published in the Journal of Clinical Oncology. 
Patients diagnosed with Acute Lymphoblastic Leukemia (ALL) were included in the DCOG ALL11 protocol. These patients were administered PEGasp as part of their treatment. Out of 818 patients, 312 were categorized as medium-risk and were randomized to receive 14 individualized doses of PEGasp. The administration of these doses occurred once every two weeks, following either a non-continuous or continuous schedule after the initial three doses during the induction phase. The primary objective of this study was to assess whether the continuous dosing schedule, without any asparaginase-free interval, would lead to a lower occurrence of hypersensitivity reactions to PEGasp compared to the standard non-continuous dosing schedule. The secondary endpoints of the study included evaluating other asparaginase-related toxicities, asparaginase activity and antibody levels, as well as overall treatment outcome.
In the induction phase, hypersensitivity reactions were detected in 27 out of 818 patients. Following random assignment assignment of 312 medium risk patients, 4 out of 155 (2.6%) patients in the continuous treatment arm and 17 out of 157 (10.8%) patients in the noncontinuous treatment arm reported hypersensitivity reactions. Among these reactions, 2 versus 13 were inactivating reactions. In the continuous treatment arm, the occurrence of inactivating hypersensitivity reactions was 7 times lower. Additionally, antibody levels were notably reduced in the continuous treatment arm. There were no notable differences in the total number of asparaginase-related toxicities between the two treatment groups, besides a lower incidence of elevated amylase in the continuous treatment group. 
As a result, a continuous PEGasp dosing schedule is successful in preventing antibody formation neutralizing and hypersensitivity responses. This continuous schedule demonstrated no rise in toxicity levels and had no impact on the efficacy.
 

The correlation between chronic sinonasal inflammation and nasopharyngeal carcinoma

In a recent systematic review and meta-analysis, the presence of chronic sinonasal inflammation shows a significant correlation with nasopharyngeal carcinoma. Findings of this study were documented in the American Journal of Otolaryngology.

This meta-analysis involved a comprehensive search of four international databases from 1^st January 1973 to 28^th March 2022 for studies addressing sinonasal inflammation and NPC in adults (greater than 18 years old). Case-control, cohort, or cross-sectional studies were included that explored the association between a prior history of sinonasal inflammation and the risk of developing NPC. The incidence of nasopharyngeal carcinoma (NPC) in patients with prior sinonasal inflammation is the outcome.

A total of eight studies, comprising 8,245 individuals diagnosed with NPC and 1,036,087 individuals without NPC, were examined. The overall odds ratio for developing NPC following sinonasal inflammation was found to be 1.81 (95% confidence interval 1.73-1.89). Chronic rhinosinusitis (CRS) exhibited a stronger association with an increased risk of NPC, with an odds ratio of 1.78 (95% confidence interval: 1.68-1.90), in comparison to allergic rhinitis (AR) (odds ratio of 1.60; 95% confidence interval: 1.52-1.68).

Thus, it can be concluded that chronic sinonasal inflammation is strongly linked to nasopharyngeal carcinoma. It is important to thoroughly examine the cause-and-effect relationship and the potential effects of targeted screening using large-scale prospective studies.

Patients with metastatic castration-resistant prostate cancer benefit from niraparib plus abiraterone acetate and prednisone

A recent study suggests that patients with metastatic castration-resistant prostate cancer (mCRPC) and BRCA alterations showed clinically relevant outcomes when treated with niraparib plus abiraterone acetate and prednisone (AAP). This study’s results were published in the Annals of Oncology.

The phase 3, MAGNITUDE trial included 212 HRR+ patients with/without BRCA1/2 alterations. They were randomized in a 1:1 ratio to receive 200mg of niraparib orally plus AAP (1000 mg/10 mg orally) or placebo plus AAP. At the second prespecified interim analysis (IA2), the secondary endpoints assessed were time to symptomatic progression, time to initiation of cytotoxic chemotherapy and overall survival (OS).

It was found that at IA2 with 24.8 months of median follow-up, niraparib plus AAP showed significantly prolonged radiographic progression-free survival (rPFS) (19.5 versus 10.9 months; hazard ratio (HR) = 0.55 [95% confidence interval (CI) 0.39-0.78] consistent with the first prespecified interim analysis. Similarly, in the total HRR+ population, rPFS was also prolonged. In the niraparib plus AAP group, time to symptomatic progression and time to initiation of cytotoxic chemotherapy showed improvements. Even the analysis of OS with niraparib plus AAP in the BRCA1/2 subgroup demonstrated a lower hazard ratio.

From the above results, it is clear that niraparib plus AAP in patients with BRCA1/2-altered mCRPC, may demonstrate an improved rPFS and other clinically relevant outcomes.