FRIDAY, Feb. 23, 2024 (HealthDay News) -- For patients with nonepithelioid pleural mesothelioma, pegargiminase plus chemotherapy is associated with improved survival versus placebo plus chemotherapy, according to a study published online Feb. 15 in JAMA Oncology.

Peter W. Szlosarek, M.D., Ph.D., from Queen Mary University of London, and colleagues examined the effect of pegargiminase-based chemotherapy on survival in nonepithelioid pleural mesothelioma in a phase 2 to 3 double-blind randomized clinical trial conducted at 43 centers in five countries. A total of 249 patients were randomly assigned (1:1) to receive weekly intramuscular pegargiminase (36.8 mg/m2) or placebo. In addition, all patients received intravenous pemetrexed (500 mg/m2) and platinum chemotherapy every three weeks for up to six cycles.

The researchers found that median overall survival was 9.3 and 7.7 months with pegargiminase-chemotherapy and placebo-chemotherapy, respectively (hazard ratio [HR] for death, 0.71). The corresponding median progression-free survival was 6.2 and 5.6 months, respectively (HR, 0.65). Grade 3 to 4 adverse events occurred in 28.8 percent of patients with pegargiminase and 16.9 percent of patients with placebo. Drug hypersensitivity and skin reactions occurred in 2.4 and 1.6 percent of patients, respectively, in the pegargiminase arm versus none in the placebo arm.

"The pegargiminase-pemetrexed-platinum triplet was safe and validates arginine deprivation as a novel therapeutic antimetabolite strategy for patients with nonepithelioid mesothelioma," the authors write. "Additional studies of pegargiminase-based regimens are warranted in patients with other urea cycle-dysregulated cancers."

Several authors disclosed ties to pharmaceutical companies, including Polaris Group, which is developing pegargiminase and funded the study.

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FRIDAY, Feb. 23, 2024 (HealthDay News) -- Clinician recommendations are the most significant factor in driving prostate-specific antigen (PSA) screening in transgender women, according to a study published online Feb. 14 in JAMA Network Open.

Sandhya Kalavacherla, from the University of California in San Diego, and colleagues sought to understand factors associated with recent PSA screening in transgender women. The analysis included 255 transgender women and 1,020 matched cisgender men participating in the 2018 and 2020 Behavioral Risk Factor Surveillance System surveys.

The researchers found that recent PSA screening rates among transgender women and cisgender men aged 55 to 69 years were 22.2 and 36.3 percent, respectively. Among those aged 70 years and older, rates were higher (41.8 and 40.2 percent, respectively). Transgender women had lower odds of recent screening than cisgender men (odds ratio [OR], 0.65; 95 percent confidence interval [CI], 0.46 to 0.92; P = 0.02). Effect size and significance were similar when accounting for time since the last primary care visit (OR, 0.61; 95 percent CI, 0.42 to 0.87; P = 0.007). However, odds were similar when accounting for whether a clinician recommended a PSA test (OR, 0.83; 95 percent CI, 0.45 to 1.27; P = 0.21). Among transgender women, having a recommendation for PSA testing was the factor most strongly associated with recent screening (OR, 12.40; 95 percent CI, 4.47 to 37.80; P < 0.001).

"These data suggest that disparities in PSA screening among transgender women may be associated with clinician patterns of care rather than differences in sociodemographic characteristics or access to care," the authors write.

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THURSDAY, Feb. 22, 2024 (HealthDay News) -- For patients with polycythemia vera, rusfertide treatment reduces the use of phlebotomy and maintains hematocrit of less than 45 percent, according to a study published in the Feb. 22 issue of the New England Journal of Medicine.

Marina Kremyanskaya, M.D., Ph.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues examined the safety and efficacy of rusfertide in patients with phlebotomy-dependent polycythemia vera. Seventy patients were enrolled in a 28-week dose-finding assessment (part 1) and 59 were randomly assigned to receive rusfertide or placebo for 12 weeks in part 2 (30 and 29 patients, respectively).

The researchers found that the estimated mean number of phlebotomies per year was 8.7 ± 2.9 and 0.6 ± 1.0 during the 28 weeks before the first dose of rusfertide and during part 1, respectively. The corresponding mean maximum hematocrit was 50.0 ± 5.8 and 44.5 ± 2.2 percent. During part 2, 60 and 17 percent of the patients who received rusfertide and placebo, respectively, had a response. For patients with moderate or severe symptoms at baseline, rusfertide treatment was associated with a reduction in the individual symptom scores on the Myeloproliferative Neoplasm Symptom Assessment Form between baseline and the end of part 1. Grade 3 adverse events occurred in 13 percent of patients during parts 1 and 2; none had a grade 4 or 5 event.

"Rusfertide is a potentially effective treatment option for achieving and sustaining hematocrit control in patients with polycythemia vera, reducing the use of phlebotomy and the occurrence of debilitating disease-related symptoms," the authors write.

The study was funded by Protagonist Therapeutics, which developed rusfertide.

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