H aematology & O ncology N ews • Vol. 9 • No. 1 • 2016

Ovarian suppression during breast cancer chemotherapy helped preserve long-term function

disease free at 5 years (HR, 1.17; 95% CI, 0.72 to 1.92; P = 0.52). The increase in risk among triptorelin patients was generally limited to those with hormone receptor-negative disease (5-year DFS, 62% and 76%), the investigators said. When combined with recent findings from the POEMS study, the results show that tem- porary ovarian suppression before and during chemotherapy is an option for preserving ovar- ian function in premenopausal women with early-stage breast cancer, they concluded. Istituto Nazionale per la Ricerca sul Cancro and the Associazione Italiana per la Ricerca sul Cancro funded the study. Dr Lambertini reported no relevant disclosures. Two coauthors reported receiving research funding and honoraria from Amgen, GlaxoSmithKline, and Eisai. The sen- ior author reported financial relationships with Takeda and with Ipsen, which supplied the triptorelin used in the study. recommending low-dose aspirin for colorectal cancer prevention based on age and risk. Randomised trials have also suggested that a single dose of human papillomavirus vaccine can provide durable protection against HPV infection. Tumour biology studies established new chemoprevention for familial adenoma- tous polyposis syndrome and universal tumour screening guidelines based on DNA mismatch repair mutations and microsatellite instability for colorectal cancer in patients with Lynch syndrome. Further, remarkable advances have been made in liquid biopsy technology, high-through- put functional screening, and computational biology methods and algorithms that “provide unprecedented opportunities to interrogate the biology of premalignancy...” they noted. In an American Association for Cancer Re- search blog post, Dr Lippman acknowledges that not everyone is the same page when it comes to the underlying principles of cancer prevention. A “contentious” paper published at the start of 2015 suggested that variations in cancer risk are due to random mutations or what might otherwise be called bad luck. The new year was heralded in by a second paper, however, that came to roughly the opposite conclusion or that most cancers are preventable. In February, an AACR Cancer Prevention Summit will bring together various stake- holders to discuss the current state of cancer prevention and to identify top priorities and research directions for the field, he noted. The authors acknowledged grant support from the US National Institutes of Health/National Cancer Institute.

receptor-positive or hormone receptor-negative breast cancer to receive chemotherapy alone or with 3.75 mg triptorelin, given intramuscu- larly at least 1 week before and every 4 weeks during cancer treatment. The median age of patients was 39 years, the range was 24–45 years ( JAMA 2015;314:2632–40). Nearly 73% of the triptorelin group and 64% of controls resumed menstruating within 5 years of completing chemotherapy, for an age-adjusted hazard ratio of 1.48 (95% CI, 1.12 to 1.95; P = 0.006). Cumulative 5-year pregnancy rates were 2.1% for the triptorelin group and 1.6% for controls (aHR, 2.4; 95% CI, 0.62 to 9.22; P = 0.2). About 81% of trip- torelin patients and 84% of controls remained being translated to the clinic and showing great promise. We stand at the edge of a new frontier that will include comprehensively characteris- ing the molecular and cellular events that drive premalignant progression (eg, PCGA),” Dr Scott M. Lippman, director of the University of Cali- fornia SanDiegoMoores Cancer Centre, and his coauthors wrote ( Cancer Prev Res 2016;9:2–10). The report details some of the clinical firsts in 2015 including genomic studies suggesting that clonal haematopoiesis is a premalignant state for blood cancer, the first precision medicine trial in cancer prevention (EPOC) reporting that loss of heterozygosity can predict which patients with premalignant mouth lesions are most likely to develop oral cancer, and the United States Preventive Services Task Force

BY AMY KARON Frontline Medical News From JAMA O varian suppression with triptorelin during chemotherapy for early-stage breast cancer significantly increased the chances that women would recover their long-term ovarian function, according to a multicentre phase III open-label study published online Dec. 22 in JAMA . The treatment and control groups had simi- larly low pregnancy rates at 5 years, with no significant overall difference in disease-free survival, reported Dr Matteo Lambertini of Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy, and his associates.

Cryopreserving embryos or oocytes remains the main way to protect fertility in young women with breast cancer. Clinicians have debated whether to use luteinising hormone- releasing hormone analogues because of scarce data showing efficacy and concerns about compromising disease-free survival, the investigators noted. They randomised 281 pre- menopausal women with stage I–III hormone Nearly 73% of the triptorelin group and 64% of controls resumed menstruating within 5 years of completing chemotherapy.

Cancer prevention field riding high into the new year BY PATRICE WENDLING Frontline Medical News From Cancer Prevention Research

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Anne Neilson anne.neilson@elsevier.com Carolyn Ng carolyn.ng@elsevier.com Jana Sokolovskaja j.sokolovskaja@elsevier.com Dr Barry M Dale Consultant Haematologist Medical Oncologist

T he new year has us all looking forward and the cancer prevention community is no exception. In a special report entitled “Transforming Cancer Prevention through PrecisionMedicine and Immune-Oncology,” a team of experts offer a brief look at what we can expect in the near future for cancer prevention research, includ- ing a Pre-Cancer Genome Atlas (PCGA), and highlight some of the recent advances shaping their optimism. “Just as precision therapy and immunotherapy are transforming cancer treatment, precision medicine and immunoprevention approaches are



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