Somnath Roy

PURPOSE The global, phase 3, open-label, randomized TROPION-Breast01 study assessed the trophoblast cell surface antigen 2–directed antibody-drug conjugate datopotamab deruxtecan (Dato-DXd) versus investigator's choice of chemotherapy (ICC) in hormone receptor–positive/human epidermal growth factor receptor 2–negative (HR+/HER2–) breast cancer. METHODS Adult patients with inoperable/metastatic HR+/HER2‒ breast cancer, who had disease progression on endocrine therapy, for whom endocrine therapy was unsuitable, and had received one to two previous lines of chemotherapy in the inoperable/metastatic setting, were randomly assigned 1:1 to Dato-DXd (6 mg/kg once every 3 weeks) or ICC (eribulin/vinorelbine/capecitabine/gemcitabine). Dual primary end points were progression-free survival (PFS) by blinded independent central review (BICR) and overall survival (OS). RESULTS Patients were randomly assigned to Dato-DXd (n = 365) or ICC (n = 367). Dato-DXd significantly reduced the risk of progression or death versus ICC (PFS by BICR hazard ratio [HR], 0.63 [95% CI, 0.52 to 0.76]; P < .0001). Consistent PFS benefit was observed across subgroups. Although OS data were not mature, a trend favoring Dato-DXd was observed (HR, 0.84 [95% CI, 0.62 to 1.14]). The rate of grade ≥3 treatment-related adverse events (TRAEs) with Dato-DXd was lower than ICC (20.8% v 44.7%). The most common TRAEs (any grade; grade ≥3) were nausea (51.1%; 1.4%) and stomatitis (50%; 6.4%) with Dato-DXd and neutropenia (grouped term, 42.5%; 30.8%) with ICC. CONCLUSION Patients receiving Dato-DXd had statistically significant and clinically meaningful improvement in PFS and a favorable and manageable safety profile, compared with ICC. Results support Dato-DXd as a novel treatment option for patients with inoperable/metastatic HR+/HER2‒ breast cancer who have received one to two previous lines of chemotherapy in this setting.

AIM: There are few studies on pyrexia of unknown origin (PUO) from India. The present study was planned to elucidate the causes of in PUO Eastern India and to define the changing patterns of PUO, if any. STUDY DESIGN: Prospective case series. PATIENTS: One hundred patients meeting the classic criteria of pyrexia of unknown origin. MAIN OUTCOME MEASUREMENT: The final diagnosis established at discharge or during follow up. RESULTS: Infections, especially tuberculosis was the most dominant cause (53%), followed by neoplasms (17%), and collagen vascular disorders (11%), Miscellaneous causes were responsible in 5% cases and in 14% the cause of fever remained undiagnosed. CONCLUSION: It is concluded that infections remain the most important cause of PUO in India, confirming the trends found earlier in other studies. The incidence of neoplasms was much higher compared to other studies from India.

Background: Head-and-neck cancer (HNC) is one of the most common cancers in India and requires a multidisciplinary approach for disease management. Objectives: We aimed to report the demographic profile and pattern of care of patients with HNC and their treatment compliance at our center. Materials and Methods: This single-center, retrospective study was conducted in the Department of Medical Oncology of Homi Bhabha Cancer Hospital, Tata Memorial Center, Varanasi, India, from May 2018 to April 2020. Patients with HNCs of any sub-site, stage, and histology were included in the study. The patients underwent routine clinical and imaging evaluation, baseline investigations, and tissue biopsy. After diagnosis and staging, the cases were discussed by a multidisciplinary team for treatment planning. The number of patients presenting at our center within the specified time period, the intent of care, and the treatment received were recorded, and treatment compliance was assessed. Continuous and noncontinuous variables were described using median and proportions, respectively, and P < 0.05 was considered statistically significant. Results: A total of 1229 patients were included in the analysis, of which 87% were male and 90% belonged to Uttar Pradesh, a state in northern India. The predominant (91%) histological type was squamous cell carcinoma. Majority (81%) of the patients presented with disease in a locally advanced stage, and oral cavity was the most common sub-site (71%), followed by the oropharynx (9.7%) and the hypopharynx and larynx (10%). The treatment intent was curative in 62%, palliative in 31%, and supportive in 6% of the patients. Of patients receiving curative treatment, 12% received two to three cycles of neoadjuvant chemotherapy followed by surgery, 25% underwent upfront surgery followed by adjuvant chemo-radiation or radiation, 7% underwent surgery alone, and 11% received radical chemo-radiation. Among patients receiving treatment with palliative intent, 13% received oral metronomic chemotherapy and 13% received some form of intravenous chemotherapy. About 78% of the patients complied with their cancer-directed therapies, with male patients showing significantly better compliance than the female ones. Conclusion: This study reports the demographic profile and pattern of care of patients with HNCs from a newly developed tertiary care center in North India, and highlights the emergent need for a more dedicated cancer center in this region.

A total of 105 cases of soft tissue tumours were studied by fine needle aspiration cytology (FNAC). All the cases were corroborated by histological examination. Sixty five were benign, 33 were malignant and 7 cases were inconclusive. On histopathological examination, accuracy rate of benign tumours was found to be 90.6% and that of malignant tumours was 91.3%. The overall accuracy rate was 90.8%. So FNAC is to be considered as an useful cost effective procedure for the diagnosis of soft tissue tumours.