Oncology Round-Up: HIV Vaccine Administered in Trial; and More

First dose of mRNA vaccine for HIV is administered; septic shock is linked to mortality in blood cancer patients; and more oncology news featured this week on DocWire…

This Week: MRNA Vaccine for HIV; Septic Shock and Blood Cancer; and More

Each week on DocWire News, editors bring you the latest in oncology news and cancer research. In case you missed it, here are this week’s top headlines:

Keep reading for the breakdown on these top stories.

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mRNA HIV Vaccine Administered in Trial

Vaccinations have been given to the first volunteers in a phase 1 trial of the experimental Moderna HIV vaccine, the company has announced.

The vaccine uses mRNA technology — similar to that utilized in breakthrough COVID-19 vaccines — to deliver HIV-specific antigens that could trigger an immune response against the virus that causes AIDS, the company said in a statement about the trial.

“At Moderna, we believe that mRNA offers a unique opportunity to address critical unmet public health needs around the world,” Stephen Hoge, M.D., the president of Moderna, said in a company news release. “We believe advancing this HIV vaccine program in partnership with IAVI and Scripps Research is an important step in our mission to deliver on the potential for mRNA to improve human health.”

Moderna has partnered with IAVI, a nonprofit scientific research organization, for the trial being conducted at four locations in the United States: George Washington University School of Medicine, Hope Clinic of Emory Vaccine Center, Fred Hutchinson Cancer Research Center, and the University of Texas Health Science Center at San Antonio.

“We are tremendously excited to be advancing this new direction in HIV vaccine design with Moderna’s mRNA platform,” Mark Feinberg, M.D., president and CEO of IAVI, said in a statement. “The search for an HIV vaccine has been long and challenging, and having new tools in terms of immunogens and platforms could be the key to making rapid progress toward an urgently needed, effective HIV vaccine. We are grateful to all of our partners and especially to the Bill & Melinda Gates Foundation for funding this trial.”

The trial will follow 56 HIV-negative adults to determine the safety and efficacy of the vaccine. Forty-eight of the volunteers will receive at least one dose of the primary vaccine, and 32 will also receive a booster version. The remaining eight participants will receive the booster vaccine alone.

First Shots Given in Trial of Moderna mRNA-Based HIV Vaccine

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Septic Shock Linked to Mortality in Blood Cancer

For patients with hematologic malignancies, septic shock is associated with high mortality rates and poor 90-day survival, according to a study published in the January issue of the Journal of the National Comprehensive Cancer Network.

Nirmala K. Manjappachar, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues describe short-term outcomes and independent predictors of 28-day mortality in adults with hematologic malignancies and septic shock. Data were included for 459 hematologic patients with septic shock admitted to the intensive care unit from April 2016 through March 2019.

The researchers found that 23.7 percent of the patients received hematopoietic stem cell transplant. Nonsurvivors had a higher Charlson comorbidity index, longer length of stay before admission to the intensive care unit, and greater severity of illness at diagnosis and through the hospital course. At 28 days, the mortality rate was 67.8 percent and increased with an increasing sequential organ failure assessment score on admission, respiratory failure, and maximum lactate level (odds ratios [ORs], 1.11, 3.12, and 1.16, respectively). Lower 28-day mortality was seen in association with aminoglycosides administration (OR, 0.42), serum albumin (OR, 0.51), and granulocyte colony-stimulating factor (OR, 0.40). In 81.6 percent of patients, life support limitations were present at death. Overall, 19.4 percent of the patients were alive after 90 days.

“We must develop preventive strategies to reduce infection rates in patients with blood cancers and promote early detection of sepsis before it progresses to septic shock,” a coauthor said in a statement.

Septic Shock Linked to Mortality in Hematologic Malignancies

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Overdiagnosis of Lung Cancer with Screening Nonsmokers

Low-dose computed tomography (LDCT) screening of mostly nonsmoking Asian women is associated with considerable early-stage lung cancer overdiagnosis, according to a study published online Jan. 18 in JAMA Internal Medicine.

Wayne Gao, Ph.D., from Taipei Medical University in Taiwan, and colleagues used data from the Taiwan Cancer Registry to identify women diagnosed with lung cancer between 2004 and 2018. The association of lung cancer incidence with the promotion of screening in a largely nonsmoking population was evaluated.

The researchers found that after the introduction of LDCT screening, the incidence of early-stage (stages 0 to I) lung cancer in women increased more than sixfold, from 2.3 to 14.4 per 100,000 population. For late-stage (stages II to IV) lung cancer, no change in incidence was observed (absolute difference, 0.6; 95 percent confidence interval, –0.5 to 1.7). Virtually all the additional cancers detected represent overdiagnosis, the authors said, because the early-stage cancers were not accompanied by a concomitant decline in late-stage cancers. Mortality remained stable, but five-year survival more than doubled from 2004 to 2013, because of increased detection of indolent early-stage lung cancers.

“Unless randomized trials can demonstrate some value to low-risk groups, LDCT screening should remain targeted only to heavy smokers,” the authors write.

Screening Nonsmokers May Up Lung Cancer Overdiagnosis, Spurious Survival Rates

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Rate of Metastasis in Cutaneous SCC

Metastases develop in about 2 percent of cutaneous squamous cell carcinomas (cSCCs), according to a study published in the February issue of the Journal of the American Academy of Dermatology.

Selin Tokez, from the Erasmus MC Cancer Institute in Rotterdam, Netherlands, and colleagues examined the cumulative incidence and disease-specific survival of patients with metastatic cSCC (mcSCC) in the Dutch population. Data were included for 11,137 patients with first cSCC in 2007 or 2008, with a median follow-up of 9.1 years.

The researchers found that metastases developed in 1.9 percent of the patients, with a median time to metastasis of 1.5 years. Risk factors for metastases included age (adjusted hazard ratio, 1.03), male sex (adjusted hazard ratio, 1.7), and immunosuppression (adjusted hazard ratios: 5.0 and 2.7 for organ transplant recipient and hematological malignancy, respectively). For patients with mcSCC, the five-year disease-specific survival was 79.1 percent.

“We showed that the majority of metastases occur within four years and that this risk is higher with male sex, increasing age, and immunosuppression,” the authors write. “Individual risk prediction models should include these high-risk patient characteristics to tailor follow-up care to the subgroups of patients with cSCC at increased risk of mcSCC among the large group of predominantly low-risk cSCC patients.”

Metastases Occur in About 2 Percent of Cutaneous SCCs

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