Should immune checkpoint inhibitors be contraindicated in lung cancer patients with latent tuberculosis?

Early-Stage Renal Cell Carcinoma: Who Needs Adjuvant Therapy?

Surgery is the oldest modality of kidney cancer therapy and is usually the first step in the treatment process. To improve surgical outcomes, adjuvant therapy is frequently administered to eliminate residual tumors and reduce the risk of recurrence and metastasis. However, not all patients require adjuvant treatment. The decision regarding whether to treat or not to treat renal cell carcinoma patients depends on the risk of recurrence, including tumor stage and histology, and clinical, biological, and personal risk factors. This article will address the challenges of treating renal cell carcinoma patients with adjuvant therapy and review the current evidence and ongoing clinical trials.

Latent infection screening and prevalence in cancer patients born outside of Australia: a universal versus risk-based approach?

PURPOSE

Contention surrounds how best to screen patients for latent and undiagnosed infection prior to cancer treatment. Early treatment and prophylaxis against reactivation may improve infection-associated morbidity. This study sought to examine rates of screening and prevalence of latent infection in overseas-born patients receiving cancer therapies.

METHODS

A single-centre retrospective audit of 952 overseas-born patients receiving chemotherapy, targeted agents and immunotherapy between January 1 and December 31 2019 was undertaken at Peter MacCallum Cancer Centre. Pre-treatment screening for hepatitis B (HBV), hepatitis C (HCV), human immunodeficiency virus (HIV), latent tuberculosis (LTBI), toxoplasmosis and strongyloidiasis was audited.

RESULTS

Approximately half of our overseas-born patients were screened for HBV (58.9%) and HCV (50.7%). Fewer patients were screened for HIV (30.5%), LTBI (18.3%), strongyloidiasis (8.6%) or toxoplasmosis (8.1%). Although 59.7% of our patients were born in countries with high epidemiological risk for latent infection, according to World Health Organization data, 35% were not screened for any infection prior to commencement of therapy.

CONCLUSION

The prevalence of latent infections amongst overseas-born patients with cancer, and complexities associated with risk-based screening, likely supports universal latent infection screening amongst this higher-risk cohort.