Survivors reported few cancer-related problems with only a small subset reporting problems in adjustment. Although differences were small, younger cancer survivors reported significantly worse adaptation than older survivors. Much of the adaptation to having had cancer may have already occurred in long-term survivors.

The combination of sorafenib, docetaxel, and cisplatin has an encouraging efficacy profile with tolerable toxicity. Additional studies of sorafenib with chemotherapy are warranted in gastric cancer.

Background and Aims-Clinical genetic testing can help direct cancer screening for members of Lynch Syndrome families; however there is limited information about family communication of genetic test results.

Background: Many patients with metastatic non-small-cell lung cancer (mNSCLC) experience disease progression after firstand second-line treatment; more treatment options are required for these patients. ARCTIC, a phase III, randomized, open-label study, assessed durvalumab AE tremelimumab versus standard of care (SoC) as ! third-line treatment of mNSCLC. Patients and methods: ARCTIC comprised two independent sub-studies. Study A: 126 patients with !25% of tumor cells (TCs) expressing programmed cell death ligand-1 (PD-L1) were randomized (1 : 1) to durvalumab [up to 12 months 10 mg/kg every 2 weeks (q2w)] or SoC. Study B: 469 patients with PD-L1 TC <25% were randomized (3 : 2 : 2 : 1) to durvalumab þ tremelimumab (12 weeks durvalumab 20 mg/kg þ tremelimumab 1 mg/kg q4w then 34 weeks durvalumab 10 mg/kg q2w), SoC, durvalumab (up to 12 months 10 mg/kg q2w), or tremelimumab (24 weeks 10 mg/ kg q4w then 24 weeks q12w). Primary end points: overall survival (OS) and progression-free survival (PFS) for durvalumab versus SoC (study A; descriptive only) and durvalumab þ tremelimumab versus SoC (study B). Results: Study A: median OS 11.7 (durvalumab) versus 6.8 (SoC) months {hazard ratio (HR) 0.63 [95% confidence interval (CI), 0.42e0.93]}; median PFS 3.8 (durvalumab) versus 2.2 (SoC) months [HR 0.71 (95% CI, 0.49e1.04)]. Study B: median OS 11.5 (durvalumab þ tremelimumab) versus 8.7 (SoC) months [HR 0.80 (95% CI, 0.61e1.05); P ¼ 0.109]. Median PFS of 3.5 months for both groups [HR 0.77 (95% CI, 0.59e1.01); P ¼ 0.056]. Treatment-related grade 3/4 adverse events: 9.7% (durvalumab) and 44.4% (SoC; study A) and 22.0% (durvalumab þ tremelimumab) and 36.4% (SoC; study B). Conclusions: In heavily pretreated patients with mNSCLC, durvalumab demonstrated clinically meaningful improvements in OS and PFS versus SoC (patients with PD-L1 TC !25%); numerical improvements in OS and PFS for durvalumab þ tremelimumab versus SoC were observed (patients with PD-L1 TC <25%). Safety profiles were consistent with previous studies. Trial registration: Clinicaltrials.gov identifier: NCT02352948.

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CVS Caremark.

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Background Lynch Syndrome (LS) is a hereditary cancer syndrome which conveys a high risk of colorectal cancer (CRC). Guidelines recommend colonoscopy every 1–2 years. There is limited information about screening compliance in this high risk group. Methods Data about cancer screening behaviors were obtained from subjects recruited through 4 U.S. cancer genetics clinics. The main outcome was prevalence of appropriate CRC surveillance for LS. Results 181 individuals had a family history that met Amsterdam Criteria for LS (n=154) and/or had an identified mutation in a mismatch repair (MMR) gene (n=105). 132/181 (73%) had appropriate LS surveillance with colonoscopies at least every 2 years for individuals age ≥25. Of those with inadequate surveillance, 26/49 (53%) had colonoscopies at 3–5 year intervals. There were no significant differences in health care setting, perceived risk of CRC, or compliance with screening for other cancers. Rates of appropriate surveillance were higher among individuals who had been referred for genetic evaluation for LS compared to those who had not (109/136 (80%) vs 23/45 (51%), respectively p=0.0004). In multivariate analysis, personal history of CRC (OR 2.81), having a first degree relative with CRC at age<50 (OR 2.61), and having undergone a genetic evaluation (OR 4.62) were associated with appropriate CRC surveillance for LS. Conclusions The time between colonoscopic exams in patients with LS is often longer than recommended by current guidelines and may place them at risk for interval cancers. Recognizing clinical features of LS and providing genetic counseling, evaluation, and intensive surveillance may improve cancer prevention for those at highest risk for CRC.