Background: Little is known about the 2019 novel coronavirus disease (COVID-19) course and outcomes in patients receiving immunotherapy. Here we describe a metastatic Merkel cell carcinoma patient ...

Background: PRRT can be an option for all-grade GEP-NETs, but selecting patients is challenging. In this scenario, clinical-pathological and radiological characteristics, such as pre-treatment Ga-68 DOTA PET/CT, might have the potential to help. Methods: A retrospective chart review was conducted on advanced GEP-NETs treated with at least one PRRT dose. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan–Meier method. Krenning Score (KS), and the maximum standardized uptake value (SUVmax) were derived from the pre-treatment scans. A maximally selected rank statistics test was used for SUVmax simple cut point estimate. Results: Among 36 patients, 19 had primary pancreatic tumors. The numbers of G1, G2, and G3 tumors were 10, 18, and 7, respectively. During a median follow-up of 90.5 months, 4 patients died. Median OS was not reached for G1 and G2 tumors, and it was 30 months for G3 (p = 0.001). Median PFS was 23 months, with G3 showing lower PFS compared to G1 [7 versus 30 months; HR 8.41 (95%CI 2.2–31.0; p = 0.001)]. Conclusions: PRRT provides long-term PFS in patients with G1/G2 GEP-NETs independent of clinical characteristics and primary site. G3 has worse survival, but selected patients may experience long OS after PRRT treatment.

PURPOSE: Oncotype DX (ODX) is a validated gene expression assay that provides prognostic and predictive information to guide adjuvant chemotherapy (ACT) decisions in hormone receptor–positive, HER2-negative (HR+/HER2–) early breast cancer (eBC), including node-negative (N0) and 1-3 node-positive (N1) disease. In Brazil, limited access to gene expression signatures (GES) remains a barrier to individualized treatment decisions. METHODS: We conducted a multicenter retrospective study across nine Brazilian private cancer centers to evaluate clinicopathologic predictors of high genomic risk (ODX recurrence score [RS] >25) and to assess the clinical impact of ODX on ACT decision making. RESULTS: Between 2005 and 2024, 935 patients were included, with a notably higher representation of young (≤40 years: 10.9%) and premenopausal (40.7%) women than typically reported in randomized clinical trials. Ki-67 >20%, progesterone receptor (PR) expression ≤30%, and histologic grade 3 were independently associated with high RS in both univariable and multivariable analyses (all P <.001), with Ki-67 emerging as the strongest clinicopathologic predictor. Overall, ODX testing was associated with an estimated 12.6% absolute reduction in ACT recommendations, with substantial impact among postmenopausal patients with N1 disease (94% absolute reduction) and N0 patients older than 50 years with high clinical risk (65.2% absolute reduction). With a median follow-up of 4.8 years, the estimated 5-year real-world invasive disease-free survival and distant disease-free survival were 100% and 100% for those with RS 25, respectively. CONCLUSION: In this data set, ODX demonstrated utility in guiding ACT decision making and supporting personalized treatment by reducing both overtreatment and undertreatment. In resource-constrained settings, surrogate markers such as Ki-67, PR expression, and histologic grade may serve as practical tools to guide risk-adapted clinical decisions.