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Background In patients with renal cell carcinoma (RCC) enrolled in the phase III KEYNOTE-564 trial (NCT03142334), disease-free survival (DFS) following nephrectomy was prolonged with use of adjuvant pembrolizumab therapy versus placebo. Patient-reported outcomes (PROs) provide an important measure of health-related quality of life (HRQoL) and can complement efficacy and safety results. Patients and Methods In KEYNOTE-564, 994 patients were randomly assigned to receive pembrolizumab 200 mg (n  = 496) or placebo (n  = 498) intravenously every 3 weeks for ≤17 cycles. Patients who received ≥1 dose of treatment and completed ≥1 HRQoL assessment were included in this analysis. HRQoL end points were assessed using the EORTC QLQ-C30, FKSI-DRS, and EQ VAS. Prespecified and exploratory PRO end points were mean change from baseline in EORTC QLQ-C30 GHS/QoL score, EORTC QLQ-C30 physical function subscale score, and FKSI-DRS score. Results No clinically meaningful difference in least squares mean scores for pembrolizumab versus placebo were observed at week 52 for EORTC QLQ-C30 GHS/QoL (–2.5; 95% CI –5.2 to 0.1), EORTC QLQ-C30 physical functioning (–0.87; 95% CI –2.7 to 1.0), and FKSI-DRS (–0.7; 95% CI –1.2 to –0.1). Most PRO scores remained stable or improved for the EORTC QLQ-C30 GHS/QoL (pembrolizumab, 54.3%; placebo, 67.5%), EORTC QLQ-C30 physical functioning (pembrolizumab, 64.7%; placebo, 68.8%), and FKSI-DRS (pembrolizumab, 58.2%; placebo, 66.3%). Conclusions Adjuvant treatment with pembrolizumab did not result in deterioration of HRQoL. These findings together with the safety and efficacy findings support adjuvant pembrolizumab treatment following nephrectomy. Trial Registration Clinicaltrials.gov Identifier: NCT03142334 [ABSTRACT FROM AUTHOR]

Background Convalescent plasma (CP), despite limited evidence on its efficacy, is being widely used as a compassionate therapy for hospitalized patients with COVID-19. We aimed to evaluate the efficacy and safety of early CP therapy in COVID-19 progression. Methods and findings The study was an open-label, single-center randomized clinical trial performed in an academic medical center in Santiago, Chile, from May 10, 2020, to July 18, 2020, with final follow-up until August 17, 2020. The trial included patients hospitalized within the first 7 days of COVID-19 symptom onset, presenting risk factors for illness progression and not on mechanical ventilation. The intervention consisted of immediate CP (early plasma group) versus no CP unless developing prespecified criteria of deterioration (deferred plasma group). Additional standard treatment was allowed in both arms. The primary outcome was a composite of mechanical ventilation, hospitalization for >14 days, or death. The key secondary outcomes included time to respiratory failure, days of mechanical ventilation, hospital length of stay, mortality at 30 days, and SARS-CoV-2 real-time PCR clearance rate. Of 58 randomized patients (mean age, 65.8 years; 50% male), 57 (98.3%) completed the trial. A total of 13 (43.3%) participants from the deferred group received plasma based on clinical aggravation. We failed to find benefit in the primary outcome (32.1% versus 33.3%, odds ratio [OR] 0.95, 95% CI 0.32-2.84, p > 0.999) in the early versus deferred CP group. The in-hospital mortality rate was 17.9% versus 6.7% (OR 3.04, 95% CI 0.54-17.17 p = 0.246), mechanical ventilation 17.9% versus 6.7% (OR 3.04, 95% CI 0.54-17.17, p = 0.246), and prolonged hospitalization 21.4% versus 30.0% (OR 0.64, 95% CI, 0.19-2.10, p = 0.554) in the early versus deferred CP group, respectively. The viral clearance rate on day 3 (26% versus 8%, p = 0.204) and day 7 (38% versus 19%, p = 0.374) did not differ between groups. Two patients experienced serious adverse events within 6 hours after plasma transfusion. The main limitation of this study is the lack of statistical power to detect a smaller but clinically relevant therapeutic effect of CP, as well as not having confirmed neutralizing antibodies in donor before plasma infusion. Conclusions In the present study, we failed to find evidence of benefit in mortality, length of hospitalization, or mechanical ventilation requirement by immediate addition of CP therapy in the early stages of COVID-19 compared to its use only in case of patient deterioration. Trial registration NCT04375098., Author(s): María Elvira Balcells 1,*, Luis Rojas 2,3, Nicole Le Corre 4,5, Constanza Martínez-Valdebenito 4,5, María Elena Ceballos 1, Marcela Ferrés 4,5, Mayling Chang 6, Cecilia Vizcaya 4, Sebastián Mondaca [...]

Major advances in sequencing technologies and targeted therapies have accelerated the incorporation of oncology into the era of precision medicine and "biomarker-driven" treatments. However, the impact of this approach on the everyday clinic has yet to be determined. Most precision oncology reports are based on developed countries and usually involve metastatic, hard-to-treat or incurable cancer patients. Moreover, in many cases race and ethnicity in these studies is commonly unreported and real-world evidence in this topic is scarce. Herein, we report data from a total of 202 Chilean advanced stage refractory cancer patients. Retrospectively, we collected patient data from NGS tests and IHC in order to determine the proportion of patients that would benefit from targeted treatments. Overall >20 tumor types were included in our cohort and 37% of patients (n = 74) displayed potentially actionable alterations, including on-label, off-label and immune checkpoint inhibitor recommendations. Our findings were in-line with previous reports such as the cancer genome atlas (TCGA). To our knowledge, this is the first report of its kind in Latin America delivering real-world evidence to estimate the percentage of refractory tumor patients that might benefit from precision oncology. Although this approach is still in its infancy in Chile, we strongly encourage the implementation of mutational tumor boards in our country in order to provide more therapeutic options for advanced stage refractory patients. [ABSTRACT FROM AUTHOR]

Background: The first interim analysis of the KEYNOTE-564 study showed improved disease-free survival with adjuvant pembrolizumab compared with placebo after surgery in patients with clear cell renal cell carcinoma at an increased risk of recurrence. The analysis reported here, with an additional 6 months of follow-up, was designed to assess longer-term efficacy and safety of pembrolizumab versus placebo, as well as additional secondary and exploratory endpoints.Methods: In the multicentre, randomised, double-blind, placebo-controlled, phase 3 KEYNOTE-564 trial, adults aged 18 years or older with clear cell renal cell carcinoma with an increased risk of recurrence were enrolled at 213 hospitals and cancer centres in North America, South America, Europe, Asia, and Australia. Eligible participants had an Eastern Cooperative Oncology Group performance status of 0 or 1, had undergone nephrectomy 12 weeks or less before randomisation, and had not received previous systemic therapy for advanced renal cell carcinoma. Participants were randomly assigned (1:1) via central permuted block randomisation (block size of four) to receive pembrolizumab 200 mg or placebo intravenously every 3 weeks for up to 17 cycles. Randomisation was stratified by metastatic disease status (M0 vs M1), and the M0 group was further stratified by ECOG performance status and geographical region. All participants and investigators involved in study treatment administration were masked to the treatment group assignment. The primary endpoint was disease-free survival by investigator assessment in the intention-to-treat population (all participants randomly assigned to a treatment). Safety was assessed in the safety population, comprising all participants who received at least one dose of pembrolizumab or placebo. As the primary endpoint was met at the first interim analysis, updated data are reported without p values. This study is ongoing, but no longer recruiting, and is registered with ClinicalTrials.gov, NCT03142334.Findings: Between June 30, 2017, and Sept 20, 2019, 994 participants were assigned to receive pembrolizumab (n=496) or placebo (n=498). Median follow-up, defined as the time from randomisation to data cutoff (June 14, 2021), was 30·1 months (IQR 25·7-36·7). Disease-free survival was better with pembrolizumab compared with placebo (HR 0·63 [95% CI 0·50-0·80]). Median disease-free survival was not reached in either group. The most common all-cause grade 3-4 adverse events were hypertension (in 14 [3%] of 496 participants) and increased alanine aminotransferase (in 11 [2%]) in the pembrolizumab group, and hypertension (in 13 [3%] of 498 participants) in the placebo group. Serious adverse events attributed to study treatment occurred in 59 (12%) participants in the pembrolizumab group and one (<1%) participant in the placebo group. No deaths were attributed to pembrolizumab.Interpretation: Updated results from KEYNOTE-564 support the use of adjuvant pembrolizumab monotherapy as a standard of care for participants with renal cell carcinoma with an increased risk of recurrence after nephrectomy.Funding: Merck Sharp & Dohme LLC, a subsidiary of Merck & Co, Inc, Rahway, NJ, USA. [ABSTRACT FROM AUTHOR]

In the phase 3 KEYNOTE-564 study (NCT03142334), adjuvant pembrolizumab prolonged disease-free survival (DFS) in patients with clear cell renal cell carcinoma (ccRCC) at increased risk of recurrence after nephrectomy compared with placebo (DFS at 24 months: 77.3% vs 68.1%; hazard ratio [HR] for recurrence or death, 0.68; 95% CI, 0.53-0.87; P=0.002).;Continued DFS improvement with adjuvant pembrolizumab was observed after 30 months of follow-up. Results of a post hoc exploratory analysis of DFS in patient subgroups based on UCLA Integrated Staging System (UISS) risk groups and disease stage are reported. Patients with histologically confirmed ccRCC (pT2, grade 4 or sarcomatoid, N0, M0; pT3 or pT4, any grade, N0, M0; any pT, any grade, N+, M0; or M1 with no evidence of disease [NED]) were randomly assigned 1:1 to receive intravenous pembrolizumab 200 mg or placebo every 3 weeks for up to 17 cycles (∼1 year). DFS was assessed by investigator. UISS risk groups were derived retrospectively from TNM stage, Fuhrman nuclear grade, and Eastern Cooperative Oncology Group performance status (ECOG PS). UISS groups were intermediate risk (pT2, grade 4, N0, M0; pT3, grade 1, N0, M0; or pT3, grades 2-4, N0, M0, ECOG PS of 0), high risk (pT3, grades 2-4, N0, M0, ECOG PS 1; pT4, any grade, N0, M0; or N1, M0), or M1 NED. Other subgroups based on disease stage were also evaluated. Baseline characteristics were generally balanced within subgroups. Median follow-up was 30.1 months (range, 20.8-47.5). Of 994 enrolled patients, most had UISS intermediate risk (n = 732 [73.6%]; pembrolizumab, n = 359; placebo, n = 373); 195 patients (19.6%; pembrolizumab, n = 100; placebo, n = 95) had UISS high risk, and 58 patients (5.8%; pembrolizumab, n = 29; placebo, n = 29) had M1 NED. DFS favored pembrolizumab versus placebo in the UISS intermediate-risk group (HR, 0.65 [95% CI, 0.48-0.88]; 24-month rate: 81.5% vs 72.4%), UISS high-risk group (HR, 0.77 [95%;CI, 0.49-1.20]; 24-month rate: 65.0% vs 55.9%), and M1 NED group (HR, 0.28 [95% CI, 0.12-0.66]; 24-month rate: 78.4% vs 37.9%). DFS favored pembrolizumab versus placebo across all patient subgroups based on disease stage (Table). Consistent with the results of the intention-to-treat (ITT) population, adjuvant pembrolizumab prolonged DFS compared with placebo for all patient subgroups based on UISS risk groups and disease stage. Taken together with results in the ITT population, these results further support the use of adjuvant pembrolizumab as standard of care for patients with RCC at increased risk of recurrence after nephrectomy. ©2023 American Society of Clinical Oncology, Inc. Reused with permission. This abstract was accepted and previously presented at the 2023 Genitourinary Cancers Symposium. All rights reserved. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer is the fifth cause of cancer incidence worldwide. Multidisciplinary approaches that improve the survival are needed. Perioperative chemotherapies show improvement in pathological complete remission (pCR) and overall survival (OS), but less than 50% of the patients completed the chemotherapeutic regimen. The recent 5-fluorouracil, leucovorin, oxaliplatin, docetaxel-4 (FLOT4) study shows OS 50 months and pCR 16.6%, but only 46% of the patients completed pre- and postoperative treatment. This case series report evaluated pCR and safety in patients that received complete preoperative chemotherapeutic with FLOT. Methods: Patients received eight cycles FLOT regimen before surgery. Each cycle comprised 50 mg/m² docetaxel intravenous (iv) on day 1, 85 mg/m² oxaliplatin iv on day 1, 200 mg/m² leucovorin iv on day 1 and 2,600 mg/m² 5-fluorouracil iv in a 24-hour infusion on day 1, every 2 weeks. Results: Fifty-nine patients were evaluated, 58 patients received preoperative cycles. Thirty-one patients received all eight cycles of preoperative therapy. 65.5% patients presented any major adverse event. Thirty-nine patients underwent surgery. Thirty-three biopsy reports were obtained. Six patients (18.2%) presented pCR, 13 patients (39.4%) had no lymph node involvement. OS was 21.32 months. Patients with histology of signet ring carcinoma cells had a shorter survival than other histologies. Conclusion: Total neoadjuvant with FLOT chemotherapy presents an adequate safety profile, a similar pathologic regression rate, and a slightly higher rate of completing treatment to report in perioperative FLOT regimen studies. A prospective clinical study with suitable diagnostic, staging tools and an adequate follow-up may prove total neoadjuvant chemotherapy's efficacy. [ABSTRACT FROM AUTHOR]

Breast cancer is the leading cause of cancer death among women worldwide. While triple-negative breast cancer is less common among various sub-types of breast cancer, it tends to affect younger women and is more aggressive, having a higher rate of early recurrence and mortality compared to other sub-types. We know about the association between triple-negative breast cancer and BRCA mutations, which are highly prevalent in founding populations of European origin, but the true prevalence of these mutations in Latin American populations is unknown. There is also very little information about the demographic and epidemiological aspects of triple-negative breast cancer in Latin America, which we will try to summarise in this article. In addition, we will try to provide a brief introduction to the most common recommendations for treating this histological class in Latin America. [ABSTRACT FROM AUTHOR]

Background: Adjuvant pembrolizumab therapy after surgery for renal-cell carcinoma was approved on the basis of a significant improvement in disease-free survival in the KEYNOTE-564 trial. Whether the results regarding overall survival from the third prespecified interim analysis of the trial would also favor pembrolizumab was uncertain., Methods: In this phase 3, double-blind, placebo-controlled trial, we randomly assigned (in a 1:1 ratio) participants with clear-cell renal-cell carcinoma who had an increased risk of recurrence after surgery to receive pembrolizumab (at a dose of 200 mg) or placebo every 3 weeks for up to 17 cycles (approximately 1 year) or until recurrence, the occurrence of unacceptable toxic effects, or withdrawal of consent. A significant improvement in disease-free survival according to investigator assessment (the primary end point) was shown previously. Overall survival was the key secondary end point. Safety was a secondary end point., Results: A total of 496 participants were assigned to receive pembrolizumab and 498 to receive placebo. As of September 15, 2023, the median follow-up was 57.2 months. The disease-free survival benefit was consistent with that in previous analyses (hazard ratio for recurrence or death, 0.72; 95% confidence interval [CI], 0.59 to 0.87). A significant improvement in overall survival was observed with pembrolizumab as compared with placebo (hazard ratio for death, 0.62; 95% CI, 0.44 to 0.87; P = 0.005). The estimated overall survival at 48 months was 91.2% in the pembrolizumab group, as compared with 86.0% in the placebo group; the benefit was consistent across key subgroups. Pembrolizumab was associated with a higher incidence of serious adverse events of any cause (20.7%, vs. 11.5% with placebo) and of grade 3 or 4 adverse events related to pembrolizumab or placebo (18.6% vs. 1.2%). No deaths were attributed to pembrolizumab therapy., Conclusions: Adjuvant pembrolizumab was associated with a significant and clinically meaningful improvement in overall survival, as compared with placebo, among participants with clear-cell renal-cell carcinoma at increased risk for recurrence after surgery. (Funded by Merck Sharp and Dohme, a subsidiary of Merck; KEYNOTE-564 ClinicalTrials.gov number, NCT03142334.)., (Copyright © 2024 Massachusetts Medical Society.)

On February 24, 2022, a war began within the Ukrainian borders. At least 3.0 million Ukrainian inhabitants have already fled the country. Critical infrastructure, including hospitals, has been damaged. Children with cancer were urgently transported to foreign countries, in an effort to minimize interruption of their life-saving treatments. Most adults did not have that option. War breeds cancer-delaying diagnosis, preventing treatment, and increasing risk. We project that a modest delay in care of only 4 months for five prevalent types of cancer will lead to an excess of over 3,600 cancer deaths in the subsequent years. It is critical that we establish plans to mitigate that risk as soon as possible., Competing Interests: Christian CaglevicConsulting or Advisory Role: MSD, RocheSpeakers' Bureau: MSD, RocheResearch Funding: Merck Sharp & Dohme, Medivation, AstraZeneca, Roche, Astellas Pharma, Bristol Myers Squibb, GlaxoSmithKline, Athenex Christian RolfoConsulting or Advisory Role: Archer, Inivata, Merck Serono, Bristol Myers Squibb, Novartis, Boston Pharmaceuticals, Eisai, Mirati TherapeuticsSpeakers' Bureau: MSD, AstraZeneca, Guardant Health, Roche Molecular DiagnosticsResearch Funding: Lung Cancer Research FoundationTravel, Accommodations, Expenses: AstraZenecaUncompensated Relationships: Guardant Health Ignacio Gil-BazoConsulting or Advisory Role: MSD Oncology, Lilly, AstraZeneca Spain, Bristol Myers Squibb/CelgeneSpeakers' Bureau: MSD Oncology, AstraZeneca, Bristol Myers Squibb/Celgene, Roche, AmgenTravel, Accommodations, Expenses: MSD Oncology, Lilly Andrés CardonaHonoraria: Bristol Myers Squibb, Roche, Boehringer Ingelheim, AbbVie, Merck Sharp & Dohme, CelldexConsulting or Advisory Role: Roche, Merck Sharp & Dohme, Novartis, AstraZeneca, Bristol Myers Squibb, Foundation Medicine, Boehringer Ingelheim, Foundation for Clinical and Applied Cancer Research (FICMAC)Speakers' Bureau: Merck Sharp & Dohme, Roche, Bristol Myers Squibb, Novartis, Foundation for Clinical and Applied Cancer Research (FICMAC), Foundation MedicineTravel, Accommodations, Expenses: Merck Sharp & Dohme, Bristol Myers Squibb, Roche, Boehringer Ingelheim, Foundation Medicine Fred R. HirschConsulting or Advisory Role: AstraZeneca, Genentech, Merck, Bristol Myers Squibb, Novartis, Amgen, Oncocyte, Sanofi/Regeneron, Daiichi Sankyo/UCB Japan, Nectin Therapeutics, Novocure, Blueprint MedicinesPatents, Royalties, Other Intellectual Property: EGFR FISH and IHC for prediction of outcome in patients treated with EGFR inhibitors (Inst)Expert Testimony: Gerson Lehrman Group David R. GandaraHonoraria: Merck, AmgenConsulting or Advisory Role: AstraZeneca (Inst), Guardant Health (Inst), OncoCyte (Inst), IO Biotech (Inst), Roche/Genentech (Inst), Lilly, Novartis, Adagene (Inst), OncoHost (Inst), Ocean Genomics (Inst), Daiichi Sankyo Alliance, SanofiResearch Funding: Merck (Inst), Amgen (Inst), Genentech (Inst), AstraZeneca (Inst) Gilberto MorganConsulting or Advisory Role: Novartis Silvia NovelloConsulting or Advisory Role: SanofiSpeakers' Bureau: AstraZeneca, MSD, Bristol Myers Squibb, Roche, Pfizer, Lilly, Takeda, AbbVie, Boehringer Ingelheim, Bayer, Amgen, Beigene, Novartis, Janssen Marina-Chiara GarassinoHonoraria: MSD Oncology, AstraZeneca/MedImmune, GlaxoSmithKline, Takeda, Roche, Bristol Myers SquibbConsulting or Advisory Role: Bristol Myers Squibb, MSD, AstraZeneca, Novartis, Takeda, Roche, Tiziana Life Sciences, Sanofi, Celgene, Daiiki Sankyo, Inivata, Incyte, Pfizer, Seattle Genetics, Lilly, GlaxoSmithKline, Bayer, Blueprint Medicines, Janssen, RegeneronSpeakers' Bureau: AstraZeneca, Takeda, MSD Oncology, Celgene, Incyte, Roche, Bristol Myers Squibb, Otsuka, LillyResearch Funding: Bristol Myers Squibb (Inst), MSD (Inst), Roche/Genentech (Inst), AstraZeneca/MedImmune (Inst), Pfizer (Inst), GlaxoSmithKline (Inst), Novartis (Inst), Merck (Inst), Incyte (Inst), Takeda (Inst), Spectrum Pharmaceuticals (Inst), Blueprint Medicines (Inst), Lilly (Inst), AstraZeneca (Inst), Ipsen (Inst), Janssen (Inst), Exelixis (Inst), MedImmune (Inst), Sanofi (Inst), Amgen (Inst)Travel, Accommodations, Expenses: Pfizer, Roche, AstraZeneca Giannis MountziosHonoraria: Roche, Boehringer Ingelheim, AstraZeneca, MSD, BMS GmbH & Co KG, Novartis, Amgen, TakedaConsulting or Advisory Role: Roche, Astra Zeneca Greece, MSD, Amgen, Novartis, BMS GmbH & Co KG, TakedaSpeakers' Bureau: AstraZenecaTravel, Accommodations, Expenses: AstraZeneca, Ipsen, MSD, Roche, Novartis, BMS GmbH & Co KG Natasha B. LeighlResearch Funding: Roche Canada (Inst), Guardant Health (Inst), MSD (Inst), EMD Serono (Inst), Lilly (Inst), AstraZeneca Canada (Inst), Takeda (Inst), Amgen (Inst), Bayer (Inst), MSD Oncology (Inst)Travel, Accommodations, Expenses: Merck Sharp & Dohme Oscar ArrietaHonoraria: Pfizer, AstraZeneca, Boehringer Ingelheim, RocheConsulting or Advisory Role: AstraZeneca, Roche, Lilly, Merck, Bristol Myers SquibbResearch Funding: Roche (Inst), BMS (Inst), Merck (Inst), AstraZeneca (Inst)Travel, Accommodations, Expenses: Lilly Alfredo AddeoConsulting or Advisory Role: Roche, AstraZeneca/MedImmune, Bristol Myers Squibb Foundation, MSD Oncology, Pfizer, Novartis, Astellas Pharma, Amgen, LillySpeakers' Bureau: Lilly, AstraZeneca/MedImmuneTravel, Accommodations, Expenses: Roche, Takeda Stephen V. LiuConsulting or Advisory Role: Genentech, Lilly, Bristol Myers Squibb, AstraZeneca, Takeda, Regeneron, Guardant Health, Janssen Oncology, MSD Oncology, Jazz Pharmaceuticals, Blueprint Medicines, Daiichi Sankyo/UCB Japan, BeiGene, Amgen, Turning Point Therapeutics, Elevation Oncology, Novartis, Eisai, Bayer, Gilead Sciences, SanofiResearch Funding: Genentech/Roche (Inst), Pfizer (Inst), Bayer (Inst), Merck (Inst), Blueprint Medicines (Inst), Lilly (Inst), Rain Therapeutics (Inst), Alkermes (Inst), Bristol Myers Squibb (Inst), Turning Point Therapeutics (Inst), RAPT Therapeutics (Inst), Merus (Inst), Elevation Oncology (Inst), Nuvalent, Inc (Inst), Gilead Sciences (Inst)Travel, Accommodations, Expenses: Caris Life Sciences Luis CorralesConsulting or Advisory Role: AstraZeneca, Roche, MSD Oncology, PfizerSpeakers' Bureau: Roche, AstraZeneca, MSD OncologyResearch Funding: RocheTravel, Accommodations, Expenses: Roche, AstraZeneca, MSD Oncology Vivek SubbiahConsulting or Advisory Role: MedImmune, Helsinn Therapeutics, Loxo, R-Pharm, QED TherapeuticsResearch Funding: Novartis (Inst), GlaxoSmithKline (Inst), NanoCarrier (Inst), Northwest Biotherapeutics (Inst), Genentech/Roche (Inst), Berg Pharma (Inst), Bayer (Inst), Incyte (Inst), Fujifilm (Inst), PharmaMar (Inst), D3 Oncology Solutions (Inst), Pfizer (Inst), Amgen (Inst), AbbVie (Inst), Multivir (Inst), Blueprint Medicines (Inst), LOXO (Inst), Vegenics (Inst), Takeda (Inst), Alfasigma (Inst), Agensys (Inst), Idera (Inst), Boston Biomedical (Inst), Inhibrx (Inst), Exelixis (Inst), Turning Point Therapeutics (Inst)Travel, Accommodations, Expenses: PharmaMar, Bayer, Novartis, Helsinn TherapeuticsOther Relationship: Medscape Franz Villarroel-EspindolaConsulting or Advisory Role: Ilico GeneticsResearch Funding: Gebrax-Chile Laboratory & Gebrax Cia Ltda Ricardo MoralesConsulting or Advisory Role: Pfizer Luis RaezResearch Funding: Genentech/Roche (Inst), Merck Serono (Inst), Boehringer Ingelheim (Inst), Novartis (Inst), Pfizer (Inst), Syndax (Inst), Loxo (Inst), Merck (Inst), Bristol Myers Squibb (Inst), Guardant Health (Inst), Heat Biologics (Inst), Amgen (Inst), Calithera Biosciences (Inst), Daiichi Sankyo/UCB Japan (Inst), NantHealth (Inst) Jorge AlatorreHonoraria: Bristol Myers Squibb (Mexico), AstraZeneca, Roche/GenentechConsulting or Advisory Role: MSD Oncology, AstraZeneca, Roche/Genentech, Bristol Myers Squibb, NovartisSpeakers' Bureau: Roche/Genentech, AstraZeneca, MSDTravel, Accommodations, Expenses: AstraZeneca, Roche Edgardo SantosSpeakers' Bureau: Genentech/Roche, Pfizer, Amgen, Boehringer Ingelheim, Merck, Novartis, AstraZeneca, Takeda, Genzyme, Lilly, Astellas Pharma, G1 Therapeutics, Regeneron Luis UbillosHonoraria: Tecnofarma, Fármaco UruguayoConsulting or Advisory Role: Tecnofarma, Roche, Fármaco Uruguayo, PfizerSpeakers' Bureau: Tecnofarma, RocheTravel, Accommodations, Expenses: GlaxoSmithKline, Roche, Pfizer, AstraZeneca, Tecnofarma Daniel S.W. TanHonoraria: Bristol Myers Squibb, Takeda, Novartis, Roche, PfizerConsulting or Advisory Role: Novartis, Merck, Loxo, AstraZeneca, Roche, Pfizer, C4 TherapeuticsResearch Funding: Novartis (Inst), GlaxoSmithKline (Inst), AstraZeneca (Inst)Travel, Accommodations, Expenses: Pfizer, Boehringer Ingelheim, Roche Christoph ZielinskiHonoraria: Athenex, MSD, Roche, AstraZeneca, ImugeneConsulting or Advisory Role: Roche (Inst), Merck Sharp & Dohme (Inst), Imugene, Fibrogen (Inst), AstraZeneca (Inst), Servier (Inst), Athenex, Lilly (Inst), Amgen (Inst), Bristol Myers Squibb (Inst)Research Funding: Pfizer (Inst), Bristol Myers Squibb (Inst), AstraZeneca (Inst), Merck Sharp & Dohme (Inst)Patents, Royalties, Other Intellectual Property: Patent Property, ImugeneNo other potential conflicts of interest were reported.

Background: Patients with renal-cell carcinoma who undergo nephrectomy have no options for adjuvant therapy to reduce the risk of recurrence that have high levels of supporting evidence., Methods: In a double-blind, phase 3 trial, we randomly assigned, in a 1:1 ratio, patients with clear-cell renal-cell carcinoma who were at high risk for recurrence after nephrectomy, with or without metastasectomy, to receive either adjuvant pembrolizumab (at a dose of 200 mg) or placebo intravenously once every 3 weeks for up to 17 cycles (approximately 1 year). The primary end point was disease-free survival according to the investigator's assessment. Overall survival was a key secondary end point. Safety was a secondary end point., Results: A total of 496 patients were randomly assigned to receive pembrolizumab, and 498 to receive placebo. At the prespecified interim analysis, the median time from randomization to the data-cutoff date was 24.1 months. Pembrolizumab therapy was associated with significantly longer disease-free survival than placebo (disease-free survival at 24 months, 77.3% vs. 68.1%; hazard ratio for recurrence or death, 0.68; 95% confidence interval [CI], 0.53 to 0.87; P = 0.002 [two-sided]). The estimated percentage of patients who remained alive at 24 months was 96.6% in the pembrolizumab group and 93.5% in the placebo group (hazard ratio for death, 0.54; 95% CI, 0.30 to 0.96). Grade 3 or higher adverse events of any cause occurred in 32.4% of the patients who received pembrolizumab and in 17.7% of those who received placebo. No deaths related to pembrolizumab therapy occurred., Conclusions: Pembrolizumab treatment led to a significant improvement in disease-free survival as compared with placebo after surgery among patients with kidney cancer who were at high risk for recurrence. (Funded by Merck Sharp and Dohme, a subsidiary of Merck; KEYNOTE-564 ClinicalTrials.gov number, NCT03142334.)., (Copyright © 2021 Massachusetts Medical Society.)

Gastric cancer is a neoplasm with a high incidence and mortality rate in Chile where more than 3000 people die every year from this type of cancer. This study shows the clinical and epidemiological considerations of this disease, information about translational research on this pathology in Chile, the contribution of Chilean doctors to the development of gastric cancer management awareness and the general situation of gastric cancer in Chile.