https://repository.monashhealth.org/monashhealthjspui/handle/1/42663 Tue, 26 May 2026 11:56:09 GMT 2026-05-26T11:56:09Z https://repository.monashhealth.org/monashhealthjspui/handle/1/58210 Title: Circulating tumor DNA (ctDNA) analysis guiding adjuvant therapy in patients (pts) with colorectal cancer (CRC): Impact on fear of cancer recurrence (FCR). Authors: McLachlan S.-A.; Mostafa R.; Sharpe L.; Burge M.E.; Day F.; Blum R.h.; Campbell R.; Lynam J.F.; Lee B.; Singh M.S.; Lee M.; Chantrill L.A.; Lundy J.; Wong Z.W.; Wong R.; Joshi S.; Saqib A.; Karikios D.J.; Gibbs P.; Tie J. Abstract: 11125Background: ctDNA detection following curative intent treatment is highly prognostic, with potential to impact patient fear of cancer recurrence (FCR). In 3 separate randomized trials (DYNAMIC II, III, rectal), pts with early-stage CRC were randomly assigned to treatment decision guided by ctDNA results (adjuvant chemotherapy escalation if ctDNA positive, de-escalation or no treatment if ctDNA negative), or according to standard clinicopathological features. The relationship between being informed of a high recurrence risk, or treatment de-escalation, and FCR is unclear. This study aims to explore the relationship between biomarker-informed adjuvant chemotherapy (ACT) decision making and FCR, including changes over time. Method(s): A subset of pts from the 3 DYNAMIC studies completed validated self-report questionnaires measuring FCR, anxiety, depression and quality of life. Data were collected at three time points: after surgery (T1), at the time of the ACT decision (T2), and 9-12 months later (T3). Pts randomized to the ctDNA-guided group received a ctDNA test result (positive or negative) at T2, while those in the standard of care (SOC) group did not. The primary endpoint was the FCR Inventory Short Form score (FCRI-SF). FCR patterns over time were analyzed using a mixed model 2 (Randomization) x 3 (Time) ANCOVA. A 2 (Randomization) x 2 (Chemotherapy Status) ANCOVA was used to assess ACT's impact on FCR at follow-up. Gender, age, and cancer stage were included as covariates. Result(s): 317 pts from 35 Australian sites participated in the FCR substudy (74% response rate for all timepoints). Two-thirds were male, and the mean age was 60 years. Of the ctDNA-guided group (n=176), 73% had a negative ctDNA result. At baseline, 63% of patients exhibited clinically significant levels of FCR (FCRI-SF >13). Younger age, female gender, anxiety, and higher cancer stage all predicted higher baseline FCR. FCR significantly decreased over time for all pts (F(2, 176) = 3.64, p =.03). This reduction was more pronounced in the ctDNA-guided group compared to the SOC group (F(2, 176) = 3.83; p =.02), although the effect size was small (Cohen's d =0.24). In the ctDNA-guided group, no differences in FCR were found between pts based on ctDNA result (positive vs. negative). High baseline anxiety was the only independent predictor of FCR at 12 months. Chemotherapy receipt, cancer stage, depression, and quality of life scores were not predictive of FCR over time. Conclusion(s): In pts with early-stage CRC, neither a positive nor negative ctDNA result impacted FCR. ctDNA-guided approach to determining ACT was associated with a greater reduction in FCR over time compared to SOC. This biomarker-guided treatment approach has potential to improve ACT selection as well as psychosocial outcomes. Temporal reduction in FCR is likely driven by increased prognostic certainty over time. Clinical trial information: 12615000381583.Copyright © 2025 by American Society of Clinical Oncology Thu, 23 Apr 2026 00:00:00 GMT https://repository.monashhealth.org/monashhealthjspui/handle/1/58210 2026-04-23T00:00:00Z https://repository.monashhealth.org/monashhealthjspui/handle/1/58209 Title: IBI354 (anti-HER2 antibody-drug conjugate [ADC]) in patients (pts) with HER2-positive breast cancer (BC) and other solid tumors: Updates from a phase 1 study. Authors: Lemech C.R.; Sun Y.; Nagrial A.; Wu X.; Morris M.F.; Ning F.; Yang J.; Pan Y.; Cai J.; Lu P.; Zhang T.; Qiu F.; Hu C.; Zhang M.; Liu Z.; Han G.; Nie J.; Teng C.; Zhou H.; Day D. Abstract: 1029Background: HER2 has been established as an important therapeutic target for BC. IBI354 consists of trastuzumab (anti-HER2 antibody) conjugated to a camptothecin derivative. In a global, multicenter, phase 1 study, IBI354 was well tolerated and showed promising efficacy in BC and other solid tumors (2024 ESMO 345MO/720MO/576P). Here, we report updated safety and efficacy of IBI354. Method(s): Eligible pts with advanced solid tumors who had failed or were intolerant to standard treatment were enrolled. Positive HER2 was defined as immunohistochemistry (IHC) 2+/in situ hybridization (ISH)+ or IHC 3+. IBI354 was administered intravenously at 6-15 mg/kg Q3W or Q2W. Primary endpoint was safety. Secondary endpoints were objective response rate (ORR), disease control rate (DCR), duration of response (DoR) and progress-free survival (PFS) assessed by investigators per RECIST v1.1 and overall survival (OS). Result(s): As of Nov 12, 2024, a total of 368 pts with solid tumors were enrolled in China and Australia (females: 89.4%, median age: 56.0 years [range: 27-82], ECOG PS 1: 75.0%). Median follow-up time was 11.3 months (range: 5-19). Median treatment duration was 25.0 weeks (range: 3.1-63.3) and 124 (33.7%) pts remain on treatment. Treatment-related adverse events (TRAEs) occurred in 331 (89.9%) pts while >=grade 3 (G3) TRAEs occurred in 93 (25.3%) pts. Most common TRAEs included white blood cell count decreased (48.6%, with 7.1% >=G3), anemia (46.7%, with 4.9% >=G3), nausea (46.2%, with 0.8% >=G3) and neutrophil count decreased (38.3%, with 9.8% >=G3). Interstitial lung disease occurred in 8 (2.2%) pts (5 treatment-related and 3 treatment-unrelated, all G1-2). TRAEs led to dose reduction in 5 (1.4%) pts and treatment discontinuation in 4 (1.1%) pts. No TRAE led to death. Efficacy was evaluable in 88 pts with HER2-positive BC (stage IV: 97.7%; prior systemic therapy regimens>=5: 65.9%; IHC 2+/ISH+: 19.3%, IHC 3+: 80.7%). The overall confirmed ORR was 58.0% (95% CI: 47.0-68.4) and DCR was 90.9% (95% CI: 82.9-96.0). Among 51 pts with confirmed responses, median DoR was not reached (events rate: 19.6%) and 12-month DoR rate of 71.8% (95% CI: 52.9-84.2). Median PFS was not reached with events rate of 37.5%. Median OS was not reached with events rate of 5.7% and 9-month OS rate of 96.2% (95% CI: 88.7-98.8). Conclusion(s): IBI354 continues to demonstrate favorable safety profiles with no new safety signals. Encouraging efficacy was observed in HER2-positive BC. Clinical trial information: NCT05636215.Copyright © 2025 by American Society of Clinical Oncology Thu, 23 Apr 2026 00:00:00 GMT https://repository.monashhealth.org/monashhealthjspui/handle/1/58209 2026-04-23T00:00:00Z https://repository.monashhealth.org/monashhealthjspui/handle/1/58176 Title: Embedding imaging within emergency: A satellite model for enhanced patient-centred care. Authors: Ardley N. Abstract: In order to improve efficiency and meet rising demand for emergency-referred imaging examinations, a new satellite imaging department has been established within the emergency department (ED) of a major metropolitan hospital. This initiative was designed to improve access and responsiveness for emergency patients requiring X-ray, CT and ultrasound services. The project involved relocating emergency imaging from the central medical imaging department to a dedicated ED-based facility, exclusively serving emergency presentations. This separation from inpatient and outpatient workflows allows imaging staff the ability to focus exclusively on emergency cases. This has led to improved responsiveness and reduced delays. Existing ordering and procedural workflows remain unchanged with the only change being the physical location of service delivery. The dedicated imaging space within the ED allows timely access to diagnostics with minimal interference from broader hospital demand, ensuring critically unwell patients can be imaged promptly without leaving the ED environment. Preliminary data comparing turnaround times before and after implementation show a notable improvement in general X-ray services, with up to a 16% reduction in time to scan. CT turnaround times also improved, particularly during business hours, though gains were less consistent overnight. The results highlight the value of infrastructure changes in improving efficiency and patient care. Locating imaging within the ED has streamlined the imaging service, enabling faster access for clinical teams and improving the overall patient experience in emergency care. Tue, 28 Apr 2026 00:00:00 GMT https://repository.monashhealth.org/monashhealthjspui/handle/1/58176 2026-04-28T00:00:00Z https://repository.monashhealth.org/monashhealthjspui/handle/1/58171 Title: Constructing a collaborative education culture: First-year achievements of a radiology education team. Authors: Monsour L. Abstract: Introduction: In 2024, we identified a need for enhanced education, consistency and upskilling across our network. To address this, a collaborative education team was established, uniting modality-specific educators to strengthen clinical learning, professional development and staff engagement across a large tertiary service. Objective(s): To outline the implementation and impact of the imaging education team, with emphasis on achievements within the general and fluoroscopy education stream. Method(s): A multi-modality approach was adopted to create a cohesive framework for education delivery. Initiatives included comprehensive updates to training manuals and resources, structured CPD programs, cross-modality workshops and communication tools to connect staff and promote a culture that encourages engagement in education and continuous learning. Result(s): Since the team's formation, several outcomes have been achieved: * a department-wide newsletter was introduced to share updates, achievements and learning opportunities * a multi-modality workshop series was established, fostering collaboration across imaging disciplines and providing accessible CPD opportunities * within the general/fluoroscopy stream, extensive resources were created, including detailed training manuals, structured CPD calendars and competency tools. These initiatives led to a measurable increase in CPD participation, improved accessibility of educational materials, and stronger engagement across the department. Conclusion(s): The creation of the imaging education team has strengthened educational consistency, engagement, and collaboration across modalities. While there are still many areas to develop and improve, the structured approach and resource development within the general/fluoroscopy area have contributed to a sustainable culture of learning and professional excellence within a large tertiary network. Tue, 28 Apr 2026 00:00:00 GMT https://repository.monashhealth.org/monashhealthjspui/handle/1/58171 2026-04-28T00:00:00Z