Clinical Edge Journal Scan

Key clinical point: High rates of sentinel lymph node biopsy (SLNB) and radiotherapy (RT) do not show benefit in older women with early estrogen receptor-positive (ER+) breast cancer.

Major finding: Among all patients, 65.3% received SLNB and 54.4% received adjuvant RT. No association was found between SLNB and locoregional recurrence-free survival (LRFS; P = .71) or disease-free survival (DFS; P = .11). RT showed no association with LRFS (P = .10) or DFS (P = .97).

Study details: A retrospective cohort study of 3,361 consecutive patients aged 70 years or older with early ER+ breast cancer.

Disclosures: This study was funded by UPMC Health Services Division and Shear Family Foundation. The authors declared receiving consulting fees, personal fees and/or research funding outside this work.

Source: Carleton N et al. JAMA Netw Open. 2021 Apr 1. doi: 10.1001/jamanetworkopen.2021.6322.

Key clinical point: High rates of sentinel lymph node biopsy (SLNB) and radiotherapy (RT) do not show benefit in older women with early estrogen receptor-positive (ER+) breast cancer.

Major finding: Among all patients, 65.3% received SLNB and 54.4% received adjuvant RT. No association was found between SLNB and locoregional recurrence-free survival (LRFS; P = .71) or disease-free survival (DFS; P = .11). RT showed no association with LRFS (P = .10) or DFS (P = .97).

Study details: A retrospective cohort study of 3,361 consecutive patients aged 70 years or older with early ER+ breast cancer.

Disclosures: This study was funded by UPMC Health Services Division and Shear Family Foundation. The authors declared receiving consulting fees, personal fees and/or research funding outside this work.

Source: Carleton N et al. JAMA Netw Open. 2021 Apr 1. doi: 10.1001/jamanetworkopen.2021.6322.

Key clinical point: High rates of sentinel lymph node biopsy (SLNB) and radiotherapy (RT) do not show benefit in older women with early estrogen receptor-positive (ER+) breast cancer.

Major finding: Among all patients, 65.3% received SLNB and 54.4% received adjuvant RT. No association was found between SLNB and locoregional recurrence-free survival (LRFS; P = .71) or disease-free survival (DFS; P = .11). RT showed no association with LRFS (P = .10) or DFS (P = .97).

Study details: A retrospective cohort study of 3,361 consecutive patients aged 70 years or older with early ER+ breast cancer.

Disclosures: This study was funded by UPMC Health Services Division and Shear Family Foundation. The authors declared receiving consulting fees, personal fees and/or research funding outside this work.

Source: Carleton N et al. JAMA Netw Open. 2021 Apr 1. doi: 10.1001/jamanetworkopen.2021.6322.

Key clinical point: The addition of oral alisertib to a reduced dose of weekly paclitaxel improves progression-free survival (PFS) compared with paclitaxel alone in patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer.

Major finding: At a median follow-up of 22 months, the median PFS was 10.2 months with paclitaxel plus alisertib vs. 7.1 months with paclitaxel alone (hazard ratio, 0.56; P = .005) in the patients with ER+, HER2-negative disease. Grade 3-4 adverse event rate was higher with paclitaxel plus alisertib vs. paclitaxel alone (84.8% vs. 48.6%).

Study details: A phase 2, open-label, randomized study of 139 patients with metastatic breast cancer who received either paclitaxel or paclitaxel plus alisertib.

Disclosures: The study was supported by a research grant from Takeda Pharmaceuticals. Dr. O’Shaughnessy and Dr. Andorsky declared receiving personal fees, consulting and/or serving on steering committee meetings for various sources.

Source: O'Shaughnessy J et al. JAMA Netw Open. 2021 Apr 20. doi: 10.1001/jamanetworkopen.2021.4103.

Key clinical point: The addition of oral alisertib to a reduced dose of weekly paclitaxel improves progression-free survival (PFS) compared with paclitaxel alone in patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer.

Major finding: At a median follow-up of 22 months, the median PFS was 10.2 months with paclitaxel plus alisertib vs. 7.1 months with paclitaxel alone (hazard ratio, 0.56; P = .005) in the patients with ER+, HER2-negative disease. Grade 3-4 adverse event rate was higher with paclitaxel plus alisertib vs. paclitaxel alone (84.8% vs. 48.6%).

Study details: A phase 2, open-label, randomized study of 139 patients with metastatic breast cancer who received either paclitaxel or paclitaxel plus alisertib.

Disclosures: The study was supported by a research grant from Takeda Pharmaceuticals. Dr. O’Shaughnessy and Dr. Andorsky declared receiving personal fees, consulting and/or serving on steering committee meetings for various sources.

Source: O'Shaughnessy J et al. JAMA Netw Open. 2021 Apr 20. doi: 10.1001/jamanetworkopen.2021.4103.

Key clinical point: The addition of oral alisertib to a reduced dose of weekly paclitaxel improves progression-free survival (PFS) compared with paclitaxel alone in patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer.

Major finding: At a median follow-up of 22 months, the median PFS was 10.2 months with paclitaxel plus alisertib vs. 7.1 months with paclitaxel alone (hazard ratio, 0.56; P = .005) in the patients with ER+, HER2-negative disease. Grade 3-4 adverse event rate was higher with paclitaxel plus alisertib vs. paclitaxel alone (84.8% vs. 48.6%).

Study details: A phase 2, open-label, randomized study of 139 patients with metastatic breast cancer who received either paclitaxel or paclitaxel plus alisertib.

Disclosures: The study was supported by a research grant from Takeda Pharmaceuticals. Dr. O’Shaughnessy and Dr. Andorsky declared receiving personal fees, consulting and/or serving on steering committee meetings for various sources.

Source: O'Shaughnessy J et al. JAMA Netw Open. 2021 Apr 20. doi: 10.1001/jamanetworkopen.2021.4103.

Key clinical point: The detrimental effects of chemotherapy on quality of life (QoL) are significant at 12 months in older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer treated with either chemotherapy plus trastuzumab vs. trastuzumab monotherapy. There was no difference in QoL after 36 months between treatments.

Major finding: At 12 months, the proportion of patients showing QoL deterioration was significantly lower in the trastuzumab monotherapy vs. trastuzumab plus chemotherapy group (19% vs. 38%; P = .009). A significantly higher number of patients showed improvement in QoL with trastuzumab monotherapy at 12 months (43% vs. 25%; P = .021). No difference was reported in any QoL items at 36 months between the 2 treatment groups.

Study details: The QoL analysis of phase 3, randomized RESPECT trial included 231 older patients with HER2-positive breast cancer who received either trastuzumab monotherapy (mean age, 73.9 years) or trastuzumab plus chemotherapy (mean age, 73.7 years).

Disclosures: The analysis was supported by the Comprehensive Support Project for Oncology Research of the Public Health Research Foundation, Japan. The authors received consulting fees, honoraria, and research funding outside this work.

Source: Taira N et al. J Clin Oncol. 2021 Apr 9. doi: 10.1200/JCO.20.02751.

Key clinical point: The detrimental effects of chemotherapy on quality of life (QoL) are significant at 12 months in older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer treated with either chemotherapy plus trastuzumab vs. trastuzumab monotherapy. There was no difference in QoL after 36 months between treatments.

Major finding: At 12 months, the proportion of patients showing QoL deterioration was significantly lower in the trastuzumab monotherapy vs. trastuzumab plus chemotherapy group (19% vs. 38%; P = .009). A significantly higher number of patients showed improvement in QoL with trastuzumab monotherapy at 12 months (43% vs. 25%; P = .021). No difference was reported in any QoL items at 36 months between the 2 treatment groups.

Study details: The QoL analysis of phase 3, randomized RESPECT trial included 231 older patients with HER2-positive breast cancer who received either trastuzumab monotherapy (mean age, 73.9 years) or trastuzumab plus chemotherapy (mean age, 73.7 years).

Disclosures: The analysis was supported by the Comprehensive Support Project for Oncology Research of the Public Health Research Foundation, Japan. The authors received consulting fees, honoraria, and research funding outside this work.

Source: Taira N et al. J Clin Oncol. 2021 Apr 9. doi: 10.1200/JCO.20.02751.

Key clinical point: The detrimental effects of chemotherapy on quality of life (QoL) are significant at 12 months in older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer treated with either chemotherapy plus trastuzumab vs. trastuzumab monotherapy. There was no difference in QoL after 36 months between treatments.

Major finding: At 12 months, the proportion of patients showing QoL deterioration was significantly lower in the trastuzumab monotherapy vs. trastuzumab plus chemotherapy group (19% vs. 38%; P = .009). A significantly higher number of patients showed improvement in QoL with trastuzumab monotherapy at 12 months (43% vs. 25%; P = .021). No difference was reported in any QoL items at 36 months between the 2 treatment groups.

Study details: The QoL analysis of phase 3, randomized RESPECT trial included 231 older patients with HER2-positive breast cancer who received either trastuzumab monotherapy (mean age, 73.9 years) or trastuzumab plus chemotherapy (mean age, 73.7 years).

Disclosures: The analysis was supported by the Comprehensive Support Project for Oncology Research of the Public Health Research Foundation, Japan. The authors received consulting fees, honoraria, and research funding outside this work.

Source: Taira N et al. J Clin Oncol. 2021 Apr 9. doi: 10.1200/JCO.20.02751.

Key clinical point: Pembrolizumab plus eribulin shows activity in patients with heavily pretreated, hormone-receptor–positive (HR+), human epidermal growth factor receptor 2 (HER2)-negative, locally recurrent, or metastatic breast cancer.

Major finding: The clinical benefit rate was 56.8%, and the objective response rate was 40.9%. The median progression-free survival was 6.0 months. The serious adverse event rate was 31.8%, and 25.0% of patients experienced immune-related adverse events.

Study details: Phase 2 study of 44 previously treated patients with HR+, HER-negative, inoperable, locally recurrent breast cancer received pembrolizumab plus eribulin.

Disclosures: The study was supported by MSD Spain. Some of the authors declared receiving consulting fees, honoraria, travel expenses and/or research funding from various sources.

Source: Pérez-García JM et al. Eur J Cancer. 2021 Mar 29. doi: 10.1016/j.ejca.2021.02.028.

Key clinical point: Pembrolizumab plus eribulin shows activity in patients with heavily pretreated, hormone-receptor–positive (HR+), human epidermal growth factor receptor 2 (HER2)-negative, locally recurrent, or metastatic breast cancer.

Major finding: The clinical benefit rate was 56.8%, and the objective response rate was 40.9%. The median progression-free survival was 6.0 months. The serious adverse event rate was 31.8%, and 25.0% of patients experienced immune-related adverse events.

Study details: Phase 2 study of 44 previously treated patients with HR+, HER-negative, inoperable, locally recurrent breast cancer received pembrolizumab plus eribulin.

Disclosures: The study was supported by MSD Spain. Some of the authors declared receiving consulting fees, honoraria, travel expenses and/or research funding from various sources.

Source: Pérez-García JM et al. Eur J Cancer. 2021 Mar 29. doi: 10.1016/j.ejca.2021.02.028.

Key clinical point: Pembrolizumab plus eribulin shows activity in patients with heavily pretreated, hormone-receptor–positive (HR+), human epidermal growth factor receptor 2 (HER2)-negative, locally recurrent, or metastatic breast cancer.

Major finding: The clinical benefit rate was 56.8%, and the objective response rate was 40.9%. The median progression-free survival was 6.0 months. The serious adverse event rate was 31.8%, and 25.0% of patients experienced immune-related adverse events.

Study details: Phase 2 study of 44 previously treated patients with HR+, HER-negative, inoperable, locally recurrent breast cancer received pembrolizumab plus eribulin.

Disclosures: The study was supported by MSD Spain. Some of the authors declared receiving consulting fees, honoraria, travel expenses and/or research funding from various sources.

Source: Pérez-García JM et al. Eur J Cancer. 2021 Mar 29. doi: 10.1016/j.ejca.2021.02.028.

Key clinical point: Long-term data show similar local control rates with 10-Gy intraoperative electron radiotherapy (IOERT) vs. external beam radiotherapy (EBRT).

Major finding: The cumulative risk for in-breast true recurrences at 10 years was 4.3% after IOERT vs. 5.3% after EBRT boost (P = .493). The cumulative risk for out-field local recurrence at 10 years was 7.9% for IOERT vs. 10.3% for EBRT (P = .611).

Study details: Phase 3 randomized study of 245 patients with early-stage breast cancer who underwent breast-conserving surgery with either 10-Gy IOERT or EBRT boost.

Disclosures: An author received a study grant from IntraOp Medical. The authors declared no conflict of interests.

Source: Ciabattoni A et al. Breast Can Res. 2021 Apr 13. doi: 10.1186/s13058-021-01424-9.

Key clinical point: Long-term data show similar local control rates with 10-Gy intraoperative electron radiotherapy (IOERT) vs. external beam radiotherapy (EBRT).

Major finding: The cumulative risk for in-breast true recurrences at 10 years was 4.3% after IOERT vs. 5.3% after EBRT boost (P = .493). The cumulative risk for out-field local recurrence at 10 years was 7.9% for IOERT vs. 10.3% for EBRT (P = .611).

Study details: Phase 3 randomized study of 245 patients with early-stage breast cancer who underwent breast-conserving surgery with either 10-Gy IOERT or EBRT boost.

Disclosures: An author received a study grant from IntraOp Medical. The authors declared no conflict of interests.

Source: Ciabattoni A et al. Breast Can Res. 2021 Apr 13. doi: 10.1186/s13058-021-01424-9.

Key clinical point: Long-term data show similar local control rates with 10-Gy intraoperative electron radiotherapy (IOERT) vs. external beam radiotherapy (EBRT).

Major finding: The cumulative risk for in-breast true recurrences at 10 years was 4.3% after IOERT vs. 5.3% after EBRT boost (P = .493). The cumulative risk for out-field local recurrence at 10 years was 7.9% for IOERT vs. 10.3% for EBRT (P = .611).

Study details: Phase 3 randomized study of 245 patients with early-stage breast cancer who underwent breast-conserving surgery with either 10-Gy IOERT or EBRT boost.

Disclosures: An author received a study grant from IntraOp Medical. The authors declared no conflict of interests.

Source: Ciabattoni A et al. Breast Can Res. 2021 Apr 13. doi: 10.1186/s13058-021-01424-9.

Key clinical point: Sacituzumab govitecan improves survival vs. single-agent chemotherapy in patients with metastatic triple-negative breast cancer (TNBC).

Major finding: Sacituzumab govitecan vs. chemotherapy showed 59% and 52% reduction in the risk for progression and mortality, respectively (P less than .001 for both). The objective response rate was 35% with sacituzumab govitecan and 5% with chemotherapy. Grade 3-4 adverse event rate was 64% and 47% in the sacituzumab govitecan and chemotherapy groups, respectively.

Study details: A phase 3 ASCENT study of patients with relapsed or refractory TNBC, randomly assigned to receive either sacituzumab govitecan or single-agent chemotherapy of physician’s choice.

Disclosures: The study was supported by Immunomedics, a subsidiary of Gilead Sciences. The authors received consulting fees outside this work.

Source: Bardia A et al. New Eng J Med. 2021 Apr 22. doi: 10.1056/NEJMoa2028485.

Key clinical point: Sacituzumab govitecan improves survival vs. single-agent chemotherapy in patients with metastatic triple-negative breast cancer (TNBC).

Major finding: Sacituzumab govitecan vs. chemotherapy showed 59% and 52% reduction in the risk for progression and mortality, respectively (P less than .001 for both). The objective response rate was 35% with sacituzumab govitecan and 5% with chemotherapy. Grade 3-4 adverse event rate was 64% and 47% in the sacituzumab govitecan and chemotherapy groups, respectively.

Study details: A phase 3 ASCENT study of patients with relapsed or refractory TNBC, randomly assigned to receive either sacituzumab govitecan or single-agent chemotherapy of physician’s choice.

Disclosures: The study was supported by Immunomedics, a subsidiary of Gilead Sciences. The authors received consulting fees outside this work.

Source: Bardia A et al. New Eng J Med. 2021 Apr 22. doi: 10.1056/NEJMoa2028485.

Key clinical point: Sacituzumab govitecan improves survival vs. single-agent chemotherapy in patients with metastatic triple-negative breast cancer (TNBC).

Major finding: Sacituzumab govitecan vs. chemotherapy showed 59% and 52% reduction in the risk for progression and mortality, respectively (P less than .001 for both). The objective response rate was 35% with sacituzumab govitecan and 5% with chemotherapy. Grade 3-4 adverse event rate was 64% and 47% in the sacituzumab govitecan and chemotherapy groups, respectively.

Study details: A phase 3 ASCENT study of patients with relapsed or refractory TNBC, randomly assigned to receive either sacituzumab govitecan or single-agent chemotherapy of physician’s choice.

Disclosures: The study was supported by Immunomedics, a subsidiary of Gilead Sciences. The authors received consulting fees outside this work.

Source: Bardia A et al. New Eng J Med. 2021 Apr 22. doi: 10.1056/NEJMoa2028485.

Key clinical point: The clinical presentation of exocrine pancreatic insufficiency (EPI) is probably mild in the early postoperative period following gastric resectional surgery. Thus, routine pancreatic supplementation may not be needed after surgery; however, worsening of EPI symptoms should be carefully monitored.

Major finding: During a mean follow-up of 3 months, none of the patients developed clinically significant steatorrhoea or fat malabsorption in postoperative setting. Incidence of EPI (fecal elastase less than 200 μg/g) following gastric resectional surgery was 33.3%.

Study details: This prospective study included 60 patients who received total or subtotal gastrectomy for adenocarcinoma of the stomach. Pre- and postoperative FE testing was done in 27 patients.

Disclosures: This study was funded by the Internal Fluid research Grant, Christian Medical College, Vellore, India. The authors declared no conflicts of interest.

Source: Sridhar RP et al. Indian J Surg Oncol. 2021 Apr 5. doi: 10.1007/s13193-021-01315-7.

Key clinical point: The clinical presentation of exocrine pancreatic insufficiency (EPI) is probably mild in the early postoperative period following gastric resectional surgery. Thus, routine pancreatic supplementation may not be needed after surgery; however, worsening of EPI symptoms should be carefully monitored.

Major finding: During a mean follow-up of 3 months, none of the patients developed clinically significant steatorrhoea or fat malabsorption in postoperative setting. Incidence of EPI (fecal elastase less than 200 μg/g) following gastric resectional surgery was 33.3%.

Study details: This prospective study included 60 patients who received total or subtotal gastrectomy for adenocarcinoma of the stomach. Pre- and postoperative FE testing was done in 27 patients.

Disclosures: This study was funded by the Internal Fluid research Grant, Christian Medical College, Vellore, India. The authors declared no conflicts of interest.

Source: Sridhar RP et al. Indian J Surg Oncol. 2021 Apr 5. doi: 10.1007/s13193-021-01315-7.

Key clinical point: The clinical presentation of exocrine pancreatic insufficiency (EPI) is probably mild in the early postoperative period following gastric resectional surgery. Thus, routine pancreatic supplementation may not be needed after surgery; however, worsening of EPI symptoms should be carefully monitored.

Major finding: During a mean follow-up of 3 months, none of the patients developed clinically significant steatorrhoea or fat malabsorption in postoperative setting. Incidence of EPI (fecal elastase less than 200 μg/g) following gastric resectional surgery was 33.3%.

Study details: This prospective study included 60 patients who received total or subtotal gastrectomy for adenocarcinoma of the stomach. Pre- and postoperative FE testing was done in 27 patients.

Disclosures: This study was funded by the Internal Fluid research Grant, Christian Medical College, Vellore, India. The authors declared no conflicts of interest.

Source: Sridhar RP et al. Indian J Surg Oncol. 2021 Apr 5. doi: 10.1007/s13193-021-01315-7.

Key clinical point: Exogenous digestive enzyme replacement was associated with increased weight gain and head circumference growth in very low birth weight preterm infants with growth failure and signs and symptoms of exocrine pancreatic insufficiency (EPI).

Major finding: Average daily weight gain increased from 14.4 g/kg/day to 17.4 g/kg/day (P = .001) and head circumference growth rate increased from 0.74 cm/week to 0.95 cm/week (P = .028) during 2 weeks following administration of digestive enzyme replacement.

Study details: This was a retrospective study of 132 preterm infants with gestational age below 2 weeks and birth weight below 1250 g who survived for more than 14 days. Growth restriction despite intensified nutrition and poor exocrine pancreatic function was observed in 66 and 38 infants, respectively, of which 33 infants recieved exogenous digestive enzyme replacement.

Disclosures: No specific funding source was identified. Open Access was funded by ProjektDEAL. The authors declared no conflicts of interest.

Source: Münch A et al. Eur J Pediatr. 2021 Apr 10. doi: 10.1007/s00431-021-04069-0.

Key clinical point: Exogenous digestive enzyme replacement was associated with increased weight gain and head circumference growth in very low birth weight preterm infants with growth failure and signs and symptoms of exocrine pancreatic insufficiency (EPI).

Major finding: Average daily weight gain increased from 14.4 g/kg/day to 17.4 g/kg/day (P = .001) and head circumference growth rate increased from 0.74 cm/week to 0.95 cm/week (P = .028) during 2 weeks following administration of digestive enzyme replacement.

Study details: This was a retrospective study of 132 preterm infants with gestational age below 2 weeks and birth weight below 1250 g who survived for more than 14 days. Growth restriction despite intensified nutrition and poor exocrine pancreatic function was observed in 66 and 38 infants, respectively, of which 33 infants recieved exogenous digestive enzyme replacement.

Disclosures: No specific funding source was identified. Open Access was funded by ProjektDEAL. The authors declared no conflicts of interest.

Source: Münch A et al. Eur J Pediatr. 2021 Apr 10. doi: 10.1007/s00431-021-04069-0.

Key clinical point: Exogenous digestive enzyme replacement was associated with increased weight gain and head circumference growth in very low birth weight preterm infants with growth failure and signs and symptoms of exocrine pancreatic insufficiency (EPI).

Major finding: Average daily weight gain increased from 14.4 g/kg/day to 17.4 g/kg/day (P = .001) and head circumference growth rate increased from 0.74 cm/week to 0.95 cm/week (P = .028) during 2 weeks following administration of digestive enzyme replacement.

Study details: This was a retrospective study of 132 preterm infants with gestational age below 2 weeks and birth weight below 1250 g who survived for more than 14 days. Growth restriction despite intensified nutrition and poor exocrine pancreatic function was observed in 66 and 38 infants, respectively, of which 33 infants recieved exogenous digestive enzyme replacement.

Disclosures: No specific funding source was identified. Open Access was funded by ProjektDEAL. The authors declared no conflicts of interest.

Source: Münch A et al. Eur J Pediatr. 2021 Apr 10. doi: 10.1007/s00431-021-04069-0.

Key clinical point: Exocrine pancreatic function appeared normal in critically ill children during the first week of admission to the pediatric intensive care unit (PICU).

Major finding: Fecal elastase-1 concentrations were normal (1-2 μg/g; n=10). Mean amylase levels on admission and PICU discharge were 13 (interquartile range [IQR], 6.5-41.5) U/L and 15.5 (IQR, 7-44) U/L, respectively. Mean lipase levels on admission and at PICU discharge were 11 (IQR, 6.8-19.5) U/L and 16.5 (IQR, 12.3-36.8) U/L, respectively.

Study details: Findings are from a prospective observational study that included 15 critically ill children (median age, 5 months) admitted to PICU (median stay, 15 days) at a tertiary hospital in Madrid, Spain.

Disclosures: No specific funding source was identified. The authors did not report any disclosures.

Source: Solana Garcia MJ et al. Pedia Crit Care Med. 2021 Mar doi: 10.1097/01.pcc.0000738960.34833.ce.

Key clinical point: Exocrine pancreatic function appeared normal in critically ill children during the first week of admission to the pediatric intensive care unit (PICU).

Major finding: Fecal elastase-1 concentrations were normal (1-2 μg/g; n=10). Mean amylase levels on admission and PICU discharge were 13 (interquartile range [IQR], 6.5-41.5) U/L and 15.5 (IQR, 7-44) U/L, respectively. Mean lipase levels on admission and at PICU discharge were 11 (IQR, 6.8-19.5) U/L and 16.5 (IQR, 12.3-36.8) U/L, respectively.

Study details: Findings are from a prospective observational study that included 15 critically ill children (median age, 5 months) admitted to PICU (median stay, 15 days) at a tertiary hospital in Madrid, Spain.

Disclosures: No specific funding source was identified. The authors did not report any disclosures.

Source: Solana Garcia MJ et al. Pedia Crit Care Med. 2021 Mar doi: 10.1097/01.pcc.0000738960.34833.ce.

Key clinical point: Exocrine pancreatic function appeared normal in critically ill children during the first week of admission to the pediatric intensive care unit (PICU).

Major finding: Fecal elastase-1 concentrations were normal (1-2 μg/g; n=10). Mean amylase levels on admission and PICU discharge were 13 (interquartile range [IQR], 6.5-41.5) U/L and 15.5 (IQR, 7-44) U/L, respectively. Mean lipase levels on admission and at PICU discharge were 11 (IQR, 6.8-19.5) U/L and 16.5 (IQR, 12.3-36.8) U/L, respectively.

Study details: Findings are from a prospective observational study that included 15 critically ill children (median age, 5 months) admitted to PICU (median stay, 15 days) at a tertiary hospital in Madrid, Spain.

Disclosures: No specific funding source was identified. The authors did not report any disclosures.

Source: Solana Garcia MJ et al. Pedia Crit Care Med. 2021 Mar doi: 10.1097/01.pcc.0000738960.34833.ce.

Key clinical point: Lipomatous pseudohypertrophy (LPH) of the pancreas is a rare disease with varied clinical presentation and different signs and symptoms. It could be a cause of exocrine pancreatic insufficiency (EPI) and thus requires patient follow-up and appropriate treatment.

Major finding: LPH of pancreas was diagnosed in a 26-year-old man under evaluation. Computed tomography scan and magnetic resonance imaging showed a diffusely enlarged pancreas with scattered remnants of pancreatic parenchyma. Pancreatic exocrine and endocrine functions were maintained as pockets of pancreatic parenchyma were preserved. The patient was discharged with an advice for regular follow-ups.

Study details: Findings are from analysis of a 26-year-old man admitted to hospital with loss of appetite for 6 months.

Disclosures: No specific funding source was identified. The authors declared no conflicts of interest.

Source: Luu VD et al. Radiology Case Reports. 2021 Apr 9. doi: 10.1016/j.radcr.2021.03.045.

Key clinical point: Lipomatous pseudohypertrophy (LPH) of the pancreas is a rare disease with varied clinical presentation and different signs and symptoms. It could be a cause of exocrine pancreatic insufficiency (EPI) and thus requires patient follow-up and appropriate treatment.

Major finding: LPH of pancreas was diagnosed in a 26-year-old man under evaluation. Computed tomography scan and magnetic resonance imaging showed a diffusely enlarged pancreas with scattered remnants of pancreatic parenchyma. Pancreatic exocrine and endocrine functions were maintained as pockets of pancreatic parenchyma were preserved. The patient was discharged with an advice for regular follow-ups.

Study details: Findings are from analysis of a 26-year-old man admitted to hospital with loss of appetite for 6 months.

Disclosures: No specific funding source was identified. The authors declared no conflicts of interest.

Source: Luu VD et al. Radiology Case Reports. 2021 Apr 9. doi: 10.1016/j.radcr.2021.03.045.

Key clinical point: Lipomatous pseudohypertrophy (LPH) of the pancreas is a rare disease with varied clinical presentation and different signs and symptoms. It could be a cause of exocrine pancreatic insufficiency (EPI) and thus requires patient follow-up and appropriate treatment.

Major finding: LPH of pancreas was diagnosed in a 26-year-old man under evaluation. Computed tomography scan and magnetic resonance imaging showed a diffusely enlarged pancreas with scattered remnants of pancreatic parenchyma. Pancreatic exocrine and endocrine functions were maintained as pockets of pancreatic parenchyma were preserved. The patient was discharged with an advice for regular follow-ups.

Study details: Findings are from analysis of a 26-year-old man admitted to hospital with loss of appetite for 6 months.

Disclosures: No specific funding source was identified. The authors declared no conflicts of interest.

Source: Luu VD et al. Radiology Case Reports. 2021 Apr 9. doi: 10.1016/j.radcr.2021.03.045.