Neoadjuvant Pembro+chemo followed by surgery and adjuvant pembro had a superior PFS and pCR rate compared to neoadjuvant chemo followed by surgery. PCR rates were 30 vs. 11%, and PFS rates at 24 months were 62 vs. 41%, in the chemoIO vs. chemo alone groups, respectively. Still, OS was not significantly different, and this has yet to make it onto NCCN.
The ADAURA trial reported its 5-year data at the plenary session of ASCO. No surprise, given the 3-year data was very compelling, adjuvant Osimertinib should be considered SOC for EGFR-mutated stage IB – IIIA NSCLC patients.
Capivasertib + fulvestrant was superior to fulvestrant alone in HR+ MBC with prior failure of AI with or without a CDK4/6 inhibitor. This is an AKT-pathway inhibitor; main SEs were rash and diarrhea in the experimental arm. Combo to keep in mind for the future, yet to be approved by the FDA.
Nice, targeted option to consider in an otherwise limited therapeutic menu. It should be considered in patients with grade 2 glioma who have disease progression after surgery and could be pursued off-label in higher-grade cases with a positive IDH mutation. SEs were like other IDH inhibitors.
Large phase III study of carbo/taxol+pembro x 6 followed by pembro alone x 14 cycles in metastatic endometrial cancer. There was a benefit in both pMMR and dMMR patients, although the magnitude was unsurprisingly higher in those with dMMR. OS results are still pending, and carcinosarcoma-type histology was excluded. This combination has been approved and is on NCCN as a cat-1 recommendation.
Large phase III study showing short-term ADT + EBRT did not show an improvement in OS compared to EBRT alone. There was an improvement in PSA failure, metastasis rates and prostate cancer-related deaths. If used, SADT+EBRT should be highly individualized, preferably in patients with longer life expectancies and higher SE risk tolerance.
Benign heme article of the month– A significant portion of patients with stable platelet counts can be gently tapered from TPO-agonists. Those who needed to be re-challenged had a good response. This is likely an underutilized strategy.
Retrospective review showing equivocal outcomes in cT2-T4N0 patients treated with radical cystectomy vs TURBT + chemoradiation. There were similar rates of neoadjuvant chemotherapy being given in both groups. Based on prospective data, the SOC remains cisplatin-based neoadjuvant chemo followed by radical cystectomy; however, trimodality therapy may not have worse outcomes, and it would be great to see a prospective head-to-head study.
The NADIM-II study looked at perioperative Nivo+chemo vs. chemo alone in stIIIA – stIIIB NSCLC. High pCR rates with chemoIO are again seen, as in the Checkmate 816 and NADIM-I study, they were even higher in this cohort (37%), suggesting higher-stage patients derive the biggest benefit from neoadjuvant chemoIO. Pretty impressive results, however, I still must point out that this was a phase II study with a small sample size, OS benefits have not been demonstrated and this has yet to make it on to NCCN.
FCS Hematology Oncology Review creates a platform for our physician network to observe the most recent articles and studies available in the oncology and hematology world. By sharing these articles we are building our wealth of knowledge of new observations and treatments as they come available.
