A study from Singapore showing that each COVID-19 booster protected cancer patients for approximately five months after receiving third and fourth vaccine doses. Interest in the COVID-19 booster in 2023 has waned, and although infection is not as common today, many patients will die due to COVID-19 this year.
A nicely done Spanish study showing that in metastatic NSCLC, asymptomatic patients with brain metastases can have radiation therapy deferred.
Starting with systemic therapy was found to be reasonable and effective, validating a common practice. Patients were treated with atezolizumab + carboplatin + pemetrexed + steroids, and any number of brain mets was allowed as long as they had at least one 10mm in size or greater. This study excluded patients harboring EGFR/ALK driver mutations.
A Phase II basket study looking at tucatinib + trastuzumab in mBTC, only 30 patients were studied as this is a small subpopulation. However, the results were compelling, with an ORR of 47%. For a 3L patient who has failed gem/cis and FOLFONI, this would be a targeted option to consider.
This great Italian study uses eltrombopag in patients with low/intermediate risk MDS. The intervention arm had significantly fewer minor bleeding events and better platelet counts that were durable. Those with higher baseline Hb’s seemed to respond better to therapy, particularly if the Hb was >8g/dL. AML evolution/blast progression was not more common in the treatment arm, which refutes some prior concerns.
A very compelling option to keep an eye out for as larger studies are sure to come in the future. EV + pembrolizumab had an ORR of ~65% with durable responses.
The combo arm had unsurprisingly higher grade 3-4 AE’s. For platinum-ineligible patients, it would be worth considering this regimen even today.
The poor OS of 1.5 years in node-positive patients is striking in this retrospective review of 287 patients treated with definitive intent. The OS was not different between those treated with TURBT + chemoradiation vs. chemotherapy + radical cystectomy, suggesting that surgery may not be superior to multi-modal therapy and QOL may be superior in a non-operative approach.
An interesting study where the authors performed a post hoc analysis of randomized trials using molecular classification of endometrial cancers. There was good evidence to omit RT for those with POLE mutations and def-MMR. There seems to be a higher degree of benefit in those with a p53 mutation.
An interesting study showing that, on average, a cancer patient wastes >$4000 on unused drugs due to discontinuation of oral agents or dose modifications. Allowing a safe recycling method for patients to submit unused drugs could save a lot of wasted healthcare dollars.
The EMPOWER-Lung1 study looked at patients with metastatic NSCLC and PDL1 expression >= 50%, randomized to cemiplimab vs. chemo; no surprise, the benefit was significant in the CPI therapy group. Interestingly, they allow the patients on the CPI arm to have chemo added at the time of progression, which would be a different approach. We should see more results on this as follow-up matures.
The final results from the OVHIPEC1 study confirm a survival benefit in stage III epithelial ovarian cancers. The OS benefit was about 12 months, and the PFS benefit was four months in favor of CRS + HIPEC compared to CRS alone. This should be offered to patients in the context of definitive surgery.
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.
