A Collection of Hematology & Oncology Articles
The practice of oncology and hematology is in constant evolution. These articles highlight some of the most notable advancements and discoveries in the modern medical world. We invite you to use this site frequently and collaborate with medical professionals across the globe.
Welcome
At Florida Cancer Specialists & Research Institute (FCS), our physicians and advanced practice providers are deeply vested in clinical research to provide the most cutting-edge treatment options available to our patients. In our own practices we are fortunate to offer over 300 clinical trials across 37 locations including 3 dedicated Phase 1 Drug Development Units. We value every opportunity to share best practices and the latest research both within and outside of our institution. We welcome you to use this collection as a resource to support your own research and understanding as we strive together to advance cancer care one step at a time.
Recent Articles
Ibrutinib for early-stage CLL: genetic risk factors and treatment outcome in the GCLLSG CLL12 trial
Patients with high-risk asymptomatic early-stage CLL (del(17p) or mutated TP53) do not derive an EFS benefit from early ibrutinib treatment. Watch-and-wait remains standard for early-stage CLL regardless of genetic subgroup; genetic test findings must not prompt early treatment
Low-Dose Tamoxifen in Noninvasive Breast Neoplasia: Long-Term Results From an Individual-Participant Data Pooled Analysis
Among 1,545 women included with a median follow-up of 9.4 years in postmenopausal women, breast cancer events occurred in 40 of 335 receiving low-dose tamoxifen versus 93 of 401 controls HR, 0.51, with a 10-year absolute reduction of 11.2%. Among premenopausal women, no significant reduction was observed dose was 5mg daily of 10mg every other day in ductal carcinoma in situ (DCIS) and high-risk pts. Less is as good.
Reduced/No Dexamethasone With Netupitant/Palonosetron and Olanzapine for Chemotherapy‑Induced Nausea/Vomiting in Highly Emetogenic Chemotherapy: Phase III Noninferiority Trial
This is a practical, easy-to-adopt result. In 644 patients on highly emetogenic chemotherapy, all getting NEPA plus olanzapine, a single 6 mg day-1 dex dose or no dex at all was noninferior to the standard 4-day course (complete response 72%, 72%, and 70%), with clearly less insomnia, hiccups, anxiety, and reflux. The day-1-only arm is the sweet spot, since going fully dex-free cost some early nausea control over days 1 to 3 before catching up. Caveats: it was open-label, only 6% were on concurrent immunotherapy, and the high-dose cisplatin subgroup was small, but for most of our HEC patients, olanzapine plus one day of dex looks like plenty.
Daraxonrasib for Previously Treated RAS-Mutant Non–Small-Cell Lung Cancer
This feels like the first real crack in the "undruggable" non-G12C RAS wall in lung cancer: a pan-RAS(ON) inhibitor with responses across G12D, G12V, and other alleles in patients who had already received platinum and immunotherapy. At the 160–220 mg range (the phase 3 dose is 200 mg), patients who hadn't yet received docetaxel had a 42% response rate, median progression-free survival (PFS) of 8 mos, and median overall survival (OS) of 16 mos, which looks well ahead of what we expect from docetaxel, though that's a cross-trial comparison. The catch is tolerability: about half had grade 3 or higher events, 9 in 10 got rash, and most got diarrhea, so rash prophylaxis and proactive GI management will matter just as it does on PDAC. The randomized RASolve 301 trial against docetaxel is the one to watch before this moves into practice.
Mosunetuzumab With Response-Adapted Polatuzumab Vedotin and Obinutuzumab in Untreated Indolent B-Cell Non-Hodgkin Lymphoma
This is a really encouraging look at chemo-free frontline therapy for symptomatic or high-burden FL and MZL. Eight cycles of mosunetuzumab alone produced a 71% complete response (CR) rate, escalation to pola-obinutuzumab for PET-positive patients pushed CR to 86%, and 2-year progression-free survival (PFS) was 89% with no maintenance. Toxicity was impressively outpatient-friendly: CRS was all grade 1, no one needed tocilizumab, and there was no immune effector cell–associated neurotoxicity syndrome (ICANS), though the shingles and HSV reactivations make a good case for antiviral prophylaxis. It's a small single-center study with two CD20-negative relapses to keep in mind, but the ctDNA–PET concordance hints at an MRD-guided "treat less when you can" future.
Outbreak of Severe Methemoglobinemia during Maritime Migration
This is a fascinating toxicology detective story with real hematology lessons. Among 82 mostly young male migrants arriving in Lampedusa, median methemoglobin was 45% (43% were at 50% or higher), and the culprit was dermal absorption of N-methylaniline, a gasoline additive, from fuel-contaminated seawater pooling in the boats. Our takeaway is the delayed hemolysis: it hit most patients with available data around days 2 to 4 (up to day 7), every patient with transfusion data needed blood, 4 had splenic rupture, and G6PD deficiency turned up in 16 of 44 tested. It's a good reminder that antidotes only work if they are on the shelf.
Phase 1 Study of Anito-cel, a d-Domain BCMA CAR T Cell for Refractory or Recurrent Myeloma
These are very compelling phase 1 numbers in a heavily pretreated, all triple-class–refractory population. All 38 patients responded, 79% had a complete response, median progression-free survival (PFS) was 30 mos, and 3-year overall survival (OS) was 65%. The safety profile is the real headline: at the recommended dose there was no grade 3 or higher CRS, only one grade 3 immune effector cell–associated neurotoxicity syndrome (ICANS), and none of the delayed parkinsonism, cranial-nerve palsies, or colitis we’ve learned to watch for with cilta-cel. That said, it’s a small single-arm study, and the “cleaner binder” comparison to cilta-cel is in vitro and hypothesis-generating, so the iMMagine phase 2/3 data will tell us whether this truly earns a spot ahead of cilta-cel.
Colonoscopy Intervals and Colorectal Cancer Incidence after Adenoma Removal
This one could reshape post-polypectomy surveillance. In nearly 11,000 patients with high-risk adenomas, waiting 5 years instead of 3 for the first surveillance colonoscopy was noninferior for colorectal cancer incidence (under 1% in both arms), with no apparent shift toward later-stage disease and roughly half as many colonoscopies. The 3-year arm picked up more advanced adenomas (15% vs 11%), but that didn't translate into fewer or earlier cancers. Caveats: this is an interim analysis that only narrowly met noninferiority, and only about two-thirds of patients completed 5-year surveillance, so the 10-year data will be the real test before guidelines move.
FCS Physician Focus
Plasma Proteome–Based Test for First-Line Treatment Selection in Metastatic Non–Small Cell Lung Cancer
FCS medical oncologist and hematologist Ernesto Bustinza-Linares, MD has co-authored an abstract published in the American Society of Clinical Oncology Journal, JCO Precision Oncology, that uncovers a new testing method to determine personalized care options for patients with metastatic non-small cell lung cancer (NSCLC). The abstract’s authors address the limitations of existing guidelines that recommend checkpoint immunotherapy, sometimes in combination with chemotherapy, for treating NSCLC, which often discounts patient variability and immune factors. The findings from the study show that by incorporating additional plasma proteome-based testing, combined with the standard protein inhibitor testing, clear differences in patient outcomes were observed after applying targeted treatments based on the testing results.
Florida Cancer Specialists & Research Institute