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Mindfulness and Tai Chi for Cancer Health (MATCH) Study: Primary Outcomes of a Preference-Based Multisite Randomized Comparative Effectiveness Trial

July 1, 2025

The MATCH study was a large, pragmatic, preference-based, multisite RCT comparing Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ) in distressed cancer survivors. Both MBCR and TCQ significantly improved mood disturbance (POMS TMD) compared to waitlist, with the largest effect size for MBCR vs waitlist (0.44) and a significant reduction for TCQ vs waitlist (estimate –5.13; 95% CI, –9.44 to –1.23; P = .01). MBCR had the greatest impact on tension, anger, and vigor, while TCQ was most effective for anger, depression, and vigor; subgroup analysis showed women benefited more from MBCR, and younger or advanced-stage patients benefited more from TCQ. In short, both MBCR and TCQ are viable, evidence-based options for improving mood in our cancer survivors, and it doesn’t seem to matter whether patients choose their intervention or are randomized—everyone does better than waitlist. These are probably underutilized in our communities and more widely available than appreciated.

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Acalabrutinib Plus Bendamustine-Rituximab in Untreated Mantle Cell Lymphoma

July 1, 2025

The phase III ECHO trial evaluated acalabrutinib + bendamustine-rituximab (A+BR) vs placebo + BR in previously untreated mantle cell lymphoma (MCL) patients ≥65 years, showing a significant improvement in progression-free survival (PFS) (66.4 vs 49.6 months) with A+BR, including in high-risk subgroups. Objective response rate (ORR)/complete response (CR) rates were higher with A+BR (91.0%/66.6% vs 88.0%/53.5%), but overall survival (OS) was not significantly different (HR 0.86). Grade ≥3 adverse events (AEs) were similar between arms (88.9% vs 88.2%), with more COVID-19–related events in the acalabrutinib group, likely reflecting longer exposure. Bottom line: adding acalabrutinib to BR gives us a real PFS advantage in older, untreated MCL, with manageable toxicity, but OS benefit remains elusive—likely due to crossover and effective salvage BTKi at relapse.

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Overall Survival with Inavolisib in PIK3CA-Mutated Advanced Breast Cancer

July 1, 2025

The INAVO120 trial evaluated inavolisib + palbociclib–fulvestrant vs placebo + palbociclib–fulvestrant in patients with PIK3CA-mutated, HR+/HER2– advanced breast cancer progressing on or shortly after adjuvant endocrine therapy (ET). Inavolisib significantly improved overall survival (OS) (34.0 vs 27.0 mo) and progression-free survival (PFS) (17.2 vs 7.3 mo), with a higher objective response rate (ORR) (62.7% vs 28.0%) and longer DoR (19.2 vs 11.1 mo). Toxicities were manageable but included more hyperglycemia (63.4%), stomatitis (55.3%), GI, and ocular AEs. Bottom line: this triplet sets a new bar for first-line PIK3CA-mutant HR+ MBC, but we’ll need to stay vigilant about metabolic and mucosal side effects as we bring it into practice.

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Neoadjuvant and Adjuvant Pembrolizumab in Locally Advanced Head and Neck Cancer

July 1, 2025

The KEYNOTE-689 trial evaluated perioperative pembrolizumab + SOC (surgery + adjuvant RT ± cisplatin) in resectable, locally advanced head and neck squamous-cell carcinoma (HNSCC) that is at least 1% PDL1 positive. The addition of pembrolizumab significantly improved 3-year event-free survival (EFS) in all PD-L1 subgroups: CPS≥10 (59.8% vs 45.9%), CPS≥1 (58.2% vs 44.9%), and the total population (57.6% vs 46.4%). Three-year overall survival (OS) also favored pembrolizumab: CPS≥10 (68.2% vs 59.2%), CPS≥1 (69.0% vs 60.2%), and total (68.4% vs 61.1%), though OS was not formally tested at this interim. Toxicities were as expected. Bottom line: perioperative pembro is now a part of the treatment paradigm for locally advanced HNCSCC with PDL1 expression.

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Perioperative Durvalumab in Gastric and Gastroesophageal Junction Cancer

July 1, 2025

The MATTERHORN trial assessed patients with resectable gastric cancer/gastroesophageal junction cancer and assigned them 1:1 to perioperative durvalumab 1500 mg Q4W + FLOT (neoadjuvant and adjuvant) vs placebo + FLOT. Durvalumab + FLOT significantly improved 2-yr EFS (67.4% vs 58.5%) and increased pathological complete response (pCR) (19.2% vs 7.2%), with a numerically higher 2-year overall survival (OS) (75.7% vs 70.4%). Safety was comparable between arms (grade 3–4 AEs 71.6% vs 71.2%) with no excess surgical delays, unexpected toxicities or adjuvant initiation delays. Bottom line: Immunotherapy (IO) benefit appears linked to the FLOT backbone—as cis/FP + IO regimens have not consistently improved event-free survival (EFS)—and mature OS plus broader representation remain needed, but this looks like a meaningful advance.

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Trastuzumab Deruxtecan or Ramucirumab plus Paclitaxel in Gastric Cancer

July 1, 2025

The phase III DESTINY-Gastric04 trial randomized HER2+ metastatic gastric/GEJ adenocarcinoma progressing on trastuzumab to T-DXd versus RAM+PTX, showing a significant overall survival (OS) benefit with T-DXd (14.7 vs 11.4 months) and improved PFS (6.7 vs 5.6 months). Objective response rate (ORR) was higher with T-DXd (44.3% vs 29.1%), and duration of response was longer (7.4 vs 5.3 months). Grade ≥3 AE rates were comparable (50.0% vs 54.1%), though adjudicated ILD/pneumonitis was more frequent with T-DXd (13.9% vs 1.3%, mostly grade 1–2), underscoring the need for vigilant monitoring. Bottom line: T-DXd looks like the new second-line standard for HER2+ disease that stays HER2-positive post-trastuzumab—meaningful survival gains. Please make sure to plan for a repeat biopsy in this setting.

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Measurable Residual Disease–Guided Therapy in Newly Diagnosed Myeloma

July 1, 2025

Quadruplet induction with isatuximab, carfilzomib, lenalidomide, and dexamethasone (Isa‑KRd) has reset expectations for transplant‑eligible NDMM and enables measurable residual disease (MRD)‑adapted strategies; MRD‑negativity at 10^-5 is strongly prognostic, and the necessity of autologous stem-cell transplantation (ASCT)—particularly tandem ASCT—amid deep responses is being re‑examined. Practically, MRD‑adapted consolidation after Isa‑KRd suggests no added depth from ASCT in MRD patients and no advantage for tandem ASCT over single ASCT + Isa‑KRd in MRD+ patients. So in day‑to‑day practice, this looks like a chance to de‑escalate transplant intensity while awaiting mature progression-free survival (PFS)/overall survival (OS) data.

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Prescribing Changes After Accelerated vs Regular Approval of Oncology Therapies

July 1, 2025

This study analyzed prescribing patterns for oncology drugs granted FDA Accelerated Approval (AA) versus those later converted to Regular Approval (RA) using data from over 63,000 patients with advanced solid tumors. Prescribing of AA drugs increased sharply—by an average of 23 percentage points—immediately after AA, while conversion to RA led to only a minimal further increase. Off-label use of AA drugs, either in earlier lines of therapy or in biomarker-negative patients, was rare. The findings suggest that oncologists rapidly adopt AA drugs into practice, often without waiting for confirmatory evidence required for RA. In summary, AA status drives substantial and immediate uptake of oncology drugs, highlighting the importance of timely confirmatory trials to ensure clinical benefit.

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Mapping the rapid growth of multi-omics in tumor immunotherapy: Bibliometric evidence of technology convergence and paradigm shifts

July 1, 2025

The article demonstrates that multi-omics research in tumor immunotherapy has grown rapidly since 2019, with China leading in publication volume but showing limited international collaboration. Early research focused on immune checkpoint blockade, while recent trends emphasize machine learning, multi-omics integration, and lncRNA, reflecting a shift toward predictive modeling and biomarker discovery. Multi-omics approaches have enabled the development of immune infiltration-based prognostic models and identified metabolic and spatial biomarkers, such as oxidative phosphorylation in melanoma and ENPP1 in Ewing sarcoma, which may guide therapeutic strategies. Overall, the study provides a systematic framework for tracking technological convergence and emerging frontiers, highlighting the need for longitudinal omics monitoring, AI-driven integration, and enhanced international collaboration to optimize precision-driven tumor immunotherapy.

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Uterine leiomyosarcoma

July 1, 2025

Shout out to Dr. Monk who is the first author on this study!
Uterine leiomyosarcoma (uLMS) is a rare, aggressive uterine malignancy with a 5-year OS ranging from 51–76% in FIGO stage I to just 10–15% in stage IV, and a median OS of 10 months for advanced disease. The mainstay of treatment for localized disease is en-bloc TH ± BSO, with observation recommended postoperatively for stage I; adjuvant chemo or RT has not shown a clear survival benefit in early-stage disease. For advanced or unresectable cases, doxorubicin-based regimens (± trabectedin) remain standard, but even with multimodal therapy, outcomes remain poor (5-year recurrence 40–75%, 70% distant). Novel strategies—anti-angiogenics, ICIs, PARP inhibitors—are under investigation, but robust data are lacking. Bottom line: uLMS continues to challenge us with its aggressive biology and limited therapeutic gains, so we need to keep pushing for trial enrollment and molecularly targeted approaches.

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