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Sacituzumab Govitecan in Untreated, Advanced Triple-Negative Breast Cancer

ASCENT-03 shows that in first-line, PD-1/PD-L1–ineligible advanced TNBC, sacituzumab improves PFS to 9.7 vs 6.9 months and extends median duration of response (DOR) to 12.2 vs 7.2 months, with similar overall response rate (ORR) (48% vs 46%) and immature overall survival (OS) (21.5 vs 20.2 months) Grade ≥3. Adverse events (AEs) were comparable (66% vs 62%), but sacituzumab had more neutropenia and diarrhea, fewer discontinuations (4% vs 12%), and early-cycle infection-related deaths in patients without primary G-CSF. For PD-1/PD-L1–ineligible mTNBC, SG offers more durable control than chemo with manageable myelosuppression — so consider SG first-line and start G-CSF early in higher-risk patients.

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Engasertib versus Placebo for Bleeding in Hereditary Hemorrhagic Telangiectasia

This randomized, double-blind, placebo-controlled phase 1b trial of engasertib (an oral AKT1/2 inhibitor) in patients with HHT with moderate-to-severe epistaxis, showing dose-dependent reductions in epistaxis duration and frequency over 12 weeks, with further improvement through 12 months in the open-label extension. The 40 mg dose reduced monthly epistaxis duration by 41.4% and frequency by 27.8% vs placebo, and increased epistaxis-free days by 4.6/month. Safety was manageable and most notably, no thromboembolic signals were observed. Larger studies are needed, but this could be a game changer for our HHT patients sent to us for management of bleeding and anemia.

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Modified Fluorouracil, Leucovorin, Irinotecan, and Oxaliplatin or S-1, Irinotecan, and Oxaliplatin Versus Nab-Paclitaxel + Gemcitabine in Metastatic or Recurrent Pancreatic Cancer (GENERATE, JCOG1611): A Randomized, Open-Label, Phase II/III Trial

Japanese studies, which included S-1 with oxaliplatin and irinotecan—both 5-FU–based regimens—showed no superiority to gemcitabine/nab-paclitaxel in first- or second-line therapy. The trial was terminated for futility. So, what is your regimen du jour?

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Novel Systemic Anticancer Treatments and Health Services Use the End of Life Among Adults With Cancer

This study reviewed the effects of using novel agents (immunotherapy and targeted therapy) in patients at the end of life (EOL), based on the perception that these therapies may be less toxic than chemotherapy. Adjusted odds of high health service utilization and hospital death were more than twofold greater among patients receiving systemic anticancer therapy (SACT) at the EOL compared to those receiving none.

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