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Atezolizumab plus FOLFOX for Stage III Mismatch Repair–Deficient Colon Cancer

This is a strong adjuvant signal in resected stage III dMMR colon cancer, adding atezolizumab to mFOLFOX6 cut the risk of recurrence or death in half and improved 3-year DFS from 76% to 86%. OS hasn’t separated yet, but that may be confounded by immunotherapy at relapse. Toxicity was higher, as expected, with more grade 3–4 events and immune-related adverse events (AE)s, but overall manageable. This feels practice changing for stage III dMMR disease.

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Setidegrasib in Advanced Non–Small-Cell Lung Cancer and Pancreatic Cancer

Setidegrasib represents a meaningful advance in targeting KRAS G12D–mutant tumors, demonstrating a 36% response rate with median PFS exceeding 8 months in heavily pretreated NSCLC, and a 24% response rate with ~10 month median overall survival (OS) in third line pancreatic cancer, both notable signals in populations lacking approved targeted therapies.

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BRUIN CLL-313: Randomized Phase III Trial of Pirtobrutinib Versus Bendamustine Plus Rituximab in Untreated Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Pirtobrutinib demonstrated superiority over bendamustine rituximab in IRC assessed progression free survival (PFS) in treatment naïve CLL/SLL, with a 24 month PFS rate of 93.4% versus 70.7%. Overall survival trends favored pirtobrutinib, despite the study design allowing for crossover. Who would have thought this was coming????

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Ifinatamab Deruxtecan in Patients With Extensive-Stage Small Cell Lung Cancer: Primary Analysis of the Phase II IDeate-Lung01 Trial

A B7 homolog 3–directed antibody-drug conjugate, demonstrated an overall response rate of 48.2%, with a median duration of response of 5.3 months, and a median progression-free survival of 4.9 months. The 9-month overall survival estimate was 59.1%. This represents another ADC with promising activity, although interstitial lung disease remains a concern, occurring in approximately 12% of patients.

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