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Efficacy and Safety of Intravenous Efgartigimod in Adults with Primary Immune Thrombocytopenia: Results of a Phase 3, Multicenter, Double-Blinded, Placebo-Controlled, Randomized Clinical Trial (ADVANCE IV)

Another new (potential) option for refractory ITP patients, efgartigimod is an IgG1-Fc-fragment engineered to reduce IgG autoantibody levels.  131 patients enrolled and 67% had >=3 prior lines of therapy, placebo controlled study.  The study group had a 90% sustained platelet response, with >50% having plt counts of >30k >= 7 days apart.

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Primary Retroperitoneal Lymph Node Dissection for Patients With Pathologic Stage II Nonseminomatous Germ Cell Tumor—N1, N2, and N3 Disease: Is Adjuvant Chemotherapy Necessary?

Thought provoking retrospective study regarding primary RPLND for stage II NSGCT.  Study found that after RPLND N1-3 disease had a recurrence rate of about 20%, which flattens at years 2 to 5, and in patients who recurred all were treated successfully with chemotherapy.  Adjuvant chemotherapy is preferred on the NCCN for post-RPLND patients who are pN2-N3, however this suggests close surveillance may be an option in centers with high surgical expertise.

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Durvalumab With or Without Tremelimumab in Combination With Chemotherapy as First-Line Therapy for Metastatic Non–Small-Cell Lung Cancer: The Phase III POSEIDON Study

Suddenly met-NSCLC is a crowded space.  This study did not conclude that T+D+CT was better than D+CT, the findings showed that D+CT was better than CT alone.  The addition of T to D+CT improved the PFS and OS trend but I don’t think this was a homerun result.  There was not a significant OS benefit and further follow-up will declare these results.  Also an improved outcomes were not seen in the non-squamous population.  The pembrolizumab studies have 5+ years of follow-up and an improvement in PFS and OS across NSCLC subtypes.

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COAST: An Open-Label, Phase II, Multidrug Platform Study of Durvalumab Alone or in Combination With Oleclumab or Monalizumab in Patients With Unresectable, Stage III Non–Small-Cell Lung Cancer

Oleclumab (MEDI9447) is a human IgG1λ mAb that inhibits the function of cluster of differentiation 73 (CD73).8 CD73 is an enzyme found on the surfaces of cancer and immune cells and is involved in conversion of adenosine monophosphate to extracellular adenosine, which has an immunosuppressive effect on the tumor environment.9 CD73 upregulation by tumors has been shown to increase extracellular adenosine production and result in subsequent local immunosuppression in multiple canc

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Long-Term Outcomes and Genetic Predictors of Response to Metastasis-Directed Therapy Versus Observation in Oligometastatic Prostate Cancer: Analysis of STOMP and ORIOLE Trials

Another use of genomic testing in prostate cancer, pts with high risk mutation may need systemic therapy  in addition to oligometastatic stereotactic radiotherapy, well informed patients with no high risk mutation signature may elect to go under surveillance to avoid side effects of androgen deprivation therapy,  this also emphasizes the importance of genomic testing in personalizing pt’s care.

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