Articles - FCS Hematology Oncology Review

Phase III Randomized, Placebo-Controlled Clinical Trial of Donepezil for Treatment of Cognitive Impairment in Breast Cancer Survivors After Adjuvant Chemotherapy (WF-97116)

July 1, 2024

It seems donepezil did not show any cognitive benefit when added to standard adjuvant chemotherapy for breast cancer. Unfortunately, adequate treatment for ‘chemo-brain’ remains elusive. There is data that a lipid structure, S1P, may be linked to this process and may be ‘druggable’ with some of the MS agents.

Radiation Therapy With or Without Cisplatin for Local Recurrences of Endometrial Cancer: Results From an NRG Oncology/GOG Prospective Randomized Multicenter Clinical Trial

July 1, 2024

For patients with local recurrences of endometrial cancer, XRT alone is extremely effective, and the addition of cisplatin does not offer any benefit while increasing toxicity. These patients with low-grade and vaginal recurrences have a good prognosis and most should be treated with XRT alone.

Durable Responses With Mosunetuzumab in Relapsed/Refractory Indolent and Aggressive B-Cell Non-Hodgkin Lymphomas: Extended Follow-Up of a Phase I/II Study

July 1, 2024

Mosunetuzumab has an impressive response rate and durability of response in heavily pre-treated patients with B-cell NHL. This was presented at our webinar on August 7, 2024 by the cellular therapy team, slides are available upon request. We have this drug available at select sites within our practice so please contact us if you have a patient in mind.

Artificial intelligence and radiologists in prostate cancer detection on MRI (PI-CAI): an international, paired, non-inferiority, confirmatory study

July 1, 2024

Will we be replaced by AI? It seems that for radiologists, an AI system was better than the human counterpart in this study looking at prostate cancer diagnostic imaging. I doubt many of us would accept a solely computer-generated report, but this study highlights how AI may help as a supportive tool in the primary diagnostic setting. Of course, prospective validation will be needed.

Datopotamab Deruxtecan in Advanced or Metastatic HR+/HER2– and Triple-Negative Breast Cancer: Results From the Phase I TROPION-PanTumor01 Study

July 1, 2024

Datopotamab Deruxtecan is a new ADC that will likely be approved in the near future. The payload is the same as used in Enhertu, but the antibody is directed at TROP2. This report is from the TROPION-pan tumor study and shows a promising ORR in HR+/HER2- MBC. There is reasonable data for this compound in 2L met-NSCLC in the TROPION-LUNG01 study with an improvement in PFS compared to docetaxel of 4.4 vs 3.7 months. Dato also is effective in patients with actionable genetic alterations in the 2L setting. There is also an ongoing study on its use in the 1L setting for met-NSCLC in combination with pembrolizumab and chemotherapy.

Obinutuzumab vs rituximab for transplant-eligible patients with mantle cell lymphoma

July 1, 2024

For transplant-eligible patients with Mantle Cell Lymphoma, Obinutuzumab showed superior efficacy compared to Rituximab. These patients are uncommon, but the results of this study show that in this context O seems to beat R in every aspect, including a 5-yr PFS of 82.8 vs 66.6%, which is striking. I would consider this option for the appropriate patient.

Methylphenidate Versus Placebo for Treating Fatigue in Patients With Advanced Cancer: Randomized, Double-Blind, Multicenter, Placebo-Controlled Trial

July 1, 2024

Stimulant therapy with methylphenidate did not improve fatigue in a well-done, prospective, placebo-controlled trial. This refutes prior practices of using ADD medications to mitigate fatigue for patients on chemotherapy. I rarely use these in my own practice given the concern for weight loss and mood disorder.

Simplified Risk Stratification Model for Patients With Waldenström Macroglobulinemia

July 1, 2024

Maybe it’s me, but I find these prognostic/risk stratification tools helpful especially when they are simple. This study shows that LDH, albumin, age of 66-75 all were strongly prognostic. This can be easily applied in the clinic to our patients when advising the risk of the disease and the need for potential therapy. Recall that there is a growing armamentarium of drugs in this disease, as well as clinical trials, within our practice.

Oxaliplatin-Based Adjuvant Chemotherapy in Older Patients With Stage III Colon Cancer: An ACCENT/IDEA Pooled Analysis of 12 Trials

July 1, 2024

There is more movement towards using time to relapse as an endpoint for adjuvant studies. This report highlights that there is still a role for oxaliplatin in older patients with Stage III CRC. The time to relapse was not significantly different in patients who are younger vs older. TTR is suggested as a more informative endpoint as older patients uniformly have a lower DFS and OS in most trials.

Tisotumab Vedotin as Second- or Third-Line Therapy for Recurrent Cervical Cancer

July 1, 2024

This trial (innovaTV-301) led to the full FDA approval for tisotumab in patients with metastatic cervical cancer. This is the first ADC targeting Tissue Factor that I am aware of. The data showed modest survival benefits, but this was more tolerable than traditional second- and third-line chemotherapy.

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Phase III Randomized, Placebo-Controlled Clinical Trial of Donepezil for Treatment of Cognitive Impairment in Breast Cancer Survivors After Adjuvant Chemotherapy (WF-97116)

Radiation Therapy With or Without Cisplatin for Local Recurrences of Endometrial Cancer: Results From an NRG Oncology/GOG Prospective Randomized Multicenter Clinical Trial

Durable Responses With Mosunetuzumab in Relapsed/Refractory Indolent and Aggressive B-Cell Non-Hodgkin Lymphomas: Extended Follow-Up of a Phase I/II Study

Artificial intelligence and radiologists in prostate cancer detection on MRI (PI-CAI): an international, paired, non-inferiority, confirmatory study

Datopotamab Deruxtecan in Advanced or Metastatic HR+/HER2– and Triple-Negative Breast Cancer: Results From the Phase I TROPION-PanTumor01 Study

Obinutuzumab vs rituximab for transplant-eligible patients with mantle cell lymphoma

Methylphenidate Versus Placebo for Treating Fatigue in Patients With Advanced Cancer: Randomized, Double-Blind, Multicenter, Placebo-Controlled Trial

Simplified Risk Stratification Model for Patients With Waldenström Macroglobulinemia

Oxaliplatin-Based Adjuvant Chemotherapy in Older Patients With Stage III Colon Cancer: An ACCENT/IDEA Pooled Analysis of 12 Trials

Tisotumab Vedotin as Second- or Third-Line Therapy for Recurrent Cervical Cancer

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