Enfortumab Vedotin and Pembrolizumab in Cisplatin-Eligible Bladder Cancer
Is this the end of the cisplatin era in bladder cancer? It sure seems that way. The results here are no surprise based on the signal we saw in the metastatic setting.
Is this the end of the cisplatin era in bladder cancer? It sure seems that way. The results here are no surprise based on the signal we saw in the metastatic setting.
It comes as no surprise that bispecific agents are moving up into earlier lines of therapy in multiple myeloma. Here, in the setting of early relapsed, anti-CD38 and –imid exposed patients, single agent teclistimab showed an 18mo progression-free survival benefit over PFd/Kd.
This was not randomized, so it did not establish equivalence between external beam radiation therapy (EBRT) and resection or ablation, but these are strong real-world data supporting EBRT as a frontline local option when standard curative approaches are not feasible. The early-stage, treatment-naïve outcomes make it hard to keep thinking of RT as just a salvage or bridge strategy in hepatocellular carcinoma (HCC), we likely underutilize this therapy.
Shout to all the rad/onc’s who read this! This was a meaningful signal that modern adjuvant pelvic radiotherapy (RT) could finally have a role for selected very high-risk post-cystectomy patients. The lack of immunotherapy in this cohort and absence of a statistically significant survival benefit suggests this is not an automatic new standard, but it certainly makes multidisciplinary discussion of RT more interesting.
This was a reassuring finding for standard risk nontransplant patients with deep sustained responses, esp those having issues taking lenalidomide. I would be cautious in extrapolating this to high risk or post-transplant patients. This study makes the fixed duration therapy idea more palatable for many of us.
This was a reassuring finding for standard risk nontransplant patients with deep sustained responses, esp those having issues taking lenalidomide. I would be cautious in extrapolating this to high risk or post-transplant patients. This study makes the fixed duration therapy idea more palatable for many of us.
Adding belzutifan to adjuvant pembro improved disease-free survival (DFS), but overall survival (OS) remains immature and was not statistically different. This is a compelling signal that makes sense, but I would still be a bit cautious adding this until OS maturity. There is clearly an increase in rates of anemia and lung toxicity, which in the adjuvant setting need careful consideration.
It seems the old cliche of more drugs than patients is becoming true for most providers here. The data needs to mature further here but likely this will be another option for Anaplastic lymphoma kinase (ALK)+ non–small-cell lung cancer (NSCLC) patients in the adjuvant setting. It does look like CNS protection benefits are meaningful as well.
ASA alone may be just as good as Xarelto in the post-op, Deep vein thrombosis (DVT) prophylaxis setting after knee and hip replace. If this is replicated and confirmed, it seems quite compelling to stop using direct oral anticoagulants (DOACs) in this setting.
Finally, a game changer in metastatic pancreatic ductal adenocarcinoma (mPDAC), hopefully improved access will be available soon. Daxaronasib was not only more effective than chemo in the relapsed setting, but it was also more tolerable and with a better overall quality of life.