November 2024 Archives - FCS Hematology Oncology Review

Overall Survival with Pembrolizumab in Early-Stage Triple-Negative Breast Cancer

November 1, 2024

This study confirms what we saw in initial reports showing the addition of pembro increasing the rate of ypathological complete response (ypCR’s) in the neoadjuvant setting for triple-negative breast cancer (TNBC). New data shows a 5% improvement (87 vs 82%) in overall survival (OS) with the quadruplet. Higher gains but at higher cost of toxicity. The fact that adjuvant intraosseous (IO) does not seem to improve outcomes, but neoadjuvant chemo+IO does show intact tumor-immune interactions to create maximum treatment effectiveness is most likely real. Of note, this seems mostly independent of programmed death-ligand 1 (PDL1) status.

Nivolumab plus Ipilimumab in Microsatellite-Instability–High Metastatic Colorectal Cancer

November 1, 2024

Here is a large phase-III well done study confirming what we knew from earlier studies, that ipilimumab plus nivolumab (Ipi+Nivo) is highly active and effective in the microsatellite instability-high metastatic colorectal cancer (MSI-high met-CRC) population. This is most likely more effective than single agent IO therapy but with higher rates of toxicity. When all things are equal, I would consider this to be the standard of care (SOC) in this context.

Perioperative Durvalumab with Neoadjuvant Chemotherapy in Operable Bladder Cancer

November 1, 2024

Perioperative durvalumab showed an improvement of 2-year OS of 82.2 vs 75.2%, 2-year PFS was improved 67.8 vs 59.8%. There was interestingly no difference in the rates of grade 3-4 toxicity in the SOC vs periop-IO group. This is likely going to become the SOC in resectable bladder cancer.

Preoperative Chemoradiotherapy for Resectable Gastric Cancer

November 1, 2024

Preoperative chemoradiation added to perioperative chemotherapy (ECF/ECX or FLOT) was not beneficial. Of note this study was done in a non-US, predominantly caucasian population. It seems XRT has less and less of a role in gastroesophageal junction / gastroesophageal (GEJ/GE) cancers.

Neoadjuvant Nivolumab and Ipilimumab in Resectable Stage III Melanoma

November 1, 2024

I love this trial in that it advances science but also balances cost. Neoadjuvant therapy with ipilimumab + nivolumab (Ipi+Nivo) x 2 followed by surgery followed by adjuvant nivolumab. Patients with a major pathologic response went on to observation alone. Again, intact tumor-immune interactions are key to maximum treatment effectiveness. Another key to these patients is seeing a medical oncologist before surgery.

Corticosteroids for Immune-Related Adverse Events and Checkpoint Inhibitor Efficacy: Analysis of Six Clinical Trials

November 1, 2024

Pooled data of nearly 2000 patients across six trials in melanoma using IO therapy. It seems clear that high dose corticosteroid use was associated with worse outcomes, especially with high peak doses. What may be worth considering is if non-steroid based immunosuppression can be used as an adjunct to blunt this concerning effect.

Oxaliplatin Added to Fluoropyrimidine/Bevacizumab as Initial Therapy for Unresectable Metastatic Colorectal Cancer in Older Patients: A Multicenter, Randomized, Open-Label Phase III Trial (JCOG1018)

November 1, 2024

This Japanese study showed no benefit with the addition of oxaliplatin to fluoropyrimidine plus bevacizumab (5FU+bev) in patients who were aged 70-74 but unfit, or >=75. Interestingly survival was actually shorter in the patients who received oxaliplatin at 21.3 vs 19.7 months.

Addition of Metastasis-Directed Therapy to Systemic Therapy for Oligometastatic Pancreatic Ductal Adenocarcinoma (EXTEND): A Multicenter, Randomized Phase II Trial

November 1, 2024

Interesting study using local therapy in metastatic pancreatic ductal adenocarcinoma (MPDAC) patients with <=5 metastatic sites. I would really like to see overall survival data here as I think progression-free survival (PFS) is a tricky endpoint to use in a trial like this. Most likely the study arm will take a lot longer to demonstrate progression if all lesions are ablated, but most important to me is the quality of life, survival and overall exposure to cytotoxic therapy; the last of which is likely much better with local therapy being utilized.

A Multicenter Phase II Trial of Ruxolitinib for Treatment of Corticosteroid Refractory Sclerotic Chronic Graft-Versus-Host Disease

November 1, 2024

Most of us don’t have many autologous stem cell transplant (Auto-HSCT) patients whom we follow, but this topic seems ripe for an American Board of Internal Medicine (ABIM) question. Ruxolitinib seems quite effective for steroid refractory sclerotic chronic graft-versus-host disease (cGHVD).

Article Search

Overall Survival with Pembrolizumab in Early-Stage Triple-Negative Breast Cancer

Nivolumab plus Ipilimumab in Microsatellite-Instability–High Metastatic Colorectal Cancer

Perioperative Durvalumab with Neoadjuvant Chemotherapy in Operable Bladder Cancer

Preoperative Chemoradiotherapy for Resectable Gastric Cancer

Neoadjuvant Nivolumab and Ipilimumab in Resectable Stage III Melanoma

Corticosteroids for Immune-Related Adverse Events and Checkpoint Inhibitor Efficacy: Analysis of Six Clinical Trials

Oxaliplatin Added to Fluoropyrimidine/Bevacizumab as Initial Therapy for Unresectable Metastatic Colorectal Cancer in Older Patients: A Multicenter, Randomized, Open-Label Phase III Trial (JCOG1018)

Addition of Metastasis-Directed Therapy to Systemic Therapy for Oligometastatic Pancreatic Ductal Adenocarcinoma (EXTEND): A Multicenter, Randomized Phase II Trial

A Multicenter Phase II Trial of Ruxolitinib for Treatment of Corticosteroid Refractory Sclerotic Chronic Graft-Versus-Host Disease

Keyword Search

Article Search

Cancer Types

Month Contributed

Show FCS Articles Only

Sort Order

Number of Posts

Menu

About This Site