Oncology Times - OncTimes Talk

Adding checkpoint inhibition immunotherapy to adjuvant chemotherapy did not improve survival among patients with triple-negative breast cancers.

 

These findings from a study reported at the 14th European Breast Cancer Conference were presented by Heather McArthur, MD, MPH, Clinical Director of Breast Cancer and Komen Distinguished Chair in Clinical Breast Research at the University of Texas Southwestern Medical Center.

 

After McArthur’s talk in Italy, she shared the details with Peter Goodwin, OncTimesTalk correspondent.

About a quarter of all patients with newly diagnosed triple-negative breast cancer will not benefit from neoadjuvant checkpoint inhibitor immunotherapy with an agent such as pembrolizumab—even though it improves outcomes among the remaining majority.

 

At the 14th European Breast Cancer Conference, held in Milan, Italy, Laura van ’t Veer, PhD, Program Leader of the Breast Oncology Program at the UCSF Helen Diller Family Comprehensive Cancer Center, reported findings from the I-SPY2 TRIAL showing that analysis of “response predictive subtypes” identified a subset of patients with triple-negative early-stage breast cancers with a very low likelihood of response to neoadjuvant immunotherapy and can be spared potential toxicities.

 

After her talk in Milan, van ’t Veer called in to the OncTimesTalk studio to talk about the I-SPY findings with Peter Goodwin. 

An early study of patients (Phase I/II) with acute myeloid leukemia found that a new three-drug combination therapy greatly improved outcomes—both in patients with relapsed or refractory disease and as initial therapy. 

The new research involved adding quizartinib that targets fms-related tyrosine kinase 3 (FLT3) oncogene. Mutations of FLT3 are present in nearly a third of all AML tumors. The internal tandem duplication mutation of FLT3, in particular, is associated with poor prognosis in AML. So, it was hypothesized that targeting FLT3 could help in treating FLT3-mutated AML.

First author Musa Yilmaz MD, Associate Professor in the Department of Leukemia at the University of Texas MD Anderson Cancer Center, has been talking with OncTimesTalk correspondent Peter Goodwin. 

How best to treat patients with relapsed or refractory mantle cell lymphoma has been made clearer by a report from the multinational Phase III Sympatico Study, presented at the 65th ASH Annual Meeting and Exposition held in San Diego. Lead author Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at the University of Texas MD Anderson Cancer Center in Houston, told the conference how a combination of two targeted drugs—ibrutinib and venetoclax—improved outcomes.

2024 is the 20th year of clinical studies conducted as part of the STAMPEDE (Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy) trial, a series of investigational approaches to initial therapy for patients with high-risk prostate cancer. Patient accrual has now ended, but practice-changing data continue to emerge from STAMPEDE. New agents, regimens, and optimized treatment combinations have been assessed in patients whose tumors already metastasized or were localized but judged highly likely to progress.

 

Noel Clarke, MBBS, FRCS, ChM, FRCS (Urol), Consultant Urological Surgeon and Professor of Urological Oncology at the Christie at Salford Royal Hospitals in Manchester, said the study is a multi-arm, multi-stage trial in which the current standard of care has continually been compared during the past 20 years with various candidate interventions tested against it. 

 

“Multiple thousands of patients have taken part in the trial,” Clarke said. “It has changed the standard of care serially in the last decade and has given a fantastic body of clinical and scientific material to work on, which helps us to understand prostate cancer, its natural history, the effect of different treatments, and the biology of prostate cancer, helping us to design future treatments.”

 

OncTimesTalk correspondent Peter Goodwin met up with Professor Clarke at his office in Manchester, England, and asked him about findings and clinical take-home messages that have come out of the STAMPEDE studies. They also discussed translational research the investigators are now conducting in their ongoing battle to fight prostate cancer.

The multicenter RAMOSE randomized clinical trial has found that doublet growth factor tyrosine kinase inhibitor therapy, when compared with standard osimertinib monotherapy, achieved a statistically significant improvement in progression-free survival in patients whose advanced non-small cell lung cancers were driven by mutated epidermal growth factor receptor.

First author Xiuning Le, MD, PhD, Associate Professor in the Department of Thoracic/Head and Neck Medical Oncology at the University of Texas MD Anderson Cancer Center, has been discussing her group’s findings with Peter Goodwin, an OncTimesTalk correspondent.

A new targeted drug, revumenib, was found to increase response rates and survival in patients whose previously treated acute leukemias relapsed or were refractory to treatment. A Phase II clinical study found revumenib met its primary endpoint and was stopped early because of a high patient response rate and clinical efficacy.

Revumenib acts on the hitherto untargeted histone-lysine N-methyltransferase 2A (KMT2A)-rearranged gene, which is present in around 1 in 10 acute leukemias among patients of all ages. The drug inhibits the interaction of the protein menin (associated with tumor suppression) and the KMT2A-fusion protein, which is believed to be an oncogenic driver in leukemias.

OncTimesTalk correspondent Peter Goodwin heard the latest from lead study author Ibrahim Aldoss, MD, Associate Professor in the Division of Leukemia of the Department of Hematology & Hematopoietic Cell Transplantation at the City of Hope, after his report to the 65th ASH Annual Meeting & Exposition.

A marked improvement in the outlook for patients with locally advanced cervical cancer has been achieved thanks to a neoadjuvant regimen using standard anti-cancer drugs added to usual therapy. 

At the ESMO Congress 2023 held in Madrid, Spain, Mary McCormack, PhD, MBBS, FRCR, Consultant Clinical Oncologist at University College London Hospitals, reported findings from the GCIG INTERLACE randomized Phase III trial of induction chemotherapy. This involved the use of carboplatin with paclitaxel for 6 weeks immediately before standard chemoradiotherapy.

After the conference, OncTimesTalk’s correspondent Peter Goodwin visited McCormack to find out more about the clinical implications arising from the INTERLACE study.

Patients whose advanced non-small cell lung cancers harbor the RET gene fusion should receive initial treatment with the RET-targeted agent selpercatinib rather than chemotherapy or chemotherapy combined with immunotherapy.

This clear message comes from the randomized Phase III LIBRETTO-431 study reported at ESMO Congress 2023 by Herbert Ho Fung Loong, MBBS, FRCP, Associate Professor in the Department of Clinical Oncology at The Chinese University of Hong Kong in China.

After his talk in Madrid, OncTimesTalk correspondent Peter M. Goodwin talked with him about the study findings and clinical implications, as well as selpercatinib’s role in the landscape of cancer treatments along with other targeted therapies, chemotherapy, and immunotherapy.

The preferred first-line treatment for patients with uncommon sensitizing mutations in tumor epidermal growth factor receptor (EGFR) should now be the tyrosine kinase inhibitor (TKI) afatinib, rather than osimertinib, according to Japanese researchers reporting the ACHILLES trial results at the ESMO Congress 2023 held in Madrid.

OncTimesTalk correspondent Peter Goodwin talked with Satoru Miura, MD, from the Niigata Cancer Center Hospital in Japan, after he reported his findings at the ESMO meeting.