Articles related to Oncology, Radiation

Recent studies identify DNA damage repair (DDR) genes as a new class of endocrine therapy resistance driver that contributes to poor survival among ER+ breast cancer patients. This study reveals differences in DDR regulation in Black women that may in part contribute to the higher breast cancer mortality in Black women vs. other populations. Based on their findings, the authors recommend more effort to refine biomarker profiles to ensure precision medicine for underserved populations.

In a randomized clinical trial of 128 patients with refractory mCRC, the addition of the PD-L1 inhibitor atezolizumab to capecitabine and bevacizumab therapy resulted in marginally longer PFS vs the placebo comparator arm. However, the median improvement — 4.4 vs 3.6 months – was deemed not clinically relevant.

This update on the PACIFIC trial comparing durvalumab with placebo in patients with unresectable, stage III non–small-cell lung cancer demonstrated robust and sustained OS and durable PFS benefit. The updated, exploratory analyses of survival, approximately 5 years after the last patient was randomly assigned demonstrate robust and sustained OS and durable PFS benefit with durvalumab after chemoradiotherapy. An estimated 42.9% of patients randomly assigned to durvalumab remain alive at 5 years and 33.1% of patients randomly assigned to durvalumab remain alive and free of disease progression. These results establish a new benchmark for standard of care in this setting.

Joyce A. O’Shaughnessy, MD provides updates on several key presentations from SABCS, touching on SERD therapy, ribociclib combinations, the datopotamab deruxtecan antibody-drug conjugate targeting overexpression of the calcium signal transducer TROP2, trastuzumab deruxtecan, and more. The MONALEESA phase 3 trial is looking at letrozole + ribociclib vs letrozole + placebo in postmenopausal women with ER+ HER2- advanced breast cancer. The trial arm outperformed the control arm with a median OS of 63.9 months vs 51.4 months respectively at a median follow up of just over 6.5 years. That median OS is the longest reported for any phase 3 trial in advanced breast cancer.

PIK3CA is the most mutated oncogene across many of the common solid tumor types. Consequently, targeting PIK3CA has been of major clinical interest. Initial efforts at have not been promising, however. The limiting factors have primarily been lack of isoform specificity of inhibitors and dose-limiting toxicities. This study evaluates copanlisib, an α and δ isoform–specific phosphoinositide 3-kinase (PI3K) inhibitor, in patients with PIK3CA mutations.

The CDC has released updated guidelines for prescribing opioids. The newest guidelines focus on patient-centered decisions and reduce some limitations on prescribing that were put in place back in 2016. The updated guidance recognizes the ongoing increase in opioid-related deaths, but seeks to give physicians and patients more direction in managing individual therapy.