Articles related to Oncology, Radiation

A potentially practice-changing clinical trial for first line therapy is the first to show that the combination of two immunotherapy medications is an effective treatment for hepatocellular carcinoma (HCC). The HIMALAYA study evaluated combination immunotherapy (IO-IO), durvalumab with tremelimumab, as frontline therapy in patients with unresectable HCC. Overall survival was significantly improved with the IO-IO combination compared with sorafenib monotherapy (16.4 vs 13.8 months; hazard ratio [HR], 0.78; 96% CI, 0.65-0.92; P =.0035). Early results of the phase three LAUNCH trial are also promising. This trial compared the combination of lenvatinib with transarterial chemoembolization (TACE) to lenvatinib alone in an Asian population with advanced HCC. The lenvatinib-TACE group achieved a higher median overall survival (17.8 vs. 11.5 months and median progression-free survival (10.6 vs. 6.4 months). Muhammad Shaalan Beg, MD, director for GI Medical Oncology at UT Southwestern Medical Center in Dallas summarizes these and other takeaways from emerging research on advanced HCC presented at the recent ASCO GI Symposium.

The interpretation of genomic sequencing data is complex. Not all tumors have alterations within therapeutically targetable or actionable genes, and not all alterations detected within a therapeutically actionable gene may confer sensitivity to genomic biomarker–linked therapies. ASCO’s expert panel provides a provisional opinion, giving guidance on using genomic sequencing to inform treatment selection for patients with metastatic or advanced solid tumors.

Double-hit lymphoma presents as both aggressive, systematic disease with extra-nodal involvement and, apparently, as low-stage, less clinically aggressive disease. Since R-CHOP is much less effective in double-hit lymphoma, options such as CAR-T as well as novel drugs targeting cell-surface markers are being investigated. This interview with Dr. Ann S. LaCasce of Dana Farber summarizes current understanding and approaches to double-hit lymphoma.

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.