Articles related to Oncology, Surgical

This randomized, open-label, phase III trial compared elacestrant, a novel, oral selective ER degrader, vs. standard of care endocrine monotherapy in patients with ER-positive/HER2-negative advanced breast cancer who had one-two lines of endocrine therapy, required pretreatment with a cyclin-dependent kinase 4/6 inhibitor, and ≤ 1 chemotherapy. Elacestrant showed a significant PFS improvement versus SOC both in the overall population and in patients with ESR1 mutations.

Per guidelines, cancers with HER2 expression with a score of 3+ was considered HER2-positive. Cancers with scores of 0 and 1+, or those with an IHC score of 2+ and a negative ISH result, have been characterized as HER2-negative. These guideline-directed binary distinctions — HER2-positive vs HER2-negative — have until now guided physicians’ treatment decisions. New research suggests that patients with HER2-2+, ISH-negative breast cancer present a clinical picture closer to that of patients with HER2-positive breast cancer.

To date, FDA has approved three next-generation AR inhibitors for nonmetastatic CRPC: apalutamide, enzalutamide, and darolutamide. All three agents improve metastasis-free survival and overall survival. Selection of treatment can be guided by factors such as the patient’s overall health and frailty, potential drug-drug interactions, and the safety profile associated with each agent. This review summarizes the data from the practice-changing SPARTAN, PROSPER, and ARAMIS trials and provides insights on implementation in practice and promotes early intervention with AR inhibitors as standard of care for patients with high-risk nonmetastatic CRPC.

RhoVac AB’s RV001 (onilcamotide) was granted Fast Track designation by FDA based on positive performance in its phase I/II trial. Unfortunately, in the follow-on Phase IIb BRaVac trial, the drug failed to demonstrate superiority over the placebo.

This editorial comments on Tilki and colleagues’ “Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death.” Those researchers found that adjuvant radiotherapy (RT) was associated with a lower all-cause mortality risk compared with early salvage RT. Yet in today’s practice environment, early salvage radiotherapy (sRT) is being broadly embraced over aRT despite a continuous lack of randomized data for certain high-risk groups. The editorialist recommends that “all patients with pN1 prostate cancer—and particularly those with increasing node positivity— should be counseled on the potential survival benefits of upfront adjuvant RT demonstrated in this study and the risk that early salvage RT may not be early enough.”

In patients with NETs with distant metastasis, 90Y radioembolization (90Y RE) might be an important treatment option; however, data to support clinical benefits are scarce. The authors purposed to analyze the use of 90Y RE in NET patients with hepatic metastases in an international, multicenter retrospective analysis. In reviewing response data, they conclude that 90Y RE could be an important alternative to peptide receptor radionuclide therapy as second-line treatment in patients with progressive liver-dominant disease pretreated with somatostatin analogs.