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Recent draft guidelines from the United States Preventive Services Task Force (USPSTF) propose a change in routine screening mammography recommendations. The new guidelines suggest that women should begin undergoing regular mammograms 10 years earlier than previously advised, starting at the age of 40. This recommendation applies to all individuals assigned female at birth. Simultaneously, FDA has made updates to federal mammography regulations, with a particular focus on reporting requirements related to breast density. These regulatory changes are motivated by studies indicating that approximately half of women over the age of 40 have dense breast tissue in concordance with the high prevalence of breast cancer in the population.

During its April 28 meeting, the FDA’s Oncologic Drugs Advisory Committee (ODAC) voted 11-1 on whether access to the combination should be limited to patients whose tumors carry BRCA mutations. The majority of members shared the FDA reviewers’ concerns regarding clinical trial results and uncertainty about whether people without the BRCA mutation would benefit from the regimen. The FDA argued that the results of the phase 3 PROpel clinical trial could not be applied to patients who had not had their BRCA or HRR mutation status determined. As a result, the FDA contended that the PROpel intention-to-treat (ITT) group was heterogeneous, complicating the interpretation and application of the trial’s results to unselected patients.

The FDA has authorized the use of the mRNA bivalent COVID-19 vaccine (Moderna and Pfizer-BioNTech) for all doses administered to individuals 6 months of age and older. The monovalent vaccines are no longer authorized for use in the US. This simplifies the vaccination schedule and encourages future vaccination. For child vaccination, unvaccinated children may receive a 2-dose series of the Moderna bivalent vaccine (6 months through 5 years) or a 3-dose series of the Pfizer-BioNTech bivalent vaccine (6 months through 4 years). Children who are 5 years old may receive 2 doses of Moderna bivalent vaccine or a single dose of Pfizer-BioNTech bivalent vaccine. For immunocompromised children 6 months through 4 years, eligibility depends on the vaccine previously received. For individuals 5 years of age and older with certain kinds of immunocompromise, a single additional dose of bivalent vaccine may be administered at least 2 months following the initial dose of a bivalent vaccine. Additional doses may be administered at the discretion of the health care provider, taking into consideration the individual’s clinical circumstances.

The FDA’s Oncologic Drugs Advisory Committee (ODAC) has voted to support the use of polatuzumab vedotin-piiq (Polivy) in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola+R-CHP) for the first-line treatment of patients with previously untreated large B-cell lymphoma (LBCL). The committee voted 11-2 in favour of the drug following the confirmatory POLARIX trial, a double-blind, placebo-controlled, phase 3 study, which enrolled 879 patients with LBCL, including diffuse large B-cell lymphoma (DLBC), not otherwise specified (NOS). Although concerns were raised about modest benefits in progression-free survival (PFS) and similar overall survival (OS) between Pola+R-CHP and the standard treatment R-CHOP, ODAC member Neil Vasan, MD, PhD, said that the benefits outweighed the risks and Pola+R-CHP should be an option for first-time treatment of DLBCL with curative intent, as it could spare patients from more toxic and complicated salvage therapies.

The decision was based on the findings of the open-label, multi-cohort, multicenter, phase 1b/2 clinical trial EV-103/KEYNOTE-869. Patients who participated in the study and were included in the current analysis had locally advanced or metastatic disease, were ineligible for cisplatin-containing chemotherapy, and had not previously received systemic therapy. The primary efficacy outcome measures for the study were the objective response rate (ORR) and duration of response (DoR), which were determined by an independent central review using RECIST v1.1. The ORR for the 121 patients treated with the combination was 68%, with 12% having a complete response. The median DoR for dose escalation was 22 months for two cohorts but not for a third.

According to the FDA, more than 101,000 fatal overdoses were reported during the 12-month period that ended in October 2022. Nearly half of fatal overdoses involve bystanders, but naloxone is only used in a small percentage of those situations. According to medical professionals who support the approval, there would be a critical opportunity to close this gap and lower the number of opioid-related deaths if naloxone were available over-the-counter.