Recent developments in oncology highlight promising advancements in the treatment of various cancers, including myelodysplastic syndromes (MDS), breast cancer, and hepatocellular carcinoma (HCC). Clinical trials and FDA actions are paving the way for new therapeutic strategies and improved patient outcomes. Here's a review of some of the key updates.
Myelodysplastic Syndromes (MDS) Advancements
Ongoing research is deepening the understanding of MDS, leading to the design of more effective clinical trials. David Sallman, MD, from H. Lee Moffitt Cancer Center and Research Institute, highlights the VERONA (NCT04401748) and SELECT-MDS-1 (NCT04797780) trials as particularly noteworthy. The VERONA trial is evaluating azacitidine with venetoclax (Venclexta) versus azacitidine alone, while the SELECT-MDS-1 trial is assessing azacitidine/tamibarotene (Amnolake) versus azacitidine alone. Positive results from these trials could significantly alter the treatment approach for MDS.
Enhertu's Potential in HER2-Low Breast Cancer
The FDA has granted priority review to fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu) for HER2-low/ultra-low breast cancer. This decision follows promising results from the DESTINY-Breast06 (NCT04494425) trial. Susan Galbraith, executive vice president, Oncology R&D, AstraZeneca, noted that Enhertu has the potential to become the first targeted treatment for patients with HER2-low or HER2-ultralow expression following endocrine therapy, addressing a significant unmet need in hormone receptor-positive metastatic breast cancer.
Lenvatinib and Pembrolizumab Combination for HCC
The phase 3 LEAP-012 trial (NCT04246177) demonstrated that lenvatinib (Lenvima) combined with pembrolizumab (Keytruda) and transarterial chemoembolization (TACE) significantly improved progression-free survival in patients with intermediate-stage hepatocellular carcinoma (HCC). Josep M. Llovet, MD, PhD, director of the Liver Cancer Program at the Icahn School of Medicine at Mount Sinai Hospital, emphasized that this combination represents a robust frontline option for patients with intermediate HCC, which constitutes approximately 30% of HCC cases.
Pembrolizumab in Early-Stage Triple-Negative Breast Cancer
Data from the phase 3 KEYNOTE-522 trial (NCT03036488) showed that neoadjuvant pembrolizumab (Keytruda) combined with chemotherapy, followed by adjuvant pembrolizumab, significantly improved overall survival in patients with early-stage triple-negative breast cancer. Peter Schmid, MD, PhD, of Barts Cancer Institute at Queen Mary University in London, highlighted the trial's co-primary endpoints: pathological complete response (pCR) and event-free survival, underscoring the long-term benefits of this treatment approach.
