AMERICAN SOCIETY OF CLINICAL ONCOLOGY

The 2024 ASCO annual meeting presented novel cancer studies, including osimertinib's 84% PFS improvement in EGFR-mutated NSCLC, no CRS in teclistamab pilot, new FDA approvals' uses and adverse effects, MCED tests' potential in health equity challenges, and telehealth's effectiveness in early palliative care for advanced NSCLC.

Innovent Biologics announced China's NMPA approval of DOVBLERON®, a next-gen ROS1 TKI for previously treated ROS1-positive NSCLC. DOVBLERON®, Innovent's 13th commercial product, addresses unmet needs, especially for patients with brain metastases and resistance to prior ROS1 TKIs. A second NDA for DOVBLERON® was accepted for ROS1-positive NSCLC patients without prior ROS1 TKI treatment.

CMOs Davey B. Daniel and Stephen “Fred” Divers discuss challenges in keeping up with practice-changing data, integrating clinical decision support, and the importance of strategic data alliances and interoperability for effective patient care in oncology.

Belzutifan (Welireg) showed comparable efficacy at 120 mg and 200 mg doses in previously treated clear cell RCC patients, with similar safety profiles. The study, LITESPARK-013, found no significant differences in objective response rate, duration of response, progression-free survival, or overall survival between doses. These findings support 120 mg as the optimal dose for belzutifan.

Cisplatin-based neoadjuvant chemotherapy (NAC) followed by cystectomy is standard for muscle-invasive bladder cancer (MIBC). A phase II trial evaluated a risk-adapted approach with AMVAC NAC and biomarker sequencing for ATM, ERCC2, FANCC, RB1. Patients with ≥1 mutation and cT0 post-NAC began active surveillance (AS). 2-year metastasis-free survival (MFS) was 72.9% overall, 76.0% in AS group. 17% of all patients and 48% of AS group avoided cystectomy without metastatic disease.

A multi-institutional team developed a computational methodology using biomarkers from the MMRF dataset and FDA database to identify optimal treatment regimens for multiple myeloma patients, reducing AEs and mortality. The study, presented at ASCO, used 7 machine learning algorithms to assess disease outcomes, identifying 11 genes significantly correlated with survival, and suggested AI's potential in optimizing clinical trials.

ctDNA testing, a liquid biopsy, detects cancer DNA in blood, aiding early detection, monitoring tumor growth, and guiding treatment decisions. It complements traditional biopsies and NCCN guidelines, offering a noninvasive, sensitive option. However, it has limitations in detecting small tumors and low tumor burden cases. It's particularly useful for cancers like colorectal, lung, and breast, but challenges remain in kidney, prostate, and thyroid cancers. ctDNA testing can reduce anxiety by providing quicker, more frequent monitoring compared to imaging.

Roswell Park experts at the 2024 San Antonio Breast Cancer Symposium aim to clarify lifestyle factors affecting breast cancer outcomes. Dr. Rikki Cannioto highlighted evidence that exercise during treatment reduces fatigue, anxiety, and improves quality of life, with adherence to CDC guidelines linked to lower mortality and recurrence risks. Despite recommendations, less than 15% of survivors meet exercise guidelines. Poster sessions also featured new findings on breast cancer research.

CMS created CPT codes for patient navigation services, allowing providers to bill for them. The American Cancer Society developed a training program for navigators. Karen Knudsen, ACS CEO, celebrated this as a major step forward in improving cancer outcomes before resigning due to board conflicts. Other top stories included election implications for oncology, oncologist struggles with terminal cancer, and GRAIL's multi-cancer detection test.

ASH 2024 highlights include GSK's Blenrep Phase 3 data supporting re-market, J&J's Darzalex Faspro delaying progression in smoldering multiple myeloma, Arcellx's anito-cel showing comparable safety to Carvykti, and J&J/Legend's Carvykti improving survival outcomes. Kura Oncology's ziftomenib showed high response rates in leukemia, Eli Lilly's Jaypirca reduced disease progression risk, and Merck's zilovertamab vedotin achieved high complete response rates in lymphoma. Beam Therapeutics' BEAM-101 showed durable effects in sickle cell disease, Novo Nordisk's etavopivat reduced crises, and Bristol Myers Squibb's arlo-cel demonstrated durable responses in multiple myeloma. Galapagos' GLPG5101 showed encouraging cell therapy results, Orca Bio's Orca-T improved survival in blood cancers, and Sanofi's rilzabrutinib improved platelet response in thrombocytopenia. Regeneron's drug combo showed better disease control than Ultomiris in PNH.