A B7-H3 antibody-drug conjugate halved the risk of death in relapsed small-cell lung cancer

The edition in brief

The oncology desk today is led by a phase 3 interim analysis in relapsed small-cell lung cancer, a setting where topotecan has been the unloved standard for two decades. Tambotatug pelitecan, an antibody-drug conjugate targeting B7-H3, was compared with topotecan in 451 patients progressing after first-line platinum. Median overall survival was 13.3 months against 9.4 (stratified hazard ratio 0.46, 95% CI 0.35 to 0.62), progression-free survival 7.4 months against 2.8 (hazard ratio 0.29, 95% CI 0.23 to 0.37), and confirmed objective response 59.1% against 9.7%. Grade 3 or higher adverse events were less frequent with the conjugate, 55.4% against 77.9%. A network meta-analysis of nine randomised trials in treatment-naive EGFR-mutant advanced non-small-cell lung cancer found overall survival benefit over first-generation inhibitors for dacomitinib (hazard ratio 0.75, 95% CI 0.59 to 0.95) and osimertinib (0.80, 95% CI 0.67 to 0.96). All second- and third-generation agents improved progression-free survival, furmonertinib ranking highest at 0.44. No agent differed significantly from first-generation comparators on grade 3 or higher toxicity, and the authors conclude no single drug was superior across all outcomes. A single-centre randomised trial reports lower anxiety and depression scores on days 1 and 3 after laparoscopic colorectal cancer resection when esketamine was given at induction and in patient-controlled analgesia. A supplement to the abrocitinib application has been approved, with the nature of the change not specified in the record.