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The edition · Oncology

Surveillance colonoscopy at five years was non-inferior to three after high-risk adenomas

EPoS II's interim analysis supports lengthening the first surveillance interval after high-risk adenoma removal; iberdomide doubled MRD-negative complete responses in relapsed myeloma at a cost in neutropenia and infection; and a pan-RAS inhibitor showed activity in RAS-mutant lung cancer.

The edition in brief

In EPoS II, 10,799 European patients with high-risk adenomas removed were randomised to first surveillance colonoscopy at 3 or 5 years. At a 5.5-year interim analysis, colorectal cancer incidence was 0.82% versus 0.77%, meeting non-inferiority; colorectal cancer deaths were 2 and 3. In EXCALIBER-RRMM, iberdomide with daratumumab and dexamethasone produced MRD-negative complete response in 41% versus 21% with daratumumab, bortezomib and dexamethasone in relapsed myeloma after one or two prior lines, but grade 3–4 neutropenia (84% vs 11%), infection (39% vs 22%) and pneumonia were more common; progression-free survival is not yet reported. In a phase 1–2 study, the oral RAS(ON) inhibitor daraxonrasib produced responses in 31–37% of 136 previously treated patients with RAS-mutant NSCLC, with grade 3 or higher adverse events in 54%. An analysis of IQVIA data from 71 countries found essential cancer medicines requiring complex genomic tests had about 65% lower uptake, lowest in lower-income countries. And a meta-analysis of four observational studies linked androgen deprivation therapy with higher odds of acute kidney injury (OR 1.34).

In this edition
01
Clinical update

Iberdomide–daratumumab–dexamethasone doubled MRD-negative complete response in relapsed myeloma

Iberdomide with daratumumab and dexamethasone doubled MRD-negative complete response in early-relapse myeloma, but with far more neutropenia and infection, and survival data are pending.

2 min · The Lancet. OncologyRead →
Primary outcome
MRD-negative complete response (co-primary with PFS)
Effect
41% vs 21%, difference 20.1% (95% CI 11.5–28.6); OR 2.8 (1.8–4.3)
02Research

Daraxonrasib, a pan-RAS inhibitor, produced responses in about a third of pretreated RAS-mutant NSCLC

Daraxonrasib showed activity across RAS-mutant NSCLC in early trials, but at the cost of substantial toxicity — a trial option, not yet a treatment.

1 min · The New England journal of medicineRead →
03Research

Essential cancer medicines that need genomic tests reached far fewer patients, especially in poorer countries

Access to precision cancer drugs depends on access to the tests that select patients for them.

1 min · The Lancet. OncologyRead →
04Research

Androgen deprivation was associated with a third higher odds of acute kidney injury

Androgen deprivation therapy is associated with higher odds of acute kidney injury; monitor renal function and avoid nephrotoxins.

1 min · Cancer chemotherapy and pharmacologyRead →
05Pearl

Fever on a myeloma regimen with a cereblon modulator: treat as neutropenic sepsis until proven otherwise

Any fever in a myeloma patient on a cereblon modulator or anti-CD38 antibody needs same-hour assessment for neutropenic sepsis.

1 minRead →
06
Practice changer

After high-risk adenoma removal, first surveillance at five years was non-inferior to three

After complete removal of high-risk adenomas at a quality colonoscopy, first surveillance at five years was as safe as three on interim data.

2 min · The New England journal of medicineRead →
Primary outcome
Cumulative colorectal cancer incidence (10-year primary; 5-year interim)
Effect
0.77% vs 0.82% at 5 years; upper 99.12% CI bound 0.68 points (margin 0.7)

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