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).
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.
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.
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.
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.
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.
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.
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