The edition · Oncology
A deeper myeloma response, and longer gaps between surveillance colonoscopies
An oral immunomodulatory triplet raised MRD-negative responses in relapsed myeloma, the gut microbiome shapes immunotherapy outcomes, bone loss is common on prostate cancer treatment, and a large trial suggests five-year surveillance after high-risk polyps is as safe as three.
The edition in brief
Today's oncology edition leads with EXCALIBER-RRMM, a phase 3 trial in relapsed or refractory myeloma where iberdomide plus daratumumab and dexamethasone roughly doubled MRD-negative complete response versus daratumumab, bortezomib and dexamethasone (41% vs 21%), at the cost of more neutropenia and infection; progression-free survival is still awaited. A review summarises how the gut microbiome influences checkpoint-inhibitor efficacy and toxicity, with antibiotics and proton pump inhibitors linked to worse outcomes. A meta-analysis of nearly 92,000 men with prostate cancer finds osteoporosis in about 22% and low bone mass in 42%, underlining bone care on androgen-deprivation therapy. A pearl reinforces that febrile neutropenia is an emergency needing antibiotics within the hour. The edition closes on EPoS II, an interim analysis of nearly 11,000 patients with high-risk adenomas showing that starting surveillance colonoscopy at five years was noninferior to three years for colorectal cancer incidence, though guidelines still advise three.
An oral triplet deepens responses in relapsed myeloma
Consider iberdomide, daratumumab and dexamethasone as an effective, largely outpatient option in relapsed myeloma, with active infection prophylaxis and pending survival data.
The gut microbiome shapes how immunotherapy works
Around checkpoint-inhibitor therapy, avoid unnecessary antibiotics and proton pump inhibitors, but do not withhold treatment a patient truly needs.
Bone loss is common in men with prostate cancer
Build bone-density assessment and protection into care for men on androgen-deprivation therapy, where reduced bone mass is common.
Febrile neutropenia is an emergency: antibiotics within the hour
In suspected febrile neutropenia, give empirical broad-spectrum antibiotics within the hour, before culture results.
Five-year surveillance after high-risk polyps held up against three
A longer, five-year first surveillance interval after high-risk adenomas looks safe on interim data, but keep to three-year guidance until the ten-year result.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this one is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for oncology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free