A B7-H3 antibody-drug conjugate beat topotecan on survival in relapsed small-cell lung cancer

The edition in brief

In the phase 3 TAISHAN-302 trial, 451 patients with small-cell lung cancer that progressed after platinum were randomised to tambotatug pelitecan, an antibody-drug conjugate targeting B7-H3, or topotecan. At a prespecified interim analysis, median overall survival was 13.3 against 9.4 months (hazard ratio 0.46, 95% CI 0.35 to 0.62), progression-free survival 7.4 against 2.8 months, and responses 59% against 10%, with fewer grade 3 or higher adverse events (55% vs 78%). The trial was open-label and conducted in China. In the single-arm phase 2 NANT trial, two cycles of neoadjuvant niraparib in 67 women with HRD-positive advanced ovarian cancer unsuitable for primary surgery gave a response rate of 63% and R0 resection in 80% of those operated, with grade 3 to 4 thrombocytopenia in 48%; it remains investigational. Korean consensus guidance sets 15 recommendations for ctDNA testing on pleural effusion and bronchoalveolar lavage fluid in lung cancer, with most evidence from pleural fluid. The FDA approved a supplement to the baricitinib application in September; the notice does not state its content. The pearl: in suspected febrile neutropenia, give broad-spectrum antibiotics within an hour without waiting for the count.