The edition · Oncology
Chemotherapy-free ponatinib plus blinatumomab raised two-year event-free survival to 86% in adult Ph-positive ALL
GIMEMA ALL2820 on frontline Ph-positive ALL, a B7-H3 antibody-drug conjugate against topotecan in relapsed small-cell lung cancer, what the randomised evidence says about allogeneic transplant in T-cell lymphoma, and CRT in cancer therapy-related cardiomyopathy.
The edition in brief
GIMEMA ALL2820, a phase 3 trial in 236 adults with Philadelphia-positive ALL (median age 55), found frontline ponatinib plus blinatumomab gave 86% two-year event-free survival against 67% with imatinib plus chemotherapy, with relapse 5% vs 13%; overall survival was 90% vs 85%, and only 19% in the experimental arm went on to transplant. TAISHAN-302, a phase 3 trial published in September, found the B7-H3 antibody-drug conjugate tambotatug pelitecan extended median overall survival to 13.3 months against 9.4 with topotecan in relapsed small-cell lung cancer (HR 0.46), with fewer grade 3 or higher adverse events; the drug is investigational. A Cochrane review found only low to very low certainty evidence on allogeneic transplant in mature T-cell lymphoma: first-line, it showed no survival gain over autologous transplant but much higher treatment-related mortality. A meta-analysis of 110 patients found CRT raised ejection fraction by about 10 points in cancer therapy-related cardiac dysfunction. The pearl covers baseline cardiac assessment before cardiotoxic therapy.
Tambotatug pelitecan extended survival over topotecan in relapsed small-cell lung cancer
For relapsed small-cell lung cancer, B7-H3-directed antibody-drug conjugates are the class to watch; consider trial referral where available, as tambotatug pelitecan is not approved.
Allogeneic transplant in mature T-cell lymphoma: no first-line survival gain and much higher treatment-related mortality
Reserve allogeneic transplant in mature T-cell lymphoma mainly for relapsed or refractory disease, after discussion in a transplant multidisciplinary meeting.
CRT improved ejection fraction by about 10 points in cancer therapy-related cardiac dysfunction
Do not exclude cancer survivors with cardiomyopathy from CRT when they meet standard criteria; refer to cardio-oncology.
Record baseline cardiac function before cardiotoxic therapy
Obtain a baseline echocardiogram and ECG before anthracyclines or HER2-directed therapy, and plan surveillance by risk.
Ponatinib plus blinatumomab beat imatinib plus chemotherapy as frontline therapy for adult Ph-positive ALL
For adults with newly diagnosed Ph-positive ALL, a chemotherapy-free ponatinib-blinatumomab regimen is now supported by phase 3 evidence; discuss it in the leukaemia team, weighing ponatinib's vascular risks.
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