The edition · Oncology
A chemotherapy-free frontline regimen beat imatinib and chemotherapy in Philadelphia-positive ALL
Ponatinib with blinatumomab raised two-year event-free survival in adult Ph-positive ALL, a B7-H3 antibody-drug conjugate cut the risk of death in relapsed small-cell lung cancer, and intensified therapy held up at five years in high-risk myeloma.
The edition in brief
GIMEMA ALL2820 (NEJM, 15 October) randomised 236 adults with Ph-positive ALL to frontline ponatinib plus blinatumomab or imatinib plus chemotherapy; two-year event-free survival was 86% against 67%, relapse 5% against 13%, and only 19% of the chemotherapy-free group had gone on to transplant. TAISHAN-302 (NEJM, 12 September) found tambotatug pelitecan, a B7-H3-directed antibody-drug conjugate, extended median overall survival from 9.4 to 13.3 months against topotecan in 451 patients with small-cell lung cancer relapsing after platinum (HR 0.46), with fewer grade 3 or worse adverse events, at an interim analysis. Five-year OPTIMUM data (Lancet Oncology, 7 September) showed intensified, extended therapy in high-risk myeloma was associated with longer survival than a matched external control (overall survival HR 0.43), except in patients with three or more high-risk abnormalities. ENABLE (JMIR, 28 October) found weekly patient-reported symptom triage during early breast cancer treatment produced small, domain-specific gains in fatigue, anxiety and social participation, all below the minimal important difference. The pearl covers the first hour of febrile neutropenia.
A B7-H3 antibody-drug conjugate cut the risk of death by half in relapsed small-cell lung cancer
A B7-H3 antibody-drug conjugate improved survival over topotecan in relapsed small-cell lung cancer; watch for regulatory decisions.
Intensified, extended therapy for high-risk myeloma held its survival advantage at five years
Identify high-risk myeloma at diagnosis; intensified, extended therapy was associated with longer survival in that group.
Weekly symptom triage in early breast cancer gave small gains in fatigue and anxiety
Electronic symptom triage in early breast cancer gives modest benefit, and only if alerts reach a team that acts.
Febrile neutropenia: antibiotics within the hour
Treat fever in a chemotherapy patient as febrile neutropenia and give antibiotics within an hour.
Ponatinib with blinatumomab beat imatinib with chemotherapy in adult Ph-positive ALL
For adults with Ph-positive ALL, ponatinib with blinatumomab may replace imatinib and chemotherapy frontline, where available.
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