Ovarian Cancer 2024: Year at a Glance, Part 1
Thematic Newsreels
Over the past year, several important studies in ovarian cancer have been presented at multiple oncology meetings and published in a number of peer-reviewed publications. In this installment of a two-part discussion for The ASCO Post Newsreels, Ursula A. Matulonis, MD, and Joyce F. Liu, MD, MPH, discuss antibody-drug conjugates and clinical trials including PRIMA and ATHENA. In part two of this feature, Dr. Matulonis and Dr. Liu talk about low-grade serous ovarian carcinoma and an important recently published study.
Filmed November 22, 2024
The phase III frontMIND trial demonstrated improved outcomes vs R-CHOP in high-risk patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL), paralleling the POLARIX trial. Despite efficacy, tafasitamab/lenalidomide/R-CHOP has not achieved comparable guideline adoption. Uncertainty regarding overall survival benefit, limited follow-up, cross-trial comparisons, and implementation complexity may contribute to the underutilization of this regimen despite its manageable toxicity.
ESR1 mutations are a major mechanism of acquired endocrine resistance in hormone receptor–positive metastatic breast cancer and are associated with poorer outcomes. Serial ctDNA testing enables dynamic detection of emergent ESR1 mutations and clonal evolution, potentially informing treatment selection. As Neil M. Iyengar, MD, outlines via a patient case and deeper data review, ESR1 testing strategies should be individualized based on treatment duration, disease stability, and patient preferences.
The ASCO Post Staff
Raajit K. Rampal, MD, PhD, Director of the Center for Hematologic Malignancies and the Myeloproliferative Neoplasms Program at Memorial Sloan Kettering Cancer Center, reviews the four FDA-approved Janus kinase (JAK) inhibitors for patients with myelofibrosis, touching upon differences in their mechanisms of action and toxicity profiles. He also discusses clinical trials of add-on drugs to the currently approved JAK inhibitors, which may increase their efficacy and durability, as well as trials of novel JAK inhibitors and immunotherapies targeting CALR.
Benjamin P. Levy, MD, of Johns Hopkins Sidney Kimmel Cancer Center, reviews currently available therapies for patients with KRAS G12C–mutated non–small cell lung cancer (NSCLC), noting the importance of genomic testing to identify individuals eligible for treatment with these agents. He discusses the two FDA-approved second-line drugs in this space—sotorasib and adagrasib—touching on their efficacy and associated adverse events. He also mentions divarasib, an investigational next-generation KRAS G12C inhibitor, which showed superiority over both sotorasib and adagrasib in a recent head-to-head phase III trial.
Jennifer Gile, MD, of Willamette Valley Cancer Institute, talks about the first positive phase III trials in the high-risk diffuse large B-cell lymphoma (DLBCL) space—POLARIX and frontMIND. POLARIX established the superiority of a modified regimen of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) called pola-R-CHP, in which vincristine was replaced with polatuzumab vedotin, over standard R-CHOP; frontMIND showed that the addition of the CD19 monoclonal antibody tafasitamab plus the immunomodulatory drug lenalidomide to R-CHOP also improved outcomes over standard R-CHOP. Dr. Gile discusses current considerations when choosing between these regimens and how future research may lead to even more refined patient selection.
