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 ASCO Post Staff
Erika Hamilton, MD, Director, Breast Cancer Research at Sarah Cannon Research Institute, provides a look at “where we stand in 2025” in the field of oral selective estrogen receptor degraders (SERDs) for patients with estrogen receptor–positive, HER2-negative breast cancer. She discusses the first and only FDA-approved oral SERD, elacestrant, indicated for use after CDK4/6 inhibitor therapy in patients with ESR1 mutations; reviews agents still being tested in clinical trials, such as imlunestrant and camizestrant; and highlights the role of oral SERDs as both monotherapies and in novel combinations. As Dr. Hamilton explains, “there haven’t been novel endocrine backbones [for these patients] since fulvestrant.”
Access to second-line chimeric antigen receptor (CAR) T-cell therapy remains suboptimal in relapsed/refractory diffuse large B-cell lymphoma (DLBCL). Matthew Lunning, DO, FACP, of the University of Nebraska Medical Center, explains that prior tafasitamab exposure may theoretically affect CD19 detection or antigen persistence, but clinical evidence demonstrating impaired subsequent CAR T-cell efficacy is lacking. Real-world data have not established CD19 loss, supporting continued consideration of CAR T-cell therapy following tafasitamab-based treatment.
Jennifer Gile, MD, of Willamette Valley Cancer Institute, reviews findings from the POLARIX study, a double-blind, placebo-controlled, international phase III trial that evaluated pola-R-CHP—a modified regimen of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), in which vincristine was replaced with polatuzumab vedotin—as compared with standard R-CHOP, in patients with previously untreated intermediate-risk or high-risk diffuse large B-cell lymphoma (DLBCL). With a 5-year update from the trial being published recently, Dr. Gile discusses long-term results, the regimen’s performance in key high-risk subgroups, and how the study altered the front-line management of this disease.
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.
The ASCO Post Staff
Atish D. Choudhury, MD, PhD, a medical oncologist and clinical/translational investigator at the Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute, discusses current guideline recommendations for the use of relugolix and leuprolide, relugolix as a combination backbone, and important considerations when applying these data to clinical practice.
References
1. De La Cerda J, Dunshee C, Gervasi L, et al: A phase I clinical trial evaluating the safety and dosing of relugolix with novel hormonal therapy for the treatment of advanced prostate cancer. Target Oncol 3:383-390, 2023.
2. George DJ, Saad F, Cookson MS, et al: Impact of concomitant prostate cancer medications on efficacy and safety of relugolix versus leuprolide in men with advanced prostate cancer. Clin Genitourin Cancer 3:383-392, 2023.
3. Brown G, Belkoff L, Hafron JM, et al: Coadministration of apalutamide and relugolix in patients with localized prostate cancer at high risk for metastases. Target Oncol 1:95-103, 2023.
