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
Kent Shih, MD, of Tennessee Oncology, presents three patients cases that show how the use of gene-expression profile testing guides patient and practitioner decision-making when choosing the appropriate path of adjuvant treatment among individuals with melanoma.
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.
Benjamin P. Levy, MD, of Johns Hopkins Sidney Kimmel Cancer Center, discusses research into moving KRAS G12C inhibitors from the second to the first line, as well as combining them with immunotherapies and EGFR antibodies. Some potential combinations under investigation include KRAS G12C inhibitors (such as olomorasib, fulzerasib, divarasib, and adagrasib) and single-agent immunotherapy (pembrolizumab) or EGFR-targeting therapies (cetuximab).
In hormone receptor–positive, HER2-negative metastatic breast cancer, co-occurring ESR1 and PIK3CA mutations create therapeutic complexity. Oral SERDs, including elacestrant, retain activity despite PIK3CA co-mutation and may offer an efficacy–toxicity balance compared with PI3K/AKT pathway inhibitors. Treatment selection should incorporate molecular profile, anticipated efficacy, toxicity, and shared decision-making, states Neil M. Iyengar, MD.
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 forms of hormonal therapy for patients with prostate cancer, with a focus on the HERO trial, which evaluated oral relugolix vs injectable leuprolide in patients with advanced hormone-sensitive disease. Dr. Choudhury touches on additional analyses from HERO as well, including the effects seen with relugolix on major cardiovascular events.
References
1. Shore ND, Saad F, Cookson MS, et al: Oral relugolix for androgen-deprivation therapy in advanced prostate cancer. N Engl J Med 382:2187-2196, 2020.
2. Saad F, George DJ, Cookson MS, et al: Relugolix vs leuprolide effects on castration resistance-free survival from the phase 3 HERO study in men with advanced prostate cancer. Cancers 15:4854, 2023.
3. Tombal B, Collins S, Morgans AK, et al: Impact of relugolix versus leuprolide on the quality of life of men with advanced prostate cancer: Results from the phase 3 HERO study. Eur Urol 6:579-57, 2023.
4. Spratt DE, George DJ, Shore ND, et al: Efficacy and safety of radiotherapy plus relugolix in men with localized or advanced prostate cancer. JAMA Oncol 5:594-602, 2024.
