Allison Betof Warner, MD, PhD, on TIL Therapy for Advanced Melanoma: Innovative Clinical Advances in Treatment
Thematic Newsreels
Allison Betof Warner, MD, PhD, reviews important clinical research in the treatment of advanced melanoma, including tumor-infiltrating lymphocyte (TIL) therapy, the role of this innovative treatment in advanced melanoma, and relevant data, peer-reviewed literature, and FDA approvals in 2024. She also provides a look ahead at what is on the horizon in 2025 with regard to care for patients with advanced melanoma.
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.
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.”
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.
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 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.
