30-Second Takeaway
- ctDNA and radiomic biomarkers are emerging as powerful tools for risk stratification, selection, and treatment monitoring.
- Targeted and immune combinations continue to extend survival in select metastatic settings with clearer long-term data.
- Evidence in KIT exon 9 GIST and very small TNBC refines adjuvant systemic therapy decisions.
Week ending February 28, 2026
ctDNA, imaging, and refined systemic strategies reshape solid tumor management
ctDNA FGFR testing complements tissue for erdafitinib selection in metastatic urothelial cancer
In this prospective multicenter study of 208 metastatic urothelial carcinoma patients, ctDNA FGFR testing closely paralleled clinical tissue testing for erdafitinib eligibility. Among 125 patients with detectable ctDNA and paired tissue, FGFR status was concordant in 90%, with ctDNA showing 84% sensitivity for tissue-detected alterations. ctDNA uncovered seven additional actionable FGFR-altered cases missed by tissue, highlighting spatial heterogeneity and sampling limitations. Twenty-one erdafitinib-treated patients had a median progression-free survival of 7.5 months, including one ctDNA-only case on therapy for 33 months.
Tumor-informed ctDNA sharply stratifies post-CRT risk in non-metastatic anal SCC
This two-center prospective cohort evaluated a tumor-informed ctDNA assay in 84 adults with non-metastatic anal squamous cell carcinoma treated with curative chemoradiation. Pre-treatment ctDNA was positive in 79% overall and 89% of stage III patients, indicating high baseline detection sensitivity. End-of-treatment ctDNA positivity identified patients with markedly worse one-year overall survival, progression-free survival, and higher locoregional failure. Patients ctDNA-negative at baseline or who cleared ctDNA during treatment had 100% locoregional failure-free survival.
Adjuvant imatinib improves survival in resected KIT exon 9–mutant GIST
This international cohort included 367 patients with localized KIT exon 9–mutant GIST undergoing curative-intent surgery at 35 centers or in a registry. Adjuvant imatinib, received by 276 patients for a median of 27.3 months, substantially reduced early recurrence or death versus observation (HR 0.19). Imatinib also improved overall survival (HR 0.37), with similar benefit in the modified NIH high-risk subgroup. Causal inference and sensitivity analyses confirmed these associations, consistent with predominantly cytostatic activity that attenuates after treatment cessation.
Three-year RATIONALE-309 data support tislelizumab plus chemotherapy first line in recurrent/metastatic NPC
RATIONALE-309 randomized 263 untreated recurrent or metastatic nasopharyngeal carcinoma patients in Asia to tislelizumab plus gemcitabine–cisplatin or placebo plus chemotherapy. At 27.5 months median follow-up, tislelizumab improved progression-free survival to 9.6 versus 7.4 months (HR 0.53). Median overall survival was 45.3 versus 31.8 months, with crossover-adjusted analyses suggesting a larger true survival benefit. Grade 3 or higher adverse event rates were comparable between arms, although immune-mediated toxicities were more frequent with tislelizumab.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.