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Grand RoundsWeekly Evidence Brief

Oncology

Edition

30-Second Takeaway

  • Adjuvant chemotherapy appears underused yet clearly beneficial in fit older adults with nonmetastatic TNBC.
  • Trimodality therapy for inflammatory breast cancer is declining despite survival benefit, with no population-level survival gains.
  • Tumor burden and leptomeningeal-directed EGFR strategies refine prognosis in EGFR-mutant NSCLC beyond genotype alone.
  • New PD-1–based combinations expand options in R/M nasopharyngeal carcinoma, pending mature OS data.
  • Routine symptom and function PROs during chemotherapy carry independent prognostic information and should inform risk assessment.

Week ending April 11, 2026

Actionable signals from recent oncology studies: adjuvant TNBC in older adults, IBC trimodality gaps, EGFR NSCLC nuances, ctDNA windows, and prognostic PROs

Adjuvant chemotherapy improves survival in women ≥70 years with nonmetastatic TNBC

JAMA NETWORK OPENApr 6, 2026

In a SEER-based cohort of 5730 women ≥70 years with nonmetastatic TNBC after surgery, adjuvant chemotherapy was linked to better survival. Breast cancer–specific survival improved with chemotherapy (HR 0.69; 95% CI, 0.58-0.82), as did overall survival (HR 0.55; 95% CI, 0.49-0.62). Benefit was consistent across subgroups, yet chemotherapy use declined sharply with increasing age, especially ≥80 years. Findings support offering adjuvant chemotherapy to fit older TNBC patients using geriatric assessment to individualize risk–benefit.

Penpulimab plus chemotherapy prolongs PFS in first-line recurrent/metastatic nasopharyngeal carcinoma

SIGNAL TRANSDUCTION AND TARGETED THERAPYApr 8, 2026

In a double-blind phase 3 trial of 291 patients with recurrent/metastatic nasopharyngeal carcinoma, penpulimab plus platinum-gemcitabine improved progression-free survival. Median PFS was 9.63 months with penpulimab versus 7.00 months with placebo (HR 0.45; 95% CI, 0.33-0.62; P < .0001). Overall survival was immature, with no clear difference yet observed (HR 0.94; 95% CI, 0.63-1.40). Grade ≥3 treatment-related adverse events were frequent and similar between arms, with cytopenias predominating and few high-grade immune events. Penpulimab plus chemotherapy represents an additional PD-1–based first-line option, with benefit currently driven by PFS.

Long-term survivors after 2 years of pembrolizumab for advanced NSCLC rarely need further systemic therapy

JAMA ONCOLOGYApr 9, 2026

Using French national data, investigators studied 1480 advanced NSCLC patients who completed roughly 2 years of pembrolizumab and survived at least 29 months. At 48 months post-landmark, overall survival was 76.9% and about half remained free of new systemic therapy or death. Only 26.1% required subsequent treatment; most received chemotherapy or radiotherapy, with very limited immunotherapy rechallenge use. These data suggest many patients completing 2 years of pembrolizumab can discontinue with durable disease control and infrequent need for additional systemic therapy.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Across solid tumors, several large datasets highlight missed opportunities for aggressive but evidence-based local or systemic therapy.
  • Real-world EGFR-mutant NSCLC data suggest simple clinical features and CSF ctDNA can meaningfully stratify risk and guide intensity.
  • Checkpoint inhibitor duration and rechallenge patterns in NSCLC show durable benefit post-discontinuation with limited need for further therapy.