Oncology

Elraglusib plus gemcitabine/nab-paclitaxel extends survival in first-line metastatic PDAC

In previously untreated metastatic PDAC, elraglusib plus gemcitabine/nab-paclitaxel improved median overall survival to 10.1 months vs 7.2 months (HR 0.62). The 1-year survival rate nearly doubled with elraglusib (44.1% vs 22.3%). Grade ≥3 neutropenia increased with elraglusib (52.3% vs 30.8%), while high-grade anemia and fatigue were similar or only modestly higher. Correlative analyses linked baseline circulating immune factors and increased intratumoral cytotoxic immune cells with better elraglusib outcomes. 1

Network meta-analysis prioritizes GC–durvalumab and GC–S-1 in advanced biliary tract cancer

This Bayesian network meta-analysis of 33 randomized trials (7303 patients) compared first-line regimens for unresectable or metastatic biliary tract cancer. Versus gemcitabine–cisplatin (GC), GC plus sintilimab plus anlotinib, GC plus S-1, and GC plus durvalumab yielded the largest PFS gains. Overall survival improved with capecitabine–oxaliplatin, GC plus durvalumab, and gemcitabine–oxaliplatin compared with GC. Objective response rates were highest with GC plus S-1, GC plus cediranib, and GC plus durvalumab versus GC. 2

MSI-H/dMMR gastroesophageal adenocarcinoma derives high, durable benefit from checkpoint inhibitors

Among 1638 tested patients with gastroesophageal adenocarcinoma, 5.1% had dMMR tumors. In dMMR disease, ICI-based therapy produced a 61.5% objective response rate in metastatic cases and 52.2% pCR/cCR in locoregional cases with assessments. Patients achieving pCR or cCR after nivolumab–ipilimumab or pembrolizumab had no recurrences or deaths at a median 26-month follow-up. Several locoregional complete responders avoided surgery and remained disease-free on active surveillance. 3

Two-week FDG-PET predicts short- and long-term outcomes in newly diagnosed metastatic breast cancer

The multicenter IMPACT-MBC cohort enrolled 200 patients with newly diagnosed metastatic breast cancer starting first-line systemic therapy. Non-progression on FDG-PET after 2 weeks had a 94.7% negative predictive value for non-progression on 8-week CT. Patients without early PET progression had substantially longer median PFS and OS than those with early PET progression under standard-of-care treatment. Patients with early PET progression but non-progressive 8-week CT still had significantly shorter PFS and OS than concordant non-progressors. 4