A selection of informative oncology videos from August 17 highlights critical advancements and insights in cancer treatment. Designed for oncologists seeking brief yet impactful information, these videos cover varying topics, including new therapeutic strategies and ongoing challenges in patient care.
Reducing JAK2 Allele Burden in Polycythemia Vera
Naseema Gangat, MBBS of Mayo Clinic evaluates the effectiveness of ruxolitinib (Jakafi) compared to ropeginterferon alfa-2b-njft (Besremi) for lowering JAK2 allele burden in patients with polycythemia vera. Ruxolitinib, which has received FDA approval for second-line treatment in patients resistant to hydroxyurea (Hydrea), is noted for its ability to alleviate splenomegaly and related symptoms.
Emerging data reveal that both ruxolitinib and ropeginterferon alfa-2b-njft can effectively reduce JAK2 burden, while direct comparisons may clarify which treatment is preferable for patients. Efficacy and safety were confirmed in the phase 3 RESPONSE trial (NCT01243944) and phase 2 MAJIC-PV trial (ISRCTN61925716), where ruxolitinib demonstrated improved symptom management and hematocrit levels over the best available therapy.
Unresolved Issues in CAR T-Cell Therapy for Myeloma
In another segment, Prerna Mewawalla, MD from Allegheny Health Network and Drexel University College of Medicine addresses the outstanding questions regarding early CAR T-cell therapy for relapsed or refractory multiple myeloma. Mewawalla emphasizes the lack of clarity surrounding salvage options and treatment sequencing following initial CAR T-cell therapy.
Aspects such as the potential use of bispecific antibodies versus traditional treatment regimens remain undefined. Mewawalla also highlights the critical need for expanded access to these therapies, as limitations in infusion center capacity and geographic disparities hinder patient treatment options.
Fruquintinib’s Role in Metastatic Colorectal Cancer
John L. Marshall, MD of Georgetown University Hospital discusses the significance of fruquintinib (Fruzaqla) in the treatment of metastatic colorectal cancer (mCRC). Clinical trials indicate a survival benefit associated with fruquintinib particularly in third-line settings, primarily offering disease stabilization rather than complete tumor regression.
Marshall warns against delaying treatment until patients become too ill, as this may diminish the drug’s effectiveness. He also stresses the importance of individualizing treatment plans based on factors such as tumor burden and previous therapies, particularly when considering sequencing with trifluridine/tipiracil (Lonsurf; TAS-102).
Investigating JNJ-90014496 for Large B-Cell Lymphoma
The rationale for exploring JNJ-90014496 in patients with relapsed or refractory large B-cell lymphoma is presented by Matthew Ku, MBBS, PhD from St Vincent’s Hospital. This dual CD19/CD20-targeted bispecific CAR T-cell therapy is under investigation in a global phase 1b study (NCT05421663).
Ku points out that while CD19-targeted CAR T-cell therapies have revolutionized treatment, many patients do not achieve durable remissions due to antigen escape. The study involves administering escalating doses of autologous CAR T cells, with a recommended phase 2 dose established at 75 million CAR-positive T cells to ensure optimal safety and efficacy.
Improving Outcomes in High-Risk Mantle Cell Lymphoma
Lastly, Martin Dreyling, MD, PhD from University Hospital Munich shares findings from the phase 3 ECHO trial (NCT02972840) regarding the efficacy of acalabrutinib (Calquence) combined with bendamustine and rituximab (Rituxan) in high-risk mantle cell lymphoma (MCL).
Dreyling notes that previous studies suggested BTK inhibitors could replace chemotherapy in low-risk patients; however, this trial indicates that high-risk patients derive greater benefit from combining chemotherapy with a BTK inhibitor. The combination therapy achieved an overall complete response rate of 66.6%, with a notable 67.9% in high-risk patients. Subgroup analyses revealed significant progression-free survival advantages among those with blastoid morphology or elevated Ki-67 indices.
These insights underscore the need for targeted therapies in treating high-risk MCL, highlighting that chemotherapy alone is often insufficient for these patients.