OncoAlert

Case Discussion
Localised High Risk #ProstateCancer

58yr old male
DRE: Hard mass c3
PSA 12.4
Gleasons 4+5=9
Imaging M0

later PSMA M1 in bone

Faculty 
Dr. Neeraj Agarwal
Dr. Eleni Efstathiou
Dr. Axel Merseburger
Dr. Sean McBride

Dear Colleagues,

Welcome to the ASCO22 RoundUp for Day one of the congress

Starting with with KRYstal1 with a concomitant publication in the New England

Phase One report of Adagrasib in Non Small Cell Lung Cancer, targeting KRAS G12C shows promise in  clinical efficacy without new safety signals

Large number of response

 median follow-up of 12.5 months

the median PFS 6.5 months 

 median OS 12.6 months

The EVEREST Trial

Adjuvant everolimus improves RFS in resected renal cell carcinoma in over 1,500 patients

6-year estimated RFS was 64% for everolimus Vs 61% placebo.

Just missing respecified 0.0222 significance. 

That is a minimal improved RFS with significantly higher AEs.

There was a 21% improvement in RFS in everolimus in those with high risk for recurrence with no benefit seen in those in an intermediate high-risk group.

Update of COSMIC-021 Trial

This was first-line treatment in urothelial carcinoma 

Combining Cabo/Atezo shows encouraging results with manageable tox

in patients who were 

ineligible for cisplatin

cisplatin eligible 

or with 1 prior immune checkpoint inhibitor and no prior VEGF TKIs

OR 20% in cisplatin-ineligible patients,

30% in cisplatin-eligible patients,

10%for those w prior ICI.

Lung-MAP S1800A

in Second-line pembrolizumab plus ramucirumab in Non Small Cell Lung Cancer

Here there was a possible survival benefit with immune checkpoint inhibitor resistance VS Standard of care 

This is the first successful trial in the second-line setting for advanced NSCLC in those withAcquired resistance to immune checkpoint inhibitor therapy with out a Chemo backbone

Great to see lung cancer patients who progressed on prior immunotherapy, living significantly longer when treated with the combo of Pembrolizumab plus ramucirumab 

OS 14.5 months vs 11.6 months

Very encouraging

Checkmate 9ER

Depth of response to  nivolumab plus cabozantinib is associated with durable efficacy and improved prognosis in previously untreated advanced renal cell carcinoma

The 12-month PFS rate for patients with the deepest responses in nivo cabo was 46.2% Vs 27.4% in sunitinib.

The 18-month OS rate was twice as high in nivolumab plus cabozantinib 37.9% vs 17.4%)

An improvement in Prognosis!

And those are just SOME of the top trials presented at DAY1 of ASCO22 

Looking forward to an Amazing Day 2

Reminding everyone to mask up and enjoy ASCO

41 year female, no past medical history
Comes to MedOnc after left breast lumpectomy & SN evaluation

Path: 2.1 cm grade 2 tumor
ER 100%
PR 90%
Her2 1+ FISH-
1/2 Sentinel Node positive (4mm tumor deposit w/extranodal extension)

Systemic staging-
OncotypeDX 20
#BreastCancer #OncoAlertTB

Dr. Hamilton
Dr. Lustberg
Ms. Mapes
Dr. Lambertini
Dr. Meattini 

Moderators
Dr. Grainne O'kane
Dr. Ben Westphalen

Host
Dr. Gil Morgan