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OncoAlert VJ Oncology
Journal Club
​
A collaborative series from VJOncology and OncoAlert that brings together leading oncology experts to discuss the most impactful and practice-changing research in the field. 

Brought to you via Webcast & Podcast by OncoAlert & VJ Oncology

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Top Advances of the Year in SCLC

Dr. Misty Shields guides us through this great paper out on Cancer (ACS) on the TOP advances in Small Cell Lung Cancer. Small cell lung cancer (SCLC) remains a leading cause of cancer mortality, with its aggressive nature and frequent relapse leading to poor outcomes. In recent years, immunotherapy has provided some survival benefits, and in 2024, key breakthroughs have significantly improved patient outcomes. Notable advances include the use of consolidative durvalumab immunotherapy for limited-stage SCLC, new insights into timing immunotherapy with radiation, and promising treatments such as the bispecific T-cell engager tarlatamab and antibody-drug conjugates. Precision medicine approaches, like neuroendocrine subtyping, may guide future treatments, while advocacy efforts, such as the Small Cell SMASHERS group, offer new support for patients with this historically stigmatized disease.

​Misty Dawn Shields MD PhD (Presenter and first author) Department of Medicine, Division of Hematology/Oncology, Indiana University School of Medicine, Indiana University Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA

LITESPARK-005
​Health Related QoL w/ belzutifan Vs. Everolimus in adv RCC 

Dr. Brian Rini and Dr. Tom Powles guide us through the phase 3 LITESPARK-005 trial which evaluated patient-reported outcomes (PROs) for belzutifan, a HIF-2α inhibitor, versus everolimus in patients with advanced renal cell carcinoma previously treated with immune checkpoint and anti-angiogenic therapy. Among 746 randomized participants, PRO assessments showed that belzutifan maintained disease-related symptom stability and quality of life (QOL), while everolimus was associated with worsening symptoms. At week 17, belzutifan demonstrated a favorable difference in FKSI-DRS (1.5 points, 95% CI 0.7–2.2) and QLQ-C30 global health status-QOL scores (6.4 points, 95% CI 3.2–9.6). Physical and role functioning remained similar between groups, with a slight trend toward delayed deterioration with belzutifan. These findings, alongside previously reported efficacy and safety data, suggest that belzutifan provides a clinical benefit without compromising QOL, supporting its role as a treatment option for this patient population.

SANO TRIAL in Esophageal cancer by Dr. van der Wilk 

The phase 3 trial investigated whether active surveillance could be a non-inferior alternative to standard surgery in individuals with oesophageal cancer who achieved a clinical complete response after neoadjuvant chemoradiotherapy. Conducted in 12 Dutch hospitals, the study randomized 309 participants to either active surveillance or standard oesophagectomy. After a median follow-up of 38 months, the 2-year overall survival for active surveillance (74%) was non-inferior to that of standard surgery (71%), with no significant differences in postoperative complications or mortality between groups. These results suggest active surveillance could be a viable option for patient counseling and shared decision-making, although extended follow-up is needed to assess long-term efficacy.

Prognostic implications of risk definitions from monarchE & NATALEE by Dr. Luca Arecco

Study compares the prognostic impact of differing high-risk inclusion criteria used in the monarchE and NATALEE trials among patients with hormone receptor-positive/HER2-negative early #BreastCancer , using data from the MIG1, GIM2, and GIM3 trials. Patients were stratified into high- and low-risk cohorts per each trial’s criteria, and further grouped into concordant low-risk, discordant risk, and concordant high-risk categories.

Link to Article
https://academic.oup.com/jnci/advance-article/doi/10.1093/jnci/djaf031/8002826?login=false#google_vignette

Nonoperative Management of Technically Resectable Pancreatic Cancer With Ablative Radiation Therapy by Dr. Reyngold

Cohort study evaluated the use of ablative radiation therapy (A-RT) as a noninvasive alternative to surgery in 25 patients with technically resectable pancreatic ductal adenocarcinoma (PDAC) who were ineligible for surgery due to comorbidities. Conducted at Memorial Sloan Kettering Cancer Center between 2016 and 2022, the study found that A-RT, delivered with high precision and dose intensity, provided promising local control and overall survival, with a 2-year OS rate of 43.7% and manageable toxicity. Despite advanced age, poor performance status, and limited chemotherapy use in the cohort, outcomes suggest A-RT may be a viable local therapy for select patients with resectable PDAC, warranting further prospective investigation.

Link To Article
https://jamanetwork.com/journals/jamaoncology/article-abstract/2832566 

Assisted reproductive technology in young BRCA carriers with a pregnancy after breast cancer by Dr. Magaton

This international retrospective cohort study evaluated the safety of assisted reproductive technology (ART) in BRCA1/2 carriers who conceived after a breast cancer diagnosis at age 40 or younger. Among 543 women, 107 conceived using ART and 436 conceived spontaneously. ART methods included oocyte/embryo cryopreservation, in vitro fertilization, ovulation induction, and oocyte donation. Patients who used ART were generally older, had more hormone receptor-positive tumors, and a longer interval from diagnosis to conception. After a median follow-up of 5.2 years post-conception, ART use was not associated with an increased risk of disease-free survival events, suggesting that ART is a safe option for pregnancy after breast cancer in this population.
Link
https://www.ejcancer.com/article/S0959-8049(25)00215-1/fulltext