What's Hot in Hematology/Oncology

“Very well stated. Unfortunately, I'm continuing to meet thoracic oncologists who have become blinded by their enthusiasm for nCIO and are not actually thinking about the consequences of poor patient selection. And when radiation oncologists question recommendations for a surgical management plan, they are cast as biased. It is my opinion that the discord among specialists taking care of stage III NSCLC has reached unprecedented levels in the history of lung cancer care. This is simply not acceptable, and our patients expect more of us while we keep touting that we provide "MDT care". We need more people to speak up and ask the difficult questions needed to optimize patient selection and match the best treatment for each and every patient with stage III NSCLC. We also need more adults in the room to make it clear that it's okay to question our recommendations. ”

“It seems more pronounced among med oncs who were previously biased to over-recommend PACIFIC, and not necessarily thinking about the local therapy type. I’ve discussed this with several influential medoncs who hesitated to agree, but eventually saw the light. Curious of your perspective.”

“The distinction I think gets lost is between proving that perioperative IO improves a surgical strategy and proving that the surgical strategy is superior to definitive CRT + IO. We have excellent evidence for the former, but not the latter. INT0139/ESPATUE never demonstrated an OS advantage for surgery, while modern perioperative trials have dramatically improved surgical outcomes. Conversely, PACIFIC cannot establish superiority of CRT in operable disease. That is genuine equipoise, particularly in N2 disease, and exactly why trials such as InDuRanS are important. Until then, careful MDT selection; not “resectable = surgery” or “stage III = CRT”; seems the most evidence-based approach.”

“Neoadjuvant chemoimmunotherapy in stage III lung cancer: new standard or still evolving? Radiation oncologists vs everyone… are we always the ones raising objections at every meeting? Or just asking the right questions?”

“There is one in Germany- InDuRans. Should we expand to US? Would people have equipoise?”

“Update on LAURA (osimertinib after definitive chemoradiation for EGFR+ NSCLC) published @CCR_AACR. Post-progression endpoints favor osimertinib (TFST HR 0.13, PFS2 HR 0.62, TSST HR 0.51). Second interim OS analysis: HR 0.67 (0.40-1.14, 31% maturity).”

“LAURA trial : Subsequent Treatments & Post-progression Outcomes 📚Clin Cancer Res 2026 🔑 Key Results 💊 TFST: 43.8 vs 9.5 months (HR 0.13) 📉 PFS2: HR 0.62 (P=0.088) ⏳ OS (2nd interim): HR 0.67 (31% maturity) 💉 Subsequent Treatments: Among patients discontinuing study treatment (osimertinib vs placebo; n=63 vs 66): - EGFR-TKIs: 35% vs 85% - Osimertinib: 22% vs 76% - Chemo: 25% vs 5% - Radiotherapy: 27% vs 8% 6 of 14 patients receiving osimertinib as their first subsequent therapy in the osimertinib arm also received radiotherapy”

“Phase III FURVENT trial of 1L firmonertinib monotherapy vs pemetrexed-based chemo does not meet primary endpoint of PFS in pts with EGFR exon 20 insertion mutant NSCLC. Press release notes OS trend and clinical benefit by RR and PFSinv. Await full data.”

“☔️ FURVENT Phase 3: primary endpoint NOT met 1L firmonertinib for EGFR exon 20 ins+ advanced NSCLC failed to significantly improve BICR-PFS vs platinum/pemetrexed ✅ 240 mg vs chemo ・mPFS: 11.0 vs 9.5 mo 　HR 0.75 (95% CI 0.55–1.02), p=0.0654 ・ORR: 60% vs 33% ✅ OS remains immature, with a trend favoring firmonertinib ✅ No new safety signals”

“#HER2CLIMB05 regimen now @FDA approved for 1st line #HER2 #bcsm maintenance! Amazing to now have a maintenence option for patients that have HR- tumors as well! ”

“We’ve long treated HER2+ breast cancer similarly. Until everything changed. Within 1 year, T-DXd moved earlier, palbo and tucatinib reshaped maintenance, some chemos are nearly gone, biomarkers guide us. The right-sizing era for HER2+ BC has begun.”

“2/ In the curative setting, therapy can be finally tailored to the tumor biology and patient features. Many patients can get away with abbreviated THPx12. Adding T-DXd can boost pCR rates (DB11) or rescue resistant tumors (DB05). AC is mostly gone, TCHP rapidly losing ground.”

“7/ Profoundly grateful to have had the chance to write this review with rising stars @ValenzaCarmine & @elia_segui, with continued mentoring by some of those that led the revolution in HER2+ breast cancer management over the last decade. @stolaney1 @curijoey @nlinmd @adawaksmd #AleixPrat @DFCI_BreastOnc ”

“- PFS delta with tucatinib added to capecitabine/trastuzumab: 2.2 months (7.8 vs 5.6, #HER2CLIMB) - PFS delta with tucatinib added to T-DM1: 2.1 months (9.5 vs 7.4, #HER2CLIMB-02) - PFS delta with tucatinib added to maintenance HP: 8.6 months (24.9 v 16.3, #HER2CLIMB-05)”

“@FDA approval of maintenance tucatinib + HP after 1L THP in metastatic HER2+ BC. Another example with PATINA of novel therapies strategically deployed in maintenance setting.”

“Although the FDA approval of tucatinib based on HER2CLIMB-05 expands maintenance options after first-line therapy, when considered alongside the DB-09 and PATINA data, it is unlikely to be my preferred option. If I were to use it, I would consider maintenance tucatinib + trastuzumab + pertuzumab particularly for patients with HER2 3+ disease, no visceral metastases, HR-negative disease (if used in HR-positive disease, please use it together with endocrine therapy), and PIK3CA wild-type tumors.”

“FDA approved #HER2CLIMB05. Metastatic HER2+ #breastcancer is now crowded, and there is no sequencing trial. Until there is one, here is how I think about it. Most of my patients will see T-DXd in the neoadjuvant or adjuvant setting. When they recur, HER2CLIMB-05 with tucatinib comes into play. If she is HR+, palbociclib per PATINA. If she has not seen T-DXd, I start with T-DXd. Brain metastases are the hard part. If I use T-DXd up front and she develops brain metastases, tucatinib is what I have left. So do I hold T-DXd for the brain, or use it first and keep tucatinib for the brain? I use it first as soon as I can and hope to better sequencing trials or new agents for subsequent lines”

“The FDA has approved atezolizumab + chemotherapy after surgery for stage III colon cancer with mismatch repair deficiency (dMMR: 10-15% of all Stage III colon cancer cases). A subcutaneous formulation (Tecentriq Hybreza) was also approved. In the phase III ATOMIC trial (712 patients, NEJM): - 3-year disease-free survival: 86.3% vs 76.2% - 50% reduction in the risk of recurrence or death (HR 0.50) In the trial, treatment was 6 months of FOLFOX + atezolizumab, followed by 6 months of atezolizumab alone. An important advance for patients with this type of colon cancer, although increased side effects remain a consideration.”

“The scientific evidence is clear, and I have nothing to argue with there. However, with the NICHE-2 data available, I still find it difficult to accept this adjuvant approach. I think MMR status should be routinely assessed by reflex IHC testing on endoscopic biopsy specimens in all patients with colon cancer, and neoadjuvant immunotherapy should be seriously considered in eligible patients with dMMR tumors🕵‍♂️”

“⚠️ Primary 5-yr failure-free survival 66% vs 62%, HR 0.80, p=0.14 (not met)”

“For an ADC, the compartment matters. 🎯”

“Combination therapy is emerging as a standard in refractory RCC. Combos increase tumor shrinkage endpoints. TKI provides early disease control. CRs are possible but is cure? Toxicity consideration is critical in this setting.”

“Availability is not access. Proud to lead our ARON-AID study: revealing major gaps in kidney cancer treatment access across 58 countries.”

“EXCALIBER-RRMM: IberDd mPFS 42 mo! I've said "harder, better, faster, stronger" for CELMoDs > IMiDs based on correlative data... now clinical data too 👏”

“#Myeloma Paper of the Day: Extended follow-up of in vivo BCMA CAR-T therapy in RRMM shows 100% ORR (2/4 CR, 2/4 PR) but median PFS only 4 mos, OS 5.5-10.9 mos, 3/4 relapsed & had extramedullary disease; authors conclude need to extend persistence”

“#IMS26 recap: CERVINO trial: Etentamig in triple class exposed RRMM: ➡️Unlike other BsAb monotherapy trials, this was a phase III RCT but with suboptimal control arms (Kd,EPd,SVd) ➡️1 step-up dose → monthly + CRS 28% (0% w/ ppx toci) makes it very conducive for outpt/community-based administration”

“If a patient achieves a rapid deep response/MRD negativity with Tec-Dara, should we still expose them to indefinite bispecific therapy OR can ASCT provide a finite consolidation strategy and treatment-free interval?”

“1/🧵 BCMA targeting, redesigned: meet MK-4002. Pleased to share our first-in-human phase 1 study of MK-4002 (HPN217) in relapsed/refractory multiple myeloma, published in The Lancet Haematology. Here are the key findings. #Myeloma”

“MAIA frailty subgroup analysis: long-term follow-up with daratumumab plus lenalidomide/dexamethasone in transplant-ineligible newly diagnosed myeloma”

“Glofit + Pola-R-CHP in untreated DLBCL (IPI ≥2): - 95% CR - 24-mo PFS 95% - CRS 10%, all grade 1 - No ICANS”

“The broader implication is that radiotherapy may be doing more than providing local disease control before CAR-T.”

“In @BloodAdvances we report on 56 patients with secondary MDS after CAR T cell therapy compared to @Ramikomrokji database of patients with tMN after auto transplant or standard chemo/XRT 🧵”

“If you don’t adopt new DLBCL treatments with PFS but no “ITT statistically significant” OS benefit, then do you only give 2L axi-cel, no liso-cel?”

“Beginning of the end of Cell therapies in lymphomas (or at least a sharp decline);”