Jessica Hergert

Expanding the definition of personalized medicine to include social determinants of health disparities is needed to ensure patients with cancer receive optimal care, said Karen Winkfield, MD, PhD, who added that lessons learned from the COVID-19 pandemic have sparked a new wave of enthusiasm to advocate for change and bridge existing gaps in oncology.

ESMO Clinical Practice Guidelines indicate that the management of metastatic breast cancer requires nuanced and multidisciplinary decision making to optimize and personalize locoregional, systemic, and supportive care.

Paul Lawrence Baron, MD, discussed best practices for determining a patient’s risk of developing breast cancer, the significance of targeting HER2 in patients with early-stage and metastatic disease, and remaining questions with radiation therapy in the field.

Maher Albitar, MD, discusses the unmet needs with genomic testing that served as the impetus to start GTC, the process of becoming a partner with the organization, and the importance of genomic profiling for all patients with cancer.

Men carrying MSH2 and MSH6 pathogenic variants, which are associated with Lynch syndrome, were found to have a higher incidence of prostate cancer compared with age-matched non-carrier individuals, supporting the value of annual, targeted prostate-specific antigen screening from age 40 to identify men with clinically significant prostate cancer.

As the armamentarium continues expanding for the treatment of patients with chronic graft-vs-host disease, research is ongoing to determine whether earlier integration of novel therapies, such as ruxolitinib, could yield better response rates for patients.

Although CAR T-cell therapies have demonstrated unprecedented activity in patients with heavily pretreated relapsed/refractory hematologic malignancies, they are marked by a significant risk of infections and may limit the efficacy of COVID-19 vaccines.

Yi-Bin Chen, MD, discusses the nuances of diagnosing patients with cGVHD, the need for biomarkers to inform who is likely to develop the disease, the introduction of ruxolitinib and belumosudil to the paradigm, and future directions with novel strategies in the space.

A proportion of patients with multiple myeloma receiving CD38-directed and BCMA-directed therapies had a lack of T-cell responses and an absence of anti–SARS-CoV-2 Spike antibodies following SARS-CoV-2 vaccination, underscoring the need for serological testing after vaccination to identify these patients.

Antoinette Wozniak, MD, FACP, FASCO, highlights the importance of monitoring patients with lung cancer for toxicities and significant advances on the horizon that are expected to further expand the lung cancer armamentarium.

The investigational NEDD8-activating enzyme inhibitor pevonedistat in combination with ibrutinib demonstrated high response rates with a tolerable safety profile in patients with relapsed/refractory chronic lymphocytic leukemia and mantle cell lymphoma.

Anurag Singh, MD, discussed the potential advantage to treating patients with radiation therapy at specific times of day, how the utilization of prophylactic gabapentin has decreased the need for narcotics in managing oral mucositis in patients with head and neck cancer, and the potential use of single-fraction radiation therapy in oncology.

The phase 2 ACE-Breast03 trial has been launched to evaluate the efficacy and safety of ARX788, an investigational antibody-drug conjugate, in patients with metastatic HER2-positive breast cancer who have progressed on prior HER2-directed therapies.

Francisco Javier Esteva, MD, PhD, discussed the current approach to treating patients with early-stage HER2-positive breast cancer, unmet needs in the space, and future directions with neratinib and T-DM1.

Harry Paul Erba, MD, PhD, spotlights practice-changing data that emerged in recent years in hematologic malignancies and speaks to remaining questions, particularly with CAR T-cell therapy, in each paradigm.

Evan Y. Yu, MD, provided insight into treatment sequencing for patients with metastatic urothelial carcinoma, considerations for treatment decisions, and emerging therapies in the paradigm. 

Across the paradigms of leukemias and lymphomas, novel therapies—such as BTK inhibitors, PI3K inhibitors, time-limited therapies, and even CAR T-cell therapies—have transformed the treatment of patients and prolonged survival without the need for chemotherapy.

Shikha Jain, MD, FACP, and Mario Spaggiari, MD, highlight key advancements made in the treatment of patients with colorectal cancer and liver metastases, patient and disease factors to consider for surgical and systemic treatment, and the importance of multidisciplinary care for this population.

Retroperitoneal surgery for patients with sarcoma requires nuanced decision making that incorporates technical aspects of resection, as well as patient-related and tumor-related factors, according to a presentation given during the 2021 ESMO Congress.

As novel therapies, new treatment strategies, and ongoing clinical trials continue to steer the path forward in lung cancer, treatment patterns for patients with non–small cell lung cancer, small cell lung cancer, and mesothelioma are continuing to evolve.

David R. Gandara, highlights key data regarding the earlier integration of targeted therapy in NSCLC, the growing role of molecular testing with tissue and liquid biopsy, and the importance of incorporating a multidisciplinary approach to patient care in the paradigm.

Zahi Mitri, MD, MS, discusses recent advancements made across the breast cancer paradigm and spotlighted key data that led to the integration of novel agents into the armamentariums.

Amivantamab-vmjw in combination with lazertinib demonstrated significant clinical activity with durable responses in patients with EGFR-mutated non–small cell lung cancer who had progressed on osimertinib.

A linear correlation between magnitude of circulating tumor DNA reduction and improved overall survival was observed in patients with metastatic uveal melanoma who were treated with tebentafusp, suggesting that ctDNA may be a better surrogate end point for OS compared with RECIST response criteria.

Although adjuvant targeted therapy options are reserved for patients with EGFR-mutated non–small cell lung cancer, molecular testing is a critical step in the treatment of all patients with metastatic disease, where multiple driver mutations are associated with FDA-approved therapeutics.

Immunotherapy is emerging as a preferred second-line treatment option for patients with gynecologic cancers, including endometrial and cervical cancer. Checkpoint inhibitors may also be preferred to chemotherapy in the frontline or adjuvant settings based on improved efficacy.

Kanwal P.S. Raghav, MBBS, MD, discussed nuances to treatment selection in mCRC, the significance of the phase 2 ReDOS trial with regorafenib, and how the paradigms for mCRC, HCC, and gastroesophageal cancers have expanded from areas of unmet need to ones with more robust armamentariums.

Rohit Jain, MD, MPH, discusses the nuances of treatment selection for patients with platinum-eligible vs -ineligible metastatic urothelial carcinoma, the current state of immunotherapy in this disease, and factors to consider during the decision-making process in RCC and mCRPC.

Updated data from the phase 3 ASCERTAIN trial demonstrated that the oral, fixed-duration combination of decitabine and cedazuridine induced a median overall survival of 31.7 months in patients with intermediate- and high-risk myelodysplastic syndrome, including chronic myelomonocytic leukemia.

Ritu Salani, MD, MBA, discussed the clinical rationale to evaluate combination strategies with immunotherapy in ovarian cancer, as well as novel agents in clinical development that could further influence the treatment paradigm.