Five Under 5: Top Oncology Videos for the Week of 5/11

Welcome to The Five Under 5, your go-to roundup of the top 5 videos of the week.

These short videos are designed for busy oncologists to view on the go, and feature expert insights on breaking news, regulatory updates, practice-changing data shared at medical meetings, and other key topics in the realm of oncology.

Here’s what you may have missed:

David S. Hong, MD, of The University of Texas MD Anderson Cancer Center, discusses the clinical significance of the FDA’s April 2025 full approval of larotrectinib (Vitrakvi) for NTRK fusion–positive solid tumors. He explained that pooled data from the LOXO-TRK-14001 (NCT02122913), SCOUT (NCT02637687), and NAVIGATE (NCT02576431) trials showed a 60% overall response rate, including a 24% complete response (CR) rate; the median duration of response was 43.3 months. Hong emphasized that these results confirm the durable, tumor-agnostic efficacy of larotrectinib in both adult and pediatric patients, irrespective of tumor type. He also highlighted its favorable toxicity profile, noting that adverse effects such as dizziness and elevated liver function tests are typically manageable. No new safety concerns were identified with the drug.

Deena M. Atieh Graham, MD, of John Theurer Cancer Center at Hackensack Meridian Health, discusses the FDA’s March 2024 regular approval of mirvetuximab soravtansine-gynx (Elahere) for patients with folate receptor α–positive, platinum-resistant ovarian, fallopian tube, or primary peritoneal cancer. The decision was based on results from the phase 3 MIRASOL trial (NCT04209855), in which patients treated with the antibody-drug conjugate (ADC) achieved a median overall survival of 16.5 months vs 12.7 months with investigator’s choice of chemotherapy. Graham emphasized that ADCs represent a durable shift in ovarian cancer treatment, and their efficacy is determined by the target, linker, and payload—elements that can be further optimized. She also noted that mirvetuximab soravtansine is now being evaluated in the maintenance setting in the phase 3 GLORIOSA trial (NCT05445778), reflecting the broader move toward personalized, targeted therapies in this disease.

Tanya B. Dorff, MD, of City of Hope, discussed early insights from the real-world OPTYX study (NCT05467176) evaluating relugolix (Orgovyx) in patients with advanced prostate cancer. This prospective, non-interventional registry is assessing how relugolix is used across diverse US clinical settings, including both academic and community practices. Initial data from 999 patients showed that relugolix is frequently used in localized and locally advanced disease, as well as in those with biochemical recurrence or metastatic disease. More than half of patients received the agent in combination with other systemic therapies, such as androgen receptor pathway inhibitors. Dorff noted that the inclusion of patient-reported outcomes, including quality of life and treatment expectations, will provide critical context for real-world treatment decisions.

Seema A. Bhat, MD, of The Ohio State University, discusses the limited treatment options and poor prognosis for patients with double-refractory chronic lymphocytic leukemia (CLL). These patients often develop mutations that render current therapies ineffective and experience rapid disease progression, highlighting the need for prompt treatment. Two FDA-approved options for this population include the noncovalent BTK inhibitor pirtobrutinib (Jaypirca), which received accelerated approval in 2023 based on phase 1/2 BRUIN trial (NCT03740529) data showing a 72% ORR, and the CD19-directed CAR T-cell therapy lisocabtagene maraleucel (Breyanzi), approved in 2024 with a 20% CR rate in the phase 1/2 TRANSCEND CLL 004 study (NCT03331198). Bhat also notes that PI3K inhibitors have limited efficacy and tolerability, which restricts their use in certain patients. Overall, these advances provide important new options but underscore the continued unmet need in double-refractory CLL.

Nusrat Jahan, MD, of the O’Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, discusses the impact of the phase 3 DESTINY-Breast06 trial (NCT04494425) evaluating fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu) for hormone receptor–positive, HER2-low or -ultralow metastatic breast cancer. The trial supported the January 2025 FDA approval of the ADC for patients with unresectable or metastatic breast cancer progressing after endocrine therapy. Data showed significantly improved progression-free survival with T-DXd compared with single-agent chemotherapy—especially in patients with HER2-low disease. The median PFS in the respective groups was 13.2 vs 8.1 months (HR 0.62; P < .001). Jahan noted that all patient subgroups benefited, including those with endocrine resistance, varied disease burden, prior CDK4/6 inhibitor exposure, and across ages.