Caroline Helwick

Total neoadjuvant therapy (TNT) followed by rectal surgery is the standard of care in proficient mismatch repair (pMMR) locally advanced rectal cancer, but studies are finding that patients with clinical complete response may often avoid surgery and be followed “nonoperatively.” In the first results of the NO-CUT trial, presented at the European Society for Medical Oncology (ESMO) Congress 2024, patients assigned to total neoadjuvant therapy followed by intensive nonoperative management achieved a distant recurrence–free survival of almost 97%. 1

In the multiarm phase II NeoCOAST-2 trial, neoadjuvant treatment with datopotamab deruxtecan (Dato-DXd) plus the monoclonal antibody durvalumab and single-agent platinum chemotherapy led to promising rates of pathologic complete and major pathologic responses in patients with early-stage non–small cell lung cancer (NSCLC). The findings were reported at the International Association for the Study of Lung Cancer (IASLC) 2024 World Conference on Lung Cancer. 1

Late-breaking findings from the phase IIIb/IV, open-label DESTINY-Breast12 trial support the use of the antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) in patients with HER2-positive metastatic breast cancer and brain metastases who have experienced disease progression on at least two therapies. The 12-month overall survival of patients both with and without brain metastases exceeded 90%, investigators reported at the European Society for Medical Oncology (ESMO) Congress 2024. 1

An updated overall survival analysis of the phase III HIMALAYA study, now at 5 years, confirms the benefit for the STRIDE regimen of the monoclonal antibodies durvalumab plus tremelimumab in unresectable hepatocellular carcinoma. 1

For women with early-stage triple-negative breast cancer, KEYNOTE-522 changed the treatment paradigm several years ago. Support for neoadjuvant use of the PD-1 inhibitor pembrolizumab plus chemotherapy, followed by adjuvant pembrolizumab, was bolstered by the positive overall survival analysis presented during Presidential Symposium II at the European Society for Medical Oncology (ESMO) Congress 2024. 1

In the final per-protocol analysis of the phase III KEYNOTE-811 trial, an overall survival benefit was shown by adding the PD-1 inhibitor pembrolizumab to trastuzumab and chemotherapy in treatment-naive, unresectable, HER2-positive metastatic gastric or gastroesophageal junction adenocarcinoma. 1

Neoadjuvant therapy for patients with resectable stage III melanoma has recently emerged as a better approach than resection plus adjuvant therapy. At the European Society for Medical Oncology (ESMO) ...

Total neoadjuvant therapy followed by rectal surgery is the standard of care in proficient mismatch repair locally advanced rectal cancer, but studies are finding that patients with clinical complete ...

Patrick M. Forde, MBBCh, PhD An examination of patient-level data from the phase III CheckMate 816 and CheckMate 77T trials supports the perioperative use of the PD-1 inhibitor nivolumab plus chemotherapy, as compared with the neoadjuvant use of nivolumab plus chemotherapy without adjuvant therapy, in resectable non–small cell lung cancer (NSCLC). The findings were presented at the International Association for the Study of Lung Cancer 2024 World Conference on Lung Cancer by Patrick M. Forde, MBBCh, PhD, Co-Director of the Division of Upper Aerodigestive Malignancies and Director of the Thoracic Oncology Clinical Research Program at Johns Hopkins Medicine. 1

In the neoadjuvant I-SPY2.2 trial, a treatment strategy including the antibody-drug conjugate datopotamab deruxtecan (Dato-DXd), partnered with the PD-L1 inhibitor durvalumab, yielded a high pathologic complete response rate, especially in immune-positive and “all-negative” subtypes. 1