Five Under 5: Top Oncology Videos for the Week of 10/5

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:

Investigating Olaparib Plus Temozolomide vs Investigator’s Choice of Therapy in Advanced Uterine Leiomyosarcoma: Brian A. Van Tine, MD, PhD

Brian A. Van Tine, MD, PhD, of Washington University School of Medicine, discussed the rationale behind the phase 2/3 Alliance A092104 trial (NCT05432791) examining olaparib (Lynparza) paired with temozolomide (Temodar) vs investigator’s choice in patients with advanced uterine leiomyosarcoma whose disease progressed following chemotherapy. He explained that earlier data from the phase 2 ETCTN 10250 trial (NCT03880019) showed an overall response rate (ORR) of 27% with the combination. Patients with homologous recombination–deficient (HRD) tumors experienced a median progression-free survival (PFS) of 11.2 months vs 5.4 months in those without those tumors. Van Tine noted that these data support HRD as a biologically relevant vulnerability in a subset of uterine leiomyosarcomas, as PARP inhibition with olaparib amplifies the cytotoxic effects of temozolomide-induced DNA damage.

Role of Ruxolitinib in Polycythemia Vera and Myelofibrosis: Akriti G. Jain, MD

Akriti G. Jain, MD, of Cleveland Clinic, discussed the role of ruxolitinib (Jakafi) in the treatment of patients with polycythemia vera and myelofibrosis. She explained that ruxolitinib remains the only FDA-approved JAK inhibitor for polycythemia vera, indicated in the second-line setting for those who are resistant or intolerant to hydroxyurea. Jain noted that ruxolitinib was also approved in 2011 for those with myelofibrosis, a disease in which JAK inhibitors have proven effective for controlling symptoms and spleen volume, although evidence of fibrosis reversal and durable disease modification remains limited. Combination trials are evaluating ways to strengthen these outcomes. Jain concluded that the myelofibrosis treatment landscape has evolved with the addition of other JAK inhibitors such as fedratinib (Inrebic), pacritinib (Vonjo), and momelotinib (Ojjaara), which broaden options across subgroups.

Limitations of the ASCENT-04 Trial of Sacituzumab Govitecan Plus Pembrolizumab in TNBC: Alexis LeVee, MD

Alexis LeVee, MD, of City of Hope, discussed limitations of the phase 3 ASCENT-04/KEYNOTE-D19 trial (NCT05382286), which assessed sacituzumab govitecan-hziy (Trodelvy) plus pembrolizumab (Keytruda) in patients with triple-negative breast cancer (TNBC). LeVee noted that only 9 patients in the study had previously received PD-1 or PD-L1 therapy in the neoadjuvant or adjuvant setting, limiting the interpretability of outcomes for this subgroup. She explained that this small representation leaves uncertainty about the benefit of rechallenging with pembrolizumab in the metastatic setting after previous exposure. According to LeVee, further data are needed to inform treatment sequencing for these patients. She added that, overall, the trial underscores the expanding role of antibody-drug conjugates (ADCs) in TNBC and the potential for ADC-based regimens to complement or replace chemotherapy earlier on in the disease course.

Daratumumab/Lenalidomide With Ixazomib/Dexamethasone in Multiple Myeloma: Andrew Yee, MD

Andrew Yee, MD, of Massachusetts General Hospital and Harvard Medical School, discussed a phase 2 study (NCT04009109) examining lenalidomide (Revlimid) plus ixazomib (Ninlaro), dexamethasone, and daratumumab (Darzalex) in patients with newly diagnosed multiple myeloma. Yee reported that among enrolled patients (n = 79), the regimen achieved a high ORR of 92.4%, with very good partial response or better in 69.6% of patients and complete response (CR) or better in 22.8%. He noted that this translated into a 12-month PFS rate of 92.4%, comparable to standard-of-care approaches but with lower rates of neutropenia. Yee concluded that the regimen may be adapted for older or frail patients, maintaining efficacy while improving tolerability.

Efficacy and Safety of Eque-Cel in Relapsed/Refractory Multiple Myeloma: Lugui Qiu, MD

Lugui Qiu, MD, of the China Academy of Chinese Medical Sciences, discussed updated 3-year data from the phase 1b/2 FUMANBA-1 trial (ChiCTR2000033946) examining equecabtagene autoleucel (eque-cel) in patients with relapsed or refractory multiple myeloma. Among efficacy-evaluable patients (n = 107), the therapy elicited an ORR of 96.3%, with 83.2% achieving a CR or better. In those without prior CAR T-cell therapy (n = 95), the respective ORR and CR rates were 98.9% and 88.4%. The median PFS was 30.5 months overall and 35.9 months in those without prior CAR T therapy exposure. The median overall survival with the approach had not yet been reached; 66.3% of patients were alive at 3 years. He noted that the toxicity profile was well tolerated, with approximately 94% of patients experiencing cytokine release syndrome, mostly grade 1 or 2, and minimal high-grade neurotoxicity.