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The top 5 OncLive videos of the week cover insights in colorectal cancer, myeloma, HER2+ breast cancer, and KRAS G12X+ pancreatic ductal adenocarcinoma.
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:
Marwan G. Fakih, MD, of City of Hope, emphasizes the importance of genetic testing for patients with colorectal cancer (CRC) and KRAS G12C mutations, which are found in around 4% of patients with metastatic CRC. He advocates for next-generation sequencing at diagnosis to guide treatment decisions and improve treatment outcomes. The combination of sotorasib (Lumakras) and panitumumab (Vectibix) has shown efficacy with acceptable safety in patients with CRC and KRAS G12C mutations, leading to the FDA’s decision to approve the doublet in January 2025. Fakih stresses the need for early identification of targetable mutations and the incorporation of precision oncology strategies in patient care, based on data from clinical trials.
Paul G. Richardson, MD, of Dana-Farber Cancer Institute, discusses the evolution of treatment for newly diagnosed multiple myeloma, with triplet regimens now being the standard of care, replacing the former doublet regimens. Key triplet combinations include bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (VRd) and carfilzomib (Kyprolis), lenalidomide, and dexamethasone (KRd), with additional promising results from combinations including daratumumab (Darzalex) or isatuximab (Sarclisa). Ixazomib (Ninlaro)-based regimens offer an oral treatment option, which is ideal for frailer patients or those unable to frequently visit infusion centers. He notes that the addition of anti-CD38 monoclonal antibodies like isatuximab has further improved response quality and depth, particularly for high-risk patients.
Aditya Bardia, MD, MPH, FASCO, of UCLA Health Jonsson Comprehensive Cancer Center, discusses the FDA approval of fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu) for patients with pretreated HER2-low and -ultralow metastatic breast cancer, highlighting its impact on future HER2 testing strategies. The decision applies to patients with unresectable or metastatic, hormone receptor–positive HER2-low or -ultralow breast cancer who have progressed on at least 1 endocrine therapy. Bardia emphasizes the importance of evaluating HER2 expression by immunohistochemistry (IHC), as even minimal expression qualifies patients for treatment with the antibody-drug conjugate, although its efficacy in patients with HER2 IHC 0 disease remains uncertain. Ongoing trials, such as DESTINY-Breast15 (NCT05950945), are investigating the drug’s potential in patients with HER2 IHC 0 breast cancer, with future research efforts expected to further refine HER2-targeted treatments.
Ignacio Garrido-Laguna, MD, PhD, MBA, discusses the safety profile of daraxonrasib (RMC-6236) in patients with KRAS G12X–mutated pancreatic ductal adenocarcinoma (PDAC), based on updated data from an ongoing phase 1 study (NCT05379985). Among 127 patients treated at doses ranging from 160 mg to 300 mg, 98% experienced treatment-related adverse effects (TRAEs), with 29% having grade 3 or higher TRAEs. Rash was the most common toxicity, reported in 91% of patients, and dose modifications were needed in 35% to 42% of patients due to TRAEs, particularly rash. Proactive management strategies, including tetracyclines and supportive measures like topical steroids, are employed to mitigate rash. Further analyses are expected to refine the understanding of the drug’s toxicity profile.
Marco Ruella, MD, of University of Pennsylvania Perelman School of Medicine and Hospital of the University of Pennsylvania, emphasizes the importance of ensuring cancer treatments, including CAR T-cell therapies are accessible to diverse patient populations—especially in multiple myeloma. He argues that although advanced therapies are frequently showcased at conferences like the ASH Annual Meeting, their real-world benefits remain unclear if they are not accessible to all patients. Ruella highlights that treatments limited to tertiary centers may exclude many patients, stressing the need to incorporate these therapies into community practices for broader access. At the 2024 ASH Annual Meeting, his team presented research showing that although minority health populations have equitable access to tertiary care, they face reduced access to commercial anti-BCMA CAR T-cell therapy.
For more insights from interviews with key opinion leaders in the oncology field, check out our recent OncLive TV segments. Rather listen to expert interviews on important topics in the space? Check out OncLive On Air.
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