Five Under 5: Top Oncology Videos for the Week of 4/20

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:

Framework of a Meta Analysis of BTK Inhibitors in R/R CLL: Mazyar Shadman, MD, MPH

Mazyar Shadman, MD, MPH, of Fred Hutchinson Cancer Center and Seattle Cancer Care Alliance, discussed the rationale for using network meta-analysis to compare BTK inhibitors for relapsed/refractory chronic lymphocytic leukemia in the absence of direct trials between zanubrutinib (Brukinsa) and acalabrutinib (Calquence). Although some head-to-head data exist comparing each to ibrutinib (Imbruvica), no prospective trial directly compares the two newer agents. Shadman and colleagues conducted a systematic review and selected similar phase 3 trials to indirectly assess relative efficacy among ibrutinib, acalabrutinib, zanubrutinib, and chemoimmunotherapy. Although he acknowledged the limitations of indirect comparisons, Shadman emphasized their value in informing clinical decisions when direct evidence is lacking.

Investigation of Niraparib/Bevacizumab in Platinum-Sensitive Recurrent Ovarian Cancer: Hyun-Woong Cho, MD, PhD

Hyun Woong Cho, MD, PhD, of Korea University College of Medicine, discussed the rationale behind combining niraparib (Zejula) and bevacizumab (Avastin) as maintenance therapy for patients with platinum-sensitive, recurrent ovarian cancer who had prior PARP inhibition. Although PARP inhibitors are standard in this setting, many patients relapse within 5 years and show reduced responses to subsequent chemotherapy. The phase 2 NIRVANA-R trial (NCT047346655) was launched to explore whether dual maintenance therapy could improve outcomes, building on findings from the phase 3 OReO trial (NCT03106987), which supported PARP inhibitor rechallenge. Subgroup analysis showed a 6-month progression-free survival (PFS) rate of 68%, with a median PFS of 11.5 months, supporting further investigation of this treatment strategy.

Rationale for Evaluating Anito-Cel in R/R Myeloma: Michael R. Bishop, MD

Michael R. Bishop, MD, of The University of Chicago Medicine, discussed the evaluation of anitocabtagene autoleucel (anito-cel), a novel BCMA-directed CAR T-cell therapy with a synthetic binder, in relapsed/refractory multiple myeloma. Unlike traditional CAR T therapies that use monoclonal antibody–derived receptors, anito-cel features a synthetic D-domain binder, prompting FDA-guided investigation to assess its functionality. In a phase 1 trial (NCT04155749), anito-cel showed a 100% overall response rate, with 79% achieving a complete or stringent complete response and 89% reaching minimal residual disease negativity. The treatment was well tolerated, with no delayed or severe neurotoxicities observed, surprising investigators with its strong efficacy and safety profile.

Reasons for Studying Real-World CAR T-Cell Therapy Outcomes in LBCL: Andrew Ip, MD

Andrew Ip, MD, of John Theurer Cancer Center and Hackensack University Medical Center, emphasized the need for real-world data to validate CAR T-cell therapy outcomes in large B-cell lymphoma, especially since clinical trials often exclude older or comorbid patients. To address this, Ip and colleagues conducted a multinational retrospective analysis of 501 patients treated with commercial CD19-directed CAR T-cell therapies in the United States and Israel. The study found that lisocabtagene maraleucel (Breyanzi) showed higher overall and complete response rates compared to axicabtagene ciloleucel (Yescarta), along with a more favorable toxicity profile, although progression-free and overall survival were similar. Tisagenlecleucel (Kymriah) had inferior efficacy outcomes, and the findings were consistent across second- and later-line treatment settings.

Diving Into the Phase 2 BMT CTN 1902 Trial in Myeloma: Alfred L. Garfall, MD, MS

Alfred L. Garfall, MD, MS, of Perelman School of Medicine of University of Pennsylvania, explained the rationale behind the phase 2 BMT CTN 1902 trial (NCT05032820), which explored the use of idecabtagene vicleucel (Abecma) followed by lenalidomide (Revlimid) maintenance in patients with multiple myeloma who had a suboptimal response after frontline autologous transplant. The trial enrolled patients who had less than a complete response post-transplant and maintenance therapy, aiming to assess whether early integration of CAR T-cell therapy could deepen responses. Results showed a 63% complete response rate by 6 months, with 87% of patients achieving minimal residual disease negativity at that point. The treatment was well tolerated, with mostly low-grade cytokine release syndrome and no reported cases of neurotoxicity.