For this year-end post, I’m pulling together some of the top stories about cancer research that have been reported over the past year.
Let’s get right to them. Here are my picks for five of 2022’s top cancer research stories.
1. The targeted drug trastuzumab deruxtecan (Enhertu) has become a new treatment option for the sub-group of people with metastatic breast cancer whose cancer expresses low levels of the protein HER2.
The phase 3 DESTINY-Breast04 trial showed that Enhertu extended overall survival by about 6 months (compared with chemotherapy) for individuals with metastatic breast cancer that previously had been considered “HER2-negative”. Researchers found that, in many cases, these breast cancers actually express low (rather than zero) levels of HER2. Because of the way Enhertu works, these low expression levels of HER2 are enough to bring about significant benefit from the drug. But Enhertu comes with many side effects, including sometimes serious lung problems that need to be carefully monitored for.
2. In a small clinical trial, 12 individuals with stage 2 or 3 rectal cancer were treated with only immunotherapy, and all of them had no detectable cancer after completing 6 months of the immunotherapy treatment.
This study received headlines after being reported at the ASCO annual meeting this year and published in the New England Journal of Medicine. Although a small trial, a 100% complete response in oncology is extremely rare, if unheard of. All of the patients had tumors with a mutation known as “mismatch repair deficiency”. The mutation apparently makes the cancer more sensitive to treatment with a checkpoint inhibitor, a type of immunotherapy drug that “releases the brakes on the immune system.” All of the patients were able to avoid surgery and chemotherapy, at least so far. In addition, it seems that side effects were moderate in this small study.
The individuals will need to be monitored closely to see if their cancer recurs. And the study will need to be repeated in larger groups of patients. But the treatment seems to hold promise, not just for individuals with rectal cancer, but also for people with other types of cancer whose tumors have mismatch repair deficiency.
3. There is growing evidence that treatment with immunotherapy before surgery may improve overall survival for people with early stage lung cancer.
Several clinical trials are exploring the hypothesis that treatment with immunotherapy before surgery may benefit patients with early stage, operable lung cancer. The idea behind this approach is that the presence of the tumor may allow for a more effective priming of the immune system. Findings from several of the ongoing trials were presented at this year’s annual meeting of the American Association of Cancer Research, and are discussed in this post on the AACR’s blog.
4. Some hormone receptor-positive early stage breast cancer patients may not need radiation therapy, based on scores on a new 16-gene molecular profile.
A typical treatment regimen in early stage hormone receptor-positive breast cancer is breast conserving surgery followed by radiation therapy. But many may not actually need radiation. A recent study evaluated the ability of a 16-gene molecular profile score to predict when someone would truly benefit from radiation treatment, and when they would not and therefore could safely omit it. The findings from the study were presented at this year’s San Antonio Breast Cancer Symposium.
5. Liquid biopsies are increasingly being used to guide and personalize cancer treatment.
A liquid biopsy is a blood test that detects cancer cells or DNA that are circulating in the blood. In May 2022, the FDA approved the Parsortix device for the detection of circulating tumor cells in the blood of metastatic breast cancer patients. Numerous liquid biopsy studies were presented at this year’s ASCO annual meeting, and many clinical trials remain ongoing.
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