Noted This Week

April 30–May 6

The FDA granted accelerated approval to the PD-1 inhibitor pembrolizumab (Keytruda; Merck) plus trastuzumab (Herceptin; Genentech) and chemotherapy in patients newly diagnosed with certain HER2-positive gastric or gastroesophageal cancers. In the phase III KEYNOTE-811 trial, patients treated with the investigational combination had an overall response rate of 74%, compared with 52% in patients who received trastuzumab plus chemotherapy. In April, an FDA advisory committee recommended revoking accelerated approval of pembrolizumab monotherapy as a third-line option in these patients, citing little evidence of benefit and the upcoming first-line approval.

AstraZeneca/Daiichi Sankyo’s trastuzumab deruxtecan (Enhertu) may be effective in HER2-positive metastatic colorectal cancer (Lancet Oncol 2021 May 4 [Epub ahead of print]). In the phase II DESTINY-CRC01 trial, 53 patients had an objective response rate of 68% and a median progression-free survival of 6.9 months. A HER2-targeted antibody–drug conjugate, trastuzumab deruxtecan is FDA approved for certain HER2-positive breast and gastric cancers.

A deep learning algorithm may predict where cancers originate (Nature 2021 May 5 [Epub ahead of print]). During a test run of 6,500 cancers with known primary sites, the model identified the site of origin in 83% of cases and listed the correct diagnosis among its top three predictions in 96% of cases. Of 317 cancers with unknown primary sites for which a differential diagnosis had been assigned, the algorithm agreed with the pathologist in 61% of cases and had top-three agreement in 82% of cases.

Pfizer announced a pause in enrollment in the phase I MagnetisMM-3 trial of elranatamab (PF-06863135) in multiple myeloma due to three cases of peripheral neuropathy. The company has also halted a phase II trial of the drug while it provides additional safety information to the FDA. Elranatamab targets BCMA and CD3.

Parents and siblings of patients with colorectal polyps may have a higher risk of colorectal cancer (Br J Cancer 2021;373;n877). Researchers analyzed data from 68,060 patients with colorectal cancer and 333,753 matched controls. They found that 8.4% of patients with the disease had a first-degree relative with colorectal polyps, compared with 5.7% of healthy participants; the risk of colorectal cancer was even more pronounced in those who had at least two first-degree relatives with polyps, or a relative who developed polyps at a young age.

Researchers have developed a fluorescent imaging system based on the visual system of mantis shrimp to assist surgical oncologists as they operate (Sci Transl Med 2021;13:eaaw7067). The system, which consists of layers of silicon photodetectors and spectral filters stacked into a single chip, can detect multiple colors and near-infrared light. In mice with human prostate tumors, the system distinguished cancer cells from healthy tissue in 92% of cases; in 18 patients with breast cancer, it helped surgeons map lymph nodes close to tumors.


Research Watch