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:
Need for Increased Awareness in Multiple Myeloma: Jeffrey Zonder, MD
Jeffrey Zonder, MD, of Barbara Ann Karmanos Cancer Institute and Wayne State University School of Medicine, emphasizes the need for increased awareness of multiple myeloma, especially during Multiple Myeloma Awareness Month in March. Although advancements in therapy have improved survival, the rising prevalence of the disease highlights the importance of education on risk factors, early detection, and disease progression. Precursor conditions like monoclonal gammopathy of undetermined significance can increase the risk of multiple myeloma, making early intervention and monitoring crucial. Zonder stresses that greater awareness, risk stratification, and targeted education—particularly in high-risk populations—can improve outcomes and advance disease management.
Predictive Biomarkers for pCR With De-Escalated Chemo in HER2+ Breast Cancer: Oleg Gluz, MD
Oleg Gluz, MD, of Breast Cancer Niederrhein, discusses findings from the phase 2 WSG-TP-II trial (NCT03272477), which compared neoadjuvant endocrine therapy plus trastuzumab (Herceptin) and pertuzumab (Perjeta) vs de-escalated chemotherapy plus trastuzumab and pertuzumab in patients with hormone receptor–positive, HER2-positive early breast cancer. The study showed higher pathologic complete response (pCR) rates in the de-escalated chemotherapy arm, with similar 5-year survival outcomes between both groups. HER2 expression was identified as a strong predictive marker for pCR, but overall survival did not significantly differ among patient subgroups. Although the results support de-escalated chemotherapy for patients with stage IIA disease, Gluz advises caution in applying this approach to those with locally advanced disease due to their higher tumor burden.
Choosing Between CAR T-Cell Therapy and Bispecific Antibodies in R/R Multiple Myeloma: Syed Abbas Ali, MBBS
Syed Abbas Ali, MBBS, of Johns Hopkins School of Medicine and Sidney Kimmel Comprehensive Cancer Center, discusses the factors influencing the choice between CAR T-cell therapy and bispecific antibodies for relapsed/refractory multiple myeloma, particularly in patients previously treated with BCMA-targeted agents. He emphasizes that sequencing these therapies is crucial, with CAR T-cell therapy typically preferred first, followed by a BCMA-targeting bispecific antibody for better outcomes. A treatment-free interval of 3 to 6 months between BCMA-directed therapies may improve efficacy, and patients who receive a non-BCMA therapy in between may respond better to subsequent BCMA-targeted treatments. If CAR T-cell therapy is not feasible, alternative strategies include bispecific antibodies in clinical trials or therapies targeting different antigens, such as the FDA-approved GPRC5D-targeted bispecific antibody talquetamab-tgvs (Talvey).
Factors Influencing the Selection of Nadofaragene Firadenovec in BCG-Unresponsive NMIBC: Mark D. Tyson, II, MD, MPH
Mark D. Tyson, II, MD, MPH, of Mayo Clinic, discusses the selection of nadofaragene firadenovec-vncg (Adstiladrin), nogapendekin alfa inbakicept-pml (Anktiva), and pembrolizumab (Keytruda) for treating Bacillus Calmette-Guérin (BCG)–unresponsive non–muscle-invasive bladder cancer (NMIBC). Although pembrolizumab was once a viable option, intravesical therapies like nadofaragene firadenovec and nogapendekin alfa are now preferred due to their efficacy and favorable tolerability. The choice between these agents depends on logistics, as nadofaragene firadenovec is administered every 90 days, and nogapendekin alfa requires BCG and follows a standard induction and maintenance schedule. Since no head-to-head trials exist, treatment selection is based on patient preferences, institutional factors, and available BCG supply.
Niraparib Rechallenge Plus Bevacizumab in Platinum-Sensitive, Recurrent Ovarian Cancer: Hyun-Woong Cho, MD, PhD
Hyun-Woong Cho, MD, PhD, of Korea University College of Medicine, discusses findings from the phase 2 KGOG 3056/NIRVANA-R trial (NCT04734665), which evaluated niraparib (Zejula) rechallenge plus bevacizumab (Avastin) as maintenance therapy in patients with platinum-sensitive, recurrent ovarian cancer previously treated with a PARP inhibitor. The trial showed a 6-month progression-free survival (PFS) rate of 68% and a median PFS of 11.5 months. Subgroup analysis indicated that patients with a longer treatment-free interval and those who achieved a complete response to prior platinum-based chemotherapy experienced better PFS outcomes. Specifically, patients with a treatment-free interval of at least 24 months had a 6-month PFS rate of 82%, compared with 56% in those with shorter intervals.
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