George W Sledge MD

Long Road Home: The Continuing Journey of Metastatic Disease. asco.altmetric.com/details/199033…

Please see, and I hope enjoy, my new JCO OP editorial on where we sit with metastatic cancer.

Also for TROPION 01, obviously need OS. For field as a whole we could use structured crossover trials from ADC1–>ADC2. And we need a better understanding of resistance: resistance based on target vs payload.

TROPION Breast01 updated from October ESMO shows 2.4 mo improvement in PFS vs ineffective late line CT with improved QOL vs CT. Question: should we require, going forward, comparisons vs other ADCs rather than vs essentially inactive CT?

Monarch 3 frontline OS results for Abema continue to show numerically impressive improvements but a significant p value remains frustratingly elusive. This is confusing given positive second line and adjuvant results.

With both neoadjuvant Nivo and Pembro in ER pos BC pCR rates increase strongly as PD-L1 increases. Two questions: should we use PD-L1 as a predictive biomarker, and should we use either of these drugs in the absence of solid EFS improvements?