Oncology Nursing News Top Stories: May 2023

In May 2023, oncology nurse investigators presented research demonstrating the efficacy, or lack thereof, of different methods of reducing contaminated aerosols in hospital settings; pembrolizumab (Keytruda) plus lenvatinib (Lenvima) were incorporated into a clinical guideline update in the United Kingdom; and toripalimab demonstrated a statistically significant survival benefit for select patients with lung cancer.

Moreover, adagrasib (Krazati) garnered responses in patients with KRAS G12C–mutated solid tumors. Aumolertinib demonstrated intracranial activity in patients with intracranial oligometastatic EGFR-mutant non–small cell lung cancer (NSCLC).

Below are the top 5 articles from May 2023. For more, please sign-up for our newsletter.

5. Splashblocker Shows Promise in Reducing Spread of Hospital Toilet Contaminants

Findings presented during the 48th Annual Oncology Nursing Society (ONS) Annual Congress suggest that the Splashblocker device is an effective, and environmentally friendly way to decrease the risk of drug contaminated aerosols emitted with toilet flushing. However, experiences with plastic-backed pads (PBPs) were mixed.

“As a reusable barrier control, the Splashblocker is an environmentally friendly option with the benefit of potential long-term cost savings for health care organizations,” Seth Eisenberg, ASN, RN, OCN, BMTCN, said in a poster presentation. “Both interventions significantly reduced the number of particles, which can provide measurable safety benefits for health care workers. However, the PBP was sucked into the toilet bowl as a result of negative pressure generated by the siphonic action of the toilet.”

Yet, other nurse investigators reported that PBPs were not as effective as Eisenberg described.

“We expected consistently lower levels of contamination in the experimental condition, which would support the efficacy of PBPs that has been described in another recent study,” AnnMarie Walton, PhD, MPH, RN, OCN, CHES, FAAN,wrote in a poster presentation of her research, which was also presented at the Congress. “This was not consistent with our results.”

4. Pembrolizumab Plus Lenvatinib Gains NICE Recommendation for Previously Treated Advanced or Recurrent Endometrial Cancer

The United Kingdom’s National Institute for Health and Care Excellence (NICE) have updated their guidelines to now include pembrolizumab plus lenvatinib for patients with previously treated advanced or recurrent endometrial cancer whose cancer has progressed on or after platinum-based chemotherapy and who cannot have curative surgery or radiotherapy.

Data from the phase 3 KEYNOTE-775 trial (NCT03517449) back the recommendation. These findings showed that at a median follow-up of 14.7 months, patients treated with the combination experienced a median progression-free survival of 7.3 months compared with 3.8 months for those given paclitaxel or doxorubicin monotherapy (HR, 0.56; 95% CI, 0.48-0.66). Moreover, in KEYNOTE-775, patients who received the dual immunotherapy achieved a median overall survival of 18.7 months vs 11.9 months for the paclitaxel or doxorubicin monotherapy arm (HR, 0.65; 95% CI, 0.55-0.77).

3. Toripalimab Plus Chemotherapy Offers EFS Benefit in Patients With Resectable Stage III NSCLC

Toripalimab, an anti–PD-1 monoclonal antibody, led to a statistically significant improvement in event-free survival (EFS), when combined with perioperative chemotherapy and administered to patients with stage III NSCLC, according to findings from the phase 3 Neotorch study (NCT04158440).

Data, which were presented at the 2023 April ASCO April Plenary Series, showed tha, at a median follow-up of 18.25 months, the median EFS for patients with stage III disease who received toripalimab plus chemotherapy (n = 202) was not estimable (NE; 95% CI, 24.4-NE) by investigator assessment vs 15.1 months (95% CI, 10.6-21.9) for patients who received placebo plus chemotherapy (n = 202; HR, 0.40; 95% CI, 0.277-0.565; 2-sided P < .0001). The 1-year EFS rates were 84.4% vs 57.0%, respectively, and the 2-year EFS rates were 64.7% vs 38.7%, respectively.

“A significant improvement in EFS was observed in the toripalimab arm over the placebo [arm],” Shun Lu, MD, PhD, chief of the Shanghai Lung Cancer Center, Shanghai Chest Hospital, School of Medicine, Shanghai Jiaotong University in China, said during a presentation of the findings. “The HR was 0.40, representing a 60% risk reduction in disease progression, disease recurrence, or death. The P value crossed the prespecified stopping boundary of 0.01683.”

2. Adagrasib Elicits Clinically Meaningful Activity in Patients With KRAS G12C–Mutated Solid Tumors

Updated findings from the phase 2 KRYSTAL-1 study (NCT03785249) showed that

single-agent adagrasib demonstrated a manageable safety profile and meaningful clinical activity in patients with KRAS G12C–mutated solid tumors, including patients with pancreatic ductal adenocarcinoma and biliary tract cancers.

Findings were presented as part of the April 2023 ASCO plenary session. Patients with solid tumors, excluding those with colorectal cancer (CRC) and NSCLC (n = 57), who received the covalent KRAS inhibitor in the phase 1/2 study experienced an objective response rate of 35.1% per blinded independent central review. All responses were partial responses. At the data cutoff of October 1, 2022, with a median follow-up 16.8 months, the median PFS was 7.4 months (95% CI, 5.3-8.6). the 6- and 12-month PFS rates were 56.5% and 17.7%, respectively. The median OS was 14.0 months (95% CI, 8.5-18.6) and the 6- and 12-month OS rates were 84.0% and 53.5%, respectively.

1. Aumolertinib Plus SRT Achieves Intracranial Responses in Oligometastatic EGFR+ NSCLC

Aumolertinib demonstrated central nervous system (CNS) activity when used in combination with stereotactic radiation therapy (SRT) to treat patients with intracranial oligometastatic EGFR-mutant NSCLC, according to data from a prospective phase 2 study (NCT04519983) presented at the 2023 European Lung Cancer Conference (ELCC).

After oral administration of the third-generation EGFR tyrosine kinase inhibitor, efficacy-evaluable patients (n = 32) experienced an intracranial objective response rate of 100%, which included 3 complete responses and 29 partial responses. The intracranial disease control rate was also 100%. Notably, no grade 3 or higher toxicities were observed following continued treatment with aumolertinib.

“Aumolertinib has promising efficacy and good tolerability in intracranial oligometastatic EGFR-mutated NSCLC,” lead study author Jiayan Chen, MD, of Fudan University Shanghai Cancer Center in China, and colleagues, wrote in a poster on the data.