No abstract

Trastuzumab deruxtecan is a novel antibody–drug conjugate for the treatment of advanced solid tumors, including breast cancer, which overexpress or have amplification of the human epidermal growth factor receptor 2 (HER2). The novel structure of this exciting new agent means that it can deliver a highly potent cytotoxic agent to HER2-expressing tissues resulting in selective killing of cancer cells. In phase I and II trials, trastuzumab deruxtecan has shown impressive response rates in heavily pretreated populations, including patients who had received prior treatment with trastuzumab emtansine, another highly active antibody–drug conjugate. The most common side effects are gastrointestinal and hematological. Importantly, a high rate of interstitial lung disease was seen in early trials, but this appears manageable in most patients with corticosteroids. In light of its efficacy, this promising new drug may change the treatment paradigm of HER2-positive breast cancer.

Early onset colorectal cancer (EOCRC), defined as colorectal cancers in patients aged less than 50 years, is becoming an increasingly common issue, globally. Since 1994, the incidence of this condition has been rising by 2% annually. Approximately one in five patients under 50 years of age diagnosed with colorectal cancer have an underlying genetic predisposition syndrome. The detection of cancer among the other 80% of patients poses a considerable task, as there is no family history to advocate for commencing early screening in this group. Patients with EOCRC have distinct social, spiritual, fertility, and financial needs from their older counterparts that need to be addressed. This review discusses the risk factors associated with the development of EOCRC and current best practice for the management of this disease.

Blockade of the programmed cell death 1 immune inhibitory pathway has revolutionized the treatment of advanced non–small cell lung cancer and led to significant improvements in overall survival. In contrast, early-stage surgically resectable lung cancer has had few treatment advances in many years and continues to be associated with a high risk of relapse despite apparent curative resection. In this review, we discuss the many ongoing efforts to incorporate programmed cell death 1 pathway blockade into the treatment paradigm for surgically resectable lung cancer both as adjuvant and neoadjuvant therapy. We review the early-phase results from neoadjuvant clinical trials, the landscape of phase III trials that are ongoing, and look to the future of immune checkpoint blockade as a potential curative therapy for surgically resectable lung cancer.

e24178 Background: Medicinal cannabis is currently approved for symptom control in cancer patients. There is limited evidence to suggest cannabis is efficacious in the treatment of cancer. In this study we aim to characterise the extent of cannabis use in patients receiving anti-cancer therapies and what impact they think cannabis use has on their cancer. Methods: An anonymous survey was distributed to patients with cancer attending the Beaumont Hospital Oncology Day Unit for anti-cancer therapy over a period of 4 weeks. Results: 175 patients completed the survey. 166 (95%) of patients said they would be comfortable talking to their oncologist about cannabis use. 161 (92%) felt their oncologist should prescribe cannabis as part of their cancer treatment. 17% thought cannabis would cure their cancer. 38% thought cannabis would slow the growth of their cancer and 33% thought cannabis would treat cancer related symptoms. 42 (24%) of all patients had tried some form of cannabis at least once in their life. 26 (15%) were actively taking CBD (Cannabidiol) oil as part of their treatment independently of any healthcare professional guidance. More females (15) were taking CBD compared to males (11). A higher proportion of patients < 50 years (14) were taking CBD during their treatment. 30% of patients using CBD had breast cancer and 23% had a primary CNS malignancy. Of the patients taking CBD, 20 (77%) patients felt it would cure or slow cancer growth and 10 (38%) patients believed it would help with cancer related symptoms. Conclusions: Patients with cancer appear to have a positive attitude towards cannabis as part of their treatment despite limited evidence to support this. With the increasing availability of cannabis-based products globally, medical oncologists must now take into consideration patient’s attitude towards cannabis while treating their cancer. [Table: see text]