Sergio Cifuentes: Key Changes to My Oncology Practice from ASCO2024

Sergio Cifuentes, Cancer Research Project Manager at CENEIT México, shared a post on X:

“My 10 Key Changes to My Oncology Practice from ASCO2024,

1. LA GEJ Adenocarcinoma:
   I will now treat patients with perioperative FLOT rather than preoperative CROSS.
2. Stage III Melanoma:
   For patients with clinically involved lymph nodes, I will use neoadjuvant immunotherapy.
3. Unresectable Stage III EGFR-Mutated NSCLC:
   I will use indefinite adjuvant osimertinib.
4. Limited SCLC:
   I will be treated with a year of adjuvant Durvalumabafter CT-RT.
5. ABC:
   For patients progressing on ET + iCDK4/6, I will consider adding abemaciclib to ET.
   postMONARCH: improvement in mPFS from 3.9 to 5.6 months. ORR were 23% with abemaciclib vs. 8% without (P = .0008)
6. HR+ EBC with Low/Ultra-Low HER2:
   I will consider T-DXd for initial treatment.
   DB-06 study: T-DXd had an HR of 0.62 for PFS compared to chemotherapy, with mPFS of 13.2 months vs. 8.1 months. ORR was 56.5% vs. 32.2%.
7. HR TNBC:
   I will add CBP to ATAX-based chemotherapy (AC-T).
   –PEARLY: significant increase in 5-year EFS with carbo (82.3% vs. 75.1%), with a hazard ratio of 0.67 (P = .012).
8. Advanced ALK+ NSCLC:
   I will use Lorlatinib as first-line therapy.
   CROWN: 5-year PFS of 60% with lorlatinib vs. 8% with crizotinib, with a significantly longer time to intracranial progression.
9. mCRC MSI-H/dMMR:
   I will offer NIVO ± IPI in a 1L setting.
   CM 8HW: NIVO + IPI showed a 79% reduction in the risk of disease progression or death compared to chemotherapy (HR 0.21 [95% CI 0.14–0.32]; P < 0.0001).
10. Hot Flashes in Men on ADT for Prostate Cancer:
    I will try oxybutynin (OXY).
    Alliance A222001: a higher dose of OXY significantly reduced daily hot flash scores compared to placebo (P = .002).”

Source: Sergio Cifuentes/X