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Enhertu Approved for Metastatic HER2-ultralow Breast Cancer

The Food and Drug Administration (FDA) has expanded the approved use of Enhertu (trastuzumab deruxtecan) to people with unresectable or metastatic hormone receptor (HR)-positive, HER2-ultralow breast cancer. A HER2-directed antibody-drug conjugate, Enhertu was first approved in December 2019 as a treatment for unresectable or metastatic HR-positive, HER2-positive breast cancer after at least two other treatments had been tried. Then in 2022, the FDA approved the drug as a second-line treatment and for people with HER2-low breast cancer. With this latest approval, the drug can now be used in people with HER2-ultralow disease. The decision was based on results from a phase III clinical trial published Sept. 14, 2024, in the New England Journal of Medicine. In the trial, 713 people with HER2-low breast cancer and 153 with HER2-ultralow disease received either Enhertu or standard chemotherapy, Healio reported. Participants who received Enhertu had longer median progression-free survival than those who received chemotherapy (13.2 months vs. 8.1 months), with the benefit holding true in the HER2-ultralow group. “With a median progression-free survival exceeding one year and a response rate of more than 60 per cent, trastuzumab deruxtecan offers a potential new standard of care for patients with HR-positive, HER2-low or HER2-ultralow metastatic breast cancer following endocrine therapy,” Aditya Bardia, a trial investigator and a breast oncologist at UCLA Health Jonsson Comprehensive Cancer Center in Los Angeles, said in a press release.

Young People With Cancer More Likely to Die if They Live in Redlined Areas

Children and young adults with cancer living in historically redlined neighborhoods have a higher likelihood of dying than their peers who live in other areas, according to a study published in Cancer. Redlining refers to the practice of banks denying mortgages to people of color. Starting in the 1920s, banks drew red lines on maps around neighborhoods with primarily minority residents, refusing to lend money to people in those areas. In a study of 4,355 people younger than 40 with cancer in Seattle and Tacoma, Washington, researchers looked at redlining’s impact on cancer outcomes. They found people living in redlined areas had lower five-year (85.1% vs. 90.3%) and 10-year survival (81% vs. 88%) than those not living in redlined neighborhoods, HealthDay reported. This association had previously been found in adults, but this was the first study to evaluate redlining’s effect among younger cancer patients, according to researchers. While redlining has been illegal since the 1970s, researchers said the study shows its lingering impact and the health effects of structural racism. “Our study names racism as a potential driver of outcomes for young patients with cancer,” Kristine Karvonen, the study’s lead author and a pediatric hematologist-oncologist at Fred Hutchinson Cancer Center in Seattle, said in a press release.

Aspirin Use Cuts Colorectal Cancer Recurrences in Half

Taking low-dose aspirin significantly reduced recurrence among people with colorectal cancer with a PI3K pathway mutation, according to a study presented at the American Society of Clinical Oncology Gastrointestinal Cancers Symposium. In the study, researchers followed 626 people in Scandinavia who had colorectal cancer with a PI3K mutation, Healio reported. The 314 participants in group A had a PIK3CA mutation, while the 312 in group B had other types of mutations in the PIK3 pathway. Half of each group was randomly assigned to take 160-milligram aspirin daily for three years, while the other half received a daily placebo. In group A, people who took aspirin had a lower recurrence rate at three years (7.7% vs. 14.1%) than those who took a placebo, but there was no statistically significant difference in disease-free survival. In group B, after three years, participants who received aspirin had a lower recurrence rate (7.7% vs. 16.9%) and a higher disease-free survival rate (89.1% vs. 78.7%) than those who took a placebo. “This is an example of repurposing a safe, inexpensive and globally available drug, and it stresses the importance of upfront genomic testing [for people] with colorectal cancer,” Anna Martling, a study author and a professor of surgery at Karolinska Institutet in Stockholm, said during a press conference.