Enfortumab vedotin (with Pfizer), zolbetuximab (CLDN18.2, 2024), enzalutamide (with Pfizer), gilteritinib.
Enfortumab vedotin is an ADC against Nectin-4 that, combined with pembrolizumab, nearly doubled survival in advanced bladder cancer.
The most widely used androgen-receptor blocker, approved across every stage of advanced prostate cancer, including rising PSA after surgery.
Erlotinib was one of the first EGFR pills for lung cancer; it was approved before anyone knew EGFR mutations predicted who would respond, then redefined by them.
A single pill that beats salvage chemotherapy for relapsed FLT3-mutated AML, and the backbone of the triplets now being tested in frontline disease.
Zolbetuximab is the first drug against Claudin 18.2, a protein exposed on stomach cancer cells. Added to chemotherapy it extends survival by two to three months; nausea is the price.
Almost every patient newly diagnosed with advanced bladder or urothelial cancer should now be offered enfortumab vedotin plus pembrolizumab rather than chemotherapy, with median survival extended from about 16 months to over two and a half years. Neuropathy and skin toxicity need monitoring and dose adjustment, and patients with severe diabetes or pre-existing neuropathy need care. Platinum chemotherapy remains an option for those who cannot receive the combination.
Patients with newly diagnosed advanced stomach cancer should now have Claudin 18.2 tested alongside HER2, PD-L1 and mismatch repair, because roughly a third will be eligible for zolbetuximab, which adds about three months of median survival. The main practical problem is nausea and vomiting during infusions, which needs aggressive prophylaxis. How to sequence or combine it with immunotherapy in PD-L1-positive tumours is unresolved.
ADMIRAL showed that a targeted oral drug can beat chemotherapy outright in relapsed AML, and made gilteritinib the standard bridge to transplant for FLT3-mutated relapse. Its success also underpinned FLT3 inhibitor use in first-line combinations. Resistance through FLT3-independent clones and RAS pathway mutations limits durability without transplant.
Pages like this
not linked directly; found by shared links- TrialADMIRAL
Shares Gilteritinib, ADMIRAL: gilteritinib pills versus chemotherapy for relapsed FLT3-mutated acute myeloid leukaemia, Acute myeloid leukaemia.
- PersonShilpa Gupta
Shares EV-302: enfortumab vedotin plus pembrolizumab replaces chemotherapy as first treatment for advanced bladder cancer, Enfortumab vedotin, Bladder & urothelial cancer.
- PersonDingwei Ye
Shares Enzalutamide, Bladder & urothelial cancer, Prostate cancer.
- PersonYoon-Koo Kang
Shares Zolbetuximab, SPOTLIGHT: zolbetuximab, the first Claudin 18.2 antibody, added to chemotherapy in gastric cancer, Gastric & gastro-oesophageal junction cancer.
- TrialEV-302 / KEYNOTE-A39
Shares EV-302: enfortumab vedotin plus pembrolizumab replaces chemotherapy as first treatment for advanced bladder cancer, Enfortumab vedotin, Bladder & urothelial cancer.
- TrialARCHES
Shares Enzalutamide, Prostate cancer.
- Key paperQuANTUM-First: quizartinib added to intensive chemotherapy and continued as maintenance in newly diagnosed FLT3-ITD AML
Shares Gilteritinib, ADMIRAL: gilteritinib pills versus chemotherapy for relapsed FLT3-mutated acute myeloid leukaemia, Acute myeloid leukaemia.
- PersonKohei Shitara
Shares Zolbetuximab, SPOTLIGHT: zolbetuximab, the first Claudin 18.2 antibody, added to chemotherapy in gastric cancer, Gastric & gastro-oesophageal junction cancer.