The Five Under 5 highlights five concise expert videos for busy oncologists, covering breaking news, regulatory updates, practice-changing data from meetings, and clinical management insights.
Real-world Outcomes Following Treatment With Obe-Cel and Brexu-Cel in R/R ALL: Yannis K. Valtis, MD
Yannis K. Valtis of Memorial Sloan Kettering Cancer Center reviewed ROCCA registry data presented at the 2025 ASH Annual Meeting comparing obecabtagene autoleucel (obe-cel; Aucatzyl) and brexucabtagene autoleucel (brexu-cel; Tecartus) in relapsed/refractory acute lymphoblastic leukemia. Early efficacy was comparable, with MRD-negative complete response/CR with incomplete hematologic recovery rates of 81% for obe-cel and 80% for brexu-cel at day 28. Valtis noted these findings support both CAR T products as highly active in heavily pretreated patients but emphasized that longer follow-up is needed to assess durability of remission and curative potential.
Challenges in the Diagnosis and Management of LEMS in SCLC: Jacob Sands, MD
Jacob Sands of Dana-Farber Cancer Institute discussed diagnostic and management challenges for Lambert-Eaton myasthenic syndrome in patients with small cell lung cancer. He highlighted that proximal muscle weakness and autonomic symptoms often overlap with treatment-related toxicity or cancer-related fatigue, leading to underrecognition. Sands advised maintaining a low threshold for paraneoplastic antibody testing and early neurology involvement when patients with SCLC present with vague or unexplained neurologic symptoms.
Where CELMoDs Could Fit in the Myeloma Treatment Paradigm: Joshua Richter, MD
Joshua Richter of Mount Sinai outlined evolving roles for the CELMoDs iberdomide (CC-220) and mezigdomide (CC-92480) in multiple myeloma. He cited phase 2 EMN26 data showing iberdomide produced MRD-negativity conversion rates of 30%–50% post–autologous stem cell transplant, surpassing historical lenalidomide benchmarks, and noted promising activity in combinations such as with elranatamab in MagnetisMM-30. Richter positioned mezigdomide as a potentially more potent option for high-risk disease, including extramedullary myeloma, where early studies have reported deep remissions.
Updated Efficacy Data for Avapritinib in Indolent Systemic Mastocytosis: Tsewang Tashi, MD
Tsewang Tashi of the University of Utah presented 3-year follow-up results from part 3 of the phase 2 PIONEER trial evaluating avapritinib (Ayvakit) in indolent systemic mastocytosis. Long-term data showed deep, sustained improvements in total symptom score and durable quality-of-life benefits at two and three years. No new safety signals emerged with continued treatment at either the 25-mg or 50-mg dose levels.
Factors Informing Frontline Chemotherapy Selection in Pancreatic Cancer: Dong Kim, MD
Dong Kim discussed key considerations for choosing frontline chemotherapy in pancreatic cancer, emphasizing tumor stage and resectability, patient performance status and comorbidities, molecular profiling (including BRCA and MSI status), expected toxicity profiles, treatment goals, and patient preferences. He stressed the importance of multidisciplinary discussion and clinical trial enrollment when appropriate, and noted that regimen selection—such as more intensive approaches like FOLFIRINOX versus less intensive options like gemcitabine-based therapy—should be individualized based on patient fitness and goals of care.
Leave a Reply