Advancements and Challenges in Oncology: Addressing Disparities and Exploring New Treatment Frontiers

Despite advancements in oncology, Black women in the US face a disproportionately high burden of triple-negative breast cancer (TNBC), marked by higher incidence, poorer prognosis, and greater mortality rates than other racial groups. In the peer-reviewed literature review on page 9, authors Britny Brown, PharmD, BCOP; Madison Savidge, PharmD, MBA; and Olivia Arukwe, PharmD, demonstrate how clinical trial data leading to FDA approval of TNBC therapies from 2019 to 2023 show the underrepresentation of Black women, with median enrollment at just 6.5%, far below the US census proportion of 14.4%. Addressing this disparity requires prioritizing equitable enrollment, targeted recruitment, and systemic interventions to improve access and representation in clinical research.

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Small cell lung cancer (SCLC) is a highly aggressive cancer with a poor 5-year survival rate of less than 10%. In the peer-reviewed literature review on page 24, authors Aubrey R. Lasko, PharmD, BCOP; and Catherine B. Meador, MD, PhD, discuss recent advances in SCLC treatment, including immune checkpoint inhibitors, which have modestly improved outcomes. However, treatment options for SCLC remain limited, especially in later-line settings. DLL3, a ligand expressed in 80% of SCLC cells, has emerged as a promising therapeutic target. This review highlights the development of DLL3-targeting therapies.

Targeting the DLL3 protein, tarlatamab-dlle (Imdelltra; Amgen Inc) has shown durable responses and manageable safety in clinical trials, although it requires careful monitoring for cytokine release syndrome and neurologic toxicities. In the peer-reviewed new drug review on page 14, author Avani Yenamandra, PharmD, BCOP, discusses tarlatamab’s indication for extensive-stage SCLC with disease progression after platinum-based chemotherapy. The drug’s mechanism of action and promising efficacy establish it as a critical second-line treatment option.

In the peer-reviewed literature review on page 18, authors Thomas Bokinz, PharmD; and Britny R. Brown, PharmD, BCOP, discuss the FDA’s April 2024 approval of fam-trastuzumab deruxtecan-nxki (Enhertu; Daiichi Sankyo, Inc) for HER2-positive solid tumors. The approval marks a significant advancement in site-agnostic cancer therapy, expanding its use beyond specific cancer types to a broader patient population. Clinical trial data, including those of DESTINY-PanTumor02 (NCT04482309), demonstrate its efficacy across multiple tumor types, with notable responses in patients with gynecologic malignancies.

These peer-reviewed literature reviews underscore the advancements and persistent challenges in oncology. By prioritizing diverse enrollment, leveraging targeted therapies, and expanding site-agnostic approaches, the oncology community can work toward more inclusive and effective treatment strategies for all patients.