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width="1.25rem" xmlns="http://www.w3.org/2000/svg"><polyline points="6 9 6 2 18 2 18 9"></polyline><path d="M6 18H4a2 2 0 0 1-2-2v-5a2 2 0 0 1 2-2h16a2 2 0 0 1 2 2v5a2 2 0 0 1-2 2h-2"></path><rect x="6" y="14" width="12" height="8"></rect></svg></a></button></div></div><div><div class="flex flex-wrap"><p class=" text-primary font-semibold">News</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1"></div><p class=" text-primary font-semibold">Article</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1 "></div><time class="text-gray-500 " dateTime="2025-02-07T21:21:18.648">February 7, 2025</time></div><h1 class="text-[26px] font-medium leading-8">Study Finds Declining SCLC Incidence, but Stagnant Survival Rates</h1><div class="py-3 text-gray-600 md:flex flex-col md:justify-between"><div class="flex flex-col xs:flex-row"><p class="mr-1 self-start">Author(s):</p><div class="flex flex-col xs:flex-row mb-3 md:mb-0"><div class="flex flex-wrap"><span class="text-md mr-2"><a class="text-author text-gray-500 hover:text-primary underline hover:no-underline decoration-gray-400" href="/authors/hayden-e-klein">Hayden E. Klein</a></span></div></div></div><div class="max-w-full"><div class="flex flex-wrap sm:flex-nowrap items-center w-fit my-2"></div><div class="w-full flex flex-col sm:flex-row justify-between mt-2"><div class="block md:hidden "><div class="mt-2 flex items-center max-w-fit"><button title="Study Finds Declining SCLC Incidence, but Stagnant Survival Rates" aria-label="facebook" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#3b5998"></circle><path d="M34.1,47V33.3h4.6l0.7-5.3h-5.3v-3.4c0-1.5,0.4-2.6,2.6-2.6l2.8,0v-4.8c-0.5-0.1-2.2-0.2-4.1-0.2 c-4.1,0-6.9,2.5-6.9,7V28H24v5.3h4.6V47H34.1z" fill="white"></path></svg></button><button aria-label="twitter" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg fill="#DC7633" 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!important; box-shadow: 0px 0px 2px 2px rgba(0,0,0,0.1); } .rhap_progress-section { width: 150px; margin-left: 35px; } .rhap_controls-section { position: relative; bottom: .75rem; } .rhap_time { font-size: 12px; color: rgb(0,55,103); } .rhap_progress-bar { color: rgb(0,55,103) !important; } .rhap_progress-filled { background-color: rgb(0,55,103) !important; } .rhap_progress-indicator { height: 15px; width: 5px; top: -5px; margin-left: 1px; background-color: rgb(0,55,103) !important; } .rhap_repeat-button { display: none; } .rhap_volume-bar, rhap_volume-button, .rhap_volume-indicator { background: rgb(0,55,103) !important; } .rhap_volume-bar { height: 2px; width: 35px; position: relative; left: 22px; bottom: 21px; } .rhap_volume-button { // width: 5px; // height: 5px; flex: 0 0 26px; position: relative; left: 22px; bottom: 21px; } .rhap_volume-button svg { height: 18px; width: 18px; } .rhap_volume-indicator { height: 8px; width: 8px; top: -2.75px } .rhap_button-clear { color: rgb(0,55,103) !important; } .rhap_play-pause-button { color: rgb(0,55,103) !important; font-size: 30px !important; width: 30px !important; height: 30px !important; position: relative; right: 90px; bottom: 22px; } .rhap_main-controls button { color: rgb(0,55,103) !important; } audio::-webkit-media-controls-play-button, video::-webkit-media-controls-play-button { -webkit-appearance: media-play-button; color: #b8dcf6; } audio::-webkit-media-controls-panel { background-color: white !important; color: #000; } audio::-webkit-media-controls-current-time-display, audio::-webkit-media-controls-time-remaining-display { font-size: 12px; } </style></div></div></div><div class=" lg:w-full flex flex-col lg:flex-row lg:items-center lg:justify-end"></div><div class="w-full flex flex-col px-4 py-4 border-t border-b border-solid border-gray-400 my-4 "><h3 class="text-primary text-xl font-semibold">Key Takeaways</h3><ul class="list-disc px-8"><li class="py-2 "> SCLC incidence decreased by 3% annually from 2000 to 2020, attributed to reduced smoking rates and smoking-related policies. </li><li class="py-2 "> Survival rates for SCLC have shown only minor improvements despite decreased incidence, with 1-year relative survival increasing slightly. </li><li class="py-2 hidden"> Immune checkpoint inhibitors have provided some improvement in extensive-stage SCLC, but long-term survival impact remains modest. </li><li class="py-2 hidden"> Annual CT screening's effectiveness for SCLC is limited due to the cancer's rapid progression and high likelihood of metastasizing within a year.</li></ul><span class="text-xs font-bold text-primary underline cursor-pointer mt-2 ml-4">SHOW MORE</span></div><p class="py-2 mb-2 text-sm italic text-gray-600">SEER data show that small cell lung cancer (SCLS) incidence has steadily declined due to reduced smoking rates, but survival outcomes have seen only minimal improvement, underscoring the need for more effective treatments.</p><div class="py-2"><div class="blockText_blockContent__TbCXh"><p class="pb-2">The incidence of <a target="_blank" href="https://www.ajmc.com/compendium/lung-cancer">small cell lung cancer</a> (SCLC) has steadily declined in the US over the past 2 decades, largely due to reduced smoking rates, but survival outcomes remain largely unchanged, according to a new study published in <a rel="nofollow noreferrer noopener" target="_blank" href="https://onlinelibrary.wiley.com/doi/10.1002/cam4.70608"><em>Cancer Medicine</em></a>.<sup class="text-inherit">1</sup></p><p class="pb-2"></p><p class="pb-2">The analysis, which examined data from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2020, highlights both the progress in cancer prevention and the urgent need for more effective treatment options.</p><p class="pb-2"></p><div class=""><div style="width:35%;float:right;max-width:525px;margin:0 0 1.5rem 1.5rem;clear:both;cursor:" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%278192%27%20height=%274608%27/%3e"/></span><img alt="Doctor showing patient lung x-ray. | Image credit: Dragana Gordic – stock.adobe.com" title="Doctor showing patient lung x-ray. | Image credit: Dragana Gordic – stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="Doctor showing patient lung x-ray. | Image credit: Dragana Gordic – stock.adobe.com" title="Doctor showing patient lung x-ray. | Image credit: Dragana Gordic – stock.adobe.com" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fcfb706b50be1f17b68f7a1eef146583c4f2d7741-8192x4608.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 1x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fcfb706b50be1f17b68f7a1eef146583c4f2d7741-8192x4608.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">Despite the implementation of CT lung screening in 2013, most patients already had distant metastatic disease at the time of diagnosis. | Image credit: Dragana Gordic – stock.adobe.com</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/ajmc/cfb706b50be1f17b68f7a1eef146583c4f2d7741-8192x4608.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2">The researchers found that the age-adjusted incidence rate of SCLC decreased by an average of 3% per year, from 9 per 100,000 people in 2000, to 4.6 in 2020. This decline was consistent across all demographic groups, including different races, sexes, and age categories. Incidence-based mortality rates also decreased, from 6.6 per 100,000 in 2005, to 3.5 in 2020. However, while fewer people are being diagnosed with SCLC, survival rates have shown only minor improvements. The 1-year relative survival rate increased slightly from 33.1% in 2000 to 35.3% in 2019, while the 1-year observed survival rose from 32.4% to 34.5% over the same period.</p><p class="pb-2"></p><p class="pb-2">“Since SCLC almost always occurs in smokers, the decrease in smoking prevalence in the United States, predominately driven by implantation of smoking-related policies is likely responsible for this notable decline,” the authors said.</p><p class="pb-2"></p><p class="pb-2">SCLC is a particularly aggressive form of lung cancer, with nearly 60% of patients presenting with metastatic disease at diagnosis.<sup class="text-inherit">2</sup> For years, platinum-etoposide chemotherapy has been the standard treatment, offering strong initial responses but limited long-term survival.<sup class="text-inherit">3</sup> More recently, the addition of immune checkpoint inhibitors (ICIs) such as atezolizumab and durvalumab has provided some improvement in extensive-stage SCLC, yet their impact on long-term survival remains modest.<sup class="text-inherit">1</sup></p><p class="pb-2"></p><p class="pb-2">They also examined the impact of lung cancer screening efforts, particularly the implementation of low-dose computed tomography (CT) scans for high-risk individuals. While screening has led to earlier detection of non–small cell lung cancer, its effectiveness for SCLC is less clear due to the rapid progression of the disease. Despite the implementation of CT lung screening in 2013, most patients (55.9%) in the study already had distant metastatic disease at the time of diagnosis.<sup class="text-inherit">4,1</sup> According to the authors, this indicates that annual CT screening may not be the most effective tool for detecting SCLC early, as the cancer's aggressive progression and high likelihood of metastasizing within a year may outpace the 1-year screening interval.</p><p class="pb-2"></p><p class="pb-2">At the same time, the study found a slight increase in the diagnosis of localized SCLC and a corresponding decline in metastatic cases over time, particularly after 2013. While the trend was slow before 2013—potentially due to the growing use of diagnostic CT scans—the more noticeable shift afterward suggests that screening may be helping detect some cases at an earlier stage.</p><p class="pb-2"></p><p class="pb-2">“Moreover, advancements in radiation techniques, early-stage at diagnosis with screening CT scans, may have improved survival for patients with limited-stage disease,” the study authors added. “Population-based studies to assess the survival benefit of improved cancer care, enhanced radiation techniques and the introduction of immunotherapy are lacking.”</p><p class="pb-2"></p><p class="pb-2">The study’s limitations include the retrospective nature of SEER data, which does not capture detailed treatment regimens or emerging therapies in real time. Additionally, data before 2004 lacked complete staging information, limiting some analyses.</p><p class="pb-2"></p><p class="pb-2"><strong>References</strong></p><p class="pb-2"></p><ol class="my-2"><li class="list-decimal ml-8">Uprety D, Seaton R, Niroula A, Hadid T, Parikh K, Ruterbusch JJ. Trends in the incidence and survival outcomes in patients with small cell lung cancer in the United States: an analysis of the SEER database. <em>Cancer Med</em>. 2025;14(3):e70608. doi:10.1002/cam4.70608</li><li class="list-decimal ml-8">Rudin CM, Brambilla E, Faivre-Finn C, Sage J. Small-cell lung cancer. <em>Nat Rev Dis Primers</em>. 2021;7(1):3. doi:10.1038/s41572-020-00235-0</li><li class="list-decimal ml-8">Farid S, Liu SV. Chemo-immunotherapy as first-line treatment for small-cell lung cancer. <em>Ther Adv Med Oncol</em>. 2020;12:1758835920980365. doi:10.1177/1758835920980365</li><li class="list-decimal ml-8">Moyer VA; U.S. Preventive Services Task Force. screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. <em>Ann Intern Med</em>. 2014;160(5):330-338. doi:10.7326/M13-2771</li></ol></div></div><div class="flex items-center lg:w-3/4 mb-4 pb-12"></div><div class="jsx-19ede9f0a5a45918 py-4 relative bg-primary md:px-8 -ml-6 xs:ml-0 w-screen xs:w-auto"><div class="jsx-19ede9f0a5a45918 px-4 sm:px-0"><div class="flex justify-between items-center py-1 space-x-4 border-0 select-none sm:border-b border-secondary"><div class="text-3xl text-white text-lg sm:text-3xl">Related Videos</div></div></div><div style="scroll-snap-type:none" class="jsx-19ede9f0a5a45918 flex items-start overflow-x-auto space-x-4 py-4 relative mx-auto w-full pl-4"><a id="" class="w-[200px] h-fit space-y-3 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class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 15th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/powles-highlights-transformative-benefit-of-ev-plus-pembro-while-sharing-long-term-data-for-ev-302?utm_source=www.ajmc.com&utm_medium=relatedContent">Powles Highlights “Transformative” Benefit of EV Plus Pembro While Sharing Long-Term Data for EV-302</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/mary-caffrey">Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/powles-highlights-transformative-benefit-of-ev-plus-pembro-while-sharing-long-term-data-for-ev-302?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The lead investigator for EV-302 said not long ago, survival of 12 to 14 months in this type of bladder cancer was considered an achievement; in this study, median overall survival was 34 months after treatment with enfortumab vedotin (EV) and pembrolizumab (pembro).</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/analysis-looks-at-benefits-toxicity-of-adc-combinations-in-advanced-bladder-cancer?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/a13ef0cd0e6b56f4e0f3835241425ff4035f5ade-600x450.jpg?fit=crop&auto=format" alt="Analysis Looks at Benefits, Toxicity of ADC Combinations in Advanced Bladder Cancer" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 15th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/analysis-looks-at-benefits-toxicity-of-adc-combinations-in-advanced-bladder-cancer?utm_source=www.ajmc.com&utm_medium=relatedContent">Analysis Looks at Benefits, Toxicity of ADC Combinations in Advanced Bladder Cancer</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/mary-caffrey">Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/analysis-looks-at-benefits-toxicity-of-adc-combinations-in-advanced-bladder-cancer?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">City of Hope's Salvador Jaime-Casas, MD, discusses a systematic review of recent trials examining objective response rate and adverse events of antibody-drug conjugate (ADC) combinations in advanced urothelial cancer. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="relative hidden sm:block"><div class="mt-4 overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end items-end"><div class="hidden w-full lg:flex flex-wrap pb-2 gap-x-2 gap-y-1 justify-end items-end"></div></div></div><div class="w-full mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="flex flex-wrap w-full"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/getting-more-doctors-to-record-a-life-saving-prostate-cancer-calculation?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/8aceeba5763fb50cb7e3fc6c5a174b0ffc43a652-566x487.jpg?fit=crop&auto=format" alt="Alicia Morgans MD, MPH | Image credit: Dana-Farber" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/getting-more-doctors-to-record-a-life-saving-prostate-cancer-calculation?utm_source=www.ajmc.com&utm_medium=relatedContent">Getting More Doctors to Record a Life-Saving Prostate Cancer Calculation</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/mary-caffrey">Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/getting-more-doctors-to-record-a-life-saving-prostate-cancer-calculation?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Accurate calculation of prostate-specific antigen doubling time can be crucial for prostate cancer treatment decisions but is often missed by doctors, impacting patient care.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/exploring-racial-ethnic-disparities-in-cancer-care-prior-authorization-decisions?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9de113904a026205cbaf84d08420c4065d52fd67-1000x563.jpg?fit=crop&auto=format" alt="managed care cast logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">October 24th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/exploring-racial-ethnic-disparities-in-cancer-care-prior-authorization-decisions?utm_source=www.ajmc.com&utm_medium=relatedContent">Exploring Racial, Ethnic Disparities in Cancer Care Prior Authorization Decisions</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/exploring-racial-ethnic-disparities-in-cancer-care-prior-authorization-decisions?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">On this episode of Managed Care Cast, we're talking with the author of a study published in the October 2024 issue of The American Journal of Managed Care® that explored prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/alcohol-and-cancer-risk-murthy-s-parting-call-for-warning-labels?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/7d5dbaf91804139bbdcde69a900f16b170de4602-678x452.jpg?fit=crop&auto=format" alt="Vivek Murthy, MD | Image credit: NBC News" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 19th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/alcohol-and-cancer-risk-murthy-s-parting-call-for-warning-labels?utm_source=www.ajmc.com&utm_medium=relatedContent">Alcohol and Cancer Risk: Murthy’s Parting Call for Warning Labels</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/maggie-l-shaw">Maggie L. Shaw</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/alcohol-and-cancer-risk-murthy-s-parting-call-for-warning-labels?utm_source=www.ajmc.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/examining-low-value-cancer-care-trends-amidst-the-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/453ff95d3edc29442e2af71658751e2f26adc78e-2500x2500.jpg?fit=crop&auto=format" alt="Managed Care Cast logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">April 25th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/examining-low-value-cancer-care-trends-amidst-the-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent">Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/examining-low-value-cancer-care-trends-amidst-the-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/powles-highlights-transformative-benefit-of-ev-plus-pembro-while-sharing-long-term-data-for-ev-302?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/3a19b338994d57764d7f408c063ffc36b037edcc-640x410.jpg?fit=crop&auto=format" alt="Powles Highlights “Transformative” Benefit of EV Plus Pembro While Sharing Long-Term Data for EV-302" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 15th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/powles-highlights-transformative-benefit-of-ev-plus-pembro-while-sharing-long-term-data-for-ev-302?utm_source=www.ajmc.com&utm_medium=relatedContent">Powles Highlights “Transformative” Benefit of EV Plus Pembro While Sharing Long-Term Data for EV-302</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/mary-caffrey">Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/powles-highlights-transformative-benefit-of-ev-plus-pembro-while-sharing-long-term-data-for-ev-302?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The lead investigator for EV-302 said not long ago, survival of 12 to 14 months in this type of bladder cancer was considered an achievement; in this study, median overall survival was 34 months after treatment with enfortumab vedotin (EV) and pembrolizumab (pembro).</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/analysis-looks-at-benefits-toxicity-of-adc-combinations-in-advanced-bladder-cancer?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/a13ef0cd0e6b56f4e0f3835241425ff4035f5ade-600x450.jpg?fit=crop&auto=format" alt="Analysis Looks at Benefits, Toxicity of ADC Combinations in Advanced Bladder Cancer" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 15th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/analysis-looks-at-benefits-toxicity-of-adc-combinations-in-advanced-bladder-cancer?utm_source=www.ajmc.com&utm_medium=relatedContent">Analysis Looks at Benefits, Toxicity of ADC Combinations in Advanced Bladder Cancer</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/mary-caffrey">Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/analysis-looks-at-benefits-toxicity-of-adc-combinations-in-advanced-bladder-cancer?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">City of Hope's Salvador Jaime-Casas, MD, discusses a systematic review of recent trials examining objective response rate and adverse events of antibody-drug conjugate (ADC) combinations in advanced urothelial cancer. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="pb-24"></div></div><script type="application/ld+json">{"@context":"https://schema.org","@type":"NewsArticle","headline":"Study Finds Declining SCLC Incidence, but Stagnant Survival Rates","datePublished":"2025-02-07T21:21:18.648Z","dateModified":"2025-02-07T21:47:17Z","inLanguage":"en-US","image":"https://cdn.sanity.io/images/0vv8moc6/ajmc/cfb706b50be1f17b68f7a1eef146583c4f2d7741-8192x4608.jpg?fit=crop&auto=format","mainEntityOfPage":{"@type":"WebPage","@id":"https://www.ajmc.com/view/study-finds-declining-sclc-incidence-but-stagnant-survival-rates"},"publisher":{"@type":"Organization","name":"AJMC","logo":{"@type":"ImageObject","url":"https://www.ajmc.com/ajmc_logo_inverted.png"}},"keywords":"small cell lung cancer incidence trends,SCLC survival rates 2025,lung cancer screening effectiveness,immune checkpoint inhibitors for SCLC","articleBody":"The incidence of small cell lung cancer (SCLC) has steadily declined in the US over the past 2 decades, largely due to reduced smoking rates, but survival outcomes remain largely unchanged, according to a new study published in Cancer Medicine.1\n\n\n\nThe analysis, which examined data from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2020, highlights both the progress in cancer prevention and the urgent need for more effective treatment options.\n\n\n\n\n\nThe researchers found that the age-adjusted incidence rate of SCLC decreased by an average of 3% per year, from 9 per 100,000 people in 2000, to 4.6 in 2020. This decline was consistent across all demographic groups, including different races, sexes, and age categories. Incidence-based mortality rates also decreased, from 6.6 per 100,000 in 2005, to 3.5 in 2020. However, while fewer people are being diagnosed with SCLC, survival rates have shown only minor improvements. The 1-year relative survival rate increased slightly from 33.1% in 2000 to 35.3% in 2019, while the 1-year observed survival rose from 32.4% to 34.5% over the same period.\n\n\n\n“Since SCLC almost always occurs in smokers, the decrease in smoking prevalence in the United States, predominately driven by implantation of smoking-related policies is likely responsible for this notable decline,” the authors said.\n\n\n\nSCLC is a particularly aggressive form of lung cancer, with nearly 60% of patients presenting with metastatic disease at diagnosis.2 For years, platinum-etoposide chemotherapy has been the standard treatment, offering strong initial responses but limited long-term survival.3 More recently, the addition of immune checkpoint inhibitors (ICIs) such as atezolizumab and durvalumab has provided some improvement in extensive-stage SCLC, yet their impact on long-term survival remains modest.1\n\n\n\nThey also examined the impact of lung cancer screening efforts, particularly the implementation of low-dose computed tomography (CT) scans for high-risk individuals. While screening has led to earlier detection of non–small cell lung cancer, its effectiveness for SCLC is less clear due to the rapid progression of the disease. Despite the implementation of CT lung screening in 2013, most patients (55.9%) in the study already had distant metastatic disease at the time of diagnosis.4,1 According to the authors, this indicates that annual CT screening may not be the most effective tool for detecting SCLC early, as the cancer's aggressive progression and high likelihood of metastasizing within a year may outpace the 1-year screening interval.\n\n\n\nAt the same time, the study found a slight increase in the diagnosis of localized SCLC and a corresponding decline in metastatic cases over time, particularly after 2013. While the trend was slow before 2013—potentially due to the growing use of diagnostic CT scans—the more noticeable shift afterward suggests that screening may be helping detect some cases at an earlier stage.\n\n\n\n“Moreover, advancements in radiation techniques, early-stage at diagnosis with screening CT scans, may have improved survival for patients with limited-stage disease,” the study authors added. “Population-based studies to assess the survival benefit of improved cancer care, enhanced radiation techniques and the introduction of immunotherapy are lacking.”\n\n\n\nThe study’s limitations include the retrospective nature of SEER data, which does not capture detailed treatment regimens or emerging therapies in real time. Additionally, data before 2004 lacked complete staging information, limiting some analyses.\n\n\n\nReferences\n\n\n\nUprety D, Seaton R, Niroula A, Hadid T, Parikh K, Ruterbusch JJ. Trends in the incidence and survival outcomes in patients with small cell lung cancer in the United States: an analysis of the SEER database. Cancer Med. 2025;14(3):e70608. doi:10.1002/cam4.70608\n\nRudin CM, Brambilla E, Faivre-Finn C, Sage J. Small-cell lung cancer. Nat Rev Dis Primers. 2021;7(1):3. doi:10.1038/s41572-020-00235-0\n\nFarid S, Liu SV. Chemo-immunotherapy as first-line treatment for small-cell lung cancer. Ther Adv Med Oncol. 2020;12:1758835920980365. doi:10.1177/1758835920980365\n\nMoyer VA; U.S. Preventive Services Task Force. screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330-338. doi:10.7326/M13-2771","description":"SEER data show that small cell lung cancer (SCLS) incidence has steadily declined due to reduced smoking rates, but survival outcomes have seen only minimal improvement, underscoring the need for more effective treatments.","author":[{"@type":"Person","name":"Hayden E. Klein"}]}</script></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div class="collapse-container " style="overflow:hidden;max-height:900px;transition:max-height .4s ease-in-out"></div></div></div></div><div id="div-gpt-ad-pixel" style="width:1px;height:1px" class=""></div><noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-NK5KQXS" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript><div id="footerOuterWrap" class=" mx-auto flex"><div class="bg-[#00598D] xl:w-[70%] w-[70%] py-12 pl-auto"><div class="xxl:w-[75%] w-[90%] ml-auto"><div><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span 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However, many physicians estimate rather than accurately calculate PSADT, leading to inconsistent documentation and potential treatment delays. A study highlighted that patients with unknown PSADT often experience rapid PSA doubling and delayed treatment initiation. Implementing standardized PSADT calculations in electronic health records could improve accuracy and treatment outcomes. Overestimating PSADT may result in underestimating cancer aggressiveness, risking missed treatment opportunities and increased metastasis-related complications.","seoTag":["prostate cancer"," PSADT","Dana-Farber","high-risk","androgen deprivation therapy","genitourinary","PSA"],"body":[{"markDefs":[],"children":[{"_key":"ddf6e3087857","_type":"span","marks":[],"text":"What if your ability to receive the right treatment for prostate cancer came down to whether a doctor wrote down a math problem?"}],"_type":"block","style":"normal","_key":"3b160010e5e1"},{"style":"normal","_key":"b5ff33b229ff","markDefs":[],"children":[{"_type":"span","marks":[],"text":"It sounds far-fetched, but it’s not: The math calculation in question is called prostate-specific antigen doubling time (PSADT), which is the number of months it takes for the patient’s PSA level to double.","_key":"c91e33d6749d"}],"_type":"block"},{"_type":"figure","_key":"a3dd22855282","disableTextWrap":false,"imgcaption":[{"_key":"556bd2fc7dc5","markDefs":[],"children":[{"_key":"e28fb88f196a","_type":"span","marks":[],"text":"Alicia Morgans MD, MPH"}],"_type":"block","style":"normal"},{"style":"normal","_key":"e0cdec8441c4","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Image credit: Dana-Farber Cancer Institute","_key":"8e05f039f450"}],"_type":"block"}],"alt":"Headshot of Alicia Morgans MD, MPH | Image credit: Dana-Farber Cancer Institute","alignment":"left","asset":{"_ref":"image-8aceeba5763fb50cb7e3fc6c5a174b0ffc43a652-566x487-jpg","_type":"reference"},"widthP":25,"disableLightBox":true},{"_type":"block","style":"normal","_key":"d48d59200380","markDefs":[],"children":[{"_type":"span","marks":[],"text":"This measure of how quickly PSA is increasing is used to monitor cancer recurrence, and it’s considered one of the best predictors of outcomes for patients who have been treated for prostate cancer. Physicians use the PSADT metric to gauge a patient’s risk level and to decide if they need to start salvage androgen deprivation therapy (ADT).","_key":"c8e58d5f31aa"}]},{"style":"normal","_key":"8ab49d13fa9a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"So, what’s the issue? According to Alicia Morgans, MD, MPH, genitourinary medical oncologist and director of the Survivorship Program at Dana-Farber Cancer Institute, the PSADT metric is well-known to physicians, but many of them may be estimating it instead of fully calculating it—or they may be calculating the PSADT but not recording it in their notes.","_key":"41589b8a35f9"}],"_type":"block"},{"style":"normal","_key":"1de2fba05b8e","markDefs":[],"children":[{"_type":"span","marks":[],"text":"“It takes time,” Morgans said in an interview with ","_key":"9ad42cb8f0ec"},{"_type":"span","marks":["em"],"text":"The American Journal of Managed Care","_key":"4014ddecb029"},{"_type":"span","marks":[],"text":". “You have to pull up the calculator, then you type in the numbers, then you type in the PSA and the date. And you have to do this several times so you can look at a period of time to calculate that doubling time. So, it does take effort.”","_key":"49ce2811a623"}],"_type":"block"},{"_type":"block","style":"normal","_key":"841bd87d027e","markDefs":[],"children":[{"marks":[],"text":"According to data that Morgans presented recently at the American Society of Clinical Oncology Genitourinary Cancers Symposium in San Francisco, all this leads to incomplete or inconsistent recording of PSADT data, which can mean some patients are not receiving the right care.","_key":"7ac300807173","_type":"span"}]},{"_type":"block","style":"h3","_key":"691d54df2dab","markDefs":[],"children":[{"text":"Methods","_key":"4b247db577e4","_type":"span","marks":["strong"]}]},{"markDefs":[{"_type":"link","href":"http://clinicaltrials.gov/show/NCT02319837","_key":"ebbaa6ac17e4"}],"children":[{"_type":"span","marks":[],"text":"Morgans’ study involved a chart review of patients who recorded a HR of biochemical recurrence (BCR) from the Cardinal Health Oncology Provider Extended Network from 2018 to 2020 in the United States.","_key":"6ffb41b88a15"},{"_type":"span","marks":["sup"],"text":"1","_key":"b56cb16e031f"},{"_type":"span","marks":[],"text":" The HR BCR definition was at least 9 months with a PSA at or above the threshold of the EMBARK trial, which had evaluated enzalutamide (","_key":"504d8e6aad0c"},{"_type":"span","marks":["ebbaa6ac17e4"],"text":"NCT02319837","_key":"09ba844194eb"},{"marks":[],"text":").","_key":"a6085539f9d0","_type":"span"},{"_type":"span","marks":["sup"],"text":"2","_key":"3e6a1a3a98ee"},{"marks":[],"text":" Follow-up was from the date the HR BCR was met until disease progression, the last follow-up, or death through 2022.","_key":"814da17532cf","_type":"span"}],"_type":"block","style":"normal","_key":"87c978de3bd6"},{"_type":"block","style":"normal","_key":"b67cb1ffe029","markDefs":[],"children":[{"_key":"3fc991880c74","_type":"span","marks":[],"text":"Physicians were asked to report PSADT in case reports, using doubling time from labs, clinical judgment, or an online calculator. If none of these were available, PSADT was calculated retrospectively based on values that had been entered into the case reports; these were listed in the study as unknown PSADT. The study also looked at time to treatment."}]},{"_type":"block","style":"h3","_key":"f90a42cb7331","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Results","_key":"7d1b1594138c"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Among 284 patients with HR BCR, the median time from prostate cancer diagnosis to end of follow-up was 39.1 months. Most patients had known PSADT. Other data were as follows:","_key":"423fd067ed4b"}],"_type":"block","style":"normal","_key":"1e8795c6819e"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"A higher share of patients with unknown PSADT had PSADT that rapidly doubled (61% vs 20%, ","_key":"b9e8b24b98ed"},{"text":"P","_key":"cf03a0ed6ac9","_type":"span","marks":["em"]},{"marks":[],"text":" \u003c .001)","_key":"f0051232ec20","_type":"span"}],"level":1,"_type":"block","style":"normal","_key":"96c525dcfb0a","listItem":"bullet"},{"_type":"block","style":"normal","_key":"9d81a4e81864","listItem":"bullet","markDefs":[],"children":[{"_type":"span","marks":[],"text":"A higher share of patients with known PSADT (64%) compared with unknown PSADT (17%) received treatment within 60 days after the index date, with a shorter median time to treatment (1.0 month vs 6.7 months; HR 3.4; 95% CI, 2.6-4.4, ","_key":"b2da01d57487"},{"text":"P","_key":"49256d66538c","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":" \u003c .0001).","_key":"44080cb0c991"}],"level":1},{"style":"normal","_key":"349d30894666","listItem":"bullet","markDefs":[],"children":[{"_key":"31ffcd976279","_type":"span","marks":[],"text":"Patients with known PSADT were more likely to be older with slower doubling time and get treatment than patients with unknown PSADT. The authors of the abstract wrote that this could mean treatment opportunities are being missed in clinical practice, and some patients are not getting treatment that could delay disease progression."}],"level":1,"_type":"block"},{"style":"h3","_key":"108e0c7110d5","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Explaining the Results","_key":"e6f7f9ed2f2a"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Morgans suspects that many doctors are looking at the numbers and dates and making an estimate about the approximate doubling time, “which is probably overestimating the doubling time as we suggest in the paper…. They’re doing some form of [PSADT], but they’re not doing it in a structured, standardized way.\"","_key":"363bc9de7d21"}],"_type":"block","style":"normal","_key":"dc5c9eb917e8"},{"style":"normal","_key":"6dafb36bdf11","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Could software in the electronic health record be modified to perform the PSADT calculation for the doctors? “That would be fantastic,” Morgans said. “That would be very, very helpful, because if there is a standardized approach to calculation that gets you the true number, then that would be used in the regulatory approval of the drugs that we use for those high-risk patients with the shorter doubling time.”","_key":"a34f87a8ad24"}],"_type":"block"},{"_type":"block","style":"normal","_key":"afc5873a6c7e","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Adding a quality measure based on whether doctors record PSADT is another possibility, but that also raises issues of administrative burden.","_key":"3e8c568ed6df"}]},{"style":"normal","_key":"10fc3db82630","markDefs":[],"children":[{"_key":"5de6e68d24d6","_type":"span","marks":[],"text":"Morgans noted that the study also revealed that if doctors overestimate the doubling time, they in turn also underestimate how aggressive the cancer is; thus, they underestimate the risk of metastasis in that individual patient."}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"If a patient’s calculation is off and not listed as high risk—when in fact the cancer is aggressive—does that mean the patient may not be approved for the treatment needed?","_key":"9d80d409caed"}],"_type":"block","style":"normal","_key":"910caba7bd97"},{"children":[{"_type":"span","marks":[],"text":"“True,” Morgans said. “It may also lead to [the physician] not treating the patient when it’s absolutely appropriate, and they’re not taking that opportunity to prevent metastasis, which is associated with all kinds of other complications—pain, bleeds, other therapies.”","_key":"08c1e574ae0f"}],"_type":"block","style":"normal","_key":"099aeca92545","markDefs":[]},{"_key":"4f74be9c675a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"She added, “It can also be quite expensive for other interventions.”","_key":"9d4cc820b889"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Performing the calculation correctly doesn’t add any cost or inconvenience to the patient—it’s strictly a matter of getting doctors to do PSADT correctly and to record it consistently. Morgans said because the study was relatively small, the group doesn’t have information on which doctors are most likely to do PSADT correctly and consistently.","_key":"58140f32219f"}],"_type":"block","style":"normal","_key":"aec413143443"},{"_key":"cd422c855dd0","markDefs":[],"children":[{"_type":"span","marks":[],"text":"“I can't say, except to say that I think every doctor is actually at risk for not calculating it because of the time issues, because of the pressures that they have,” Morgans said.","_key":"3beef631c001"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"text":"References","_key":"e8251ef3294a","_type":"span","marks":["strong"]}],"_type":"block","style":"normal","_key":"567a8764f81f"},{"style":"normal","_key":"ddb9772c28a6","listItem":"number","markDefs":[],"children":[{"marks":[],"text":"Morgans AK, Touya M, El-Chaar NN, et al. Impact of physicians’ awareness of prostate-specific antigen doubling time (PSADT) on treatment (Tx) decisions in high-risk (HR) biochemically recurrent (BCR) prostate cancer (PC). ","_key":"d89bd4a38c7a","_type":"span"},{"_key":"fdf2e8dcbe62","_type":"span","marks":["em"],"text":"J Clin Oncol."},{"_type":"span","marks":[],"text":" 43(suppl 5): Abstract 354. doi:10.1200/JCO.2025.43.5_suppl.354","_key":"e240f5c66047"}],"level":1,"_type":"block"},{"_key":"97e388bd6b76","listItem":"number","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Freedland SJ, Luz MdA, DeGiorgio U, et al. Improved outcomes with enzalutamide in biochemically recurrent prostate cancer. ","_key":"b20dae704e25"},{"_type":"span","marks":["em"],"text":"N Engl J Med. ","_key":"701d171e101d"},{"_type":"span","marks":[],"text":"2023;389(16):1453-1465. doi:10.1056/NEJMoa2303974","_key":"815609d7d1b3"}],"level":1,"_type":"block","style":"normal"}],"summary":"Accurate calculation of prostate-specific antigen doubling time can be crucial for prostate cancer treatment decisions but is often missed by doctors, impacting patient care.","targeting":{"content_placement":["conference","news","compendium/oncology"],"document_url":["getting-more-doctors-to-record-a-life-saving-prostate-cancer-calculation"],"document_group":{"_id":"9fa06b80-be6e-4dc1-8258-e845d7d319c6","pixelTrackingCode":null,"_createdAt":"2025-01-27T19:28:54Z","_rev":"DjkOSIyr2rhb00e8aWRacW","_type":"documentGroup","_updatedAt":"2025-01-27T19:29:19Z","identifier":{"current":"asco-gu","_type":"slug"},"parent":{"_createdAt":"2020-04-03T18:14:34Z","_rev":"4o2kwjzNDJRdyxUiyQV0Zp","_type":"documentGroup","_id":"a0e8a8bf-62dd-45ed-a1e1-cd1e5e8de6f6","parent":null,"_updatedAt":"2022-07-31T01:49:46Z","identifier":{"current":"conference","_type":"slug"},"pixelTrackingCode":{"_ref":"c42e5374-778f-4c0d-9f48-73dc34bb9008","_type":"reference"},"name":"Conference"},"name":"ASCO GU: ASCO Genitourinary Cancers Symposium"},"rootDocumentGroup":["conference"],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"Bimekizumab, Brodalumab Safe, Effective Up to 36 Weeks for Psoriasis","url":{"current":"bimekizumab-brodalumab-safe-effective-up-to-36-weeks-for-psoriasis","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"Psoriasis | Image credit: SergeVo - 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Rabin RC. Surgeon general calls for cancer warnings on alcohol. New York Times. January 3, 2025. Accessed January 6, 2025. https://www.nytimes.com/2025/01/03/health/alcohol-surgeon-general-warning.html\n2. US surgeon general issues new advisory on link between alcohol and cancer risk. News release. US Department of Health and Human Services; January 3, 2025. Accessed January 14, 2025. https://www.hhs.gov/about/news/2025/01/03/us-surgeon-general-issues-new-advisory-link-alcohol-cancer-risk.html\n3. US Department of Agriculture. Dietary Guidelines for Americans, 2020-2025. 9th edition. US Department of Agriculture; 2020. Accessed January 6, 2025. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf\n4. O’Keefe JH, Bhatti SK, Bajwa A, DiNicolantonio JJ, Lavie CJ. Alcohol and cardiovascular health: the dose makes the poison…or the remedy. ","_key":"22a9e7f4b3f7","_type":"span","marks":[]},{"_key":"1bc4ee890f92","_type":"span","marks":["em"],"text":"Mayo Clin Proc. "},{"_type":"span","marks":[],"text":"2014;89(3):382-393. doi:10.1016/j.mayocp.2013.11.005\n5. IARC Handbooks of Cancer Prevention volume 20A: reduction or cessation of alcohol consumption. World Health Organization. Accessed January 6, 2025. https://www.iarc.who.int/faq/iarc-handbooks-of-cancer-prevention-volume-20a-reduction-or-cessation-of-alcohol-consumption/#:~:text=In%201987%2C%20the%20IARC%20Monographs,to%20humans%20(Group%201)\n6. Acetaldehyde. Australian Government Department of Climate Change, Energy, the Environment, and Water. Accessed January 6, 2025. https://www.dcceew.gov.au/environment/protection/npi/substances/fact-sheets/acetaldehyde\n7. Current intelligence bulletin 55. National Institute for Occupational Safety and Health. September 1991. Accessed January 6, 2025. https://www.cdc.gov/niosh/docs/91-112/default.html\n8. Stone W. What to know about Trump’s picks for CDC, FDA, and surgeon general. NPR. November 23, 2024. Accessed January 14, 2025. https://bit.ly/42kyCn0\n9. Alcohol’s effects on health. National Institute on Alcohol Abuse and Alcoholism. Updated December 2024. Accessed January 6, 2025. https://www.niaaa.nih.gov/alcohols-effects-health/what-standard-drink\n10. Alcorn T. Should alcoholic beverages have cancer warning labels? New York Times. Updated April 11, 2024. Accessed January 6, 2025. https://www.nytimes.com/2024/04/09/health/alcohol-cancer-warning.html\n11. Baldwin SL. Surgeon general calls for cancer risk warning on beverages with alcohol. CBS News. Updated January 4, 2025. Accessed January 6, 2025. https://www.cbsnews.com/news/surgeon-general-alcohol-cancer-risk-warning-label-beverages/#:~:text=Warning%20labels%20are%20currently%20required,and%20may%20cause%20health%20problems.%22","_key":"cf06b59bd56a"}],"_type":"block"}],"issueSection":{"_ref":"65282bb4-b905-43a3-b11d-b9c4483f3438","_type":"reference"},"_createdAt":"2025-02-19T02:54:24Z","title":"Alcohol and Cancer Risk: Murthy’s Parting Call for Warning Labels","thumbnail":{"alt":"Vivek Murthy, MD | Image credit: NBC News","caption":"Vivek Murthy, MD | Image credit: NBC News","asset":{"_ref":"image-7d5dbaf91804139bbdcde69a900f16b170de4602-678x452-jpg","_type":"reference"},"_type":"mainImage"},"authors":[{"displayName":"Maggie L. 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You can connect with Mary on ","_key":"c2027cf5a357"},{"_type":"span","marks":["4f88673cb2c4"],"text":"LinkedIn","_key":"9737335da1ed1"},{"_type":"span","marks":[],"text":".","_key":"9737335da1ed2"}],"_type":"block"}],"url":{"current":"mary-caffrey","_type":"slug"},"_updatedAt":"2023-10-12T05:02:06Z"}],"documentGroup":{"parent":{"identifier":{"current":"conference","_type":"slug"},"pixelTrackingCode":{"_ref":"c42e5374-778f-4c0d-9f48-73dc34bb9008","_type":"reference"},"_rev":"4o2kwjzNDJRdyxUiyQV0Zp","_type":"documentGroup","_createdAt":"2020-04-03T18:14:34Z","parent":null,"name":"Conference","_id":"a0e8a8bf-62dd-45ed-a1e1-cd1e5e8de6f6","_updatedAt":"2022-07-31T01:49:46Z"},"_createdAt":"2025-01-27T19:28:54Z","_rev":"DjkOSIyr2rhb00e8aWRacW","_type":"documentGroup","name":"ASCO GU: ASCO Genitourinary Cancers Symposium","_updatedAt":"2025-01-27T19:29:19Z","pixelTrackingCode":null,"identifier":{"current":"asco-gu","_type":"slug"},"_id":"9fa06b80-be6e-4dc1-8258-e845d7d319c6"},"_updatedAt":"2025-02-16T04:20:35Z","_type":"article","seoTag":["pembrolizumab","EV-302","enfortumab vedotin","Padcev","Keytruda","bladder cancer","advanced urothelial sarcoma","adverse events"],"targeting":{"content_placement":["conference","compendium/oncology","news"],"document_url":["powles-highlights-transformative-benefit-of-ev-plus-pembro-while-sharing-long-term-data-for-ev-302"],"document_group":{"parent":{"identifier":{"current":"conference","_type":"slug"},"pixelTrackingCode":{"_ref":"c42e5374-778f-4c0d-9f48-73dc34bb9008","_type":"reference"},"_rev":"4o2kwjzNDJRdyxUiyQV0Zp","_type":"documentGroup","_createdAt":"2020-04-03T18:14:34Z","parent":null,"name":"Conference","_id":"a0e8a8bf-62dd-45ed-a1e1-cd1e5e8de6f6","_updatedAt":"2022-07-31T01:49:46Z"},"_createdAt":"2025-01-27T19:28:54Z","_rev":"DjkOSIyr2rhb00e8aWRacW","_type":"documentGroup","name":"ASCO GU: ASCO Genitourinary Cancers Symposium","_updatedAt":"2025-01-27T19:29:19Z","pixelTrackingCode":null,"identifier":{"current":"asco-gu","_type":"slug"},"_id":"9fa06b80-be6e-4dc1-8258-e845d7d319c6"},"rootDocumentGroup":["conference"],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"Bimekizumab, Brodalumab Safe, Effective Up to 36 Weeks for Psoriasis","url":{"current":"bimekizumab-brodalumab-safe-effective-up-to-36-weeks-for-psoriasis","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"Psoriasis | Image credit: SergeVo - 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","body":[{"children":[{"_type":"span","marks":[],"text":"Antibody-drug conjugates (ADCs), used with and without immunotherapy, have been game-changers in treating advanced urothelial carcinoma (aUC), a bladder cancer that spreads to other parts of the body. Yet, there have been tradeoffs: in some cases, patients see results but experience adverse events (AEs), including skin rashes.","_key":"f421cc4031eb"}],"_type":"block","style":"normal","_key":"b25e0004b962","markDefs":[]},{"imgcaption":[{"_key":"a29c698ec042","markDefs":[],"children":[{"marks":[],"text":"Salvador Jaime-Casas, MD | Image credit: X","_key":"3ad7b780bea4","_type":"span"}],"_type":"block","style":"normal"}],"alignment":"left","widthP":25,"alt":"Salvador Jaime-Casas, MD | Image credit: X","asset":{"_type":"reference","_ref":"image-e53c36fe3de257cfba46535f2909dfe433a299c3-400x400-jpg"},"disableTextWrap":false,"_type":"figure","disableLightBox":true,"_key":"96b90b6eb43d"},{"style":"normal","_key":"ba12690dcf8c","markDefs":[],"children":[{"_type":"span","marks":[],"text":"To gain a better understanding of the data on ADC combinations in aUC, investigators led by Salvador Jaime-Casas, MD, a post-doctoral research fellow in the Department of Genitourinary Oncology at City of Hope, in Los Angeles, California, led a systematic review of 5 recent trials involving the use of sacituzumab govitecan (Trodelvy; Gilead) and enfortumab vedotin (Padcev; Astellas/Seagen) in combination regimens. Jaime-Casas presented in a poster","_key":"5e48b7e02ee5"},{"_type":"span","marks":["sup"],"text":"1","_key":"71ff41aa1915"},{"marks":[],"text":" at the American Society of Clinical Oncology Genitourinary Cancers Symposium (ASCO GU), which met February 13-15, 2025, in San Francisco, California.","_key":"fd44e4c4aece","_type":"span"}],"_type":"block"},{"_type":"block","style":"normal","_key":"592e20449d79","markDefs":[{"_type":"link","href":"https://www.onclive.com/view/fda-approves-sacituzumab-govitecan-for-advanced-urothelial-cancer","_key":"ae354bb7ead3"},{"_type":"link","href":"https://www.ajmc.com/view/oig-report-seeks-better-oversight-records-for-fda-s-accelerated-approvals","_key":"3cf4d935dec4","nofollow":true,"blank":true}],"children":[{"text":"The 2 ADC therapies have had different paths in bladder cancer. Sacituzumab govitecan (SG) was granted ","_key":"b0494d00b130","_type":"span","marks":[]},{"_type":"span","marks":["ae354bb7ead3"],"text":"accelerated approval","_key":"a23cf4bfd1aa"},{"_type":"span","marks":[],"text":" as a monotherapy in April 2021 to for patients with previously treated aUC. However, last fall Gilead voluntary withdrew it from the market after follow-up data failed to meet end points for overall survival (OS).","_key":"beb410689319"},{"_key":"0dd0ab237368","_type":"span","marks":["sup"],"text":"2"},{"_type":"span","marks":[],"text":" A recent report from the HHS ","_key":"0cfc21927151"},{"text":"Office of the Inspector General","_key":"5ed236923095","_type":"span","marks":["3cf4d935dec4"]},{"_type":"span","marks":[],"text":" highlighted the frequency of cancer therapies being pulled from the market, sometimes years after receiving an accelerated approval, when long-term data fail to meet end OS targets.","_key":"07bda595d094"}]},{"children":[{"marks":[],"text":"Enfortumab vedotin (EV), meanwhile, received a ","_key":"47aa2a0c6607","_type":"span"},{"_type":"span","marks":["12172197ff07"],"text":"regular approval","_key":"55b0cc94ae18"},{"marks":[],"text":" for previously treated patients with locally advanced or metastatic urothelial cancer in July 2021. Then, in December 2023, a combination with pembrolizumab (Keytruda; Merck) received accelerated approval to treat all newly diagnosed patients with aUC, based on the phase 3 EV-302 trial.","_key":"51bd2f3c1a74","_type":"span"}],"_type":"block","style":"normal","_key":"db59ddc81efd","markDefs":[{"_type":"link","href":"https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-regular-approval-enfortumab-vedotin-ejfv-locally-advanced-or-metastatic-urothelial-cancer","_key":"12172197ff07"}]},{"children":[{"_type":"span","marks":[],"text":"Final OS data from the EV-302 trial, ","_key":"c0c45ff610e3"},{"_type":"span","marks":["c958d886fb62"],"text":"announced ahead","_key":"c06e681e930f"},{"_type":"span","marks":[],"text":" of ASCO GU and presented Friday showed that the combination of EV and pembrolizumab cut the risk of death 49% compared with chemotherapy.","_key":"c9bb5b7b9ee8"},{"marks":["sup"],"text":"3","_key":"60ff8dfd4d67","_type":"span"}],"_type":"block","style":"normal","_key":"bac68de3ef33","markDefs":[{"_type":"link","href":"https://www.ajmc.com/view/positive-os-for-bladder-cancer-combo-biomarkers-on-tap-at-asco-gu-2025","_key":"c958d886fb62"}]},{"children":[{"_type":"span","marks":[],"text":"The trials in the review presented at ASCO GU were: the phase 1 DAD trial (NCT04724018) that studied the dual ADC combination of sacituzumab govitecan (SG) and EV; the EV-302 trial (NCT04223856) combining EV and pembrolizumab; EV-301 (NCT03474107), cohort K, a phase 1b/2 study that also evaluated EV plus pembrolizumab; EV-103 (NCT03288545), cohort A, also phase 1b/2; and TROPHY-U-01 (NCT03547973), the phase 3 study evaluating SG plus pembrolizumab.","_key":"b8ef95a06d35"}],"_type":"block","style":"normal","_key":"b1b47594cc1c","markDefs":[]},{"_type":"block","style":"normal","_key":"9ef2d867f053","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Investigators identified 627 evaluable patients from these 5 trials; they recorded an objective response rate (ORR) of 66.2%, and 366 patients across all studies had AEs of grade 3 or higher, for a risk rate (RR) of 58.4%. The most common AE of at least grade 3 was neutropenia (RR 0.14), followed by anemia (RR 0.10), and maculopapular rash (RR 0.10). Data presented on the poster showed that there was a higher incidence of AEs of at least grade 3 in the SG-based regimens compared with the EV-based regimens.","_key":"c07142774811"}]},{"children":[{"_key":"ec6e5027b466","_type":"span","marks":[],"text":"This week, Jaime-Casas joined "},{"_type":"span","marks":["em"],"text":"The American Journal of Managed Care","_key":"fe1145ba5391"},{"_type":"span","marks":["sup"],"text":"®","_key":"a8fb3552a69e"},{"_type":"span","marks":[],"text":" (","_key":"5f292ad88cb7"},{"_type":"span","marks":["em"],"text":"AJMC","_key":"cab9bdd287c1"},{"text":"®","_key":"09eb8ae6d927","_type":"span","marks":["sup"]},{"_type":"span","marks":[],"text":") for an interview about the findings and what they mean within the context of recent news surrounding ADCs.","_key":"45527d8827c6"}],"_type":"block","style":"normal","_key":"f3a57661530e","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"This interview has been lightly edited for length and clarity.","_key":"af4deeb8389c"}],"_type":"block","style":"normal","_key":"ea839dbed8bb","markDefs":[]},{"markDefs":[],"children":[{"text":"AJMC","_key":"86898dfd9d08","_type":"span","marks":["strong","em"]},{"_type":"span","marks":["strong"],"text":":","_key":"2c26432d19d8"},{"text":" Your findings note that the AE incidence varied by regimen, with events being more common in SG-based regimens. Last fall, Gilead announced it was withdrawing an indication for SG in aUC based on overall survival data. Do the data in your study offer support for that decision?","_key":"dcc5f27169b5","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"aadf05d98225"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Jaime-Casas:","_key":"6253f5d13ff3"},{"text":" The systematic reiew evaluated 5 prospective clinical trials using either in EV or SG as combination-based regimens. So, for most of these trials, it was SG or EV in combination with immunotherapy. And although we did not analyze overall survival, recurrence-free survival, which was part of the reason why SG was pulled off the market, because the TROPiCS-04 trial (NCT0457991) failed to show this improved survival compared to chemotherapy, we also mirror these results by showing that there is a modest improvement in the objective response rate, that comes at the cost of a high rate of adverse events, particularly grade 3 or above adverse events. And these were actually very similar if you look at the TROPiCS-04 publication","_key":"2005ca277a25","_type":"span","marks":[]},{"marks":["sup"],"text":"4","_key":"2216d831341d","_type":"span"},{"_type":"span","marks":[],"text":" and our results, we also recorded that one of the highest adverse events for patients receiving sacituzumab govitecan was neutropenia. We record hematological adverse events such as neutropenia, anemia and diarrhea.","_key":"15c0d33fca97"}],"_type":"block","style":"normal","_key":"a148c68eaa51"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"So, I would say, although our analyses are not the same, because we do not assess in our paper the recurrence-free survival and recurrence-free survival, they do reflect the same trend, and that is even if there is some benefit to receiving this therapy, it is modest at best, and it comes at the cost of a high rate of adverse events.","_key":"a7f62b37f5f1"}],"_type":"block","style":"normal","_key":"98c214fd4e99"},{"children":[{"text":"AJMC","_key":"590721ce0047","_type":"span","marks":["strong","em"]},{"_type":"span","marks":["strong"],"text":": ","_key":"6f296692a946"},{"_type":"span","marks":[],"text":"How should payers view these results? Are there steps that can be taken to mitigate AEs that payers should support/encourage?","_key":"ed177c500ee0"}],"_type":"block","style":"normal","_key":"9674c9c8c387","markDefs":[]},{"_key":"41350bac5e7a","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Jaime-Casas:","_key":"41ef8333b0f3"},{"_type":"span","marks":[],"text":" Definitely, in the context of EV, it's a little bit more safe to say that payers should invest more money, as we know that EV-[pembrolizumab] has been recently approved in the metastatic setting in patients who have previously been untreated. But I think in particular for sacituzumab govitecan-based regimens and combination regimens, payers should be a little bit more cautious, not only because of the cost of medication, but also because of the cost associated with care for these adverse events.","_key":"c8d662466c41"}],"_type":"block","style":"normal"},{"style":"normal","_key":"ef1b74f4f722","markDefs":[],"children":[{"_key":"1ed6beb46229","_type":"span","marks":[],"text":"Essentially, we know that patients who have a high chance of encountering things like hematological toxicity, neutropenia or anemia may require more frequent blood evaluation. Some patients may even require transfusions of blood units or even like colony stimulating factors. At least from the perspective of a [genitourinary] clinic, this is very multidisciplinary in nature. I think one of the associated costs that payers should focus on would be multi-disciplinary teams that include medical oncologists, but [they should] also considered dermatologists and even pharmacists who are able to make modifications to the dosages if we encounter these toxicities."}],"_type":"block"},{"_key":"63a3aa2ee9d7","markDefs":[],"children":[{"text":"AJMC:","_key":"13ba2a7ef1b7","_type":"span","marks":["strong","em"]},{"_type":"span","marks":[],"text":" Is it known how AE differences compare when ADCs were used in second-line treatment vs first-line?","_key":"4834c2a4c072"}],"_type":"block","style":"normal"},{"style":"normal","_key":"17ed0020d65f","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Jaime-Casas:","_key":"90ecc99005d0"},{"_type":"span","marks":[],"text":", I would say right now, we do not have very mature data to strictly say, what are the things we could expect for patients who receive an ADC firstline. We can definitely expect a much better functional baseline status, and patients may be able to tolerate a little bit more toxicity before withholding or discontinuing completely the drug, in contrast with patients who may be receiving it as their second- or third-line treatment. So, for instance, if we talk about EV-302 we know that in this case, EV and [pembrolizumab], which is part of our poster in our systematic review, this was given in patients who were treatment naïve. So, it was given firstline, and patients were able to tolerate it more. But when we talk about, for instance, the TROPICS-04 patients, this was a heavily pretreated patient population. This frailty may also impact the results, as these patients already have some hematological malignancies, myelosuppression, or even peripheral neuropathy from previous platinum-based chemotherapy.","_key":"b541f2a4ec26"}],"_type":"block"},{"style":"normal","_key":"4af208c978ca","markDefs":[{"href":"https://www.ajmc.com/view/how-antibody-drug-conjugates-and-chemotherapy-shortages-are-affecting-patients-with-bladder-cancer","_key":"53a255053cce","nofollow":true,"blank":true,"_type":"link"}],"children":[{"_type":"span","marks":["strong","em"],"text":"AJMC:","_key":"f560f8476e43"},{"_type":"span","marks":[],"text":" During part of the period that your data covers, we were experiencing a severe cisplatin shortage. ","_key":"da99b2427939"},{"_type":"span","marks":["em"],"text":"AJMC","_key":"76d29ae7d941"},{"_key":"59ad27b65d1d","_type":"span","marks":[],"text":" was "},{"text":"talking in real time","_key":"f38b88d66442","_type":"span","marks":["53a255053cce"]},{"marks":[],"text":" with doctors who used ADCs instead of cisplatin to treat patients, because sometimes nothing else was available—although cisplatin was indicated in the National Comprehensive Cancer Network (NCCN) guidelines for firstline treatment. Can physicians look at the data you are presenting and gain comfort about those decisions, especially if they may someday be confronted with not having cisplatin available?","_key":"5130d07ac0b9","_type":"span"}],"_type":"block"},{"style":"normal","_key":"3a653244d8cd","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Jaime-Casas:","_key":"6646fe7988eb"},{"text":", in our data, what we did find is there is a promising objective response rate seen overall for these 5 included studies. Three of the studies that we included, EV-302 and EV-103 cohort A and cohort K were given in the context of EV plus immunotherapy. And you know, for EV-103, for that study, this one of the inclusion criteria was patients who were cisplatin ineligible already. So, I think the comfort here is that at least in the context of EV therapy, we could say that it was good at that moment before it was approved; it was a good alternative when you were encountering a patient with advanced urothelial carcinoma, and you had this context of a cisplatin shortage. Giving EV in this disease setting was not a bad option, because we do see that there is a tolerable adverse event profile and optimal response. And in the end, we now know that EV and pembrolizumab actually got approved in the metastatic setting firstline, while the same could not be said for sacituzumab govitecan.","_key":"1a06de75dbee","_type":"span","marks":[]}],"_type":"block"},{"style":"normal","_key":"6d65d1819c9f","markDefs":[],"children":[{"text":"To sum up, we do believe that data for [sacituzumab govitecan] is still necessary, as we see that it may not be superior in terms of survival according to TROPiCS-04 trial when compared to chemotherapy.","_key":"9a7ab9e1e8d1","_type":"span","marks":[]}],"_type":"block"},{"_key":"6ca7a6a387bd","markDefs":[],"children":[{"_type":"span","marks":["strong","em"],"text":"AJMC:","_key":"b373153e1cec"},{"_type":"span","marks":[],"text":" If there’s a key data point from your presentation that you'd like to highlight for our readers, what would that be?","_key":"0b87f09e0668"}],"_type":"block","style":"normal"},{"style":"normal","_key":"43a3a7b62024","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Jaime-Casas:","_key":"0ecce8ea37bd"},{"_type":"span","marks":[],"text":" We found only one clinical trial that was evaluating 2 antibody drug conjugates in combination. The there was a single phase 1 clinical trial evaluating EV and sacituzumab govitecan. This is a very small phase 1 clinical trial, but I think it shows promise in the sense that antibody-drug conjugates by having different structures, by having different payloads, and even by having different linkers and then non-overlapping adverse event profile, they show promise for the future where new antibody drug conjugates will come into the market, and clinical trials could potentially be designed around combining these either with immunotherapy or another antibody-drug conjugate. 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