Top trial results of 2024: A year of major progress in cancer treatment

Below, we feature seven studies with key findings reported during 2024 by researchers with ECOG-ACRIN Cancer Research Group and our related organization, PrECOG. These discoveries generated great interest throughout the patient and research communities.

Brain Cancer – A striking survival improvement for adults with slow-growing brain tumors

• Both radiation and temozolomide (teh-muh-ZOW-luh-mide), a chemotherapy in pill form, are used to treat adults with low-grade gliomas. A clinical trial called E3F05 showed that combining these treatments improved the 10-year survival rate to 70% compared to 47% with radiation alone. Temozolomide is easier to take and less toxic than some other chemotherapy drugs. Learn more.

Breast Cancer – First trial to show that CDK4/6 inhibitors may benefit patients with double-positive metastatic disease

• The PATINA clinical trial showed that patients with advanced double-positive breast cancer (HR+, HER2+) with the CDK4/6 mutation may benefit from CDK4/6 inhibitors like palbociclib (PAL-boe-SYE-klib). This drug has already been approved by the US Food and Drug Administration (FDA) for another type of breast cancer. When added to standard therapy, palbociclib improved progression-free survival to 44.3 months, compared to 29.1 months for those who did not receive the drug. Learn more.

DCIS Breast Cancer – Tamoxifen reduces 15-year risk of recurrence in ‘good risk’ patients

• For patients with ductal carcinoma in situ (DCIS), recurrence risk is a key factor when choosing therapy after breast-conserving surgery. Treatment guidelines suggest tamoxifen for those with hormone-positive (HR+) tumors, with or without radiation. Analysis of two prior trials (EA5194 and NRG/RTOG 9804) found that tamoxifen significantly benefits patients with ‘good-risk’ features (smaller, less aggressive tumors and clear surgical margins). The estimated 15-year recurrence risk was 11.4%, compared to 19% for those who did not take tamoxifen. Learn more.

Geriatric Oncology – The ground-breaking GIANT trial offers new approaches

• The GIANT trial (EA2186) is ECOG-ACRIN’s first treatment trial for older patients and a milestone in geriatric oncology. It introduces a new clinical tool to better assess older patients for clinical trial participation. It considers physical and mental health, ability to perform daily activities, and other factors that could affect patients’ capacity to endure the demands of cancer treatments. 

• GIANT compared two common chemotherapy treatments in vulnerable older patients with metastatic pancreas cancer. It found the two therapies equally effective with similar side effects, concluding that both are viable options. Watch a discussion with the lead researcher.

Leukemia – Trial leads to FDA approval of a new treatment for patients with B-ALL

• In June 2024, the FDA approved a drug called blinatumomab (blih-nuh-TOO-moh-mab) to treat some patients with a certain type of B-cell acute lymphoblastic leukemia (B-ALL). The approval was mainly based on an ECOG-ACRIN clinical trial that found that combining blinatumomab with standard chemotherapy improved survival. Learn more in ECOG-ACRIN’s E1910 Clinical Trial Summary for the public.

Nose and Sinus Cancer – First evidence that chemotherapy helps spare patients from debilitating eye and bone removal

• A clinical trial showed the benefits of chemotherapy before surgery for patients with advanced cancer of the nose or sinus. These patients were at risk of losing an eye, the base of the skull bone, or both. The trial found that the group that had chemotherapy first had a 50% chance of preserving facial structures, compared to just 15% for those who underwent the standard approach of surgery alone. Learn more in ECOG-ACRIN’s EA3163 Clinical Trial Summary for the public.

Mantle Cell Lymphoma – First evidence that some patients may be able to rely on highly effective standard treatments and avoid the rigors of a stem cell transplant

• Mantle cell lymphoma is an incurable blood cancer mainly affecting older adults. After years of research, patients today can have remissions lasting 8-10 years or even longer through highly effective standard treatments. These include intensive chemotherapy, immunotherapy, and targeted drugs. The added benefits of an autologous stem cell transplant (ASCT) were previously unclear. A key trial (EA4151) found that ASCT offers no additional survival benefits for patients under 70 with no detectable disease after initial treatment. Learn more.

Melanoma – First trial to find the ideal treatment sequence for patients with BRAF-mutated advanced melanoma

• After years of research, there are several effective combination treatments for patients with advanced melanoma whose tumors have a mutation in the BRAF gene. However, the use of one treatment can affect a patient's response to another, leading to multiple treatment options but doubt about their use. The DREAMseq (EA6134) trial found the most effective series of treatments for these patients. In January 2024, ECOG-ACRIN researchers won the 2023 Paper of the Year award from the Journal of Clinical Oncology for the impactful DREAMseq trial results. Learn more in ECOG-ACRIN’s DREAMseq Clinical Trial Summary for the public.