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Trial Results: ECOG-ACRIN research round-up – Fall 2025

Research dictionary entry

  • Below, we highlight results from clinical trials by the ECOG-ACRIN Cancer Research Group and PrECOG, LLC that were recently published in medical journals or reported at scientific meetings. These studies demonstrate progress toward developing more effective treatments and enhancing the quality of life for cancer patients.

    Breast Cancer A potential new treatment for HR+, HER2- metastatic breast cancer

    • Hormone receptor–positive (HR+), HER2-negative (HER2−) breast cancer is the most common subtype. While there are many effective treatments, some patients may develop metastatic disease, making it harder to treat. For example, immunotherapy, which uses the patient's own immune system to target cancer cells and eliminate them, has not shown much effectiveness so far. A small clinical trial, BRACELET-1, tested combinations of cancer drugs to see if they could enhance the effectiveness of immunotherapy. Promising results were observed with a unique immunotherapy called pelareorep (pel-a-REE-oh-rep) and paclitaxel (PA-klih-TAK-sil) chemotherapy. This combination resulted in longer survival without the disease getting worse, compared to the other combinations studied in the trial. Researchers suggest further study in a larger clinical trial, with careful attention to side effects. Read the press release to learn more about how this new treatment could possibly keep the disease at bay longer than before.

    Breast Cancer Study finds declines in mental health 2 years after DCIS surgery

    • Ductal carcinoma in situ (DCIS), sometimes called stage 0 breast cancer, is not invasive and not life-threatening. Most women with DCIS successfully have their cancer removed. Their prognosis is excellent, with a 98% survival rate 10 years after treatment. However, are certain patients more vulnerable than others to a decline in mental well-being after treatment? The answer is ‘yes’ according to a newly published analysis. It is based on patient surveys, and it reveals that minority racial identity, non-private insurance, and more surgery (such as a follow-up mastectomy) were all associated with poorer mental and physical health 2 years after surgery. Researchers studied patient-reported outcomes from a prior treatment trial (E4112), which included women with DCIS in one breast. Participants completed questionnaires before surgery, at the first post-operative visit, and 1 and 2 years after surgery. Don’t miss this news interview with Dr. Lynne Wagner, who explains how this study gets to the heart of the issues women with DCIS face after treatment and identifies those at greatest risk. She emphasizes the importance of ongoing monitoring of mental well-being over time—well beyond the completion of treatment.

    Nose and Sinus Cancer Chemotherapy before surgery helps patients avoid debilitating eye and bone removal

    • A striking improvement was observed in patients who received chemotherapy before surgery to remove nose and sinus cancer. Patients enrolled in the EA3163 trial had signs that surgery would result in loss of the eye, the base of the skull bone, or both. This study found that the group that received chemotherapy before surgery had a 50% chance of preserving these organs. In contrast, patients who only had surgery—the usual treatment—had a much lower 15% chance. Read the press release with Dr. Nabil Saba to learn how pre-surgery treatment is dramatically increasing the chances of preserving vision and critical bone structure.

    Leukemia Immunotherapy in the treatment of young adults with B-ALL

    • We know that combining the immunotherapy drug blinatumomab (blih-nuh-TOO-moh-mab) with chemotherapy significantly improves overall survival for adult patients with B-cell acute lymphoblastic leukemia (B-ALL), a type of blood cancer, that has gone into remission following initial treatment. This discovery is from the E1910 trial, which studied the treatment in patients aged 30-70 years. The study changed clinical practice and helped lead to an FDA approval of the treatment. Recently, researchers reported survival rates for the under-55 subgroup and, more narrowly, the 30-39 age group. They confirmed a substantial survival benefit with blinatumomab and chemotherapy in younger adults. Their finding is consistent with separate studies in adolescents and young adults. Watch this video interview with Dr. Shira Dinner to hear how this treatment is boosting survival and shaping the future of care for young adults with this disease.

    Lung Cancer Treatment headway gives much-needed hope

    • Small-cell lung cancer (SCLC) is an aggressive cancer that often spreads quickly and is associated with high recurrence rates after initial treatment. When diagnosed at an advanced stage, SCLC has spread too far for surgery or radiation therapy to be helpful as the initial treatment. A small clinical trial, EA5161, explored giving the immunotherapy drug nivolumab (nih-VOL-yoo-mab) to patients with untreated extensive-stage SCLC in combination with chemotherapy. This approach was compared to chemotherapy alone. The published results show that nivolumab plus chemotherapy was better at helping patients live longer without the disease getting worse. 

    Lung Cancer Crizotinib targeted therapy did not improve survival for early-stage ALK+ patients

    • About 1 in 25 people with non-small cell lung cancer have tumors with an ALK gene change. The ALCHEMIST E4512 study tested whether the targeted drug crizotinib (krih-ZOH-tih-nib) could help people with early-stage ALK+ disease live longer after surgery. At a recent medical meeting, researchers reported that crizotinib did not improve survival compared with observation alone—the standard approach after surgery—and caused more side effects. They noted that newer ALK drugs have been developed since this trial began, which appear to be more effective and have fewer side effects. Watch Dr. David Gerber’s trial presentation video to hear how these drugs offer hope for improving outcomes in the future.

    Lung Cancer Starting immunotherapy during chemotherapy and radiation did not help patients live longer 

    • For people with stage 3 lung cancer that cannot be removed by surgery, standard treatment is chemotherapy and radiation, followed by a year of immunotherapy with durvalumab (dur-VAL-yoo-mab). The EA5181 trial tested whether starting durvalumab earlier—during chemotherapy and radiation—could help patients live longer. Researchers reported at a recent medical meeting that the study found no added benefit from giving durvalumab at the same time as chemo and radiation. Doctors continue to recommend durvalumab after chemo and radiation, not during it. To learn more, watch a trial presentation video with Dr. John Varlotto.

    Skin CancerImmunotherapy after surgery shows potential in preventing the spread of aggressive skin cancer

    • A drug that uses the body’s immune system to target and eliminate cancer cells appeared to reduce the risk of risk of the cancer spreading to other parts of the body for an aggressive form of skin cancer when given immediately after surgery, but did not significantly reduce the overall risk of recurrence, which was a co-primary endpoint of the trial. The STAMP trial (EA6174) is the largest study to evaluate immunotherapy with pembrolizumab (pem-broh-LIH-zoo-mab) after surgery to remove the cancer. This is much-needed good news for people who are living with the highly aggressive cancer known as Merkel cell carcinoma. Read the press release with Dr. Janice Mehnert to learn more about the hope this brings for those suffering from this disease.

    Throat Cancer Excellent long-term outcomes after less intense treatment

    • E3311 is a clinical trial that improved treatment for patients with human papillomavirus (HPV+) associated throat cancer and at medium risk for recurrence. The trial showed the benefits and safety of providing low-dose radiation without chemotherapy after surgery. Now, the published long-term results continue to show excellent outcomes, with 90% of the patients being cancer-free after 4 ½ years. Not only does this less-intense treatment approach achieve very high survival, but it also delivers an outstanding quality of life for patients. For example, it preserves patients’ swallowing and voice functions and spares them unnecessary side effects. To learn more about how this trial has helped patients, read the lay-friendly trial summary and the original press release.

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

Common treatments for adults with grade 2 glioma include radiation and temozolomide (tem-oh·ZOL·oh·mide), which is a kind of chemotherapy in pill form. The E3F05 trial, which followed patients for more than 10 years, showed that combining temozolomide with radiation therapy resulted in a 10-year survival rate of 70%, compared to only 47% for radiation alone. This trial provides the first evidence from a randomized phase 3 trial showing that temozolomide chemotherapy enhances long-term survival for these patients. Temozolomide is a less toxic chemotherapy pill, making it easier for patients to tolerate and more manageable for oncologists to administer than other chemotherapies used for these patients. Read the press release.

Breast Cancer – Palbociclib demonstrates benefit in HR+, HER2+ metastatic disease  

Approximately 10% of all breast cancers are hormone-receptor positive (HR+) and human epidermal growth factor receptor 2-positive (HER2+), often referred to as double-positive or triple-positive breast cancer. Patients with this type of breast cancer need better treatment options due to the development of resistance to current therapies. The phase 3 PATINA trial evaluated palbociclib (pal·bow·SAI·klib) as a potential treatment for these patients. Palbociclib is a targeted drug therapy already approved by the FDA to treat HR+, HER2- metastatic breast cancer. The study showed that adding palbociclib to standard anti-HER2 and endocrine therapy led to an increase in progression-free survival, with patients experiencing 44.3 months without progression versus 29.1 months for those not receiving the drug. PrECOG is among the large group of collaborators on this study co-led by Alliance Foundation Trials and Pfizer Inc. Read the press release.

DCIS Breast Cancer – Tamoxifen reduces recurrence risk for patients deemed ‘good-risk’

For patients with ductal carcinoma in situ (DCIS), the risk of recurrence is a key consideration when choosing therapy options after breast-conserving surgery. Current guidelines recommend considering tamoxifen post-surgery, regardless of radiation therapy. However, a patient’s individualized risk of recurrence and other factors can influence which therapy options they prefer to pursue. A study comparing outcomes in higher-risk and ‘good-risk’ DCIS patients—defined as grade 1 or 2, 2.5 cm or smaller, and having clear surgical margins of 3 mm or greater—found that tamoxifen (ta-MOX -i-fen) significantly reduced the risk of recurrence in the same breast. The estimated 15-year recurrence risk was 11.4% for those on tamoxifen compared to 19% for those who were not. This finding is from an analysis of combined data from two trials: ECOG-ACRIN E5194 and NRG/RTOG 9804. Read the press release.

Nose and Sinus CancerChemotherapy helps avoid debilitating eye and bone removal

Striking results have emerged from the only prospective multi-center randomized trial to examine the effects of chemotherapy before surgery to shrink tumors and reduce the amount of normal tissue that surgeons need to remove. Surgery is required for patients diagnosed with advanced squamous cell-type cancer of the nose or sinus—but at a high physical cost. Patients enrolled in the EA3163 trial had signs that surgery would result in loss of the eye, the base of the skull bone, or both. The trial demonstrated that patients who received chemotherapy before surgery had a 50% chance of structure preservation. In contrast, patients having surgery, the usual treatment, had only a 15% chance of preserving both the eye and the base of the skull bone. Read the press release.

Mantle Cell Lymphoma – Patients may be able to safely avoid the risks of a stem cell transplant

Mantle cell lymphoma (MCL) is an incurable blood cancer more common in older men. Advances in therapies have improved patient outcomes, with remissions lasting 8-10 years or longer. Treatment options include intensive chemotherapy, immunotherapy, targeted drugs, and BTK inhibitors. Rituximab (ri-TUX-i-mab), a targeted immunotherapy drug, in one option. Patients under age 70 may also receive an autologous stem cell transplant (ASCT) if they are physically fit enough to withstand the difficult procedure, which involves high-dose chemotherapy followed by re-infusion of the patient’s own blood stem cells. However, the benefit of ASCT is debated heavily due to outdated trial data. Study EA4151 is the first randomized trial to assess ASCT for MCL patients in the current era of highly effective treatments. It was stopped early after an interim analysis found that ASCT did not improve survival for MCL patients in first complete remission with no detectable minimal residual disease (MRD). The 3-year overall survival rates were similar: 82.1% for ASCT plus rituximab versus 82.7% with rituximab alone. MRD-positive patients may still benefit from ASCT. Longer follow-up will be essential to confirm these findings. Read the press release.


For other ECOG-ACRIN study results that have been presented at major scientific meetings, visit the News and Info section of the ECOG-ACRIN website.

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