Delving Into Brain Cancer Treatment Takeaways Following ASCO 2025

The de-escalation of therapy helps avoid unnecessary toxicity from treatment, making it an important consideration during the treatment of patients with brain cancer or metastases, Dr. Manmeet Singh Ahluwalia said during an interview with Dr. Joshua K. Sabari on the topic of the ASCO 2025 Annual Meeting. Ahluwalia went on to highlight the emergence of antibody-drug conjugates and immunotherapy in across the therapeutic landscape, new drugs and approaches which help improve survival and neurologic function for patients, and pushing the envelope of treatment.

To kick off their conversation, Ahluwalia and Sabari began by highlighting the CATNON trial, a randomized, multicenter trial for patients with grade 3 gliomas being conducted by EORTC with U.S. cooperative group participation. The investigation aimed to understand if treatment with temozolomide chemotherapy provided patients with benefit when given concurrently with radiation versus after radiation.

According to Ahluwalia, investigators of the CATNON trial found that the concurrent treatment did not provide benefit, and that there was a clear benefit derived in patients who were treated with adjuvant therapy post-radiation

Moreover, Sabari and Ahluwalia went on to highlight the HER3-DXd antibody-drug conjugate to be used in patients with brain metastases from their lung and/or HER2-positive breast cancer. Ahluwalia explained that, of those treated with the investigational therapy, he trial reported a 30% intracranial response rate in patients with lung cancer brain metastases. Additionally, there was a 23% intracranial response rate for patients with brain metastases from their breast cancer.

Of the patients with leptomeningeal disease, 65% of patients survived three or more months, while 50% experienced benefit of 6 months or more. Overall, Ahluwalia said that the HER3-DXd agent provided intracranial activity in this difficult-to-treat patient population, including those with leptomeningeal disease.

Sabari is the editor in chief of CURE. He also serves as an assistant professor in the Department of Medicine at NYU Grossman School of Medicine and director of High Reliability Organization Initiatives at Perlmutter Cancer Center. Ahluwalia is a neuro-oncologist. He serves as the chief scientific officer, chief of medical oncology, deputy director and Fernandez Family Endowed Chair in Cancer Research at Baptist Health Miami Cancer Institute.

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