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PACULit Literature Updates September 2025: Oncology

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  1. Immune mediated adverse events in the randomized phase 3 TOPAZ 1 study of durvalumab plus gemcitabine and cisplatin in advanced biliary tract cancer
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  2. Belantamab mafodotin plus bortezomib and dexamethasone in patients with relapsed or refractory multiple myeloma DREAMM7 updated overall survival analysis from a global randomised open label phase 3 trial
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  3. PACULit Daily Literature Update: Real-world patient profile and step-up dosing process of early initiators of teclistamab for multiple myeloma in US hospitals An analysis using the Premier Healthcare Database
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  4. PACULit Daily Literature Update: Effects of BojungikkiTang on immune response and clinical outcomes in NSCLC patients receiving immune checkpoint inhibitors a randomized pilot study
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  5. PACULit Daily Literature Update: Long acting lipegfilgrastim and antimicrobials as vigorous primary prophylaxis in bendamustine treated patients with indolent B cell non Hodgkin lymphoma a multicentric real life experience
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  6. First-line treatment with HDACis plus tislelizumab combined with chemotherapy in advanced NSCLC a single-arm phase II study
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  7. Comparison of outcomes with elranatamab and real world treatments in the UK for triple class exposed relapsed and refractory multiple myeloma
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  8. Overall Survival with Inavolisib in PIK3CA-Mutated Advanced Breast Cancer
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  9. Enhanced CAR T-Cell Therapy for Lymphoma after Previous Failure
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  10. Phase I II clinical trial on the safety and preliminary efficacy of donor derived anti leukemia cytotoxic T lymphocytes for the prevention of leukemia relapse in children given haploidentical hematopoietic stem cell transplantation study rational and design
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  11. Brentuximab vedotin plus chemotherapy for the treatment of frontline systemic anaplastic large cell lymphoma subgroup analysis of the ECHELON2 study at 5 years followup
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  12. Effectiveness and Safety of Immunotherapy for Hepatocellular Carcinoma in Clinical Practice A Brazilian Multicenter Study
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  13. Talquetamab improves patient reported symptoms and health related quality of life in relapsed or refractory multiple myeloma Results from the phase 12 MonumenTAL1 study
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  14. Encorafenib, Cetuximab, and mFOLFOX6 in BRAF-Mutated Colorectal Cancer
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  15. Durvalumab Alone or Combined With Novel Agents for Unresectable Stage III Non Small Cell Lung Cancer Update From the COAST Randomized Clinical Trial
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  16. Real world patient profile and step up dosing process of early initiators of teclistamab for multiple myeloma in US hospitals An analysis using the Premier Healthcare Database
    1 Topic
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    1 Quiz
  17. Virtual reality for outpatient management of cancer pain a pilot dosing study
    1 Topic
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    1 Quiz
  18. Brentuximab vedotin plus chemotherapy for the treatment of frontline systemic anaplastic large cell lymphoma
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  19. Optimal treatment duration in metastatic renal cell carcinoma patients responding to immune checkpoint inhibitors should we treat beyond two years
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  20. Effects of Metformin on Survival and Toxicity in Patients with Metastatic Non Small Cell Lung Cancer Treated with Nivolumab
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  21. ACPE Required Forms: PACULit Literature Updates September 2025: Oncology
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Daily Literature Update

Effects of BojungikkiTang on immune response and clinical outcomes in NSCLC patients receiving immune checkpoint inhibitors a randomized pilot study

Ko MM, Na SW, Yi JM, et al. Effects of BojungikkiTang on immune response and clinical outcomes in NSCLC patients receiving immune checkpoint inhibitors a randomized pilot study. BMC Cancer. 2025;25(1):1229. doi:10.1186/s12885-025-14629-4.

Study Type: Multicenter randomized placebo-controlled pilot trial

Population: 28 patients with advanced non-small cell lung cancer (NSCLC)

Intervention: Bojungikki-tang (BJIKT) adjunct to atezolizumab monotherapy vs placebo

Outcomes: Primary – adverse events (AEs), immune-related adverse events (irAEs); Secondary – fatigue, muscle loss; Exploratory – immune profiling of PBMCs and plasma

Key Findings

  • AEs occurred in 53.57% overall; 64.29% in BJIKT group with 23 events (1 severe irAE), 42.86% in placebo with 12 events; mostly mild/moderate and resolved by study end
  • Non-statistically significant trends favoring BJIKT in objective response rate (16.67% vs 8.33%) and disease control rate (41.67% vs 25.0%)
  • BJIKT showed non-significant reductions in fatigue and muscle-related symptoms
  • Exploratory immune profiling suggested activation of CD4+ T cells, increased CD3+CD4+ proportion, enhanced T cell function, and reduced immune exhaustion
  • Significant decrease in PD-1+ CD8+ T cells and significant increase in natural killer (NK) cells with BJIKT, indicating possible improved innate immune surveillance
  • Findings suggest potential synergistic effect of BJIKT with immune checkpoint inhibitors in boosting antitumor immunity
  • Bojungikki-Tang (BJIKT) enhances immune function and alleviates fatigue in East Asian traditional medicine (Ko et al., 2025; PMID:40731270)
  • Preclinical data indicate BJIKT combined with anti-PD-L1 antibody increases CD3+ and CD8+ T-cell tumor infiltration, augmenting antitumor immunity (Frontiers Pharmacology, 2022; PMID:35623401)
  • BJIKT modulates tumor microenvironment by regulating immune checkpoints and enhancing immune cell activity, potentially reducing irAEs (PMID:39427737)
  • Clinical trials underway to assess BJIKT in combination with immune checkpoint inhibitors for NSCLC (SAGE Journals, 2025; PMID:38103792)
  • Synergistic effects with ICIs may improve treatment outcomes and toxicity profiles in advanced lung cancer (Preclinical & early clinical evidence)

Strengths & Limitations

Strengths Limitations
Randomized placebo-controlled design; multicenter setting Small sample size (N=28), pilot study limits generalizability
Detailed immune profiling exploratory analysis Exploratory immune outcomes mostly non-significant; hypothesis-generating only
Assessment of both clinical outcomes and immune-related AEs Short-term follow-up; insufficient power for efficacy endpoints

Clinical Implications & Impact

Pharmacists should be aware that Bojungikki-Tang may be a promising adjunctive therapy with immune checkpoint inhibitors for NSCLC, potentially enhancing immune activation and reducing fatigue symptoms. Monitoring for AEs remains essential, given the trend for increased but mostly mild/moderate events. Coordination with oncology teams is advised to evaluate patient eligibility for complementary herbal therapies, with attention to drug interactions and safety profiles. Further large-scale trials will clarify clinical utility and guide incorporation into practice.

Conclusion

This pilot study suggests Bojungikki-Tang adjunctive to atezolizumab may enhance immune responses with a trend toward improved clinical outcomes in advanced NSCLC but requires further validation in larger trials.

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Citations

  • Ko MM et al. BMC Cancer. 2025;25(1):1229. PMID:40731270
  • Frontiers Pharmacology. 2022; PMID:35623401
  • PMID:39427737
  • SAGE Journals. 2025; PMID:38103792

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