Blenrep comeback makes the case for early-first cancer approach: a Perspective

There’s an unspoken rule that cancer drugs should be tested in the sickest patients first. It’s time to turn that paradigm on its head. I’m not alone in that stance; it’s the focus of the Project FrontRunner initiative of FDA’s Oncology Center of Excellence. Now, GSK’s Blenrep comeback story is amplifying the message.

The case for introducing new experimental therapies earlier in the course of treatment is logical. Patients who are less sick, and who haven’t endured months or years of toxic standard-of-care therapies, tend to receive greater benefit from innovative drugs. At that stage, patients have fewer comorbidities, can tolerate treatments better and can stay on them longer. Immune systems are more robust and capable of mobilizing against cancers when stimulated, and tumors have collected fewer resistance variants...