Health news, 18 October 2026: tucatinib maintenance in HER2-positive breast cancer, an oral GLP-1 tablet in Europe, alternatives to patching for amblyopia, and an oral TREM2 drug for Alzheimer's
Four events from 7 to 16 October: FDA approval of tucatinib as maintenance treatment in advanced HER2-positive breast cancer, an EMA recommendation for the once-daily GLP-1 tablet orforglipron, a meta-analysis of 11 trials of alternatives to patching in childhood amblyopia, and a phase 1 trial of an oral TREM2 activator for Alzheimer's disease.
The FDA approved tucatinib as maintenance treatment for advanced HER2-positive breast cancer
On 7 October 2026 the US Food and Drug Administration approved tucatinib (Tukysa) together with trastuzumab and pertuzumab as maintenance treatment for adults with unresectable locally advanced or metastatic HER2-positive breast cancer whose disease had not progressed after initial (induction) treatment. In the phase 3 HER2CLIMB-05 trial, 654 such adults, with or without brain metastases, were randomised to tucatinib or placebo on top of the two antibodies after 4–8 cycles of trastuzumab, pertuzumab and a taxane. Median progression-free survival was 24.9 months with tucatinib and 16.3 months with placebo.
Why it matters. HER2CLIMB-05 tested adding tucatinib during maintenance, before progression. Among the 654 randomised adults, median progression-free survival was longer with tucatinib than with placebo in the double-blind trial.
Status and limits. Approved in the United States for this indication. Overall survival data were not mature at the time of the analysis, so it is not yet known whether people live longer. The label carries a boxed warning for liver toxicity and warnings for diarrhoea, harm to a fetus and a rise in blood creatinine without a change in kidney function.
The European Medicines Agency recommended orforglipron, a once-daily GLP-1 tablet
On 16 October 2026 the European Medicines Agency announced that its committee recommended authorising Foundayo (orforglipron) in the European Union for weight management in adults with obesity, or with overweight and at least one weight-related health problem, and for adults with type 2 diabetes. Orforglipron is a small non-peptide molecule that activates the GLP-1 receptor, so it can be taken as a tablet at any time of day, with or without food. In two studies of 4,740 adults, people on orforglipron lost around 5% to 11% of body weight after 72 weeks, depending on the dose, compared with around 2% to 2.5% on placebo.
Why it matters. The agency presents Foundayo as an alternative to injectable and other oral GLP-1 receptor agonists. In four diabetes studies of 3,765 adults, HbA1c fell by around 1.2 to 1.9 percentage points, compared with 0.8 with dapagliflozin and 1.2 to 1.5 with oral semaglutide at 7 and 14 mg.
Status and limits. This is a committee opinion, not yet a marketing authorisation: the European Commission still has to decide, and price and reimbursement are set by each country. The data concern adults only. The most common side effects were nausea, vomiting and diarrhoea, mostly while the dose was being increased.
A meta-analysis of 11 trials compared alternatives to patching for childhood amblyopia
On 16 October 2026 a group from Santiago de Compostela published in Strabismus a meta-analysis of 11 randomised trials in 1,582 children, mostly aged 9 or younger, comparing alternative treatments for amblyopia (lazy eye) with patching of the stronger eye. Taken together, the alternatives did not differ from patching in gain of visual acuity. The picture changed by type: atropine drops, Bangerter filters and first-generation binocular games tended to do worse than patching, while current dichoptic and eye-tracking systems, which show each eye a different image, showed no detectable difference from it.
Why it matters. Patching is hard to stick to for many children. The analysis suggests that the question is not whether a game or a device works in general, but which generation of it was tested.
Status and limits. The authors state that no detectable difference does not prove that dichoptic treatment is as good as patching. The comparison by device generation was decided after the data were seen, results varied substantially between trials, and atropine and filters were each represented by a single trial. The authors call it a hypothesis for larger trials, not a reason to stop patching.
An oral TREM2-activating drug for Alzheimer's disease completed a phase 1 trial
On 14 October 2026 researchers from Vigil Neuroscience, a Sanofi company, reported in Science Translational Medicine the laboratory and first human results for VG-3927 (now SAR448851), an oral small-molecule drug that activates TREM2, a receptor on microglia, the brain's immune cells. In a randomised, double-blind, placebo-controlled phase 1 trial in 115 people, including healthy adults, older adults and people with Alzheimer's disease, single and repeated doses up to 140 mg were well tolerated. The drug concentration in cerebrospinal fluid was close to its unbound concentration in plasma (ratio 0.91), and soluble TREM2 there fell in a dose-dependent way, a biomarker of target engagement.
Why it matters. In human genetics, loss-of-function TREM2 variants are major risk factors for late-onset Alzheimer's disease. In the same paper, a TREM2-activating antibody failed to engage microglia around amyloid plaques in mice; a small molecule that enters the brain is a different way to test the idea.
Status and limits. Phase 1 measures safety, dosing and target engagement. It does not show any effect on memory, the course of the disease or survival. In mice, the related tool compound VG-3909 enhanced amyloid-beta phagocytosis and brain glucose metabolism; these effects were not shown in people.
This material is for information only and does not replace a consultation with a doctor.
Sources
US Food and Drug Administration. FDA approves tucatinib with trastuzumab and pertuzumab for maintenance treatment of HER2-positive breast cancer. 7 October 2026. fda.gov
HER2CLIMB-05 trial record. NCT05132582
European Medicines Agency. New oral GLP-1 medicine for weight management and type 2 diabetes. 16 October 2026. ema.europa.eu
ATTAIN-1, orforglipron in adults with obesity or overweight. NCT05869903
de Esteban Maciñeira E et al. Alternative therapies versus patching for childhood amblyopia: a modality-stratified meta-analysis. Strabismus. 2026. PMID 42885917
Dejanovic B et al. Preclinical and first-in-human evaluation of VG-3927/SAR448851, an oral small-molecule TREM2 agonist for Alzheimer's disease. Sci Transl Med. 2026. PMID 42873892
VG-3927 phase 1 trial record. NCT06343636
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Articles in this section are educational and are not medical advice, a diagnosis, or a prescription. Consult a qualified professional before acting on anything you read here.
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