Category: 3. Business

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‘Shrinking into greatness’

River Island store closures

Gastrointestinal (GI) cancers remain among the most common and deadly malignancies worldwide, accounting for nearly 1 in 4 cancer-related deaths globally.¹ Despite improvements in screening and diagnostics, many patients are diagnosed at an advanced stage, where treatment options have historically been limited and outcomes suboptimal.

Now, a review published ahead of print in Clinical Advances in Hematology & Oncology highlights several recent advances in GI oncology, particularly for colorectal and pancreatic cancers, offering new hope and new challenges for prescribers and pharmacists alike.²

The New Front Line

A team of researchers summarized key regulatory approvals, clinical trials, and novel mechanisms of action that are shaping today’s GI oncology treatment landscape. The review highlights several new therapies and expanded indications, including oral tyrosine kinase inhibitors and HER2-targeted therapeutic options.²

Major developments include fruquintinib (Fruzaqla; Takeda), which was FDA-approved in 2023 for refractory metastatic colorectal cancer. This oral VEGFR inhibitor helps block tumor angiogenesis and may offer a new option for patients who have had multiple failed treatments.²

Additionally, the combination of tucatinib (Tukysa; Pfizer) and trastuzumab (Enhertu; Daiichi-Sankyo, AstraZeneca), already used for HER2-positive breast cancer, is now approved for HER2-positive metastatic colorectal cancer (CRC0. This combination offers an alternative to cycotoxic regimens in select patients.²

Finally, trifluridine-tipiracil (Lonsurf; Taiho Oncology) continues to be a cornerstone of late-line CRC management. New data further support its use in combination strategies for prolonged benefit.²

The Pharmacist Battle Strategy: What You Should Know

Oral agents such as fruquintinib and trifluridine-tipiracil require clear counseling on adherence, common toxicities (including hypertension and hand-foot syndrome), and cycle-based dosing schedules. Pharmacists should also be aware that tucatinib is a CYP3A4 substrate, necessitating caution when it is coadministered with common outpatient drugs. Frequent laboratory monitoring for neutropenia, liver enzymes, and blood pressure is essential—particularly in older patients who may have diminished organ function or face increased polypharmacy risks.

Pharmacists play a key role in patient education by helping individuals distinguish between manageable adverse effects and those that require medical intervention, such as febrile neutropenia or severe diarrhea. Consultant pharmacists should closely assess cumulative toxicity and renal dosing, especially in long-term care or assisted living settings where geriatric patients are more vulnerable. In emergency settings, pharmacists must be prepared to recognize complications such as hypertensive crisis or chemotherapy-induced dehydration, ensuring timely intervention and continuity of care.

Clinical Impact

The researchers conclude that staying up to date with these evolving regimens is critical as treatment paradigms continue to shift away from 1-size-fits-all chemotherapy.² Pharmacists across all settings have significant responsibilities in monitoring, managing adverse effects, and improving outcomes through patient education and interdisciplinary collaboration.

As medication experts, pharmacists must remain continuously updated in rapidly evolving fields like hematology and oncology. Staying informed on emerging therapies, expanded indications, and clinical guidelines is essential to delivering safe, effective, and personalized care across all practice settings.

REFERENCES

1. Arnold M, Abnet CC, Neale RE, et al. Global burden of 5 major types of gastrointestinal cancer. Gastroenterology. 2020;159(1):335-349.e15. doi:10.1053/j.gastro.2020.02.068

2. Chong X, Madeti Y, Cai J, et al. Recent developments in immunotherapy for gastrointestinal tract cancers. J Hematol Oncol. 2024;17:65. doi:10.1186/s13045-024-01578-x

River Island has got the green light for a rescue restructure that saves more than 4,000 jobs but will shut 33 of the clothing chain’s 230 stores as people shift to buying online.

The plan to reduce costs, which still puts more than 1,000 jobs and a further 70 sites at risk, won approval of a high court judge on Friday after a majority of creditors gave their backing earlier in the week.

There had been fears the family-owned company could collapse after it told creditors in June that if a restructure was not approved it could run short of cash by the end of August and would be “unable to pay its debts as they fall due”.

Ben Lewis, the retailer’s chief executive, said the approved plan, which involves a sharp reduction in rent payments, would enable the company to “align our store estate to our customers’ needs. He said: “We are pleased that River Island’s restructuring plan has been approved by the high court.

“We have a clear transformation strategy to ensure the long-term viability of the business, and this decision gives us a strong platform to deliver this. Recent improvements in our fashion offer and shopping experience are starting to show results, and the restructuring plan will enable us to align our store estate to our customers’ needs.”

There had been a question over whether the court would approve the deal as fewer than 75% of landlords, one class of creditors, did not back the plan in the online vote this week.

The decision protects the future of a high street fashion stalwart that has outlived rivals from Topshop to Oasis, Ted Baker and Warehouse, all of which trade solely online in the UK.

Fashion retailers are facing heavy competition from cheap, fast-growing online players including Shein and Temu, which benefit from a tax break on imported goods sent straight to shoppers.

River Island, formerly known as Chelsea Girl, began selling clothing under the name Lewis’s in the 1940s.

In a plan first announced in June, the retailer said it needed £10m in funds by the second week of September. It warned that that figure could rise to £50m by the end of the year.

River Island said it would not be able to continue trading as a going concern and would be subject to administration or other insolvency proceedings if it could not agree a deal to slash rents and close some stores.

Conversations around have long been dominated by countries like the United States and China due to their primacy as compute, talent, and financial hubs. The discourse on AI safety, broadly defined as the management of risks associated with AI, has similarly centered on these regions, despite the global implications of AI technologies. Yet Southeast Asia—home to over 700 million people, many of whom are young and digitally connected—is rapidly emerging as a powerful force in the global digital economy. As the region becomes increasingly digitized, Southeast Asia must be actively included in the global AI safety circles to ensure equitable and responsible development and deployment.

On August 28, join the Center for Technology Innovation at Brookings and AI Safety Asia (AISA) for an online discussion about a new report examining the role of Southeast Asia in global AI governance. Panelists will delve into how diverse and developing regions can draw from global best practices while tailoring solutions to their own realities.

Viewers can submit questions for speakers by emailing [email protected] or via X at @BrookingsGov by using #AISafetyAsia.