OncoPharm

Empiric dose reductions for variant DPYD alleles isn't necessarily new, but the outcomes of patients treated with those dose reductions isn't well described. Dutch researchers provide some much needed evidence. Link: https://pubmed.ncbi.nlm.nih.gov/?term=37639651 Is there a role for ICIs in dMMR/MSI-h pancreatic cancer? This retrospective says, uh maybe probably. Link: https://pubmed.ncbi.nlm.nih....

A Foundations of OncoPharm episode on nab-paclitaxel, with a focus on the pharmaceutical differences from conventional paclitaxel.

A combination product is now available of niraparib + abiraterone for use in mCRPC. Another BCMA-CD3 agent is approved for r/r multiple myeloma and melphalan hepatic arterial infusion for metastatic uveal melanoma is approved.

Talquetamab is approved for r/r multiple myeloma and the STOP-CA trials asks if atorvastatin can prevent anthracycline cardiotoxicity. STOP-CA: https://jamanetwork.com/journals/jama/fullarticle/2807988

The Ruby trial leads to an FDA approval for dostarlimab + chemo in advanced/recurrent endometrial cancer, but only dMMR/MSI-H patients. Quizartinib's label and REMS program provide some clear, but concerning, warnings about its toxicity.

By listener request! What is BCOP, why pursue it, and some simple tips on studying for the exam.

A Landmark of OncoPharm from 2004: FOLFIRI --> FOLFOX or FOLFOX --> FOLFIRI. Some interesting dosing to discuss in this study. Link: https://pubmed.ncbi.nlm.nih.gov/?term=37379692

We welcome Dr. Donald Harvey to the podcast to discuss Phase 1 clinical trials in oncology. Topics include goals of Phase 1 trials, how these early studies are conducted, how doses are determined, and some limitations of current practices.

We welcome Jacqueline (Jackie) Saunders to the podcast to talk about investigational drug services (IDS) in oncology and how pharmacists manage the storage, preparation, & delivery of experimental drugs.

This episode... More evidence to support the use of neoadjuvant ICI/chemo in stage III NSCLC to obtain pCR published this week with NADIM II. Time to rethink giving ICI/TKI combination therapy to favorable-risk metastatic RCC patients? (Finally, I'm not the only one saying this anymore.) NADIM II: https://www.nejm.org/doi/full/10.1056/NEJMoa2215530 FDA Pooled Analysis Favorable Risk metastatic RCC...

This week's Pod looks at the 2nd CD20-CD3 bispecific T-Cell engager approved this year (or at all), glofitamab, and the TALAPRO-2 study of combining talazoparib to enzalutaimide. TALAPRO-2: https://doi.org/10.1016/S0140-6736(23)01055-3

We highlight notable data from this month's ASCO annual meeting. 1. SONIA: sequence (1st or 2nd-line) CKD 4/6i in MBC 2. ADAURA OS results and low rate of osimertinib use in control arm 3. Keynote 671: perioperative pembrolizumab in NSCLC 4. PROSPECT: Can radiation therapy be omitted in locally advanced rectal cancer? 5. Nivo-AVD vs. Bv-AVD in stage III Hodgkin's (ages 12+) 6. ZUMA-7: 2nd line Axl...

ASCO '23 Appetizers by John Bossaer

Olaparib + Abiraterone is FDA approved for mutated-BRCA prostate cancers. Olaparib has a bit of convoluted story to unpack in this patient population. Have we finally found a way to minimize the peripheral neuropathy from paclitaxel.....with cilostazol? PROpel: https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200043 Cilostazol RCT: https://doi.org/10.1002/phar.2830 Cilostazol effect on Schwann ce...

We discuss the newly approved CD20-CD3 T-cell engager for subcutaneous (SC) administration to treat DLBLC after 2 or more lines of therapy.

A recent paper serves as a good prompt to discuss trimodality treatment for muscle-invasive bladder cancer and the data supporting its use. Zlotta et al: https://doi.org/10.1016/S1470-2045(23)00170-5

Today's Pod discusses... 1) A large trial comparing 4 different CLL treatments GAIA-CLL13: https://www.nejm.org/doi/full/10.1056/NEJMoa2213093 2)Adding Cabozantinib + Nivo/Ipo vs. Nivo/Ipi in intermediate/poor risk mRCC COSMIC-313: https://www.nejm.org/doi/full/10.1056/NEJMoa2212851 3) A potential future biomarker for predicting response to PD-(L)1 targeted therapies Functional PD-1/PD-L1 Engageme...

Talking 3rd-line treatment of metastatic colon cancer. Tipiracil-trifluridine + bevacizuamb vs. tipiracil-trifluridine alone. And a bit on the theory of "bevacizumab beyond progression." SUNLIGHT: https://www.nejm.org/doi/full/10.1056/NEJMoa2214963

Quizartinib vs. Placebo(?) + Chemo in newly diagnosed AML. We add a bit of context about quizartinib's history leading up to this study preview possible role in therapy if approved in the future. Link: https://doi.org/10.1016/S0140-6736(23)00464-6

We take a peak at an intriguing study (n = 29) that gave some metastatic RCC patients receiving nivolumab + ipilimumab a supplement of a bacterium (n = 19) and a control group. We discuss what to look for in the future studies that are likely to follow with similar methods.

The Landmarks of OncoPharm series returns to discuss NSABP's B18 story of neoadjuvant vs. adjuvant AC in stages I & II breast cancer from 1998. B18: https://pubmed.ncbi.nlm.nih.gov/?term=36989610 Flashback Flashforeward: https://pubmed.ncbi.nlm.nih.gov/?term=36989608

Lots of updates: Olanzapine increases weight gain, QOL in some advanced cancer: https://pubmed.ncbi.nlm.nih.gov/?term=36977285 Chemotherapy Toxicity - When Less is More: https://www.nejm.org/doi/full/10.1056/NEJMcibr1202395 Pembro + Chemo improves PFS > chemo alone in advanced endometrial cancer: https://www.nejm.org/doi/full/10.1056/NEJMoa2302312 Enfortumab vedotin + pembrolizumab gets an acceler...

With new Pod this week, we're re-releasing the 2nd episode from way back in 2017 that provides a historical overview of how the use of EGFR TKIs changed from their use in all NSLCLC to only with activating mutations.

Not that you always need extended gram positive coverage, but if you did... As is often the case with this Pod, this is mostly providing historical context. Link: https://doi.org/10.1086/500139

Prompted by a recent JCO review article (link below), it seemed like a good idea to discuss risks of ovarian dysfunction in women of childbearing potential, what drugs have the highest risk, and fertility preservation techniques. Review article: https://pubmed.ncbi.nlm.nih.gov/?term=29620997 Cyclophosphamide dose equivalent calculator: https://www.oncofertilityrisk.com/CED.html