OncoPharm

We open up the Ask #OncoPharm inbox to answer a listener question - What advice do you have before starting my PGY2 Oncology Pharmacy Residency?

Discussing recent FDA-approvals of pembrolizumab for metastatic or unresectable, recurrent Head & Neck Cancer (1st line) and Small Cell Lung Cancer (3rd line)

A newly approved drug for relapsed/refractory diffuse large B-cell lymphoma is discussed as well as PBR.

Concise reviews of 6 studies from ASCO '19. #Oncopharm agents discussed include olaparib, ribociclib, pembrolizumab, dabrafenib/trametinib, and *losartan. *caveats apply

Discussing the 1st PI3-kinase inhibitor approved for a solid tumor, alpelisib for HR(+), HER2(-) metastatic breast cancer as 2nd line treatment. Worth sharing with her endocrine/DM colleagues...

The Landmarks in #OncoPharm continues down its breast cancer-centric track with the landmark CALGB 9344 trial that established the role of paclitaxel in the adjuvant setting --> https://ascopubs.org/doi/pdf/10.1200/JCO.2003.02.063

The Landmarks in #OncoPharm series returns with a discussion of NSABP B-15, which established AC as a standard adjuvant chemo regimen for breast cancer --> (https://ascopubs.org/doi/abs/10.1200/JCO.1990.8.9.1483)

Running through updated FDA approvals from this month (ivosidenib, T-DM1, ramucirumab, avelumab/axitinib, & venetoclax/obinutuzumab) and how these approvals raise more questions.

The Foundations of OncoPharm returns with imatinib, the 1st TKI. Discussion includes its history (and how imatinib's Phase I study almost didn't happen), uses, and toxicity.

Discussion of 2 important malignant hematology updates: the NEJM publication of the 1st published results of CAR-T therapy in multiple myeloma and the FDA-approval of ivosidenib in frail AML patients (with IDH1 mutations).

Reviewing the REFLECT (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30207-1/fulltext) study and its take-home points on selecting an agent for advanced HCC.

Summary of erdafitinib's FDA-approval including dosing, MOA, toxicity, and (wait 'til the end) prevalence of FGFR mutations. Ifos. Eye-Phos.

Reflections offered from HOPA's 2019 annual conference on cabozantinib, regorafenib, low-dose azacitidine, SC granisetron (this is a thing), clinical trial hope, and opportunities for students in HOPA

Debut of a new feature: OncoPharm M & M, where we'll discuss notable case reports of #oncopharm misadventures....how they happened...and how we can prevent them in the future. Our first installment in this series discusses a drug interaction between idelalisib & diazepam (Case Report Link: https://doi.org/10.1177%2F1078155216653705).

Our Foundations in #OncoPharm returns with etoposide, including a deeper than necessary discussion of the historical medical(?) uses of podophyllotoxins, its MOA, uses, and toxicities.

This week brought several notable updates we discuss: the FDA's concern with a venetoclax clinical trial in multiple myeloma patients, atezolizumab's expected FDA-approval for small cell lung cancer, and some neuro-oncology guideline endorsements.

Brief background on metastatic pancreatic cancer is provided, followed by a brief discussion of the main landmark clinical trials (and one not-so-landmark study) in this difficult disease state.

Coming to a P & T committee meeting near you....it's subcutaneous (S.C.) monoclonal antibodies. We discuss the two currently FDA-approved formulations: rituximab + hyaluronidase and trastuzumab + hyaluronidase.

Providing some clinical pearls learned in the last week regarding patient education for ruxolitinib & alectinib. Then (11:50) we recap follow-up publications from Keynote-24 & the BRIGHT studies, before finishing up the week's journal scan with a discussion of the optimal dose of nivolumab + ipilimumab in melanoma and who may NOT benefit from palbociclib.

Axitinib studies presented at ASCO-GU '19 with simultaneous NEJM publication are discussed, followed by a brief overview (18:50) of darolutamide, a new anti-androgen, and its drug interaction potential.

The Landmarks in Oncology Pharmacy series returns to discuss the International Randomized Study of Interferon vs. STI571 (imatinib) aka IRIS.

CBD use is becoming more widespread in society, including in cancer patients. Potential, and significant, drug interaction concerns should be considered.

Mucositis & stomatitis are basically interchangeable terms for one of the hallmark chemotherapy toxicities. We discuss its pathophysiology, prevalent, and prevention/treatment.

Olaratumab received accelerated approval in 2016 under the condition a phase III study would confirm its benefit. It didn't. We explore some possible explanations why a seemingly promising drug for a tough disease hasn't panned out...

It's always enlightening to talk to a cancer survivor and is an essential part of the patient care process. This conversation touches on chemo-induced toxicities (e.g. ifosfamide neurotoxicity), supportive care advances (olanzapine!), and the anxiety of survivors live with while living scan-to-scan. Brought to you by the Bill Gatton College of Pharmacy.