OncoPharm

Two nice studies have been recently published in the supportive care realm. SPARED asks if we can omit dexamethasone on days 2-4 following cisplatin-based chemotherapy. D-TORCH asks if topical diclofenac can prevent capecitabine-induced hand-foot syndrome. SPARED: https://doi.org/10.1038/s41416-023-02493-7 D-TORCH: https://doi.org/10.1200/JCO.23.01730

An exciting new cellular therapy, lifileucel, is approved for metastatic melanoma. The FLAURA2 trial of osimertinib + chemotherapy has led to an FDA approval, but questions remain about a possible new standard of care. And a few minor updates on tepotinib.

New updates on metastatic pancreatic cancer (NAPOLI-3), upper tract urothelial cancer (POUT), and the drug-drug interaction between ivosidenib and azole antifungals. NAPOLI 3: https://doi.org/10.1016/S0140-6736(23)01366-1 POUT (final OS): https://doi.org/10.1200/JCO.23.01659 Ivosidenib Azole Antifungal DDIs: https://doi.org/10.1002/cncr.35251

You know about small cell lung cancer, but let's talk about small cell carcinoma of the prostate.

In oncology we are always asking questions about which treatment option is best. And that focus on the next best treatment may prevent us from rethinking some fundamentals of current practice. Three recent studies illustrate this and made me ask: Do we need a Port or PICC for every testicular cancer patient? Study: https://doi.org/10.1200/OP.23.00580 Editorial: https://doi.org/10.1200/OP.23.00730...

...on FDA approvals for belzutifan for RCC, pembrolizumab + cisplatin/RT for cervical cancer, erdafitinib (FGFR3 alterations only) for bladder cancer. Plus, early morning ICIs (https://doi.org/10.1016/j.ejca.2024.113571) & FLAG-Ida-GO in AML from NCRI AML 19 (https://doi.org/10.1200/JCO.23.00943)

Special guest Ryan Beechinor joins the pod to discuss his recent paper on the obstacles in the development of generic lenalidomide. It's a fantastic read, and this episode will be a fantastic listen! Link: https://doi.org/10.1016/j.jcpo.2023.100446

Foundations of OncoPharm episode on lenalidomide (Revlimid) and its MOA, use, dosing, & toxicity.

A Holiday Tradition returns as we review 14 new OncoPharm drugs approved this past year and ask Keep, Re-Gift, or Return.

Small bites of updates coming out of ASH's 2023 annual meeting on CLL, multiple myeloma, and lymphoma.

Our Landmarks of OncoPharm series returns to talk about 2008's VISTA study, which ushered bortezomib into the front line setting, albeit with a now outdated alkylating agent-based backbone. VISTA (VMP vs. MP): https://www.nejm.org/doi/full/10.1056/nejmoa0801479

The recent approval of nirogacestat, the first gamma secretase inhibitor on the market, provides a great opportunity to discuss desmoid tumors and Notch signaling. Review article: https://doi.org/10.1002/onco.13627 Also, a new T-cell malignancy warning for most CAR-T products. And, is belantamab mafodotin coming back based on the DREAMM-7 results?

FDA has approved two new kinase inhibitors: one for ROS1 (+) NSCLC and one for PIK3CA/AKT/PTEN altered breast cancer.

This week's Pod dives into a new VEGF-R inhibitor, fruquintinib. We also ask if FLAURA2, osimertinib + chemotherapy in combination, will become a new standard of care in EGFR-mutated metastatic NSCLC.

Aggressive hematologic malignancy publications can be challenging to interpret and translate to clinical practice. We look at two recent studies to illustrate this point. Elderly AML: 10-day decitabine vs. 7 + 3 (https://doi.org/10.1016/S2352-3026(23)00273-9) Burkitt Lymphoma: R-CODXO-M/R-IVAC vs. DA-R-EPOCH (https://doi.org/10.1016/S2352-3026(23)00279-X)

Out Landmarks of OncoPharm series returns to chronicle how treatment of stage III NSCLC has changed over time with an overview of three studies. 1. Dillman (1990) NEJM (sequential chemo --> RT): https://doi.org/10.1056/nejm199010043231403 2. Albain (1995) JCO (concurrent cisplatin/etoposide + RT): https://pubmed.ncbi.nlm.nih.gov/?term=7636530 3. Albain (2009) Lancet (concurrent cis/etposide + RT -...

Lots of practice changing new information came out of last week's ESMO conference. This Pod is packed with updates on NSCLC, bladder cancer, gastric cancer, medullary thyroid cancer, KRAS G12C colorectal cancer.....and even bendamustine (non-ESMO update).

This week we discuss the continued push to introduce 2nd generation androgen inhibitors earlier into treatment with the EMBARK trial. Nivolumab and pembrolizumab, pemrolizumab and nivolumab. Again and again. Their role (and approvals) for adjuvant melanoma make sense. But what to think about their use for NSCLC in the neoadjuvant setting? West commentary: https://dailynews.ascopubs.org/do/should-i...

Encorafenib + binimetinib gets FDA-approval for metastatic NSCLC, but how does it compare to dabrafenib/trametinib? Plus, a new pediatric approval for dabrafenib/trametinib means more dosage form options.

Trying to make sense of the limited information put out via Press Release the last 2 weeks for mobocertinib, pembrolizumab + enfortumab vedotin, nivolumab, and more.

From the Foundations of OncoPharm archives - the history and groundbreaking STI 571 (imatinib).

It's another Landmarks of OncoPharm episode looking at the carboplatin-paclitaxel regimen in ovarian cancer from 20 years ago. carboplatin/paclitaxel vs. cisplatin/paclitaxel: https://pubmed.ncbi.nlm.nih.gov/?term=37643542

An experimental drug for EGFRm NSCLC, patritumab deruxtecan (HER3-DXd), raises some eyebrows and a new agent is FDA-approved for hematopoietic stem cell mobilization (motixafortide).

You read it in every solid tumor paper - RECIST - criteria. This Pod discusses some of the details of the Response Evaluation in Solid Tumors (RECIST) criteria along with the pros and cons of its use - including a modification of the criteria for use with immunotherapy.

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....