Oncopharmpod

Updates on COVID-19 vaccination in cancer patients on immune-checkpoint inhibitors (new data!) and those getting imaging studies after vaccination. We quickly run through the AMBORO (April 6 published online in J Clin Oncol) trial demonstrating improvements in patient care with the inclusion of a clinical pharmacist (or pharmacologist) in managing PO antineoplastics.

Updates on the use of immune-checkpoint inhibitors in esophageal and gastro-esophageal junction (GEJ) cancers. First, adjuvant nivolumab (Checkmate 577). Then, pembrolizumab + chemo for initial treatment of metastatic disease (Keynote 590). Also, we mention 2 new approvals for myeloma: the 1st CAR-T for the disease and an expanded indication for isatuximab.

The Landmarks of OncoPharm series returns to discuss 2 pivotal trials that ushered in the age of aprepitant and NK-1 receptor anagonists for CINV. Aprepitant in HEC: https://ascopubs.org/doi/pdf/10.1200/JCO.2003.01.095 Aprepitant in MEC: https://ascopubs.org/doi/pdf/10.1200/JCO.2005.09.050

Tivozanib's FDA approval for mRCC was a long time in the making, but what is its role? Disappointing atezolizumab results for adjuvant treatment of bladder cancer (IMvigor-010). Preliminary data on antibody responses to COVID-19 vaccination in cancer patients.

This week, two indolent lymphoma updates: 1. CAR-T (Axl-Cel) for follicular lymphoma 2. Is there a preferred platinum salt in DHAP for Mantle cell lymphoma* patients heading to transplant? (https://pubmed.ncbi.nlm.nih.gov/33658645/) *Yes, I know - not really an indolent lymphoma in this case.

Melphalan flufenamide, a drug that makes tumor cell kinetics cool again, is our main topic. Also, brief updates on lorlatinib (ALK+ mNSCLC) and nivolumab/cabozantinib (mRCC).

Topics covered: 1. Trilaciclib's approval to minimize bone marrow suppression 2. Cemiplimab's approval for mNSLC with high PD-L1 expression 3. A brief anti-BCMA CAR-T phase II trial in multiple myeloma 4. Confirmation of enfortumab vedotin's benefit in metastatic bladder cancer 5. More of the same with lenvatinib + pembrolizumab in mRCC

Happy Birthday to a drug that ushered in its own era! We discuss its history and development and just a little bit about its benefit, role, and a few clinical pearls.

Discussing the latest TKI approval, umbralisib, and its familiar toxicity profile. Also, a few final words on a new CAR-T product and a cemiplimab expanded approval.

In light of teptinib's recent FDA-approval for exon-14 skipping MET altered metastatic NSLCC, we compare tepotinib to its predecessor in this space - capmatinib.

With the recent FDA-approval of nivolumab + cabozantinib for metastatic renal cell carcinoma (mRCC, we review Checkmate-9ER results and how they compare to other combination treatments in mRCC. We then end by discussion preliminary recommendations on vaccinating patients with cancer agains COVID-19. Checkmate-9ER abstract: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/nivolumab-cabozantinib-vs-sunitinib-in-first-line-treatment-for-advanced-renal-cell-carcinoma-first-results-from-the-randomized-phase-iii-checkmate-9er-trial

Discussing recent FDA approvals for expanded indications for trastuzumab-deruxtecan for gastric cancer (based on DESTINY-Gastric01) and SC daratumumab for AL amyloidosis. DESTINY-Gastric01: https://www.nejm.org/doi/full/10.1056/NEJMoa2004413

Our landmarks of OncoPharm series returns to discuss JBR10, adjuvant cisplatin/vinorelbine in NSCLC. JBR10: https://www.nejm.org/doi/pdf/10.1056/NEJMoa043623 JBR10 Update: https://pubmed.ncbi.nlm.nih.gov/19933915/ LACE meta-analysis: https://pubmed.ncbi.nlm.nih.gov/18506026/

The 1st episode of 2021 covers 5 FDA updates from December 2020 -Pralsetinib for RET-mutated medullary thyroid cancer -The new HER2-targeting margetuximab -Selinexor and the Boston study -Relugolix, an oral GnRH antagonist -Adjuvant osimertinib approved (ADAURA)

Our Foundations of Oncopharm series returns to discuss the history and use of trastuzumab.

Highlighting some of the bright spots, oncopharm & otherwise, for our Holiday episode. Best new drug? Best study? Best movie to take my mind off of a pandemic? Enjoy this episode with a glass of Holiday Cheer.

COVID-19 Vaccines are here!!! Will they work in patients on chemo? What about immunotherapy? Without firm answers to such questions we might as well talk about mRNA vaccines, the breakout star of 2020.

First up we discuss RxPonder and what it adds to adjuvant treatment of breast cancer in the context of TailoRx. Then we discuss a recent study (https://jamanetwork.com/journals/jama/fullarticle/2774295)of additional capecitabine following adjuvant chemo in TNBC and what it adds in the context of CREATE-X.

Final OS results are now available for IDEA - 3 vs. 6 months of adjuvant chemotherapy for colon cancer: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30527-1/fulltext Keynote-177 (pembrolizumab for MSI-H/dMMR metastatic colorectal cancer) was presented at ASCO, but interim results are now published as well: https://www.nejm.org/doi/full/10.1056/NEJMoa2017699

The Landmarks in OncoPharm series returns to discuss the practice-changing CLOT trial of a LMWH vs. a vitamin K antatogist for treating cancer-associated VTE. CLOT: https://www.nejm.org/doi/full/10.1056/nejmoa025313