Oncopharmpod

Pembro gets an approval for triple negative breast cancer with quite high PD-L1 expression based on Keynote-355 (https://ascopubs.org/doi/10.1200/JCO.2020.38.15_suppl.1000). Some reassuring information on TKI discontinuation in CML from the LAST study (doi:10.1001/jamaoncol.2020.5774) and an interesting method of identifying predictors of TKI adherence in CML (https://journals.sagepub.com/doi/pdf/10.1177/1078155220970616).

Our Landmarks of OncoPharm series returns with Ifosfamide

The BELLINI trial of venetoxlax in multiple myeloma was put on hold last year due to increased mortality. It's now published (https://doi.org/10.1016/S1470-2045(20)30525-8), so we take a look at the data and the myriad of supportive care concerns.

Discussing three recent publications: 1. Updated results of Keynote-426 (https://doi.org/10.1016/S1470-2045(20)30436-8) 2. Ph+ ALL tx with dasatinib/prednisone --> blinatumomab (https://www.nejm.org/doi/full/10.1056/NEJMoa2016272) 3. Decitabine + G-CSF to prevent AML relapse following alloHSCT (https://ascopubs.org/doi/pdf/10.1200/JCO.19.03277)

Another month, another 2 expanded FDA-approvals: nivolumab/ipilimumab for malignant pleural mesothelioma and pembrolizumab for relapsed/refractory classical Hodgkin's lymphoma.

Fulvestrant's standard dosing is now 500 mg IM on Days 1, 14, 29 & then monthly thereafter. Its initial FDA-approved doing was half that with no loading dose, 250 mg IM monthly. So, how did we come to underdose an antineoplastic for almost a decade?

Foundations in #OncoPharm returns to discuss everyone's favorite antineoplastic, dexamethasone, which is also an anti-emetic, and an oncology pre-med among other things.

Another week, another 2 studies of checkpoint inhibitors in NSCLC to talk about. IMpower 110: https://www.nejm.org/doi/full/10.1056/NEJMoa1917346 Checkmate-153: https://ascopubs.org/doi/full/10.1200/JCO.20.00131

Updates from ESMO 2020 & more on: Bladder Cancer (JAVELIN Bladder 100 & DANUBE) Lung Cancer (ADAURA & CROWN) Breast Cancer (ASCENT, IMPASSION 130/131, monarchE) And the first major publication of drugging the "undrugable" KRAS

The Landmarks in OncoPharm series returns to discuss a major breakthrough in treating advanced prostate cancer, TAX-327, which at the time established docetaxel as a new standard of care for metastatic prostate cancer that was (at that time) considered hormone-refractory. TAX 327: https://www.nejm.org/doi/full/10.1056/NEJMoa040720

We have a new drug, pralsetinib, to discuss. It's the 2nd RET inhibitor approved for RET-fusion (+) metastatic NSCLC.

After brief diatribes on PO azacitidine and COMBI-AD's 5-year non-OS analysis, we focus on BROCADE3 and the background on BRCA-mutated metastatic breast cancer treatment. BROCADE3: https://doi.org/10.1016/S1470-2045(20)30447-2

Chemotherapy-induced alopecia is the next in our series on Foundational #OncoPharm topics.

Our Landmarks in #OncoPharm Series returns to discuss ATAC: Anastrozole or Tamoxifen Alone or in Combination for adjuvant breast cancer treatment.

VIALE-A: Veneoxlax + azacitidine, a new standard of care for elderly or unfit AML patients, is now published. Lots of supportive care and management concerns to discuss: tumor lysis syndrome, prophylactic anti-microbials, G-CSF use (?), and dose modification for hematologic toxicity. Link: https://doi.org/10.1056/nejmoa2012971

Lots of new options for B-cell malignancies of all ages! We discuss brexucabtagene autoleucel (CAR-T for mantle cell lymphoma, tafasitamab (anti CD-19 monoclonal antibody), and belantamab mafadotin (anti-BCMA antibody drug conjugate). Finally, for good measure we review the newly approved regimen of atezolizumab with vemurafenib/cobimetinib for BRAF-mutated metastatic melanoma.

Next up in the Foundations of #OncoPharm series, gemcitabine.

We summarize the changes to ASCO's latest Antiemetic Guidelines update as well as their guidelines for chemotherapy-induced peripheral neuropathy (CIPN). Then, we take a look at the PO decitabine approval and ponder the question, does low albumin decrease tolerability to some TKIs?

We're joined by Dr. Karen Fancher, oncology pharmacist, to talk about her breast cancer story from diagnosis to shared-decision making treatment plans with her oncologist to treatment toxicity.

While this is a topic best covered with case examples, we do our best to provide the basics in 20 minutes. Experienced clinicians may not be aware of the How Long study briefly discussed in this episode: https://doi.org/10.1016/S2352-3026(17)30211-9