Oncopharmpod

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returns to talk about 2008's VISTA study, which ushered bortezomib into the front line setting, albeit with a now outdated alkylating agent-based backbone.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 --> surgery --> consolidation chemo): https://doi.org/10.1016/s0140-6736(09)60737-6

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-induction-chemoimmunotherapy-lead-us-broaden-our-definition-resectability-nsclc

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.gov/?term=37625102

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.