Lots of recent updates to cover this week...1. Adjuvant pembrolizumab of RCC demonstrates OS improvement in NEJM publication (DOI: 10.1056/NEJMoa2312695)2. Yet adjuvant nivolumab did not demonstrate OS improvement in the adjuvant setting. There may be a few reasons for this (https://doi.org/10.1200/JCO.2024.42.4_suppl.LBA358)3. A cytokine-fusion pr…

Arguably, the most anticipated release of 4/19/24By John Bossaer

What I learned (or relearned?) at HOPA's 2024 Annual Conference: updates in Neuro Oncology, fedratinib toxicity, and bispecific antibodies in multiple myeloma.Also, fam-trastuzumab deruxtecan (T-DXd) garnered a site-agnostic approval for HER2 amplified solid tumors.Finally, the ALINA study, adjuvant alectinib in ALK+ NSCLC, was published in this we…

Tumor Lysis Syndrome (TLS) is a foundational topic for all oncology clinicians. We discuss the what, the why, prevention, and treatment.By John Bossaer

Discussing four papers that caught our eyes from the last few weeks:Pazopanib vs. placebo following metastatectomy. Always concerning when placebo has an OS advantage.ECOG-ACRIN E2810: https://doi.org/10.1200/JCO.23.01544Gemcitabine vs. Gem + Paclitaxel (Taxol) in pancreatic cancer patients after FOLFIRINOX: https://doi.org/10.1200/JCO.23.00795An R…

Two recent publications suggest more people may be choosing non-colonoscopy screening practices in the future. One is a new stool DNA test, while the other is a blood test.How do they compare to the gold standard of colonoscopy?Cell-free DNA blood test: DOI: 10.1056/NEJMoa2304714Next generation stool DNA test: DOI: 10.1056/NEJMoa2310336…

EV-302 is finally published, and you have to squint to find any major critiques. Enfortumab bedouin + pembrolizumab fully arrives as a standard 1st-line regimen of advanced urothelial cancer.Also, nivolumab gets a 1st-line FDA approval for urothelial carcinoma in conjunction with cisplatin + gemcitabine based on CHECKMATE-901.…

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.By John Bossaer

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)01366-1POUT (final OS): https://doi.org/10.1200/JCO.23.01659Ivosidenib 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.By John Bossaer

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…

...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)By John Bossaer

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.2023.100446By John Bossaer

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

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

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

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/nejmoa0801479By John Bossaer

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.13627Also, 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.By John Bossaer

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.By John Bossaer

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)002…

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/nejm1990100432314032. Albain (1995) JCO (concurrent cisplatin/etoposide + RT): https://pubmed.ncbi.nlm.nih.gov/?term=76365303. Albai…

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).By John Bossaer

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 commen…

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.By John Bossaer

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.By John Bossaer

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

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=37643542By John Bossaer

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).By John Bossaer

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.By John Bossaer

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=37639651Is there a role for ICIs in dMMR/MSI-h pancreatic cancer? This retrospective says, uh ma…

A Foundations of OncoPharm episode on nab-paclitaxel, with a focus on the pharmaceutical differences from conventional paclitaxel.By John Bossaer

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.By John Bossaer

Talquetamab is approved for r/r multiple myeloma and the STOP-CA trials asks if atorvastatin can prevent anthracycline cardiotoxicity.STOP-CA: https://jamanetwork.com/journals/jama/fullarticle/2807988By John Bossaer

The Ruby trial leads to an FDA approval for dostarlimab + chemo in advanced/recurrent endometrial cancer, but only dMMR/MSI-H patients.Quizartinib's label and REMS program provide some clear, but concerning, warnings about its toxicity.By John Bossaer

By listener request! What is BCOP, why pursue it, and some simple tips on studying for the exam.By John Bossaer

A Landmark of OncoPharm from 2004: FOLFIRI --> FOLFOX or FOLFOX --> FOLFIRI.Some interesting dosing to discuss in this study.Link: https://pubmed.ncbi.nlm.nih.gov/?term=37379692By John Bossaer

We welcome Dr. Donald Harvey to the podcast to discuss Phase 1 clinical trials in oncology. Topics include goals of Phase 1 trials, how these early studies are conducted, how doses are determined, and some limitations of current practices.By John Bossaer

We welcome Jacqueline (Jackie) Saunders to the podcast to talk about investigational drug services (IDS) in oncology and how pharmacists manage the storage, preparation, & delivery of experimental drugs.By John Bossaer

This episode...More evidence to support the use of neoadjuvant ICI/chemo in stage III NSCLC to obtain pCR published this week with NADIM II.Time to rethink giving ICI/TKI combination therapy to favorable-risk metastatic RCC patients? (Finally, I'm not the only one saying this anymore.)NADIM II: https://www.nejm.org/doi/full/10.1056/NEJMoa2215530FDA…

This week's Pod looks at the 2nd CD20-CD3 bispecific T-Cell engager approved this year (or at all), glofitamab, and the TALAPRO-2 study of combining talazoparib to enzalutaimide.TALAPRO-2: https://doi.org/10.1016/S0140-6736(23)01055-3By John Bossaer

We highlight notable data from this month's ASCO annual meeting.1. SONIA: sequence (1st or 2nd-line) CKD 4/6i in MBC2. ADAURA OS results and low rate of osimertinib use in control arm3. Keynote 671: perioperative pembrolizumab in NSCLC4. PROSPECT: Can radiation therapy be omitted in locally advanced rectal cancer?5. Nivo-AVD vs. Bv-AVD in stage III…

ASCO '23 Appetizers by John BossaerBy John Bossaer

Olaparib + Abiraterone is FDA approved for mutated-BRCA prostate cancers. Olaparib has a bit of convoluted story to unpack in this patient population.Have we finally found a way to minimize the peripheral neuropathy from paclitaxel.....with cilostazol?PROpel: https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200043Cilostazol RCT: https://doi.org/10…

We discuss the newly approved CD20-CD3 T-cell engager for subcutaneous (SC) administration to treat DLBLC after 2 or more lines of therapy.By John Bossaer

A recent paper serves as a good prompt to discuss trimodality treatment for muscle-invasive bladder cancer and the data supporting its use.Zlotta et al: https://doi.org/10.1016/S1470-2045(23)00170-5By John Bossaer

Today's Pod discusses...1) A large trial comparing 4 different CLL treatments GAIA-CLL13: https://www.nejm.org/doi/full/10.1056/NEJMoa22130932)Adding Cabozantinib + Nivo/Ipo vs. Nivo/Ipi in intermediate/poor risk mRCCCOSMIC-313: https://www.nejm.org/doi/full/10.1056/NEJMoa22128513) A potential future biomarker for predicting response to PD-(L)1 tar…

Talking 3rd-line treatment of metastatic colon cancer. Tipiracil-trifluridine + bevacizuamb vs. tipiracil-trifluridine alone. And a bit on the theory of "bevacizumab beyond progression."SUNLIGHT: https://www.nejm.org/doi/full/10.1056/NEJMoa2214963By John Bossaer

Quizartinib vs. Placebo(?) + Chemo in newly diagnosed AML. We add a bit of context about quizartinib's history leading up to this study preview possible role in therapy if approved in the future.Link: https://doi.org/10.1016/S0140-6736(23)00464-6By John Bossaer