Episoder
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Tisotumab vedotin garners a regular FDA approval for metastatic cervical cancer with OS benefit data.
A lingering question that demands a focused RCT: What is the optimal dose of methotrexate in primary CNS lymphoma? I'm glad I'm not the only one with this question: https://doi.org/10.1177/10781552231176754
What, some BRAF mutations in colorectal cancer might respond to EGFR-mab therapy? https://doi.org/10.1200/OP.21.00160 -
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 protein, nogapendekin alfa inbakicept, is approved for intravesicular use in BCG-unresponsive bladder cancer. This agent appears to activity in NSCLC too...
4. The Phase II APPLE trial provides some evidence than deferring osimertinib to the second-line setting in metastatic EGFR-mutated NSCLC may yield similar OS to first-line use of osimertinib. (https://doi.org/10.1200/JCO.23.01521)
5.The METALLICA study provides a nice roadmap for empiric metformin use when starting alpelisib (https://doi.org/10.1016/j.eclinm.2024.102520)
6. Does CPX-351 cause less intestinal damage than 7 + 3? And could that explain the discordance between time of neutropenia and infection rates? A mouse model suggests yes. (https://doi.org/10.1200/jco.2017.77.6112) -
Manglende episoder?
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Arguably, the most anticipated release of 4/19/24
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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 week's NEJM. -
Tumor Lysis Syndrome (TLS) is a foundational topic for all oncology clinicians. We discuss the what, the why, prevention, and treatment.
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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.23.01544
Gemcitabine vs. Gem + Paclitaxel (Taxol) in pancreatic cancer patients after FOLFIRINOX: https://doi.org/10.1200/JCO.23.00795
An RNA assay to predict gemcitabine sensitivity: https://doi.org/10.1200/JCO.22.02668
Management of skin cancers with ICIs in kidney transplant patients: https://doi.org/10.1200/JCO.23.02570 -
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/NEJMoa2304714
Next 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.
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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.
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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
Is vaginal estrogen safe if breast cancer patients?
Study: https://jamanetwork.com/journals/jamaoncology/article-abstract/2811413
Does paclitaxel work differently than we always thought?
Study: https://doi.org/10.1371/journal.pbio.3002339 -
...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)
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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.
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A Holiday Tradition returns as we review 14 new OncoPharm drugs approved this past year and ask Keep, Re-Gift, or Return.
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Small bites of updates coming out of ASH's 2023 annual meeting on CLL, multiple myeloma, and lymphoma.
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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? - Vis mere