Antiandrogen withdrawal is an historically well described phenomenon where prostate cancer patients experience PSA responses AFTER stopping their anti-androgen. But does this happen with today's 2nd generation antiandrogens?
A plethora of recent updates: -Pembrolizumab (perioperative) in head & neck cancer (Keynote-689) -Prostate cancer updates on cabozantinib/atezolizumab (yes, really) and talazoparib -Pirtobrutinib improves PFS in CLL -Zanubrutinib has a new dosage form on the way -Another mitomycin product approved with "reverse thermal properties" -A new regimen for FL of tafasitamab/rituximab/lenalidomide -A comparison of the new ROS1-inhibitor, taltrectenib, compared to other 1st-line treatment options
A recap of notable updates from ASCO 2025 1. Destiny-Breast09 2. BREAKWATER 3. ATOMIC 4. Delphi-304 5. CM 816 OS update 6. C-POST 7. Matterhorn
Our Landmarks of OncoPharm series returns to discuss the CLEOPATRA study, which established docetaxel, trastuzumab, pertuzumab (THP) as a standard first-line regimen for metastatic HER2-amplified breast cancer.
If you've been struggling with how to talk to patients about ivermectin for cancer, then this podcast is for you. 1. Cancer misinformation on social media (Loeb, et al): https://doi.org/10.3322/caac.21857 2. Clinician communication with patients about cancer misinformation (Bylund, et al): https://doi.org/10.1200/OP.22.00526
Discussing recent FDA approvals of penpulimab, avutometenib, defactinib, and telisotuzumab vedotin.
A splashy large study and two small studies suggest IV Mg in pre-hydration fluids can decrease the risk of cisplatin kidney injury. Gupta et al. JAMA Oncol (2025): doi:10.1001/jamaoncol.2025.0756 PRAGMATIC. ESMO Open (2022): https://doi.org/10.1016/j.esmoop.2021.100351 Yamamoto et al. Anticancer Res (2015): https://pubmed.ncbi.nlm.nih.gov/25862878/
This episode summarizes recent updates on: Tumor infiltrating clonal hematopoiesis (TI-CH) and its apparent negative impact on solid tumors (https://www.nejm.org/doi/full/10.1056/NEJMoa2413361) Updated dostarlimab data on MMRd use in rectal cancer and other solid tumors in the neoadjuvant (definitive?!?!) setting (https://www.nejm.org/doi/full/10.1056/NEJMoa2404512) Phase 1 study of 7 + 3 + Venetoclax (https://doi.org/10.1182/blood.2024026700) Zongertinib, a new HER2 TKI (https://www.nejm.org/do...
BRCA revision mutations may explain some of the limited benefit seen in long-term follow-up studies with PARP inhibitors. Bibliography: 1: BRCA reversion mutations predict resistance. https://doi.org/10.1158/2159-8290.CD-18-0715 2: SOLO3 Final OS Data. https://doi.org/10.1200/JCO.24.00933 3: Elucidating acquired PARP inhibitor resistance in advanced prostate cancer. https://doi.org/10.1016/j.ccell.2024.10.015
Recapping HOPA 25 and Portland *Great food (not discussed, the most excellent ETSU dinner at Arden) *COCOON *Pharmacists make everyone's job easier and keep patients out of the ED *A few more tidbits too!
FDA expands approvals for durvalumab (bladder cancer) and Lutetium-177 vipivotide tetraxetan (pre-taxane in metastatic prostate cancer). Portland has places.
A Foundations of OncoPharm episode on Topotecan. (Originally to be released week of 3/27)
We discuss reduced dose apixaban for months 6+ of treating cancer-associated VTE (API-CAT) and the impact (or lack thereof) of pausing BTK-inhibitors around vaccination (IMPROVE)
The updated Keynote 811 OS results convert an accelerated approval for pembrolizumab to a regular approval, albeit restricted by PD-L1 CPS status of 1 or higher.
There is a decent track record with mixed results for cryotherapy to prevent taxane-induced peripheral neuropathy. The POLAR trial adds to this body of evidence that trends in favor of cryotherapy. Compression therapy is another alternative. Both are studied in POLAR. POLAR: doi:10.1001/jamaoncol.2025.0001
Ten of the top herb-chemotherapy interactions. About Herbs website: https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs/search Also, search 'About Herbs' in your app store.
Two recent publications suggest modifications to standard subcutaneous daratumumab pre-meds is safe...and saves time! Padmaraju et al experience from Chicago Med Center: https://doi.org/10.1093/oncolo/oyae158 Vazirnia et al experience from Mayo Clinic: https://doi.org/10.1200/OP.23.00470 We end summarizing some emerging evidence about the need, or lack thereof, for pre-paclitaxel H2RAs.
We take a deep look at the recently published, and guideline changing, AMPLIFY trial of fixed-duration acalabrutinib in CLL. Link: DOI: 10.1056/NEJMoa2409804
Morbidity & Mortality (M & M) are common case conferences to learn from unfortunate cases to improve care in the future. This episode looks at two recently published case reports. 1. Fatal tumor lysis syndrome following a lack of venetoclax ramp-up in AML: https://www.jhoponline.com/issue-archive/2024-issues/december-2024-vol-14-no-6/rapid-onset-of-fatal-tumor-lysis-syndrome-in-a-patient-with-acute-myeloid-leukemia-receiving-azacitidine-and-venetoclax-without-a-ramp-up-schedule-a-case-re...
Dipping into the archives (technology issues with new computer) to re-release the Foundations of OncoPharm episode on rituximab. Where did that 375 mg/m2 dose come from anyway?
FDA approves two new treatment regimens: 1. Acalabrutinib + BR for untreated mantle cell lymphoma patients deemed ineligible for autologous HSCT 2. Sotorasib + panitumumab for KRAS-G12C mutated metastatic colorectal cancer (after chemotherapy, including oxaliplatin and irinotecan)
Datopotamab deruxtecan, a newly approved agent for breast cancer, is discussed.
HOPA Pharmacy Outcomes & Practice-Based Collaboration Survey: https://www.surveymonkey.com/r/MXNVRBR Dexamethasone Dosing Intensity in Multiple Myeloma: https://doi.org/10.1182/blood.2024025939 Talquetamab + Teclistamab: https://doi.org/10.1182/blood.2024025939 postMONARCH: https://doi.org/10.1200/JCO-24-02086
We discuss recent approvals of ensartinib and nivolumab-hyaluronidase as well as new front-line option for BRAV-V600E mutated metastatic colorectal cancer.
Weighing the Pros & Cons of the accelerated approval pathway as it relates to oncology. An updated draft guidance document from FDA regarding this pathway and some compelling data regarding the public's perceived value of newly approved drugs for cancer. Article: Preferences for speed of access versus certainty of the survival benefit of new cancer drugs: a discrete choice experiment. Forest R, et al. Lancet Oncology 2024. Link: https://doi.org/10.1016/S1470-2045(24)00596-5
Looking back at new approvals from 2024 - what to keep, re-gift, or return? And yes, as soon as this was recorded 2 new drugs were approved.
Lots of recent clinical trial updates to discuss: AQUILA: Daratumumab for high-risk smoldering multiple myeloma Checkmate 8HW: Nivo/Ipi for MSI-high/MMRd metastatic colorectal cancer DESTINY-Breast06: T-DXd in HER2-low MBC after hormonal treatment, but without previous chemo for MBC ARMANI: Switch maintenance ramucirumab-paclitaxel in metastatic gastric/GEJ cancer HELEN-006: Neoadjuvant nab-paclitaxel/trastuzumab/pertuzumab vs. TCHP in breast cancer SONIA: finally published!
A first-in-class approval of a bispecific HER2-HER3 monoclonal antibody for NRG1 fusion (+) NSCLC and pancreatic cancer.
The 1st menin inhibitor, revumenib, is approved for relapsed/refractory acute leukemias. Understanding the Pathway: https://doi.org/10.1200/JCO-24-01265
A nice editorial succinctly summarizes a framework for thinking about how to incorporate anthracyclines into the treatment of early stage breast cancer patients. Anthracyclines in Early Breast Cancer: The Long Goodbye -https://doi.org/10.1200/JCO-24-01916 10-year Outcomes of READ trial: https://doi.org/10.1200/JCO.24.00836 Bonus - Practical Guide for Testing for Pharmacogenomics: https://doi.org/10.1200/OP.24.00191
