We return to our Landmarks of OncoPharm series to dive deep into an article that provided some of our foundational understanding of how anthracycline cardiotoxicity risk is influenced by rate of administration. Link: https://pubmed.ncbi.nlm.nih.gov/2910423/
FDA approves 2-years of abemaciclib plus endocrine therapy for high-risk HR+, HER2(-) patients. Quite a bit to discuss about this. Also, FDA expands indications for pembrolizumab (of course) and brexucabtagene autoleucel. NOTE: A 5cm breast tumor is a T3 lesion, not a T2 as misstated in this episode.
Dr. Ali McBride joins the Pod to spar over same-day vs. next-day pegfilgrastim. (There is some audio feedback early in the Pod that we clean up after a few minutes. Apologies!) Bibliography: Burris et al: https://pubmed.ncbi.nlm.nih.gov/20808556/ AOC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819939/ McBride et al (CHOP): https://www.futuremedicine.com/doi/10.2217/fon-2021-0532 McBride et al (NHL): https://doi.org/10.18553/jmcp.2021.21010
An oversimplified approach to thinking about sarcomas.
Lots to discuss from ESMO 2021 to new drug approvals. First, we discuss the updates in cervical cancer from ESMO (pembrolizumab with chemo) and the newly approved tisotumab-vedotin. Then, we discuss another new agent, mobocertinib and its scary QT prolongation profile as well as cabo-confusion in thyroid cancer. Finally, we discuss the potentially practice changing, but preliminary, data from ESMO in bladder cancer (VESPER) and HER2+ MBC (DESTINY-Breast03).
Discussing the updated results after the 2nd randomization of CASSIOPEIA looking at daratumumab maintenance following ASCT. Link: https://doi.org/10.1016/S1470-2045(21)00490-3
Discussing the use of mycophenolate mofetil (MMF) for ITP (https://www.nejm.org/doi/full/10.1056/NEJMoa2100596) as well as regulatory updates on atezolizumab and zanubrutinib.
Foundations of OncoPharm: Hypercalcemia of Malignancy (in under 10 minutes)
Belzutifan, the 1st hypoxia-inducible factor (HIF) inhibitor is FDA-approved. Plus, expanded indication approvals for nivolumab, dostarlimab, lenvatinib/pembrolizumab, & Ivosidenib. Finally, my Top 5 Rolling Stones Songs (14:30).
Looking into the data behind the FDA & CDC's allowance for a booster mRNA vaccine for immunocompromised patients.
A recent patient experience serves as a reminder than TKIs, like cabozantinib, can produce many "minor" toxicities that can really add up and affect QOL.
Two recent publications to discuss: 1. The publication of a study discussed on our ASCO '21 Pod on acalabrutinib vs. ibrutinib and patient implications (https://ascopubs.org/doi/pdf/10.1200/JCO.21.01210) 2. A good illustration of the "crossing of the curves" and interpreting Kaplan-Meier curves using alloHSCT vs. 5-aza in MDS patients. https://ascopubs.org/doi/pdf/10.1200/JCO.20.02724
Two breast cancer updates (pembrolizumab in TNBC and adjuvant AI duration) and two cGVHD updates (belumosudil and ruxolitinib).
The almost-award winning* Landmarks in OncoPharm series returns to discuss the landmark Armstrong et al 2006 NEJM paper on using intraperitoneal chemotherapy in stage III ovarian cancer. Link: https://www.nejm.org/doi/full/10.1056/nejmoa052985 *not really
A case study in misbranding promotional materials and how to help FDA regulate them.
Foundations of OncoPharm: capecitabine
A foundational topic in oncology - managing toxicities of tamoxifen and AI's in breast cancer patients. An excellent evidence-based review was recently published, and is worth our time on the Pod. Link: https://doi.org/10.1016/S1470-2045(20)30666-5
So-called negative trials still offer information. We discuss ECOG-ACRIN EA1131 in breast cancer and TOURMALINE-MM1 in myeloma in this epidose. EA1131: https://ascopubs.org/doi/pdf/10.1200/JCO.21.00976 TOURMALINE-MM1 (final OS analysis): https://ascopubs.org/doi/pdf/10.1200/JCO.21.00972
Why is learning oncology so hard? To get the students perspective I ask a few pharmacy students why in hopes of learning how to better teach and precept oncology trainees.
Highlighting results presented at ASCO's 2021 annual meeting.
Two new drugs approved in the last week: 1. sotorasib, a drug for a specific KRAS mutation (G12C) in 2nd line metastatic NSCLC 2. infigratinib, basically a "me too" FGFR inhibitor approved for metastatic cholangiocarcinoma We all discuss the latest adjuvant CHECKMATE study (nivolumab in urothelial carcinoma) and a recent study of seropositivity in cancer patients following COVID vaccination.
Discussing a first of its kind drug, amivantamab, a bispecific (MET & EGFR) monoclonal antibody just approved for advanced exon20 insertion NSCLC (2nd line).
The Foundations of Oncopharm series tackles veneotoclax with special guest, Dr. Kayleigh Marx - clinical pharmacy specialist in leukemia. She tells us everything we need to know and consider when using venetoclax for leukemia patients. Drug-drug interaction references: 1. https://doi.org/10.1002/jcph.858 2. https://doi.org/10.1016/j.clinthera.2017.01.003 3. https://doi.org/10.1002/jcph.730 4. https://doi.org/10.1007/s12325-018-0793-y
ASCO releases updated guidelines for the dosing of cancer drugs in patients with obesity. Not a ton new from the original guidelines, but worthy of discussion. Link: https://ascopubs.org/doi/full/10.1200/JCO.21.00471
Two brand new drugs to discuss and their possible roles in practice. Plus, updates on the treatment of HER2-amplified gastric cancer and colorectal cancer.
An abbreviated edition of our Landmarks in #OncoPharm series returns to discuss weekly cisplatin + radiotherapy for locally advanced cervical cancer. As a bonus, we cover a new study establishing FOLFOX as the standard-of-care for 2nd line treatment of metastatic biliary cancer. All of this is discussed against the backdrop of the relative importance (or lack thereof?) of obtaining an approved indication.
First, we review some early evidence of antibody response following COVID vaccination in patients with multiple myeloma and CLL. Then, we discuss nivolumab's approval with chemo for first-line treatment of gastric cancer (& GEJ & adenocarcinoma of the esophagus) and the MANHATTAN study and its high rate of MRD-negativity in myeloma. 5-yr OS data is published for pembrolizumab in PD-L1 > 50% NSCLC and a new drug is approved for the 1st time while recording the Pod.
Immunotherapy (IO) takes a few steps back as several prior accelerated approvals are withdrawn...with possibly more bad news to come.
Updates on COVID-19 vaccination in cancer patients on immune-checkpoint inhibitors (new data!) and those getting imaging studies after vaccination. We quickly run through the AMBORO (April 6 published online in J Clin Oncol) trial demonstrating improvements in patient care with the inclusion of a clinical pharmacist (or pharmacologist) in managing PO antineoplastics.
Updates on the use of immune-checkpoint inhibitors in esophageal and gastro-esophageal junction (GEJ) cancers. First, adjuvant nivolumab (Checkmate 577). Then, pembrolizumab + chemo for initial treatment of metastatic disease (Keynote 590). Also, we mention 2 new approvals for myeloma: the 1st CAR-T for the disease and an expanded indication for isatuximab.
