Oncopharmpod

First, we run through 4 recent FDA-approved expanded indications for HCC, small cell lung cancer, MDS-related anemia, and BRAF-v600e-mutated colorectal cancer. Then, we review the evidence that warranted bevacizumab's FDA-approval for metastatic breast cancer way back in 2008 (E2100) and its subsequent labeled indication removal by the FDA (Avado & Ribbon-1). Why talk about old news? Perhaps there's a lesson here as we consider using untested drugs... E2100: https://www.nejm.org/doi/full/10.1056/nejmoa072113 Avado: https://www.ncbi.nlm.nih.gov/pubmed/20498403 Ribbon-1: https://www.ncbi.nlm.nih.gov/pubmed/21383283

Reviewing the lasted DOAC study in treating cancer-associated VTE: Caravaggio. We compare it the other major DOAC studies in this patient population. Caravaggio: https://www.nejm.org/doi/full/10.1056/NEJMoa1915103 Also, announcing our first journal club! This will be our 4/16 Pod. It is especially for an oncology APPE students missing out on an oncology experience, but all are welcome to participate. Journal Club link: https://www.futuremedicine.com/doi/pdf/10.2217/fon-2018-0787

The Foundations of OncoPharm series returns with a unique chemotherapy drug: bleomycin. Also, Covid Thoughs (14:00).

Recent updated survival analyses for CLEOPATRA and Keynote-189 (6:45) require some historical context to truly see their impact. Finally, #AskOncoPharm returns (15:05) with a listener question about infusion rates when restarting daratumumab.

We all should do what we can to "flatten the curve" and that includes our patients on treatment. While there is no such thing as elective chemo, there are some practical ways we can minimize patients needing to come into our facilities.

Looking back at a 2012 NYT op-ed (https://www.nytimes.com/2012/10/15/opinion/a-hospital-says-no-to-an-11000-a-month-cancer-drug.html) that led to a 50% price decrease in a biologic cancer medication.

A plethora of #oncopharm updates! Isatuximab is approved and neratinib gets another breast cancer indication (2:00) Pembrolizumab with chemo for triple-negative breast cancer (8:50) New EPOC updated survival analysis on FOLFOX+cetuximab in isolated liver metastatic colon cancer (15:00) Precision medicine in pancreatic cancer (19:30) Cladribine + rituximab for hairy cell leukemia (23:30)

Two recent publications add to our knowledge concerning the utility of CYP2D6 genotyping and tamoxifen. TARGET-1: https://www.ncbi.nlm.nih.gov/pubmed/31821071 Tamoxifen D/C rates by 2D6 genotype: https://www.ncbi.nlm.nih.gov/pubmed/31800347

You've heard of CAR-T therapy, and now it's time to learn about CAR-NK cells. Reference: https://www.nejm.org/doi/full/10.1056/NEJMoa1910607

Drug-drug interactions are a key consideration when determining which NK-1 antagonist to use in patients receiving highly emetogenic chemotherapy. We discuss the issues for (fos)aprepitant, netupitant, & rolapitant. A nice aprepitant review (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5595939/) and the case for an aprepitant-vincristine interaction (https://doi.org/10.1177/1078155219870840).

All the need-to-know items about the latest #oncopharm approved drug, tazemetostat, to start the Pod. We end (9:15) with a brief discussion of how gut bacteria may lead to gemcitabine resistance.

Foundations of OncoPharm: Bendamustine

New Drug Update! We discuss the efficacy and safety data surrounding avapritinib's approval as well as its likely role in GIST management.

How common are upon safety concerns from FDA on newly approved #oncopharm agents? Does the accelerated approval process lead to more safety updates? We discuss (https://doi.org/10.1634/theoncologist.2019-0653). We also look at a possible way to mitigate 6-MP hepatoxicity (5:45) using allopurinol (https://doi.org/10.1080/10428194.2019.1702183). Finally (10:55) we review the most recent FDA indications for olaparib and pembrolizumab.

Kicking off the 2020 Pod season with the last FDA-approval of 2019 - trastuzumab deruxtecan.

Closing out the year discussing FDA's approval of enfortumab-vedotin for urothelial cancer and a new, but pharmacologically unique, TKI with activity in CML (12:45). Happy New Year!

The Foundations of #OncoPharm series combines with a thematic critique of an animated Holiday classic to examine the links between The Grinch and Arsenic Trioxide.

Reviewing pertinent abstracts from ASH's 2019 annual meeting. Abstracts discussed: LBA-1 (blinatumomab), 2640 (venetoclax-azoles interactions), 2639 (FLAG/CLAG vs. CPX-351 in sAML), LBA-6/862/860 (myeloma), and 3310 (PK-targeted dosing of melphalan for autoHSCT). Search here: https://ash.confex.com/ash/2019/webprogram/start.html

The Landmarks in #OncoPharm series returns with dose-dense AC, published in JCO in 2003 by Citron et al. Link: https://www.ncbi.nlm.nih.gov/pubmed/12668651

The menu: sirolimus vs. prednisone for standard risk aGVHD, levofloxacin prophylaxis in myeloma patients (9:00), acalabrutinib's approval for CLL/SLL (12:00), OS analysis from osimertinib's FLAURA (14:30), optimal sequencing of abiraterone & enzalutamide (23:20), some novel non-malignant heme drugs (26:45), outro music (30:00), 2 new drugs for sickle cell (30:30), pecan pie.