Oncopharmpod

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/doi/full/10.1056/NEJMoa2503704)

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.

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)

A Foundations of OncoPharm episode on Topotecan. (Originally to be released week of 3/27)

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-report 2. CD4+ T-cell lymphoma harboring a CAR integration into TP53: https://www.nejm.org/doi/full/10.1056/NEJMoa2411507

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.