Are we nearing the end of the Platinum Era in bladder cancer? A press release suggests enfortumab vedotin + pembrolizumab in a perioperative approach is better than the current standard of care: neoadjuvant cisplatin-based chemo followed by surgery. We eagerly await seeing this data.

Also, a subcutaneous amivantamab/hyaluronidase formulation is approved, which offers a much lower risk of infusion reactions - but some chances for dosing errors based on weights and available dosage forms.

ASH 2025 Highlights:

MajesTEC-3: Teclistamab + Daratumumab in relapse refractory Multiple Myeloma

Paradigm: HMA + Ven vs. 7+3 or CPX-351

Denosumab safety & dosing in Multiply Myeloma and renal dysfunction

Trilaciclib and CDK 4/6 inhibition as protection against TP53-mutated clonal hematopoiesis?

DPYD testing is more complicated than one would think! We talk through the steps to consider when initiating DPYD testing at your site. Resources below:

Guide for implementing DPYD testing at your site: https://doi.org/10.1002/cpt.3567

CPIC Dosing Guidline: https://doi.org/10.1002/cpt.911

CPIC DPYD Resources: https://cpicpgx.org/guidelines/guideline-for-fluoropyrimidines-and-dpyd/

We are back with lots of OncoPharm updates:

1. The belantamab mafodotin REMS program details are available....and it's a lot.

How will belantamab mafodin-regimens be used with the upcoming MAJESTIC-3 data of teclistamab-daratumumab?

2. The capecitabine label is updated and calls for pre-treatment DPYD testing

3. Daratumumab gets an FDA approval for high-risk smoldering myeloma based on the AQUILA study

Critique of AQUILA: https://doi.org/10.1093/oncolo/oyaf216

4. A pertuzumab biosimilar (Poherdy) is approved

5. Epcoritamab nets regular approval and a new indication with lenalidomide/rituximab (RR) for Follicular Lymphoma

6. Ziftomenib, a new menin inhibitor, is approved for NPM1 relapsed/refractory AML

7. Sevabertinib, a new HER2 inhibiting TKI, is approved for ERBB2 mutated NSCLC, with evidence of activity in patients previously treated with HER2-antibody-drug conjugates

8. Expected FDA approvals for durvalumab + FLOT in preoperative gastric/GEJ cancer; neoadjuvant pembrolizumb + enforumab vedotin in bladder cancer (non-cisplatin eligible), and tarlatamab regular approval for small cell lung cancer

9. Happy Thanksgiving!

Our 3rd and final installment in this Oncology Pharmacy Training Pathways mini-series discusses the PGYNone route. I am joined by Vineetha Thomas and Sheila Pierre to discuss their experiences in becoming oncology pharmacists, forgoing residency training, positions they held earlier in their career, and ultimately becoming thriving oncology pharmacists.

This mini-series is supported by the ELO Collaborative, a fantastic training opportunity for those seeking get more oncology training outside traditional pathways.

Use this link to explore: https://elojbossaer--kelleycpharmd.thrivecart.com/elo-collaborative-1-year/651082f1e4e3c/

There is no universal pathway to become an oncology pharmacist, and the discussions in this mini-series reflect the views & experiences of those involved.

Our 2nd installment in this Oncology Pharmacy Training Pathways mini-series discusses the PGY1 pharmacy residency route, without a PGY2 oncology residency. I am joined by Kayla Fry and Amber Burgess to discuss their experience to becoming oncology pharmacists. There are some similarities and differences in their paths to their current roles (and one It's-A-Small-World shared connection too!)

This mini-series is supported by the ELO Collaborative, a fantastic training opportunity for those seeking get more oncology training outside traditional pathways.

Use this link to explore: https://elojbossaer--kelleycpharmd.thrivecart.com/elo-collaborative-1-year/651082f1e4e3c/

The last episode in this mini-series will cover the PGY-NONE pathway of becoming an oncology pharmacist.

There is no universal pathway to become an oncology pharmacist, and the discussions in this mini-series reflect the views & experiences of those involved.

Our 1st installment in this Oncology Pharmacy Training Pathways mini-series discusses the PGY2 oncology pharmacy residency rout. I am joined by Brooke Adams and Sarah Wheeler to discuss our experience and PGY2 training. We discuss the pros/cons of pursuing a PGY2 oncology residency with the understanding that residency training (or additional residency) training isn't for everyone.

This mini-series is supported by the ELO Collaborative, a fantastic training opportunity for those seeking get more oncology training outside traditional pathways.

Use this link to explore: https://elojbossaer--kelleycpharmd.thrivecart.com/elo-collaborative-1-year/651082f1e4e3c/

The next two episodes in the mini-series will cover the PGY1 pathway and the PGY-NONE pathway of becoming an oncology pharmacist.

There is no universal pathway to become an oncology pharmacist, and the discussions in this mini-series reflect the views & experiences of those involved.

[Moving Trailer Voice] This Halloween: They always come back....

The latest revival is belantamab mafodotin, FDA approved...again. After being vanquished in DREAMM3, it returned in DREAMM7 and even Daratumumab (in combination with Vd) couldn't overcome this blindingly effective drug (in combination with Vd).

This pod reviews belantamab mafodotin's checkered past and wonders what the sequels may have in store for us.

This week's episode recaps some highlights from ESMO 2025:

1. Destiny-Breast05: T-DXd > T-DM1 in persistent HER2+ disease after neoadjuvant chemo + surgery

2. Keynote-905: Neoadjuvant Enfortumab Vedotin + pembro in cisplatin-ineligible bladder cancer

3. POTOMAC: Durvalumab + BCG in non-muscle invasive bladder cancer

4. IMvigor011: ctDNA-guided adjuvant atezolizumab in bladder cancer

5. Dynamic-III: ctDNA guide de-escalation or escalation of chemotherapy in stage III colon cancer

6. HARMONi-6: an excuse to talk about ivonescimab, a bispecific antibody unlike any other currently FDA approved

IL-2, one of the founding fathers of our current immunotherapy landscape, is discussed.