OncoPharm

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Immunotherapy (IO) takes a few steps back as several prior accelerated approvals are withdrawn...with possibly more bad news to come.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.

The Landmarks of OncoPharm series returns to discuss 2 pivotal trials that ushered in the age of aprepitant and NK-1 receptor anagonists for CINV.

Aprepitant in HEC: https://ascopubs.org/doi/pdf/10.1200/JCO.2003.01.095

Aprepitant in MEC: https://ascopubs.org/doi/pdf/10.1200/JCO.2005.09.050

Tivozanib's FDA approval for mRCC was a long time in the making, but what is its role?

Disappointing atezolizumab results for adjuvant treatment of bladder cancer (IMvigor-010).

Preliminary data on antibody responses to COVID-19 vaccination in cancer patients.

This week, two indolent lymphoma updates:

1. CAR-T (Axl-Cel) for follicular lymphoma

2. Is there a preferred platinum salt in DHAP for Mantle cell lymphoma* patients heading to transplant? (https://pubmed.ncbi.nlm.nih.gov/33658645/)

*Yes, I know - not really an indolent lymphoma in this case.

Melphalan flufenamide, a drug that makes tumor cell kinetics cool again, is our main topic. Also, brief updates on lorlatinib (ALK+ mNSCLC) and nivolumab/cabozantinib (mRCC).