OncoPharm

COVID-19 Vaccines are here!!! Will they work in patients on chemo? What about immunotherapy? Without firm answers to such questions we might as well talk about mRNA vaccines, the breakout star of 2020.

First up we discuss RxPonder and what it adds to adjuvant treatment of breast cancer in the context of TailoRx.

Then we discuss a recent study (https://jamanetwork.com/journals/jama/fullarticle/2774295)of additional capecitabine following adjuvant chemo in TNBC and what it adds in the context of CREATE-X.

Final OS results are now available for IDEA - 3 vs. 6 months of adjuvant chemotherapy for colon cancer: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30527-1/fulltext

Keynote-177 (pembrolizumab for MSI-H/dMMR metastatic colorectal cancer) was presented at ASCO, but interim results are now published as well:

https://www.nejm.org/doi/full/10.1056/NEJMoa2017699

The Landmarks in OncoPharm series returns to discuss the practice-changing CLOT trial of a LMWH vs. a vitamin K antatogist for treating cancer-associated VTE.

CLOT: https://www.nejm.org/doi/full/10.1056/nejmoa025313

Pembro gets an approval for triple negative breast cancer with quite high PD-L1 expression based on Keynote-355 (https://ascopubs.org/doi/10.1200/JCO.2020.38.15_suppl.1000).

Some reassuring information on TKI discontinuation in CML from the LAST study (doi:10.1001/jamaoncol.2020.5774) and an interesting method of identifying predictors of TKI adherence in CML (https://journals.sagepub.com/doi/pdf/10.1177/1078155220970616).

Our Landmarks of OncoPharm series returns with Ifosfamide

The BELLINI trial of venetoxlax in multiple myeloma was put on hold last year due to increased mortality. It's now published (https://doi.org/10.1016/S1470-2045(20)30525-8), so we take a look at the data and the myriad of supportive care concerns.

Discussing three recent publications:

1. Updated results of Keynote-426 (https://doi.org/10.1016/S1470-2045(20)30436-8)

2. Ph+ ALL tx with dasatinib/prednisone --> blinatumomab (https://www.nejm.org/doi/full/10.1056/NEJMoa2016272)

3. Decitabine + G-CSF to prevent AML relapse following alloHSCT (https://ascopubs.org/doi/pdf/10.1200/JCO.19.03277)

Another month, another 2 expanded FDA-approvals: nivolumab/ipilimumab for malignant pleural mesothelioma and pembrolizumab for relapsed/refractory classical Hodgkin's lymphoma.

Fulvestrant's standard dosing is now 500 mg IM on Days 1, 14, 29 & then monthly thereafter. Its initial FDA-approved doing was half that with no loading dose, 250 mg IM monthly.

So, how did we come to underdose an antineoplastic for almost a decade?