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PACUPod is your trusted source for evidence-based insights tailored to advanced clinical pharmacists and physicians. Each episode dives into the latest primary literature, covering medication-focused ... more
FAQs about PACUPod: Oncology:How many episodes does PACUPod: Oncology have?The podcast currently has 67 episodes available.
August 17, 2025Unusual Clinical Presentation of BCell Prolymphocytic Leukemia Cases as Splenic Marginal Zone Lymphoma Effectively Treated With Rituximab Monotherapy summary...more1minPlay
August 17, 2025Phase 1b2 study evaluating safety efficacy and immune effects of TLR9 agonist cavrotolimod with antiPD1 antibodies among patients with advanced solid tumors summary{ "episode_description": "PACULit Daily Literature Update: Today we review a Phase 1b2 open-label multicenter trial evaluating cavrotolimod, a TLR9 agonist, in combination with anti-PD-1 antibodies (pembrolizumab or cemiplimab) for advanced cutaneous malignancies, including melanoma, Merkel cell carcinoma, and cutaneous squamous cell carcinoma. The study (NCT03684785) enrolled 58 adults with heavily pre-treated disease, beginning with cavrotolimod monotherapy dose escalation followed by combination therapy. Primary endpoints focused on safety and tolerability; secondary endpoints assessed objective response rate (ORR), disease control rate (DCR), and duration of response, along with pharmacokinetics, pharmacodynamics, and immune biomarkers. Among 51 evaluable patients, ORR was 12% (6/51) and DCR was 27% (14/51) with median duration of response of 54 weeks; regression occurred in both injected and distant lesions, indicating an abscopal effect. Safety was manageable, with fatigue and injection-site reactions being the most common grade 3/4 events. Immune profiling showed robust peripheral cytokine/chemokine induction and increased tumor immune cell infiltration, suggesting synergy between cavrotolimod and anti-PD-1 therapy. While promising in a refractory population, limitations include the single-arm design and small, heterogeneous cohort. Full study details are reported by Milhem et al., 2025 in the Journal for Immunotherapy of Cancer, and ongoing trials will clarify potential clinical benefit of this approach for resistant skin cancers.", "keywords": [ "TLR9 agonist", "cavrotolimod", "intratumoral administration", "anti-PD-1 therapy", "pembrolizumab", "cemiplimab", "Phase 1b2", "open-label", "multicenter", "cutaneous malignancies", "melanoma", "Merkel cell carcinoma", "cutaneous squamous cell carcinoma", "refractory to anti-PD-(L)1", "safety and tolerability", "...more1minPlay
August 17, 2025Influence of different photobiomodulation protocols on the prevention of chemotherapy induced dysgeusia in breast cancer patients treated with Doxorubicin Cyclophosphamide a phase III randomized triple blinded non inferiority clinical trial summaryWelcome back to PACULit, your daily literature update for clinical pharmacists and physicians. Today we review a Phase III, triple-blind, placebo-controlled randomized trial evaluating photobiomodulation (PBM) to prevent chemotherapy-induced dysgeusia in breast cancer patients receiving doxorubicin–cyclophosphamide. The study directly compares a combined red plus infrared PBM protocol against single-wavelength PBM (red only or infrared only) to isolate each wavelength’s contribution. Primary endpoint was objective taste function; secondary endpoints included subjective taste measures, quality of life, salivary flow, ECOG status, BMI/weight, and safety. Enrolling 180 patients across three arms, the results showed that the combination of red and infrared PBM best preserved objective taste and yielded the most favorable ECOG improvements and weight trends, with salivary flow maintained and no increase in adverse events. By contrast, red-light alone led to objective taste decline, while infrared alone produced worse subjective taste outcomes, suggesting a synergistic effect when both wavelengths are used together. Contextualized with prior Phase II findings and WALT recommendations, these results strengthen PBM as a non-pharmacologic supportive care option to mitigate chemo-induced dysgeusia, though limitations include single-center design and short-term follow-up, with no dose–response exploration. The authors call for multicenter trials across other regimens and cancers, and potential integration with nutrition and oral health interventions. Clinicians should consider proactive taste assessment in patients on anthracyclines and discuss combined PBM as a preventive strategy where feasible. DOI: 10.1007/s00520-025-09756-4....more1minPlay
August 17, 2025First in human evaluation of a no alpha interleukin 2 mutein safety and preliminary pharmacodynamic and clinical effect summaryA concise overview of the first-in-human study of a no-alpha interleukin-2 (IL-2) mutein in patients with advanced solid tumors. The episode covers the rationale for avoiding IL-2 receptor alpha (CD25) to spare regulatory T cells, the phase I dose-escalation design, safety and pharmacodynamic findings showing selective activation of CD8+ T cells and NK cells, and the preliminary clinical signals. We discuss the implications for pharmacists and physicians, including dosing considerations, safety monitoring, and future study directions, with attention to limitations such as small sample size and lack of a control arm....more1minPlay
August 17, 2025Durvalumab Alone or Combined With Novel Agents for Unresectable Stage III Non Small Cell Lung Cancer Update From the COAST Randomized Clinical Trial summaryThis episode reviews the COAST trial, which evaluated durvalumab alone or in combination with two novel immunomodulators—oleclumab (anti-CD73) and monalizumab (anti-NKG2A)—as consolidation therapy after platinum-based concurrent chemoradiotherapy in unresectable stage III NSCLC. In this phase 2, open-label, randomized study (n=186), patients with ECOG 0–1 were assigned to durvalumab alone, durvalumab plus oleclumab, or durvalumab plus monalizumab for up to 12 months. The primary endpoint was confirmed objective response rate; secondary endpoints included progression-free survival, overall survival, and safety. Results showed higher objective response rates with the combinations (durvalumab alone 23.9%; with oleclumab 35.0%; with monalizumab 40.3%), and significant improvements in progression-free survival for both combination arms (hazard ratios ~0.59 and ~0.63, respectively) compared with durvalumab alone. No OS improvement was observed yet, consistent with the phase 2 design and limited follow-up. Safety profiles were similar across arms, with immune-related events aligning with known durvalumab toxicities and no major increases in toxicity from adding oleclumab or monalizumab. Mechanistically, oleclumab reduces adenosine-mediated immunosuppression by blocking CD73, while monalizumab relieves NKG2A-mediated inhibition of NK and CD8+ T cells, theoretically enhancing PD-L1 blockade efficacy. Clinicians should note the selective eligibility (post-cCRT, ECOG 0–1) and ongoing need for phase 3 confirmation (PACIFIC-9) to determine OS benefit and potential shifts in standard of care. Practical takeaways include vigilant monitoring for immune-related adverse events, adherence to durvalumab consolidation, and awareness of potential overlapping toxicities. The COAST data are encouraging but require further validation before changing practice....more1minPlay
August 17, 2025Talquetamab improves patient reported symptoms and health related quality of life in relapsed or refractory multiple myeloma Results from the phase 12 MonumenTAL1 study summaryToday on PACULit, we review the Phase 2 MonumenTAL-1 trial evaluating talquetamab, a bispecific antibody targeting GPRC5D and CD3, in relapsed or refractory multiple myeloma (RRMM). We discuss patient-reported outcomes and health-related quality of life data collected over up to ~42 weeks, using validated tools (EORTC QLQ-C30, EQ-5D-5L VAS, and PGIS). Key findings show an initial transient worsening in PROs during cycle 1, followed by meaningful improvements by cycle 21, including global health status up by 4.9 points and emotional functioning up by 12.5 points; pain decreased by 11.4 points and fatigue by 4.0 points. The single-arm, open-label design included 118 heavily pretreated patients, some with high-risk cytogenetics and extramedullary disease, highlighting real-world applicability. While PRO improvements align with disease control, limitations include lack of a comparator and a relatively small sample for long-term PROs, underscoring the need for real-world data and future comparative trials. Practical takeaways emphasize integrating PROs into clinical decisions, proactive symptom management, multidisciplinary care, and monitoring early adverse events such as cytokine release syndrome to maximize patient benefit. The discussion also covers dosing (0.8 mg/kg every other week), safety considerations, and potential future directions, including combination strategies and direct PRO comparisons in future studies....more1minPlay
August 17, 2025Brentuximab vedotin plus chemotherapy for the treatment of frontline systemic anaplastic large cell lymphoma summaryPACULit Daily Literature Update reviews the 5-year subgroup analysis of the ECHELON-2 trial focusing on frontline treatment for systemic anaplastic large cell lymphoma (sALCL). Hosted discussion covers study design (randomized, double-blind, active-controlled) and the sALCL patient cohort, comparing brentuximab vedotin plus CHP (BV+CHP) to CHOP. Key findings at five years include not reached median progression-free survival for BV+CHP vs 29.4 months for CHOP (hazard ratio 0.71, 95% CI 0.54–0.93; p=0.011), and 5-year overall survival of 70.1% vs 60.9%. The complete remission rate favored BV+CHP (67% vs 50%). Safety signals showed higher peripheral neuropathy with BV+CHP (54% vs 32%, mostly grade 1–2 but reversible) but lower febrile neutropenia (18% vs 31%), possibly reflecting vincristine omission. The episode explains the mechanism of brentuximab vedotin as an antibody-drug conjugate delivering MMAE to CD30-positive cells, and discusses clinical implications, including adopting BV+CHP as frontline standard of care for untreated sALCL, supportive care considerations, and guideline context (NCCN/NICE). Limitations of subgroup analyses and the need for longer-term follow-up are also highlighted....more1minPlay
August 17, 2025Effectiveness of rasburicase 45 mg in the treatment of tumor lysis syndrome related hyperuricemia summaryIn this PACULit episode, Britany and Seth discuss a retrospective real-world study evaluating a single fixed 4.5 mg dose of rasburicase for TLS-related hyperuricemia. They explain stratification by baseline uric acid (moderate 12 to <15 mg/dL versus high ≥15 mg/dL) and report rapid uric acid reductions in both groups, with no significant differences in clinical outcomes. The discussion highlights potential cost savings, easier pharmacy workflows, and expanded access in resource-limited settings, along with safety considerations (G6PD screening, uric acid assay interference) and key limitations of retrospective data. They also outline practical takeaways and directions for future prospective trials and broader populations (pediatric and renal impairment)....more1minPlay
August 17, 2025Unusual Clinical Presentation of BCell Prolymphocytic Leukemia Cases as Splenic Marginal Zone Lymphoma Effectively Treated With Rituximab Monotherapy summaryIn this PACULit episode, Britany and Seth discuss Sachanas et al.'s August 2025 study on B-cell prolymphocytic leukemia cases that mimic splenic marginal zone lymphoma. The hosts review how SMZL-like biology can occur within B-PLL phenotypes, evaluate Rituximab monotherapy as a safer alternative to chemotherapy or splenectomy, and emphasize the importance of comprehensive immunophenotyping and cytogenetics to guide therapy. Key findings include complete remission in 40% and prolonged responses in 80%, the relevance of 7q deletions, and the study's limitations and implications for future guidelines and personalized treatment in older or frail patients....more1minPlay
August 17, 2025Phase 1b2 study evaluating safety efficacy and immune effects of TLR9 agonist cavrotolimod with antiPD1 antibodies among patients with advanced solid tumors summary{ "episode_title": "PACULit Daily Literature Update: Cavrotolimod + Anti-PD-1 in Advanced Skin Cancers (Phase 1b2)", "episode_description": "Britany and Seth review a Phase 1b2 open-label trial evaluating intratumoral cavrotolimod, a TLR9 agonist, in combination with systemic anti-PD-1 antibodies (pembrolizumab or cemiplimab) in 58 patients with advanced or metastatic melanoma, Merkel cell carcinoma, or cutaneous squamous cell carcinoma who largely progressed on prior anti-PD-(L)1 therapy. The discussion covers trial design, safety and early efficacy signals (ORR 12%, DCR 27%), durable responses, and evidence of an abscopal effect. Immune profiling showed robust innate/adaptive activation, including interferon signaling and increased tumor-infiltrating cytotoxic T cells and dendritic cells. The episode also highlights safety, pharmacodynamics, and the need for larger trials to confirm efficacy and guide patient selection.", "study_details": { "trial_phase": "Phase 1b2", "trial_nct": "NCT03684785", "design": "open-label, multicenter, dose-escalation and expansion, single-arm", "population": [ "advanced/metastatic melanoma", "Merkel cell carcinoma", "cutaneous squamous cell carcinoma" ], "number_enrolled": 58, "evaluable_for_response": 51 }, "outcomes": { "objective_response_rate": "12%", "disease_control_rate": "27%", "median_duration_of_response_weeks": 54, "median_duration_of_stable_disease_weeks": 24, "abscopal_effect": true }, "safety_and_tolerability": { "common_grade_3_4_AEs": [ "fatigue", "injection_site_reactions" ], "overall_tolerability": "manageable" }, "immune_correlates": [ "increased circulating chemokines/cytokines", "lymphocyte activation in blood", "upregulation of interferon pathway genes in tumor", "enhanced tumor infiltration by cytotoxic T cells and dendritic cells" ], "mechanism_and_rationale": "TLR9 activation by cavrotolimod primes innate and adaptive immunity to overcome PD-1 blockade resistance; after...more1minPlay
FAQs about PACUPod: Oncology:How many episodes does PACUPod: Oncology have?The podcast currently has 67 episodes available.