OncoPharm

ASCO '23 Appetizers by John Bossaer

Olaparib + Abiraterone is FDA approved for mutated-BRCA prostate cancers. Olaparib has a bit of convoluted story to unpack in this patient population. Have we finally found a way to minimize the peripheral neuropathy from paclitaxel.....with cilostazol? PROpel: https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200043 Cilostazol RCT: https://doi.org/10.1002/phar.2830 Cilostazol effect on Schwann cells: https://doi.org/10.1016/j.neuropharm.2021.108514

We discuss the newly approved CD20-CD3 T-cell engager for subcutaneous (SC) administration to treat DLBLC after 2 or more lines of therapy.

Dive into the compelling discussion on trimodality treatment for muscle-invasive bladder cancer. Discover how combining surgical resection, chemotherapy, and radiation can preserve the bladder while weighing the pros and cons against radical cystectomy. The episode emphasizes the significance of personalized patient care and shared decision-making in crafting effective treatment plans.

Today's Pod discusses... 1) A large trial comparing 4 different CLL treatments GAIA-CLL13: https://www.nejm.org/doi/full/10.1056/NEJMoa2213093 2)Adding Cabozantinib + Nivo/Ipo vs. Nivo/Ipi in intermediate/poor risk mRCC COSMIC-313: https://www.nejm.org/doi/full/10.1056/NEJMoa2212851 3) A potential future biomarker for predicting response to PD-(L)1 targeted therapies Functional PD-1/PD-L1 Engagement: https://pubmed.ncbi.nlm.nih.gov/?term=36821809

Talking 3rd-line treatment of metastatic colon cancer. Tipiracil-trifluridine + bevacizuamb vs. tipiracil-trifluridine alone. And a bit on the theory of "bevacizumab beyond progression." SUNLIGHT: https://www.nejm.org/doi/full/10.1056/NEJMoa2214963

Quizartinib vs. Placebo(?) + Chemo in newly diagnosed AML. We add a bit of context about quizartinib's history leading up to this study preview possible role in therapy if approved in the future. Link: https://doi.org/10.1016/S0140-6736(23)00464-6

We take a peak at an intriguing study (n = 29) that gave some metastatic RCC patients receiving nivolumab + ipilimumab a supplement of a bacterium (n = 19) and a control group. We discuss what to look for in the future studies that are likely to follow with similar methods.

The Landmarks of OncoPharm series returns to discuss NSABP's B18 story of neoadjuvant vs. adjuvant AC in stages I & II breast cancer from 1998. B18: https://pubmed.ncbi.nlm.nih.gov/?term=36989610 Flashback Flashforeward: https://pubmed.ncbi.nlm.nih.gov/?term=36989608

Lots of updates: Olanzapine increases weight gain, QOL in some advanced cancer: https://pubmed.ncbi.nlm.nih.gov/?term=36977285 Chemotherapy Toxicity - When Less is More: https://www.nejm.org/doi/full/10.1056/NEJMcibr1202395 Pembro + Chemo improves PFS > chemo alone in advanced endometrial cancer: https://www.nejm.org/doi/full/10.1056/NEJMoa2302312 Enfortumab vedotin + pembrolizumab gets an accelerated approval for cisplatin-ineligible patients with urothelial carcinoma. Safety signals seen.