OncoPharm

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Immunotherapy (IO) takes a few steps back as several prior accelerated approvals are withdrawn...with possibly more bad news to come.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

Topics covered: 1. Trilaciclib's approval to minimize bone marrow suppression 2. Cemiplimab's approval for mNSLC with high PD-L1 expression 3. A brief anti-BCMA CAR-T phase II trial in multiple myeloma 4. Confirmation of enfortumab vedotin's benefit in metastatic bladder cancer 5. More of the same with lenvatinib + pembrolizumab in mRCC

Happy Birthday to a drug that ushered in its own era! We discuss its history and development and just a little bit about its benefit, role, and a few clinical pearls.