OncoPharm

Discussing recent FDA approvals of penpulimab, avutometenib, defactinib, and telisotuzumab vedotin.

A splashy large study and two small studies suggest IV Mg in pre-hydration fluids can decrease the risk of cisplatin kidney injury. Gupta et al. JAMA Oncol (2025): doi:10.1001/jamaoncol.2025.0756 PRAGMATIC. ESMO Open (2022): https://doi.org/10.1016/j.esmoop.2021.100351 Yamamoto et al. Anticancer Res (2015): https://pubmed.ncbi.nlm.nih.gov/25862878/

This episode summarizes recent updates on: Tumor infiltrating clonal hematopoiesis (TI-CH) and its apparent negative impact on solid tumors (https://www.nejm.org/doi/full/10.1056/NEJMoa2413361) Updated dostarlimab data on MMRd use in rectal cancer and other solid tumors in the neoadjuvant (definitive?!?!) setting (https://www.nejm.org/doi/full/10.1056/NEJMoa2404512) Phase 1 study of 7 + 3 + Venetoclax (https://doi.org/10.1182/blood.2024026700) Zongertinib, a new HER2 TKI (https://www.nejm.org/doi/full/10.1056/NEJMoa2503704)

BRCA revision mutations may explain some of the limited benefit seen in long-term follow-up studies with PARP inhibitors. Bibliography: 1: BRCA reversion mutations predict resistance. https://doi.org/10.1158/2159-8290.CD-18-0715 2: SOLO3 Final OS Data. https://doi.org/10.1200/JCO.24.00933 3: Elucidating acquired PARP inhibitor resistance in advanced prostate cancer. https://doi.org/10.1016/j.ccell.2024.10.015

Recapping HOPA 25 and Portland *Great food (not discussed, the most excellent ETSU dinner at Arden) *COCOON *Pharmacists make everyone's job easier and keep patients out of the ED *A few more tidbits too!

FDA expands approvals for durvalumab (bladder cancer) and Lutetium-177 vipivotide tetraxetan (pre-taxane in metastatic prostate cancer). Portland has places.

We discuss reduced dose apixaban for months 6+ of treating cancer-associated VTE (API-CAT) and the impact (or lack thereof) of pausing BTK-inhibitors around vaccination (IMPROVE)

A Foundations of OncoPharm episode on Topotecan. (Originally to be released week of 3/27)

The updated Keynote 811 OS results convert an accelerated approval for pembrolizumab to a regular approval, albeit restricted by PD-L1 CPS status of 1 or higher.

There is a decent track record with mixed results for cryotherapy to prevent taxane-induced peripheral neuropathy. The POLAR trial adds to this body of evidence that trends in favor of cryotherapy. Compression therapy is another alternative. Both are studied in POLAR. POLAR: doi:10.1001/jamaoncol.2025.0001