OncoPharm

Dive into the fascinating world of irinotecan, a chemotherapy drug rooted in the ancient use of camptothecin. Explore how genetic differences impact treatment outcomes and side effects. Learn about the drug's complex dosing considerations and the notorious issue of diarrhea. Discover recent innovations, like the FDA-approved liposomal formulation, and how pharmacogenetic insights are reshaping personalized cancer care.

Running through the drug information highlights of the latest approved #oncopharm agents: entrectinib and fedratinib.

This week we look at the NEJM publication earlier this month (https://www.nejm.org/doi/full/10.1056/NEJMoa1817073) of E1912. Points of discussion include IGHV mutational status, PFS vs. OS as endpoints in CLL, the benefit of rituximab in addition to ibrutinib, and ibrutinib toxicity in younger vs. older CLL patients. (Also, apologies to my APPE student for dropping this Pod *after* your journal club on this paper.)

Updates on ASCO's updated VTE guidelines with a focus on prophylaxis for ambulatory cancer patients (1:15) and VTE treatment (12:50). Pembrolizumab's latest FDA-approval is discussed (16:00), as is pexidartinib's FDA-approval (18:00), and finally a comparison of BCOP pass rates by training status (22:34).

The recent FDA approval of darolutamide marks a significant advancement in non-metastatic castrate-resistant prostate cancer treatment. The discussion highlights how it compares to other second-generation anti-androgens, like enzalutamide and apalutamide. Listeners will learn about differences in clinical efficacy and side effects. Additionally, the podcast dives into critical drug interactions with the cytochrome P450 enzyme system, emphasizing why understanding these interactions is vital for effective patient management.

Our Landmarks in #OncoPharm series returns to the breast cancer patient population to review the landmark 2008 NEJM article from Sparano et al (https://www.nejm.org/doi/full/10.1056/NEJMoa0707056) investigating the optimal taxane regimen to follow adjuvant AC.

A brief discussion on FDA's approval decision on selinexor and its possible role in therapy. Then, a more in-depth details on its MOA, dosing, and toxicity profile.

An overview of pain management principles in cancer patients. Topics covered include the role of NSAIDs, bisphosphonates, and opioids in treating or preventing pain. Also discussed: bowel regimens & opioid conversions.

The Foundations in #Oncopharm series returns with the story of a failed contraceptive candidate that became the first (?) targeted therapy for use in cancer. Tamoxifen's use, MOA, toxicities, and drug interactions are also discussed.

We open up the Ask #OncoPharm inbox to answer a listener question - What advice do you have before starting my PGY2 Oncology Pharmacy Residency?