OncoPharm

Dive into the complexities of Tumor Lysis Syndrome, a crucial topic for oncology professionals. Discover the implications during chemotherapy and the importance of monitoring lab values to prevent severe complications. Explore effective prevention strategies for at-risk patients and learn about practical management techniques, including IV fluids and medications. This knowledge is vital for ensuring patient safety during treatment.

Discussing four papers that caught our eyes from the last few weeks: Pazopanib vs. placebo following metastatectomy. Always concerning when placebo has an OS advantage. ECOG-ACRIN E2810: https://doi.org/10.1200/JCO.23.01544 Gemcitabine vs. Gem + Paclitaxel (Taxol) in pancreatic cancer patients after FOLFIRINOX: https://doi.org/10.1200/JCO.23.00795 An RNA assay to predict gemcitabine sensitivity: https://doi.org/10.1200/JCO.22.02668 Management of skin cancers with ICIs in kidney transplant patients: https://doi.org/10.1200/JCO.23.02570

Two recent publications suggest more people may be choosing non-colonoscopy screening practices in the future. One is a new stool DNA test, while the other is a blood test. How do they compare to the gold standard of colonoscopy? Cell-free DNA blood test: DOI: 10.1056/NEJMoa2304714 Next generation stool DNA test: DOI: 10.1056/NEJMoa2310336

Recent FDA approvals of drugs like enforte map, pembrolizumab, and nivoleumab for metastatic urothelial cancer. Positive outcomes seen in the EV302 study with Fort Tumab Vadot and Pembrolizumab combination therapy. Exploration of new treatments in bladder cancer, including immune checkpoint inhibitors. Revolutionizing treatment for metastatic bladder cancer with high complete response rates and improved overall survival compared to traditional chemotherapy.

Two nice studies have been recently published in the supportive care realm. SPARED asks if we can omit dexamethasone on days 2-4 following cisplatin-based chemotherapy. D-TORCH asks if topical diclofenac can prevent capecitabine-induced hand-foot syndrome. SPARED: https://doi.org/10.1038/s41416-023-02493-7 D-TORCH: https://doi.org/10.1200/JCO.23.01730

An exciting new cellular therapy, lifileucel, is approved for metastatic melanoma. The FLAURA2 trial of osimertinib + chemotherapy has led to an FDA approval, but questions remain about a possible new standard of care. And a few minor updates on tepotinib.

New updates on metastatic pancreatic cancer (NAPOLI-3), upper tract urothelial cancer (POUT), and the drug-drug interaction between ivosidenib and azole antifungals. NAPOLI 3: https://doi.org/10.1016/S0140-6736(23)01366-1 POUT (final OS): https://doi.org/10.1200/JCO.23.01659 Ivosidenib Azole Antifungal DDIs: https://doi.org/10.1002/cncr.35251

You know about small cell lung cancer, but let's talk about small cell carcinoma of the prostate.

In oncology we are always asking questions about which treatment option is best. And that focus on the next best treatment may prevent us from rethinking some fundamentals of current practice. Three recent studies illustrate this and made me ask: Do we need a Port or PICC for every testicular cancer patient? Study: https://doi.org/10.1200/OP.23.00580 Editorial: https://doi.org/10.1200/OP.23.00730 Is vaginal estrogen safe if breast cancer patients? Study: https://jamanetwork.com/journals/jamaoncology/article-abstract/2811413 Does paclitaxel work differently than we always thought? Study: https://doi.org/10.1371/journal.pbio.3002339

...on FDA approvals for belzutifan for RCC, pembrolizumab + cisplatin/RT for cervical cancer, erdafitinib (FGFR3 alterations only) for bladder cancer. Plus, early morning ICIs (https://doi.org/10.1016/j.ejca.2024.113571) & FLAG-Ida-GO in AML from NCRI AML 19 (https://doi.org/10.1200/JCO.23.00943)