OncoPharm

Small bites of updates coming out of ASH's 2023 annual meeting on CLL, multiple myeloma, and lymphoma.

Our Landmarks of OncoPharm series returns to talk about 2008's VISTA study, which ushered bortezomib into the front line setting, albeit with a now outdated alkylating agent-based backbone. VISTA (VMP vs. MP): https://www.nejm.org/doi/full/10.1056/nejmoa0801479

The recent approval of nirogacestat, the first gamma secretase inhibitor on the market, provides a great opportunity to discuss desmoid tumors and Notch signaling. Review article: https://doi.org/10.1002/onco.13627 Also, a new T-cell malignancy warning for most CAR-T products. And, is belantamab mafodotin coming back based on the DREAMM-7 results?

FDA has approved two new kinase inhibitors: one for ROS1 (+) NSCLC and one for PIK3CA/AKT/PTEN altered breast cancer.

This week's Pod dives into a new VEGF-R inhibitor, fruquintinib. We also ask if FLAURA2, osimertinib + chemotherapy in combination, will become a new standard of care in EGFR-mutated metastatic NSCLC.

Aggressive hematologic malignancy publications can be challenging to interpret and translate to clinical practice. We look at two recent studies to illustrate this point. Elderly AML: 10-day decitabine vs. 7 + 3 (https://doi.org/10.1016/S2352-3026(23)00273-9) Burkitt Lymphoma: R-CODXO-M/R-IVAC vs. DA-R-EPOCH (https://doi.org/10.1016/S2352-3026(23)00279-X)

Out Landmarks of OncoPharm series returns to chronicle how treatment of stage III NSCLC has changed over time with an overview of three studies. 1. Dillman (1990) NEJM (sequential chemo --> RT): https://doi.org/10.1056/nejm199010043231403 2. Albain (1995) JCO (concurrent cisplatin/etoposide + RT): https://pubmed.ncbi.nlm.nih.gov/?term=7636530 3. Albain (2009) Lancet (concurrent cis/etposide + RT --> surgery --> consolidation chemo): https://doi.org/10.1016/s0140-6736(09)60737-6

Lots of practice changing new information came out of last week's ESMO conference. This Pod is packed with updates on NSCLC, bladder cancer, gastric cancer, medullary thyroid cancer, KRAS G12C colorectal cancer.....and even bendamustine (non-ESMO update).

This week we discuss the continued push to introduce 2nd generation androgen inhibitors earlier into treatment with the EMBARK trial. Nivolumab and pembrolizumab, pemrolizumab and nivolumab. Again and again. Their role (and approvals) for adjuvant melanoma make sense. But what to think about their use for NSCLC in the neoadjuvant setting? West commentary: https://dailynews.ascopubs.org/do/should-induction-chemoimmunotherapy-lead-us-broaden-our-definition-resectability-nsclc

Encorafenib + binimetinib gets FDA-approval for metastatic NSCLC, but how does it compare to dabrafenib/trametinib? Plus, a new pediatric approval for dabrafenib/trametinib means more dosage form options.