Topic covered include the latest updates to the seminal Hallmarks of Cancer work, adjuvant pembrolizumab for stage IIB/IIC melanoma, a prospective study of UGT1A1 testing, and Keynote-775.

Hallmarks of Cancer: New Dimensions. https://cancerdiscovery.aacrjournals.org/content/12/1/31

UGT1A1 Genotype-guided dosing of irinotecan: https://doi.org/10.1016/j.ejca.2021.12.009

Keynote-775: https://www.nejm.org/doi/full/10.1056/NEJMoa2108330

New Hallmarks Of Cancers & LenPembro For Endometrial Cancer

Docetaxel

Updates on billiary track cancer - a role for durvalumab?

And pemigatinib - an approval in r/r myeloid/lymphoid neoplasms.

Plus, an oral suspension of ibrutinib is approved and more evidence ICI combination should be given early in BRAF-mutated metastatic melanoma (rather than waiting until disease progression on TKIs)

Biliary Tract Cancer & Pemigatinib (unrelated) Updates

A new drug for small-cell lung cancer, a bispecific, targeting DLL3 on small-cell lung cancer and CD3 on T-cells is FDA approved.  But, infigratinib's FDA approval for cholangiocarcinoma is withdrawn.

Tarlatamab

Two recent publications suggest modifications to standard subcutaneous daratumumab pre-meds is safe...and saves time!

Padmaraju et al experience from Chicago Med Center: https://doi.org/10.1093/oncolo/oyae158

Vazirnia et al experience from Mayo Clinic: https://doi.org/10.1200/OP.23.00470

We end summarizing some emerging evidence about the need, or lack thereof, for pre-paclitaxel H2RAs.

Rethinking Premeds

If you've been struggling with how to talk to patients about ivermectin for cancer, then this podcast is for you.

1. Cancer misinformation on social media (Loeb, et al): https://doi.org/10.3322/caac.21857
2. Clinician communication with patients about cancer misinformation (Bylund, et al): https://doi.org/10.1200/OP.22.00526

Talking about cancer misinformation

Our Landmarks of OncoPharm series returns to discuss the CLEOPATRA study, which established docetaxel, trastuzumab, pertuzumab (THP) as a standard first-line regimen for metastatic HER2-amplified breast cancer.

CLEOPATRA

A plethora of recent updates:
-Pembrolizumab (perioperative) in head & neck cancer (Keynote-689)
-Prostate cancer updates on cabozantinib/atezolizumab (yes, really) and talazoparib
-Pirtobrutinib improves PFS in CLL
-Zanubrutinib has a new dosage form on the way
-Another mitomycin product approved with "reverse thermal properties"
-A new regimen for FL of tafasitamab/rituximab/lenalidomide
-A comparison of the new ROS1-inhibitor, taltrectenib, compared to other 1st-line treatment options

June 2025 Updates

A few supportive care updates:

1. Skin prophylaxis to prevent severe dermatologic toxicity with Nivo/Ipi.
Note* published in JCO Oncology Practice (NOT JAMA Oncol as stated in the episode
Link: https://doi.org/10.1200/OP-25-00100

2. Stampede-Metformin and how metformin has some beneficial effects in prostate cancer patients who don't have diabetes
Link: https://doi.org/10.1016/S1470-2045(25)00231-1

Supportive Care Updates

Testicular Cancer in a Nutshell

A new ERBB2 (HER2) targeting TKI is approved for NSCLC. We review the characteristics of the drug and summarize the current landscape in treating HER-mutated advanced NSCLC.

Zongertinib

Malignant Hematology Updates:

Venetoclax dosing strategies continue to evolve
HMA/Ven + IDH1/2 inhibitors: https://doi.org/10.1200/JCO-25-00640
HMA/Ven + revumenib: https://doi.org/10.1200/JCO-25-00914
Venetoclax + CPX-351: https://doi.org/10.1002/ajh.27723

APOLLO: https://doi.org/10.1200/JCO-25-00535
Iland APOLLO editorial: https://doi.org/10.1200/JCO-25-01496

ctDNA assessment vs. PET in Large B-Cell Lymphoma: https://doi.org/10.1200/JCO-25-01534

Venetoclax Dosing & APOLLO

The potential breakthrough in RNA vaccine technology has been increasingly discussed on social media.  This episode looks at one promising study and its early, early results so far.

UF GBM study: https://doi.org/10.1016/j.cell.2024.04.003
RNA Treatment Vaccine Review: https://doi.org/10.1002/ctm2.1384

RNA Vaccine Potential as a Cancer Treatment

The 5-year+ follow-up from CARTITUDE-1 has people asking if cilta-cel can cure multiple myeloma? We discuss this data and the broad comparison to the other BCMA-targeting CAR-T product, idi-cel and a recent comparison on plasma cell leukemia.

CARTITUDE-1 Long-Term F/U: https://doi.org/10.1200/JCO-25-00760

Cilta-cel & ide-cel in plasma cell leukemia: https://doi.org/10.1182/bloodadvances.2025016966

Time to Cilta-Cel-ebrate?

The 2025 World Conference on Lung Cancer just concluded, and there are several notable updates concerning treatment of EGFR-mutated NSCLC.

1. The COMPEL study tries to find the value of continuing osimertinib (with the addition of chemotherapy) after progression on osimertinib.  The results are, well, compelling!

2/3. We now have updates on the OS benefits of osimertinib + chemotherapy (FLAURA2) and amivantamab + lazertinib (MARIPOSA) compared to osimertinib monotherapy in initial treatment of metastatic disease.

4. NEOADAURA tries to determine if neoadjuvant osimertinib has value, but longer follow-up will be needed to assess this practice.

EGFRm NSCLC Updates

We discuss the ALASCCA study (Adjuvant Low-doseASpirin in Colorectal CAncer

ALASCCA

The long awaited subcutaneous formulation of pembrolizumab is not FDA-approved.  We discuss its administration and toxicity & PK differences vs. IV use.

Biotin supplementation can interfere with lots of labs cancer patients get routinely - Who knew? (Ahem, not me.) Link: https://doi.org/10.1200/OP-25-00693

POLARIX 5-year Data: https://doi.org/10.1200/JCO-25-00925

SC Pembro, Biotin, 5-yr POLARIX data

Our Landmarks of OncoPharm series returns to discuss PARAMOUNT, a landmark study that helped solidify the role of maintenance pemetrexed in NSCLC.

PARAMOUNT - Maintenance Pemetrexed

Maintenance therapy with ICIs (atezolizumab or durvalumab) is already established in extensive stage small-cell lung cancer, but lurbinectedin enters the chat with a recent FDA approval.  Next up - tarlatamab?

IMforte (maintenance lurbinectedin + atezolizumab): https://doi.org/10.1016/S0140-6736(25)01011-6

DeLLphi-303 (phase 1b maintenance tarlatamab + ICI): https://doi.org/10.1016/S1470-2045(25)00480-2

Maintenance Therapy in Small Cell Lung Cancer

IL-2, one of the founding fathers of our current immunotherapy landscape, is discussed.

IL-2

This week's episode recaps some highlights from ESMO 2025:

1. Destiny-Breast05: T-DXd > T-DM1 in persistent HER2+ disease after neoadjuvant chemo + surgery
2. Keynote-905: Neoadjuvant Enfortumab Vedotin + pembro in cisplatin-ineligible bladder cancer
3. POTOMAC: Durvalumab + BCG in non-muscle invasive bladder cancer
4. IMvigor011: ctDNA-guided adjuvant atezolizumab in bladder cancer
5. Dynamic-III: ctDNA guide de-escalation or escalation of chemotherapy in stage III colon cancer
6. HARMONi-6: an excuse to talk about ivonescimab, a bispecific antibody unlike any other currently FDA approved

ESMO 2025

[Moving Trailer Voice] This Halloween: They always come back....

The latest revival is belantamab mafodotin, FDA approved...again. After being vanquished in DREAMM3, it returned in DREAMM7 and even Daratumumab (in combination with Vd) couldn't overcome this blindingly effective drug (in combination with Vd).

This pod reviews belantamab mafodotin's checkered past and wonders what the sequels may have in store for us.

Tale from the Crypt: Belantamab Mafodotin

Our 1st installment in this Oncology Pharmacy Training Pathways mini-series discusses the PGY2 oncology pharmacy residency rout.  I am joined by Brooke Adams and Sarah Wheeler to discuss our experience and PGY2 training.  We discuss the pros/cons of pursuing a PGY2 oncology residency with the understanding that residency training (or additional residency) training isn't for everyone. 

This mini-series is supported by the ELO Collaborative, a fantastic training opportunity for those seeking get more oncology training outside traditional pathways.

Use this link to explore: https://elojbossaer--kelleycpharmd.thrivecart.com/elo-collaborative-1-year/651082f1e4e3c/

The next two episodes in the mini-series will cover the PGY1 pathway and the PGY-NONE pathway of becoming an oncology pharmacist.  

There is no universal pathway to become an oncology pharmacist, and the discussions in this mini-series reflect the views & experiences of those involved.

PGY2 Pathway: A Planned City

Our 2nd installment in this Oncology Pharmacy Training Pathways mini-series discusses the PGY1 pharmacy residency route, without a PGY2 oncology residency.  I am joined by Kayla Fry and Amber Burgess to discuss their experience to becoming oncology pharmacists.  There are some similarities and differences in their paths to their current roles (and one It's-A-Small-World shared connection too!)

This mini-series is supported by the ELO Collaborative, a fantastic training opportunity for those seeking get more oncology training outside traditional pathways.

Use this link to explore: https://elojbossaer--kelleycpharmd.thrivecart.com/elo-collaborative-1-year/651082f1e4e3c/

The last episode in this mini-series will cover the PGY-NONE pathway of becoming an oncology pharmacist.  

There is no universal pathway to become an oncology pharmacist, and the discussions in this mini-series reflect the views & experiences of those involved.

PGY1 Pathway: Road Trip!

Our 3rd and final installment in this Oncology Pharmacy Training Pathways mini-series discusses the PGYNone route. I am joined by Vineetha Thomas and Sheila Pierre to discuss their experiences in becoming oncology pharmacists, forgoing residency training, positions they held earlier in their career, and ultimately becoming thriving oncology pharmacists.

This mini-series is supported by the ELO Collaborative, a fantastic training opportunity for those seeking get more oncology training outside traditional pathways.

Use this link to explore: https://elojbossaer--kelleycpharmd.thrivecart.com/elo-collaborative-1-year/651082f1e4e3c/

There is no universal pathway to become an oncology pharmacist, and the discussions in this mini-series reflect the views & experiences of those involved.

PGYNone: Dandelion Effect

We are back with lots of OncoPharm updates:
1. The belantamab mafodotin REMS program details are available....and it's a lot.
  How will belantamab mafodin-regimens be used with the upcoming MAJESTIC-3 data of teclistamab-daratumumab?
2. The capecitabine label is updated and calls for pre-treatment DPYD testing 
3. Daratumumab gets an FDA approval for high-risk smoldering myeloma based on the AQUILA study
  Critique of AQUILA: https://doi.org/10.1093/oncolo/oyaf216
4. A pertuzumab biosimilar (Poherdy) is approved
5. Epcoritamab nets regular approval and a new indication with lenalidomide/rituximab (RR) for Follicular Lymphoma
6. Ziftomenib, a new menin inhibitor, is approved for NPM1 relapsed/refractory AML
7. Sevabertinib, a new HER2 inhibiting TKI, is approved for ERBB2 mutated NSCLC, with evidence of activity in patients previously treated with HER2-antibody-drug conjugates
8. Expected FDA approvals for durvalumab + FLOT in preoperative gastric/GEJ cancer; neoadjuvant pembrolizumb + enforumab vedotin in bladder cancer (non-cisplatin eligible), and tarlatamab regular approval for small cell lung cancer
9. Happy Thanksgiving!

Cornucopia of Autumn Updates

DPYD testing is more complicated than one would think!  We talk through the steps to consider when initiating DPYD testing at your site.  Resources below:

Guide for implementing DPYD testing at your site: https://doi.org/10.1002/cpt.3567

CPIC Dosing Guidline: https://doi.org/10.1002/cpt.911

CPIC DPYD Resources: https://cpicpgx.org/guidelines/guideline-for-fluoropyrimidines-and-dpyd/

DPYD Deficiency Testing

ASH 2025 Highlights:

MajesTEC-3: Teclistamab + Daratumumab in relapse refractory Multiple Myeloma

Paradigm: HMA + Ven vs. 7+3 or CPX-351

Denosumab safety & dosing in Multiply Myeloma and renal dysfunction

Trilaciclib and CDK 4/6 inhibition as protection against TP53-mutated clonal hematopoiesis?

ASH 2025

Are we nearing the end of the Platinum Era in bladder cancer?  A press release suggests enfortumab vedotin + pembrolizumab in a perioperative approach  is better than the current standard of care: neoadjuvant cisplatin-based chemo followed by surgery.  We eagerly await seeing this data.

Also, a subcutaneous amivantamab/hyaluronidase formulation is approved, which offers a much lower risk of infusion reactions - but some chances for dosing errors based on weights and available dosage forms.

Bladder Cancer Updates & SC Amivantamab

Overview of doxorubicin from its Italian origins to its Red Devil alias.  Uses and toxicities also discussed, of course.

OncoPharmPod

Foundations in Oncology Pharmacy: Doxorubicin

OncoPharm is a podcast dedicated to all things oncology pharmacy.  Most episodes cover updates and recent publications concerning the use of medications in caring for patients with cancer.  Periodically, episodes drop devoted to Landmark Clinical Trials in oncology and Fundamentals of Oncology Pharmacy.

OncoPharmPod

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