Drug Therapies

The key arguments supporting the use of combination therapy with checkpoint blockade immunotherapies as the standard of care for treating metastatic melanoma arise from the combination’s high disease control rates; rapid deep responses; improved response rates; longer progression-free survival (PFS); and good estimated overall survival (OS), approaching 70% at 3 years, said Steven J. O’Day, MD, Professor of Medical Oncology, John Wayne Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, at the recent HemOnc Today Melanoma and Cutaneous Malignancies meeting.
Boston, MA-Rociletinib, a specially engineered third-generation EGFR inhibitor, is accumulating an impressive track record in early studies of non-small-cell lung cancer (NSCLC). The drug is specifically designed for use in patients with NSCLC and the T790M mutation, a heretofore patient population with unmet needs. T790M, the most common mutation associated with resistance to first-line EGFR-directed tyrosine kinase inhibitor (TKI) therapy, is present in 60% of patients with resistance to TKIs.

The management of complex oncology drugs in pharmacy and in medical benefits presents unique challenges for all parties who seek cost-effective, positive clinical outcomes for patients with cancer. New therapies are offering the exciting prospect of improved outcomes, prolonged life, and, in some cases, a cure for specific diseases. Targeted oncolytics and pharmacogenomics, which carry the promise of improved likelihood of successful treatment, have become welcome additions to the current standards of care.

Patients with HER2+ breast cancer who develop resistance to trastuzumab may soon have an alternative therapy, according to recent findings published in Clinical Cancer Research.

Use of hormone therapy for menopause is associated with reduced risks for esophageal, gastric, and colorectal cancers, according to results of a prospective study that were then combined with published studies in a meta-analysis. In this British study of women aged 50 to 64 years, researchers found no significant differences in risk by type of hormone therapy, duration of use, or between past and current users. The reduction in risk, however, was small in comparison to the increased risk of breast cancer that has been attributed to hormone therapy in this population.

 

Hsp90 inhibition has been found to be a successful therapeutic approach for combating diseases that use JAK/STAT signaling for tumor growth. In in vivo and in vitro models, researchers showed that the small molecule Hsp90 inhibitor ganetespib exhibited potent activity in tumor cells dependent specifically on JAK2 signaling. Specifically, ganetespib sustained depletion of JAK2 including active JAK2V617Fmutant, subsequently decreasing STAT activity and reducing STAT-target gene expression.

 

Tissue velocity imaging and strain imaging can predict preclinical changes in left ventricular (LV) systolic function before a patient experiences a change in left ventricular ejection fraction (LVEF), according to a prospective study in HER2-positive patients receiving trastuzumab in the adjuvant setting. Cardiac biomarkers, however, did not predict the development of cardiac dysfunction.

ORLANDO—High-dose melphalan followed by an autologous hematopoietic stem-cell transplant is standard initial therapy for multiple myeloma; however, the toxicity and efficacy of this treatment is variable. “The sources of this variability are not well understood,” said Dan T. Vogl, MD, of the Multiple Myeloma Program at the Abramson Cancer Center in Philadelphia. “We hypothesized that variation in melphalan pharmacokinetics would explain differences in outcomes after transplant.”

 

ANAHEIM—Pharmacist assessment of palonosetron use for the prevention of emesis associated with chemotherapy has the potential to capture inappropriate use and result in cost savings, said John P. Jezak, PharmD.

SAN ANTONIO—For women with human epidermal growth factor receptor type 2 (HER2)-overexpressing breast cancer, preoperative treatment with agents that block HER2 leads to high rates of pathological complete response (pCR), according to the results of three studies presented at the 33rd annual San Antonio Breast Cancer Symposium. 

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