TOP - January 2020, Vol 13, No 1

The January issue of The Oncology Pharmacist (TOP) features the latest medical news, expert perspectives, clinical trial results, and drug updates, as well as key highlights from national and international meetings, including the European Society for Medical Oncology (ESMO) Congress 2019, the 2019 Supportive Care in Oncology Symposium, and the National Comprehensive Cancer Network (NCCN) 2019 Hematologic Malignancies meeting.
San Francisco, CA—Cannabis has been credited as a medicinal plant with benefits ranging from pain and inflammation relief to epileptic seizure reduction to insomnia and anxiety cures, but the evidence is still limited, particularly in the setting of advanced cancer.
Barcelona, Spain—Alterations in the fibroblast growth factor receptor (FGFR2)2 gene have been identified as driver mutations in cholangiocarcinoma (CCA). Durable objective responses were observed in >33% of patients with locally advanced or metastatic CCA and FGFR2 rearrangements or fusions who received treatment with pemigatinib, a selective oral inhibitor of FGFR1, FGFR2, and FGFR3. Data from the single-arm, open-label phase 2 clinical trial FIGHT-202, which was presented at the ESMO Congress 2019, revealed that investigational pemigatinib induced a response in 35.5% of the 107 patients with FGFR2 fusions or rearrangements (cohort A), with a median duration of response of 7.5 months.
On November 14, 2019, the FDA granted accelerated approval to zanubrutinib capsules (Brukinsa; BeiGene), a Bruton’s tyrosine kinase (BTK) inhibitor, for the treatment of adults with mantle-cell lymphoma who have received at least 1 previous therapy. This is the second BTK inhibitor to be approved by the FDA.
Barcelona, Spain—The immunotherapy combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) improved overall survival (OS) compared with chemotherapy as first-line treatment in patients with advanced non–small-cell lung cancer (NSCLC) and PD-L1 expression ≥1%, according to results of CheckMate 227. The OS was also improved with nivolumab plus ipilimu­mab compared with chemotherapy in the total study population and in patients whose tumors had low (<1%) PD-L1 expression.
San Francisco, CA—Keeping up with the many treatment advances in relapsed or refractory multiple myeloma can be a challenge for even the most informed providers, according to Jorge J. Castillo, MD, Clinical Director, Bing Center for Waldenström’s Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA.
San Francisco, CA—We are in a “golden age” in chronic lymphocytic leukemia (CLL), according to Andrew D. Zelenetz, MD, PhD, Medical Oncologist, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York City.
San Francisco, CA—Personalization of therapy in the treatment of patients with myelodysplastic syndrome (MDS) is focused primarily on risk classification of patients. Once clinical risk has been ­established, treatment considerations should be informed by features such as disease subtype, prognostic somatic mutations, chromosomal abnormalities, targetable somatic mutations, immunologic features, and patient factors, according to Rafael Bejar, MD, PhD, Assistant Professor of Medicine, UC San Diego Moores Cancer Center, La Jolla, CA.
Barcelona, Spain—Poly (ADP-ribose) polymerase (PARP) inhibition has an established role as maintenance therapy in women with newly diagnosed high-grade advanced ovarian cancer and a BRCA mutation. At the ESMO Congress 2019, results of 3 clinical trials expand the use of PARP inhibition in ovarian cancer to all patients. The 3 studies had different enrollment criteria, used a different PARP inhibitor, and 2 of them used PARP inhibitor plus bevacizumab (Avastin); however, taken together, all 3 trials show that the PARP inhibition era is here.
Barcelona, Spain—The poly (ADP-ribose) polymerase (PARP) inhibitor olaparib (Lynparza) delayed disease progression and showed a trend toward improved survival compared with newer hormonal agents in men with pretreated metastatic castrate-resistant prostate cancer (CRPC) and homologous recombinant repair (HRR) gene mutations or with BRCA1, BRCA2, and ATM mutations. Results of this late-breaker were reported at the ESMO Congress 2019 during the presidential session.
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