OncoPharm

This episode looks at the combination of PARP inhibitors in combination with androgen receptor pathway inhibitors (ARPi) for untreated advanced prostate cancer.

BRCA2 sensitivity > BRCA 1 commentary: https://doi.org/10.1200/JCO.20.02246

Methylphenidate for fatigue in hematologic cancers: https://doi.org/10.1200/JCO-26-00578

Download the Learning Oncology Companion: https://www.kelleycpharmd.com/learning-oncology-companion-oncopharm

ESMO 2026 concluded this past weekend, so this Pod is packed with lots of updates!

1. DeLLphi-305: Maintenance tarlatamab + durvalumab improves OS compared to maintenance durvalumab in extensive stage SCLC. Impressive improvement, but a puzzlingly high rate of dysguesia in the tarlatamab arm that is ~2x what has been reported in tarlatamab monotherapy.

2. Non-ESMO, but related - Lurbinectedin's mono therapy approval for SCLC was was withdrawn following the negative results of the LAGOON trial, which followed the negative results of the ATLANTIS trial.

3. INTerpath-001 was a phase III trial that showed improved recurrence free survival with intismeran autogene + pembrolizumab vs. pembrolizumab in advanced melanoma. This patient-specific mRNA treatment is exciting with more trials planned across solid tumors.

4. Darolutamide may have a role in high-risk prostate cancer following prostatectomy and adjuvant ADT, but longer follow-up (and publication) is likely needed before implementation.

5. VOLGA provides evidence for another sandwich approach in muscle-invasive bladder cancer with durvalumab + enforumab vedotin --> radical cystectomy --> durvalumab (But no more EV). The addition of the CTLA-4 targeting agent tremilimumab appeared to offer no additional benefit.

6. Pemroblizumab's sight agnostic accelerated approval for high Tumor Mutation Burden (TMB) was narrowed from 10+ to 13+ mutations/megabase after a few hundred more patients enrolled and 6 years of follow-up.

7. Adding venetolcax to DA-EPOCH-R in double-hit NHL was associated with excess mortality.

Download the Oncology Learning Companion: https://www.kelleycpharmd.com/learning-oncology-companion-oncopharm

This week we take a (brief) stop back in time to the beginning of dostarlimab's journey that has ended (for now) in an accelerated approval for rectal cancer that is mismatch repair-deficient or high in micro-satellite instability (MMRd/h-MSI).

Download the Learning Oncology Companion: https://www.kelleycpharmd.com/learning-oncology-companion-oncopharm

This week we discuss the recent RCT of blinatumomab-ponatinib in Ph+ Adult ALL and how this regimen compares to previously publishes uses of Blin-Ponatinib in induction treatment.
Link: DOI: 10.1056/NEJMoa2606208

Finally, we discuss two recent expanded indications in bladder cancer (nogapendekin alfa inbakicept + BCG) and colon cancer (atezolizumab with FOLFOX for dMMR colon cancer in the adjuvant setting).

Download the Learning Oncology Companion: https://www.kelleycpharmd.com/learning-oncology-companion-oncopharm

Tucatinib gets an expanded FDA approval in the 1st-line treatment of HER2(+) metastatic breast cancer based on the results of HER2-Climb05.

Pirtobrutinib also gets FDA approved for initial treatment of CLL/SLL (without 17p deletion).

Australia makes a bold decision regarding Nivo/Ipi and Pembrolisumab: https://doi.org/10.1200/JCO-26-01340

Download the Learning Oncology Companion: https://www.kelleycpharmd.com/learning-oncology-companion-oncopharm