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Cancer Chemotherapy and Treatment

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Content Update

May 28, 2020

Selpercatinib Approved for Treatment of RET Fusion-Positive Non-small-cell Lung Cancer (NSCLC) And Thyroid Cancer: Selpercatinib (Retevmo) is indicated for adults with RET fusion-positive NSCLC and adults and children older than age 12 with RET fusion-positive thyroid cancer. A trial involving 144 patients with NSCLC and 143 patients with thyroid cancer who had advanced or metastatic RET fusion-positive disease gave patients selpercatinib 160 mg orally twice a day. The overall response rate was 64% (95% CI: 54%, 73%) in NSCLC patients who received prior therapy, 69% (95% CI: 55%, 81%) in treatment-naïve individuals, and 73% (95% CI: 62%, 82%) in treatment-naïve patients with thyroid cancer. Common adverse effects were diarrhea and hypertension.

Content Update

March 7, 2020

Tazemetostat Approved for Treatment of Sarcoma: Tazemetostat (Tazverik) is the first EZH2 inhibitor approved by the FDA and is indicated for adults and children older than 16 for the treatment of epithelioid sarcoma. In a phase II, open-label trial of patients with locally-advanced or metastatic epithelioid sarcoma, 62 patients were treated with tazemetostat 800 mg orally twice a day. The disease control rate (defined as complete responses, partial response and stable disease) was 26% (15/62) with a median overall survival of 82.4 weeks (95% CI: 47.4, not estimable) for all 62 pts. Tazemetostat was well tolerated; the most common adverse effects were fatigue and nausea.

Content Update

August 28, 2019

Erdafitnib Approved for FGFR Mutated Bladder Cancers: Erdafitnib (Balversa®) is the first FGFR inhibitor approved by the FDA and is indicated for adults with FGFR3 or FGFR2 mutations in locally advanced and unresectable or metastatic bladder cancer who have progressed on prior therapy. FGFR mutations are common, occurring in up to 60% of bladder cancers. In an open-label, multicenter, Phase II trial, the median progression free survival was 5.5 months (95% CI, 4.2-6.0). The overall response rate to erdafitnib was 40%. The most common adverse effects were hyperphosphatemia, stomatitis and diarrhea.

Content Update

May 7, 2019

ASCO Practice Guidelines on Management of Immune-Related Adverse Events in Patients Treated with Immune Checkpoint Inhibitors: In February 2018, the American Society of Clinical Oncology (ASCO) published a new guideline regarding the management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy. Recommendations are outlined by organ-specific toxicities with diagnosis and management criteria presented. Differences in treatment approaches exist, but most patients with Grade 1 toxicities may continue immune checkpoint inhibitor therapy. Corticosteroids may be initiated for Grade 3 toxicities and higher and must be tapered over at least 4 to 6 weeks. In severe and refractory cases, other immunosuppressive therapies may be required to control immune-related adverse events. In most cases, immune checkpoint inhibitor therapy is permanently discontinued with Grade 4 toxicities.

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