OncLive On Air®

In case you missed any, below is a recap of every episode of OncLive On Air® that aired in October 2024. Check out our podcast page for a full episode lineup and to stay up to date with all the latest releases!

FDA Approval Insights: Perioperative Durvalumab for Resectable NSCLC

In this episode of OncLive On Air, we sat down with Sandip P. Patel, MD, of the University of California San Diego and Brendon M. Stiles, MD, of the Montefiore Einstein Comprehensive Cancer Center in Bronx, New York, to discuss the FDA approval of perioperative durvalumab (Imfinzi) for patients with resectable non–small cell lung cancer (NSCLC).

On August 15, 2024, the FDA granted approval to durvalumab in combination with platinum-containing chemotherapy in the neoadjuvant setting, followed by durvalumab monotherapy in the adjuvant setting, for the treatment of adult patients with resectable NSCLC harboring no known EGFR mutations or ALK rearrangements. This regulatory decision was supported by findings from the phase 3 AEGEAN trial (NCT03800134), in which patients who received the durvalumab regimen had a median event-free survival was not reached (95% CI, 31.9 months-not estimable [NE]) vs 25.9 months (95% CI, 18.9-NE) in those who received placebo in combination with chemotherapy (stratified HR, 0.68; 95% CI, 0.53-0.88; P = .0039).

“The significance of the approval of using durvalumab, an anti–PD-L1 immunotherapy, in combination with chemotherapy in the perioperative setting, meaning given both with chemotherapy before surgery and then after surgery as durvalumab alone, is important because it brings one of our most potent therapies, immune checkpoint blockade, into earlier-stage disease, where it may be more efficacious and increase the number of patients with NSCLC who we can cure,” Patel said.

“Surgeons aren’t always the best at getting their patients to return to intended oncologic therapy. We have to do a good operation,” Stiles added. “We have to do a safe operation. We have to get the patient feeling well and back on their feet so they can tolerate adjuvant therapy. Too often, the adjuvant therapy is either not started or not completed, and surgeons can do a bit more to help that process.”

Updated VISION Trial Data Showcase the Efficacy of Tepotinib in MET + NSCLC: With Martin Dietrich, MD

In this episode, Martin Dietrich, MD, of Cancer Care Centers of Brevard, The US Oncology Network, in Space Coast, Florida, highlighted findings from the 18-month follow-up of the phase 2 VISION trial (NCT02864992), which investigated the efficacy of tepotinib (Tepmetko) in patients with NSCLC harboring MET exon 14 skipping mutations.

“Look at liquid and tissue biopsy up front to identify these tumors,” Dietrich emphasized in the interview. “That would be the segue to match a patient to the right targeted therapy up front.”

FDA Approval Insights: Vorasidenib in IDH1/2+ Grade 2 Astrocytoma and Oligodendroglioma

In this episode, Jennie W. Taylor, MD, MPH, of the University of California San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, discusses the FDA approval of vorasidenib (Voranigo) for patients with IDH-positive grade 2 astrocytoma or oligodendroglioma.

On August 6, 2024, the FDA approved vorasidenib for the treatment of adult and pediatric patients 12 years of age or older with grade 2 astrocytoma or oligodendroglioma harboring susceptible IDH1 or IDH2 mutations who have previously undergone surgery. This regulatory decision was supported by findings from the phase 3 INDIGO trial (NCY04164901), in which, at a median follow-up of 14.0 months (interquartile range [IQR], 10.1-17.9), vorasidenib (n = 168) generated a median progression-free survival of 27.7 months (95% CI, 17.0-NE) compared with 11.1 months (95% CI, 11.0-13.7) in the placebo arm (n = 163) at a median follow-up of 14.3 months (IQR, 10.0-18.1; HR, 0.39; 95% CI, 0.27-0.56; P < .001).

“This is the first drug in several decades that’s been approved [that] demonstrates effectiveness for patients with IDH-mutant [brain] tumors, who often live for several decades and have significant consequences, often, of more traditional treatments, such as surgical approaches, traditional chemotherapy approaches, and radiation,” Taylor emphasized. “That can often create more of an effect on their quality of life and cognitive outcomes, and so to have a new, well-tolerated treatment that may delay the need for some of those more aggressive therapies is exciting.”

Navigating Myelofibrosis: Updates for Community Hematologist Oncologists

In this exclusive conversation, Aaron T. Gerds, MD, MS, of Cleveland Clinic in Ohio, and James K. McCloskey, MD, of Hackensack John Theurer Cancer Center in New Jersey, discussed disease factors and patient characteristics that influence their choice between FDA-approved JAK inhibitors for patients with myelofibrosis, tips for myelofibrosis symptom management, and emerging myelofibrosis research they are excited to see read out.

“We have more [JAK inhibitor] options today than we have ever before,” Gerds noted. “The primary objectives for us as oncologists is to address our patients’ spleen-related symptoms and cytokine-related symptoms when we’re managing their myelofibrosis, and then bear in mind that spleen volume reduction correlates with survival benefits.”

“At any point along the line, after [a patient’s] disease changes, becomes more aggressive, develops new cytopenias, or JAK inhibitors are no longer controlling their spleen or symptoms, you want to think about sending those patients over to transplant, because transplant is the only therapy that has shown curative potential in patients with myelofibrosis,” McCloskey emphasized.

FDA Approval Insights: Denileukin Diftitox in Relapsed/Refractory CTCL

In this episode, we spoke with Francine Foss, MD, of Yale Cancer Center in New Haven, Connecticut, about the FDA approval of denileukin diftitox-cxdl (Lymphir) for the treatment of patients with relapsed/refractory cutaneous T-cell lymphoma (CTCL) who have received at least 1 prior systemic therapy. 

On August 8, 2024, the FDA approved denileukin diftitox for the treatment of patients with relapsed/refractory CTCL who have received 1 or more prior systemic therapies. This regulatory decision was backed by findings from the phase 3 Study 302 (NCT01871727), in which patients who received the agent (n = 69) achieved an objective response rate of 36.2% (95% CI, 25.0%-48.7%), including a complete response rate of 8.7%.

“CTCL is an unmet medical need,” Foss said. “We have a couple therapies approved for CTCL, but our patients have the disease over a long period of time, and many of them cycle through a number of these treatments, so there’s always a need for a new treatment…especially for a drug like this, where we understand the mechanism and where it targets a specific receptor in the surface of the cells.”

Phase 1 Trials Provide Oncology Fellows With Valuable Clinical Research Experience: With Samuel A. Kareff, MD, MPH

In this episode, we spoke with Samuel A. Kareff, MD, MPH, of Baptist Health in Boca Raton, Florida, about his involvement in early-phase clinical research, as well as mentorship experiences he valued during his oncology/hematology fellowship.

“I would recommend any trainee in hematology/medical oncology to identify multiple mentors, sponsors, coaches, you name it, to make sure they maximize their career training,” Kareff said. “I feel like those of us who are completing training now or in the upcoming years have a unique way of looking at cancers at the molecular, genetic, ancestral, socioeconomic, etc. levels, and that will aid in our treatment of patients with cancer as we move forward.”

Delve into Recent NCCN Guideline Updates for Hepatobiliary and CRC Management: With Alan P. Venook, MD

In this exclusive interview, we were joined by Alan P. Venook, MD, of the UCSF Helen Diller Family Comprehensive Cancer Center, to discuss updates to the National Comprehensive Cancer Network (NCCN) guidelines for hepatobiliary and colorectal cancers, recent evolutions across the gastrointestinal (GI) cancer treatment paradigm, and the guidelines’ shift toward differentiating between treatment recommendations for different subsets of GI cancers.

“In hepatocellular carcinoma [HCC], we’ve gone from years where there were no changes in the guidelines, virtually nothing, to now, [where we have] a robust set of recommendations that include a number of drugs in use,” Venook said. “The missing piece for HCC globally, for the field, is still that all these studies are highly selective for patients with reasonably good liver function, so I’m not clear that these changes are dramatic in terms of offering options for many patients.”

Liquid Biopsy Ushers in a New Era of NSCLC Biomarker Testing: With David R. Gandara, MD

In this episode, we spoke with David R. Gandara, MD, of the University of California Davis Comprehensive Cancer Center in Sacramento, about biomarker testing in lung cancer, including the optimal use of liquid biopsy, important considerations when testing for KRAS mutations in NSCLC, and available therapies for the treatment of patients with KRAS-mutant disease.

“In NSCLC, we now test for 9 oncogenes at the time of diagnosis in an advanced-stage patient,” Gandara explained. “If a patient has an oncogene-driven cancer such as EGFR or ALK, and they’re treated with a standard-of-care TKI…at the time of progressive disease, it’s useful to first go to liquid biopsy to see if you can determine the mechanism [of resistance] because it’s faster and accurate by comparison with tissue biopsy.”

SUNLIGHT QOL Data Show Positive Outcomes With Trifluridine-Tipiracil Plus Bevacizumab in CRC: With Joleen Hubbard, MD

In this episode, we spoke with Joleen Hubbard, MD, of Allina Health Cancer Institute in Minneapolis, Minnesota, about CRC management updates. Dr Hubbard highlighted top findings from the phase 3 SUNLIGHT trial (NCT04737187) investigating trifluridine-tipiracil (Lonsurf) plus bevacizumab (Avastin) in patients with refractory metastatic CRC; the importance of using quality of life (QOL) outcomes from this trial to inform clinical practice; and notable updates to the NCCN guidelines for CRC.

“The combination of trifluridine-tipiracil with bevacizumab improved the time to deterioration in QOL,” Hubbard said. “This is important in this setting where patients have limited time; quality is of utmost importance during that time.”