PACULit Literature Updates September 2025: Oncology Quiz

Mr. Lee is a 62-year-old male diagnosed with advanced biliary tract cancer. His medical history includes well-controlled hypertension and no known drug allergies. He has recently started treatment with durvalumab 1500 mg every 4 weeks combined with gemcitabine and cisplatin chemotherapy. After 4 months of therapy, he presents to the oncology pharmacy with complaints of new-onset fatigue and dry skin. Laboratory tests reveal mild hypothyroidism.
Question: What is the most appropriate pharmacist recommendation regarding the management of Mr. Lee’s immune-mediated adverse event (imAE) related to durvalumab therapy?

John is a 65-year-old male with relapsed multiple myeloma after one prior line of therapy. He has an ECOG performance status of 1 and no significant comorbidities. His current regimen includes bortezomib and dexamethasone. He is considering adding a third agent to improve outcomes. He is concerned about overall survival and long-term disease control.
Question: Based on the updated DREAMM-7 trial results, which regimen should the pharmacist recommend to maximize John’s overall survival benefit?

Mary is a 68-year-old female with multiple myeloma and peripheral neuropathy starting teclistamab therapy. During her step-up dosing hospitalization, she develops a fever and mild hypotension. The oncology pharmacist is consulted to recommend management strategies for suspected cytokine release syndrome (CRS).
Question: According to recent real-world data, which combination of medications is most commonly used to manage mild to moderate CRS in patients receiving teclistamab?

Mr. Lee is a 65-year-old male with advanced non-small cell lung cancer (NSCLC) currently receiving atezolizumab monotherapy. He is interested in complementary therapies and asks about adding Bojungikki-Tang (BJIKT) to his regimen. His medical history includes controlled hypertension and no known drug allergies. He is currently on lisinopril 10 mg daily and atezolizumab every 3 weeks. He has no prior experience with herbal supplements.
Question: As a pharmacist, what is the most appropriate counseling point regarding adverse events when Mr. Lee starts Bojungikki-Tang alongside atezolizumab?

Mr. Johnson is a 72-year-old male diagnosed with indolent B-cell non-Hodgkin lymphoma starting frontline bendamustine-rituximab chemotherapy. His medical history includes well-controlled hypertension and no known drug allergies. Current medications include lisinopril 10 mg daily and aspirin 81 mg daily. He is concerned about infection risk during chemotherapy and asks about strategies to prevent febrile neutropenia and treatment delays.
Question: Based on recent evidence from Giordano et al., which prophylactic regimen should the pharmacist recommend to minimize febrile neutropenia and chemotherapy disruptions in Mr. Johnson?

Mr. Chen is a 62-year-old male recently diagnosed with stage IV non-small cell lung cancer (NSCLC), driver-gene negative, with PD-L1 expression of 5%. He has no prior systemic therapy and presents to the oncology pharmacy for counseling on his new treatment regimen. His oncologist has prescribed chidamide (an HDAC inhibitor) combined with tislelizumab and platinum-based chemotherapy for 4 cycles, followed by maintenance therapy. Mr. Chen is concerned about the potential side effects and treatment efficacy.
Question: Based on the phase II study by Wang et al., what key counseling point should the pharmacist emphasize regarding the expected efficacy and safety profile of this triplet regimen?

John is a 65-year-old male diagnosed with triple class exposed, relapsed and refractory multiple myeloma (TCE RRMM). He has undergone multiple prior therapies including proteasome inhibitors, immunomodulatory drugs, and anti-CD38 antibodies. Currently, he is being evaluated for further treatment options after disease progression on pomalidomide plus dexamethasone. He has no significant comorbidities and is insured under the NHS.
Question: Based on the recent evidence comparing elranatamab to real-world UK treatments for TCE RRMM, what is the most significant clinical benefit of initiating elranatamab therapy for John?

Linda is a 59-year-old postmenopausal woman diagnosed with hormone receptor-positive, HER2-negative advanced breast cancer harboring a confirmed PIK3CA mutation. She has progressed on first-line endocrine therapy and is currently receiving fulvestrant. Her medical history includes well-controlled type 2 diabetes mellitus and hypertension. She presents to the oncology pharmacy to discuss options for next-line therapy.
Question: Based on the latest evidence from the INAVO120 trial, what is the most appropriate recommendation for Linda’s treatment to improve overall survival?

Maria is a 65-year-old female with refractory B-cell lymphoma scheduled to receive huCART19-IL18 therapy after prior CD28-based CAR T failure. She has a history of mild baseline cytopenias and is concerned about potential side effects. Her current medications include prophylactic antibiotics and supportive care agents.
Question: What specific toxicity monitoring should the pharmacist emphasize for Maria during and after huCART19-IL18 infusion based on current evidence?

Emily is a 9-year-old female diagnosed with acute lymphoblastic leukemia (ALL) undergoing haploidentical hematopoietic stem cell transplantation (haplo-HCT). She is enrolled in the Leuk-CTL-001 trial and is scheduled to receive donor-derived anti-leukemia cytotoxic T lymphocytes (CTLs) infusion within 60 days post-transplant. Her medical history includes mild eczema, and she is currently on immunosuppressive therapy to prevent graft-versus-host disease (GVHD).
Question: As the clinical pharmacist, what is the most critical safety parameter to monitor closely following Emily’s infusion of donor-derived anti-leukemia CTLs?