Nathan Bahary, MD, PhD, an associate professor at the University of Pittsburgh School of Medicine, as well as a medical oncologist and hematologist at the University of Pittsburgh Medical Center​ Hillman Cancer Center, discusses the benefits of ivosidenib (Tibsovo) in patients with intrahepatic cholangiocarcinoma whose tumors harbor 

 mutations are known to occur in 10% to 13% of patients with intrahepatic cholangiocarcinoma, according to Bahary. 

Ivosidenib (Tibsovo) is 1 agent that is currently 

-mutated acute myeloid leukemia. Another study examined the agent in patients with 

-mutated cholangiocarcinoma. Ivosidenib was found to improve progression-free survival and elicit durable responses in this population. Notably, this trial permitted crossover; thus, no confirmed overall survival benefit was noted, but benefit is possible given the extent of the mutations and the durability of responses to treatment, Bahary concludes.

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Nathan Bahary, MD, PhD, discusses the benefits of ivosidenib in patients with intrahepatic cholangiocarcinoma whose tumors harbor IDH1 mutations.

Dr. Bahary on the Benefits of Ivosidenib in IDH1-Mutated Cholangiocarcinoma

Nathan Bahary, MD, PhD, associate professor, University of Pittsburgh School of Medicine, medical oncologist and hematologist, University of Pittsburgh Medical Center​ Hillman Cancer Center, discusses the role of pemigatinib (Pemazyre) in biliary tract cancers.

Although biliary tract cancers are difficult to treat, significant progress has been made in developing treatment options, particularly with regard to targeted therapy, Bahary says.

 translocations are observed in about 25% to 33% of patients with intrahepatic cholangiocarcinoma, says Bahary. Pemigatinib is a selective and potent FGFR1/2/3 inhibitor that is administered orally. The open-label, phase 2 FIGHT-202 study evaluated the role of pemigatinib in patients with cholangiocarcinoma with or without 

 fusions. Findings from cohort A of the study showed that 3 patients with 

 fusions achieved complete responses and 35 achieved a partial response. Additionally, 50 patients had stable disease, and 16 of 107 patients experienced disease progression, Bahary explains.

 Based on these findings, on April 17, 2020, the FDA approved pemigatinib for the treatment of patients with previously treated, unresectable, locally advanced or metastatic cholangiocarcinoma with 

 fusions orrearrangements, as detected by an FDA-approved test, Bahary concludes.

Nathan Bahary, MD, PhD, discusses the role of pemigatinib in biliary tract cancers. 

Dr. Bahary on the Role of Pemigatinib in Biliary Tract Cancers 

Nathan Bahary, MD, PhD, an associate professor at the University of Pittsburgh School of Medicine, as well as a medical oncologist and hematologist at the University of Pittsburgh Medical Center​ Hillman Cancer Center, discusses the prognosis of 

mutated CRC has been incredibly poor with a median overall survival (OS) ranging from 11 to 14 months compared with 26 to 30 months in those without the 

 mutation, says Bahary. BRAF inhibitor monotherapies and BRAF/MEK inhibitor combinations have been examined, although they did not elicit the same durable responses that have been observed in melanomas or other tumors, notes Bahary.

Updated results from the phase 3 BEACON CRC trial were presented during the 

. Results demonstrated a dramatic improvement in tumor response and OS, says Bahary. These positive results were seen in patients with 

 V600E–mutated CRC who were treated with the BRAF inhibitor encorafenib (Braftovi) ​plus the MEK inhibitor binimetinib (Mektovi) and the EGFR inhibitor cetuximab (Erbitux) compared with standard chemotherapy. Notably, no benefit was observed with the doublet combination of encorafenib/binimetinib; however, encorafenib and cetuximab alone appear to offer a survival benefit for patients, concludes Bahary.

Nathan Bahary, MD, PhD, discusses the prognosis of BRAF-mutant colorectal cancer. 

Dr. Bahary on the Prognosis of BRAF-Mutant Colorectal Cancer

Nathan Bahary, MD, PhD, associate professor, University of Pittsburgh School of Medicine, medical oncologist and hematologist, University of Pittsburgh Medical Center​ Hillman Cancer Center, discusses treatment strategies for right- versus left-sided tumors in colorectal cancer (CRC).

Patients with right-sided tumors ​tend to have more microsatellite instab​ilty, says Bahary. Typically, ​this is due to methylation of MLH1, which is sensitive to immunotherapy.

Prior to immunotherapy, patients with CRC ​often received EGFR inhibitor​s, such as cetuximab ​(Erbitux) or panitumumab ​(Vectibix), says Bahary. However, past research ​revealed that patients with 

 mutations do not derive benefit from EGFR inhibitors alone. 

Furthermore, in the metastatic setting, ​patients with right-sided tumors do not respond to the combination of chemotherapy and EGFR inhibitors, whereas ​patients with left-sided tumors can respond to such combinations, Bahary explains.

As such, patients with ​metastatic CRC and right-sided tumors ​should receive bevacizumab (Avastin) or anequivalent anti-VEGF agent, Bahary concludes.

Nathan Bahary, MD, PhD, discusses treatment strategies for right- versus left-sided tumors in colorectal cancer.








Nathan Bahary, MD, PhD

Articles

Dr. Bahary on the Benefits of Ivosidenib in IDH1-Mutated Cholangiocarcinoma

Dr. Bahary on the Role of Pemigatinib in Biliary Tract Cancers

Dr. Bahary on the Prognosis of BRAF-Mutant Colorectal Cancer

Dr. Bahary on Treatment Strategies for Right- Versus Left-Sided Tumors in CRC