Dordaviprone in Practice — Dosing, Safety, and Monitoring

In this episode, Dr. Chong asks Dr. Shonka to describe how she frames the dordaviprone regimen with patients and how its administration compares with other glioma therapies. Dr. Shonka highlights the practical advantages: once-weekly oral dosing on an empty stomach, no injections, and capsules that can be opened and mixed with liquid for patients with swallowing difficulties. Baseline ECG and electrolyte levels are required before starting treatment, with periodic monitoring thereafter. Nausea is uncommon, myelosuppression is rare, and the Dr.ug has generally been an easy one to manage in her practice. Dr. Shonka then asks Dr. Chong what he tells patients about safety and how dordaviprone compares with other neuro-oncology therapies. Dr. Chong draws on pooled safety data across the five studies: common adverse reactions (AEs) include fatigue, headache, vomiting, and nausea; among lab abnormalities seen in 20% or more of patients are decreased lymphocytes, decreased calcium, and increased alanine aminotransferase (ALT). Grade 3 AEs occurred in about 20% of patients, with no grade 4 events or treatment-related deaths and no apparent additional toxicity in pediatric versus adult patients. Key warnings include QTc prolongation (the basis for ECG monitoring) and embryo-fetal toxicity. Dr. Shonka closes by underscoring the importance of pregnancy testing and contraception counseling — particularly important given the young adult demographic with this disease.

In the next episode, “Positioning Dordaviprone and the Treatment Landscape in Glioblastoma vs Diffuse Midline Glioma,” Dr. Shonka and Dr. Chong discuss when to use dordaviprone and where the greatest unmet needs remain.