Journal of Clinical Oncology (JCO) Podcast
American Society of Clinical Oncology (ASCO)
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The JCO Podcast hosted by Dr. Shannon Westin features discussions of new and noteworthy results published in ASCO’s Journal of Clinical Oncology.
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Nov 30, 2023
Role of Molecular Classification in Predicting Response to Radiation in Early Endometrial Cancer
Dr. Shannon Westin and her guest, Dr. Nanda Horeweg and Dr. Carien Creutzberg, discuss the paper "Molecular Classification Predicts Response to Radiotherapy in the Randomized PORTEC-1 and PORTEC-2 Trials for Early-Stage Endometrioid Endometrial Cancer" recently published in the JCO.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Shannon Westin: Hello everyone, and welcome to another episode of JCO After Hours, the podcast where we get in-depth on manuscripts published in the Journal of Clinical Oncology. I'm your host Shannon Westin, Social Media Editor for the JCO and GYN Oncologist by trade.
And I'm so excited about today's topic because it is a GYN Oncologist dream. Before I start, please note that none of the authors have any conflict of interest. We are going to be discussing molecular classification predicts response to radiotherapy in the randomized PORTEC-1 and PORTEC-2 trials for early-stage endometrioid endometrial cancer. And this was published in the JCO on September 20th, 2023.
And we're going to be speaking to two of the lead authors. First is Nanda Horeweg. She's a senior researcher in the Department of Radiation Oncology at the Leiden University Medical Center in the Netherlands. Welcome.
Nanda Horeweg: Thank you. Happy to be here.
Shannon Westin: And Dr. Carien Creutzberg. She's professor at the Department of Radiation Oncology at the Leiden Medical Center as well.
Carien Creutzberg: Thank you.
Shannon Westin: So, let's get into it. And I want to really level set because we have a mixed audience here. So, why don't you start by speaking about the incidents and mortality of endometrial cancer?
Nanda Horeweg: Yes, of course. Endometrial cancer is the sixth most common cancer in women with around 400,000 new diagnoses made globally each year. And a woman's lifetime risk to get endometrial cancer is around 3%, and the median age, the diagnosis is 61 years.
Most of the women who are diagnosed with endometrial cancer are diagnosed at an early stage, around two thirds, and they have an excellent prognosis. Actually, the five-year survival rates are around 92%. For stage 2 disease, this is actually already going down a bit to 74%. Therefore, stage 3 disease is only 48%. Women that are diagnosed with advanced disease have only a five-year survival, 15%.
Shannon Westin: So, given that we know the majority of endometrial cancers are diagnosed at this early stage, prior to your evaluation, what was known about the optimal way to treat this early-stage patient population?
Carien Creutzberg: Well, of course, the PORTEC trials were done … were started PORTEC-1 in the 19th of the last century, and PORTEC-2 in 2002. So, at that time, there were still many, many women treated adjuvantly with external beam radiation therapy. And we just developed risk factors to decide on their risk and the incidents for radiotherapy.
And in PORTEC-2, because in PORTEC-1 we had seen that most of the recurrences in these early stage cancers were in the vaginal fold, we compared local vaginal brachytherapy only three sessions within full course of pelvic radiotherapy and showed that it had similar pelvic control and survival.
Of course, this study, which Nanda conducted, was a long-term analysis with many new factors known from the translational research in the tissue samples of these patients who participate in PORTEC-1 and 2.
And in the meantime, we've developed much more knowledge on the molecular factors and other important factors such as LVSI, which tell us much more about the individual prognosis to patients. So, the treatment has been developing greatly in the past 20 years.
Shannon Westin: Yeah, and I think this is a great case of less is more, right? We were doing so much for so many people that really didn't need it. And so, really tailoring who needs less treatment, who doesn't need any treatment, and then also, conversely, who may need more treatment that would be missed by the traditional risk factors that you're speaking of.
So, I think that brings us right into my next question, which is just bringing the audience up to date on the cancer genome atlas and how that's changed the way we classify endometrial cancer.
Nanda Horeweg: Yes, I think the molecular classification of the TCGA has shaped the way we think about endometrial cancer, and has huge impact on decisions on adjuvant treatments in the years to come. The TCGA performed an extensive characterization of the endometrial cancers and found that in fact, this disease exists of four different groups.
And the first of the groups I'd like to discuss is the ultra-mutated group, which is characterized by POLE mutations. And this group is shown to have an excellent prognosis in many independent studies. A second group that also has a high mutational burden is characterized by microsatellite instability, and mismatch repair deficiency and has shown to have an intermediate prognosis.
Then there's another group that has a low mutational burden with high copy number alterations and frequent TP53 mutations, and these have a poor prognosis. And then lastly, there's a group that does not have any of the classifying features and is often called non-specific molecular profile or TP53 wild type. And this group also has an intermediate prognosis.
And then finally, there's a small group of cancers that has more than one of these classifying features, the so-called multiple classifiers. And the WHO 2020 has developed an algorithm which can be used to classify them into the four groups.
And that's first on the POLE status. And for the POLE wild type tumors, they are assigned according to mismatch repair deficiency status. And for those that are mismatch repair proficient than POLE wild type, they are classified according to the TP53 status into NSMP or p53 abnormal.
Carien Creutzberg: Yeah, that is because of in the ultra-mutated and hyper mutated groups, many of the other mutations are secondary mutations in the context of the ultra-mutated stage, and they behave like the first molecular group.
Shannon Westin: Yeah. So, that POLE mutation is going to trump anything else, and it's so important. And I will just say as a sidebar, it's been challenging with the price of next gen sequencing sometimes to get that for everyone.
So, sometimes for us when we see a p53 mutation, we actually go back and do the full next gen sequencing to make sure that we're not going to act on that core prognostic feature when it really is in the setting of that more simplistic or that more positive prognostic place.
So, this is great, we already kind of highlighted a little bit PORTEC-1 and 2, but if you don't mind, I would love to get the audience a little bit more information just maybe about the populations that were included as we were figuring out how aggressive to be with radiation just to remind people of that, or to teach them that if they haven't gotten a chance to look at those studies.
Carien Creutzberg: Yeah, that's important to know because PORTEC-1 was still in the era that we also treated intermediate risk stage 1 endometrial cancer patients. So, deep invasion with grade 1 and 2 or superficial invasion with grade 2 and 3. That's what we defined at that point.
Then we compared external beam radiation or no further treatment, showing no survival difference, but a higher risk of recurrence with higher risk being older age over 60, grade 3 for deep myometrial invasion. And we kept those high intermediate risk factors as also similarly found by GOG-99 at the time to do PORTEC-2.
So, at the time, about 50% of patients did not have an indication for adjuvant therapy anymore, and with a high intermediate risk population for PORTEC-2, we compare external beam or vaginal brachytherapy and found the benefit of vaginal brachytherapy. A simple outpatient treatment, very short with almost no side effects ensuring local control.
And nowadays, using the molecular classification of…
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Nov 27, 2023
JCO Article Insights: Impact of Physical Activity on Mortality and of BMI on Treatment-Related Adverse Events
In this JCO Article Insights episode, Davide Soldato provides summary on two articles published in the November issues of the Journal of Clinical Oncology. The first article provides data on the prognostic effect of physical exercise on overall mortality and cancer-related mortality in a pan-cancer analysis of the PLCO study. The second article provides data regarding the impact of BMI on treatment-related adverse events and adherence to Palbociclib in the PALLAS trial. Overall, results of these study support the need to conduct studies investigating lifestyle behavioral factors and their impact on outcomes in survivors of and patients diagnosed with cancer.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Davide Soldato: Welcome to the JCO Article Insights episode for the November issue of the Journal of Clinical Oncology. This is Davide Soldato, your host, and today, I will be providing a summary on two articles focused on the impact of exercise on cancer prognosis and of BMI on treatment side effects.
In the first article titled Pan-Cancer Analysis of Postdiagnosis, Exercise, and Mortality, Lavery and colleagues investigated whether higher exercise was associated with a reduced risk of mortality among individuals diagnosed with cancer. The authors conducted a pan-cancer analysis using data from the Prostate, Lung, Colorectal, and Ovarian cancer screening study or PLCO, using data from a questionnaire that was administered to participants in the study at a median of nine years after initial randomization.
The questionnaire including 12 questions related to physical activity, both occupational and non-occupational. Of these 12 questions, four were used to assess the prognostic impact of moderate and strenuous exercise evaluated both in terms of frequency, so a number of sessions per week, and duration of exercise sessions.
The exposure to exercise was defined according to international guidelines, and patients were so divided among those who had a moderate intensity exercise defined as at least four days per week with each session on average for 30 minutes in duration, and strenuous intensity exercise equal or more to two days per week with each session on average of at least 20 minutes in duration.
So, based on this definition, the patients were categorized as either exerciser, if they were meeting the recommendation or non-exercisers. Additionally, to assess the existence over those response relationship between exercise and mortality, the authors further categorize patients on a four level scale as reporting no exercise, exercise, not meeting recommendation, meeting recommendation, or exceeding recommendation.
The primary endpoint of the study was all-cause mortality, and secondary endpoints included cancer mortality and mortality from other causes. This study included more than 11,000 patients diagnosed with cancer. 38% of them reported meeting guidelines recommendation with a median of 44 and 19 minutes spent in moderate and strenuous exercise respectively.
Individuals belonging to the group of exerciser were more frequently male, non-smokers, and with a lower prevalence of cardiovascular diseases. The most common cancer diagnosis were prostate cancer, breast cancer, and colon cancer observed respectively in 37%, 20%, and 7% of the participants.
Patients who died within six months from the completion of the questionnaire were excluded from this study. A median follow-up time between this landmark point and the last follow-up was 11 years. More than 4,500 deaths were observed in this period, and less than half were related to cancer meeting.
Meeting exercise recommendation was associated with a 25% risk reduction in all-cause mortality, a 21% risk reduction in cancer mortality, and a 28% risk reduction in mortality from other causes. In particular, five-year cancer mortality rate was 12% among exerciser and 16% among non-exerciser.
Interestingly, the positive prognostic effect of exercise was observed starting within the first five years of observation, but persisted up to 20 years afterwards. An inverse to those response relationship between exercise and mortality was observed, so increasing exercise was overall associated with incremental reduction in the risk of death.
The authors compared patients reporting no exercise with those reporting exercise under at the recommendation or over the recommendation. For all-cause mortality, the risk reduction was equal to 25% among those reporting exercise below the recommendation, and increased to 35 and 36% among those meeting and exceeding recommendation respectively.
Similar results were observed for cancer mortality, risk reduction ranged from 19% in those reporting exercise below recommendation, up to 33% for those exceeding recommendation. Finally, the authors investigated the effect of exercise on mortality by cancer type, and observed a significant reduction in cancer mortality only for head and neck cancer and renal cancer.
While reduction all-cause mortality and mortality from other causes were observed across a wide range of cancer, including breast, endometrial, and hematopoietic and prostate. The study confirms previous findings by showing an inverse relationship between higher level of exercise and lower risk of all-cause mortality, and provides novel insights on the topic by reporting that those response association, data on other causes of death, and edited analysis by cancer site diagnosis.
All limitation of the study is related to the generalizability of the findings. The study included only patients that were alive at a median of 4.5 years after cancer diagnosis, which might have applied to selection of patients with good prognosis, and thus, reducing the number of cancer mortality events. Additionally, these patients were willing to complete an additional questionnaire in the context of the trial, which might be related to a higher motivation in engaging in healthy lifestyle behaviors.
The study did not replicate previous findings observing a reduction in cancer mortality for breast, colon, and prostate cancer, among those reporting higher exercise. Although this might be related to the inclusion of long-term survivors in the study.
In the second article titled Impact of BMI in Patients With Early Hormone Receptor-Positive Breast Cancer Receiving Endocrine Therapy With or Without Palbociclib in the PALLAS trial, Dr. Pfeiler and colleagues investigated the impact of BMI on side effects, adherence to treatment, and efficacy of palbociclib in the PALLAS trial.
Just as a reminder, PALLAS is a randomized clinical trial that investigated whether the addition of two years of palbociclib to standard endocrine therapy in patients treated for stage two, three hormone receptor-positive HER2-negative breast cancer could improve invasive disease-free survival. Previous report of the trial showed that palbociclib did not improve invasive disease-free survival compared to endocrine therapy alone.
More than 5,500 patients were included in this analysis, and among them, more than two third at a BMI equal or over 25 diagnoses with 32% being overweight and 30% obese. Overweight and obese patients were more frequently older and coming from North America rather than from Europe.
In line with the age difference, normal weight patients were treated more frequently with Tamoxifen alone or in combination with ovarian function suppression or with aromatase inhibitors in combination with ovarian function suppression.
No differences in tumor characteristics was observed according to BMI. However, there were some minor differences regarding the type of surgery and administration of chemotherapy. The authors observed that side effects of palbociclib were significantly different according to BMI and in particular, they observed a lower incidence of a hematological toxicity among overweight and obese patients.
Conversely, higher rates of arthralgia, nausea and…
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Nov 5, 2023
Durvalumab Plus Carboplatin/Paclitaxel Followed by Maintenance Durvalumab With or Without Olaparib as First-Line Treatment for Advanced Endometrial Cancer: The Phase III DUO-E Trial
In this "Podcast Takeover," Dr. Lidia Schapira guest hosts to discuss with Dr. Shannon Westin her own JCO paper, which reports on the DUO-E Trial. Dr. Ramez Eskander also joins in this lively discussion.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast where we get in depth on manuscripts published in the Journal of Clinical Oncology. I am your host, Shannon Westin, Social Media Editor of the JCO and Gynecologic Oncologist by trade. And actually, I'm super excited today because we are going to have a podcast takeover because we are discussing my own work, which was simultaneously presented at the European Society of Medical Oncology 2023 Congress and published in the Journal of Clinical Oncology on October 21st, 2023. And this was the DUO-E trial, “Durvalumab Plus Carboplatin/Paclitaxel Followed by Maintenance Durvalumab With or Without Olaparib as First-Line Treatment for Advanced Endometrial Cancer.” Because we’re discussing this work and we wanted you to have an unbiased podcast discussion, Dr. Lidia Schapira, who is a Professor of Medical Oncology at Stanford University and an Associate Editor of JCO and the Art of Oncology podcast host, is going to take over this podcast and really just pepper me with questions about this exciting work.
Welcome, Dr. Schapira.
Dr. Lidia Schapira: Thank you so much. It's such a pleasure to be with you.
Dr. Shannon Westin: And before I turn over the reins, I also want to introduce one of my colleagues, who’s going to be providing quite a bit of insight on this topic, Dr. Ramez Eskander, who is Professor of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Diego. And you will know he’s the principal investigator of the GY-018 study, which established pembrolizumab and chemotherapy as the new standard of care in endometrial cancer. Welcome, Ramez.
Dr. Ramez Eskander: Thank you. Thank you, Dr. Westin. It's a pleasure to be here. And congratulations again to you and your study team for this exceptional work.
Dr. Shannon Westin: Thank you. And congratulations to you.
Dr. Schapira, thank you for being here and please do take it away.
Dr. Lidia Schapira: So let's start by having you tell us a little bit about the standard of care for women with endometrial cancer and advanced endometrial cancer prior to this study. Ramez, I'm going to direct this question to you first.
Dr. Ramez Eskander: For many years, actually since about 2012, carboplatin and paclitaxel, which ironically is a chemotherapy backbone really across all of our gynecologic tumors, emerged as the preferred doublet chemotherapy regimen for the management of advanced-stage metastatic or recurrent endometrial cancer. It evolved through a series of different clinical trials, in fact taking us from whole abdominal radiation, systemic chemotherapy, comparing single agents to doublets and then triplet regimen of TAP to carboplatin and paclitaxel, which ultimately, then, following the presentation of GOG Protocol 209 and its publication, as the chemotherapy backbone, being carboplatin and paclitaxel. And it’s been that way for many, many years.
Dr. Lidia Schapira: And how effective is the regimen?
Dr. Ramez Eskander: The response rates to carboplatin and paclitaxel are actually quite reasonable in the patients who have advanced-stage disease, particularly if they haven't had prior systemic chemotherapy. Response rates in the 50% to 60% range. The issue is that the responses tend to be limited and disease recurrence is an expectation in these patients who have advanced-stage disease. And so that really highlighted the importance of trying to continue to advance therapeutic opportunities in these patients to improve long-term outcomes.
Dr. Lidia Schapira: As we think about improved long-term outcomes, we're thinking about a better treatment and also a kinder treatment, perhaps one that is also less toxic. Can you talk a little bit about the population of women with endometrial cancer? Are these older women? Do they have comorbidities?
Dr. Ramez Eskander: What we’re seeing is, interestingly, there has been an evolution a bit in this space. Historically, we used to think about endometrial cancer as—the phrases we used to use are type I and type II. These type I tumors, we would say, are estrogen-driven malignancies; they tend to be seen in overweight or obese patients. And we would identify them in a theoretically younger patient population. And then we had these type II, or what we termed estrogen-independent malignancies, that we would see in an older patient population. Of course, with obesity came metabolic syndrome and other cardiovascular comorbidities, etc. But really, that narrative has evolved dramatically, and that’s really something that will be highlighted in, I think, our discussion of these studies today, where the nomenclature that we used to historically use has evolved because of our understanding of the molecular characterization of this disease. So we’ve really gone away from that, and now we understand that we’re seeing all of these different heterogeneous endometrial cancer types amongst patients of different ages, different comorbidities, different races and ethnicities. And so it’s created a more complex picture for us. But certainly, there are comorbidities that these patients face, and that’s important as we look to identify treatments strategies that are both effective and tolerable.
Dr. Lidia Schapira: My final question before we jump into this very exciting study is about the Cancer Genome Atlas work. Can you tell us how that’s changed the thinking and the design of the studies?
Dr. Ramez Eskander: It was a seminal publication, really, back in 2012/2013 looking at an assessment of endometrial cancers to try and determine whether or not all of these "endometrial cancers" that we used to enroll on a single study are similar or divergent. And it’s important because the study I referenced that really established the standard of care, GOG Protocol 209, as carboplatin and paclitaxel, there was no real consideration of molecular characterization at all. We enrolled all patients onto this study without thinking about these variables, of course, because it was designed, conducted, and completed before the TCGA data emerged. But what we learned from the TCGA is there appeared to be four distinct molecular subgroups. There were the POLE-mutated patient population. There was the mismatch repair deficient or MSI-high endometrial cancer population. There was the copy number-high or what we say are the p53-mutated. And then the last cohort was called the NSMP (no specific molecular profile). But now, that’s even evolved; some people term it TP53 wild type. That’s a bit of even a heterogeneous cohort amongst itself. So we’re going to take these subsets, independent of POLE and an MSI-high, and we’re going to look at TP53 or copy number-high, and that will probably be divvied out further, and the NSMP, and that will probably be subdivided. But really, it gave us these four components, which has then evolved. Many of you may have heard of the ProMisE algorithm or ProMisE Plus, which looked to take the data from TCGA so that we can start to really look at it in clinical practice. So it’s really revolutionized how we think about these patients, how we think about the disease, and how we design trials.
Dr. Shannon Westin: And I just want to add to that because I think that it's so important, what Ramez said about the way we were developing trials, the way we were designing trials. We knew that these classifiers—we were learning these classifiers are prognostic. Now what we’re really trying to hone in on is how predictive they are. And certainly, one of the major classifiers that we’re going to talking…
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Oct 30, 2023
JCO Article Insights: Safety and efficacy of a Novel ADC Targeting TROP-2 in Metastatic Non-Small Cell Lung Cancer (NSCLC)
In this JCO Article Insights episode, Davide Soldato interviews Dr. Jacob Sands, medical oncologist at Dana Farber Cancer Institute (Boston, MA) and Assistant Professor at Harvard Medical School, on their paper “First-in-Human, Phase I Dose-Escalation and Dose-Expansion Study of Trophoblast Cell-Surface Antigen 2-Directed Antibody-Drug Conjugate Datopotamab Deruxtecan in Non-Small-Cell Lung Cancer: TROPION-PanTumor01”. The interview offers a deep dive into the safety and efficacy data of this novel drug and puts these data in the context of the current treatment landscape of NSCLC and of the revolution that ADC are bringing into the oncology world.
TRANSCRIPT
Davide Soldato: Welcome to this JCO Article Insights episode for the October issue of Journal of Clinical Oncology. This is Davide Soldato, and today I will have the pleasure of interviewing Dr. Jacob Sands, co-author of the manuscript titled, “First-in-Human, Phase I Dose-Escalation and Dose-Expansion Study of Trophoblast Cell-Surface Antigen 2-Directed Antibody-Drug Conjugate Datopotamab Deruxtecan in Non-Small-Cell Lung Cancer: TROPION-PanTumor01.” Dr. Sands is a Medical Oncologist working at Dana-Farber Cancer Institute in Boston and Assistant Professor at Harvard Medical School. His main field of research and clinical interests revolve around improving screening and diagnosis of lung cancer and also on developing novel therapeutic agents for this disease.
So, welcome Dr. Sans, and thank you very much for accepting our invitation today.
Dr. Jacob Sands: Happy to join. Thanks for having me.
Davide Soldato: I just wanted to start with a very general question because I think that we are going to discuss a very important study and the manuscript that you co-authored is going to look at the safety and the efficacy of this novel ADC datopotamab-deruxtecan that is targeting TROP2. But I just wanted to have a little bit of context before starting to discuss the safety and efficacy data. So the population that was included in the study included more or less 60% of patients that received three or more lines of therapy and also 20% of patients who received five or more lines of therapy. So I think that this is a very particular population, especially considering that we are speaking about non-small cell lung cancer. And so I wanted to get from you like a general context, like what are the therapeutic options for these patients normally in clinical practice and what do we expect in terms of outcomes and in terms of toxicity?
Dr. Jacob Sands: Yeah, so as you point out, this is a highly pretreated population in general, which is to say that they've really gotten the most effective lines of treatment up to this point. Now, we certainly do see some efficacy from some of the later lines of therapies in some patients, but inherently there is a decreasing response rate and decreasing durability of these responses as patients get further along in their treatment courses as far as lines of therapy. So it's generally considered to be a challenging clinical scenario, which is part of what makes the data that we're going to discuss, I think, so meaningful.
Davide Soldato: Yeah, I think that especially if we look at the population that was included first, I think that the very particular thing is that included both oncogene-addicted and non-oncogenic addicted patients, and also the great majority of these patients received the most effective treatments that are available because they all received more or less immunotherapy and platinum-based chemotherapy, if I'm not mistaken.
Dr. Jacob Sands: That's right. And that's an important distinction that you're drawing in the patients with oncogenic drivers and, of course, there's plenty of data with this compound with Dato-DXD in that population as well. But broadly speaking, in the non-oncogenic actionable alterations where they've gotten chemo-immunotherapy, those really are the most meaningful. Of course, docetaxel has been a long-standing second line that I'd say there is less and less enthusiasm about that as a line of treatment as we've seen some of these other more novel therapies that have just a better toxicity profile in particular, but also some with really durability that we don't quite see with docetaxel as well. And so once you're getting past that, you're really now reaching a bit deeper to then have something that is well tolerated and has efficacy. That's a setting where we really need it even more.
Davide Soldato: So, going back to the results of the study, as we kind of pointed out, this was a very standard classic with a Bayesian design, phase I dose escalation and dose expansion study of this novel ADC datopotamab-deruxtecan. So I just wanted to go over with you and to provide our listeners a little bit with some data regarding the doses that were explored and then what were the doses that were selected for the expansion. And also to discuss a little bit the safety data. We were discussing the tradeoff between risk and benefit, especially in patients that are very pretreated, searching for these kind of sweet spots between the toxicity and the efficacy. So I just wanted to put in context a little bit the data that you reported in the manuscript.
Dr. Jacob Sands: Yeah, that's right. So, like phase I’s go, we started with a low dose at 0.27 milligrams per kilogram, and dose escalations occurred up to 10 milligrams per kilogram. The 10 milligram per kilogram dose did have toxicities that really made it not considered to be tolerable, and that mostly being mucositis and skin. And so it was then back down to 8 milligrams per kilogram. And then there was a dose expansion at 4, 6, and 8 milligrams per kilogram. The 4 and 6 milligram per kilogram doses had 50 patients enrolled within those cohorts and 80 patients within the 8 milligram per kilogram cohort to then get much more data, of course, for efficacy and tolerability within those levels. Ultimately, each of them really demonstrated some efficacy as well as general tolerability. The 6 milligram per kilogram dose was really the one selected overall for further testing and future trials based upon the data out of this one that we're going to discuss further.
Davide Soldato: What were the main side effects that you observed in the trial? And particularly, do you think that there is some kind of special toxicity that should be looked at when using this novel type of ADC?
Dr. Jacob Sands: Certainly there are some novel toxicities to really pay attention to. And maybe I'll just point out before diving into the toxicities, that this is in many ways chemotherapy. The antibody drug conjugates, as listeners probably know, are an antibody that has a linker bound to chemotherapy, what's called the payload. And in this case, it's a topoisomerase I inhibitor with the antibody, the TROP2. So the cells on the surface, when there's TROP2 expression, the drug binds to that, gets pulled into the cell and releases that chemotherapy intracellular, but it is still chemotherapy. And so some of the toxicities are things that we commonly see with chemotherapy drugs. Although, broadly speaking, I would say we're able to deliver higher doses of that chemo to the cells in this kind of targeted dosing of chemotherapy to give the chemo intracellular.
Now, that being said, some of the toxicities that we see from this drug in particular that are a bit different is the stomatitis, mucositis. That is something that has occurred. Now, I've found that if it's really severe, then with a dose reduction that has really substantially improved any toxicities with future dosing. And at a 6 milligram per kilogram dose, a dose reduction to 4 milligram per kilogram is still within a dose range where we saw plenty of efficacy within the trial that we're discussing. That being said, if one can help patients tolerate it better, if it's more mild symptoms, if it's not severe, then that's better in maintaining that dos…
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Oct 28, 2023
Economic Evaluation of a Non-Medical Financial Assistance Program on Missed Treatment Appointments Among Adults With Cancer
Dr. Shannon Westin, Dr. Stephanie Wheeler, and Dr. Caitlin Biddell discuss the paper "Economic Evaluation of a Non-Medical Financial Assistance Program on Missed Treatment Appointments Among Adults With Cancer," a simultaneous publication, podcast, and presentation at the ASCO Quality Care Symposium.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast where we get in-depth on manuscripts published in the Journal of Clinical Oncology. I'm your host, Shannon Westin, Social Media Editor of the JCO and GYN Oncologist. And I am so excited that today we have a simultaneous publication in JCO and presentation at the 2023 ASCO Quality Care Symposium here on 10/28/2023. And this is going to be the manuscript “Economic Evaluation of a Nonmedical Financial Assistance Program on Missed Treatment Appointments Among Adults With Cancer.” Very exciting work. And I'm thrilled to tell you I have two of the authors here with me today. First is Dr. Caitlin Biddell. She's a Health Services Researcher at Mathematica Policy Research.
Welcome, Caitlin.
Dr. Caitlin Biddell: Thank you. Happy to be here.
Dr. Shannon Westin: And we also have Dr. Stephanie Wheeler. She is the Michael S. O'Malley Distinguished Professor in the Department of Health Policy and Management at the University of North Carolina, Chapel Hill, as well as being the Associate Director of Community Outreach and Engagement at UNC Lineberger Comprehensive Cancer Center.
Welcome.
Dr. Stephanie Wheeler: Thank you. Happy to be here as well.
Dr. Shannon Westin: Please note that our authors and participants have no conflicts of interest.
Let's get started. So first I would love to level set. Can you speak a little bit about what financial toxicity is and how common it is among patients with cancer?
Dr. Stephanie Wheeler: Sure, Shannon. I'm happy to take that one. This is Stephanie. So we know that financial hardship is often reported by patients and survivors who've experienced cancer. And as many as 50% of people with cancer have trouble with financial toxicity. There has been prior work that has conceptualized financial toxicity in three domains. So there's the material hardship, kind of the out-of-pocket material costs associated with cancer, which include both medical and nonmedical expenses. There is the stress and the psychosocial effects of that material hardship. And then there's coping behaviors that patients and their caregivers may employ to help deal with the high cost of cancer care. And as we've seen, cancer care increases in cost over time, and these expenditures really have very burdensome effects on patients and their families. We've been interested in looking at ways that we can try to mitigate that harm and really thinking about interventions in addition to the health policy changes that are needed to really ensure that this doesn't become a barrier to patients seeking and receiving the best quality care that they can.
Dr. Shannon Westin: I think that kind of leads pretty nicely into my next question, which is really: How does this toxicity potentially impact equitable cancer care delivery?
Dr. Stephanie Wheeler: Yeah, I'm happy to talk about that a little bit as well. So we know from prior research, including some of our own, that patients of color, those from rural areas, and those who are uninsured or underinsured face the largest financial burdens associated with their cancer care. So to the extent that those financial hardships influence people's ability to seek and continue with and complete their cancer care that's been recommended, this actually is directly in the pathway and a mechanism through which patients are not able to get recommended treatment and therefore can contribute to differences in cancer outcomes. So there's direct health impacts in terms of their ability to receive and respond to cancer treatment.
In addition to that, we know that this financial hardship contributes to household-level harms both economic and psychosocial in nature. And in some other work, this financial hardship has translated to worse quality of life, worse economic outcomes, things like being able to stay employed and seeking changes in employment or remaining within a particular position because you don't want to lose your insurance—this is referred to as “job lock”—or can also contribute to higher mortality. So there's been some really important work showing that financial toxicity is directly linked with cancer mortality.
And so, as we think about ways that we need to address this, it's really key to ensuring cancer health equity that we are thoughtful about multiple solutions implemented at multiple levels that can deal with not only the contributors to high cancer costs but that can also start to affect both the nonmedical and the medical components of this cost burden. And by nonmedical, I mean things like the cost associated with transportation and seeking care, accommodations for people who need to receive radiation therapy multiple days in a row at a different healthcare facility than where they live, childcare costs. These things really start to add up in addition to the medical costs associated with cancer treatment.
Dr. Shannon Westin: I really was intrigued by the intervention here that you all are studying around this Cancer Patient Assistance Fund. Can you tell me a little bit more about exactly what that was or is?
Dr. Caitlin Biddell: Yeah, absolutely. So this is a program at the North Carolina Basnight Cancer Hospital, located within the Lineberger Comprehensive Cancer Center, and it started back in 2013, actually, and has really grown in size. But the main goal of this program is to ensure that patients do not face the nonmedical financial barriers to care that Dr. Wheeler was just talking about. So thinking about giving patients gas cards so that they are able to drive to and from treatment. Lineberger has a catchment area of the entire state, so many people are coming a long distance to come for cancer treatment. They also provide things like lodging and accommodations, as Stephanie mentioned, and then even paying patients’ utility bills, things to keep them housed with electricity, the lights on, while they're undergoing cancer treatment. So just last year, in 2022, they distributed almost $350,000 to over 700 patients, and most of this is funded by philanthropic grants to ensure that patients can access the care they need. And it is a program that's really targeted to patients with low incomes. So they target patients with household incomes less than 250% of the federal poverty level.
Dr. Shannon Westin: And how does a patient get connected to the fund? How do they find it and get hooked up?
Dr. Caitlin Biddell: Yeah, there's a couple different ways. So one path is through the outpatient social work team. So they often perform distress screening for new cancer patients. So they use the Distress Thermometer, which was developed by the National Comprehensive Cancer Network. And it measures a variety of different factors that may be contributing to distress, but that does include financial stress, job stress, and the expense of daily living stress. And so, when a patient scores a certain amount on that thermometer, a social worker will meet with them for a full assessment. And then part of the referral pathway from that assessment includes the Cancer Patient Assistance Fund. Patients who are in inpatient will often be screened with the Social Determinants of Health Module, which is housed in the electronic health record. And so that can also generate referrals for assistance. And then beyond the kind of standard pathways, there's also many other ways that a patient may express concerns to a nurse, a care coordinator, an oncologist, and then that provider can reach out directly to the Cancer Patient Assistance Fu…
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Oct 12, 2023
Disparities in End-of-Life Cancer Care
Shannon Westin speaks with Holly Prigerson and Alfred Neugut about their thought-provoking editorial, "You Get (Offered) What You (Can) Pay For: Explaining Disparities in End-of-Life Cancer Care."
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of the JCO After Hours podcast. And this is where we get in-depth on manuscripts and editorials that have been published in the Journal of Clinical Oncology. As always, I am your host, Shannon Westin, Gynecologic Oncologist and Social Media Editor for the Journal of Clinical Oncology, and I'm so excited to be here today. We are going to be talking about a very compelling editorial that is called “You Get (offered) What You (can) Pay for: Explaining Disparities in End-of-Life Cancer Care." And this was published on June 20th, 2023, in the Journal of Clinical Oncology as an editorial on an article entitled the "End-of-Life Systemic Oncologic Treatment in the Immunotherapy Era: The Role of Race, Insurance, and Practice Setting." So a very timely topic and very exciting for us to discuss today.
I'm joined by two of the authors of the editorial, Dr. Holly Prigerson, Professor of Sociology and Medicine, the Irving Sherwood Wright Professor in Geriatrics Medicine at the Weill Cornell Medical College and the Director of Cornell Center for Research on End-of-Life Care. Welcome, Dr. Prigerson.
Dr. Holly Prigerson: Great to be here.
Dr. Shannon Westin: And also accompanied by Dr. Alfred Neugut, the Myron M. Studner Professor of Cancer Research and Professor of Medicine and Epidemiology at Columbia University and the former Associate Director for Population Science and Racial Disparities Program for the Herbert Irving Comprehensive Cancer Center at Columbia. Welcome, Dr. Neugut.
Dr. Alfred Neugut: Thank you very much.
Dr. Shannon Westin: Very excited to talk about this topic today, and I like to always start with a little bit of level setting. So I'd love for one of you to discuss: How common is the use of systemic anticancer treatment at the end of life?
Dr. Holly Prigerson: So, based on the article, it looks like the rates within the last 30 days of death, it was 34% on average overall. So that was sort of the—you say level setting—the base statistic. Within 14 days of death, it dropped to 13% overall. So all the associations that are described are really disparities from that level.
Dr. Neugut: Speaking as an oncologist, I don't think any of my clinical colleagues will be surprised that it's that high. There is an effort made really to, in desperation, try to help. Patients want it. Families want it. So there really is efforts made to try to do that to prolong life or palliate or whatever.
Dr. Holly Prigerson: The design also, which is probably going to be a question that's coming up, does raise a question for me that I'm wondering if Al could enlighten at least me on. They did select patients who were getting treatment for metastatic or advanced cancer starting in 2011 and then who died four years later. Does the selection for the fact that they were getting treatment initially—because everyone, that's how they sampled the study—does that increase the likelihood that they'll get treatment later on so that the rates are somewhat inflated is my question.
Dr. Alfred Neugut: Yeah, no, for sure. People who start chemo tend to continue partially because there is a certain amount of those who do well do well. If you respond to chemo initially, you tend to respond to the second-line therapy, you tend to respond to third-line therapy. If you didn't do well on first-line chemo, you're not likely to respond to a second line or a third line, so you don't have the enthusiasm to continue with it, and the patient certainly tends to lose interest in it. So you're right; there is a certain, call it, momentum or inertia in going forward with chemo once you've started.
Dr. Shannon Westin: I mean, I think this just always highlights some of the issues we have, right, with any kind of retrospective data is how well can we design a population without—because we can't always do randomized control trials, and certainly not in this kind of setting. That would not be acceptable, I think, to providers nor patients. And I do agree that it can be tricky. Any other kind of, maybe just to help the listeners if they haven't gotten a chance to read this Canavan study, about the design, exactly what they were looking at in this population?
Dr. Holly Prigerson: Basically, they took these patients who were getting systemic therapy and had advanced metastatic cancer prior, and then who died. So there's always a question about the sampling on death issue, that they had to have died to be in the sample. So those are methodological issues, but there’s really very little way around that. If you want to know what treatments people received in the last month of life, they have to die for there to be a last month of life.
So then the treatments were divided into chemotherapy alone, chemotherapy with immunotherapy, and then immunotherapy with and without targeted therapy. So there were three types of treatment, which is sort of an important update because Al and I had published something in 2015 on chemotherapy and the outcome of what was called palliative chemotherapy at that time. And this was sort of a very refreshing–well, not—I shouldn’t say refreshing, but important update to our study, which had said that there are questionable outcomes of palliating someone with palliative chemotherapy so far along in the disease. And then the question became, well, is it different? Is it different with immunotherapies? Is it different with targeted therapies? And that's why I was delighted to see this paper, because it answered…
Dr. Alfred Neugut: I'd have to say there are probably differing views on this, but Holly and I are probably relatively nihilistic in terms of thinking that chemotherapy in late stages or near terminal patients is probably not all that helpful. Third-line, fourth-line therapy probably not going to get you very far. And maybe it's best to be thinking more about hospice care and supportive care. And now we have terrific palliative care programs at most or all cancer centers, and we really should be taking advantage of this. I think a real benchmark study was the Temel study from 2010 or 2011, which really—for those of your listeners who haven't read it or seen it, they should really take a look at it. It really changes the playing field and makes you realize that treatment is not really always the best thing for patients, and there are other options. And we go to hospice care or palliative care really, I think, too late in the game a lot of the time, and we really should be thinking otherwise.
Dr. Holly Prigerson: That is one of the outcomes that we had looked at before. So we had looked at palliative chemo, and not only does it not palliate, and we didn't show that it significantly enhanced survival; we also showed that it resulted in a lower likelihood of earlier enrollment in hospice, a higher likelihood of not dying where your family members thought you would have wanted to die, a higher likelihood of dying in the ICU or getting some kind of aggressive care. So it's not only what the chemo does or doesn't do in terms of treatment or survival or quality of life; it also seems to exacerbate and put someone at risk for very burdensome interventions that having avoided it might have enabled patients to avoid getting very burdensome care that's largely futile. But as Al said, we are probably more the nihilistic type.
Dr. Shannon Westin: Well, I think you bring up a couple of good points because you've got objective data, and these studies that you're mentioning are just some of them that show that early hospice care and early enrollment and even just a palliative care program or a supportive care program or wh…
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Sep 28, 2023
Advance Care Planning in Adolescents and Young Adults with Cancer
A variety of perspectives are explored as Dr. Westin speaks with Dr. Jennifer Mack, Dr. Chun Chao, and Mallory Casperson about end-of-life care planning in adolescent and young adult cancer.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast where we get down and dirty with manuscripts that are being published in the Journal Clinical Oncology. And I am your host, Shannon Westin, GYN Oncologist and Social Media Editor of the Journal of Clinical Oncology. I am so very excited to have a number of guests with us today to discuss a very important paper entitled “Discussions About Goals of Care and Advanced Care Planning Among Adolescents and Young Adults with Cancer Approaching the End of Life.”
And I'm joined by several of the authors of this important paper. The first is Dr. Jennifer Mack. She is the Associate Chief in the Division of Population Sciences, an Associate Professor at Harvard Medical School and Senior Physician in Pediatric Hematology Oncology at the Dana-Farber Cancer Institute. Welcome, Dr. Mack.
Dr. Jennifer Mack: Thank you.
Dr. Shannon Westin: We also have Mallory Casperson. She is the cofounder and CEO of the Cactus Cancer Society. They provide online support programs and resources to young adult cancer survivors and caregivers in the comfort of their own homes. Welcome.
Mallory Casperson: Thanks for having me.
Dr. Shannon Westin: And then, finally, last but not least, Dr. Chun Chao. She is a Senior Research Scientist in the Division of Epidemiologic Research in the Department of Research and Evaluation at Kaiser Permanente Southern California. Welcome.
Dr. Chun Chao: Thank you. It's a pleasure being here.
Dr. Shannon Westin: So I want to get right into this. I think that there certainly has been a lot of discussion, at least at our institution as well as at the ASCO level, around advanced care planning across all patients with cancer and anyone with a diagnosis of cancer. And I would love to just start and level set and make sure all of our listeners are all on the same baseline around the incidence and prevalence of cancer in adolescents and young adults. Like, first, define what are the age groups that we're looking at here? How common is cancer in this population?
Dr. Jennifer Mack: Right. For this study, we defined adolescents and young adults as individuals aged 12 to 39. And right now, about 90,000 adolescents and young adults are diagnosed with cancer in the United States each year. Those numbers are also rising, so more and more are diagnosed each year, and because of that, we think it's increasingly important to pay attention to the needs of this population. This population really experiences a whole range of different cancer types, some of which are more common in children, some of which are more common in adults, but the most common ones include breast and gastrointestinal cancers, sarcomas, germ cell tumors, leukemias, lymphomas, and brain tumors.
Dr. Shannon Westin: And your manuscript notes that adolescents and young adults seem to receive medically intensive measures at the end of life. Now, how common is this across this group? And do you all have a sense of some of the reasons that we see this increased use of these measures?
Dr. Jennifer Mack: That's a great question. We and others—actually, the early work that led to this study was done with Chun. We had previously found that most adolescents and young adults receive at least some kind of medically intensive care at the end of life. And that includes things like being hospitalized, being in the intensive care unit, receiving chemotherapy, and spending time in the emergency room near the end of life. And so, if you take all of those together, about two-thirds of adolescents and young adults receive at least one of these near the end of life.
And we don't know the reasons for this. There are probably complex reasons. Some adolescents and young adults may actually want to receive these kinds of measures, maybe because they're young and they want to do everything they can to live as long as they can. And some patients in this age group are parents to young children, and they may be making choices to prolong life and be there for their kids. But we also know that if we look at older adults, most people who know they're dying don't want to receive this type of care, which is also associated with more suffering and with poorer quality of life. So it's also possible they're making these choices because they don't fully recognize they're approaching the end of life or because they haven't had opportunity to plan for this time through conversations with their medical teams.
Mallory Casperson: I think the conjecture, too, that a young adult is likely to focus on extending life, even in a situation where palliation is the stated goal, is a really great conjecture. This population is really burdened by these unique psychosocial issues that are driven by the extreme disruptions that cancer has on major life milestones. Like Jenny said, they may have young children at home, they may have a new spouse at home, still be trying to advance at work, you name it. So this period of young adulthood is really characterized by constant change. And it's possible that these young adults are being driven to stay present in their lives for really as long as possible to reach some of these goals or even just to support their young families as they reach their own goals.
Dr. Shannon Westin: I really appreciate that context, and I'm going to always bring it back to what I know as a provider of gynecologic cancer care, where we see quite a bit of young people at the beginning of their life, at the beginning of their fertility. And I think it is so important to keep that context in mind as we're designing interventions and studies and things like that. So I really appreciate that, having the ability to kind of see from that standpoint.
So I think you guys have convinced me this is important. We know the reasons. So why don't we just lay out the objectives of this particular study and give our listeners a brief review of how it was designed?
Dr. Jennifer Mack: Great. We wanted to know how often adolescent and young adult patients with incurable cancer have discussions about prognosis and end-of-life care planning before they die. And a secondary goal was to understand whether having earlier discussions would change the type of care that's delivered. So, for example, having those discussions about goals of care earlier in their illness, could that make them less likely to receive intensive measures?
So, to do the study, we conducted a retrospective review of health records for nearly 2,000 adolescents and young adults who died between 2005 and 2019 after receiving care in one of three centers—the Dana-Farber Cancer Institute, Kaiser Permanente Southern California, Kaiser Permanente Northern California—and looked for documentation of discussions about care planning. For this study, we focused on patients who either had stage IV disease at diagnosis or who had experienced a recurrence because we wanted to ensure that we had a population of young people who were living with advanced disease and not people who might have died suddenly and unexpectedly during treatment, because they might not have had the same opportunity for end-of-life care planning. So we really wanted to focus on those who had the poorest prognoses.
Dr. Shannon Westin: It's a really large group of people and, I think, hopefully fairly representative. I guess my question is, when you're looking at the group that you were able to kind of pull from in this retrospective database, which I think can sometimes be limited, do you feel like it was fairly representative of the population that's out kind of across the States, let's say?
Dr. Chun Chao: So I think it's a real s…
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Sep 25, 2023
JCO Article Insights: Improving Lung Cancer Screening Using Blood-Based Biomarkers
In this JCO Article Insights episode, Davide Soldato summarized finding from the original article published in the September JCO issue: “Mortality Benefit of a Blood-Based Biomarker Panel for Lung Cancer on the Basis of the Prostate, Lung, Colorectal, and Ovarian Cohort”. The summary provides information regarding the ability of a blood-based panel of 4 biomarkers in improving the identification of individuals at risk of developing lethal lung cancer and potential of combined screening strategies to improve trade-off between potential harms and benefit of the screening process.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Davide Soldato: Welcome to the JCO Article Insights episode for the September issue of the Journal of Clinical Oncology. This is Davide Soldato, your host, and today I will be providing a summary on one article focused on the refinement of screening strategies for lung cancer. The article, titled "Mortality Benefit of a Blood-Based Biomarker Panel for Lung Cancer on the Basis of the Prostate, Lung, Colorectal, and Ovarian Cohort" by Dr. Irajizad and colleagues, investigated the ability of a panel of circulating blood biomarkers in improving the identification of individuals at risk of developing lethal lung cancer. We already know that lung cancer screening based on the use of low dose CT is associated with a reduction in mortality, as already demonstrated by the National Lung Cancer Screening Trial and the NELSON Trial. Furthermore, the US Preventive Task Force has recently recommended an expansion of screening criteria for lung cancer.
Currently, based on this recommendation, screening strategies are recommended for individuals 50 years of age and older with a smoking history of at least 20 pack-years and who are current smokers at the moment of the screening time or have quit within the past 15 years. Despite this positive data and this recommendation, the uptake of lung cancer screening in the US is still low, with reported uptake rates below 15%. The risk of false positive results, the unnecessary follow-up procedures, uneven access to lung cancer screening programs, and fear of cancer diagnosis and treatment have all been identified as potential barriers to optimal implementation and uptake of lung cancer screening. And so, in order to overcome some of these barriers, several efforts have been made in the last years to develop lung cancer screening prediction models with the aim of selecting a higher risk population who would derive higher benefit from lung cancer screening.
In the present manuscript, the author builds on their previous work where they developed and tested a clinical prediction model and a blood-based prediction model in the context of the PLCO cohort. The Prostate, Lung, Colon and Ovarian Cancer Screening Trial was a randomized, multicenter trial in the US which aimed to evaluate the impact of early detection procedures on disease-specific mortality for the aforementioned cancers. Two lung cancer screening prediction model had already been developed and tested in the cohort. The PLCOm2012 model is based on several clinical and demographic characteristics, including age, race and ethnicity group, education, BMI, chronic obstructive pulmonary disease, personal history of cancer, family history of lung cancer, smoking status and intensity, duration and quit time. In a previous study, this model demonstrated a higher sensitivity and positive predictive value with no loss in specificity for lung cancer diagnosis compared to the National Lung Screening Trial criteria.
Additionally, in the same cohort, the 4MP was a blood-based panel that included the precursor form of surfactant protein B, cancer antigen 125, carcinoembryonic antigen, and cytokeratin-19 fragment. In a previous study, a combination of this blood-based panel and the PLCOm2012 model was associated with a better identification of patients at high risk of developing lung cancer that would consequently benefit from lung cancer screening. In the manuscript that was published in the current issue of the JCO, the authors aim to expand on these previous results and test the ability of the combined 4MP and PLCO model to identify individuals at high risk of developing lung cancer death. The study used prediagnostic sera of 552 individuals that were diagnosed with lung cancer within one year from the blood draw and 2000 non-cases.
In the study, the authors assessed the performance of this combined four 4MP and PLCO model at a risk threshold of 1% and 1.7% of developing lung cancer at six years. Among the more than 500 individuals who were diagnosed with lung cancer, 70% died from it and 18% died of other causes, and the median survival times for lung cancer cases was 2.7 years. The combined 4MP and PLCO model had an area under the curve (AUC) of 0.88 for the prediction of lung cancer-specific mortality. The performance of this combined model using both clinical demographic and also a blood-based panel was higher than the ones of the two models considered alone. Furthermore, the model had similar predictive performance for both non small cell lung cancer and small cell lung cancer-related deaths.
Subsequently, the authors compared the performance of the combined 4MP and PLCO model with the 2013 and 2021 US Preventive Task Force criteria and observed that the combined model had improved sensitivity, specificity, and positive predictive value for the prediction of lung cancer-specific mortality compared to both types of criteria. Finally, the authors assessed whether the combined 4MP and PLCO model were able to determine the survival probability among individuals who had a smoking history of at least 10 pack-years. Cases and non-cases were classified as either test positive or negative according to model scores at the 1.7 and 1% risk threshold at six years. For both thresholds, the combined 4MP and PLCO model identified a significantly higher number of lung cancer deaths in test positive individuals compared with test negative ones.
So, in conclusion, these studies identify patients who are at higher risk of developing lung cancer-specific mortality using a combination of blood-based biomarkers and clinical demographic characteristics. The combined models showed higher sensitivity and specificity and positive predictive value compared to the standard US Preventive Task Force criteria. The results of this study are important because the identification of individuals at higher risk of lung cancer diagnosis and death offers the opportunity for a more favorable tradeoff between potential harms and benefits of the screening process. And so these results could assist in the design of future screening and intervention studies as well as facilitate the uptake of lung cancer screening, especially for those test-positive patients that have a higher risk of lung cancer death. Application of this model could potentially lead to a higher number of patients diagnosed in earlier stages and thus eligible for curative intent treatment.
That concludes this episode of JCO Article Insights regarding a summary of the article "Mortality Benefit of a Blood-Based Biomarker Panel for Lung Cancer on the Basis of the Prostate, Lung, Colorectal, and Ovarian Cohort" by Dr. Irajizad and colleagues.
This is Davide Soldato. Thank you for your attention and stay tuned for the next episode of JCO Article Insights.
The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.
Guests on this podcast express their own opinions, experiences, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
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Sep 14, 2023
Impact of Smoking Cessation on Mortality From Kidney Cancer
Dr. Mahdi Sheikh and Dr. David Zaridze join Dr. Shannon Westin to discuss how quitting smoking after diagnosis may impact survival in kidney cancer.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello everyone, and welcome to another episode of JCO After Hours. This is the podcast where we get in-depth on manuscripts that have been published in the Journal of Clinical Oncology. As always, I'm your host, Shannon Westin, Gynecologic Oncologist and Social Media Editor for the JCO. And I am so excited to be here today. We are going to be discussing the paper, “Smoking Cessation After Diagnosis of Kidney Cancer Is Associated With Reduced Risk of Mortality and Cancer Progression: A Prospective Cohort Study,” which was published in the JCO on March 29, 2023. And this very intriguing paper, I have two of the major authors from this paper. First is Mahdi Sheikh, who is a scientist and epidemiologist at the International Agency for Research on Cancer, the World Health Organization in Lyon, France. Welcome, Dr. Sheikh.
Dr. Mahdi Sheikh: Thank you very much, Dr. Westin, and thanks for having us.
Dr. Shannon Westin: And then with Dr. Sheikh is Dr. David Zaridze. He is the Director of the Department of Clinical Epidemiology at the N.N. Blokhin Russian Cancer Research Center in Moscow and also the President of the Russian Cancer Society. We are with greatness today.
Dr. David Zaridze: Thank you. Thank you very much. Nice to be with you.
Dr. Shannon Westin: Very nice to be with the two of you. So, let's get started. I first wanted to just level set. Could one of you review just the overall incidence of kidney cancer and what proportion of patients with kidney cancer are known to be smokers at diagnosis?
Dr. David Zaridze: The figures I'm going to present are rates. They are adjusted to standard world population. Why am I saying that? Because in America you sometimes use adjustment to the US population. These figures will be different from what you are accustomed to see. Okay, incidence of kidney cancer in Russia, in men, 14.1 per 100,000. I compare this with the United States of America, men, 16.5. Very small difference. Women in Russia, 8 per 100,000. In the United States of America, 8.8 per 100,000 of population. Exactly the same. Very close. These rates are sort of high-ish, but there are very high rates, for example, in the Czech Republic, where rates are more than 20 and other Central European countries. In Russia, kidney cancer mortality in men is 6 per 100,000. In USA, 3 per 100,000. In women in Russia, 1.9. In the United States, 1.3.
I would say that there is a difference in mortality in men, not much in women. The incidence of kidney cancer is increasing in Russia sharply, sharply. Since 1990 it has increased - it’s tripled. It increased from 5 per 100,000 in 1990 to 14 per 100,000 in 2019. Mortality is stable or declining. This is suggesting that kidney cancer is overdiagnosed in Russia and probably elsewhere. But this is not a problem of our discussion now. The frequency of the prevalence of smoking in kidney cancer patients. It is estimated that 15% to 20% of patients with kidney cancer smoke. In Russia, we have results only from our study. 18% of patients smoked at admission to our cancer center.
Dr. Shannon Westin: Got it. Okay, good. Well, that's really helpful, especially to those of us that don't take care of patients with kidney cancer every day. It helps us just understand.
And I guess the next question is what do we know about the impact of tobacco cessation on the risk of kidney cancer? So you were talking about that increasing incidence. How does tobacco cessation impact that?
Dr. Mahdi Sheikh: Tobacco smoking is a known risk factor for kidney cancer and an estimated 17% of the kidney cancer burden worldwide can be attributed to tobacco smoking. There is a recent meta-analysis of 56 studies that was published a few years ago that clearly showed a dose-response relationship between smoking and kidney cancer, meaning that the more cigarettes a day you smoke, the risk of kidney cancer will go up. For example, the risk that was shown for five cigarettes per day was 20%. It goes up until 70% for 30 cigarettes per day. And also with a duration, the more years you smoke, the risk for kidney cancer will go higher.
However, the good news is that when you quit smoking, there is strong evidence that the risk for developing kidney cancer will be lower compared to if you continue smoking. And there is some evidence that shows again dose-response relationship, meaning that the more years you spend in quitting smoking, the lower your risk would be for developing kidney cancer compared to if you continue smoking. So this is not only about renal cancer or kidney cancer but also true about many other cancer sites as well.
Dr. Shannon Westin: Okay, that's super helpful. And then I guess prior to your study that we're about to talk about, did we have any information on what happens when patients quit smoking after their diagnosis? Any limitations to those data that were available?
Dr. David Zaridze: You mean the data which was prior our study? You know, the negative effect of smoking after diagnosis has been shown nearly three decades ago. The information exists already for thirty years, but it was largely ignored not only in clinical practice but also in clinical trials. And I have to stress that in clinical trials this information is still ignored. I came across these studies and decided to review them some time ago. All they were case-control studies and to my knowledge, none of them assessed the effect of quitting smoking. I decided to review these studies and included this review in my book, Smoking: A Major Cause of Cancer, which was published in 2012 and was dedicated to Professor Richard Doll's anniversary. In fact, this was a stimulus for the study we are discussing. And in fact, the component of this study we are discussing today was built in and baked into the existing cohort study to which we added the active follow-up component for assessing the changes in smoking habit and disease status.
Dr. Mahdi Sheikh: If you review the evidence, before publishing this study just like a few years ago, we find that there are many studies published talking about the effects of smoking cessation on cancer survival. However, as David mentioned when you go deep into these studies, you’ll find a lot of limitations. First of all, most of these studies are retrospective studies, which means that either case-control or retrospective course that patients developed the outcome, and then some investigators came to see their records to assess or ask family members before they developed the outcomes. There are a lot of biases with these types of studies. And with the epidemiologic study, perspective study that we did, has less limitations compared to retrospective ones.
Another one is that when we go into the study you see, they only assess a small number of patients, small sample size. Some studies just assess 10 smokers, some assess like 30. By this study we try to assess a large number of smokers who quit smoking after diagnosis. Another limitation is that– First, let's see what exposure and what setting we are talking about. We're talking about smoking which is a very dynamic behavior. People quit smoking and they relapse smoking and they quit smoking and so on. So if you access this exposure for only a limited time, for example, for one year, then you may miss what happens after that which results in misclassification of some of the participants. So repeated assessment was not done in other studies that we did here in this study.
Another one, you are talking about special setting patients who are diagnosed with cancer. These patients have special circumstances, they have treatments, they have family support, they might go under the stress of cancer, and all these different stages at diagnosis…
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Sep 10, 2023
HER3-DXd in EGFR-Mutated NSCLC: HERTHENA-Lung01
Dr. Shannon Westin and her guest, Dr. Helena Yu discuss the paper "HERTHENA-Lung01, a Phase 2 Trial of Patritumab Deruxtecan (HER3-DXd) in EGFR-Mutated NSCLC Following EGFR TKI Therapy and Platinum-Based Chemotherapy" published in the JCO during the World Conference on Lung Cancer in Singapore.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast where we get in-depth on manuscripts that are published in the Journal of Clinical Oncology. I am your host, Dr. Shannon Westin, GYN Oncologist and Social Media Editor of the JCO. And as always, it's my pleasure to review an incredibly exciting manuscript.
Today, we're going to be talking about “HERTHENA-Lung01: A Phase II Trial of Patritumab Deruxtecan (HER3-DXd) in EGFR-mutated NSCLC Following EGFR TKI Therapy and Platinum-based Chemotherapy.” And this is exciting. This is a simultaneous publication in the JCO on September 10th, 2023 at the same time it's being presented at the World Conference on Lung Cancer in Singapore.
I am joined today by the first author and overall outstanding physician, Helena Yu. She's an Associate Attending Physician, Thoracic Oncologist, and Early Drug Development Specialist at Memorial Sloan Kettering Cancer Center in New York, New York.
Welcome, Dr. Yu.
Dr. Helena Yu: Thank you. I'm glad to be here, and thanks for having me.
Dr. Shannon Westin: So we're so excited to have you, and we love doing these simultaneous podcasts because I think not everyone can go to Singapore and be with you today. So it's awesome that we'll be able to give people the data that they want to see as soon as possible.
So first, let's just level set. Coming from the GYN Oncology standpoint, I always like to get down to the basics of the cancer. So, can you speak just a little bit about the incidence and mortality of lung cancer overall and what have been some recent trends in the treatment of this disease?
Dr. Helena Yu: Everyone knows somebody that has been touched by lung cancer. It's the second most common cancer that is diagnosed in men and women in the US today. It is the leading cause of cancer-related deaths, with 25% of cancer deaths really being attributable to lung cancer. Historically, prognosis with lung cancer has been poor, with five-year survivals around 10%. What's really interesting is over the last couple of years, there have been some improvements in survival with lung cancer. And I think that that can largely be attributed to the advent of immunotherapies as standard of care, as well as targeted therapies for driver mutation-positive lung cancer.
Dr. Shannon Westin: So that leads right into the next question: What is the role of the EGFR pathway in lung cancer? How common are these aberrations and how successful have prior treatments targeting this pathway been?
Dr. Helena Yu: Yes. So we, in lung cancer, have this mutation pie, which really describes the different oncogenes that we see in lung cancer. And probably now two-thirds of patients actually have a detectable driver mutation when their tumors undergo next generation sequencing. EGFR is probably one of the first mutations that was identified. About 15% to 20% of patients diagnosed with lung cancer in the US have mutations in EGFR. It is both activating and sensitizing. So, obviously mutations in EGFR cause cancer and they are sensitizing to different EGFR targeted therapies we have.
Right now, the standard of care for first-line treatment for EGFR mutant lung cancer are EGFR tyrosine kinase inhibitors. And those are oral therapies that actually are very successful at managing EGFR mutant lung cancer. They're not curative, but they do kind of control disease for a long period of time. But unfortunately for all patients, at some point their cancer does progress on these targeted therapies. And the most common one we use today is one called osimertinib, which is a third-generation EGFR TKI. And we do not have any approved targeted therapies after osimertinib. And so that kind of is the setting for this new drug, patritumab-deruxtecan.
Dr. Shannon Westin: So tell us a little bit about HER3-DXd and why you prioritize targeting this particular part of the EGFR pathway in this population.
Dr. Helena Yu: Yes. So HER3 is actually part of the HER EGFR family, and it is a protein that, when expressed, really portends a poor prognosis. It kind of tells us cancers that are more likely to recur and cancers where overall survival is shorter. So HER3-DXd is an antibody drug conjugate. There are a slew of new medicines in lung cancer that are ADCs. Historically, we looked at HER3 monoclonal antibodies in EGFR mutant lung cancer and they actually were not successful, not efficacious. And so it's really interesting that using these antibodies as part of an ADC construct has led to better efficacy.
The HER3-DXd has that HER3 monoclonal antibody, there is a linker and then there is a chemotherapy payload. So for the deruxtecan family of which there are a few ADCs has a topoisomerase 1 chemotherapy, and in part, we know that HER3 is sort of more significantly expressed in these EGFR mutant lung cancers. And because HER3 is part of the EGFR family and heterodimerizes with EGFR, it was sort of a natural initial population to study this drug.
Dr. Shannon Westin: Why don't you briefly highlight the design of the trial and your key eligibility for our listeners?
Dr. Helena Yu: So this phase II study came off the heels of an initial phase I study that helped us identify the appropriate dose of HER3-DXd for patients with EGFR mutant lung cancer. And so this study enrolled patients with metastatic EGFR mutant lung cancer. All patients had to have received EGFR TKI, most of them received osimertinib and that's first line standard of care globally. And then also patients had to receive platinum doublet chemotherapy, which is really our second line standard of care treatment.
The initial study randomized patients to two cohorts. One, which was all patients received 5.6 milligrams per kilogram every three weeks intravenous. The other cohort was an uptitration cohort, where they actually started with lower doses and then kind of sequentially over cycles increased the dose to see if that mitigated toxicity based on emerging phase I data that really showed that the 5.6 milligram per kilogram had the better efficacy as well as better toxicity profile. Pretty soon after the study started, all patients received that 5.6 mg per kilogram.
And I think the other important thing to say is that patients with asymptomatic brain metastases were allowed. Lung cancer, in general, has a very high incidence or frequency of brain metastases. But in EGFR mutant lung cancer that number is north of 50%. So having a therapy that is effective in the CNS is especially important for this population.
Dr. Shannon Westin: So let's talk a little bit more about this population. The group that you enrolled and treated, is it representative of the general population that we might see in the community?
Dr. Helena Yu: Yes, I think so. I think that one thing to highlight are these patients were pretty heavily pretreated. The median prior lines of therapy were three lines prior to study enrollment, but I think that went up to eleven for certain patients. And so that is one thing that I think is unique about this population, where they're able to sort of receive several sequential therapies. I think it was unique in allowing those asymptomatic brain metastases and then EGFR mutant lung cancer has certain demographic tendencies. And so we see women, Asian, never smokers, which may not kind of represent the typical demographic for lung cancer, but certainly is the typical demographic for EGFR mutant lung cancer.
Dr. Shannon Westin: Got it. And let's hear about your primary results. What did you discover?
Dr. Helena Yu: To set the stage, this is re…
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Aug 28, 2023
JCO Article Insights: Introducing The Childhood Cancer Data Initiative
In this JCO Article Insights episode, Emily Zabor interviews Dr. Gregory H. Reaman, the Scientific Director of the Childhood Cancer Data Initiative at the National Cancer Institute, on their paper titled “The Childhood Cancer Data Initiative: Using the Power of Data to Learn From and Improve Outcomes for Every Child and Young Adult with Pediatric Cancer”. Dr. Reaman introduces us to the initiative, its goals and structure, and what has already been achieved since its launch.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Emily Zabor: Welcome to this JCO Article Insights episode for the August issue of JCO. This is Emily Zabor, JCO's Biostatistics Editorial Fellow. And today I am interviewing Dr. Gregory Reaman, the Scientific Director of the Childhood Cancer Data Initiative at the National Cancer Institute, on their paper titled “The Childhood Cancer Data Initiative: Using the Power of Data to Learn from and Improve Outcomes for Every Child a…
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Aug 2, 2023
Impact of Heatwaves on the Care of Patients With Cancer
Dr. Shannon Westin, Dr. Abbas M. Hassan, and Dr. Leticia Nogueira discuss the impact of heatwaves on cancer care delivery and what can be done about it.
TRANSCRIPT
The guests on this podcast episode have no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast where we get in-depth on manuscripts that are published in the Journal of Clinical Oncology. I am your host, Shannon Westin, GYN Oncologist and Social Media Editor for the Journal of Clinical Oncology. I'm so excited to be here today to discuss a very thought-provoking manuscript. This was published on June 10, 2023, in the Comments and Controversies section of JCO, and it’s entitled “Impact of Heatwaves on Cancer Care Delivery: Potential Mechanisms, Health Equity Concerns, and Adaptation Strategies.”
And I am thrilled to tell you I am joined today by two of the authors of this very important manuscript. Dr. Abbas Hassan is an intern in the Divisi…
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Jul 21, 2023
JCO Article Insights: Immunotherapy in People Living with HIV and Cancer
In this JCO Article Insights episode, Davide Soldato interviews Dr. Naqash from University of Oklahoma. Dr. Naqash provides insight into the original article published in the July JCO issue: “Safety and Activity of Immune Checkpoint Inhibitors in People Living With HIV and Cancer: A Real-World Report From the Cancer Therapy Using Checkpoint Inhibitors in People Living With HIV-International (CATCH-IT) Consortium”. The interview offers a deep dive into the manuscript results on efficacy and safety of Immune Checkpoint Inhibitors in this specific population and offers insights on future research direction in this space.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Davide Soldato: Welcome to this JCO Article Insights episode for the July issues of JCO. This is Davide Soldato and today I will have the pleasure of interviewing Dr. Abdul Rafeh Naqash, the author of the manuscript titled "Safety and Activity of Immune Checkpoint Inhibitors in People…
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Jul 13, 2023
Racial/Ethnic Differences Discovered in Multigene Germline Testing of Early-Onset Colorectal Cancer
Dr. Shannon Westin and her guest, Dr. Andreana Holowatyj, discuss the paper "Clinical Multigene Panel Testing Identifies Racial and Ethnic Differences in Germline Pathogenic Variants Among Patients With Early-Onset Colorectal Cancer," recently published in JCO.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of the JCO After Hours podcast, the podcast where we get in-depth on manuscripts and interesting papers that are published in the Journal of Clinical Oncology. I am your host, Shannon Westin, and it's my pleasure to serve not only as a GYN Oncologist but as an Associate Editor for Social Media for the JCO. And as always, I'm super excited about the paper that we're going to discuss today. This is “Clinical Multigene Panel Testing Identifies Racial and Ethnic Differences in Germline Pathogenic Variants Among Patients With Early-Onset Colorectal Cancer.” This has been published in…
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Jun 26, 2023
JCO Article Insights: Two New Prediction Models for Risk of Venous Thromboembolism in Cancer Patients
In this JCO Article Insights episode, Emily Zabor summarizes two original articles from the June 1st, 2023 Journal of Clinical Oncology issue: “A Clinical Genetic Risk Score for Predicting Cancer-Associated Venous Thromboembolism: A Development and Validation Study Involving Two Independent Prospective Cohorts” by Muñoz et al, and “Derivation and Validation of Clinical Risk Assessment Model for Cancer Associated Thrombosis in Two Unique Healthcare Systems” by Li et al, as well as the accompanying editorial “Fine Tuning Venous Thromboembolism Risk Prediction in Patients with Cancer” by Jean Marie Connors. The original reports describe the development and validation of two new risk prediction models for venous thromboembolism in cancer patients and the editorial puts them into context of existing tools.
TRANCRIPT
The guest on this podcast episode has no disclosures to declare.
Emily Zabor: Welcome to JCO Article Insights for the June 1st, 2023 issue of JCO. I…
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Jun 22, 2023
Olanzapine for Chemotherapy-Related Anorexia
Dr. Shannon Westin, Dr. Lakshmi Sandhya, and Dr. Prasanth Ganesan discuss the use of olanzapine to treat chemotherapy-related anorexia, as recently published in JCO.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast where we get in-depth on manuscripts published in the Journal of Clinical Oncology. As always, I'm your host, Dr. Shannon Westin, GYN Oncologist and Social Media Editor for JCO. I'm very excited to be here today.
And please note that our participants do not have any conflict of interest.
So we are going to discuss a really exciting paper today entitled the "Randomized, Double-Blind, Placebo-Controlled Study of Olanzapine for Chemotherapy-Related Anorexia in Patients with Locally Advanced or Metastatic Gastric, Hepatopancreaticobiliary, and Lung Cancer." And this was published in the JCO on March 28, 2023, and has gotten a lot of excitement.…
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Jun 4, 2023
PROSPECT Trial (Alliance N1048): PROs During and After Treatment for Locally Advanced Rectal Cancer
Host Dr. Shannon Westin interviews guests Dr. Ethan Basch and Dr Deborah Schrag on their JCO simultaneous publication paper at ASCO's 2023 annual meeting: "Patient-reported outcomes during and after treatment for locally advanced rectal cancer (Alliance N1048).
TRANSCRIPT
The Disclosure for guests on this podcast can be found in the show notes
Dr. Shannon Westin: Hello, and welcome to another episode of JCO After Hours, the podcast where we get in-depth on articles that are published in the Journal of Clinical Oncology. It is your host, Shannon Weston, GYN Oncologist and Social Media Editor for the JCO. And I'm so thrilled to bring you our first podcast that will be a simultaneous podcast JCO publication and ASCO presentation at ASCO 2023, dropping on June 4, 2023. And it is an exciting one. We'll be discussing “Patient-reported Outcomes During and After Treatment for Locally Advanced Rectal Cancer: The PROSPECT Trial Alliance N1048” (10.1200/JCO.23.00903)
And let me intr…
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May 29, 2023
JCO Article Insights: Smoking Cessation for Patients with Cancer
In this JCO Article Insights episode, Davide Soldato summarizes three articles from the May 20th, 2023 Journal of Clinical Oncology issue: “Smoking Cessation After Diagnosis of Kidney Cancer Is Associated With Reduced Risk of Mortality and Cancer Progression: A Prospective Cohort Study, “Efficacy of a Smoking Cessation Intervention for Survival of Cervical Intraepithelial Neoplasia or Cervical Cancer: A Randomized Control Trial” and “Integrating Tobacco Treatment into Oncology Care: Reach and Effectiveness of Evidence-Based Tobacco Treatment across National Cancer Institute Designated Cancer Centers.” The articles discuss clinical outcomes in survivors of cancers who quit smoking, efficacy of a novel smoking intervention and implementation of tobacco treatment programs.
TRANSCRIPT
Davide Soldato: Welcome to this JCO After Hours issue summary for the May issues of the Journal of Clinical Oncology. This is Davide Soldato and today I will be reporting results from three arti…
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May 15, 2023
JCO Article Insights: Use of Independently-Assessed vs Investigator-Assessed DFS in the APACT Trial
In this JCO Article Insights episode, Emily Zabor interviews Dr. Gulam Manji from Columbia University Irving Medical Center. Dr. Manji provides insight into his editorial published in the April 10, 2023 JCO issue: "Adjuvant Gemcitabine and Nab-Paclitaxel Misses the Target in Pancreas Adenocarcinoma: Or Did an Effective Therapy Fall to the Definition of Recurrence?” (10.1200/JCO.23.00039). His editorial focuses on the JCO Original Report, “Adjuvant nab-Paclitaxel + Gemcitabine in Resected Pancreatic Ductal Adenocarcinoma: Results From a Randomized, Open-Label, Phase III Trial” by Tempero, et al on the APACT Trial.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Emily Zabor: Welcome to this JCO Article Insights episode for the April issue of JCO. This is Emily Zabor, one of JCO's editorial fellows. And today I am interviewing Dr. Manji from Columbia University on their editorial titled “Adjuvant Gemcitabine and Nab-Paclitaxel Misses the Target in P…
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May 11, 2023
Peritumoral Anesthetic Infiltration Impacts Survival in Early Breast Cancer
Dr. Shannon Westin, Dr. Rajendra Badwe, and Dr. Alastair Thompson discuss the JCO paper "Effect of Peritumoral Infiltration of Local Anesthetic Before Surgery on Survival in Early Breast Cancer."
TRANSCRIPT
The guests on this podcast episode have no disclosures to declare.
Dr. Shannon Westin: Hello, and welcome to another episode of JCO After Hours, the podcast where we get in-depth on manuscripts that are published in the Journal of Clinical Oncology. I am your host, Shannon Westin, gynecological oncologist by trade, but serve as our JCO Social Media Editor. And I'm super excited to talk to you about a paper that was just published online, April 6, 2023, entitled “The Effect of Peritumoral Infiltration of Local Anesthetic Before Surgery on Survival in Early Breast Cancer.”
Before we start, I just note that our guests have no conflicts of interest.
And so I'm accompanied by two greats in the field. First is the principal investigator on this trial, Dr. Rajendra Badwe, who is…
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Apr 27, 2023
Intensive Caring: Reminding Patients They Matter
Dr. Shannon Westin and her guest, Dr. Harvey Max Chochinov, discuss his article "Intensive Caring: Reminding Patients They Matter."
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and thank you so much for joining us for another JCO After Hours podcast. This is the podcast that gets in depth in manuscripts published in the Journal of Clinical Oncology. I'm your host, Shannon Westin, GI oncologist by trade and honored to serve as the Social Media Editor for the JCO.
And today we're going to be discussing a really exciting paper in the Comments and Controversies section called “Intensive Caring: Reminding Patients They Matter.” This has been recently published, and I'm so excited to have the author of this paper join us today, Dr. Harvey Max Chochinov, who is a distinguished professor in the Department of Psychiatry in the University of Manitoba, senior scientist with Cancer Care Manitoba Research Institute, and th…
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Apr 13, 2023
Barriers to Clinical Trial Participation for Transgender People
What factors could be excluding transgender people from oncology clinical trials, and what can we do to make them more inclusive? Dr. Westin discusses this important issue with her guests, Dr. Ash Alpert and Dr. Lola Fashoyin-Aje.
TRANSCRIPT
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of the JCO After Hours podcast. This is when we get down and dirty into manuscripts that are published in the Journal of Clinical Oncology. And I am so excited about our topic today. We are going to be discussing a Comments and Controversies article that was published online in JCO October 27, 2022, and it's entitled “Addressing Barriers to Clinical Trial Participation for Transgender People With Cancer to Improve Access and Generate Data.” And please note all authors do not have any conflicts of interest.
It is my great honor to be accompanied today by two of the co-authors on this important manuscript. First is Dr. Ash Alpert, and they are an Agency for Healthcare Research…
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Mar 27, 2023
JCO Article Insights: Trial Update on Development of Children After Maternal Cancer During Pregnancy
In this JCO Article Insights episode, Davide Soldato interviews Dr Frederic Amant from UZ Gasthuisberg - Katholieke University Leuven. Dr. Amant discusses his clinical trial update published in the March 10, 2023 JCO issue, "Cognitive and Behavioral Development of 9-Year-Old Children After Maternal Cancer During Pregnancy: A Prospective Multicenter Cohort Study", by Van Assche, et al. From the International Network on Cancer, Infertility and Pregnancy, the article reports the cognitive development of 9-year-old children after maternal cancer during pregnancy.
TRANSCRIPT
The disclosures for the guest on this podcast can be found in the show notes.
Davide Soldato: Welcome to this JCO Article Insights episode for the March issue of JCO. This is Davide Soldato, and today I will have the pleasure of interviewing Dr. Frédéric Amant, corresponding author of the manuscript titled ‘Cognitive and Behavioral Development of 9-Year-Old Children After Maternal Cancer During Pregnancy: A Pro…
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Mar 23, 2023
Cancer Screening During the 2nd Year of the COVID-19 Pandemic
Dr. Shannon Westin and her guests, Jessica Star and Dr. Ahmedin Jemal, discuss how the COVID-19 pandemic affected cancer screening in the US in 2021.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours. I am your host, Shannon Westin, the social media editor for the JCO and Gynecological Oncologist at MD Anderson. And it's my pleasure to welcome you to our next episode, which is “Cancer Screening in the United States During the Second Year of the COVID-19 Pandemic.” And please note the authors have no conflict of interest.
I'm joined by two of the authors on this important work. First is Jessica Star, who has an MA and an MPH and is Associate Scientist II for Cancer Risk Factors and Screening Surveillance Research at the American Cancer Society. Welcome.
Jessica Star: Thank you for having me.
Dr. Shannon Westin: Of course. And we're also joined by Dr. Ahmedin Jemal,…
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Mar 9, 2023
Sequencing Matters – Combination Dabrafenib/Trametinib Versus Nivolumab/Ipilimumab for Advanced BRAF-Mutant Melanoma: The DREAMseq Trial
Dr. Shannon Westin and her guests, Dr. Michael Atkins, Dr. Adil Daud, and Dr. Gary Schwartz, discuss a definitive work: The DREAMseq Trial.
TRANSCRIPT
The guests on this podcast episode have no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast that gets in-depth on articles that have been published in the Journal of Clinical Oncology. And it is my great pleasure to be your host. I'm Shannon Westin, GYN oncology, and I serve as the social media editor for the Journal of Clinical Oncology.
Today, we're going to be discussing a very exciting article describing “The DREAMseq Trial—ECOG-ACRIN EA6134, Combination Dabrafenib and Trametinib Versus Combination Nivolumab and Ipilimumab for Patients With Advanced BRAF-Mutant Melanoma.” This article was published in the JCO on January 10th, 2023.
And I am joined today by the lead author, Dr. Michael Atkins, who is Deputy Director, Georgetown Lombardi University H…
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Feb 27, 2023
JCO Article Insights: Phase III POSEIDON Clinical Trial Results
In this JCO Article Insights episode, Emily Zabor summarizes two articles from the February 20th, 2023 Journal of Clinical Oncology issue: "Durvalumab With or Without Tremelimumab in Combination With Chemotherapy as First-Line Therapy for Metastatic Non–Small-Cell Lung Cancer: The Phase III POSEIDON Study" by Johnson, et al and "The POSEIDON Trial: Will Secondary End Points Change Our Clinical Practice?" by Remon, et al.
The Original Report by Johnson, et al describes results of the Phase III POSEIDON clinical trial. The accompanying editorial by Remon, et al discusses the findings of a significant progression-free survival and overall survival benefit for the combination of tremelimumab plus durvalumab plus chemotherapy as compared to chemotherapy alone, which were secondary endpoints in the trial.
TRANSCRIPT
Emily Zabor: Welcome to JCO Article Insights for the February 20, 2023, issue of JCO. I’m your host, Emily Zabor, JCO Biostatistics Editorial Fellow.
Today, I will be pro…
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Feb 23, 2023
One-Stop-Shop Comprehensive Cancer Screening Center Focused on Asymptomatic Screening
Dr. Shannon Westin, Dr. Ezra Bernstein, and Dr. Nadir Arber discuss increasing cancer prevention and early detection with a one-stop-shop comprehensive cancer screening center.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, our podcast where we get in-depth on manuscripts that have been published in the Journal of Clinical Oncology. I am your host, Shannon Westin, GYN oncologist and social media editor of the JCO. And I am thrilled to be discussing this very interesting paper entitled “Data From a One-Stop-Shop Comprehensive Cancer Screening Center,” focused on asymptomatic screening.
And this very important work was published by these two authors who are joining me today. We have Dr. Nadir Arber, professor of Medicine and Gastroenterology, head of the Integrated Cancer Prevention Center, head of the Cancer Prevention section of the European Society of Medical On…
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Feb 9, 2023
Improving Transparency in Phase 1 Clinical Trials
Dr. Shannon Westin and her guests, Dr. Paul Frankel, Dr. Judith Karp, and Dr. Robert Maki discuss how to better inform patients of the risks involved in phase 1 clinical trials.
TRANSCRIPT
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of the Journal of Clinical Oncology After Hours podcast, where we do a deep dive on manuscripts that are published in the Journal of Clinical Oncology. We're so excited to have you all here today. I am your host, Shannon Westin, GYN Oncologist at MD Anderson Cancer Center, and it's my great pleasure to serve as the social media editor of the JCO and the host of this podcast. Today we are going to be discussing a very important manuscript titled “Ethics and Clinical Research: Improving Transparency and Informed Consent in Phase 1 Oncology Trials”. And I'm joined today by several of the authors, as well as one of our editors that helped to review this paper. But before I start, I'll note that none of our authors have any conflict…
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Jan 30, 2023
JCO Article Insights: Elderly Patients Receiving Chemotherapy for Early-Stage Breast Cancer
In this JCO Article Insights episode, Davide Soldato summarizes two articles from the January 10th, 2023 Journal of Clinical Oncology issue: “Low-Intensity Chemotherapy for Early Breast Cancer in Older Women: Results From the Prospective Multicenter HOPE Trial” and “Inflammation and Clinical Decline After Adjuvant Chemotherapy: Results From the Hurria Older Patients Prospective Study .” Both articles report on clinical outcomes of elderly patients treated with chemotherapy for early-stage breast cancer.
TRANSCRIPT
Davide Soldato: Thank you for joining JCO Article Insights. I'm Davide Soldato. Today I will be providing summaries for two different articles focused on elderly patients treated for early-stage breast cancer. Both articles are reported from the Hurria Older Patients With Breast Cancer Study. This study is also known as the HOPE Study, and it was a multicenter, prospective, study of patients aged 65 years and older treated with current standard (Neo)adjuvant chemoth…
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Jan 20, 2023
Ensuring Employment After Cancer Diagnosis
Dr. Shannon Westin discusses ways to ensure continued employment for cancer patients with her guests, Dr. Cathy Bradley, Dr. Tina Shih, and Dr. Robin Yabroff.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast for the Journal of Clinical Oncology where we get in-depth on manuscripts that have been recently published in the journal.
Today, we're going to be talking about a Comments and Controversies article titled “Ensuring Employment After Cancer Diagnosis: Are Workable Solutions Obvious?” This was published online November 3, 2020. And I'm thrilled that we're accompanied by all three of the fantastic authors of this manuscript, including Dr. Cathy Bradley, who is professor and Associate Dean for Research at the Colorado School of Public Health and Deputy Director of the University of Colorado Cancer Center. Welcome, Dr. Bradley.
Dr. Cathy Bradley: Thank…
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Dec 9, 2022
Intersectional Maxims for a New Era in Modern Medicine
Dr. Shannon Westin and Dr. Stephanie Graff discuss a revision to the famous "Simone's Maxims" and the broader nature of intersectionality.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, where we get in-depth on articles that have been published in the Journal of Clinical Oncology.
I am your host, Shannon Westin, a GYN Oncologist, and Professor at MD Anderson Cancer Center, and I'm honored to serve as the Social Media Editor of the Journal of Clinical Oncology.
Today, we're going to be discussing the very important work called “Understanding Modern Medical Centers: Beyond Simone—Intersectional Maxims for a New Era.” And this was published online in the JCO on September 27th, 2022. And joining me to discuss this important work is Dr. Stephanie Graff, who is the Director of Breast Oncology at the Lifespan Cancer Institute at the Warren Alpert Medical School, Bro…
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Nov 21, 2022
Does Medicare Advantage Lead to a Disadvantage for Patients Who Need Surgery for Cancer?
Dr. Shannon Westin and Dr. Mustafa Raoof discuss the paper "Medicare Advantage: A Disadvantage for Complex Cancer Surgery Patients."
TRANSCRIPT
Dr. Shannon Westin: Well, hello, everyone, and welcome back to another episode of the JCO After Hours podcast, where we get in-depth on articles that have been published in the JCO.
I am your host Shannon Westin, and it is my pleasure to serve as the Social Media Editor for the Journal of Clinical Oncology, as well as a Professor in GYN Oncology at The MD Anderson Cancer Center in Houston.
And today, I am very excited to be discussing a paper that was recently published in the JCO called “Medicare Advantage: A Disadvantage for Complex Cancer Surgery Patients.” And I am accompanied today by Dr. Mustafa Raoof, and he has no conflicts of interest to disclose. He is an Assistant Professor in the division of Surgical Oncology, Department of Surgery, and an Assistant Professor in the Department of Cancer Genetics and Epigenetics at the City o…
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Nov 3, 2022
Lack of Gender Equity in Oncology Clinical Trial Advisory Board Membership
Shannon Westin, Pamela Kunz, and Rachna Shroff discuss the lack of gender equity on oncology industry advisory boards.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of the JCO After Hours podcast; our podcast where we get in-depth for articles in the Journal of Clinical Oncology.
I am your fearless leader, and host, Shannon Westin, the Social Media Editor for the JCO, as well as a Professor of Gynecologic Oncology at MD Anderson Cancer Center. And I am so excited to introduce our two guests today. We are going to be discussing the article from the JCO, 'Where Are All the Women in Industry Advisory Boards?'
And none of my guests have Conflict of Interest related to this work.
So, first, let me introduce Dr. Rachna Shroff, she is from the University of Arizona, Tucson. She's not only the Interim Chief of the Division of Hematology/Oncology, she's the Associate Dean of Clinical and Tran…
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Nov 1, 2022
Universal Germline Genetic Testing in GI Malignancies
Dr. Shannon Westin discusses germline genetic testing in gastrointestinal cancer with Heather Hampel and Dr. Matthew B. Yurgelun.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours. This is our podcast where we get down in the nitty-gritty of articles that are published in the Journal of Clinical Oncology.
I am your fearless leader and host, Shannon Westin, the Social Media Editor of the Journal of Clinical Oncology, as well as Professor of Gynecologic Oncology at The University of Texas, MD Anderson Cancer Center.
And I am very excited to bring two guests in today to discuss a review article that was published in a special series on, 'Precision Medicine and Immunotherapy in GI Malignancies,' back in June of 2022, and this is, 'Point/Counterpoint: Is It Time for Universal Germline Genetic Testing for All GI Cancers?'
And please note that our participants have noted no Confl…
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Sep 20, 2022
Light From Darkness - Navigating Postmortem Tissue Donation
On this episode, our guests discuss how postmortem tissue donation can provide meaning to patients and their loved ones.
TRANSCRIPT
Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours. This is when we get in-depth on articles that are published in the Journal of Clinical Oncology. I am your host, Shannon Westin, GYN Oncologist and Social Media Editor of the JCO.
Excited to be here today to discuss a really awesome paper. It was a Comments and Controversies named “Postmortem Tissue Donation: Giving Families the Ability to Choose,” just published on August 26th, 2022.
And I'm joined by a number of the authors. It's going to be a really incredible discussion. I'd like to introduce each of them, and then we'll get right down to it.
First is Allen Gustafson. He is the founder of the Swifty Foundation, which he started with his son, Michael, who sadly died in 2013 of medulloblastoma. And this foundation really was the catalyst of the group Gift fro…
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Sep 12, 2022
Physical Activity Improves Survival in Colorectal Cancer
Dr. Westin and Dr. Justin C. Brown discuss how physical activity can improve disease-free and overall survival in colorectal cancer and its potential application across all cancer types.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Westin: Hello, everybody, and welcome to another episode of JCO After Hours, the podcast where we get in depth on recent manuscripts published in the Journal of Clinical Oncology. And it is my great pleasure today to tell you we're going to be talking about a really important manuscript: “Physical Activity in Stage III Colon Cancer: CALGB/SWOG 80702 Alliance Study.” And this was published in the JCO on August 9th, 2022.
All participants in the podcast have no conflicts of interest.
And I am very excited to welcome the first author on this important paper, Dr. Justin C. Brown.
He is the Director of the Cancer Metabolism Program and Assistant Professor in Cancer Energetics at the Pennington Biomedical Research Cente…
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Aug 29, 2022
Food Insecurity Interventions for Cancer Survivors With Dr. Francesca Gany and Dr. Theresa Hastert
Shannon Westin, Francesca Gany, and Theresa Hastert discuss the topic of food insecurity among patients with cancer.
TRANSCRIPT
Dr. Shannon Westin: The guest on this podcast episode has no disclosures to declare.
Hello friends and welcome to another episode of JCO After Hours, your podcast to get more in-depth on some of the amazing work that has been published in the Journal of Clinical Oncology.
I am thrilled to be here today with two fantastic investigators and researchers who are going to discuss a paper that is titled “Food to Overcome Outcomes Disparities – A Randomized Control Trial of Food Insecurity Interventions to Improve Cancer Outcomes.”
This was published online in the JCO on June 16, 2022. We're joined by the principal investigator Dr. Francesca Gany, who is the Chief of Immigrant Health and Cancer Disparities service at the Memorial Sloan Kettering Cancer Center in New York City.
In addition to Dr. Gany, we're also joined by Dr. Theresa Hastert, who's an ass…
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Jun 17, 2022
How to Confront Climate Change: A Framework for Change in the Operating Room and Hospital as a Whole. A Conversation with Dr. Anaeze Offodile and Dr. Elizabeth Yates
Dr. Shannon Westin discusses the topic of climate change in the operating room with Dr. Anaeze Offodile and Dr. Elizabeth Yates.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin: Hey everybody! Welcome back to JCO After Hours, a podcast where we get a little bit more intense, a little bit more specific about articles that are published in the Journal of Clinical Oncology.
My name is Shannon Westin, and it is my honor to serve as the social media editor for the JCO. I'm an associate professor at the University of Texas MD Anderson Cancer Center and a gynecologic oncologist.
Today, we are going to be discussing a really exciting paper which was published in the March online JCO. It's a Comments and Controversies piece called, “Prescriptions for Mitigating Climate Change-Related Externalities in Cancer Care: A Surgeon's Perspective.”
I have several guests with me today, none of whom have any conflict of interest.
The first is Dr. An…
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Apr 1, 2022
JCO After Hours: A Discussion With Veena Shankaran and Scott Ramsey
Shannon Westin, Veena Shankaran, and Scott Ramsey discuss the issue of financial toxicity among low- and middle-income cancer patients.
TRANSCRIPT
The guest on this podcast episode has no disclosures to declare.
Dr. Westin: Welcome to JCO After Hours. I am your fearless leader, Shannon Westin, the editor for social media of the Journal of Clinical Oncology, and it's my great pleasure to bring you another episode.
Today, we are going to be talking about a paper published in the January 7th version of the JCO called “Risk of Adverse Financial Events in Cancer Patients: Evidence From a Novel Linkage Between Cancer Registry and Credit Records.” And none of the participants have any conflicts of interest.
I am joined by two amazing people. First, let me introduce Dr. Veena Shankaran. She is a physician in the Seattle Cancer Care Alliance, professor in the Division of Medical Oncology at the University of Washington School of Medicine, and co-director of the Hutchinson Institute for…
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Feb 21, 2022
JCO After Hours: A Discussion With Virginia Sun
Shannon Westin and Virginia Sun discuss the JCO article "Patient-Reported Outcome-Based Symptom Management Versus Usual Care After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial"
TRANSCRIPT
Speaker 1:
The guest on this podcast episode has no disclosures to declare.
Dr. Shannon Westin:
Hello everyone. This is Dr. Shannon Westin, your JCO Social Media Editor here with another episode of Journal Clinical of Oncology After Hours Podcast. So excited to bring you in depth discussion on some of the amazing studies and manuscripts that have been published in the JCO. I am joined today by Dr. Virginia Sun, who's Associate Professor in the Division of Nursing Research and Education and the Department of Population Sciences Education at City of Hope.
Dr. Shannon Westin:
She has 17 years experiences as an oncology nurse, four years experience as a nurse practitioner, before becoming a full-time nurse scientist. And her research program is meant to develop and test interventi…
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Feb 1, 2022
JCO After Hours: A Discussion With Antonio Di Meglio
Dr. Shannon Westin and Dr. Antonio Di Meglio discuss the issue of fatigue among cancer survivors.
Transcript
[MUSIC PLAYING]
Speaker 1: The guest on this podcast episode has no disclosures to declare.
Shannon Westin (Dr. Westin): Hello, everyone. And welcome to another episode of JCO After Hours. This is our podcast where we get in depth with different authors and experts about wonderful manuscripts that are being published in the Journal of Clinical Oncology. And today it is my great pleasure to be accompanied by Dr. Antonio Di Meglio, who is a Medical Oncologist and a Physician Scientist at the Breast Cancer Survivorship Research Program in Gustave Roussy in France. So welcome, Dr. Di Meglio.
Dr. Antonio Di Meglio (Dr. Di Meglio): Thank you so much for having me here today.
Dr. Westin: We're so excited to have you. We're going to be talking about your article, which is due to be published January 21, 2022, in the Journal of Clinical Oncology titled “The Development and Valida…
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Jan 10, 2022
JCO After Hours: A Discussion With Abby Rosenberg and Reshma Jagsi
Dr. Shannon Westin, Dr. Abby Rosenberg, and Dr. Reshma Jagsi discuss the timely issue of diversity, equity, and inclusion in the field of oncology.
TRANSCRIPT
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SHANNON WESTIN: Hey, everyone and welcome to JCO After Hours, the podcast that gets a little bit more in-depth about some of the articles and amazing research that have been published in the Journal of Clinical Oncology. I'm so excited to be with you today. And more importantly, I'm very excited to talk about this amazing manuscript, which is called "Picture a Professional-- Rethinking Expectations of Medical Professionalism Through the Lens of Diversity, Equity, and Inclusion."
And this was a Comments and Controversies article that was just published in October of 2021. And I am beyond thrilled to be joined by Dr. Abby Rosenberg, who was the lead author on this manuscript. And she is currently an associate professor in the Division of Hematology-Oncology, as well as in the Division of Bioethics and Palliative…
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Dec 7, 2021
JCO After Hours: A Discussion With Michael Gnant and Kathy Miller
Dr. Shannon Westin, Dr. Michael Gnant, and Dr. Kathy Miller discuss the results of the PALLAS trial.
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Nov 19, 2021
JCO After Hours: A Discussion With Kirsten Beyer and Jennifer Griggs
Dr. Shannon Westin, Dr. Kirsten Beyer and Dr. Jennifer Griggs discuss how mortgage lending bias and residential segregation intersect with cancer disparities and survival outcomes.
TRANSCRIPT
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SHANNON WESTIN: Hello, everyone. My name is Shannon Westin, and I'm an Associate Professor at the University of Texas MD Anderson Cancer Center in the Department of Gynecologic Oncology and Reproductive Medicine. And I currently serve as the Social Media Editor for the Journal of Clinical Oncology.
And we're starting a brand new podcast series to try to bring really exciting research that's being published in the JCO to you, and I'm so excited to kick off this series with a group of very accomplished women who are covering something that I don't think a lot of us don't know very much about. So I'm really excited to learn a ton over this next few minutes.
So it's my pleasure to introduce Dr. Kirsten Beyer, who is an Associate Professor in the Division of Epidemiology in the Ins…
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Oct 20, 2021
Is Dose-Adjusted EPOCH-R the Optimal Treatment for Children with Primary Mediastinal B-Cell Lymphoma?
This podcast will discuss data from a phase II trial evaluating the dose-adjusted EOPCH-R chemo-immunotherapy regimen for the treatment of primary mediastinal B-cell lymphoma in children.
TRANSCRIPT
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LISA GIULINO-ROTH: This JCO podcast provides observations and commentary on the JCO article "Dose-Adjusted Rituximab Therapy in Children and Adolescents with Primary Mediastinal B-cell Lymphoma, a Multicenter Phase II Trial" by Burke et al. My name is Lisa Giulino-Roth, and I am a pediatric oncologist at Weill Cornell Medical College in New York. My oncology specialty is lymphoma in children, adolescents, and young adults. I have no relevant disclosures.
Primary mediastinal B-cell lymphoma, or PMBCL, is an aggressive non-Hodgkin lymphoma derived from thymic B-cells. While previously classified as a subtype of diffuse large B-cell lymphoma, PMBCL is now recognized as a distinct clinical and pathologic entity. Unlike diffuse large B-cell lymphoma, PMBCL has a peak incidenc…
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Oct 10, 2021
Steroid Dose and Taxanes
This podcast discusses the study, steroid dose reduction, practice experience, and guidance changes.
TRANSCRIPT
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ROBIN ZON: This JCO podcast provides observations and commentary on the JCO article-- "Do Steroids Matter: A Retrospective Review of Pre-Medication for Taxane Chemotherapy and Hypersensitivity Reactions," by Lansinger et al.
My name is Dr. Robin Zon. And I am the quality oncology practice initiative lead physician for Michiana Hematology Oncology, an independent community oncology practice located in Mishawaka, Indiana. My oncologic specialty is general medical oncology. And I have a strong interest in breast cancer.
This article is based on the premise that there exists significant variation regarding the prescribing practices of steroids for pre-medication to minimize the known hypersensitivity reactions associated with the taxanes paclitaxel and docetaxel. In fact, the authors remind the reader that initial clinical development of paclitaxel was delaye…
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Sep 1, 2021
Commentary on GROINSS VII
Improving care in vulvar cancer via the prospective Vulvar GROINSS VII study
TRANSCRIPT
This JCO Podcast provides observations and commentary on the JCO article “Radiotherapy Versus Inguinofemoral Lymphadenectomy as Treatment for Vulvar Cancer Patients with Micrometastases in the Sentinel Node: Results of GROINSS-V II” by Oonk et al. My name is David Gaffney, and I am a professor and Vice Chair of Radiation Oncology at the University of Utah. I am also Senior Director for Clinical Research at the Huntsman Cancer Institute in Salt Lake City, Utah. My oncologic specialty is radiation oncology. I have no relevant disclosures to this study.
The GROINS VII study is the successor trial of the GROINS V I trial. In the GROINSS-V I study, the authors demonstrated that omission of an inguinal femoral lymphadenectomy was safe in patients with a negative sentinel lymph node with an isolated GROIN recurrence rate of 2.3%. It also showed that with long term follow up a significant proportion…
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Aug 10, 2021
Harnessing the Power of Registries to Understand the Impact of Treatment for Hodgkin Lymphoma on Fertility
Dr. Lindsay Morton of the National Cancer Institute at the National Institutes of Health reflects on research findings by Øvlisen et al that leverage large-scale linked registries in Denmark to suggest that improvements in both chemotherapy treatments and assisted reproductive technologies have made it possible for more survivors of Hodgkin lymphoma to become parents.
TRANSCRIPT
This JCO podcast provides observations and commentary on the JCO article “Rates and Use of Assisted Reproduction Techniques in Younger Hodgkin Lymphoma Survivors: A Danish Population-Based Study of 793 Patients and 3965 Matched Comparators” by Øvlisen and colleagues. My name is Lindsay Morton, and I am a Senior Investigator and Deputy Chief of the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, at the Intramural Research Program of the National Cancer Institute at the National Institutes of Health. I am trained in epidemiology, and my oncologic specialty is in hematologic ma…
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Aug 1, 2021
Subspecialty Palliative Care Involvement May Lessen the Need for High-Intensity End-of-Life Care for Adolescents and Young Adults With Cancer
This podcast describes the findings from a population-based retrospective decedent cohort study which suggest that palliative care involvement may be associated with a decreased need for high intensity of care during the final weeks of life in adolescents and young adults with cancer.
TRANSCRIPT
This JCO Podcast provides observations and commentary on the JCO article “Impact of Palliative Care Involvement on End-of-Life Care Patterns Among Adolescents and Young Adults with Cancer: A Population-Based Cohort Study” by Kassam et al. My name is Erica Kaye, and I am Director of the Quality of Life and Palliative Care Research Division at St. Jude Children’s Research Hospital in Memphis, Tennessee, USA. My oncologic specialty is pediatric palliative oncology.
In this paper, the authors aim to evaluate the prevalence and predictors of high-intensity end-of-life care in adolescents and young adults with cancer in Ontario, Canada, as well as assess the impact of palliative care involve…
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Jul 10, 2021
Can the Incorporation of Minimal Residual Disease Detection Enhance Post-CAR T Outcomes in Patients With Large B-Cell Lymphoma?
Minimal residual disease positivity is predictive of disease progression in patients with large B-cell lymphoma treated with anti-CD19 CAR T-cells.
TRANSCRIPT
This JCO Podcast provides observations and commentary on the JCO article 'Monitoring of Circulating Tumor DNA Improves Early Relapse Detection After Axicabtagene Ciloleucel in Large B-Cell Lymphoma: Results of a Prospective Multi-Institutional Trial' by Frank et al. My name is Patrick Reagan, and I am an Assistant Professor of Medicine at the Wilmot Cancer Institute, University of Rochester in Rochester, NY. My oncologic specialties are lymphoma and cellular therapy. I would like to disclose consultancy for Kite Pharma.
Frank and colleagues present data from a prospective, multicenter trial examining serial testing of circulating tumor DNA in 72 patients with large B-cell lymphoma who received treatment with the anti-CD19 CAR T-cell, axicabtagene ciloleucel, abbreviated as axi-cel. These patients had circulating tumor DNA moni…
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Jun 20, 2021
Moving Forward With Venetoclax-Based Combinations in Younger Adults With Acute Myeloid Leukemia
Venetoclax in combination with FLAG-IDA chemotherapy shows safety and promising efficacy in both untreated and relapsed/refractory AML in this phase 1b/2 study, providing a strong rationale for phase 3 trials incorporating this agent in patients fit for intensive therapy.
TRANSCRIPT
This JCO Podcast provides observations and commentary on the JCO article “Venetoclax Combined with FLAG-IDA Induction and Consolidation in Newly Diagnosed and Relapsed/Refractory Acute Myeloid Leukemia” by DiNardo et al. My name is Richard Dillon, and I am a Clinical Senior Lecturer in Cancer Genetics at King’s College London and Consultant Hematologist at Guy’s Hospital, London, UK. My oncologic specialty is Adult Acute Myeloid Leukaemia. I'd like to note that my institution receives research funding support from Abbvie.
The recently published VIALE-A and VIALE-C trials demonstrated significant efficacy of venetoclax when added to low dose chemotherapy in patients with newly diagnosed AML who ca…
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May 20, 2021
A Deep Dive Into HLA Typing For Unrelated Donor Hematopoietic Cell Transplantation
This podcast comments on a large registry study evaluating the effect of ultra-high-resolution HLA typing on outcomes of unrelated donor transplantation.
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This JCO Podcast provides observations and commentary on the JCO article ‘Impact of Previously Unrecognized HLA Mismatches Using Ultra-High-Resolution Typing in Unrelated Donor Hematopoietic Cell Transplantation” by Mayor et al. My name is Navneet Majhail, and I am the Director of the Blood and Marrow Transplant Program and the Vice-Chair for the Department of Hematology and Medical Oncology at the Taussig Cancer Institute, Cleveland Clinic. My oncologic specialty is transplantation and cellular therapy.
For patients who are potential candidates for allogeneic hematopoietic cell transplantation, the first critical step is finding an HLA-matched donor. The HLA genes are located within one of the most gene rich regions of the human genome, are highly polymorphic, and encode proteins that critically modulate t…
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May 10, 2021
PENELOPE-B: Exploration of CDK4/6 Inhibition in the Adjuvant Setting
The PENELOPE-B phase III trial did not show a benefit to the addition of one year of the CDK4/6 inhibitor palbociclib to adjuvant endocrine therapy in patients with hormone receptor-positive/HER2-negative breast cancer and residual disease after neoadjuvant chemotherapy.
TRANSCRIPT
This JCO podcast provides observations and commentary on the JCO article “Palbociclib for Residual High-Risk Invasive Hormone Receptor-positive, HER2 negative Early Breast Cancer – The PENELOPE-B Trial,” by Sybille Loibl and colleagues. My name is Erica Mayer, and I am a clinical investigator at the Dana-Farber Cancer Institute in Boston, MA who specializes in breast cancer.
Since the initial approval of the CDK4/6 inhibitor palbociclib in 2015, this class of agents has become a standard part of management for most patients with hormone receptor positive HER2 negative advanced breast cancer. Use of one of the available CDK4/6 inhibitors - palbociclib, abemaciclib, or ribociclib - in combination with…
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Apr 10, 2021
ctDNA in DLBCL: A Blueprint for Better Clinical Trials?
Current clinical characteristics and demographics are not sufficient to capture aggressive disease in clinical trials of newly diagnosed DLBCL. Novel tools, such as measurement of tumor burden via ctDNA, are needed.
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This JCO Podcast provides observations and commentary on the JCO article “Short Diagnosis-to-Treatment Interval is Associated with Higher Circulating Tumor DNA Levels in Diffuse Large B-Cell Lymphoma” by Alig et al. My name is Matthew Maurer, and I am a statistician at the Mayo Clinic in Rochester, MN. My oncologic specialty is lymphoid malignancies. I have no relevant conflicts to disclose.
The impact of any clinical research critically depends upon participating subjects being representative of the study population afflicted with the disease of interest and research efficiency is markedly enhanced when cohorts can be compared across studies. In newly diagnosed diffuse large B-cell lymphoma (DLBCL), there is a standard group of clinical variables that is…
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Mar 10, 2021
How Can We Expand Eligibility Criteria for Diffuse Large B-Cell Lymphoma Clinical Trials to Serve More Patients?
This podcast considers the impact of exclusion criteria on clinical trials, generalizability, and the complexity of modernizing eligibility while maintaining trial integrity.
TRANSCRIPT
This JCO Podcast provides observations and commentary on the JCO article “Impact of Organ Function-Based Clinical Trial Eligibility Criteria in Diffuse Large B-cell Lymphoma (DLBCL) Patients. Who Gets Left Behind?” by Khurana et al. My name is Richard Little, and I am at the National Cancer Institute. My oncologic specialty is lymphoid and myeloid malignancies. I am a federal employee with no conflicts of interest to disclose.
The authors have contributed a timely and provocative analysis examining the lack of generalizability and disappointing results of repeatedly negative randomized phase 3 trials conducted over the past 15 years failing to improve on R-CHOP. The authors have proposed that these failures may be in part explained by enrollment onto clinical trials patients who are not really re…
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Dec 20, 2020
The Pathologist, the Surgeon, and the Rare Phyllodes Tumor
This multi-institutional study highlights the heterogeneity of Phyllodes tumors of the breast and the importance of accurate pathology assessment and individualized surgical approaches.
LEE WILKE: This JCO podcast provides observations and commentary on the JCO article, Contemporary Multi-institutional Cohort of 550 Cases of Phyllodes Tumors from 2007 to 2017 Demonstrates a Need For More Individualized Margin Guidelines by Rosenberger, et al. My name Lee Wilke and I am a professor of surgery and the Hendrix chair in breast surgery research at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin. My oncologist specialty is breast surgical oncology. I have no relationships to disclose related to these studies.
As medical students we are asked to adopt an expanded vocabulary to describe a multitude of diseases. The word phyllodes is frequently one of those memorable medical school terms whose origin is Greek and describes a leaf-like growth. Phyllodes…
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Sep 29, 2020
Cancer Surgery in COVID-19-Free Facilities
In this study of cancer operations conducted during the COVID-19 pandemic, rates of pulmonary complications and SARS-COV-2 nosocomial infections were compared between patients operated on in COVID-19-free facilities and those operated on in non-segregated facilities. Because lower rates of pulmonary complications and nosocomial SARS-COV-2 infection were observed in COVID-free facilities, the authors propose a restructuring of surgical facilities and pathways for cancer patients during the COVID-19 pandemic.
This JCO podcast provides observations and commentary on the JCO article “Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International Multicenter Comparative Cohort Study, “ by Bhangu et al. My name is Ken Tanabe, and I serve as Chief of Surgical Oncology at Massachusetts General Hospital, Professor of Surgery at Harvard Medical School, and Deputy Clinical Director of the Massachusetts General Hospital Cancer Center in Boston, Mas…
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Jul 20, 2020
Finding a Needle in a Haystack of Mutations: Using Whole Genome Sequencing to Identify Patients with Low-Risk Myeloma
This podcast reviews the results of the whole genome sequencing study by Samur and colleagues that identified a genomic signature associated with superior survival in patients with newly diagnosed multiple myeloma.
Disclosures: SAH has served on advisory boards or as a consultant for Adaptive Biotechnologies, Amgen, Celgene, Genentech, GSK, Oncopeptides, Sorrento; Takeda; has received research funding from Oncopeptides.
This JCO Podcast provides observations and commentary on the JCO article “Genome-Wide Somatic Alterations in Multiple Myeloma Reveals a Superior Outcome Group” by Samur et al. My name is Sarah Holstein, and I am an Associate Professor at the University of Nebraska Medical Center in Omaha, Nebraska in the United States. My oncologic specialty is plasma cell dyscrasias. I do not have any relationships to disclose related to these studies.
The clinical heterogeneity of myeloma has long been appreciated as it is clear there is a broad range of disease behavior, with…
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Jun 11, 2020
Advancing Knowledge on the Use of Dexrazoxane in Children With Acute Myeloid Leukemia and Other Childhood Cancers
This podcast describes a study addressing the use of dexrazoxane as a cardioprotectant in a cohort of more than 1,000 pediatric acute myeloid leukemia patients.
Transcript
This JCO Podcast provides observations and commentary on the JCO article “Effect of Dexrazoxane on Left Ventricular Systolic Function and Treatment Outcomes in Patients with Acute Myeloid Leukemia: A Report From the Children’s Oncology Group” by Getz et al. My name is Elvira van Dalen, and I am an epidemiologist at the Princess Máxima Center for Pediatric Oncology in Utrecht, The Netherlands and a Coordinating Editor of Cochrane Childhood Cancer. My oncologic specialties are cardiotoxicity and systematic reviews and guidelines in the field of pediatric oncology. I have nothing to disclose.
Anthracyclines are widely used in pediatric oncology. Unfortunately, one of their most serious adverse effects is cardiotoxicity, which can occur during or shortly after treatment, but also decades later. In the Dutch LAT…
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Apr 30, 2020
Better Diet – Fewer Side Effects?
This podcast reviews the results of the observational study by Ladas and colleagues that found protective associations between dietary antioxidant intake and the occurrence of bacterial infections and mucositis.
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This JCO podcast provides observations and commentary from the JCO article "The Protective Effects of Dietary Intake of Antioxidants and Treatment-Related Toxicity in Childhood Leukemia, A Report From the DALLT Cohort" by Ladas et al.
My name is Wendy Demark-Wahnefried, and I am Webb Endowed Chair and Professor of Nutrition Sciences at the University of Alabama at Birmingham, as well as the Associate Director for Cancer Prevention and Control at the O'Neal Comprehensive Cancer Center at UAB in Birmingham, Alabama in the United States. I do not have any relationships to disclose regarding these studies, and my review is grounded by the fact that I am a nutrition scientist with particular expertise in cancer survivorship.
The topic of nutrition and cancer generat…
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Mar 11, 2020
Genetic Testing in Breast Cancer Patients: Striking the Balance Between Over Versus Undertesting
This podcast summarizes and provides commentary on the recent article by Yadav et al. in which the authors demonstrate that expansion of the current NCCN guidelines for genetic testing in breast cancer patients to include all women diagnosed at or below the age of 65 markedly improves the sensitivity for detecting pathogenic germline variants without requiring the testing of all breast cancer patients.
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This JCO Podcast provides observations and commentary on the JCO article “Evaluation of Germline Genetic Testing Criteria in a Hospital-Based Series of Women with Breast Cancer” by Yadav et al. My name is Erin Cobain, and I am a Clinical Lecturer at the University of Michigan Rogel Cancer Center in Ann Arbor, Michigan United States. My oncologic specialty is breast cancer.
In this study, the authors sought to determine the sensitivity and specificity of current genetic testing criteria for the detection of pathogenic germline variants in women with breast cancer. Curren…
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Mar 1, 2020
High Reward, High Toxicity: Combination Pembrolizumab and Lenvatinib in Advanced Endometrial Cancer
The combination of pembrolizumab and lenvatinib is a promising second line option for metastatic or recurrent MSS endometrial cancer, although there can be considerable toxicity and choosing appropriate patients is key.
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This JCO Podcast provides observations and commentary on the JCO article “Lenvatinib and Pembrolizumab in Patients With Advanced Endometrial Cancer” by Makker et al. My name is Meghan Shea, and I am an Instructor of Medicine at Harvard Medical School at Beth Israel Deaconess Medical Center in Boston, Massachusetts. My oncologic specialty is gynecologic oncology.
Patients with advanced endometrial carcinoma have limited options after receiving the carboplatin and paclitaxel doublet for recurrent or metastatic disease. The study that accompanies this podcast evaluates the combination pembrolizumab and lenvatinib, providing a much needed second-line option for this patient population. The approval of single-agent pembrolizumab for tumors with microsatelli…
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Jan 21, 2020
Optimizing Treatment Strategies for Germline BRCA/PALB2 Mutant Pancreatic Adenocarcinoma
This podcast will discuss the findings from a phase II trial of gemcitabine, cisplatin and PARP inhibitor therapy in germline BRCA/PALB2 mutant pancreatic cancer and discuss an optimal treatment strategy in this setting.
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This JCO Podcast provides observations and commentary on the JCO article “A Randomized, Multi-Center, Phase II Trial of Gemcitabine, Cisplatin with or without Veliparib in Patients with Pancreas Adenocarcinoma and a Germline BRCA/ PALB2 Mutation” by O'Reilly et al. My name is Daniel Renouf, and I am a medical oncologist at the BC Cancer Vancouver Centre in Vancouver, Canada. My oncologic specialty is pancreatic cancer.
In this podcast, we will be discussing an important and evolving area that is changing our standard treatment strategies for pancreatic cancer. Progress has been slow for pancreatic adenocarcinoma, which is now the third leading cause of cancer-related death in North America and is projected to become the second leading cause of cancer-…
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Jan 8, 2020
Immune Checkpoint Inhibitor Use in Patients With Inflammatory Bowel Disease: A Closer Look
Towards improved characterization of immune-related adverse events in the setting of pre-existing autoimmune disease.
TRANSCRIPT
This JCO Podcast provides observations and commentary on the JCO article “Immune Checkpoint Inhibitor Therapy in Patients with Preexisting Inflammatory Bowel Disease”, by Abu-Sbeih et al. My name is Katy Tsai, and I am Assistant Professor of Medicine in the Division of Hematology/Oncology at the University of California, San Francisco. My oncologic specialty is the treatment of advanced melanoma and non-melanoma skin cancers.
Immune checkpoint inhibitors, referred to as ICIs in this podcast, have transformed the landscape of treatment options in oncology. While ICIs were first approved for the treatment of advanced melanoma in 2011, since that time, ICIs have shown activity in a variety of other histologies. Anti-PD-1 or anti-PD-L1, with or without anti-CTLA-4, are now approved for the treatment of lung cancer, head and neck squamous cell carcinoma, re…
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Jan 8, 2020
The High Prevalence of Exercise Intolerance in Adult Survivors of Childhood Cancer Is Predictive of All-Cause Mortality
This podcast describes a study examining aerobic capacity in a cohort of over 1200 adult survivors of childhood cancer and related impairments of cardiac, pulmonary and neuromuscular body systems, to understand how aerobic capacity influences all-cause mortality.
TRANSCRIPT
This JCO Podcast provides observations and commentary on the JCO article 'Exercise Intolerance, Mortality, and Organ System Impairment in Adult Survivors of Childhood Cancer' by Ness et al. My name is Kristin Campbell, and I am a licenced physical therapist and associate professor in the Faculty of Medicine at the University of British Columbia in Vancouver, Canada. My oncologic specialty is in rehabilitation, primarily related to breast cancer.
Exercise intolerance is a global measure of functional capacity that reflects the complex integration of body systems. It is well established in the general population that exercise intolerance is predictive of future cardiovascular health and mortality. Whether this rela…
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Jan 8, 2020
Leptomeningeal Disease in EGFR-Mutated Lung Cancer: Can We Finally Define a Standard Treatment?
This podcast describes the results of the BLOOM study, evaluating the efficacy of osimertinib in EGFR-mutated lung cancer with leptomeningeal disease after failure of prior EGFR TKI therapy.
TRANSCRIPT
This JCO Podcast provides observations and commentary on the JCO article “Osimertinib In Patients With Epidermal Growth Factor Receptor Mutation-Positive Non-Small-Cell Lung Cancer and Leptomeningeal Metastases: The BLOOM Study” by Yang et al. My name is Jürgen Wolf and I am the medical director of the Center for Integrated Oncology at the University Hospital of Cologne in Germany. I am a medical oncologist with expertise in personalized lung cancer care.
About 10% of patients with advanced EGFR-mutated lung cancer suffer from leptomeningeal disease. While this disease manifestation in non-small-cell lung cancer is generally associated with a particularly poor prognosis, with survival times of only a few months, the question arises whether treatment with specific tyrosine kinase…
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Jan 8, 2020
Advancing Treatment Options for Mismatch Repair-Deficient Metastatic Colorectal Cancers
This podcast reviews the results of KEYNOTE 164 investigating the use of pembrolizumab for mismatch repair deficient metastatic colorectal cancer, the place of this agent in the current clinical paradigm, and future directions to identify which patients are most likely to benefit from this treatment strategy.
TRANSCRIPT
This JCO Podcast provides observations and commentary on the JCO article 'A Phase II, Open-Label Study of Pembrolizumab in Treatment-Refractory, Microsatellite Instability-High/Mismatch Repair-Deficient Metastatic Colorectal Cancer: KEYNOTE-164' by Le et al. My name is Dustin Deming, and I am an associate professor at the University of Wisconsin Carbone Cancer Center in Madison, Wisconsin. My oncologic specialty is gastrointestinal oncology.
Microsatellite instability high status or mismatch repair deficiency is found in approximately 15% of early stage colorectal cancers, but only 3-4% of metastatic colorectal cancer. The mechanisms by which these cancers acquire th…
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Jan 6, 2020
Keeping Mycosis Fungoides in Check: A Study of Pembrolizumab for Relapsed/Refractory MF and Sezary Syndrome
This podcast evaluates results from a phase II clinical trial of pembrolizumab for relapsed Mycosis Fungoides and Sezary Syndrome in the context of the current systemic treatment landscape for this disease.
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This JCO Podcast provides observations and commentary on the JCO article "Pembrolizumab in Relapsed and Refractory Mycosis Fungoides and Sezary Syndrome: A Multicenter Phase II Study" by Khodadoust et al. My name is Jennifer Amengual, and I am an Assistant Professor of Medicine at the Columbia University Irving Medical Center in New York, New York, USA. My oncologic specialty is lymphoma.
Mycosis fungoides, otherwise known as MF, and Sezary Syndrome, its leukemic variant, are rare subtypes of cutaneous T-cell lymphoma. Although most patients with MF have indolent disease, those with advanced stage MF often experience resistance to systemic therapy with a persistent and progressive disease course, which has a negative impact on overall well-being and survival. Patients…
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Dec 26, 2019
What’s in a Name? An Introductory Guide
This podcast discusses the results and implications of a recent study on gender bias in speaker introductions at an international oncology conference.
This JCO Podcast provides observations and commentary on the JCO article "Evaluating Unconscious Bias: Speaker Introductions at an International Oncology Conference" by Duma et al. My name is Dr. Tatiana Prowell. I am an Associate Professor of Oncology at Johns Hopkins Kimmel Cancer Center and Breast Cancer Scientific Liaison at the U.S. Food and Drug Administration in Silver Spring, Maryland. My oncologic specialty is breast cancer.
In the article that accompanies this podcast, Duma and colleagues report the results of a retrospective observational study of speaker introductions at two consecutive years of ASCO Annual Meetings. The investigators hypothesized that female speakers in oral sessions would be introduced with a professional form of address less frequently than male speakers. For the purposes of the study, they defined a pro…
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Dec 10, 2019
Resuming Life After Cancer Therapy: Treatment-Free Survival
Treatment-free survival is a novel endpoint in immunotherapy.
TRANSCRIPT
This JCO Podcast provides observations and commentary on the JCO article “Treatment-Free Survival: A Novel Outcome Measure of the Effects of Immune Checkpoint Inhibition—A Pooled Analysis of Patients With Advanced Melanoma” by Regan et al. My name is Adil Daud, and I am Professor of Medicine and Dermatology and Director of the Melanoma Program at the University of California, San Francisco. My oncologic specialty is medical oncology.
Cancer therapy has achieved great success in the last 40-50 years. Where treatment with chemotherapy required inpatient hospitalization and gut-wrenching toxicity, therapy today can often be achieved with lower grade side effects and limited time in the hospital or outpatient infusion center. While these changes have brought enormous benefit to patients, many patients feel that the tug of ongoing therapy for metastatic or advanced cancer and long for a time where therapy is n…
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Dec 1, 2019
Intratumoral Immune Infiltration in Follicular Lymphoma: Novel Insights into Early Relapse and Survival
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This JCO Podcast provides observations and commentary on the JCO article “Progression of Disease Within 24 Months (POD24) in Follicular Lymphoma Is Associated With Reduced Intratumoral Immune-Infiltration” by Dr. Tobin and colleagues. My name is Dr. Carla Casulo, and I am Associate Professor of Medicine, Hematology and Oncology at the Wilmot Cancer Institute of the University of Rochester in Rochester, NY, USA. My oncologic specialty is Lymphoma.
Follicular lymphoma is the most frequently occurring indolent non-Hodgkin lymphoma and has a long natural history, with median overall survival nearing two decades. Patients with follicular lymphoma may experience a variable clinical course, with periods of long remission punctuated by episodes of recurrent lymphoma requiring re-treatment. Among all patients, up to one third will have early disease recurrence, defined as occurring within 24 months of diagnosis. Please note that progression of disease within 24 months will be r…
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Nov 20, 2019
MYC Rearrangements in Diffuse Large B-Cell Lymphoma: Impact and Implications for Diagnostic Testing
This podcast summarizes the findings of the Lunenburg Lymphoma Biomarker Consortium systematic evaluation of MYC rearrangements in DLBCL, and discusses the prognostic impact of MYC, BCL2 and BCL6 rearrangements, and implications for FISH testing in newly diagnosed DLBCL.
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This JCO Podcast provides observations and commentary on the JCO article “Prognostic Significance of MYC Rearrangement and Translocation Partner in Diffuse Large B-Cell Lymphoma - A Study by the Lunenburg Lymphoma Biomarker Consortium” by Rosenwald et al. My name is Jeremy Abramson, and I am an attending physician at the Massachusetts General Hospital and an Associate Professor of Medicine at Harvard Medical School. My oncologic specialty is lymphoma.
MYC rearrangements occur in approximately 10% of diffuse large B-cell lymphomas and have been associated with a worse prognosis. When the MYC translocation occurs in concert with translocations of BCL2, BCL6, or both, initial series have suggested partic…
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Nov 10, 2019
Centralization of High-Risk Surgery: Real Benefits for Patients From Health Systems
This podcast discusses the work of Sheetz and colleagues describing the impact of centralization of high-risk cancer surgery within health care systems and networks in the United States.
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This JCO Podcast provides observations and commentary on the JCO article “Centralization of High-Risk Cancer Surgery Within Existing Hospital Systems” by Sheetz et al. My name is Stephen Edge, and I am Vice President of Healthcare Outcomes and Policy and Professor of Surgery and Oncology at the Roswell Park Comprehensive Cancer Center and the University at Buffalo in Buffalo, NY. My oncologic specialty is surgical oncology.
Recent years have seen substantial consolidation of hospitals and practices into networked care systems. The benefits of health networks may include efficiencies of scale, better ability to thrive in the shifting health care economy, and enhanced quality.
In the article that accompanies this podcast, Dr. Sheetz and colleagues at the University of Michigan studied…
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Nov 1, 2019
Microsatellite Instability as a Prognostic Marker for Resectable Gastric Cancer and a Potential Biomarker for Perioperative Chemotherapy Benefit
Dr. Osama Rahma, an Assistant Professor of Medicine at Harvard Medical School, Dana-Farber Cancer Institute, discusses the role of MSI in gastric cancer.
TRANSCRIPT
This JCO Podcast provides observations and commentary on the JCO article “Individual Patient Data Meta-Analysis of the Value of Microsatellite Instability as a Biomarker in Gastric Cancer” by Pietrantonio et al. My name is Osama Rahma, and I am an Assistant Professor of Medicine at Harvard Medical School, Dana-Farber Cancer Institute in Boston, Massachusetts. My oncologic specialty is Gastrointestinal Cancer and Cancer Immunotherapy.
Despite the advances in surgical approach and perioperative multimodalities in gastric cancer, the recurrence rate remains over 50%. While many patients benefit from perioperative chemotherapy many others don’t derive such benefits and experience toxic side effects. Accordingly, there is an unmet need to identify prognostic markers to guide chemotherapy decisions in the neoadjuvant and…
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Oct 1, 2019
Radiotherapy Dose Reduction Is Possible With Induction Chemotherapy for Pediatric Nasopharynx Cancer
This JCO Podcast provides observations and commentary on the JCO article, "Treatment of Childhood Nasopharyngeal Carcinoma with Induction Chemotherapy and Concomitant Chemoradiotherapy: Results of the Children’s Oncology Group ARAR0331 Study" by Rodriguez-Galindo et al. My name is Suzanne Wolden, and I am the Director of Pediatric Radiation Oncology at Memorial Sloan Kettering in New York City, USA. My oncologic specialty is Pediatric Radiation Oncology.
This important manuscript summarizes the results of Children’s Oncology Group protocol ARAR0331 for childhood nasopharyngeal carcinoma. The study enrolled 111 patients, of whom 75% were male and 47% were African American, with a median age of 15. Eligible patients had AJCC stage IIb-IVC disease and received three cycles of induction chemotherapy with 5-fluorouracil and cisplatin followed by concurrent cisplatin and radiotherapy. Three patients had progressive disease during induction chemotherapy, eight were removed from the study…
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Sep 9, 2019
Fine Tuning Therapy for Intermediate-Risk Neuroblastoma Using Clinical Response and Tumor Biology
This JCO Podcast provides observations and commentary on the JCO article “Maintaining Outstanding Outcomes Using Response and Biology-Based Therapy for Intermediate-Risk Neuroblastoma: A Report From the Children's Oncology Group Study ANBL0531” by Twist et al. My name is Javed Khan, and I am Deputy Chief and Senior Investigator at the Genetics Branch and an Attending for the Pediatric Oncology Branch of the National Cancer Institutes of the NIH in Bethesda, Maryland. My oncologic specialty is Pediatric Hematology Oncology.
Childhood cancer is a life-threatening disease where survival rates have increased exponentially to over 75% over the past three decades. However, this has come at a considerable cost with significant incidence of late effects including hearing loss, scoliosis, hypothyroidism, growth and development delay, infertility, psychological, emotional, cognitive and neurological sequelae, and secondary malignancies. Most of these late effects have been attributed therap…
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Jul 3, 2019
Déjà Vu or Predicted: The Failure of Dose Adjusted EPOCH-R to Improve Outcomes in Diffuse Aggressive Lymphomas
This JCO Podcast provides observations and commentary on the JCO article “Dose-Adjusted EPOCH-R Compared to R-CHOP as Frontline Therapy for Diffuse Large B Cell Lymphoma: Clinical Outcomes of the Phase III Intergroup Trial CALGB 50303 (Alliance)” by Bartlett et al. My name is Patrick Stiff, and I am Division Director of Hematology-Oncology at Loyola University Stritch School of Medicine in Maywood, Illinois. My oncologic specialty is hematologic malignancies and stem cell transplantation.
CHOP has remained the chemotherapy backbone of choice for the treatment of diffuse aggressive non-Hodgkin lymphoma since the 4 arm randomized SWOG study was performed 25 years ago1. Since then, only the addition of rituximab has improved patients' outcome2. Investigators have tried to improve outcomes by employing other strategies like increasing drug intensity, shortening the interval between cycles, adding newer agents, changing the method of administration, and adding transplantation, but none…
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Jul 2, 2019
Tackling Stage III EGFR Mutation-Positive Lung Cancer: Do We Really Know How?
This JCO Podcast provides observations and commentary on the JCO article “Erlotinib Versus Gemcitabine Plus Cisplatin as Neoadjuvant Treatment for Stage IIIA-N2 EGFR-Mutant NSCLC (EMERGING-CTONG 1103): A Randomized Phase II Study” by Zhong et al. My name is Tony Mok, and I am a Professor of Clinical Oncology at the Chinese University of Hong Kong in the Prince of Wales Hospital in Hong Kong. My oncologic specialty is Medical Oncology.
With the advent of molecular targeted therapy, patients harboring driver oncogenes may now survive longer and better than before, and EGFR mutation is the prime example of such achievement. However, evidence for “cure” of patients with metastatic EGFR mutation positive lung cancer remains scanty. In contrast, It may be more reasonable to first attempt cure of patients with earlier stage disease using molecular targeted therapy. CTONG 1103, published in this issue of Journal of Clinical Oncology, is the first randomized study comparing neoadjuvant…
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Jun 6, 2019
The Need for Continued Vigilance in Patients with Diffuse Large B-Cell Lymphoma
This JCO Podcast provides observations and commentary on the JCO article 'Late Relapses in Patients With Diffuse Large B-Cell Lymphoma Treated With Immunochemotherapy' by Yang et
My name is Ann LaCasce, and I am an Associate Professor of Medicine at the Dana-Farber Cancer Institute in Boston, USA. My oncologic specialty is lymphoma.
This podcast discusses the recent paper evaluating the risk of late relapse in patients with diffuse large B-cell lymphoma who are event free 24 months after diagnosis.
The goal of upfront chemoimmunotherapy in patients with diffuse large B-cell lymphoma (DLBCL) is the permanent eradication of disease. In the era of rituximab, few studies with sufficient follow-up have examined the risk of late recurrence. An analysis of patients with DLBCL from the University of Iowa/Mayo and validated in a separate cohort from the French Study Group of Adult Lymphoma demonstrated that patients who were alive and disease free at 24 months from diagnosis had overall surv…
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Jun 6, 2019
A Second Chance at Checkpoint Inhibition After Initial Immune-Mediated Diarrhea and Colitis
This JCO Podcast provides observations and commentary on the JCO article “Resumption of Immune Checkpoint Inhibitor Therapy After Immune-Mediated Colitis” by Abu-Sbeih et al. My name is David Oh, and I am an Assistant Professor at the University of California, San Francisco. My oncologic specialty is genitourinary medical oncology and cancer immunotherapy.
While immune checkpoint inhibitors, or ICIs, can lead to durable responses even when other standard therapies have failed, their therapeutic window is often limited by immune-related adverse events or IRAEs which are thought to be autoimmune in nature. Immune-mediated diarrhea and colitis are a frequent IRAE with ICIs, affecting up to a third of patients receiving anti-CTLA-4, approaching half of patients receiving anti-CTLA-4 in combination with anti-PD-1 or anti-PD-L1, and less frequently patients receiving anti-PD-1 or anti-PD-L1 alone. Since there is often overlap between IRAEs and response or survival with ICIs, and IRAEs s…
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May 21, 2019
Anticipating the Future of Hodgkin Lymphoma
This JCO Podcast provides observations and commentary on the JCO article “PET Score Has Greater Prognostic Significance Than Pre-Treatment Risk Stratification in Early-Stage Hodgkin Lymphoma in the UK NCRI RAPID Study” by Barrington et al. My name is Brue Cheson, and I am at Georgetown University Hospital, Lombardi Comprehensive Cancer Center. My Hematologic-oncologic specialty is Lymphoma.
Hodgkin lymphoma is clearly one of the most dramatic success stories in modern oncology. More than 90% of patients with limited disease and about 85% with advanced disease are cured using conventional chemotherapy regimens. As a consequence, current clinical trials are focusing on augmenting or modifying treatment for those at higher risk and decreasing the intensity or duration of therapy for those at a lower risk of treatment failure.
One important question has been: how best to distinguish those disparate groups? Over the years, various prognostic scoring systems have been devised. The Inte…
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Apr 23, 2019
An Advance for the Treatment of Osteosarcoma
This podcast provides observations and commentary on the JCO article "Randomized, Double-Blind, Phase II Study of Regorafenib in Patients with Metastatic Osteosarcoma" by Davis et al. My name is Brian Van Tine, and I am an Associate Professor of Medicine in the Division of Oncology at Washington University School of Medicine. My oncologic specialty is sarcoma.
Osteosarcoma (OS) is the most common type of primary malignant bone cancer, frequently occurring in children and adolescents. It can also be found in older adults around the age of 70, but unfortunately, though rare, can be found in patients of any age. Thus, Osteosarcoma is a disease that not only do pediatric oncologists need to know about, but also adult oncologists. Osteosarcoma occurs primarily at the metaphysis of the bone, in regions of rapid bone growth, in bone-forming cells called osteoblasts. Various risk factors for the development of osteosarcoma include underlying bone pathologies, such as Paget’s Disease, prior…
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Mar 13, 2019
The Heartbreak of Cancer Treatment: The Latest in Late Cardiac Toxicity
This JCO Podcast provides observations and commentary on the JCO article “Therapy-Related Cardiac Risk in Childhood Cancer Survivors: An Analysis of the Childhood Cancer Survivor Study” by Bates et al. My name is Joseph Carver, and I am the Chief of Staff at the Abramson Cancer Center of the University of Pennsylvania in Philadelphia, Pennsylvania. My specialty is cardio-oncology.
It is universally accepted that therapeutic radiotherapy and/or anthracycline-based chemotherapy have a significant impact on the heart resulting in cardiac morbidity and mortality. High risk groups are now defined on the basis of a doxorubicin-equivalent anthracycline dose of ≥250 mg/m2 and/or total radiation dose of ≥30 Gy when the heart is in the treatment field. It is universally accepted that therapeutic radiotherapy and/or anthracycline-based chemotherapy have a significant impact on the heart resulting in cardiac morbidity and mortality. High risk groups are now defined on the basis of a doxor…
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Mar 8, 2019
Programmed Cell Death-1 Pathway Inhibitors Enter Center Stage as First-Line Treatment of Advanced Merkel Cell Carcinoma
This JCO Podcast provides observations and commentary on the JCO article Durable Tumor Regression and Overall Survival in Patients with Advanced Merkel Cell Carcinoma Receiving Pembrolizumab as First-Line Therapy by Paul Nghiem, MD, PhD et al. My name is Reed Drews, and I am a member of the Cutaneous Oncology Program at Beth Israel Deaconess Medical Center in Boston, MA. My oncologic specialty is non-melanoma skin cancers.
Merkel cell carcinoma is a rare, aggressive neuroendocrine skin malignancy with high propensity for local recurrence and regional lymph node and systemic metastases. Its incidence rises exponentially with aging and is 10-fold higher in chronically immunosuppressed patients. When Merkel cell carcinoma is advanced and/or unresectable, historical 5-year overall survival rates are low, from 14 to 27%. Cytotoxic chemotherapies, like platinum plus etoposide used in other high-grade neuroendocrine malignancies, have not yielded durable response rates.
The cutaneous cell (…
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Feb 27, 2019
Potential for Parenthood After Childhood Cancer: Perceptions and Reality
This JCO Podcast provides observations and commentary on the JCO article Gonadal Functioning and Perceptions of Infertility Risk among Adult Survivors of Childhood Cancer: A Report from the St. Jude Lifetime Cohort Study by Lehmann et al. My name is Leslie Schover, and I am retired from the faculty of MD Anderson Cancer Center and currently Founder of Will2Love.com a digital health company in Houston, Texas. My oncologic specialty is cancer-related problems with reproductive health, i.e. sexual function and fertility.
Damaged fertility is unfortunately quite common in survivors of childhood cancer. A variety of chemotherapy drugs, as well as surgery affecting parts of the reproductive system or radiation therapy focused on the pelvis or brain, can damage spermatogenesis, reduce ovarian reserve, or interfere with uterine function. In general, males are more at risk than females for cancer-related infertility. Some survivors do not undergo puberty without hormonal support. For others, f…
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Feb 8, 2019
How Should We Interpret Indeterminate Pulmonary Nodules at Diagnosis in Children With Rhabdomyosarcoma?
This JCO podcast provides observations and commentaries on the JCO article entitled "Indeterminate Pulmonary Nodules at diagnosis in Rhabdomyosarcoma: Are they clinically significant?" A report from the European Pediatric Soft Tissue Sarcoma Study Group by Bas Vaarwerk, MD et al.
My name is Alberto Pappo and I am the head of the division of solid tumors at St Jude Children’s Research Hospital in Memphis, TN. My oncology specialty is pediatric oncology.
In this report, Bas Vaarwerk, and investigators from the European Pediatric Soft Tissue Sarcoma Study Group evaluated the significance of indeterminate pulmonary nodules at diagnosis in children with rhabdomyosarcoma defined as the presence of less than 5 pulmonary nodules measuring less than 5mm or 1 pulmonary nodule that measured between 5 and 9 millimeters.
This analysis included 316 patients who were enrolled on the EpSSG RMS 2005 study for non-metastatic rhabdomyosarcoma from September 2005 through December 2013 and for whom ch…
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Jan 24, 2019
The End of ENDoxifen Metabolite and CYP2D6 Testing in Tamoxifen-Treated Women?
This JCO Podcast provides observations and commentary on the JCO article “Tamoxifen pharmacogenetics and metabolism: Results from the prospective CYPTAM study” by Sanchez-Spitman et al. My name is Vered Stearns, and I am a Professor of Oncology and Co-Director of the Breast and Ovarian Cancer Program at the Kimmel Cancer Center at Johns Hopkins in Baltimore, Maryland. My oncologic specialty is medical oncology.
In the paper that accompanies this podcast, the authors report results of a prospective clinical study designated CYPTAM, which was designed to correlate endoxifen serum concentrations and outcomes of women prescribed adjuvant tamoxifen. The investigators enrolled 667 women with breast cancer who were initiating tamoxifen or who have been on tamoxifen for fewer than 12 months. The investigators obtained blood samples for CYP2D6 genotyping using the Amplichip CYP450 Test, and measured steady state concentrations of endoxifen with a high-performance liquid chromatography-tan…
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Oct 18, 2018
Less is More: Precision Surveillance Imaging for Wilms Tumor
This JCO Podcast provides observations and commentary on the JCO article “Impact of Surveillance Imaging Modality on Survival After Recurrence in Patients with Favorable Histology Wilms Tumor: A Report from the Children's Oncology Group” by Mullen et al. My name is Dr. Meredith Irwin, and I am an oncologist and Professor at the Hospital for Sick Children and University of Toronto in Toronto, Canada. My oncologic specialty is pediatric solid tumors.
Wilms tumor is the most common pediatric kidney tumor. With current therapies, the 5-year overall survival for newly diagnosed patients is 90%. For the 15% who relapse, most commonly in the lung or abdomen, the cure rates still often exceed 50%. The likelihood for cure is based on a number of risk factors, including histology, stage and previous therapies. Thus, similar to many pediatric cancer patients, those with Wilms undergo surveillance imaging during and following completion of upfront therapy in order to potentially discover recu…
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Aug 20, 2018
How Low Can You Go? Impact of Baseline Corticosteroid Use on Immunotherapy Outcomes in Patients With Advanced Non-Small-Cell Lung Cancer
This JCO Podcast provides observations and commentary on the JCO article, "Impact of Baseline Steroids on Efficacy of PD-(L)1 Blockade in Patients With NSCLC" by Arbour et al. My name is Deepa Rangachari, and I am an Assistant Professor of Medicine at the Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, Massachusetts, USA. My oncologic specialty is thoracic cancers.
For decades, the management of advanced non-small-cell lung cancer has relied on use of cytotoxic chemotherapies with a median overall survival not exceeding one year. As this longstanding therapeutic approach has been limited by modest efficacy, finite durability, and significant treatment-associated toxicity, evolving better tailored, more effective, and less toxic care strategies has long been an unmet need. Beginning in the mid-2000s with the identification of actionable oncogenic driver mutations in the epidermal growth factor receptor, the landscape for personalized care in advanced non-smal…
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Aug 14, 2018
Expanding Treatment Options for Hormone Receptor-Positive, HER2-Positive Metastatic Breast Cancer
Read the related article "First-Line Trastuzumab Plus an Aromatase Inhibitor, With or Without Pertuzumab, in Human Epidermal Growth Factor Receptor 2–Positive and Hormone Receptor–Positive Metastatic or Locally Advanced Breast Cancer (PERTAIN): A Randomized, Open-Label Phase II Trial" by Rimawi et al on JCO.org.
Transcript:
This JCO Podcast provides observations and commentary on the JCO article ‘First-Line Trastuzumab Plus an Aromatase Inhibitor, With or Without Pertuzumab, in HER2-Positive and Hormone Receptor-Positive Metastatic or Locally Advanced Breast Cancer (PERTAIN): A Randomized, Open-Label Phase II Trial’ by Rimawi et al. My name is Sara Tolaney and I am Assistant Professor of Medicine at Harvard Medical School and Senior Physician at Dana-Farber Cancer Institute in Boston, Massachusetts. My oncologic specialty is breast cancer.
Since the seminal report of the benefits of adding trastuzumab to chemotherapy, we have seen an improvement in survival for patients with…
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Aug 9, 2018
The Addition of Another Camptothecin Fails to Improve Outcomes in Patients With Intermediate-Risk Rhabdomyosarcoma
Read the related article "Addition of Vincristine and Irinotecan to Vincristine, Dactinomycin, and Cyclophosphamide Does Not Improve Outcome for Intermediate-Risk Rhabdomyosarcoma: A Report From the Children's Oncology Group" on JCO.org
This JCO podcast provides observations and commentary on the JCO article “addition of vincristine, irinotecan to vincristine, dactinomycin and cyclophosphamide does not improve outcome for intermediate risk rhabdomyosarcoma a report from the Children’s Oncology Group by Hawkins, et al.” My name is Alberto Pappo and I am a pediatric oncologist and Head of the Division of Solid Tumors at St Jude Children’s Research Hospital in Memphis, Tennessee.
Investigators of the Children’s Oncology Group (COG) developed a prospective randomized study to improve the outcome of patients with intermediate risk rhabdomyosarcoma by comparing the addition of the doublet vincristine and irinotecan (which will be called the irinotecan arm) to standard vincristine…
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Jul 26, 2018
The Addition of IKZF1 Deletion in Risk Stratification for Children with Newly Diagnosed B-Acute Lymphoblastic Leukemia Leads to Improved Survival: Results of the Malaysia-Singapore ALL 2010 Study
Intensifying therapy in children with pediatric B-ALL and IKZF1 deletions leads to improved survival.
Read the related article "Intensifying Treatment of Childhood B-Lymphoblastic Leukemia With IKZF1 Deletion Reduces Relapse and Improves Overall Survival: Results of Malaysia-Singapore ALL 2010 Study" on JCO.org
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Jul 25, 2018
Psychosocial Outcomes Following Contralateral Prophylactic Mastectomy: Insights and Opportunities
Discussion of a recent study that evaluated prospectively psychosocial well being measures in breast cancer patients before and after receipt of CPM.
Read the related article "Prospective Study of Psychosocial Outcomes of Having Contralateral Prophylactic Mastectomy Among Women With Nonhereditary Breast Cancer" on JCO.org
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Jun 18, 2018
Risky Business: PD-1 Immune Checkpoint Blockade in Thymic Epithelial Neoplasms
This podcast discusses the important risks and potential benefits of PD-1 immune checkpoint blockade in patients with thymic epithelial neoplasms.
Read the related article "Pembrolizumab for Patients With Refractory or Relapsed Thymic Epithelial Tumor: An Open-Label Phase II Trial" on JCO.org
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Jun 4, 2018
Don't Treat Me Like a Child: The Intensification of Conventional Chemotherapy in Adults With Acute Lymphoblastic Leukemia
GRAALL-2005 study shows no overall benefit for cyclophosphamide intensification in older adults with ALL, despite a general improvement in outcomes for the younger adults.
Read the associated article by Huguet et al on JCO.org.
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May 29, 2018
Multiple Myeloma Joins the Car T Race
Highlighting the importance of BCMA-CAR T therapy for patients with relapsed refractory multiple myeloma and discusses future avenues of clinical investigation.
Read the related article "T Cells Genetically Modified to Express an Anti–B-Cell Maturation Antigen Chimeric Antigen Receptor Cause Remissions of Poor-Prognosis Relapsed Multiple Myeloma" on JCO.org
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May 23, 2018
Cardiotoxicity After Breast Cancer Radiotherapy: Which Part of the Heart Matters Most?
This podcast includes commentary upon a large case control series that examined the incidence of cardiac injury in association with radiation dose to distinct segments of the left ventricle and coronary arteries.
Read the associated article by Taylor et al on JCO.org.
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May 22, 2018
Should Prophylactic Cranial Irradiation Be Used in Patients with Stage III Non-Small Cell Lung Cancer?
This is an evaluation of PCI in stage III Non-Small-Cell Lung Cancer. While the incidence of symptomatic brain metastases is reduced, neurological toxicity is increased and no effect on survival is demonstrated. This trial reconfirms that routine administration of PCI is not a current standard of care.
Read the associated article by De Ruysscher et al on JCO.org.
This JCO Podcast provides observations and commentary on the JCO article 'Prophylactic Cranial Irradiation (PCI) Versus Observation in Radically Treated Stage III Non-Small-Cell Lung Cancer (NSCLC): A Randomized Phase III NVALT-11/ DLCRG-02 Study' by De Ruysscher et al. My name is Everett Vokes, and I am the Chairman and Professor of Medicine at the University of Chicago in Chicago, United States of America. My oncologic specialty is head and neck and lung cancer.
De Ruysscher et al present a randomized trial evaluating the role of prophylactic cranial irradiation, referred to as PCI in this podcast, in patients with stage…
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May 11, 2018
The Medical Marijuana Conundrum: When Public Interest Outpaces Medical Knowledge
The public perception of medical marijuana has outpaced medical knowledge. Oncologists encounter an increasing number of patient questions and interest regarding its use. This study highlights the beliefs, attitudes and knowledge of medical oncologists regarding the therapeutic use of marijuana.
View the related article Medical Oncologists’ Beliefs, Practices, and Knowledge Regarding Marijuana Used Therapeutically: A Nationally Representative Survey Study by Braun et al on JCO.org.
This JCO Podcast provides observations and commentary on the JCO article ‘'Medical Oncologists' Beliefs, Practices and Knowledge Regarding Marijuana Used Therapeutically: A Nationally-Representative Survey Study' by Braun and colleagues. My name is Kimberson Tanco, and I am an Assistant Professor at the University of Texas MD Anderson Cancer Center in Houston, Texas. I am a Palliative Medicine physician.
Medical marijuana is one of the fastest growing medical issues nationwide, so much so it is now le…
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Apr 18, 2018
Racial Disparities in Medical Financial Hardship Among Cancer Survivors
This commentary summarizes findings from a study of racial disparities in medical financial hardship, identifies gaps in the current evidence base, and discusses health policy considerations for to reducing the risk of financial hardship.
Read the related article "Financial Impact of Breast Cancer in Black Versus White Women" on JCO.org
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Apr 17, 2018
Extending the Reach of Targeted Therapy for Hormone Receptor-Positive Advanced Breast Cancer
This podcast discusses a phase II trial evaluating the combination of everolimus and fulvestrant compared to fulvestrant alone in pretreated hormone receptor-positive metastatic breast cancer in terms of context within the current hormone treatment environment and toxicity management.
Read the related article Randomized Phase II Trial of Fulvestrant Plus Everolimus or Placebo in Postmenopausal Women With Hormone Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative Metastatic Breast Cancer Resistant to Aromatase Inhibitor Therapy: Results of PrE0102" on JCO.org
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Apr 17, 2018
Late Infectious Death: Asplenic Adult Survivors of Child Cancer
This podcast discusses a CCSS study of very late infection-related mortality in asplenic adult survivors childhood cancer, with risk increasing precipitously after age 40.
Read the related article "Late Infection-Related Mortality in Asplenic Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study" on JCO.org
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Mar 27, 2018
An International Phase II Trial of Single-Agent Nivolumab for Hodgkin Lymphoma Relapsed or Refractory After Autologous Stem Cell Transplant
This podcast describes the extended follow-up of the large International phase II CheckMate 205 study of single-agent nivolumab for patients with relapsed/refractory classical Hodgkin lymphoma after failure from autologous stem cell transplant.
Read the related article on JCO.org.
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Mar 20, 2018
Exploring a New Delivery Model for Germline Genetic Testing for Patients With Ovarian Cancer
This podcast provides comment on the accompanying JCO article “ENGAGE: Evaluation of a streamlined oncologist-led BRCA mutation testing and counseling model for patients with ovarian cancer” by Nicoletta Colombo, et al and evaluates the need for new delivery models for genetic testing for oncology patients.
Related Article: Evaluation of a Streamlined Oncologist-Led BRCA Mutation Testing and Counseling Model for Patients With Ovarian Cancer
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Mar 9, 2018
Is Earlier Treatment Better For Patients? The Case of Docetaxel in Metastatic Castration-Sensitive Prostate Cancer
This commentary examines whether patient-reported outcomes were substantially different in men given chemohormonal therapy versus hormone therapy in the CHAARTED randomized controlled trial.
Related Article: Quality of Life During Treatment With Chemohormonal Therapy: Analysis of E3805 Chemohormonal Androgen Ablation Randomized Trial in Prostate Cancer
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Jan 31, 2018
The Decision to Image Breast Cancer Patients with Local-Regional Recurrence
This podcast reflects upon a recent retrospective study of breast cancer patients with local regional recurrence, and whether imaging is needed for all such patients.
Read the related article on JCO.org.
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Jan 24, 2018
The Importance of Reading Clinical Trial Protocols Simultaneously With Published Studies
This podcast discusses whether the primary outcomes and study design for the reported trial were properly pre-specified and pre-registered prior to accruing participants.
Related Article: Improving Breast Cancer Surgical Treatment Decision Making: The iCanDecide Randomized Clinical Trial
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Jan 22, 2018
Understanding the 'Value-Added' by Specialized Pediatric Palliative Care Teams in the Care of Children With Cancer at the End of Life
This podcast reviews the aims, methodology, and results of a population-level study that investigates the value of specialized pediatric palliative care services for children with cancer at the end of life, as well as discussing practical ways in which individuals and institutions can immediately apply study findings towards improvement of clinical care, education, and research initiatives.
Related Article: Predictors of Specialized Pediatric Palliative Care Involvement and Impact on Patterns of End-of-Life Care in Children With Cancer
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Jan 12, 2018
Survival Following Radiofrequency Ablation Versus Stereotactic Body Radiotherapy for Early-Stage Hepatocellular Carcinoma
This podcast reviews the current evidence for using radiofrequency ablation or stereotactic body radiotherapy as primary treatment for nonsurgical management of early stage hepatocellular carcinoma.
Related Article: Radiofrequency Ablation Versus Stereotactic Body Radiotherapy for Localized Hepatocellular Carcinoma in Nonsurgically Managed Patients: Analysis of the National Cancer Database
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Dec 1, 2017
The True Costs of the 21-Gene Assay in a Cohort of 1,000 Patients
This podcast addresses the clinical implications of the high cost of the 21-gene assay in women with ER-positive, node-negative breast cancer.
Related Article: Population-Based Study to Determine the Health System Costs of Using the 21-Gene Assay
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Oct 19, 2017
Persistent Use of Opioids After Cancer Surgery
Though opioid abuse is clearly an issue for cancer patients post-surgery, many other potential factors were not accounted for and should be included in a more in-depth study that goes beyond database analysis.
Related Arcticle: New Persistent Opioid Use Among Patients With Cancer After Curative-Intent Surgery
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Oct 12, 2017
Discussion on the Cost–Effectiveness Analysis of the CALGB/Alliance Trial and the Use of Zoledronic Acid Generic in Women With Metastatic Breast Cancer
The paper examines the cost-effectiveness of schedules of bone-modifying agents in patients with breast cancer and skeletal metastases and supports the 3-month administration of the generic zoledronic acid in terms of cost and efficacy.
Read the accompanying article on JCO.org.
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Sep 21, 2017
Can We Simplify the Treatment of Myelofibrosis?
In this randomized trial, momelotinib was non-inferior to ruxolitinib for spleen response but was less effective in controlling symptoms.
Related Article: SIMPLIFY-1: A Phase III Randomized Trial of Momelotinib Versus Ruxolitinib in Janus Kinase Inhibitor–Naïve Patients With Myelofibrosis
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Sep 11, 2017
Lessons to be Learned about the Significance of Educational Level in Adults with Acute Myeloid Leukemia
A Danish population based study of adults with acute myeloid leukemia is described, and the potential significance of educational level as a predictor of receipt of allogeneic transplant and overall survival is explored.
Read the associated article on JCO.org.
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Aug 17, 2017
More Often but Not Early: Hospice Use Among Older Adults With AML
With a large database analysis, the authors found an increase in hospice use among older patients with AML at the end of life, but this increase was largely driven by late enrollment.
Read the associated article by Wang et al on JCO.org.
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Aug 17, 2017
T-cell Therapy for Viral Infections after Stem Cell Transplant
T-cell therapies targeting viral diseases have evolved from a patient-specific therapy, targeting a single virus, and requiring multiple months of specialized manufacturing, to readily-available cell banks capable of targeting multiple viruses for many individuals.
Read the associated article by Tzannou et al on JCO.org.
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Jul 12, 2017
Shared Risk Factors in Cancer and Cardiovascular Disease: Can We Make a Difference?
This podcast examines the growing evidence to support the link between risk factors for cardiovascular disease and cancer.
Related Article: Guideline-Based Statin Eligibility, Cancer Events, and Noncardiovascular Mortality in the Framingham Heart Study
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Jul 7, 2017
Should Metabolic Imaging to Assess Minimal Residual Disease (MRD) Become a Clinical Endpoint in Multiple Myeloma?
Normalization of PET-CT is a strong predictor for progression free survival (PFS) and overall survival (OS) in multiple myeloma (MM)
Related Article: Prospective Evaluation of Magnetic Resonance Imaging and [18F]Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography at Diagnosis and Before Maintenance Therapy in Symptomatic Patients With Multiple Myeloma Included in the IFM/DFCI 2009 Trial: Results of the IMAJEM Study
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Jul 3, 2017
Considerations in Predicting Neuropsychological Outcomes in Children Treated for ALL
Randomization to different methotrexate and steroid treatment strategies was not related to neuropsychological outcome in children treated for B-ALL, but age and insurance status were significant predictors.
Read the associated article "Neurocognitive Functioning of Children Treated for High-Risk B-Acute Lymphoblastic Leukemia (HRALL) Randomized to Capizzi (CMTX) Versus High- Dose Methotrexate (HDMTX): A Report From the Children’s Oncology Group (COG)" on JCO.org.
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Jun 8, 2017
Low-Income Subsidy and Financial Barrier to Access Costly Oral Chemotherapy Drugs for Myeloma Patients Enrolled in Medicare Part D
This podcast summarizes the study finding and discuss the clinical and policy implication of an article to appear in JCO that examined the impact of low-income subsidy on the utilization, adherence, and costs of oral immunomodulatory drugs among elderly myeloma patients.
Read the article Subsidies for Oral Chemotherapy and Use of Immunomodulatory Drugs Among Medicare Beneficiaries with Myeloma by Olszewski et al.
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May 22, 2017
Beyond the Beam: Thinking about Subsequent Malignancy Risk Outside of the Radiation Paradigm,”
In a unique approach to subsequent malignancy research, Teepen and colleagues report on subsequent solid cancer risk associated with chemotherapy exposure among survivors of childhood cancer, and emphasize the need for greater future collaborative survivorship research efforts.
Related Article: Long-Term Risk of Subsequent Malignant Neoplasms After Treatment of Childhood Cancer in the DCOG LATER Study Cohort: Role of Chemotherapy
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May 11, 2017
Discussion of the SWORD-Study and Fear of Cancer Recurrence Intervention Research Randomized Controlled Trial
The SWORD study is one of the first randomized controlled trials targeting fear of cancer recurrence (FCR) and results support the efficacy of cognitive behavior therapy for the treatment of FCR, a prevalent and distressing concern among a significant proportion of cancer survivors.
Related Article: Efficacy of Blended Cognitive Behavior Therapy for High Fear of Recurrence in Breast, Prostate and Colorectal Cancer Survivors; The SWORD- study, A Randomized Controlled Trial by van de Wal et al.
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May 5, 2017
Optimizing Up-Front Therapy for Double-Hit Lymphoma
This podcast discusses the role of consolidation stem cell transplantation in patients with double-hit lymphoma who achieve a complete response to front-line therapy and also focuses on the benefit of intensive versus standard therapy for this disease.
Related Article: Outcomes of Patients With Double-Hit Lymphoma Who Achieve First Complete Remission
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May 4, 2017
Chronic Conditions in Cancer Survivors
This podcast summarizes and discusses the findings from a study by Guy and colleagues about the economic impact of chronic conditions in cancer survivors in the United States.
Related Article: Economic Burden of Chronic Conditions Among Survivors of Cancer in the United States
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Apr 18, 2017
Do Treatment Summary Survivorship Plans Make Any Difference?
This randomized controlled trial shows that Treatment Summary Survivorship Plans increase physician recommendation of needed care among breast cancer survivors but may not significantly impact patient adherence.
Related Article: Randomized Controlled Trial of Survivorship Care Plans Among Low-Income, Predominantly Latina Breast Cancer Survivors
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Mar 30, 2017
The Impact of Cigarette Smoking on Survival in Patients with Pancreatic Cancer
This podcast discusses the association between smoking and risk of death from pancreatic cancer.
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Mar 28, 2017
Better Patient-Reported Outcomes After Autologous Breast Reconstruction Compared to Implant-Based Reconstruction Study
Patients who had autologous reconstruction had higher satisfaction with breasts and well-being than patients who had implant-based reconstruction, but both groups experienced substantial physical morbidity.
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Mar 24, 2017
Drugs Don't Work in Patients Who Don't Take Them
This podcast describes the results and implications of the article published by Landier et al, describing the relationship between 6-MP ingestion habits and outcomes, as well as adherence, among children with acute lymphoblastic leukemia.
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Mar 22, 2017
Pembrolizumab is Safe and Active in Platinum- and Cetuximab-Refractory Head and Neck Squamous Cell Carcinoma
By Amanda Psyrri
The findings of KEYNOTE-055 are summarized and compared to other immunotherapy studies in recurrent/metastatic head and neck squamous cell carcinoma.
Related Article: Pembrolizumab for Platinum- and Cetuximab-Refractory Head and Neck Cancer: Results From a Single-Arm, Phase II Study
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Mar 15, 2017
Long-Term Follow-up of AF-001JP: A Phase I/II Study of Alectinib in ALK-Positive NSCLC
Podcast re: 'Three-year Follow-up of an Alectinib Phase 1/2 Study in ALK-Positive Non-Small-Cell Lung Cancer: AF-001JP' by Tamura et al.
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Feb 28, 2017
Late Relapse in Hodgkin Lymphoma Persisting Even at 20 Years: Implications for Therapeutic Intensity and Disease Biology
This podcast discusses the JCO article, "Late Relapse of classical Hodgkin Lymphoma: An Analysis of the German Hodgkin Study Group HD7-HD12 Trials" by Paul Jan Bröckelmann, et al. which demonstrates that late relapses are seen in a small fraction of early stage good risk Hodgkin lymphoma patients, which increase in incidence up to 20 years and do not appear to plateau, and examines the implications of these findings with respect to therapy and disease biology.
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Feb 21, 2017
Intensification of Consolidation Therapy for Acute Myeloid Leukemia by the Addition of Clofarabine to Cytarabine Improves Relapse-Free Survival
By Kenneth Bradstock
This podcast describes a clinical trial of clofarabine in consolidation therapy for adults with acute myeloid leukemia.
Related article: Randomized Phase II Study of Clofarabine-Based Consolidation for Younger Adults With Acute Myeloid Leukemia in First Remission
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Feb 13, 2017
Characterizing the Patterns of Clonal Evolution in Ibrutinib-Treated CLL: A Roadmap for Continued Progress
Dr. Wiestner highlights characteristics of ibrutinib resistant CLL as reported by Woyach and colleagues and discusses how these data refine the management of CLL in the area of targeted therapy and can stratify patients for future clinical trials.
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Jan 30, 2017
Prevalence of Germline Mutations in Individuals With Colorectal Cancer as Determined Using a Multi-Gene Panel Test
Summary and discussion of JCO paper by Yurgelun at al. using a 25-gene panel to demonstrate a nearly 10% germline mutation rate in colorectal cancer patients independent of high-risk factors.
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Jan 11, 2017
Financial Barriers to Cancer Care for Patients Obtaining Insurance on the Federal Exchange
By Stacie B. Dusetzina
Considering the role of network coverage on access to accredited cancer institutions and potential out-of-pocket costs for patients.
Related Article: Access to Accredited Cancer Hospitals Within Federal Exchange Plans Under the Affordable Care Act
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Nov 21, 2016
Mindfulness-Based Interventions in Oncology: Not for Everyone?
By Linda E. Carlson
This podcast discusses the target study in the context of other research on mindfulness-based interventions for cancer patients and survivors, providing a critique and suggestions for clinical interpretation and future research.
Related Article: Mindfulness-Based Cognitive Therapy in Advanced Prostate Cancer: A Randomized Controlled Trial
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Nov 21, 2016
The Impact of Oral Targeted Therapies on the Cost of Care for Patients With Chronic Lymphocytic Leukemia
By Christopher R. Flowers
Modeling studies like the one presented by Qiushi Chen and colleagues can project where needs and opportunities exist to address the pricing structure of medications and the selection of management strategies in CLL.
Related Article: Economic Burden of Chronic Lymphocytic Leukemia in the Era of Oral Targeted Therapies in the United States
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Nov 14, 2016
Watching Nivolumab’s Balancing Act: How Immune Activation May Affect Both Safety and Efficacy in Patients With Advanced Melanoma
This podcast provides commentary on a large dataset describing the expected frequency, severity and kinetics of immune-related adverse events associated with nivolumab monotherapy and the expected use of corticosteroid supportive therapy together with observations relating to the associations between immune adverse events, corticosteroid use and efficacy.
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Oct 26, 2016
Getting to the Heart of the Matter: Biomarkers for the Assessment of Trastuzumab-Induced Cardiac Dysfunction
By Deepa Rangachari
This podcast focuses on the use of trastuzumab in adjuvant therapy for early stage, Her2-positive breast cancer and ongoing efforts to identify predictive and prognostic biomarkers for the assessment of treatment-related cardiac toxicity.
Related Article: Role of Troponins I and T and N-Terminal Prohormone of Brain Natriuretic Peptide in Monitoring Cardiac Safety of Patients With Early-Stage Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer Receiving Trastuzumab: A Herceptin Adjuvant Study Cardiac Marker Substudy
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Oct 3, 2016
Listen to Your Patients
If you are an oncologist and think that it isn’t part of your job to listen to your patients talk about depression, I urge you to re-consider. As Sullivan and colleagues show, depression can be lethal.
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Sep 12, 2016
Impact of Organizational Characteristics and Process of Care on Hospital Mortality and Resource Use in Cancer Patients Admitted to Intensive Care Units
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Sep 6, 2016
Health-Related Quality of Life: Increasingly Important in the Era of Effective, Modern Myeloma Therapy
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Aug 14, 2016
Chemotherapy Induced Peripheral Neuropathy: A Novel Method of Exploration
This podcast highlights the innovative methodology employed in this study to determine risk factors for chemotherapy induced peripheral neuropathy, as well as implications of the findings to clinical practice and future investigation of immune mechanisms of this toxicity.
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Aug 8, 2016
Changes in the Epidemiology of AIDS-Related Kaposi’s Sarcoma and Lymphomas: How This Informs the Clinician
This podcast will assist readers in understanding the clinical implications of the paper by Yanik and colleagues. The paper describes the occurrence of Kaposi’s sarcoma and lymphoma in the era of effective anti-HIV therapy where patients appear to be doing well from the standpoint of HIV clinical assessment, but continue to develop cancers associated with AIDS.
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Jul 14, 2016
Implicit Racial Bias Affects Key Aspects of Physician Communication
Implicit bias affects oncologists and their patients - a few steps can help
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Jul 14, 2016
Nivolumab Monotherapy is Safe and Active in Hematologic Malignancies
This podcast is a discussion of a clinical trial by Lesokhin et al which evaluated nivolumab monotherapy in patients with relapsed or refractory hematologic malignancies.
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Jul 13, 2016
Minimizing Frailty in Cancer Survivors: A Meaningful Goal for All Ages
This podcast discusses the prevalence of and risk factors associated with a phenotype of accelerated aging among ALL survivors. Measurement and implications of frailty/pre-frailty are discussed.
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Jul 11, 2016
1q Gain, a Prognostic Biomarker in Nephroblastoma, and What’s Next?
This podcast comments on two independent pediatric studies on both sides of the Atlantic showing the relevance of 1q gain in poor prognosis Wilms tumors which raises the perspectives for therapeutic modifications.
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Jul 5, 2016
Therapy Impacts Long-Term Survival for Patients in Germany With Heritable Retinoblastoma
While ten-year overall survival has increased for German patients with heritable retinoblastoma, treatment modalities including radiation and/or chemotherapy can impact overall survival.
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Jul 1, 2016
Dexamethasone and High-Dose Methotrexate in High-Risk B Cell Acute Lymphoblastic Leukemia—Where Should We Go From Here?
The Children's Oncology Group study led by Larsen et al. showed that children and young adult patients with high-risk B cell acute lymphoblastic leukemia benefit from receiving high-dose methotrexate during interim maintenance 1 and that those aged 1 to 9 years benefit from receiving dexamethasone for 14 days during induction.
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Jun 20, 2016
Unraveling the Significance of Mismatch Repair Deficiency in Women With Endometrioid-type Endometrial Adenocarcinoma
This podcast discusses the study by McMeekin and colleagues regarding their analysis of the prognostic and predictive implications of mismatch repair deficiency status among a tissue sample registry cohort of 1,024 endometrioid-type endometrial adenocarcinomas.
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Jun 13, 2016
Nodal Status After Neoadjuvant Chemotherapy Determines Prognosis in Localized Gastric Cancer
A central histopathological analysis of tumor material sampled within the Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) Trial shows that lymph node involvement is the only independent predictor of survival following chemotherapy plus resection
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Jun 6, 2016
Restrictions on Nutrition, Social Contacts, and Pets Are Not Effective Anti-Infective Measures in Children With Acute Myeloid Leukemia
Restrictions on nutrition, social contacts, and pets are not effective anti-infective measures in children with acute myeloid leukemia.
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May 23, 2016
Current Status of Supplemental Screening in Dense Breasts
This podcast will review results from screening ultrasound and tomosynthesis in women with dense breasts and will discuss current and future use of MRI screening which may include average risk women.
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May 11, 2016
Selective Internal Radiation Therapy for Liver-Dominant Metastatic Colorectal Cancer: Time to Put the Brakes On?
In this podcast, Dr. Andrew Ko discusses the SIRFLOX trial evaluating whether the addition of radioembolization to systemic chemotherapy confers any benefit in patients with liver-dominant metastatic colorectal cancer, and whether the results should compel us to rethink our use of this technology for this disease indication.
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May 3, 2016
Prognostication Based on Site of Metastatic Disease in Castration Refractory Prostate Cancer: Implications for Patient Care and Clinical Trial Design
Impact of site of metastasis on overall survival in castration refractory prostate, and its implications on patient care and clinical trial design.
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Apr 25, 2016
IgM-Related AL Amyloidosis: A Rare Form of a Rare Disease
This podcast This JCO Podcast provides observations and commentary on the JCO article, "A European collaborative study of natural history, outcomes and validation of prognostic and response criteria in IgM related AL amyloidosis."
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Apr 12, 2016
Quality of Life: A Critical Consideration in Women Diagnosed with Ductal Carcinoma in Situ
This podcast puts into context the findings from Hart and colleagues, highlighting the clinical care and research implications.
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Mar 29, 2016
Very Late Outcomes of Wilms Tumor Survivors: British Childhood Cancer Study
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Mar 11, 2016
Web-Based Technology Can Improve Patient Understanding and Preparedness to Discuss Cancer Clinical Trials: One Step Towards a Goal of Increased Enrollment
In this podcast, the article by Meropol et al. describing a randomized trial of a web-based educational tool versus a standard text-based resource is analyzed and placed in context of other challenges that limit the enrollment of adult cancer patients in contemporary clinical trials.
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Mar 9, 2016
How Should We Manage the Financial Toxicity of Cancer Treatment?
A study by Ramsey and colleagues suggests that extreme financial distress as manifested by personal bankruptcy might be associated with worse mortality in cancer patients. Long-term solutions have to focus on policy shifts involving how we set prices for drugs and how we design health insurance, but for more immediate solutions interventions have to focus on the oncologist and patient.
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Feb 29, 2016
Prognostication in Mantle Cell Lymphoma
The Ki-67 proliferation index improves the prognostic value of the MIPI score.
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Feb 8, 2016
Sunbelt Melanoma Trial: A Seminal Adjuvant Interferon Trial with Long Term Results
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Jan 25, 2016
Clinical Drug Development for Non-Muscle-Invasive Bladder Cancer…Definitions Matter
This podcast reviews the International Bladder Cancer Group’s recommendations regarding definitions and endpoints for the development of non-muscle-invasive bladder cancer clinical trials.
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Jan 25, 2016
Race for the Cure: How differences in Race and Ethnicity Impact the Diagnosis and Survival of T-Cell Lymphoma
Ethnicity’s impact on diagnosis and survival of T-cell lymphoma
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Jan 25, 2016
Hepatocellular Carcinoma in Children and Adolescents: Time for a Strategy and a Trial
An update on clinical trials that have included children with hepatocellular carcinoma
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Jan 12, 2016
Epidural Spinal Cord Compression: The Importance of Multi-disciplinary Treatment Planning
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Jan 11, 2016
Hard to RECIST: Updating and Simplifying Primary Tumor Response Guidelines for the Revised International Neuroblastoma Response Criteria (INRC)
This podcast reviews the accompanying article to provide the audience an understanding of the data and rationale to support updating the INRC primary site response criteria.
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Jan 11, 2016
Expanding Immunotheapy Benefit in Metastatic RCC
Discussion of a phase I trial of the checkpoint inhibitor atezolizumab in metastatic renal carcinoma.
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Jan 4, 2016
A New Oncogene Target in Lung Cancer: Exon 14 Alterations in the MET Gene
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Dec 30, 2015
The Evolution of the Polycythemia Vera Symptom Burden: Implications for a Changing Treatment Paradigm
This podcast provides commentary on the importance of symptom assessment in Polycythemia Vera, and how this may impact therapeutic decision-making.
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Dec 28, 2015
The Emerging Role of Gallium-68 Somatostatin-Receptor PET Imaging in Neuroendocrine Tumors
This podcast describes the evolving role of Gallium-68 somatostatin-receptor PET imaging in the evaluation of patients with well-differentiated neuroendocrine tumors, and compares the diagnostic sensitivity of this imaging modality to conventional scans.
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Dec 23, 2015
Dexrazoxane for childhood cancer patients – ready for prime time?
Summarize the paper by Asselin et al and review the risks of therapy-related cardiomyopathy and evidence supporting dexrazoxane use in pediatric oncology.
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Nov 9, 2015
Uterine lavage: a new approach to gynecologic cancer detection?
Recent findings represent an important and exciting step in applying the rapid advance of sequencing technologies to generate molecularly-driven approaches towards the detection of gynecologic malignancies. More work is needed to better define and validate where such an approach might add most meaningfully in the search for effective methods of ovarian and endometrial cancer detection and diagnosis.
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Nov 2, 2015
Hormonal Therapy is Out for Meningiomas: Time to Change Tactics?
The randomized placebo controlled trial of progesterone receptor blockade showed no difference in survival, finally answering the question about hormonal therapy in this disease and raising new questions about how to move forward quickly.
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Nov 2, 2015
Defining the Optimal Interval for Colonoscopic Screening in Individuals with a Family History of Colorectal Cancer
This podcast discusses the study by Hennink and colleagues regarding their randomized controlled trial of a 3-year versus 6-year interval for screening colonoscopies in individuals with a family history of colorectal cancer.
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Oct 5, 2015
Using the CLIC Study of Outcome in Advanced Stages of Mycosis Fungoides and Sezary Syndrome to Guide Treatment And Clinical Research
This podcast reviews the current knowledge of staging and prognosis of mycosis fungoides and Sezary syndrome and evaluates the CLIC study, which aims to develop a prognostic index that can be used with patients who are diagnosed with advanced disease.
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Aug 24, 2015
Geographic Access as a Barrier to Adjuvant Chemotherapy for Patients with Stage III Colon Cancer
This podcast summarizes new evidence about the role of travel distance, oncologist density, and insurance in receipt of guideline-based chemotherapy for patients with stage III colon cancer.
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Aug 17, 2015
Host Factors and Lynch Syndrome Patients: Weighing Role of Obesity and Aspirin and Risk of Colorectal Cancer
This podcast will discuss the association of obesity and risk of developing colorectal cancer in Lynch syndrome patients based on a manuscript by Mohammad Movahedi and colleagues. In this manuscript, they report an association between obesity and increased risk of colorectal cancer as well as the potential benefit of aspirin to reduce the risk of colorectal cancer in obese Lynch syndrome patients.
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Aug 17, 2015
To Stop or Not to Stop: That is the Question
Combined analysis of multiple phase three trials in multiple myeloma demonstrates improved outcomes with continued therapy
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Aug 17, 2015
The Promise and the Pitfalls of Population-Wide Screening of BRCA1 and BRCA2
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Aug 17, 2015
Breast Cancer and Weight Loss: Where Do We Go from Here?
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Aug 6, 2015
Intraperitoneal Therapy for Ovarian Cancer: No More Excuses
This podcast will examine data on utilization, toxicity and survival outcomes with the use of intraperitoneal chemotherapy for initial treatment of ovarian cancer at six NCCN institutions.
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Jun 22, 2015
Balancing Safety and Efficacy in the Treatment Hodgkin Lymphoma: Early Discontinuation of Certain Drugs Can and Should Be Done
Analogous to prior analyses with ABVD, in a large series of Hodgkin lymphoma patients treated with BEACOPP, Haverkamp and colleagues from the German Hodgkin Study Group report that early discontinuation of bleomycin or vincristine due to toxicity has no impact on cure rates or survival.
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Jun 8, 2015
When Toxicity and Efficacy Collide
This podcast explores the complicated relationship between potency, toxicity, and duration of therapy, and how each impacts the overall efficacy of therapy.
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Jun 1, 2015
First Results of Euramos I and Logistics of International Collaboration for Clinical Trials of Rare Diseases
This study involved working together across oceans, regulatory bodies in various countries, different cultures in 4 cooperative groups, different standard chemotherapy administration guidelines, and putting aside personal biases and styles to work together and come up with a document acceptable to all, in order to conduct an international trial in a rare disease for the benefit of children with osteosarcoma.
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May 18, 2015
Treatment Advances in Local-Regionally Advanced and Stage IVB/Recurrent Cervical Cancer: Can We Agree that More Isn’t Always Better?
The two recent papers by Kitagawa, et al and Rose, et al, give us treatment options and tools that help maximize not only the benefits of survival with treatment but minimization of non-beneficial treatment toxicity through identification of patients with advanced and recurrent cervical cancer that are most and least likely to benefit.
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May 11, 2015
Building Blocks in the Case for Adjuvant Therapy in Biliary Tract Cancers
This podcast places the results of SWOG S0809, a phase II intergroup trial of adjuvant capecitabine/gemcitabine followed by radiotherapy and concurrent capecitabine in extrahepatic cholangiocarcinoma and gallbladder carcinoma, in context with prior conflicting data and discusses implications for development of a definitive phase III trial.
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May 11, 2015
Androgen Deprivation Therapy for Prostate Cancer - Friend or Foe to the Psyche?
This is a well-annotated study demonstrating that men treated with androgen deprivation therapy for prostate cancer have impaired cognitive performance within six months of starting therapy and that a specific genetic polymorphism may lend toward greater susceptibility to cognitive impairment.
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May 4, 2015
Aromatase Inhibitor Arthralgias: Identification, Treatment Options and Research Perspectives
This is a requested commentary regarding a concurrently-published manuscript which evaluated the utility of omega-2 fatty acids for the treatment of aromatase inhibitor-associated arthralgias.
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Apr 20, 2015
Deciphering the Heterogeneity Within EGFR-mutant Lung Cancer
A meta-analysis of 7 randomized trials comparing EGFR kinase inhibitors to chemotherapy for advanced EGFR-mutant lung cancer has shown that some populations gain greater benefit from targeted therapy – namely never-smokers, woman, and tumor harboring exon 19 deletions.
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Apr 15, 2015
Precision Immunology: The Promise of Tumor Immunotherapy for the Treatment of Cancer
This podcast discusses a novel immunotherapy approach using an allogeneic whole tumor cell vaccine to prime, and a recombinant antigen-encoded bacterial vector to boost, immune responses against pancreatic cancer and explains why this approach may be beneficial in the treatment of advanced pancreatic cancer.
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Apr 14, 2015
The Importance of Discussing Genetics with Every Breast Cancer Patient
In summary, healthcare providers caring for breast cancer patients hopefully recognize the need for consideration of genetic testing in appropriate individuals, and communicate that need to the patient. A discussion about why genetic testing is not appropriate may be as beneficial as one about why it is, and oncology providers should consider briefly discussing genetics with all patients, even if the subject is provider-initiated.
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Mar 19, 2015
Hematopoietic Stem Cell Transplant for Children With Acute Lymphoblastic Leukemia at BFM Centers: Comparable Results With Matched Sibling Donors and Matched Unrelated Donors
Review and comments on BFM experience of ALL hematopoietic transplantation.
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Feb 9, 2015
Is It Biology or Brawn in Ovarian Cancer Surgery?
This podcasts provides perspective on a recent report evaluating disease volume and surgical complexity on post-operative tumor residuum and survival in ovarian cancer patients.
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Feb 5, 2015
Mirror Views: Reflections of Complementary Perspectives in Patient and Clinician Toxicity Reporting
In this podcast, Dr. Claire Snyder discusses how patient-reported outcomes provide a critical perspective to evaluating health conditions and their treatment, and describes several tools available to facilitate the measurement and application of PROs.
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Jan 23, 2015
Dynamic Evolution of ALK Positive Non-Small Cell Lung Cancers and Management of Associated Brain Metastases
An analysis of the PROFILE studies and opportunities for treatment of ALK-rearranged non-small cell lung cancer
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Jan 21, 2015
Prediction of Breast Cancer Risk After a Benign Breast Biopsy: A Practical Model?
The development and practical utility of a model developed in the Mayo benign breast disease cohort to predict invasive breast cancer risk after benign breast disease is described.
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Jan 21, 2015
Prophylactic Anticoagulation in High-Risk Metastatic Germ Cell Tumor Patients: Who Should We Treat?
This JCO Podcast provides observations and commentary on the JCO article, "Large retroperitoneal lymphadenopathy as a predictor of venous thromboembolism in patients with disseminated germ cell tumors treated with chemotherapy" by Amirrtha Srikanthan, et al.
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Dec 22, 2014
The Risk of Second Cancers for Patients with Endometrial and Rectal Cancer Receiving Radiation Therapy
This is an oral commentary on patients with endometrial or rectal cancer, and their risk of developing second malignancies with or without radiation.
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Dec 8, 2014
Better Outcome of Chemo-Irradiation of Head and Neck Cancer in High-Patient-Volume Institutions
In a randomized RTOG study of chemotherapy concurrent with accelerated vs standard fractionated radiotherapy for head and neck cancer, it was found that patients treated in institutions who accrued a large number of patients had better outcomes compared with those treated at low-volume institutions, highlighting the importance of referring patients with advanced cancer to high-volume centers.
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Dec 1, 2014
The Treatment of Insomnia in Cancer Patients
This four-arm randomized controlled trial of cognitive behavioral therapy for insomnia in cancer patients confirmed its effectiveness but did not demonstrate benefit from the addition of a daytime wakefulness-promoting agent.
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Dec 1, 2014
Is There a Future for Cyclooxygenase-2 Inhibition in Non-Small Cell Lung Cancer?
This podcast reviews the available data from clinical trials using cyclooxygenase-2 inhibition with chemotherapy in non-small cell lung cancer and provides a perspective on patient selection and future directions.
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Nov 25, 2014
The Biopsy Study: How the Use of Multiple Colposcopic-Directed Biopsies Improves Detection of Cervical Precancers
This podcast is a review of the submitted article by Dr. Wentzensen and colleagues regarding multiple cervical biopsies at the time of colposcopy and the implications for the management of cervical dysplasia.
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Nov 25, 2014
Intensified Frontline Chemoimmunotherapy with R-ACVBP May Improve Outcomes for Younger Patients with Non-Germinal Center B-Cell-Like Diffuse Large B-Cell Lymphoma
A secondary analysis of a multicenter randomized trial suggests that the R-ACVBP regimen may improve outcomes in younger patients with the non-germinal center B-cell subtype of diffuse large B-cell lymphoma.
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Nov 25, 2014
A Positive Study of DTC-Guided Secondary Adjuvant Treatment in Early Breast Cancer: Ready for Prime Time?
Modifying therapy based upon positive DTCs in breast cancer.
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Nov 25, 2014
A Second Course of Radiation Therapy for Painful Osseous Metastases Improves Patient Function and Quality of Life
NCIC SC.20 demonstrates that a second course of radiation for painful osseous metastases significantly improves patients quality of life and function.
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Nov 25, 2014
Adjuvant Trastuzumab Passes the Test of Time
Long-term follow up from the landmark, NCI-sponsored adjuvant trastuzumab trials confirms the clinical benefits and clinical safety of this important therapy.
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Nov 25, 2014
Prognostic Value of BRAF V600 E Mutation in Papillary Thyroid Cancer
This podcast provides a commentary on the association of braf mutation and thyroid cancer showing an increase risk of recurrence in patients with thyroid cancer that harbor this mutation.
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Nov 25, 2014
Biochemotherapy: As Time Goes By?
In this podcast, the results of the S0008 adjuvant intergroup trial are discussed and placed in the context of current advances in melanoma treatment.
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Nov 25, 2014
The First Prospective Trial of Proton Therapy for Children With Rhabdomyosarcoma: What We Learn From Preliminary Results
This is a prospective study of proton radiotherapy for rhabdomyosarcoma showing equivalent efficacy with photon treatment.
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Nov 25, 2014
Intermediate Risk Pediatric Hodgkin Lymphoma: Early Response-Adapted Treatment Is Key
Tailoring treatment in intermediate-risk pediatric Hodgkin lymphoma is feasible using an early response-based assessment for the omission of radiotherapy.
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Nov 25, 2014
Keeping Older Cancer Patients out of the Hospital: A Community Affair
Given the high rate of unplanned hospitalizations in older cancer patients, multidisciplinary care is needed for outcomes improvement.
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Nov 25, 2014
Optimal Duration of MRD Monitoring During Therapy for Childhood ALL
Minimal residual disease monitoring has been very helpful in early response evaluation and risk stratification of children with acute lymphoblastic leukemia (ALL). This podcast discusses the pros and cons of extended MRD monitoring throughout the duration of therapy for childhood ALL.
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Nov 25, 2014
Hepatitis B Reactivation in Patients Receiving Rituximab Can Be Detected Early and Managed with Antivirals
This podcast describes the report of a cohort of Chinese patients with known prior hepatitis B exposure, receiving rituximab as part of their therapy for lymphoma. The podcast includes a summary of the trial and discussion of the finding that while reactivation of hepatitis B is common in this population, if treatment with antivirals is started soon after the detection of a positive viral load, then pathology related to hepatitis B can be avoided.
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Sep 29, 2014
CT or No CT: An Important Question in Diffuse Large B-Cell Lymphoma
In this paper, the authors demonstrate that only a very small percentage of patients from 2 large, prospective cohorts developed recurrent diffuse large B-cell lymphoma detected solely on post remission imaging. In addition, the overall survival of these patients was not different from that of patients who presented with symptoms or findings on physical exam. I will review the data and discuss its possible implications for the clinical care of patients in remission at the completion of front-line chemotherapy.
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Sep 29, 2014
Glembatumumab Vedotin (CDX-011, CR011-vcMMAE): On The Brink Of Targeted Therapy For Triple-Negative Breast Cancer?
A phase I/II study of the antibody-drug conjugate glembatumumab vedotin (CDX-011 or CR011-vcMMAE) in patients with locally advanced or metastatic breast cancer, reveals an acceptable safety profile and promising clinical activity in GPNMB expressing breast cancer.
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Sep 29, 2014
Post-Transplant Cyclophosphamide for GVHD Prophylaxis: Back to the Future
Conventional GVHD prophylaxis with calcineurin inhibitors has a high incidence of chronic GVHD. Kanakri et al show that post-transplant administration of High dose cyclophosphamide is an effective way of reducing chronic GVHD. Limitations of this approach and alternative approaches are briefly discussed.
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Sep 29, 2014
The Price Of A Drug is Not the Whole Cost
Many new oncology drugs are expensive. Drug prices may not reflect the whole cost of new agents, as increases or decreases in adverse effects compared to previously available therapies may influence cost comparisons. This podcast summarizes a meta-analysis of the economic consequences of adverse effects in 41 registration trials that led to approval of new oncology drugs between 2000 and 2011.
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Sep 15, 2014
Cabozantinib in Advanced Prostate Cancer: Is the Therapeutic Window Too Narrow?
This podcast discusses a phase 2 trial of cabozantinib in men with advanced bone-metastatic prostate cancer, using a novel method to assess bone scan response.
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Sep 2, 2014
Fracture Risk after Cystectomy: Don't Ignore It
This podcast discusses the results and practical implications of a population-based study that found an increased fracture risk after cystectomy for bladder cancer.
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Aug 26, 2014
Is Hematopoietic Stem Cell Transplantation of Value in Treating Systemic Mastocytosis?
This podcast discusses the current state of knowledge regarding allogeneic transplantation as a treatment modality for advanced systemic mastocytosis.
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Aug 26, 2014
Significant Dose Effect of Radiotherapy to the Pancreas and Risk of Diabetes Mellitus in Long-Term Hodgkin Lymphoma Survivors
This study assessed diabetes mellitus risk in long-term Hodgkin lymphoma survivors, and found that a mean pancreatic tail dose of 36 Gy or higher was associated with a significantly increased risk of diabetes mellitus. This finding has important implications in the follow up of long-term Hodgkin lymphoma survivors, and also suggests that in newly diagnosed patients with upper abdominal involvement, the pancreas should be included as in organ-in-risk in the radiotherapy planning.
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Aug 26, 2014
The End of Rituximab Maintenance for Low Tumor Burden Follicular Lymphoma
This podcast reviews the publication of the RESORT manuscript, and puts these results into context with the recently published Ardeshna trial of rituximab vs. observation in follicular lymphoma, concluding that there is no longer a role for rituximab maintenance in low tumor burden follicular lymphoma.
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Aug 26, 2014
Use of Mutational Analysis to Help Decide Whether Patients with Myelodsysplastic Syndromes Should Receive Allogeneic Hematopoietic Cell Transplant
This podcast will use the study reported by Bejar and colleagues to review the role of screening for TET2, DNMT3A, and particularly TP53, mutations in deciding whether to recommend allogeneic hematopoietic cell transplant for patients with myelodysplastic syndromes.
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Jul 21, 2014
Why are Fellows' Burnout Rates as High as Those of Practicing Oncologists?
This JCO Podcast provides observations and commentary on the JCO article, "Oncology Fellows' Career Plans, Expectations and Well-Being: Do Oncology Fellows Know What They are Getting In To?" by Tait D. Shanafelt, et al.
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Jul 21, 2014
Surprisingly Good Results in BCR-ABL1-like Pediatric Acute Lymphoblastic Leukemia: What Do They Mean?
This study reports surprisingly good outcomes for children with Ph-like ALL treated on the St. Jude Total Fifteen clinical trial.
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Jul 7, 2014
Should Corticosteroids Be Used for the Treatment of Pain, Fatigue and Loss of Appetite in Cancer Patients Receiving Opioids?
Corticosteroids are recommended as part of the WHO analgesic ladder but there is limited evidence for their efficacy for the treatment of pain in cancer patients.
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Jul 3, 2014
Breast Reconstructions: Inequities in Access Affecting Choice and Quality
The availability of reconstructive surgeons restricts the use of immediate breast reconstruction, creating unintended inequities even in a system with universal health care coverage.
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Jun 23, 2014
Recurrent/Metastatic Human Papillomavirus-Associated Oropharynx Cancer: What Happens When This Good Prognostic Cancer Misbehaves?
This podcast describes the rising epidemic of HPV-associated oropharynx cancer, its unique demographic profile and natural history, and comments on new findings from Carole Fakhry et al. regarding patterns of disease recurrence seen in patients enrolled on RTOG 0129 and 0522.
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Jun 9, 2014
Long Term Cardiac Safety Data from the HERA Adjuvant Trastuzumab Trial
This podcast discusses the report of cardiac monitoring data from the HERA trial, places the findings in context with data from other trials, and considers how the report relates to clinical practice.
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Jun 9, 2014
Breast Needle Core Biopsy: The Impact Surgeons and Geography Have on Utilization and the Impact on Patient Care
This is a review of breast needle biopsy for the diagnosis of breast cancer and how surgeons and geography affect utilization and the resultant impact on quality of care.
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Jun 2, 2014
Identifying High-Risk Myeloma
FISH genetics, LDH and beta 2-microglobulin can identify a group of newly diagnosed myeloma patients with a two-year survival of only 52% in spite of bortezomib-based therapy.
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May 27, 2014
Attempting to Avoid Chemotherapy in CLL with Lenalidomide and Rituximab
The current study, reporting on the upfront use of lenalidomide and rituximab in CLL, suggests high response rates and excellent tolerability in younger as well as older patients, albeit with a modest median progression-free survival.
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May 27, 2014
Breast Cancer Chemotherapy Effects on Brain Activation During Multitasking and Relation to Cognitive Complaints
This podcast summarizes the findings of a recent longitudinal functional MRI study examining the effects of breast cancer chemotherapy on multitasking-related brain activation and its relationship to cognitive complaints, and discusses implications and future directions.
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May 12, 2014
Delayed Diagnostic Lumbar Puncture to Optimize Central-Nervous-System-Directed Therapy in Childhood Acute Lymphoblastic Leukemia
This podcast discusses the measures to optimize central-nervous-system-directed therapy in children with acute lymphoblastic leukemia.
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May 5, 2014
Capecitabine Versus Continuous Infusion 5-FU for Rectal Cancer Neoadjuvant Chemoradiation: Equivalent Effectiveness Raises Real-World Questions About Efficacy, Adherence and Economic Implications
This trial supports the use of neoadjuvant capecitabine monotherapy as a potentially more convenient radiosensitizer that does not sacrifice surgical and pathologic outcomes in rectal cancer. However, further study is needed.
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May 5, 2014
Evolving Treatment Paradigms for Primary Mediastinal Diffuse Large B-Cell Lymphoma
This podcast reviews the current role of PET and radiotherapy in PMBL.
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May 5, 2014
Response Assessment in Hodgkin Lymphoma: Size Matters!
This podcast concerns the potential complimentary role played by PET and CT in the assessment of response in patients with Hodgkin lymphoma.
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Apr 28, 2014
Second Tumors in PTEN Mutation-Positive Patients: Are They Recurrences or New Primaries?
Among more than 2,000 patients with an invasive cancer, more than 5% had a mutation in PTEN and almost half of these patients had a second malignancy. This observation has implications for patients with breast, endometrial and thyroid cancer, and those with known PTEN mutations.
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Apr 28, 2014
Are Partners of Patients HPV-Positive Oropharyngeal Cancer at Increased Risk of Infection and Cancer?
This partner study suggests that spouses of people with HPV-positive oropharyngeal cancer do not have elevated oral HPV prevalence and the partners’ risk for oropharyngeal cancer remains low.
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Apr 21, 2014
Planning to Survive: The Role of Physicians
This JCO podcast provides observations and commentary on the JCO article, "Provision and discussion of survivorship care plans with cancer survivors: Results of a nationally representative survey of oncologists and primary care physicians" by Danielle Blanch-Hartigan, et al.
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Apr 21, 2014
Minimal Residual Disease (MRD) Study to Optimize Definition and Therapy of High-Risk Acute Lymphoblastic Leukemia
The study provides evidence that several patients with high-risk ALL who show a favorable MRD response to chemotherapy can achieve a cure without stem cell transplantation.
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Mar 31, 2014
Risk-Reducing Oophorectomy in Women with BRCA1 and BRCA2 Mutations: An Opportunity to Personalize Recommendations for Cancer Prevention
This podcast summarizes and provides clinical conclusions of a large international study on ovarian cancer incidence and outcomes in women with BRCA1 and BRCA2 mutations.
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Mar 31, 2014
Anti-EGFR Monoclonal Antibodies in the First-Line Treatment of RAS Wild-Type Metastatic Colorectal Cancer: The PEAK Experience
In this podcast, I will discuss first-line usage of anti-EGFR therapies in metastatic colorectal cancer in the context of the PEAK trial findings with a focus on the emerging data surrounding RAS oncogene mutations in treatment selection.
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Mar 17, 2014
Accuracy of BRCAPRO in Women with Ovarian Cancer
This JCO podcast provides commentary on the accompanying JCO article "Underestimation of risk of a BRCA1 or BRCA2 mutation in women with high grade serious ovarian cancer by BRCAPRO: A multi-institution study" by Molly S Daniels, et al, and evaluates the need for BRCAPRO in patients with ovarian cancer and the benefit of identifying germline BRCA and other mutations in this population.
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Mar 17, 2014
Serious Bevacizumab-Associated Gastrointestinal Toxicity
This podcast discusses the results of an analysis of the risk of severe gastrointestinal toxicity associated with the administration of bevacizumab to women with advanced ovarian cancer.
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Mar 17, 2014
The Efficacy of Bevacizumab Combined with Chemotherapy for Platinum-Resistant Recurrent Ovarian Cancer Patients and Its Effects On Patient-Reported Outcomes
Observations from the AURELIA trial evaluating bevacizumab combined with chemotherapy in platinum resistant recurrent ovarian cancer patients and results from Patient-Reported Outcomes.
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Mar 3, 2014
Nivolumab: Promising Survival Signal Coupled with Limited Toxicity Raises Expectations
This JCO podcast provides observations and commentary on the JCO article, Survival, Durable Tumor Remission, and Long-Term Safety in Patients with Advanced Melanoma Receiving Nivolumab,” by Suzanne Topalian, et al.
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Feb 18, 2014
Decision Shared or Otherwise-: The Ongoing Evolution of Local Therapy for Breast Cancer
Coincident with increased reconstruction with mastectomy are higher rates of mastectomy for early stage cancer and contralateral prophylaxis, suggesting the need for assessment of decision support tools and understanding of the patient perspective.
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Feb 10, 2014
Is Early Initiation of Adjuvant Chemotherapy for Breast Cancer Better?
Early commencement of adjuvant chemotherapy is unlikely to be relevant for the majority of patients but unnecessary delay may be unwise for patients in whom the effect of adjuvant chemotherapy is expected to be significant.
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Feb 10, 2014
Single Agent Rituximab Active in Nodular Lymphocyte Predominant Hodgkin Lymphoma
This podcast describes the recent experience of single agent rituximab as management for newly diagnosed and relapsed nodular lymphocyte predominant Hodgkin lymphoma. The podcast includes a summary of the trial and discussion of the implications of the findings that rituximab has activity in both the upfront and relapsed setting.
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Feb 10, 2014
Adjuvant Treatment for Gastric Cancer: The Story Continues to Evolve
The mature results of a randomized comparison of S-1 versus observation
in Japanese patients who have undergone a D2 resection for gastric cancer continue to
show a significant survival benefit supporting the use of post-operative chemotherapy.