COR2ED Medical Education

COR2ED Medical Education: In this podcast, Prof. Jonathan Trent and Prof. Robin Jones discuss what’s new in the patient management in sarcoma from CTOS 2022. The Connective Tissue Oncology Society is an international group of physicians and scientists with a primary interest in the tumours of connective tissues. With nearly 600 attendees, 10 sessions specific for sarcoma, and over 300 posters, CTOS 2022 took place between November 16 and 19 in Vancouver, BC, Canada. Clinical practice and patient management highlights covered in the podcast include insights from the DEFI study on desmoid tumour, the REECUR study for Ewing sarcoma, and the ENLIVEN study for gastrointestinal stromal tumor (GIST). In addition, early studies with potential clinical impact are discussed. Prof. Jonathan Trent is Associate Director for Clinical Research, the Director of the Bone and Soft-tissue Sarcoma Group and Medical Director of the Precision Medicine Initiative at the Sylvester Comprehensive Cancer Center in the University of Miami Health System, Miami, FL, USA. Prof. Robin Jones is Head of the Sarcoma Unit at The Royal Marsden NHS Foundation Trust, London, UK.

Prof. Thomas Powles, a Medical Oncologist from Barts Cancer Centre in the UK and Dr Friederike Schlürmann a Medical Oncologist from University Hospital of Brest and Quimper in France, discuss the clinical implementation of targeted and immunotherapies for advanced renal cell carcinoma (RCC). In this podcast, the two experts discuss data from key trials CHECKMATE 214 (ipilimumab and nivolumab), KEYNOTE 426 (axitinib and pembrolizumab), CHECKMATE 9ER (cabozantinib and nivolumab), CLEAR (Lenvatinib and pembrolizumab) and COSMIC 313 (cabozantinib plus nivolumab and ipilimumab) and the implications for clinical practice. They also discuss management of toxicities associated with combination treatments, including dosing strategies to ensure the patient remains on optimal treatment and improved education for patients and clinicians so that they recognise side effects and how to manage them.

COR2ED Medical Education: In this podcast, Haematologists Dr Michelle Lavin and Dr Roseline d’Oiron discuss the importance of recognising and correcting iron deficiency in women and girls with bleeding disorders. Iron deficiency occurs very frequently in this population, but challenges with definitions, lab tests and reference ranges can make it hard to accurately detect. The experts discuss how to diagnose and correct iron deficiency, and how to monitor patients. They also share some practical dos and don’ts and describe how iron deficiency is easy to treat, while making an immense difference on the quality of life of patients. Dr Michelle Lavin is a Haematologist at the National Coagulation Centre, St James's Hospital, Dublin, Ireland and Dr Roseline d’Oiron is a Haematologist at the Reference Centre for Haemophilia and RBD, Bicêtre Hospital AP-HP and University of Paris-Saclay, Paris, France.

COR2ED Medical Education: In this podcast, Prof. Martyn Caplin and Dr Aman Chauhan discuss the role of somatostatin analogues (SSAs) at progression and whether to continue or not. In patients with well-differentiated Grade 1/2 neuroendocrine tumours (NETs) and slowly progressive asymptomatic disease, potential strategies for continuing SSA at progression include increasing the SSA dose frequency from every four to every two weeks, increasing the monthly SSA dose, using SSA as maintenance therapy in stable patients unable to tolerate chemotherapy, and—in patients receiving peptide receptor radionuclide therapy (PRRT)—during and/or post PRRT. They share their clinical experience and their own clinical practice, based on data from key studies including NETTER-1, CLARINET FORTE, and REMINET, as well as relevant retrospective analyses. Prof. Martyn Caplin is Professor of Gastroenterology and GI Neuroendocrinology at the Royal Free Hospital and University College London, London, UK. Dr Aman Chauhan is a Medical Oncologist and Director of NET Theranostics at the University of Kentucky Markey Cancer Center, Kentucky, USA.

COR2ED Medical Education: Haematologists Prof. Ana Boban and Dr Jonathan Roberts discuss how the type of von Willebrand disease (VWD) impacts the treatment. In this podcast, aimed at healthcare professionals outside of haematology, the experts summarise the key treatment options for VWD and discuss how they make treatment decisions on a daily basis, including treatments they tend to avoid in certain types of the disease. They also consider management in some specific clinical scenarios, including a spontaneous bleed, surgery, and heavy menstrual bleeding. Prof. Ana Boban is Head of the Haemophilia Centre, University Hospital Centre Zagreb, Croatia, and Dr Jonathan Roberts is Associate Medical Director, Associate Research Director, Bleeding and Clotting Disorders Institute, Peoria, IL, USA.

COR2ED Medical Education: In this HCC CONNECT podcast HCC Experts Prof. Matthias Pinter and Prof. Jeroen Dekervel, discuss and debate the clinical implications of new HCC Phase 3 clinical trials data presented and discussed at the ILCA and ESMO congresses. They discuss Immuno-oncology agents and their place in the upcoming updated guidance such as the proposed new ILCA Systemic Therapies Guidance algorithm. They also discuss new treatment options in first line for advanced HCC presented at ESMO including the three late breaking abstracts LEAP-002, RATIONALE-301 and tislelizumab monotherapy trials. The latter two studying first-line treatment with an anti-PD1 antibody with or without a kinase inhibitor in patients with advanced hepatocellular carcinoma. The experts evaluate and provide their insights into how to integrate these new treatments for HCC in the clinical practice.

COR2ED Medical Education: This second GI CONNECT podcast episode, covers the highlights on gastroesophageal cancer from ESMO 2022. Dr Sam Klempner (Massachusetts General Hospital, Boston, USA) and Dr Yelena Janjigian (Memorial Sloan Kettering Cancer Center, New York, USA) discuss a number of key posters and oral presentations from the meeting and their implications for clinical practice. The experts start by covering a number of first line studies. First of all, they discuss a study from Dr. Janjigian’s research group which investigated regorafenib with nivolumab and FOLFOX in HER2 negative oesophagastric cancer. They then discuss LEAP-015 which investigated first-line lenvatinib plus pembrolizumab plus chemotherapy in advanced/metastatic gastroesophageal adenocarcinoma (GEA). Dr. Klempner then covers one of his posters from ESMO 2022 on the DisTinGuish trial which looked at DKN-01 and tislelizumab plus chemotherapy as first-line investigational therapy in GEA. Later they discuss MOONLIGHT which investigated FOLFOX plus nivolumab and ipilimumab versus FOLFOX induction followed by nivolumab and ipilimumab in patients with previously untreated advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma. Later in the podcast, they cover a number of second line studies, including the PRODIGE 59 - DURIGAST trial which evaluated FOLFIRI plus durvalumab and FOLFIRI plus durvalumab plus tremelimumab in second line treatment of patients with advanced gastric or GEJ adenocarcinoma. Finally they discuss DESTINY-Gastric02 which followed on from DESTINY-Gastric01 in Asian patients and was undertaken to evaluate T-DXd in Western patients with HER2+ unresectable/metastatic gastric/GEJ cancer who progressed on or after trastuzumab-containing regimen.

COR2ED Medical Education: In the first episode of this GI CONNECT podcast covering the lower gastrointestinal (GI) cancer highlights from ESMO 2022, Dr Jenny Seligmann, Medical Oncologist from the University of Leeds in the UK and Dr Dominik Modest, Medical Oncologist from the Charité Universitaetsmedizin, Berlin, Germany discuss a number of key oral presentations from ESMO 2022 and potential implications for clinical practice. They start their discussion with the NICHE-2 which looked at neoadjuvant immune checkpoint inhibition in locally advanced MMR-deficient colon cancer. Discussion then moves to the HIPECT4 trial which explored adjuvant hyperthermic intraperitoneal chemotherapy in locally advanced colon cancer and challenges previous perceptions of HIPEC in colorectal cancer patients. The FRESCO-2 trial is reviewed which evaluated the efficacy and safety of fruquintinib in patients with refractory metastatic CRC with results potentially supporting a new option for these patients. The experts then review two trials in patients with KRASG12C mutant CRC, the KRYSTAL-1 which used adagrasib with or without cetuximab in these patients and the CodeBreaK101 study which used sotorasib in combination with panitumumab. They discuss their opinions on the results from these studies and the implications for clinical practice.

In this third episode of a three-episode podcast series, COR2ED and ASBMR have partnered with patient advocates Inês Alves (European Rare Bone Forum) and Tracy Hart (Osteogenesis Imperfecta Foundation) to provide rare bone disease highlights from the ASBMR 2022 Annual Meeting, focusing on the patient perspective. The experts opened the podcast with the importance of engaging diverse patient communities. Independent of geography, patients should be educated about their condition and prepared for clinical trial participation; advocacy groups play a central role in this engagement. The experts then discussed outcomes of the IMPACT survey in OI (osteogenesis imperfecta), whose extensive database (66 countries, >2000 participants) offers meaningful insights into the clinical, humanistic and economic challenges faced by OI patients around the world. Looking to advances in pre-clinical research, the experts reviewed data on nanoparticle-mediated delivery of small interfering RNA (siRNA) to targeted mutation sites, tested in an animal model of autosomal dominant osteopetrosis. As the experts note, patient communities struggle with lengthy research and development timelines for novel therapies; therefore, it’s important for advocates to keep communities informed about ongoing efforts.

In this second episode of a three-episode podcast series, COR2ED and ASBMR have partnered with Professor Eric Rush (Children’s Mercy Hospital) to provide rare bone disease highlights from ASBMR 2022 Annual Meeting. Prof. Rush opens with detailed information on fibrodysplasia ossificans progressiva (FOP): symptoms of this severe congenital condition include permanent heterotopic ossifications preceded by painful soft tissue swelling. Nearly all patients have the same ACVR1 receptor variant, and Prof. Rush shares therapy options for the disease. He then offers insights on hypochondroplasia (HCH), a developmental disorder caused by a defect in the FGFR3 gene. An animal model for HCH has been developed, in which infigratinib, a selective FGFR tyrosine kinase inhibitor, shows positive effects on growth as well as proportion. He then describes a clinical study in osteogenesis imperfects (OI), in which allogenic transplantation of fetal liver-derived mesenchymal stem cells was tested in children with type III and type IV OI. While increased bone density and height were observed, Prof. Rush cautions that both the number of study participants and the study duration were low. He closes the podcast with personal insights from the in-person Annual Meeting, including opportunities for engagement and exchange at “Meet the Professor” sessions.

In this first episode of a three-episode podcast series, COR2ED and ASBMR have partnered with Professor Anna Teti (University of L’Aquila) to provide rare bone disease highlights from the Rare Diseases Symposium that preceded the ASBMR 2022 Annual Meeting. Opening with an overview of ongoing clinical research in several rare bone diseases, Prof. Teti highlights the importance of preparing clinicians for unexpected adverse events. Notably, therapies used in the context of rare bone diseases can cause adverse events not seen if a common bone disease was treated. For osteogenesis imperfecta, she discusses a novel treatment based on umbilical cord mesenchymal stem cells. A safety study in 18 paediatric patients – three of whom received a pre-natal injection – is awaiting completion by the end of 2023. Initial safety data suggests that multiple stem cell transplantations in children with this disease is safe. Prof. Teti emphasizes the impact of achondroplasia, the most common rare bone disease, and one for which new treatments are also in development. Pharmacological treatment aims to reduce activity of the pathogenic, overactive variant of FGFR3 which causes the disease. She is confident that a treatment will be found that, at minimum, enhances quality of life in patients. Prof. Teti concludes with a review of the highly collaborative spirit of the Rare Diseases Symposium, emphasizing that patient well-being must be the driving force of research.

COR2ED Medical Education: In this podcast, Obstetrician and Gynaecologist Prof. Rezan Abdul-Kadir and Advanced Nurse Practicioner Debra Pollard discuss the impact of bleeding disorders before, during and after pregnancy and delivery. Their share their views on what healthcare providers should take into consideration when a woman with a bleeding disorder wants to have children and becomes pregnant, including potential risks and expectations of the pregnancy. Support for women and babies is discussed, including the importance of multidisciplinary care. The experts also explore their experience during and after delivery, and what to be aware of in the post-partum period. Prof Rezan Abdul-Kadir is an Obstetrician and Gynaecologist at the Royal Free Hospital in London and Debra Pollard is an Advanced Nurse Practicioner at the Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital in London, UK.

COR2ED Medical Education: In this podcast, Sven De Keersmaecker, RN and Assoc. Prof. Gerald Prager, MD discuss flexible dosing regimens of the oral treatments regorafenib, trifluridine / tipiracil (TAS-102) and capecitabine to optimise treatment duration and to manage adverse events in patients with metastatic colorectal cancer. The two experts also discuss the importance of keeping patients on treatment to optimise outcomes whilst managing side effects and ensuring the best possible quality of life. Treatment strategies are discussed as well as key data from the ReDOS and REARRANGE trials. The experts also discuss the importance of the nurse and other multi-disciplinary team members in terms of adverse event management and treatment adherence. Sven De Keersmaecker RN is Study Co-ordinator at Antwerp University Hospital in Belgium and Dr Gerald Prager is a Medical Oncologist and Associate Professor at Medical University of Vienna in Austria

COR2ED Medical Education: In this SARCOMA CONNECT Guidelines Podcast, two SARCOMA CONNECT Experts, Prof. Robert Maki and Prof. Silvia Stacchiotti, discuss recent updates in the ESMO and NCCN bone sarcoma guidelines. Focussing on osteosarcoma and Ewing sarcoma, but also including chordoma and Giant Cell Tumour of bone, the Experts compare and contrast the latest updates to the guidelines. They highlight the key clinical practice learning points from the guidelines, discuss the latest clinical trial data, and consider what they mean for patients.

COR2ED Medical Education: In this podcast, liver cancer experts Prof. Amit Singal and Assoc. Prof Neil Mehta discuss recent advances in systemic and locoregional therapy for advanced and early stage hepatocellular carcinoma (HCC). They focus on the role of immunotherapy and review data from three major congresses in 2022 (ASCO, WCGIC and ILC) together with recent publications. Prof. Amit Singal is Director of Liver Cancer Program at UT Southwestern Medical Center, Dallas, TX, USA and Assoc. Prof. Neil Mehta is Director of Liver Cancer Program at University of California San Francisco, USA.

Changing paradigms of haemophilia care in Europe COR2ED Medical Education: In this podcast, Prof. Cedric Hermans and Prof. Jerzy Windyga discuss their perspectives on the changing paradigms of haemophilia care. They share their past experience and their views on the current situation in Europe, based on results from a recent survey and published in Therapeutic Advances in Hematology. The aim of this survey was to determine whether the paradigms of haemophilia care in Europe have changed with the introduction of novel treatment options. In the podcast, the two experts not only discuss the past and present of haemophilia care, but also share their visions on the future. Prof. Hermans is the Head of the Division of Haematology at the Cliniques Universitaires of Saint-Luc in Brussels, Belgium. Prof. Windyga is the Head of the Department of Haemostasis Disorders and Internal Medicine at the Institute of Haematology and Transfusion Medicine in Warsaw, Poland. Both experts are members of HEMOSTASIS CONNECT’s European Collaborative Haemophilia Network.

Prostate Cancer Highlights from ASCO GU, ASCO and EAUN 2022 COR2ED Medical Education: In this podcast Dr Jason Alcorn and Jennifer Sutton discuss the oncology nursing highlights from ASCO GU, ASCO and EAUN 2022. The experts discuss: Treatment intensification with triplet therapy for mCSPC patients with practice changing data from the ARASENS trial and updated overall survival from the ENZAMET trial Subgroup analysis of prior and concomitant treatment from the VISION trial A number of practice development studies using technology to aid knowledge sharing and to improve the quality of patients’ care

Shared decision-making in nmCRPC: Treatment considerations to maintain quality of life COR2ED Medical Education: Brenda Martone, a nurse practitioner at Northwestern Medicine in Chicago Illinois and Dr Alicia Morgans, Genitourinary Medical Oncologist at the Dana-Farber Cancer Institute in the United States discuss ‘Shared decision-making in nmCRPC: Treatment considerations to maintain quality of life’ in this GU CONNECT podcast. In this podcast, the experts discuss how patients are more likely to be able to adhere to a treatment plan if they understand their choices and the implications of each treatment. They discuss how nmCRPC patients are relatively asymptomatic and the importance of understanding the patients’ goals of treatment and how these may differ from a physician’s perspective. Alicia reviews the efficacy and safety data from the key trials for nmCRPC, the SPARTAN trial with apalutamide, the PROSPER trial with enzalutamide and the ARAMIS trial with darolutamide. Brenda discusses ways to manage adverse events for the nmCRPC patients in order to keep them on treatment whilst still maintaining a good quality of life and Alicia explains how she goes about determining the right treatment for the right patient whilst considering comorbidities and drug to drug interactions.

COR2ED Medical Education: Dr. Tanya Dorff, a Medical Oncologist from the City of Hope Comprehensive Cancer Center and Dr. Neal Shore, Uro-Oncologist and Chief Medical Officer for Genesis Care and Urology and Surgical Oncology in the United States discuss ‘Timing of ARSI and taxanes for mCSPC' in this GU CONNECT podcast. In this podcast, the experts reflect on how the treatment landscape for mCSPC has evolved over the past 7 years resulting in treatment intensification with ADT plus docetaxel following the CHAARTED and STAMPEDE studies and then more recently the use of ADT and androgen receptor inhibitors including abiraterone (LATITUDE, STAMPEDE), apalutamide (TITAN), and enzalutamide (ARCHES, ENZAMET).  This has further evolved with the recent reporting of the PEACE 1 and ARASENS trials which demonstrated a survival benefit with triplet therapy with abiraterone and darolutamide respectively, being used in combination with ADT and docetaxel. The experts discuss the importance of balancing benefit against risk for their mCSPC patients but state that the triplet therapies appear to be well tolerated in both the PEACE 1 and ARASENS trials. They provide their views, Neal as a urologist and Tanya as a medical oncologist, on the things to consider when making treatment decisions for these patients such as comorbidities, age, performance status, de novo versus recurrent disease, amongst others. They finish by concluding that treatment intensification should be implemented as standard of care for mCSPC patients to enable patients to have as many treatments with different mechanisms of action as early as possible in their treatment journey. 

COR2ED Medical Education: In this podcast episode, Prof. Kris Kowdley, Director, Liver Institute Northwest, Washington State University, USA and Prof. Jörn Schattenberg, Director, Metabolic Liver Research, University Medical Centre Mainz, Germany provide their take-home messages on primary biliary cholangitis (PBC) data presented at the International Liver Congress 2022. The two experts discuss how to improve PBCdiagnosis, the importance of listening to patient needs when considering PBC treatment options, considerations for treating PBC-related symptoms, differences in PBC diagnosis and treatment guidelines between Europe and the US, and what's coming next for this rare liver disease.

COR2ED Medical Education: In this podcast, Prof. Gideon Hirschfield, Professor of Medicine, Division of Gastroenterology, University of Toronto, Canada and Prof. Ana Lleo, Professor of Internal Medicine, Humanitas University, Milan, Italy, discuss key abstracts on primary biliary cholangitis (PBC) from the International Liver Congress 2022. Their discussions focus on treatments currently available, treatment sequencing, management of adverse events, expected future therapeutic options and how to address the unmet clinical need of this rare liver disease.

COR2ED Medical Education: In this podcast, Beth Wittmer RN, Director of Care Management at Florida Cancer Specialists, USA and Prof. Hans Prenen, GI Medical Oncologist from Antwerp University Hospital, Belgium, discuss the management of dermatological side effects that patients may experience when receiving treatment with multikinase inhibitors, such as regorafenib, sunitinib, cabozantinib amongst others. They discuss the different skin related side effects that a patient may experience such as hand foot skin reactions, rash, hair and nail changes as well as mucosal changes. The experts note that these side effects can affect a patient emotionally and impair their quality of life so the objective is to effectively treat and manage side effects and to keep patients on the treatment, whilst maintaining reasonable quality of life. They discuss preventative measures, the importance of discussing potential side effects with the patient and when to involve a dermatologist as well as dose management strategies to enable the patient to stay on their cancer treatment.

COR2ED Medical Education: In this podcast, two haematology experts discuss their views on the use of immune tolerance induction (ITI) in haemophilia. Prof. Jan Astermark, professor of Clinical Coagulation Medicine from Sweden, and Dr. Katharina Holstein, Haematologist from Germany, talk about whether ITI is still the first choice in patients with haemophilia A with inhibitors. A recent survey on the use of ITI in Europe, conducted by the speakers and other members of the European Collaborative Haemophilia Network, forms the basis of the discussion. In March 2022 the results of the survey were published in the journal Haemophilia. In this podcast episode the two experts discuss the results of the survey and the implications for management of haemophilia A.

COR2ED Medical Education: In this podcast episode, myeloma experts Dr. María Victoria Mateos (Haematologist at the University Hospital Salamanca, Spain) and Dr. Alexander Lesokhin (Associate Attending on the Myeloma Service at the Memorial Sloan Kettering Cancer Center, New York, NY, USA) discuss how they choose the best treatment regimen for patients with multiple myeloma and a high-risk cytogenetic profile. Firstly, they discuss the treatment options available for patients with high-risk cytogenetics in the US and in Europe. However, the key question is how to decide, for each individual, which treatment option is the best one. Dr. Mateos and Dr. Lesokhin discuss the factors they consider in these decisions in their clinical practice. Although the prior treatment is the most important consideration in the relapsed setting, the type of cytogenetic abnormality also plays a role. The experts specifically discuss treatment decisions in patients with extramedullary multiple myeloma: a difficult-to-treat population. The speakers also discuss the future of myeloma treatment. How should trial design be adapted to better meet the needs of patients with a high-risk cytogenetic profile? What will be the role of CAR-T and bispecific antibodies in this population? The experts conclude by summarising their key take-aways from the discussion.

COR2ED Medical Education: Dr Alicia Morgans, Genitourinary Medical Oncologist at the Dana-Farber Cancer Institute in the United States and Dr. Neal Shore, Uro-Oncologist and Chief Medical Officer for Genesis Care and Urology and Surgical Oncology in the United States discuss ‘Prostate Cancer Highlights from ASCO GU 2022’ in this GU CONNECT podcast. In this podcast, the experts review data from a number of key plenary sessions from ASCO GU 2022 and discuss potential implications for clinical practice. The ARASENS trial is covered first which looked at triplet therapy in the form of ADT plus docetaxel and darolutamide in patients with metastatic castration sensitive prostate cancer (mCSPC). Discussion then moves to two trials investigating the combination of abiraterone acetate with PARP inhibitors in metastatic castration resistant prostate cancer (mCRPC) patients with and without homologous recombination repair (HRR) mutations: the PROpel trial with olaparib and the MAGNITUDE trial with rucaparib. Neal and Alicia also discuss a fascinating presentation by Dr. Daniel Spratt which looked at digitising histopathology slides and using Artificial Intelligence (AI) to inform on the likelihood of disease progression and whether or not patients needed androgen deprivation therapy (ADT) Finally, Alicia discusses a number of posters which she felt made an impact, including one on PSA responses in the TITAN and SPARTAN trials and a secondary analysis from the VISION trial looking at treatment related adverse events, amongst others.

COR2ED Medical Education: Prof. Karin Fijnvandraat, Professor of Paediatric Haematology at the University of Amsterdam in the Netherlands and Dr. Maria Elisa Mancuso, Senior Consultant in Haematology at IRCCS Humanitas Research Hospital in Milan, Italy, have an interesting discussion about prophylaxis in children with haemophilia. Along with five other members of the European Collaborative Haemophilia Network, Prof. Fijnvandraat and Dr. Mancuso recently published a white paper on prophylaxis in children in an evolving treatment landscape, in the journal Haemophilia. In this podcast episode the two experts discuss when they start prophylaxis in young children, how they choose between plasma-derived and recombinant products and how they select the right treatment regimen, as well as practical aspects of starting prophylaxis, including the importance of involving parents in the decision-making process.

Medical Education podcast by COR2ED. Professor James Harding, HCC Connect member, provides his perspectives and insights on key abstracts and topics discussed at ASCO GI 2022 and EASL liver cancer summit 2022 in hepatocellular carcinoma. He discusses the HIMALAYA study which evaluated dual immune checkpoint blockade inhibition namely, anti-CTLA-4 antibody tremelimumab with the anti-PD-L1 antibody durvalumab in the frontline setting with patients with unresectable hepatocellular carcinoma. There were other important studies at the meeting and Prof Harding highlights the RENOBATE study and the GOING study that evaluated nivolumab in combination with regorafenib and early addition of nivolumab to regorafenib regimen, respectively.

COR2ED Medical Education: Dr Jason Alcorn, nurse consultant for Uro-Oncology & Andrology at the Mid Yorkshire Hospitals NHS Trust, United Kingdom and Dr Alicia Morgans, Genitourinary Medical Oncologist and Medical Director of the Survivorship Program at the Dana-Farber Cancer Institute in the United States, discuss 'PARP inhibitors in prostate cancer: Management of adverse events and the importance of communication with patients’ as part of the GU NURSES CONNECT podcast series covering ‘PARP inhibitors in prostate cancer’. In this podcast, the experts discuss adverse events associated with PARP inhibitors and the management of them, in particular thrombocytopenia, gastrointestinal effects and fatigue. Jason provides some insight into how nurses support and communicate with patients, the importance of early reporting of side effects and how to manage these. Finally, the ongoing trials of PARP inhibitors in combination with other prostate cancer treatments are also considered and what these trials may mean for patients.

COR2ED Educación Médica: Pablo Peinado, coordinador de Enfermería de Investigación, y la Dra. Elena Castro, oncóloga médica, quienes trabajan en el Hospital Universitario Virgen de la Victoria de Málaga en España, discuten 'El potencial de los inhibidores de PARP en el cáncer de próstata: Lo que las enfermeras necesitan para saber'. En este podcast, los expertos analizan los inhibidores de PARP (PARPi), cómo funcionan y los datos clave de los ensayos de registro de rucaparib y olaparib, TRITON2 y PROfound. También discuten cómo seleccionar PARPi para sus pacientes con cáncer de próstata y dónde encajan en la secuencia general del tratamiento. Pablo brinda información sobre la comunicación con los pacientes y los tipos de preguntas e inquietudes que suelen tener en relación con las pruebas genéticas y el tratamiento con PARPi. Además, también analizan los PARPi que se encuentran actualmente en la última etapa de desarrollo, como niraparib y talazoparib, así como el posible uso futuro de los PARPi en combinación con inmunoterapias o inhibidores de la vía del receptor de andrógenos.

COR2ED Medical Education: Pablo Peinado, Research Nurse Coordinator, and Dr. Elena Castro, medical oncologist, who both work at Hospital Universitario Virgen de la Victoria in Malaga in Spain, discuss ‘The potential of PARP inhibitors in prostate cancer: What nurses need to know’. In this podcast, the experts discuss PARP inhibitors (PARPi’s), how they work and key data from the registration trials for rucaparib and olaparib, TRITON2 and PROfound. They also discuss how to select PARPi’s for their prostate cancer patients and where they fit in the overall treatment sequence. Pablo provides some insight into communicating with patients, and the types of questions and concerns they often have in relation to genetic testing and treatment with PARPi’s. In addition, they also discuss the PARPi’s currently in late-stage development such as niraparib and talazoparib as well as the potential future use of PARPi’s in combination with immunotherapies or androgen receptor pathway inhibitors.

COR2ED Medical Education: Joanne Chien, Nurse Practitioner specialising in urologic cancers at Stanford Health Care in Palo Alto, California, and Dr Alexander Wyatt, Assistant Professor in genitourinary cancer genomics at the Vancouver Prostate Centre, Department of Urologic Sciences at the University of British Columbia, discuss ‘Genetic testing and PARP inhibitors in prostate cancer’ as part of the GU NURSES CONNECT podcast series covering ‘PARP inhibitors in prostate cancer’. In this podcast, the experts discuss the gene alterations in prostate cancer and why we should consider genetic testing when thinking about treatment options such as PARP inhibitors (PARPi’s). The discussion covers why genetic testing should be performed, who should undergo testing, how to test and what this means in relation to treatment with PARP inhibitors. Dr. Alex Wyatt explains the difference between germline and somatic mutations and Joanne Chien discusses the role of the nurse during genetic counselling discussions and how this role may evolve in the future. Finally, the ongoing trials of PARP inhibitors in combination with other prostate cancer treatments are also considered and whether the outcome of these trials is likely to impact the need to perform genetic testing.

In this medical education podcast, NTRK CONNECT members Assoc. Prof. Caterina Marchiò (University of Turin, Italy) and Prof. Christian Rolfo (Center of Thoracic Oncology Tisch Cancer Institute Icahn School of Medicine at Mount Sinai, New York, USA) provide pathologist and medical oncologist perspectives about the detection and treatment of TRK fusion-positive lung cancers. They discuss a number of techniques and strategies to identify this rare fusion in lung cancer patients, before going on to summarise the robust efficacy and safety data for both entrectinib and larotrectinib. Prof. Rolfo briefly covers second-generation therapies in clinical development and describes how liquid biopsy is emerging as a new technique not only to identify but also monitor patients. They conclude by stressing the importance of the collaboration and communication between pathologists and oncologists to test for and identify TRK fusion-positive lung cancer patients.

In this medical education podcast episode, Prof. Peter Galle and Prof. Amit Singal discuss the use of VEGFR-TKIs in the treatment of advanced or unresectable HCC and explain the immunomodulation rationale to combine it with immune checkpoint inhibitor. Combination approach has been validated recently with the atezolizumab+bevacizumab combination being the new standard of care in 1L setting for advanced HCC patients. In the context of advanced HCC, both experts share their view about the dosing approach with VEGFR-TKI and provide insight to handle the dosing when combining with PD-1 inhibitor. Both experts reiterate that biomarkers are urgently needed in HCC and summarize the current stratification of patients used to predict the response with VEGFR-TKI monotherapy or in immunotherapy combination. Finally, they emphasize that pre-habilitation of HCC patients is key to make the HCC patient fit for the best available treatment option.

Prof. Thomas Powles, a Medical Oncologist from Barts Cancer Centre in the UK and Prof. Georg Hutterer, a Urologist from the Medical University of Graz, Austria, discuss the role of VEGFR-TKIs in the treatment of advanced renal cell carcinoma (RCC) alone or in combination with immunotherapy. In this podcast, by COR2ED Medical Education, the two experts discuss key trials (CHECKMATE 214, KEYNOTE 426, CHECKMATE 9ER and CLEAR) which have led to recent updates to the ESMO and EAU treatment guidelines for RCC. Combination treatment with either VEGFR targeted therapy plus a PD-1 or CTLA-4 inhibitor in the first-line setting is discussed as well as VEGFR-TKI monotherapy options at the time of disease progression. They also focus on how to manage treatment toxicity whilst trying to optimise treatment outcomes and preserving patients’ quality of life as well as the use of biomarkers and risk stratification models.

In this podcast series, Dr. Jenny Seligmann (University of Leeds, UK), Dr. Autumn McRee (University of North Carolina, USA) and Dr. Dominik Modest (Charité University of Medicine, Germany) discuss the different therapeutic options available in colorectal and gastric cancer. In this third episode, the experts turn their focus to earlier stage disease and consider how lessons learnt in the treatment of metastatic disease can be applied in the neo adjuvant setting for colorectal cancer by discussing data from the FOXTROT and NICHE trials and the adjuvant setting for gastric cancer by discussing data from CheckMate 577. Finally, the experts consider new promising data on targeting KRAS compared to the MEK and the ERK inhibitors.

In this podcast series, Dr. Jenny Seligmann (University of Leeds, UK), Dr. Autumn McRee (University of North Carolina, USA) and Dr. Dominik Modest (Charité University of Medicine, Germany) discuss the different therapeutic options available in colorectal and gastric cancer. This second episode focuses on recent developments in immunotherapy approaches in metastatic colorectal and gastric cancer – specifically whether immunotherapy should be used alone, in combination with other treatments or with chemotherapy. Data from several clinical trials are discussed such as KEYNOTE-177, CheckMate 142, CheckMate 649, KEYNOTE 062, and NICHE. The experts also consider the appropriate treatment regimens for MSI-high and MSS colorectal and gastric cancer patients and whether CPS is an appropriate biomarker for gastric cancer.

In this podcast series, Dr. Jenny Seligmann (University of Leeds, UK), Dr. Autumn McRee (University of North Carolina, USA) and Dr. Dominik Modest (Charité University of Medicine, Germany) discuss the different therapeutic options available in colorectal and gastric cancer. In this first episode the experts discuss novel targeted approaches in metastatic colorectal and gastric cancer. They discuss practice changing drug targets including BRAF and HER2 with reference to data from recent clinical trials such as DESTINY and HERACLES. They also discuss molecular testing and differences in approaches between the USA and Europe and review recommendations in the guidelines for colorectal and gastric cancer.

In this medical education podcast series, myeloma experts Dr. Karthik Ramasamy (Haematologist and Associate Professor of Haematology at the Oxford University Hospitals in London, UK) and Dr. Joshua Richter (Assistant Professor of Medicine and Director of Myeloma at the Tisch Cancer Institute at the Icahn School of Medicine and the Blavatnik Family Chelsea Medical Center at Mount Sinai in New York, USA) discuss their experience and views on choosing the best treatment every time in multiple myeloma. In this second episode, Dr. Richter and Dr. Ramasamy explore how to select the best treatment approach in the second-line setting and beyond. Firstly, they discuss at what point they consider a patient to actually be in relapse. They both believe that it’s important to stay on top of this incurable illness and act when there is a suspicion of relapse. However, the need to treat must be balanced with quality of life. They also take potential enrolment into a clinical trial into account in the treatment decision. The decision on which treatment option to select in the second line and beyond mostly depends on refractoriness to other drugs. With an increasing number of novel treatment options becoming available, choosing a regimen that does not contain a drug the patient is refractory to is becoming easier. Dr. Richter and Dr. Ramasamy discuss the challenges around these treatment decisions. Furthermore, they share their experiences with CAR-T and other T cell redirection therapies, and when to use it in the treatment sequence. The speakers conclude with a look into the future of myeloma treatment.

The use of VEGFR-TKIs monotherapy in the treatment of unresectable or advanced HCC in 1L setting: Who can benefit and guidance on implementation of dosing-strategies and pre-habilitation of patients for the prediction of efficacy and toxicities in clinical practice Prof. Josep Llovet and Prof. Stephen L. Chan discuss a very interesting topic about the use of the VEGFR TKIs monotherapy in the treatment of unresectable or advanced HCC in the first-line setting. They will go into details about who can benefit from monotherapy and will share the current guidance on the implementation of the dosing strategies for the management of toxicity in the clinical practice. They discuss first line monotherapy with TKI (lenvatinib or sorafenib) for patients who are not suitable for the treatment with atezo-bev combination (around 20% of the patients) which is the current standard of care. They summarize the HCC patients who are not ideal for this I/O combination such as HCC patients with liver transplantation, high bleeding risk, impaired liver function or severe autoimmune disease. The experts discuss about which patients can benefit from TKI and provide a summary of efficacy data and safety profile from various pivotal clinical studies (including SHARP, REFLECT, IMbrave150) as well as real-world data. Dosing-strategies for VEGFR-TKIs and management of AEs are discussed as well as guideline recommendations. Finally, the experts discuss key developments over the next few years focusing on the new immunotherapy combinations approach that could become new standard of care.

In this medical education podcast series, myeloma experts Dr. Joshua Richter (Assistant Professor of Medicine and Director of Myeloma at the Tisch Cancer Institute at the Icahn School of Medicine and the Blavatnik Family Chelsea Medical Center at Mount Sinai in New York, USA) and Dr. Karthik Ramasamy (Haematologist and Associate Professor of Haematology at the Oxford University Hospitals in London, UK) discuss their experience and views on choosing the best treatment every time in multiple myeloma. In this first episode, Dr. Richter and Dr. Ramasamy discuss how to select the best approach in newly diagnosed patients with multiple myeloma. The experts look at transplant eligibility as one of the key factors in deciding which treatment to start with in the front-line setting. They discuss the potential for personalising therapy in newly diagnosed patients, both in the transplant setting as well as in patients who are not eligible for transplantation. They also comment on the impact of MRD negativity in clinical practice and agree that the goal of treatment is to induce deep remissions. However, which patient needs triple or quadruplet therapy to achieve this goal is still unclear and the risk-benefit profile needs to be considered for each individual patient. The final topic that the experts share their points of view on is continuous vs fixed-duration maintenance therapy.

We have partnered with international experts to provide rare bone disease highlights from ASBMR 2021. This is the final episode in a series of four podcasts, in this episode Dr Eekhoff and Dr Rush discuss their rare bone disease highlights from the meeting.

We have partnered with international experts to provide rare bone diseases highlights from ASBMR 2021. This is the third episode in a series of four podcasts. In this episode Charlene Waldman (RBD Alliance) and Inês Alves (European Rare Bone Forum) discuss their highlights.

We have partnered with international experts to provide rare bone diseases highlights from ASBMR 2021. This is the second in a series of four podcasts. In this episode Dr Oliver Semler has selected and discusses his highlights.

We have partnered with international experts to provide rare bone disease highlights from ASBMR 2021. This is the first episode in a series of four podcasts, in this episode Dr Mughal and Dr Javaid discuss their highlights.

Professor Matthias Pinter, medical hepatologist from the medical University of Vienna in Austria shares some insights from key abstracts and topics discussed at ILCA 2021 and ESMO 2021 in hepatocellular carcinoma. One main topic included discussions about treatment options in first-line systemic therapy and managing patients who still may need to receive a TKI in first-line instead. Another topic covered is how to proceed with immunotherapy in HCC, in particular the rationale for triplet immunotherapy combination. There were two studies data presented on atezolizumab plus bevacizumab, the new reference standard of care in systemic front-line HCC treatment. Another interesting topic was the combination of TACE with immune checkpoint blockade in intermediate stage HCC. Regarding monotherapy TKI in first-line setting, Prof Pinter points out that around 15 to 20% of HCC patients are not ideal candidates for atezolizumab plus bevacizumab, and these are mainly patients with HCC recurrence of the liver transplantations, patients with severe autoimmune disease, or those with a high bleeding risk. He discusses several real-world evidence studies including lenvatinib, sorafenib and regorafenib in special populations that are usually excluded from clinical trials. Prof Pinter also discusses data presented covering predictive and prognostic biomarkers such as cachexia, the growing role of AI, multibipolar radiofrequency ablation and the potential role of underlying etiology as a predictor of the efficacy of immunotherapy.

In this podcast, NTRK CONNECT members Prof Frédérique Penault-Llorca (University of Clermont-Ferrand, France) and Prof Andrea Sartore-Bianchi (Niguarda Cancer Centre, Milan, Italy) provide both a pathologist and medical oncologist perspective about the detection and treatment of TRK fusion-positive GI cancers, with a particular focus on colorectal cancer. Penault-Llorca and Sartore-Bianchi start by explaining TRK fusion biology, the role as oncogenic drivers and briefly describe the two approved TRK inhibitors. They then discuss the challenges of finding patients harboring these fusions, referring to how enrichment strategies and predictors can aid identification in patients with GI cancers. Finally, they discuss key efficacy and safety data for larotrectinib and entrectinib, as well as mentioning second-generation products in development to tackle mechanisms of resistance.

In this podcast, Veerle Lamotte, an oncology nurse practitioner at Antwerp University Hospital and Paola Belardi, nurse chief at San Donato Hospital in Arezzo, Italy discuss the role of the nurse in the management of adverse events in patients receiving VEGFR-TKI treatment. Their discussion focuses specifically on patients with hepatocellular cancer (HCC), differentiated thyroid cancer and advanced renal cell carcinoma (RCC). VEGFR-TKIs are widely used treatments for these solid tumours but are associated with substantial toxicity which needs early recognition and management in order to help patients stay on optimal treatment. The most common adverse events related to these treatments are discussed together with recommendations for their management. Veerle and Paola discuss the key role of the nurse as part of the multi-disciplinary team involved in the patient’s care, and the role they have in providing close support and guidance to the patient. Education of patients regarding potential side effects and early identification and management of adverse events is key in terms of trying to keep patients on the optimum dose so that they can achieve the best outcomes.

Dr. Jaume Capdevila, a Medical Oncologist at Vall d’Hebron University Hospital in Barcelona, Spain, and Dr. Rachel van Leeuwaarde, an Endocrinologist from the University Medical Center of Utrecht in The Netherlands discuss the use of multi-kinase inhibitors (MKIs), in particular VEGFR-TKIs in patients with radioactive iodine refractory differentiated thyroid cancer (DTC). In this podcast, the two experts discuss key trials (SELECT, DECISION and COSMIC-311) and efficacy parameters of the current VEGFR-TKIs (lenvatinib, sorafenib and cabozantinib), how to manage toxicity whilst trying to optimise treatment outcomes and preserving always patients’ quality of life. They also discuss treatment strategies, when to start systemic treatment, which drug should be used first and how to sequence therapies. To close the podcast they take a look at ongoing clinical trials with other treatments in development for DTC.

In this third episode of the podcast series Women and Girls Bleed Too, Advanced Nurse Practitioner Debra Pollard (Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital, London, UK) is joined by Haematologist Dr. Michelle Lavin (RCSI and National Coagulation Centre, St James’ Hospital, Dublin, Ireland). They talk about the impact a bleeding disorder can have on the lives on women and girls and how these patients can and should be supported in first- and second-line care. When thinking about management, many healthcare providers will first consider medical treatment. Dr. Lavin gives a brief overview of the first-line treatment options for women and girls with bleeding symptoms. However, the speakers stress that the management of these patients goes beyond medical treatment options alone. They provide practical tips and recommendations for first-line healthcare professionals when they treat a patient with a bleeding disorder. As many bleeding disorders are hereditary diseases, a diagnosis not only has impact on the patient, but on their family as well. A bleeding disorder also impacts family planning, pregnancy, and quality of life. Medical and psychological support is essential throughout life. Finally, Michelle Lavin and Debra Pollard discuss some important topics for first-line healthcare providers to be aware of when they have a woman with a bleeding disorder in their practice, including the impact of a bleeding disorder on any medical invention, such as surgery, dental procedures or infertility treatment, but also on the use of pain medication.

In this second episode of the podcast series Women and Girls Bleed Too, Haematologist Dr. Roseline d’Oiron (Reference Centre for Haemophilia and RBD, Bicêtre Hospital AP-HP and University of Paris-Saclay in France) and Obstetrician/Gynaecologist Prof. Rezan Abdul-Kadir (The Royal Free Foundation Hospital in London, UK) discuss how to identify women and girls who are likely to have a bleeding disorder. Prof. Abdul-Kadir addresses the steps she takes when she suspects a potential bleeding disorder in one of her patients. Dr. d’Oiron confirms it is key to get a clear understanding of the personal bleeding history and family history. There are several screening tools available to help assess the patient’s signs and symptoms. The experts discuss when a patient should be referred to a Haematologist, it is important to know that Haematologists are easily accessible for referral when in doubt. Finally, Dr. d’Oiron and Prof. Abdul-Kadir address the types of testing that should and should not be done in first line. It turns out there are many misconceptions about laboratory testing for bleeding disorders. For example, contrary to common belief a normal aPTT and PT does not exclude a bleeding disorder. Furthermore, referring to a Haematologist for testing does not mean the patient should remain untreated. Starting basic treatment is crucial to limit the bleeding and address any iron deficiency as quickly as possible.

In this first episode of the podcast series Bleeding Disorders in Women and Girls: Women & Girls Bleed Too, Dr. Michelle Lavin (Haematologist at the National Coagulation Centre, St James’ Hospital, Dublin, Ireland) and Dr. Sarah O’Brien (Paediatric Haematologist at the Nationwide Children’s Hospital, Columbus, OH, USA) discuss how bleeding disorders occur in women and girls: Women & Girls Bleed Too. In clinical practice, sometimes girls can be forgotten about as bleeding disorders are more associated with males. Dr. Lavin and Dr. O’Brien discuss the signs and symptoms of bleeding disorders and their impact on the quality of life of young girls, adolescents and adult women. Furthermore, they address how diagnosis may be easier in adults than in children, given the longer history of bleeding challenges. The experts also explore potential taboos in discussing these signs and symptoms with patients, considering intercultural differences and gender taboos, and the importance of normalising the conversation amongst healthcare professionals. Finally, Dr. Lavin and Dr. O’Brien provide guidance on the next steps first-line healthcare providers should take when they see a patient with abnormal bleeding, including treatment initiation to limit the bleeding and address iron deficiency and referral to a haematologist for further assessment.