PVRoundup Podcast

The FDA approved lenacapavir, a twice-yearly injectable PrEP shown to be 99% effective in preventing HIV, though high cost may limit global access. A phase 3 trial found that adding pembrolizumab to standard care improved event-free survival in head and neck cancer, especially in patients with high PD-L1 expression. MASLD-related deaths in the U.S. have quadrupled since 2006, rising most sharply in older adults and rural areas, and are expected to continue increasing.

Drs. Sood and Liu discuss emerging and investigational biomarkers for interstitial lung disease and their potential utility as predictors of progression or as tools for tailoring therapy.

Gabrielle Liu, MD, MS and Namita Sood, MD, FCCP discuss advances and future treatment targets for interstitial lung disease including some that are still under investigation.

A Chinese trial found dapagliflozin improved MASH outcomes, with higher resolution and fibrosis improvement rates than placebo. A JAMA Network Open survey showed 42% of abortion providers in ban states relocated, mostly to states with protections, highlighting growing care gaps. An oncology study found AI analysis of body composition better predicted chemo dose reductions than body surface area, especially in women.

Drs. Brander and Cohen discuss the growing role of measurable residual disease (MRD) testing in CLL and its clinical implications.

Drs. Cohen and Brander review toxicity and treatment management in CLL, specifically addressing the considerations that go into subsequent lines of treatment for patients who relapse following doublet, or even triplet, therapy.

Drs. Brander and Cohen discuss an ongoing debate in the management of CLL about BTK and BCL2 inhibitor combinations in the frontline treatment of CLL. Is it better to combine BTK and BCL2 inhibitors, or to start with one or the other as monotherapy?

Drs. Lipsky and Allan discuss the emerging role of immunotherapy in the management of patients with CLL, including CAR T-cell therapy and bispecific antibodies.

The CHALLENGE trial at ASCO 2025 showed that increased physical activity improves survival rates in colon cancer patients, with the exercise group demonstrating better health outcomes and survival rates compared to those receiving only health education. A phase 3 trial in The New England Journal of Medicine found that semaglutide significantly improves liver conditions in MASH patients, showing better resolution of steatohepatitis and fibrosis improvement compared to placebo. Additionally, a study in the NEJM revealed that combining finerenone and empagliflozin offers enhanced kidney protection in patients with chronic kidney disease and type 2 diabetes, significantly reducing urinary albumin levels.

John N. Allan, MD and Andrew H. Lipsky, MD discuss the evolution of CLL therapy and the power of doublet and triplet regimens, exploring combinations including BTK inhibitors with BCL-2 inhibitors and anti-CD20 monoclonal antibodies.

Drs. Scott and Liu discuss the safety of treatments for HER2-mutant lung cancer, including key toxicities, management strategies, and how prior therapies might affect treatment decisions.

Stephen V. Liu, MD and Susan C. Scott, MD discuss advances in treating HER2-mutant lung cancer. Until recently, treatments for HER2-mutant lung cancer primarily involved chemotherapy, immunotherapy, and HER2-targeted therapies, with mixed results. Now, the treatment landscape of HER2-mutant lung cancer is changing.

Measles cases in North America have exceeded 3,200, mainly due to low vaccination rates, with children most affected. Clinicians are urged to verify immunization status and close gaps. The EU is restricting azithromycin use amid rising antimicrobial resistance, dropping certain indications and adding new warnings. A trial shows methotrexate is a viable first-line alternative to prednisone for pulmonary sarcoidosis with differing side effects.

This week's episode covers the effectiveness of a fixed-dose albuterol-budesonide combination for asthma, new findings on Nerodomelast for progressive pulmonary fibrosis, the FDA's endorsement of a new COVID-19 vaccine targeting the JN.1 lineage, and insights into extended-phase anticoagulation for pediatric venous thromboembolism.

A Lancet study warns of consequences for HIV prevention if PEPFAR loses funding, potentially millions of new pediatric HIV cases and increased AIDS-related deaths. Medicare Part D is highlighted, with research linking subsidy loss to higher mortality rates. A report from BMJ notes a 3.1% decline in U.S. drug overdose deaths, signaling a possible peak in the fentanyl crisis.

Drs. Pemmaraju and Bose discuss the revised International Working Group criteria for anemia response in patients with myelofibrosis, outlining new definitions for transfusion status, gender-specific hemoglobin thresholds, and benchmarks for major and minor responses.

Drs. Bose and Pemmaraju discuss leukemic transformation in patients with myelofibrosis, reviewing its incidence, as well as risk factors, treatment, and prognosis.

Drs. Bose and Pemmaraju review secondary myelofibrosis arising from polycythemia vera or essential thrombocythemia and how it differs from primary myelofibrosis that develops de novo.

Maternal RSV vaccines and infant nirsevimab led to major drops in hospitalizations among infants ≤7 months, especially those ≤2 months old. The CDC's 2025 nPEP guidelines stress starting HIV prevention within 72 hours of exposure, with rapid testing and follow-up care. Treatment should begin without delay, and patients at ongoing risk should transition to PrEP. Surgical site infections after colorectal surgery have increased 21% since 2019, highlighting the need to strengthen infection control.

Drs. Starling and VanderPluym discuss common diagnostic pitfalls in migraine medicine and how the misinterpretation of symptoms can lead to unnecessary testing or incorrect treatments.

Drs. VanderPluym and Starling review the updated position statement from the American Headache Society indicating that CGRP-targeting migraine therapies should be considered as a first-line option.

This episode features the Beamion LUNG-1 trial, where zongertinib showed a 71% response rate in previously treated HER2-mutant NSCLC patients. The EAGLE-1 trial found gepotidacin non-inferior to standard treatment for urogenital gonorrhoea, with a 92.6% success rate. The U.S. Department of Health and Human Services and NIH launched the Generation Gold Standard initiative, a universal vaccine platform targeting pandemic-prone viruses, with trials ongoing for H5N1 avian influenza and coronaviruses.

Elizabeth Kensinger, PhD and Andrew Budson, MD explain how healthy lifestyle habits, memory offloading strategies, and turning facts into stories can support cognitive aging. They stress that enriching and novel activities are more effective for brain health than most apps. Dr. Budson supports the theory that beta amyloid defends against brain infections, linking it to viral triggers of Alzheimer's. He also highlights new drugs like lecanemab and donanemab that may slow early Alzheimer's progression and potentially prevent its onset.

A JAMA model warns measles could become endemic in the U.S. within 21 years if MMR vaccination rates don't rise, with over 850,000 projected cases. A Phase 3 NEJM trial found brensocatib reduced exacerbations in non-CF bronchiectasis. An EPIC study correlated higher breast cancer risk to higher education levels, beyond lifestyle and reproductive factors.

Mexico's first fatal H5N1 case involved a healthy child and highlights localized risk despite low global concern. Long-term antidepressant use was linked to higher sudden cardiac death risk, especially in younger adults. A U.S. study found 25% of adults with very high LDL cholesterol lacked statin treatment. These stories reveal persistent gaps in infection control, cardiac monitoring, and preventive care.

A polygenic risk score significantly improved prostate cancer detection beyond PSA testing, identifying more treatable and aggressive cancers in high-risk men. New WHO guidelines aim to reduce global meningitis deaths by standardizing early diagnosis, treatment, and care across settings. GLP-1 receptor agonists and SGLT2 inhibitors were linked to reduced Alzheimer's risk, with GLP-1s showing the most consistent neuroprotective effects in recent studies. Lastly, breast cancer mortality was 47% higher among Black women living in disadvantaged neighborhoods, underscoring the impact of social determinants on survival.

Mary Beth Cicero, co-founder of Three Daughters, shares how her passion for women's health led to the development of a new frameless, self-assembling magnetic IUD designed to significantly reduce the pain of insertion and retrieval. The device, inspired by embryo transfer techniques and using copper as its active ingredient, aims to improve comfort, eliminate strings, and offer a more body-conforming contraceptive option—especially for younger women deterred by current IUDs. As the product moves through clinical trials, the team is focused on both efficacy and ease of use, with hopes to expand into treating other uterine conditions in the future.

A large study in Wales found that older adults who received the shingles vaccine had a 20% lower risk of developing dementia over seven years, with the strongest effect seen in women. U.S. measles cases have surged past 500, driven largely by outbreaks in West Texas and linked to international travel, underscoring critical gaps in vaccination coverage. Meanwhile, new research shows that even the wealthiest Americans have shorter life expectancies than their European peers, pointing to systemic health disadvantages in the U.S.

Drs. Yu and Sabari trace the evolution of HER2-mutant lung cancer treatment from chemotherapy to targeted therapies, highlighting key advancements, challenges, and patient responses. They also explore emerging treatment strategies, resistance mechanisms, and the future of personalized therapy based on biomarkers and co-mutations.

A study published in JAMA Internal Medicine found that statin use in patients with chronic liver disease was associated with a lower risk of liver cancer and hepatic decompensation, suggesting potential protective effects beyond lipid management. Surveys by the Annenberg Public Policy Center revealed widespread misinformation about the risks of consuming raw milk, highlighting the need for public education on the importance of pasteurization. New research links red meat allergy (alpha-gal syndrome) to bites from deer ticks and western black-legged ticks, expanding the geographic risk area and emphasizing the need for clinicians to consider this diagnosis in patients with unexplained allergic symptoms following tick bites.

Drs. Sabari and Yu discuss the molecular landscape of HER2-mutant lung cancer, including its genomic characteristics, common co-mutations, and differences between HER2 mutations and HER2 amplification. This discussion also explores the prevalence and clinical patterns of HER2 mutations, their oncogenic mechanisms, their impact on tumor behavior and metastases, and potential environmental or genetic contributors to their development.

Helena Yu, MD and Joshua Sabari, MD explore the importance of testing for HER2 alterations in lung cancer; how HER2 positivity influences clinical decision-making; and the key methods used for detection, including immunohistochemistry, fluorescence in situ hybridization, and next-generation sequencing. It also addresses challenges in standardizing HER2 testing, disparities in access to biomarker testing, and the evolving role of liquid biopsy compared to traditional tissue biopsy.

Carrie Dougherty, MD, FAHS and Jessica Ailani, MD review migraine abstracts from the 2024 European Headache Congress.

A phase 3 study showed that combining pelabresib with ruxolitinib significantly improved spleen volume reduction and symptom relief in myelofibrosis patients compared to ruxolitinib alone, offering a promising new treatment option. Long-term use of gantenerumab may delay Alzheimer's dementia onset in individuals with inherited Alzheimer's, supporting the amyloid hypothesis and paving the way for future prevention strategies. Phase 3 trials demonstrated that povorcitinib, an oral JAK1 inhibitor, significantly improved clinical outcomes in adults with moderate to severe hidradenitis suppurativa, potentially offering a new treatment option. Research linked red meat allergy to bites from additional tick species, expanding the geographic risk area and highlighting the need for clinicians to consider this diagnosis in patients with unexplained allergic symptoms following tick bites.

Jessica Ailani, MD and Carrie Dougherty, MD, FAHS debate initial preventive treatment for migraine and the in-clinic management of status migraine.

Drs. Lebin and Nagle-Yang discuss the pharmacological management of PPD, with a focus on the risks and benefits of selective serotonin reuptake inhibitors (SSRIs) and zuranolone.

Drs. Nagle-Yang and Lebin discuss the barriers to care engagement for patients with PPD, including such factors as stigma, fear of judgement, and access to treatment.

Sarah Nagle-Yang, MD and Lindsay Lebin, MD review the screening, impact, and management of suicide risk in patients with PPD, highlighting effective prevention strategies.

A study suggests GLP-1 receptor agonists may reduce hematologic cancer risk in type 2 diabetes patients by 54% compared to insulin. Two individuals have achieved functional HIV cures through stem cell transplants, offering insights into cure strategies. Additionally, women with dense breasts face double the risk of breast cancer and reduced mammogram accuracy, supporting FDA regulations for breast density notifications and additional screening methods.

An AI system trained on breast ultrasound studies showed promise in reducing false positives and biopsies by over 37% and 28%, respectively, while maintaining sensitivity, potentially aiding clinical decision-making. Second, nirsevimab demonstrated effectiveness in preventing RSV infections and hospitalizations among infants, with protection waning over time but remaining significant. Lastly, breast and colon cancer screening rates in the U.S. have surpassed pre-pandemic levels, but cervical cancer screening rates remain concerningly low, highlighting disparities in access to preventive care.

Drs. McClung and Singer delve into common questions and clinical conundrums encountered in managing osteoporosis and fractures, including calcium use and dental procedures, in patients with osteoporosis.

Drs. Singer and McClung discuss the operationalization of a bisphosphonate “drug holiday” in people treated with this class of osteoporosis medication. They address questions regarding patient selection criteria, duration of the holiday, and strategies for determining when and with what medication treatment should be resumed.

Andrea J. Singer, MD, FACP, CCD and Michael R. McClung, MD review the preservation of bone health in perimenopausal women, with a particular focus on the role of hormone therapy and how the interplay of hormonal, lifestyle, and genetic factors is key to developing effective prevention and treatment strategies.

A Texas child's measles-related death, the first in the U.S. since 2015, highlights rising cases amid declining vaccination rates. AstraZeneca's Serena 6 trial found camizestrant, delayed disease progression in HR-positive HER2-negative breast cancer. A BMJ study found no link between GLP-1 receptor agonists and increased suicidality in diabetes patients. The CDC reports an 80% decline in high-risk cervical precancers, confirming HPV vaccination success.

Dr. Andrew Budson discusses the relationship between consciousness and memory, proposing that consciousness evolved as part of the memory system. He explains how unconscious processes drive much of our decision-making, with consciousness acting as a memory-based guide to influence behavior. He highlights the role of attention in memory retention and how false memories, particularly in Alzheimer's patients, arise due to the brain's reconstructive nature. Dr. Budson also explores the implications of this understanding for treating PTSD, addiction, and cognitive disorders.

This podcast reports a severe flu season, with hospitalizations exceeding previous years and rising pediatric flu deaths. A Texas measles outbreak, mainly in unvaccinated children, has reached nearly 60 cases, with more in New Mexico, highlighting vaccine decline risks. Research finds moderate to vigorous leisure activity lowers type 2 diabetes risk, while strenuous work activity does not. A UCLA study questions Paxlovid's effectiveness in preventing COVID-19 hospitalizations in vaccinated older adults, raising cost-effectiveness concerns.

Drs. Traina and Isaacs share how they determine which patients are appropriate for neoadjuvant therapies and how to address residual disease, as well as potential treatment toxicities.

Drs. Tiffany A. Traina and Claudine Isaacs discuss how they approach HER2+ early breast cancer treatment planning and which patients can take advantage of de-escalation.

Measles cases are rising in Texas and New Mexico, with most infections occurring in unvaccinated individuals and public health officials warning of further spread. A new study in JAMA Psychiatry found that semaglutide significantly reduces alcohol craving and heavy drinking, suggesting a potential new treatment for alcohol use disorder. Research confirms that self-sampling for HPV is as effective as speculum-based exams, improving accessibility for women with disabilities and underserved populations. With the FDA's recent approval, self-collection could revolutionize cervical cancer screening in the U.S.

Professor Alexander Jensen discusses parental favoritism and its impact on family dynamics, highlighting that both mothers and fathers tend to favor daughters, potentially due to social and evolutionary factors. The study suggests that children who receive less favorable treatment may experience negative mental health and behavioral outcomes, including increased risk-taking and lower self-esteem. The discussion also touches on how favoritism can persist into adulthood, influencing sibling relationships, caregiving responsibilities, and even long-term physical health.

This podcast features Marlee Tunduk, the lead author of a study on learning and attention in young children finding that children aged 7 to 9 learn differently from adults; they absorb information more generally from their environment, regardless of specific tasks or goals. This "sponge-like" learning suggests that children benefit from immersive and engaging environments rather than structured, task-focused learning. The findings highlight the importance of understanding and accommodating children's natural attentional systems in educational and parenting contexts. The discussion also touches on the potential implications for teaching methods and future research directions, emphasizing the need to explore how these learning differences manifest in various settings.