PVRoundup Podcast

Drs. Lynce and Waks explore whether advances in HER2-targeted therapy are making metastatic HER2+ breast cancer potentially curable, highlighting long-term remissions, survival gains from trials, and ongoing studies testing treatment-free remission.

Drs. Waks and Lynce review the PATINA trial, which showed that adding a CDK4/6 inhibitor to HER2-targeted and endocrine therapy improved progression-free survival in triple-positive breast cancer, shaping how this subgroup may be managed.

New research presented at ESMO 2025 confirms that datopotamab deruxtecan significantly improves progression-free and overall survival compared with chemotherapy in advanced triple-negative breast cancer, supporting its role as a first-line standard of care. Updated SELECT trial analyses demonstrate that semaglutide reduces major cardiovascular events by 20% independent of weight loss, suggesting cardioprotective mechanisms beyond adiposity reduction. Long-term data show that HPV vaccination has led to dramatic declines in vaccine-type infections and strong herd protection, although global coverage remains suboptimal.

Drs. Lynce and Waks discuss advances in early-stage HER2+ breast cancer, focusing on how targeted therapies have transformed outcomes. They explore de-escalation strategies, the role of platinum drugs, insights from the COMPASS trial, and the importance of pathologic complete response in guiding treatment decisions.

A large real-world study of over 1.2 million adults with type 2 diabetes found that SGLT2 inhibitors and GLP-1 receptor agonists reduced major cardiovascular events compared with metformin, while sulfonylureas and insulin increased risk. A separate French population study showed no association between first-trimester mRNA COVID-19 vaccination and congenital malformations, supporting vaccine safety in pregnancy. Finally, researchers at Mass General Brigham reported that large language models can produce “sycophantic” but incorrect medical advice, emphasizing the need for clinician oversight when using AI in healthcare.

Data in ~300,000 U.S. veterans show the 2024–2025 COVID-19 booster cut COVID-related ED visits (−29%), hospitalizations (−39%), and deaths (−64%) over six months, with modest yet meaningful absolute gains. In JAMA Psychiatry, a cohort linked risperidone use in dementia to a 28% higher stroke risk, especially in those with prior cardiovascular disease and within the first three months, warranting cautious, time-limited prescribing and monitoring. An article in JAMA Network Open found restless leg syndrome associated with higher subsequent Parkinson's incidence, supporting RLS as a practical marker for heightened PD risk.

An analysis of 35,000 stage II–III colon cancer cases shows relapse risk peaks in year one and falls below 0.5% per six-month interval by year six, offering a practical definition of cure and a basis to taper long-term follow-up. A second study estimates U.S. inhaler use generates over two million metric tons of annual emissions, with propellant-free devices offering lower-impact alternatives. Finally, lifestyle cohorts reveal about one-quarter of people with prediabetes can normalize glucose without weight loss, conferring >70% risk reduction over a decade and spotlighting fat distribution as a modifiable target.

Drs. Fahkri and Seshadri review abstracts from the 18th International Conference on Malignant Lymphoma in Lugano, Switzerland, exploring investigational novel agents in CLL.

A new meta-analysis in HeartRhythm found that SGLT2 inhibitors reduced sudden cardiac death risk by about 18% across patients with type 2 diabetes, heart failure, or chronic kidney disease, with consistent effects and minimal trial variation. A Cochrane review of over 100,000 participants showed RSV vaccines are highly effective and safe: protein-based shots cut severe lower respiratory infections in older adults by ~75% and protected infants when given to pregnant mothers, halving RSV-related care and hospitalizations. Finally, WHO and EMA reaffirmed acetaminophen's safety in pregnancy, rejecting suggested links to autism or neurodevelopmental harm, noting decades of safe use and the risks of untreated pain or fever.

Drs. Seshadri and Fahkri review abstracts exploring treatments for patients with high-risk CLL, including SEQUOIA Arm C and CLL16 studies.

Drs. Fahkri and Seshadri discuss recent studies on novel fixed-duration combinations and MRD-guided regimens for CLL. The Sequoia RMD study showed high efficacy with zanubrutinib and venetoclax, achieving a 99% response rate. Similarly, a phase 1 study with sornotoclax and zanubrutinib showed a 96% response rate. The UK FLAIR study demonstrated superior PFS and overall survival with ibrutinib plus venetoclax. The CLL18 trial evaluates MRD-guided vs. fixed-duration treatments with venetoclax and obinutuzumab or pirtobrutinib. Future CLL therapies may increasingly rely on MRD-guided approaches.

Drs. Hindiyeh and Hutchinson review new FDA-issued safety warnings for Raynaud's phenomenon and hypertension in CGRP-based migraine treatment. They explore the impact of this label update and share practical strategies for patient management.

The CDC's advisory panel voted to recommend separate MMR and varicella shots for children under four, citing a slight seizure risk with the combined MMRV vaccine, a move strongly opposed by the American Academy of Pediatrics as misleading and confusing. In obesity care, a phase 3 trial showed oral semaglutide 25 mg led to an average 13.6% weight loss in adults without diabetes, reinforcing GLP-1 pills as an effective option. Meanwhile, a large study linked pediatric CT scan radiation to increased blood cancer risk, urging dose minimization and safer alternatives.

Drs. Hutchinson and Hindiyeh discuss medication overuse headache, including some clinical features, diagnostic criteria, and management strategies.

Drs. Liu and Scott discuss the future of small cell lung cancer treatment, reviewing emerging strategies including immunotherapy, antibody–drug conjugates (ADCs), and bispecific T-cell engagers, as well as other targeted agents.

Drs. Liu and Scott review second-line treatments of small cell lung cancer following first-line maintenance treatment, including platinum rechallenge and other post-platinum agents.

Drs. Liu and Scott offer their perspectives on maintenance therapy in patients with small cell lung cancer, discussing the rationale, different approaches, as well as the associated benefits and challenges.

A large meta-analysis in The Lancet found clopidogrel superior to aspirin for long-term secondary prevention in coronary artery disease, reducing major cardiovascular events by 14% without added bleeding risk. The REBOOT trial in NEJM showed no benefit of beta-blockers in post-MI patients with preserved ejection fraction, and even potential harm in women on high doses, prompting reevaluation of routine use. Finally, a phase 2 trial in JAMA Internal Medicine showed daily azelastine nasal spray reduced COVID-19 incidence by 67% and shortened illness duration, though larger studies are needed to confirm its prophylactic role.

Drs. Chaichian and Dall'Era explore the “treat to target” approach in lupus, including key targets like DORIS remission and lupus low disease activity state.

Drs. Dall'Era and Chaichian discuss earlier use of targeted biologics for treating lupus.

The FDA has endorsed vibration-controlled transient elastography as a surrogate endpoint for MASH trials, marking the first non-invasive alternative to liver biopsy. A Japanese cohort study linked breakfast skipping and late dinners to higher fracture risk, with combined habits raising risk by nearly 25%. Finally, a global meta-analysis suggests shingles vaccination reduces major cardiovascular events by ~16–18%, though most evidence is observational.

Drs. Chaichian and Dall'Era review the updated guidelines for the treatment and management of SLE in children and adults.

Drs. Fava and Petri discuss emerging therapies in systemic lupus erythematosus, including treatments for lupus nephritis and cutaneous disease.

Drs. Petri and Fava review non-invasive biomarkers in systemic lupus erythematosus, including urine proteomics.

Drs. Petri and Fava discuss updated guidelines for the screening, treatment, and management of lupus nephritis.

The FDA has approved a generic version of liraglutide injection, expanding access to obesity treatment by lowering costs and broadening eligibility across adults and adolescents, though safety monitoring remains essential. A JAMA Network Open study found that overweight older adults had lower 30-day mortality after elective surgery compared to those of normal weight, highlighting the “obesity paradox” in surgical risk assessment. Finally, a new rapid, culture-free diagnostic method for sepsis can identify pathogens within two hours using microfluidics and deep learning, offering significant potential to improve survival in critically ill patients.

The FDA has granted accelerated approval to semaglutide (Wegovy) as the first drug for metabolic dysfunction–associated steatohepatitis (MASH), showing significant improvements in liver health and weight loss in the phase 3 ESSENCE trial. A systematic review of acetaminophen use in pregnancy found potential risks with long-term or frequent use but confirmed short-term, low-dose use remains appropriate when needed. Finally, an AI model integrating MRI, biomarkers, and clinical data improved prediction of knee osteoarthritis progression, enhancing physician accuracy and suggesting future support for earlier, personalized interventions.

A new JAMA study found that 84% of abortion prescriptions from Aid Access went to patients in states with bans, enabled by “shield laws” protecting telehealth providers across state lines. Provision rates were highest in underserved Southern and Midwestern counties, highlighting telemedicine's role in maintaining access. A Scientific Reports study showed that large language models for clinical use can be manipulated into giving unsafe answers through subtle “adversarial hallucination attacks,” with success rates over 95%. Finally, JAMA Ophthalmology reported GLP-1 agonists may slightly increase risk of sudden vision loss, though benefits still outweigh risks.

A multi-site randomized trial found that the suicide-prevention app OTX202 reduced repeat suicide attempts by 58% and sustained lower suicidal ideation through 24 weeks, especially in high-risk patients with prior attempts. A phase 3 trial showed canagliflozin significantly improved glycemic control in children and adolescents with type 2 diabetes, with safety comparable to adults. Finally, the SWIFT-SEG liquid biopsy detected multiple myeloma tumor cells in over 90% of cases, offering a less invasive alternative to bone marrow biopsies for diagnosis, monitoring, and precision treatment.

New guidelines from the 2025 Alzheimer's Association International Conference support using high-performing blood tests to help diagnose Alzheimer's in memory care patients, offering a less invasive option than spinal taps or PET scans. A NEJM trial found the smaller NTCU380mini IUD nearly as effective as the standard TCU380A, with fewer side effects and better tolerability. Lastly, a large study showed that adults with diabetes who exercised—even only on weekends—had significantly lower mortality, supporting flexible activity patterns.

A large observational study found small but potentially meaningful differences in cardiovascular safety among sulfonylureas compared to DPP-4 inhibitors in type 2 diabetes, with glipizide showing a statistically higher risk of MACE. A separate study revealed that over half of advanced-stage lung and colorectal cancer cases involved missed diagnostic opportunities, highlighting systemic delays in workups and follow-up. Finally, the EchoNext deep learning model accurately predicted structural heart disease from ECG data alone, outperforming cardiologists and showing potential for scalable, cost-effective screening. These findings underscore the importance of individualized treatment, earlier cancer detection, and AI-enabled cardiac diagnostics.

A new NEJM trial found methotrexate offers similar lung function improvements as prednisone in pulmonary sarcoidosis, but with fewer side effects—suggesting it could be a safer first-line option for some patients. A JAMA study revealed that patients trust physicians less when AI is mentioned in care ads, highlighting the importance of framing AI as a tool that supports—not replaces—clinical judgment. Another NEJM trial showed that giving take-home ondansetron to children after ED visits for gastroenteritis significantly reduced vomiting and return visits, with no added risks. Together, these studies support a shift toward individualized care, better patient communication, and practical interventions to improve outcomes.

Drs. Patel and Armstrong discuss how they are integrating FDA-approved therapies into geographic atrophy care. They share their perspectives on emerging treatments, including the potential for combination or staged approaches.

Drs. Armstrong and Patel discuss current and emerging therapies for diabetes-related macular edema and wet age-related macular degeneration including anti-VEGF agents, the need for durability and reduced treatment burden, alternative delivery strategies, novel molecules, and gene-therapy.

Dr. Richard S. Ostfeld discusses how human disruption of natural ecosystems, such as forest fragmentation and predator loss, has increased the risk of tick-borne diseases like Lyme and Powassan virus. He explains how climate change extends tick seasons and how common hosts like mice thrive in altered environments, boosting tick populations. Despite promising tick-control interventions, personal prevention remains key, as broad environmental strategies have yet to show consistent reductions in human disease.

Drs. Patel and Armstrong discuss the implementation and evaluation of AI-powered diabetic retinopathy and diabetes-related macular edema screening and telemedicine, including ways to handle an influx of referrals, questions about reimbursement, staffing, and liability.

Drs. Modi and Dedania discuss GLP-1 receptor agonists and the retinal patient, including how GLP-1 receptor agonists work, benefits and risks in patients with retinal disease, and data from retrospective studies.

Drs. Dedania and Modi discuss vitreous opacities, or floaters, including imaging, evaluating, and when and whether to pursue surgery. They discuss conditional circumstances that may influence whether to pursue surgery or not, as well as patient counseling.

Drs. Modi and Dedania discuss imaging, biomarkers, and diagnosis in geographic atrophy, as well as current therapies and those in late stage clinical trials.

This podcast highlights three updates: Moderna's Spikevax COVID-19 vaccine is now fully FDA-approved for high-risk children 6 months to 11 years, though rare myocarditis remains a concern. A large study found first-trimester TMP-SMX antibiotics increase congenital malformation risks compared to β-lactams, reinforcing β-lactams as safer. Finally, a trial showed no cardiovascular benefit from taking blood pressure medication at bedtime versus morning dosing.

Drs. Sabari and Socinski discuss maintenance therapy strategies in small cell lung cancer, including immunotherapy, chemotherapy, targeted agents, and radiation.

Drs. Socinski and Sabari discuss a couple of abstracts from ASCO 2025 about emerging therapeutics in small cell lung cancer.

Mark A. Socinski, MD and Joshua Sabari, MD review new data from ASCO 2025 that have a substantial impact on how oncologists treat patients with extensive-stage small cell lung cancer.

A Lancet analysis warns that USAID cuts could cause over 14 million preventable deaths by 2030, reversing decades of progress against infectious diseases. The TARGET Protein Trial found high-protein nutrition in ICU patients did not improve outcomes and may raise risks in kidney injury. A study in npj Vaccines showed older adults getting AS01-adjuvanted shingles or RSV vaccines had lower dementia risk, possibly due to immune effects. These findings stress the importance of global health funding, cautious ICU nutrition, and more research on vaccines and neurodegeneration.

The measles outbreak stands at 1,227 confirmed cases in 2025 so far—nearly five times the total for all of 2024—mostly among unvaccinated individuals. New data from the INTERACT trials show that rapidly lowering blood pressure after intracerebral hemorrhage improves survival and function, especially when treatment starts within three hours. The CDC's Vaccine Advisory Panel, controversially reconstituted with vaccine skeptics, voted to recommend only thimerosal-free single-dose flu vaccines despite decades of evidence showing no harm from thimerosal. This decision followed an unvetted presentation citing questionable data, raising concerns about scientific integrity and vaccine access.

Drs. Yuan and Callahan discuss data presented at ASCO 2025 about DESTINY-Breast06, SHR-A1811, and TQB2101, along with real-world data on rechallenging patients with T-DXd post grade 1 ILD.

Drs. Callahan and Yuan discuss data presented at ASCO 2025 on DESTINY-Breast09, PATINA, and MINI Trial, the utility of PFS-2 as an endpoint, and sequencing of treatments after first-line therapy.

Drs. Zaman and Podolanczuk discuss data for new and emerging therapies for ILD presented at ATS 2025, including nerandomilast, inhaled therapies for IPF and ILD, TNIK inhibitors, as well as new biomarkers and imaging for diagnosing ILDs.

Tanzira Zaman, MD and Elizabeth Volkmann, MD, MS discuss the new official American Thoracic Society Clinical Statement on the diagnosis and management of interstitial lung abnormalities which Dr. Podolanczuk presented at ATS 2025.

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.