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Dr. Jack West reviews emerging new information and controversial topics in health care in general, cancer treatment in particular.


    • Mar 8, 2019 LATEST EPISODE
    • infrequent NEW EPISODES
    • 7m AVG DURATION
    • 75 EPISODES


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    Latest episodes from The Beacon

    Dr. David Spigel, Part 2: Identifying the Optimal Duration for Immunotherapy in Responding Patients with Advanced Lung Cancer (BMIC-075)

    Play Episode Listen Later Mar 8, 2019 20:37


    Dr. Jack West interviews Dr. David Spigel of Sarah Cannon Research Institute on the evidence on an optimal duration of immunotherapy for long-responding patients with advanced NSCLC, weighing efficacy, potential toxicity, and cost concerns.

    Dr. David Spigel, Part 1: Clinical Research and the Growing Complexity of Cancer Care in a Community Setting (BMIC-074)

    Play Episode Listen Later Mar 5, 2019 24:33


    Dr. Jack West interviews Dr. David Spigel of Sarah Cannon Research Institute on the challenges of conducting clinical trials and delivering increasingly complex patient care, along with the possible future role of artificial intelligence and telemedicine.

    Top 5 Most Influential Trial Findings in Lung Cancer Management in 2018 (BMIC-073)

    Play Episode Listen Later Dec 28, 2018 13:28


    Dr. Jack West summarizes his list of the top 5 most influential trials in lung cancer that reported results in 2018, including why they matter.

    What does the CheckMate-331 trial of nivolumab vs. chemo for relapsed SCLC tell us? (BMIC-072)

    Play Episode Listen Later Dec 21, 2018 8:58


    Dr. Jack West reviews the trial design, key results, and implications of the CheckMate-331 trial of nivolumab (Opdivo) vs. standard chemotherapy for relapsed small cell lung cancer.

    The IMpower130 Trial of Carbo/Nab-Paclitaxel +/- Atezolizumab: Does this Positive Trial Change Management? (BMIC-071)

    Play Episode Listen Later Dec 11, 2018 9:58


    Dr. Jack West reviews the IMpower130 trial of carboplatin + nab-paclitaxel with or without atezolizumab as first line treatment for advanced non-squamous NSCLC and whether this positive trial changes management in this setting.

    Overall Survival Benefit for Local Ablative Therapy as Consolidation for Oligometastatic Stage IV NSCLC: Where Does it Fit in Practice Now? (BMIC-070)

    Play Episode Listen Later Dec 9, 2018 9:53


    Dr. Jack West describes recently updated results of a small randomized trial of consolidation local ablative therapy (LAT) for oligometastatic advanced NSCLC after initial systemic therapy & considers whether these results should shape clinical practice.

    The IMpower132 Trial: Does This Change the Advanced NSCLC Landscape? (BMIC-069)

    Play Episode Listen Later Dec 4, 2018 6:39


    Dr. Jack West reviews the IMpower132 trial of platinum + pemetrexed with or without atezolizumab as first line treatment for advanced non-squamous NSCLC and where these results fit into management of patients in this setting.

    The MYSTIC Trial has Failed on Overall Survival in Advanced NSCLC: What Does and Doesn't This Tell Us? (BMIC-068)

    Play Episode Listen Later Dec 2, 2018 9:42


    Dr. Jack West reviews the trial design of the MYSTIC trial of durvalumab alone or in combination with tremelimumab, what we know about results, and the implications for the current & future landscape in NSCLC.

    Pembrolizumab for Patients with Advanced NSCLC and a Performance Status (PS) of 2: Results of the PePS2 Trial (BMIC-067)

    Play Episode Listen Later Nov 16, 2018 4:13


    Dr. Jack West summarizes new information presented at ESMO 2018 on the PePS2 trial of pembrolizumab (Keytruda) in patients with advanced NSCLC performance status (PS) of 2, which demonstrated favorable efficacy and no concerning challenges with toxicity in this population.

    Long-Term Management of Patients Doing Well on Immunotherapy for Advanced NSCLC: Insights from KEYNOTE-010 (BMIC-066)

    Play Episode Listen Later Nov 14, 2018 8:04


    Dr. Jack West reviews longitudinal outcomes for patients on the KEYNOTE-010 trial of pembrolizumab (Keytruda) vs. docetaxel as 2nd line therapy for advanced NSCLC, with helpful new info on those completing 2 years of pembro & implications for practice.

    Updated Results on PACIFIC Trial: Should we Revise Who Should Receive Consolidation Immunotherapy after Chemo/Radiation? (BMIC-065)

    Play Episode Listen Later Nov 8, 2018 7:22


    Dr. Jack West discusses the trial design of the PACIFIC trial of consolidation durvalumab (Imfinzi) after chemo/radiation for unresectable stage III NSCLC and highlights new data on overall survival and the different results in patient subgroups.

    IMpower133: Is there Finally a New Standard of Care for Extensive Stage SCLC? (BMIC-064)

    Play Episode Listen Later Nov 6, 2018 7:19


    Dr. Jack West reviews the IMpower133 trial that integrated atezolizumab with first line chemo for extensive stage SCLC and discusses whether the results improve outcomes enough to change our standard of care in this setting.

    "Best Treatment First": Implications for front-Loading Combinations in Lung Cancer (BMIC-063)

    Play Episode Listen Later Sep 7, 2018 9:09


    Dr. Jack West describes an emerging theme that the best outcomes for patients with lung cancer and likely other cancer are best served by receiving the best agents up front, a strategy that implies a value in integrating more treatments into early combos.

    Local Therapy for Advanced NSCLC: Revising Outdated Principles for Selected Patients (BMIC-062)

    Play Episode Listen Later Sep 4, 2018 15:37


    Dr. Jack West reviews general principles for how local therapies are increasingly appropriate for selected patients with advanced NSCLC, whether at initial management, for limited progression on systemic therapy, or as local consolidation therapy.

    TIP or BEP for Intermediate or Poor Risk Testicular Cancer?: Highlights in GU Oncology from ASCO 2018 (BMIC-061)

    Play Episode Listen Later Aug 31, 2018 3:40


    Dr. Dan Goldstein reviews results of a trial of chemo regimen TIP (paclitaxel, ifosfamide, cisplatin) vs BEP (bleomycin, etoposide, cisplatin) for intermediate/poor risk germ cell tumors, with discussion of outcomes in patients with a p53 mutation.

    Adjuvant Docetaxel for Intermediate or High Risk Prostate Cancer After Radiation: Highlights in GU Oncology from ASCO 2018 (BMIC-060)

    Play Episode Listen Later Aug 29, 2018 1:35


    Dr. Daniel Goldstein summarizes findings of a trial presented at ASCO 2018 by Dr. Kellolumpu-Lehtinen, assessing the benefit of adjuvant docetaxel for patients after radiation for patients with high or intermediate risk localized prostate cancer.

    What is Positive Predictive Value of PET PSMA in Biochemical Recurrence of Prostate Cancer? Highlights in GU Oncology from ASCO 2018 (BMIC-059)

    Play Episode Listen Later Aug 27, 2018 2:47


    Dr. Daniel Goldstein reviews data on the positive predictive value of PET PSMA imaging in patients with biochemically relapsed prostate cancer, as presented by Wolfgang Fendler & colleagues at ASCO 2018.

    New Data & Context for a PARP Inhibitor/Abiraterone Combination in Metastatic Prostate Cancer: Highlights in GU Oncology from ASCO 2018 (BMIC-058)

    Play Episode Listen Later Aug 24, 2018 3:03


    Dr. Daniel Goldstein considers new data by Clarke & colleagues on a combination of the PARP inhibitor olaparib with abiraterone for molecularly unselected metastatic prostate cancer, along with providing a context of results from similar prior research.

    Is PROSTVAC the Vaccine Therapy We've Been Waiting for in Advanced Prostate Cancer? Highlights in GU Oncology from ASCO 2018 (BMIC-057)

    Play Episode Listen Later Aug 22, 2018 2:03


    Dr. Daniel Goldstein reviews data by Drs. Gulley & colleagues on PROSTVAC vaccine in metastatic prostate cancer & discusses the implications of trials that fail in phase III despite looking extremely favorable in phase II studies.

    Is More Better with Radium-223 for Metastatic Prostate Cancer? Highlights in GU Oncology from ASCO 2018 (BMIC-056)

    Play Episode Listen Later Aug 20, 2018 1:08


    Dr. Daniel Goldstein reviews data in genitourinary oncology from ASCO 2018, including a study of higher dose or prolonged duration of radium-223 (Xofigo) compared to standard dosing for 6 months with this agent in patients with metastatic prostate cancer.

    Immunotherapy with Pembrolizumab in Metastatic Prostate Cancer: Highlights in GU Oncology from ASCO 2018 (BMIC-055)

    Play Episode Listen Later Aug 17, 2018 2:18


    Dr. Daniel Goldstein summarizes key data in genitourinary oncology from ASCO 2018, including new results on pembrolizumab (Keytruda) for metastatic prostate cancer, asking whether it could find a place as treatment for a subset of these patients.

    Quality of Life on the Atezolizumab/Bevacizumab Combination for Metastatic Kidney Cancer: Highlights from ASCO 2018 (BMIC-054)

    Play Episode Listen Later Aug 15, 2018 2:19


    Dr. Daniel Goldstein reviews data from ASCO 2018 on patient-reported quality of life on atezolizumab/bevacizumab compared to sunitinib in metastatic kidney cancer, along with the context of other treatment options in this setting.

    Pembrolizumab in First Line Clear Cell RCC & the Evolving Role of Immunotherapy in Metastatic RCC: Highlights from ASCO 2018 (BMIC-053)

    Play Episode Listen Later Aug 13, 2018 3:19


    Dr. Daniel Goldstein discusses the results of a trial of first line pembrolizumab (Keytruda) as first line therapy for patients with metastatic clear cell renal cell carcinoma and the implications for the future role of immunotherapy in RCC.

    Does Adjuvant Sunitinib Offer a Benefit after Oligometastasectomy for Kidney Cancer? Highlights from ASCO 2018 (BMIC-052)

    Play Episode Listen Later Aug 10, 2018 2:07


    Dr. Daniel Goldstein summarizes the findings of a randomized trial assessing the benefit of adjuvant sunitinib following resection of oligometastatic disease in patients with renal cell carcinoma (RCC).

    Is There Still a Role for Cytoreductive Nephrectomy for advanced Kidney Cancer in the Wake of the CARMENA Trial? Highlights from ASCO 2018 (BMIC-051)

    Play Episode Listen Later Aug 8, 2018 4:38


    Dr. Daniel Goldstein reviews the key data and limitations from the CARMENA trial that re-evaluated the role of nephrectomy in metastatic renal cell carcinoma (RCC), providing insight into how the data should be applied in clinical practice.

    Can We Effectively Target FGFR with the Novel Agent Erdafitinib for Muscle-Invasive Bladder Cancer? Highlights from ASCO 2018 (BMIC-050)

    Play Episode Listen Later Aug 6, 2018 2:59


    Dr. Daniel Goldstein reviews highlights in bladder cancer from ASCO 2018, including the novel agent erdafitinib as a treatment targeting fibroblast growth factor receptor (FGFR) alterations in muscle-invasive, advanced bladder cancer.

    Novel Agent Enfortumab, a Nectin-4 Inhibitor, for Transitional Cell Carcinoma of the Bladder: Highlights from ASCO 2018 (BMIC-049)

    Play Episode Listen Later Aug 2, 2018 1:58


    Dr. Daniel Goldstein reviews provocative and highly promising results with enfortumab, an inhibitor of nectin-4, as a treatment for advanced transitional cell carcinoma of the bladder.

    Does Nab-Paclitaxel Improve Outcomes Compared to Paclitaxel in Second Line Treatment of Transitional Cell Carcinoma of the Bladder (or other cancers)? Highlights from ASCO 2018 (BMIC-048)

    Play Episode Listen Later Jul 31, 2018 1:41


    Dr. Daniel Goldstein reviews trial results comparing nab-paclitaxel to standard paclitaxel in second line treatment of bladder cancer, comparing these results to those in breast cancer and raising questions of utility in pancreatic cancer.

    Could Immunotherapy Replace Neoadjuvant Chemo for Muscle-Invasive Transitional Cell Carcinoma? Highlights from ASCO 2018 (BMIC-047)

    Play Episode Listen Later Jul 28, 2018 3:35


    Dr. Daniel Goldstein reviews highlights in bladder cancer from ASCO 2018, including important studies evaluating the efficacy of neoadjuvant immunotherapy instead of chemotherapy for muscle-invasive transitional cell carcinoma of the bladder?

    How do Patients with Advanced NSCLC on Daily Steroids Do on Immune Checkpoint Inhibitors? (BMIC-046)

    Play Episode Listen Later Jul 12, 2018 9:07


    Dr. Jack West summarizes findings of a retrospective analysis from Dr. Arbour of MSKCC, evaluating the clinical outcomes of patients with advanced NSCLC on daily steroids while receiving an immune checkpoint inhibitor against PD-1 or PD-L1.

    Is Chemo the Key to the Best Combination for EGFR Mutation-Positive NSCLC? The Data Too Good to Overlook (BMIC-045)

    Play Episode Listen Later Jul 9, 2018 12:38


    Dr. Jack West reviews the remarkable results of the NEJ009 trial that tested the combination of carboplatin/pemetrexed with gefitinib as initial therapy compared to gefitinib followed by chemotherapy in patients with EGFR mutation-positive advanced NSCLC.

    Is the Survival Benefit from Dacomitinib on the ARCHER-1050 Trial Enough to Make it a Contender as First Line Treatment for EGFR Mutation-Positive NSCLC Today? (BMIC-044)

    Play Episode Listen Later Jul 5, 2018 7:05


    Dr. Jack West reviews results from ARCHER-1050, a trial of dacomitinib vs. gefitinib, in EGFR mutation-positive NSCLC, asks whether the demonstrated survival benefit is enough to make dacomitinib a player as first line treatment.

    The Erlotinib/Bevacizumab Combination in EGFR Mutation-Positive Advanced NSCLC: Is Progression-Free Survival without Overall Survival Benefit Enough? (BMIC-043)

    Play Episode Listen Later Jul 2, 2018 10:16


    Dr. Jack West discusses results and the significance of two important Japanese trials that test the combination of erlotinib (Tarceva) with bevacizumab (Avastin), which shows a consistent improvement in progression-free survival but not overall survival.

    Small Trial Shows Big Risks of Giving First Line Pembrolizumab to EGFR Mutation-Positive Patients, Even with High Tumor PD-L1 Expression (BMIC-042)

    Play Episode Listen Later Jun 28, 2018 7:12


    Dr. Jack West summarizes a small trial from UCLA that tests the utility of giving first line immunotherapy to EGFR mutation-positive patients with high tumor PD-L1 expression, which led to poor outcomes that should cast a long shadow on this approach.

    IMpower131: What is the Role for the Carbo/Nab-Paclitaxel/Atezolizumab Combination for Advanced Squamous NSCLC? (BMIC-041)

    Play Episode Listen Later Jun 25, 2018 8:10


    Dr. Jack West summarizes key data from the IMpower131 trial of patients with advanced squamous NSCLC & examines whether the carboplatin/nab-paclitaxel/atezolizumab combination is a strong treatment option in this patient setting.

    Is Nivo/Ipi the Treatment of Choice for Patients with Advanced NSCLC, Tumor PD-L1 Less Than 1%, & High TMB? New Data from CheckMate 227 (BMIC-040)

    Play Episode Listen Later Jun 22, 2018 8:57


    Dr. Jack West reviews data from the CheckMate 227 trial in patients with advanced NSCLC & tumor PD-L1

    KEYNOTE-407: Practice-Changing Positive Trial for Advanced Squamous NSCLC (BMIC-039)

    Play Episode Listen Later Jun 20, 2018 9:32


    Dr. Jack West reviews KEYNOTE-407, first line chemo/immunotherapy with pembrolizumab vs. chemo alone in advanced squamous NSCLC, which demonstrated a significant survival benefit that should change practice in this setting.

    KEYNOTE-042: Should Pembrolizumab Replace Chemo for a Broader Population of Patients with Advanced NSCLC? (BMIC-038)

    Play Episode Listen Later Jun 18, 2018 11:05


    Dr. Jack West reviews the KEYNOTE-042 trial of pembrolizumab vs. chemo in PD-L1-positive NSCLC, highlighting key findings from the presentation in the Plenary Session at ASCO 2018, clinical implications, & whether it should change practice.

    My Top 5 ASCO 2018 Abstracts in Stage I-III NSCLC, Small Cell Lung Cancer, & Mesothelioma (BMIC-037)

    Play Episode Listen Later May 23, 2018 7:13


    Dr. Jack West reviews his top 5 abstracts in stage I-III non-small cell lung cancer, small cell lung cancer, and mesothelioma at ASCO 2018, explaining why each is poised to change the landscape of patient care in this setting.

    My Top 5 ASCO 2018 Abstracts in Advanced NSCLC (BMIC-036)

    Play Episode Listen Later May 21, 2018 10:18


    Dr. Jack West reviews his top 5 abstracts in the advanced NSCLC track at ASCO 2018, explaining why each is poised to change the landscape of patient care in this setting.

    Are Tumor Mutation Burden and Nivolumab/Ipilimumab Ready for Clinical Use? Insights from CheckMate 227 (BMIC-035)

    Play Episode Listen Later May 11, 2018 9:40


    Dr. Jack West reviews the CheckMate 227 trial, summarizing highlights from efficacy & side effects of nivolumab/ipilimumab (nivo/ipi) compared to standard doublet chemotherapy in patients with advanced NSCLC & high tumor mutational burden (TMB).

    Nivolumab/Ipilimumab vs. Chemo in High TMB Advanced NSCLC: Key Results from CheckMate 227 (BMIC-034)

    Play Episode Listen Later May 10, 2018 13:07


    Dr. Jack West reviews the CheckMate 227 trial, summarizing highlights from efficacy & side effects of nivolumab/ipilimumab (nivo/ipi) compared to standard doublet chemotherapy in patients with advanced NSCLC & high tumor mutational burden (TMB).

    KEYNOTE-189: Clinical Implications in Patients with Advanced Non-Squamous NSCLC and Negative (sub 1%) Tumor PD-L1 Expression (BMIC-033)

    Play Episode Listen Later May 4, 2018 6:32


    Dr. Jack West reviews clinical results in patients with advanced non-squamous NSCLC and negative (

    KEYNOTE-189: Clinical Implications in Patients with Advanced Non-Squamous NSCLC and Low (1-49%) Tumor PD-L1 Expression (BMIC-032)

    Play Episode Listen Later May 4, 2018 6:16


    Dr. Jack West reviews clinical results in patients with advanced non-squamous NSCLC and low (1-49%) tumor PD-L1 on the KEYNOTE-189 trial, providing thoughts on the clinical implications of these findings in management of this patient subset.

    KEYNOTE-189: Clinical Implications in Patients with Advanced Non-Squamous NSCLC and High (≥50%) Tumor PD-L1 Expression (BMIC-031)

    Play Episode Listen Later Apr 30, 2018 7:58


    Dr. Jack West reviews clinical results in patients with advanced non-squamous NSCLC and high tumor PD-L1 on the KEYNOTE-189 trial, providing thoughts on the clinical implications of these findings in management of these patients.

    KEYNOTE-189: Key Summary of a Practice-Changing Trial in Advanced Non-Squamous NSCLC (BMIC-030)

    Play Episode Listen Later Apr 27, 2018 13:06


    Dr. Jack West reviews the trial design, efficacy endpoints, and toxicity results of the KEYNOTE-189 trial of pembrolizumab or placebo added to cisplatin or carboplatin with pemetrexed chemo in advanced non-squamous NSCLC with any PD-L1 expression.

    Is Chemotherapy More Effective After Prior Immunotherapy? (BMIC-029)

    Play Episode Listen Later Apr 12, 2018 5:03


    Dr. Jack West presents early data suggesting that chemotherapy may be more effective after prior immunotherapy than otherwise.

    New Insights on Acquired Resistance to Immune Checkpoint Inhibitors for NSCLC: Implications for Treatment Options (BMIC-028)

    Play Episode Listen Later Apr 10, 2018 11:34


    Dr. Jack West reviews new data on patterns of acquired resistance after a response to immune checkpoint inhibitors for advanced NSCLC, along with the clinical implications of various options based on these observations.

    Is immunotherapy ineffective in patients with driver mutation-positive advanced NSCLC? Time to walk that back. (BMIC-027)

    Play Episode Listen Later Apr 6, 2018 10:26


      Dr. Jack West summarizes the evolving data shaping our understanding of the role of immune checkpoint inhibitors for patients with EGFR- or ALK-positive advanced NSCLC, including more recent data that should change our perspective.

    Chemo/Immunotherapy in Advanced Squamous NSCLC: What is the Impact of IMpower131? (BMIC-026)

    Play Episode Listen Later Apr 4, 2018 9:15


    Dr. Jack West reviews the preliminary positive result form the IMpower131 trial of chemo +/- atezolizumab immunotherapy and considers what the clinical significance of these findings should be for patients with advanced squamous NSCLC.

    Is Durvalumab (Imfinzi) in Stage III NSCLC Curing Patients or Just Treating Metastatic Disease Earlier? Importance of Overall Survival and Implications for Duration of Treatment (BMIC-025)

    Play Episode Listen Later Feb 22, 2018 6:33


    Dr. Jack West explores the importance of following the overall survival of patients on the PACIFIC trial and considers still open questions of whether consolidation durvalumab (Imfinzi) in stage III unresectable NSCLC should be discontinued after a year.

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