Podcasts about Adjuvant therapy

In this JCO Article Insights episode, host Jospeh Mathew summaries Pancreatic Adenocarcinoma: Long-Term Outcomes of Adjuvant Therapy in the ESPAC4 Phase III Trial, by Palmer, et al published December 5, 2024. Transcript Joseph Matthew: Hello and welcome to the Journal of Clinical Oncology Article Insights. I'm your host, Joseph Matthew, and today we will be discussing the article "Long-Term Survival in Resected Pancreatic Ductal Adenocarcinoma with Adjuvant Gemcitabine plus Capecitabine Compared to Modified FOLFIRINOX from the ESPAC-4 and the PRODIGE 24 Trials" by Dr. Palmer et al. To summarize the relevant evidence, the ESPAC-4 was a European phase 3 multicenter randomized clinical trial published in 2017 comparing adjuvant gemcitabine and capecitabine (GemCap) with gemcitabine monotherapy following macroscopic margin-negative resections for operable pancreatic ductal adenocarcinoma (PDAC). The trial had included non-metastatic patients aged 18 years or older, World Health Organization (WHO) performance scores of 2 or less, creatinine clearance of at least 50 mL/min, and a life expectancy of over three months who had not received any prior anticancer treatment. Patients who had undergone R2 resections were selectively excluded. Eligible participants were randomized 1:1 within 12 weeks of pancreatectomy to one of the two treatment arms, with chemotherapy initiated within two weeks from the date of randomization. The regimens involved six cycles, each lasting four weeks, for an overall duration of 24 weeks. In the monotherapy arm, gemcitabine dosed at 1 g/m² was given as an intravenous infusion once a week for three weeks, followed by one week off. In the GemCap arm, capecitabine dosed at 1660 mg/m² was added to gemcitabine, given daily for three weeks, followed by one week off. Patients were followed up every three months, with the primary endpoint being overall survival (OS). The study showed that at a median follow-up of 43.2 months, GemCap was associated with a significantly longer OS than gemcitabine alone. Subsequently, in 2018, the Phase 3 randomized PRODIGE 24 trial was conducted in centers across France and Canada, comparing adjuvant modified FOLFIRINOX (mFOLFIRINOX) with gemcitabine in a similar subset of patients with resected PDAC and reported longer OS with the mFOLFIRINOX regimen. This study, however, had more restrictive eligibility criteria when compared to ESPAC-4, including patients aged under 80 years, WHO performance status of 0 or 1, with no significant cardiovascular disease, and a postoperative serum CA 19-9 of less than 180 U/mL. There was hence a subset of ESPAC-4 patients who did not meet the eligibility criteria for mFOLFIRINOX as set by the PRODIGE 24. The present study was conducted to estimate the overall 5-year survival rates for patients of ESPAC-4 receiving GemCap and gemcitabine, further stratifying survival in either arm according to the status of the surgical margins (R status) and the resected nodes (N status), and also to investigate whether GemCap retained a survival benefit over gemcitabine in PRODIGE 24-ineligible patients. A total of 732 patients, evenly distributed between both arms, were followed up for a median period of 104 months. Adjuvant GemCap was found to retain its survival advantage over gemcitabine, with a significantly longer median OS of 31.6 months when compared to 28.4 months with gemcitabine alone. Further subgroup analysis was performed with reference to the resection margins and the nodal status. As a reminder, in the ESPAC-4 trial, 60% of patients were found to have microscopically positive margins (an R1 resection), and 80% were node-positive. The difference in survival was greater in patients undergoing microscopic margin-negative resections (R0) who experienced a median OS of 49.9 months with GemCap when compared to 32.2 months with gemcitabine. Node-negative patients also had a significantly greater 5-year OS rate with GemCap of 59% versus 53% with gemcitabine monotherapy. However, it is important to note that no significant difference in survival outcomes was observed in margin-positive (R1) or node-positive patients in the two arms. The investigators also evaluated GemCap in the subgroup of 193 patients (comprising 26.4% of the ESPAC-4 cohort) who were not considered to have met the eligibility criteria for PRODIGE 24. The survival benefit of combination therapy was retained in this group, with patients receiving GemCap experiencing a median survival of 25.9 months compared to 20.7 months with adjuvant gemcitabine. Although cross-trial comparisons have limited validity, good agreement was noted in adverse grade 3 or greater toxicity associated with the control gemcitabine arms of ESPAC-4 and PRODIGE 24, serving as the basis for a qualitative comparison of toxicities between mFOLFIRINOX and GemCap. Neutropenia was more prevalent in the GemCap arm, affecting 40.8% of patients compared to 28.4% with mFOLFIRINOX. However, granulocyte colony-stimulating factor (G-CSF) was administered to 62.2% of patients in PRODIGE 24. Palmar-plantar erythrodysesthesia (PPE) was also more prevalent with GemCap. Patients on mFOLFIRINOX were more likely to observe grade 3 or greater fatigue, diarrhea, nausea and vomiting, sensory peripheral neuropathy, and paresthesias. The investigators concluded that GemCap was the standard adjuvant treatment for patients with PDAC undergoing an upfront resection who were not feasible for mFOLFIRINOX. Further exploratory analysis revealed that patients under the age of 70 who had undergone a microscopic margin-negative (R0) resection for node-negative PDAC were likely to derive an OS benefit from the addition of capecitabine to gemcitabine in the adjuvant setting. In contrast, mFOLFIRINOX would be more effective than gemcitabine in patients with positive margins (R1) or involved nodes, as per the PRODIGE 24 trial. Thank you for listening to JCO Article Insights. Please come back for more interviews and article summaries, and be sure to leave us a rating and review so others can find our show. For more podcasts and episodes from ASCO, please visit ASCO.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

Welcome to this week's podcast by VJOncology, where we delve into the latest developments in adjuvant therapy for hepatocellular carcinoma.... The post Adjuvant Therapy for Hepatocellular Carcinoma appeared first on VJOncology.

Featuring perspectives from Dr Kevin S Hughes and Dr Mark Robson, including the following topics: Introduction (0:00) Optimal Approach to Genetic Testing for Patients with Localized Breast Cancer (BC) — Dr Hughes (10:22) Available Data with and Practical Application of PARP Inhibition as Adjuvant Therapy for Patients with BC — Dr Robson (38:06) CME information and select publications

Commentary by Dr. Mina Sedrak

Dr. Jasmine Sukumar and Dr. Dionisia Quiroga discuss advances in adjuvant therapy for patients with early breast cancer and BRCA1/2 mutations, including how to identify patients who should receive genetic testing and the significant survival benefits of olaparib that emerged from the OlympiA trial. TRANSCRIPT Dr. Jasmine Sukumar: Hello, I'm Dr. Jasmine Sukumar, your guest host of the ASCO Daily News Podcast today. I'm an assistant professor and breast medical oncologist at the University of Texas MD Anderson Cancer Center. On today's episode, we'll be exploring advances in adjuvant therapy for high-risk early breast cancer in people with BRCA1/2 germline mutations. Joining me for this discussion is Dr. Dionisa Quiroga, an assistant professor and breast medical oncologist at the Ohio State University Comprehensive Cancer Center.  Our full disclosures are available in the transcript of this episode.  Dr. Quiroga, it's great to have you on the podcast. Thanks for being here. Dr. Dionisia Quiroga: Thank you. Looking forward to discussing this important topic. Dr. Jasmine Sukumar: Let's start by going over who should be tested for BRCA1/2 genetic mutations. How do you identify patients with breast cancer in your clinic who should be offered BRCA1/2 genetic testing? Dr. Dionisia Quiroga: So, guidelines on who to offer testing to somewhat differ between organizations at this point. I would say, generally, I do follow our current ASCO-Society of Surgical Oncology (SSO) Guidelines, though. Those guidelines recommend that BRCA1/2 mutation testing be offered to all patients who are diagnosed with breast cancer and are 65 years old or younger. For those that are older than 65 years old, there are additional factors to really take into account to decide on who to recommend testing for. Some of this has to do with personal and family history as well as ancestry. The NCCN also has their own specific guidelines for who to offer testing to. For example, people assigned male at birth; those who are found to have a second breast primary; those who are diagnosed at a young age; and those with significant family history should also be offered BRCA1/2 testing.  I think, very important for our discussion today, ASCO and SSO also made a very important point that all patients who may be eligible for PARP inhibitor therapy should be offered testing. So clearly this includes a large amount of our patient population. In my practice, we often refer to our Cancer Genetics Program. We're fortunate to have many experienced genetic counselors who can complete pre-test and post-test counseling with our patients. However, in settings where this may not be accessible to patients, it can also be appropriate for oncology providers to order the testing and ideally perform some of this counseling as well. Dr. Jasmine Sukumar: Thank you Dr. Quiroga. Let's next review where we are in current clinical practice guidelines. What current options do we have for adjuvant therapy specific to people with high-risk early breast cancer and BRCA1/2 genetic mutations? Dr. Dionisia Quiroga: Our current guidelines recommend adjuvant olaparib for one year for individuals with HER2-negative high risk breast cancer. This approval largely came from the data and the results of the OlympiA trial. This was a prospective phase 3, double blind, randomized clinical trial. It enrolled patients who had been diagnosed with HER2-negative early-stage breast cancer who also carried germline pathogenic or likely pathogenic variants of either the BRCA1 and/or BRCA2 genes. The disease also had to be considered high-risk and there were several criteria that had to be evaluated to deem whether or not these patients were high-risk. For example, those who are treated with neoadjuvant chemotherapy, if they had disease that was triple-negative, they needed to have some level of invasive residual disease at time of surgery. Alternatively, if the disease was hormone receptor-positive, they needed to have residual disease and a calculated CPS + EG score of 3 or higher. This scoring system is something that estimates relapse probability on the basis of clinical and pathologic stage, ER status, and histologic grade, and this will give you a score ranging from 0 to 6. In general, the higher the score, the worse the prognosis. This calculator though is available to the public online to allow providers to calculate this risk.  For the subset of patients who received adjuvant chemotherapy, for them to qualify for the OlympiA trial, if they had triple-negative disease, they needed to have a tumor of at least 2 cm or greater and/or have positive lymph nodes for disease. For hormone receptor-positive disease that was treated with adjuvant chemotherapy, they were required to have four or more pathologically confirmed positive lymph nodes at time of surgery. From this specified pool, patients were then randomized 1:1 to get either adjuvant olaparib starting at 300 mg twice a day or a matching placebo twice a day after they had completed surgery, chemotherapy and radiation treatment if needed. Dr. Jasmine Sukumar: And what were the outcomes of this study? Dr. Dionisia Quiroga: The study ended up enrolling over 1,800 patients and from these 1,800 patients, 70% had a BRCA1 mutation while 30% had a BRCA2 mutation. About 80% of the patients had triple-negative disease compared to hormone receptor-positive disease. Interestingly, about half of all patients enrolled had received neoadjuvant chemotherapy while the other half received adjuvant chemotherapy.  Looking at the outcomes, this was overall a very positive study. We actually now have outcomes data from a median of about 6 years out. This was just reported in December at the 2024 San Antonio Breast Cancer Symposium. There was found to be a 9.4% absolute difference in six-year invasive disease-free survival favoring the olaparib arm over the placebo arm. What was also interesting is that this was consistent across multiple subgroups of patients and the benefit was really seen whether or not they had hormone receptor-positive or triple-negative disease. The absolute difference in distant disease-free survival was also high at 7.8% and additionally favored olaparib. Most importantly, there was found to be a significant overall survival benefit. The six-year overall survival was 87.5% in the olaparib group compared to 83.2% in the placebo group. This translates to about a 4.4% difference and a relative 28% overall survival benefit in using olaparib.  Now, future follow up is going to be very important. Follow up for this study is actually planned to continue out until June 2029 so we can continue to observe if these survival curves will continue to branch apart as they have so far at each follow up. And I think this is especially important for those patients diagnosed with hormone receptor-positive cancers because we know those patients are at particular risk for later recurrences.  As an additional side note, the researchers also noted that there were fewer primary malignancies in the olaparib group, not just of the breast but also primary ovarian or fallopian tube cancers as well, which is not completely surprising knowing that this drug is also heavily used and beneficial in different types of gynecologic cancers. Ultimately, the amount of adverse events reported have been low with only about 9.9% of patients receiving olaparib needing to discontinue drug due to adverse events, and this is compared to 4.2% reported in the placebo group. Dr. Jasmine Sukumar: You mentioned that the OlympiA trial showed an overall survival benefit, but interestingly the OlympiAD trial looking at olaparib versus chemotherapy in patients with advanced metastatic HER2-negative breast cancer did not show a significant overall survival benefit. Could you discuss those differences? Dr. Dionisia Quiroga: I agree, that's a very good point. So OlympiA's comparator arm was, of course, a placebo. So while this isn't the same as comparing to chemotherapy, it does still potentially suggest that there is a degree of benefit that olaparib can provide when it's introduced in the early local disease setting compared to advanced metastatic disease. I think we need more future trials looking at potential other combinations to see if we can improve the efficacy of PARP inhibitors in the metastatic setting. Dr. Jasmine Sukumar: For patients who do choose to proceed with use of adjuvant olaparib due to the promising efficacy, what side effects should oncologists counsel their patients about? Dr. Dionisia Quiroga: The most common notable side effects, I would say with olaparib and other PARP inhibitors are really cytopenias. Gastrointestinal side effects such as nausea and vomiting can occur as well as fatigue. There are some less common but potentially more serious side effects that we should counsel our patients on. This includes pneumonitis. So counseling patients on if they're short of breath or experiencing cough to let their provider know. Venous thromboembolism can also be increased rates of occurrence. And then of course myelodysplastic syndromes or acute myeloid leukemia is something that we often are concerned about. That being said, I think it should be noted that interestingly in the OlympiA trial so far, there have been less new cases of MDS and AML in the olaparib group than actually what's been reported in the placebo group at this median follow up of over six years out. So we'll need to continue to monitor this endpoint over time, but I do think this provides some reassurance. Dr. Jasmine Sukumar: Since the initiation of the OlympiA trial, other adjuvant treatments have also been studied and FDA approved for non-metastatic HER2-negative breast cancer. So for example, the CREATE-X trial established adjuvant capecitabine as an FDA approved treatment option in patients with triple-negative breast cancer who had residual disease following neoadjuvant chemotherapy. So if a patient with triple-negative breast cancer with residual disease is eligible for both adjuvant olaparib and adjuvant capecitabine treatments, how do you decide amongst the two? Dr. Dionisia Quiroga: If a patient's eligible for both, I honestly often favor olaparib, and I do this because I find the data for adjuvant olaparib a little bit more compelling. There are also differences in toxicity profile and treatment duration between the two that I think we should discuss with patients. For example, olaparib is supposed to be taken for a year total, whereas with capecitabine we typically treat for six to eight cycles with each cycle taking three weeks. There are some who may also sequence the two drugs in very high-risk disease. However, this is very much a data free zone. We don't have any current clinical trials really comparing these two or if sequencing of these agents is appropriate. So I don't currently do this in my own clinical practice. Dr. Jasmine Sukumar: Nowadays, almost all patients with stage 2 to 3 triple-negative breast cancer will be offered neoadjuvant chemotherapy plus immune checkpoint inhibitor therapy pembrolizumab per our KEYNOTE-522 trial data. With our current approach, pembrolizumab is continued into the adjuvant setting regardless of surgical outcome, so that patients receive a year total of immunotherapy. So in patients with residual disease and a BRCA germline mutation, do you suggest using adjuvant olaparib concurrently with pembrolizumab? Do we have any data to support that approach? Dr. Dionisia Quiroga: I do. I do use them concurrently. If a patient is eligible for adjuvant olaparib, I would use it the same way as if they were not on pembrolizumab. That being said, there are no large studies currently that have shown what the benefit or the toxicity of pembrolizumab plus olaparib are for early-stage disease. However, we do have some safety data of this combinatorial approach from other studies. For example, the phase 2/3 KEYLYNK-009 study showed that patients with advanced metastatic triple-negative breast cancer who were receiving concurrent pembrolizumab and olaparib had a manageable safety profile, particularly as the toxicities of these drugs alone don't tend to overlap. Dr. Jasmine Sukumar: And what about endocrine therapy for those that also have hormone receptor-positive disease? Dr. Dionisia Quiroga: Adjuvant endocrine therapy should definitely be continued while patients are on olaparib if they're hormone receptor-positive. An important component of this will also likely be ovarian suppression, which should include recommendation of risk reducing bilateral salpingo oophorectomy due to the risk of ovarian cancer development in patients who carry BRCA1/2 gene mutations. In most cases, this should happen at age 40 or before for those that carry a BRCA1 mutation, and at age 45 or prior for those with BRCA2 mutations. Dr. Jasmine Sukumar: And do you also consider adjuvant bisphosphonates in this context? Dr. Dionisia Quiroga: Yes. Like adjuvant endocrine therapy, adjuvant bisphosphonates were also instructed to be given according to standard guidelines in the OlympiA trial, so I would recommend use of bisphosphonates when indicated. You can refer to the ASCO Ontario Health Guidelines on Adjuvant Bone-Modifying Therapy Breast Cancer to guide that decision in order to utilize this due to multiple clinical benefits. It doesn't just help in terms of adjuvant breast cancer treatment but also reduction of fracture rate and down the line, improved breast cancer mortality.  Dr. Jasmine Sukumar: Particularly in hormone receptor-positive breast cancer, another adjuvant therapy option that was not available when the OlympiA trial started are the CDK4/6 inhibitors, ribociclib and abemaciclib, based on the NATALEE and monarchE studies. So how do you consider the use of these adjuvant therapy drugs in the context of olaparib and BRCA mutations? Dr. Dionisia Quiroga: Yeah, so we are definitely in a data-free zone here. And that's in part because the NATALEE and the monarchE studies are still ongoing and reporting data out at the same time that we're getting updated OlympiA data. So unlike some of our other adjuvant treatments that we discussed, where olaparib could be safely given concurrently, the risk of myelosuppression and using both a CDK4/6 inhibitor and a PARP inhibitor at the same time would be too high. In some cases, even if a patient has a BRCA1/2 mutation, they may not meet that specified inclusion criteria that OlympiA set for what they consider to be high-risk disease. And we know from the NATALEE and the monarchE trial there are also different markers that they use to denote high-risk disease. So it's possible, for example, in the NATALEE trial that looks specifically at adjuvant ribociclib, they included a much larger pool of hormone receptor-positive early-stage breast cancers, including a subset that did not have positive axillary lymph nodes.  In cases where patients would qualify for both olaparib and a CDK4/6 inhibitor, I think this is worth a nuanced discussion with our patients about the potential benefits, risks and administration of these drugs. I think another point to bring up is the cost associated with these drugs and the length of time patients will be on for, because financial toxicity is always something that we should bring up with patients as well. When sequencing these in high-risk disease, my practice is to generally favor olaparib first due to the overall survival data. There is also some data to support that patients with BRCA1/2 germline mutations may not respond quite as well to CDK4/6 inhibitors compared to those without. But again, this is still outside of the purview of current guidelines. Fortunately, we have more potential choices for patients, and that's a good thing, but shared decision making also needs to be key. Dr. Jasmine Sukumar: And while our focus today is on adjuvant treatment for people who carry germline BRCA mutations, what about other related gene mutations such as PALB2 pathogenic variant? Dr. Dionisia Quiroga: That's a great question. Clinical trials in the advanced metastatic setting have shown that there is efficacy of olaparib in the setting for PALB2 mutations. This is largely based on the TBCRC 048 phase 2 trial and that provided a Category 2B NCCN recommendation for patients with these PALB2 gene mutations. However, we're really still lacking enough clinical data for use in early-stage disease, so I don't currently use adjuvant olaparib in this case. I am definitely eager for more data in this area as the efficacy of PARP inhibitors in PALB2 gene mutations is very compelling. I think also, in the same line, there's been some data for somatic BRCA1/2 mutations in the metastatic setting, but we still have a lack of data for the early stage setting here as well. Dr. Jasmine Sukumar: Thank you Dr. Quiroga, for sharing your valuable insights with us today on the ASCO Daily News Podcast. Dr. Dionisia Quiroga: Thank you, Dr. Sukumar. Dr. Jasmine Sukumar: And thank you to our listeners for your time today. You'll find links to the studies discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcasts. Thank you. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:   Dr. Dionisa Quiroga @quirogad @quirogad.bsky.social Dr. Jasmine Sukumar @JasmineSukumar  @jasmine.sukumar.bsky.social Follow ASCO on social media:  @ASCO on X   @ASCO on Bluesky    ASCO on Facebook    ASCO on LinkedIn    Disclosures: Dr. Dionisia Quiroga:  No relationships to disclose Dr. Jasmine Sukumar: Honoraria: Sanofi (Immediate Family Member)  

Delve into the world of adjuvant therapy for lung cancer patients through insightful discussions with Dr. Jonathan Villena-Vargas, an assistant professor of cardiothoracic surgery, and Lisa Goldman, a long-term lung cancer survivor and advocate. Dr. Villena-Vargas provides a comprehensive overview of adjuvant therapy, explaining its role in preventing cancer recurrence after primary treatment. He clarifies the differences between neoadjuvant, adjuvant, and peri-adjuvant therapies, and discusses how treatment decisions are made based on cancer stage and type. The doctor emphasizes the importance of understanding one's specific diagnosis and asking the right questions about biomarkers and treatment options. Lisa Goldman shares her personal journey with stage 4 lung cancer, diagnosed in 2014. Her story highlights the rapid advancements in lung cancer treatment over the past decade, from her initial aggressive chemotherapy to long-term targeted therapy. Lisa's experience underscores the critical role of research in extending and improving the lives of lung cancer patients. This episode offers a balanced mix of expert medical insight and personal experience, making complex medical concepts accessible to a general audience. It serves as an invaluable resource for those navigating the challenges of lung cancer diagnosis and treatment, highlighting the significant progress made in recent years and the reasons for hope in the fight against this disease. Guests Jonathan Villena-Vargas, MD Dr. Villena-Vargas is a clinician at Weill Cornell Medical Center, with particular expertise in the surgical management of lung cancer. He has written numerous clinical publications about screening, staging, and the management of thoracic cancers. Lisa Goldman, Patient-Advocate Diagnosed in 2014 with urgent stage 4 lung cancer, Lisa received immediate chemotherapy. She later co-founded The ROS1ders, a Facebook advocacy group for lung cancer patients. Show Notes | Transcript | Watch video  

Naomi Haas joins Tom and Brian in New York City at the World GU Conference to discuss several RCC topics

In this episode of the GTSC podcast, Dr. Dennis Wigle (Mayo Clinic) and Dr. Linda Martin (UVA) review the recently published ALINA trial of adjuvant alectinib for resected ALK-positive NSCLC. We also review recently presented lung and esophageal cancer data from ASCO 2024, including ESOPEC, CheckMate 816 and 77T, AEGEAN, and the LU002 trial results for oligometastatic lung cancer. This podcast is sponsored by Genentech.

Featuring perspectives from Ms Deanna A Griffie, Ms Caroline Kuhlman, Dr Manish A Shah and Dr John Strickler, including the following topics: Introduction (0:00) The Current Role of Anti-PD-1/PD-L1 Antibodies in the Management of Nonmetastatic Gastroesophageal Cancers (11:30) The Potential Role of Immune Checkpoint Inhibitors (ICIs) as Neoadjuvant Therapy for Patients with Gastric/Gastroesophageal Junction Cancer (20:53) First-Line Therapy for Metastatic Gastroesophageal Cancers (36:16) The Potential Role of Therapy Targeting Claudin 18.2 for Gastroesophageal Cancers (42:16) Targeted Therapies for HER2-Positive Gastroesophageal Cancers (51:42) Selection of Appropriate Candidates with Localized Colorectal Cancer (CRC) for Adjuvant Therapy (1:14:24) The Current Role of ICIs in the Treatment of Metastatic CRC (mCRC) (1:23:32) Tolerability and Other Practical Considerations with ICIs (1:25:57) The Role of TAS-102/Bevacizumab in the Management of Relapsed/Refractory (R/R) mCRC (1:36:14) The Potential Role of KRAS-Targeted Therapy in the Management of mCRC (1:44:36) NCPD information and select publications

Featuring perspectives from Ms Blanca Ledezma, Dr Stacey Stein, Ms Amanda K Wagner and Dr Mark Yarchoan, including the following topics: Introduction (0:00) Adjuvant Therapy for Early-Stage Hepatocellular Carcinoma (HCC) (9:40) Role of Immunotherapy in Intermediate-Stage HCC (17:02) First-Line Therapy for Advanced HCC (19:56) Immunotherapy in the Management of Advanced Biliary Tract Cancers (BTCs) (44:29) Biomarker Testing Recommendations and the Use of FGFR Inhibitors for Advanced Cholangiocarcinoma (58:02) Potential Role of HER2-Targeted Therapy for BTCs (1:17:16) CME information and select publications  

In this week's episode, we discuss the management of stage II colon adenocarcinoma, which is defined by a lack of nodal involvement and invasion through the muscularis layer of the colon. If you have not done so already, be sure to check out episode 099 (overview of colorectal cancer) and episode 100 for stage III colon cancer, as we will building on concepts discussed already. Content: - Is there a role for adjuvant chemotherapy in stage II colon cancer patients? - What is the impact on MSI/MMR testing in stage II colon cancer patients? - Is there a role for evaluating circulating tumor DNA (ctDNA) in colon cancer patients? - Is there a role for immunotherapy in the adjuvant setting?** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

CME credits: 0.75 Valid until: 26-04-2025 Claim your CME credit at https://reachmd.com/programs/cme/case-consult-adjuvant-therapy-following-localized-treatment-for-stage-iii-melanoma/24381/ This educational initiative will enhance dermatologists' and surgeons' knowledge, clinical skills, and confidence in recognizing patients who may benefit from adjuvant systemic therapy and selecting individualized, appropriate agents to improve outcomes for patients with stage IIB-IV resectable melanoma.

Interview with Evan M. Graboyes, MD, MPH, author of Neighborhood-Level Disadvantage and Delayed Adjuvant Therapy in Head and Neck Cancer. Hosted by Paul C. Bryson, MD, MBA. Related Content: Neighborhood-Level Disadvantage and Delayed Adjuvant Therapy in Head and Neck Cancer

Interview with Evan M. Graboyes, MD, MPH, author of Neighborhood-Level Disadvantage and Delayed Adjuvant Therapy in Head and Neck Cancer. Hosted by Paul C. Bryson, MD, MBA. Related Content: Neighborhood-Level Disadvantage and Delayed Adjuvant Therapy in Head and Neck Cancer

This week, we kick off our discussion of adjuvant systemic treatment in colon cancer, beginning with Stage III colon cancer. We will review the evidence basis for adjuvant therapy as well as the two main chemotherapy regimens including duration and side effects. Content: - Why do we need adjuvant therapy in stage III colon cancer? - What is FOLFOX? What is CAPOX? When do we use what?- What is the optimal duration of therapy? - What are the characteristics deemed high risk? - Can we discontinue oxaliplatin early? - What is the role of oxaliplatin in older patients? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

In this episode of SurgOnc Today®, Tina Hieken, MD, from the Mayo Clinic, in Rochester, Minnesota, interviews Jay Lee, MD, MHSc, from Duke University in Durham, North Carolina, and Julia Terhune, MD, from the University of Maryland in Baltimore, Maryland. They will discuss the current and evolving indications for adjuvant therapy in patients with stage III melanoma including vaccine trials.

Dr Teresa Amaral and Prof Mario Mandalà discuss: The typical patient for whom adjuvant therapy may be considered, and provide details on therapy choices. The long-term advantages of adjuvant treatments, and prospects for the use of biomarkers to help elucidate the best candidates for such therapies. The potential disadvantages of adjuvant therapy, and how more studies are needed to understand if these therapies can impact quality of life and fertility. This content was fully funded by Novartis Pharma AG

Hans Hammers discusses trial design and patient selection in the adjuvant setting.

Pedro Barata summarises his ASCO GU discussion on this topic.

Featuring perspectives from Prof Francois-Clement Bidard, Dr Erika Hamilton, Dr Komal Jhaveri, Dr Virginia Kaklamani and Dr Hope S Rugo, including the following topics: Introduction (0:00) Role of Genomic Assays in Treatment Decision-Making for Localized ER-Positive, HER2-Negative Breast Cancer — Dr Goetz (6:03) Integration of Ovarian Function Suppression into the Management of Breast Cancer in  Premenopausal Patients — Dr Burstein (33:34) Role of CDK4/6 Inhibitors and Other Novel Agents in Therapy for  ER-Positive Localized Breast Cancer — Dr Hurvitz (52:35) Optimizing the Use of Neoadjuvant and Adjuvant Therapy for Triple-Negative Breast Cancer — Dr O'Shaughnessy (1:16:18) Emerging Role of Circulating Tumor DNA Evaluation in the Management of Breast Cancer — Dr Pusztai (1:42:03) CME information and select publications

Your patient has endured surgery, radiation therapy, and chemotherapy. After all that, how do you discuss the risk of recurrence and additional treatment?    Credit available for this activity expires: 12/15/2024 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/999193?ecd=bdc_podcast_libsyn_mscpedu

This TOGA Podcast discusses strategies for enhancing patients' recovery from lung cancer resection in light of new and emerging data for new peri-operative therapies that improve survival. The conversation explores the guidelines available, the changing landscape for the patient with neoadjuvant and adjuvant management options, and the multidisciplinary considerations to optimise the care of patients. Dr Jazmin Eckhaus, a thoracic surgeon from The Austin, Melbourne, is joined by A/Prof Emily Stone, Head of Thoracic Medicine in the Dept of Thoracic Medicine and Lung Transplantation at St Vincent's Hospital Sydney, A/Prof Melissa Moore, a medical oncologist from St Vincent's in Melbourne and Chair of the TOGA Education Committee and Professor Catherine Granger, Head of Physiotherapy Research at The Royal Melbourne Hospital and an Associate Professor of Physiotherapy at The University of Melbourne in Australia. Professor Granger is a cardiorespiratory physiotherapist and clinician scientist with expertise in physical activity and exercise for cancer patients' populations.

What does the cutting edge of radiation oncology look like for treating triple-negative breast cancer? Tune in to hear experts Drs Kevin Kalinsky and Reshma Jagsi discuss. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/991257). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources A Review of Triple-negative Breast Cancer https://www.medscape.com/viewarticle/727195_4 A Review of the Abscopal Effect in the Era of Immunotherapy https://pubmed.ncbi.nlm.nih.gov/36321062/ The Impact of Radiation-induced DNA Damage on cGAS-STING-mediated Immune Responses to Cancer https://pubmed.ncbi.nlm.nih.gov/33238631/ Gray (Gy) https://www.nrc.gov/reading-rm/basic-ref/glossary/gray-gy.html Event-free Survival With Pembrolizumab in Early Triple-negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/35139274/ Testing MK-3475 (Pembrolizumab) as Adjuvant Therapy for Triple Receptor-negative Breast Cancer https://clinicaltrials.gov/study/NCT02954874 Pre-op Pembro + Radiation Therapy in Breast Cancer (P-RAD) https://clinicaltrials.gov/study/NCT04443348 Translational Breast Cancer Research Consortium (TBCRC) https://tbcrc.org/ Emerging Role of PARP Inhibitors in Metastatic Triple Negative Breast Cancer. Current Scenario and Future Perspectives https://pubmed.ncbi.nlm.nih.gov/34900718/ SWOG Cancer Research Network https://www.swog.org/ BRCA1 and BRCA2 Mutations https://www.ncbi.nlm.nih.gov/books/NBK470239/ Concurrent Veliparib With Chest Wall and Nodal Radiotherapy in Patients With Inflammatory or Locoregionally Recurrent Breast Cancer: The TBCRC 024 Phase I Multicenter Study https://pubmed.ncbi.nlm.nih.gov/29558281/ Radiation Therapy With or Without Olaparib in Treating Patients With Inflammatory Breast Cancer https://clinicaltrials.gov/study/NCT03598257 Breast Cancer and HER2 https://emedicine.medscape.com/article/1689966-overview ER/PgR Testing in Breast Cancer Clinical Practice Guidelines (ASCO/CAP, 2020) https://reference.medscape.com/viewarticle/924542 Oncotype DX Breast Recurrence Score®: A Review of Its Use in Early-stage Breast Cancer https://pubmed.ncbi.nlm.nih.gov/32613290/ Regional Radiotherapy in Biomarker Low-risk Node Positive and T3N0 Breast Cancer (TAILOR RT) https://classic.clinicaltrials.gov/ct2/show/NCT03488693 Postoperative Radiotherapy in High-risk Premenopausal Women With Breast Cancer Who Receive Adjuvant Chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial https://pubmed.ncbi.nlm.nih.gov/9395428/ Postoperative Radiotherapy in High-risk Postmenopausal Breast-cancer Patients Given Adjuvant Tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c Randomised Trial https://pubmed.ncbi.nlm.nih.gov/10335782/ Risk of Ischemic Heart Disease in Women After Radiotherapy for Breast Cancer https://pubmed.ncbi.nlm.nih.gov/23484825/ Radiotherapy Use and Incidence of Locoregional Recurrence in Patients With Favorable-risk, Node-positive Breast Cancer Enrolled in the SWOG S1007 Trial https://pubmed.ncbi.nlm.nih.gov/37410451/

Five years, 7 years, or 10 years: How long should follow-up last in melanoma? Dr Sapna Patel and Professor James Larkin discuss the challenges and opportunities. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989039). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Malignant Melanoma https://emedicine.medscape.com/article/280245-overview NCCN Guidelines. Melanoma: Cutaneous https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1492 Malignant Melanoma Staging https://emedicine.medscape.com/article/2007147-overview A Practical Guide to Understanding Kaplan-Meier Curves https://pubmed.ncbi.nlm.nih.gov/20723767/ SWOG Cancer Research Network https://www.swog.org/ Adjuvant Pembrolizumab Versus IFNα2b or Ipilimumab in Resected High-Risk Melanoma https://pubmed.ncbi.nlm.nih.gov/34764195/ Long-Term Outcomes With Nivolumab Plus Ipilimumab or Nivolumab Alone Versus Ipilimumab in Patients With Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/34818112/ Estimands — A Basic Element for Clinical Trials https://pubmed.ncbi.nlm.nih.gov/34857075/ Neoadjuvant-Adjuvant or Adjuvant-Only Pembrolizumab in Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/36856617/ Definitions of Additional Oncology Drug Endpoints https://www.ncbi.nlm.nih.gov/books/NBK137753/ Adjuvant Nivolumab Versus Ipilimumab in Resected Stage IIIB-C and Stage IV melanoma (CheckMate 238): 4-Year Results From a Multicentre, Double-Blind, Randomised, Controlled, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/32961119/ Adjuvant Ipilimumab Versus Placebo After Complete Resection of High-Risk Stage III Melanoma (EORTC 18071): A Randomised, Double-Blind, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/25840693/ Adjuvant Pembrolizumab Versus Placebo in Resected Stage III Melanoma (EORTC 1325-MG/KEYNOTE-054): Distant Metastasis-Free Survival Results From a Double-Blind, Randomised, Controlled, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/33857412/ Pembrolizumab Versus Placebo as Adjuvant Therapy in Completely Resected Stage IIB or IIC Melanoma (KEYNOTE-716): A Randomised, Double-Blind, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/35367007/ The Validity of Progression-Free Survival 2 as a Surrogate Trial End Point for Overall Survival https://pubmed.ncbi.nlm.nih.gov/34985773/ Neoadjuvant Talimogene Laherparepvec Plus Surgery Versus Surgery Alone for Resectable Stage IIIB-IVM1a Melanoma: A Randomized, Open-Label, Phase 2 Trial https://pubmed.ncbi.nlm.nih.gov/34608333/

Drs Sapna Patel and David Polsky explore biomarker development and the clinical utilization of liquid biopsy in melanoma. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989037). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Genomic Profiling of Circulating Tumor DNA From Cerebrospinal Fluid to Guide Clinical Decision Making for Patients With Primary and Metastatic Brain Tumors https://pubmed.ncbi.nlm.nih.gov/33192972/ Digital Droplet PCR in Hematologic Malignancies: A New Useful Molecular Tool https://pubmed.ncbi.nlm.nih.gov/35741115/ Circulating Tumour DNA in Patients With Advanced Melanoma Treated With Dabrafenib or Dabrafenib Plus Trametinib: A Clinical Validation Study https://pubmed.ncbi.nlm.nih.gov/33587894/ Association of Circulating Tumor DNA Kinetics With Disease Recurrence in Patients With Stage IIIB/C/IV Melanoma Treated With Adjuvant Immunotherapy in CheckMate 238 https://meetings.asco.org/abstracts-presentations/220160 Clinical and Molecular Response to Tebentafusp in Previously Treated Patients With Metastatic Uveal Melanoma: A Phase 2 Trial https://pubmed.ncbi.nlm.nih.gov/36229663/ TERT Expression Induces Resistance to BRAF and MEK Inhibitors in BRAF-mutated Melanoma In Vitro https://pubmed.ncbi.nlm.nih.gov/37296851/ Adjuvant Nivolumab Versus Ipilimumab in Resected Stage III/IV Melanoma: 5-year Efficacy and Biomarker Results From CheckMate 238 https://pubmed.ncbi.nlm.nih.gov/37058595/ Adjuvant Therapy of Nivolumab Combined With Ipilimumab Versus Nivolumab Alone in Patients With Resected Stage IIIB-D or Stage IV Melanoma (CheckMate 915) https://pubmed.ncbi.nlm.nih.gov/36162037/ Adjuvant Atezolizumab Versus Observation in Muscle-invasive Urothelial Carcinoma (IMvigor010): A Multicentre, Open-label, Randomised, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/33721560/ ctDNA Guiding Adjuvant Immunotherapy in Urothelial Carcinoma https://pubmed.ncbi.nlm.nih.gov/34135506/ Distant Metastasis-free Survival Results From the Randomized, Phase 2 mRNA-4157-P201/KEYNOTE-942 Trial https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.17_suppl.LBA9503 Melanoma Recurrence Patterns and Management After Adjuvant Targeted Therapy: A Multicentre Analysis https://pubmed.ncbi.nlm.nih.gov/33087895/ From Validity to Clinical Utility: The Influence of Circulating Tumor DNA on Melanoma Patient Management in a Real-world Setting https://pubmed.ncbi.nlm.nih.gov/30113761/ Five-year Analysis of Adjuvant Dabrafenib Plus Trametinib in Stage III Melanoma https://pubmed.ncbi.nlm.nih.gov/32877599/

Join experts Drs Kevin Kalinsky and Heather McArthur as they discuss the latest studies guiding their decisions when treating patients with TNBC in clinic. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/991253). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Pembrolizumab Plus Chemotherapy in Advanced Triple-negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/35857659/ Pembrolizumab for Early Triple-negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/32101663/ Event-free Survival With Pembrolizumab in Early Triple-negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/35139274/ Pembrolizumab vs. Observation in People With Triple-negative Breast Cancer Who Had a Pathologic Complete Response After Chemotherapy Plus Pembrolizumab https://classic.clinicaltrials.gov/ct2/show/NCT05812807 Datopotamab Deruxtecan, a Novel TROP2-directed Antibody-drug Conjugate, Demonstrates Potent Antitumor Activity by Efficient Drug Delivery to Tumor Cells https://pubmed.ncbi.nlm.nih.gov/34413126/ Sacituzumab Govitecan in Metastatic Triple-negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/33882206/ A Study of Dato-DXd With or Without Durvalumab Versus Investigator's Choice of Therapy in Patients With Stage I-III Triple-negative Breast Cancer Without Pathological Complete Response Following Neoadjuvant Therapy (TROPION-Breast03) https://www.cancer.gov/about-cancer/treatment/clinical-trials/search/v?id=NCI-2023-00614&r=1 Adjuvant Capecitabine for Breast Cancer After Preoperative Chemotherapy https://pubmed.ncbi.nlm.nih.gov/28564564/ A Phase Ib Trial of Pembrolizumab Plus Paclitaxel or Flat-dose Capecitabine in 1st/2nd Line Metastatic Triple-negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/37344474/ Adjuvant Olaparib for Patients With BRCA1- or BRCA2-mutated Breast Cancer https://pubmed.ncbi.nlm.nih.gov/34081848/ Testing MK-3475 (Pembrolizumab) as Adjuvant Therapy for Triple Receptor-negative Breast Cancer https://classic.clinicaltrials.gov/ct2/show/NCT02954874 A Study Comparing Atezolizumab (Anti PD-L1 Antibody) in Combination With Adjuvant Anthracycline/Taxane-based Chemotherapy Versus Chemotherapy Alone in Patients With Operable Triple-negative Breast Cancer (IMpassion030) https://classic.clinicaltrials.gov/ct2/show/NCT03498716 Neoadjuvant Atezolizumab in Combination With Sequential Nab-paclitaxel and Anthracycline-based Chemotherapy Versus Placebo and Chemotherapy in Patients With Early-stage Triple-negative Breast Cancer (IMpassion031): A Randomised, Double-blind, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/32966830/ LBA1 - Final Analysis of the Placebo-controlled Randomised Phase 3 IMpassion031 Trial Evaluating Neoadjuvant Atezolizumab (Atezo) Plus Chemotherapy (CT) Followed by Open-label Adjuvant Atezo in Patients (pts) With Early-stage Triple-negative Breast Cancer (eTNBC) https://oncologypro.esmo.org/meeting-resources/esmo-breast-cancer-congress/final-analysis-of-the-placebo-controlled-randomised-phase-3-impassion031-trial-evaluating-neoadjuvant-atezolizumab-atezo-plus-chemotherapy-ct-f The I-SPY Trials https://www.ispytrials.org/ BEGONIA: Phase 1b/2 Study of Durvalumab (D) Combinations in Locally Advanced/Metastatic Triple-negative Breast Cancer (TNBC)—Initial Results From Arm 1, D+Paclitaxel (P), and Arm 6, D+Trastuzumab Deruxtecan (T-DXd). https://ascopubs.org/doi/10.1200/JCO.2021.39.15_suppl.1023

Drs Sapna P. Patel and Kim A. Margolin sift through the data from studies presented at recent conferences, including the KEYNOTE-942 and RP1 IGNYTE studies. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989036). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources An Efficacy Study of Adjuvant Treatment With the Personalized Cancer Vaccine mRNA-4157 and Pembrolizumab in Participants With High-Risk Melanoma (KEYNOTE-942) https://classic.clinicaltrials.gov/ct2/show/NCT03897881?term=Keynote-942&draw=2&rank=1 A Personalized Cancer Vaccine, mRNA-4157, Combined With Pembrolizumab Versus Pembrolizumab in Patients With Resected High-Risk Melanoma: Efficacy and Safety Results From the Randomized, Open-Label Phase 2 mRNA-4157-P201/Keynote-942 Trial https://www.abstractsonline.com/pp8/#!/10828/presentation/10243 Distant Metastasis-Free Survival Results From the Randomized, Phase 2 mRNA-4157-P201/KEYNOTE-942 Trial https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.17_suppl.LBA9503 Neoadjuvant-Adjuvant or Adjuvant-Only Pembrolizumab in Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/36856617/ Pembrolizumab Versus Placebo as Adjuvant Therapy in Stage IIB or IIC Melanoma: Final Analysis of Distant Metastasis-Free Survival in the Phase 3 KEYNOTE-716 Study https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.17_suppl.LBA9505 Study of RP1 Monotherapy and RP1 in Combination With Nivolumab (IGNYTE) https://www.clinicaltrials.gov/study/NCT03767348?term=Study%20of%20RP1%20Monotherapy%20and%20RP1%20in%20Combination%20With%20Nivolumab%20(IGNYTE)&rank=1 Talimogene Laherparepvec (T-VEC): An Intralesional Cancer Immunotherapy for Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/33803762/ Randomized, Double-blind, Placebo-Controlled, Global Phase III Trial of Talimogene Laherparepvec Combined With Pembrolizumab for Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/35998300/ Phase I Study of Fianlimab, a Human Lymphocyte Activation Gene-3 (LAG-3) Monoclonal Antibody, in Combination With Cemiplimab in Advanced Melanoma https://oncologypro.esmo.org/meeting-resources/esmo-congress/phase-i-study-of-fianlimab-a-human-lymphocyte-activation-gene-3-lag-3-monoclonal-antibody-in-combination-with-cemiplimab-in-advanced-melanoma Significant Durable Response With Fianlimab (Anti-LAG-3) and Cemiplimab (Anti-PD-1) in Advanced Melanoma: Post Adjuvant PD-1 Analysis https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.16_suppl.9501?af=R Relatlimab and Nivolumab Versus Nivolumab in Untreated Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/34986285/ BRAF and MEK Inhibition in Melanoma https://pubmed.ncbi.nlm.nih.gov/25648338/ Anti-PD-1 and Anti-CTLA-4 Therapies in Cancer: Mechanisms of Action, Efficacy, and Limitations https://pubmed.ncbi.nlm.nih.gov/29644214/ Society for Immunotherapy of Cancer (SITC) Consensus Definitions for Resistance to Combinations of Immune Checkpoint Inhibitors https://pubmed.ncbi.nlm.nih.gov/36918224/ RECIST 1.1 – Update and Clarification: From the RECIST Committee https://pubmed.ncbi.nlm.nih.gov/27189322/ Histopathological Features of Complete Pathological Response Predict Recurrence-Free Survival Following Neoadjuvant Targeted Therapy for Metastatic Melanoma https://pubmed.ncbi.nlm.nih.gov/32739408/

CME credits: 1.00 Valid until: 17-07-2024 Claim your CME credit at https://reachmd.com/programs/cme/what-is-the-future-of-adjuvant-therapy-for-resectable-melanoma/15784/ This program is designed to improve clinicians' knowledge of the latest clinical trial data surrounding the use of immunotherapy for the adjuvant treatment of patients with melanoma. The program addresses clinical challenges faced by oncologists/surgeons, including selecting appropriate patients, determining optimal treatment schedules and dosing, and managing toxicity.

CME credits: 1.00 Valid until: 17-07-2024 Claim your CME credit at https://reachmd.com/programs/cme/how-do-patient-characteristics-impact-adjuvant-therapy-in-all-stages-of-resectable-melanoma/15783/ This program is designed to improve clinicians' knowledge of the latest clinical trial data surrounding the use of immunotherapy for the adjuvant treatment of patients with melanoma. The program addresses clinical challenges faced by oncologists/surgeons, including selecting appropriate patients, determining optimal treatment schedules and dosing, and managing toxicity.

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. To reflect on the insight-laden occasion, Stephen Harrison and Jörn Schattenberg join Roger Green to explore emerging drug development stories in detail.This conversation starts with a discussion about the importance of treating early stage cirrhosis patients. Jörn suggests that with new agents in place we may soon be looking to treat other patient populations such as, for example, those with HCC. In such instances NASH drugs will become adjuvant therapy to improve treatment against the primary disease target. Stephen agrees, noting that we will need a better test to diagnose HCC and, once available, there will be fewer presentations of advanced HCC because we will have treated more of them earlier with better agents and adjuvant therapies. Again, all this will await the approval of NASH and ideally cirrhosis drugs in the future. Roger asks how to identify the 20 to 30% of HCC patients who develop cancer before NASH. Stephen suggests it depends largely on NIT development. From there the panelists each share final thoughts around what the session has yet to cover that is important. Stephen comes up with a new idiom and Jörn speculates a new concept. Listen to the session to find out what they are.If you have questions or comments around the EASL Congress or ADA meetings, the discussed therapeutics, new nomenclature, or any other topic addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Roy Herbst, MD PhD, Deputy Director of the Yale Cancer Center at Yale School of Medicine, talks with OncTimesTalk correspondent Peter Goodwin about his group's findings from the international Phase III ADAURA clinical trial looking at adjuvant therapy with the anti EGFR-mutant drug osimertinib in patients with completely resected stage one B to three A non-small cell lung cancer. In a late-breaking abstract reported at the 2023 American Society of Clinical Oncology Meeting Plenary Session, Herbst showed that osimertinib not only improved disease-free survival, but also brought a clear and big benefit in overall survival.

Roy Herbst, MD PhD, Deputy Director of the Yale Cancer Center at Yale School of Medicine, talks with OncTimesTalk correspondent Peter Goodwin about his group’s findings from the international Phase III ADAURA clinical trial looking at adjuvant therapy with the anti EGFR-mutant drug osimertinib in patients with completely resected stage one B to three A non-small cell lung cancer. In a late-breaking abstract reported at the 2023 American Society of Clinical Oncology Meeting Plenary Session, Herbst showed that osimertinib not only improved disease-free survival, but also brought a clear and big benefit in overall survival.

Drs Sapna Patel and Yana Najjar analyze the data and share their approach to frontline therapy. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989035). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Combination Dabrafenib and Trametinib Versus Combination Nivolumab and Ipilimumab for Patients With Advanced BRAF-Mutant Melanoma: The DREAMseq Trial-ECOG-ACRIN EA6134 https://pubmed.ncbi.nlm.nih.gov/36166727/ Sequencing of Ipilimumab Plus Nivolumab and Encorafenib Plus Binimetinib for Untreated BRAF-Mutated Metastatic Melanoma (SECOMBIT): A Randomized, Three-Arm, Open-Label Phase II Trial https://pubmed.ncbi.nlm.nih.gov/36049147/ Long-Term Outcomes of Patients With Active Melanoma Brain Metastases Treated With Combination Nivolumab Plus Ipilimumab (CheckMate 204): Final Results of an Open-Label, Multicentre, Phase 2 Study https://pubmed.ncbi.nlm.nih.gov/34774225/ Health-related Quality of Life With Nivolumab Plus Relatlimab Versus Nivolumab Monotherapy in Patients With Previously Untreated Unresectable or Metastatic Melanoma: RELATIVITY-047 Trial https://pubmed.ncbi.nlm.nih.gov/37167764/ Overall Survival With Combined Nivolumab and Ipilimumab in Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/28889792/ Evaluation of Two Dosing Regimens for Nivolumab in Combination With Ipilimumab in Patients With Advanced Melanoma: Results From the Phase IIIb/IV CheckMate 511 Trial https://pubmed.ncbi.nlm.nih.gov/30811280/ Adjuvant Therapy of Nivolumab Combined With Ipilimumab Versus Nivolumab Alone in Patients With Resected Stage IIIB-D or Stage IV Melanoma (CheckMate 915) https://pubmed.ncbi.nlm.nih.gov/36162037/ Single-Agent PD-1 Blockade Is "Treatment of Choice" for Desmoplastic Melanoma https://pubmed.ncbi.nlm.nih.gov/37071762/ Single-agent Pembrolizumab May Benefit Patients With Rare Type of Skin Cancer https://www.aacr.org/about-the-aacr/newsroom/news-releases/single-agent-pembrolizumab-may-benefit-patients-with-rare-type-of-skin-cancer/ Atezolizumab, Vemurafenib, and Cobimetinib as First-Line Treatment for Unresectable Advanced BRAFV600 Mutation-Positive Melanoma (Imspire150): Primary Analysis of the Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/32534646/ Overall Survival Benefit With Tebentafusp in Metastatic Uveal Melanoma https://pubmed.ncbi.nlm.nih.gov/34551229/ Efficacy and Safety of Nivolumab Alone or in Combination With Ipilimumab in Patients With Mucosal Melanoma: A Pooled Analysis https://pubmed.ncbi.nlm.nih.gov/28056206/ Single-Agent Anti-PD-1 or Combined With Ipilimumab in Patients With Mucosal Melanoma: An International, Retrospective, Cohort Study https://pubmed.ncbi.nlm.nih.gov/35716907/ CheckMate 067: Long-Term Outcomes in Patients With Mucosal Melanoma. https://ascopubs.org/doi/abs/10.1200/JCO.2020.38.15_suppl.10019 A Randomized Phase 2 Trial of Encorafenib + Binimetinib + Nivolumab Vs Ipilimumab + Nivolumab In BRAFV600-Mutant Melanoma Brain Metastases https://www.swog.org/clinical-trials/s2000

CME credits: 0.25 Valid until: 09-06-2024 Claim your CME credit at https://reachmd.com/programs/cme/preventing-disease-recurrence-adjuvant-therapy-stage-iibiic-melanoma/15392/ The 5-year recurrence rates for stage IIB and IIC melanoma are up to 46%, but now new immunotherapy options are FDA-approved for the adjuvant treatment of stage IIB and IIC melanoma. Find out why this matters and hear Drs. Jason Luke and Tara Mitchell break down the latest data on treating stage IIB and IIC melanoma with adjuvant immunotherapy.=

Host: Jason J. Luke, MD, FACP Guest: Tara Mitchell, MD The 5-year recurrence rates for stage IIB and IIC melanoma are up to 46%, but now new immunotherapy options are FDA-approved for the adjuvant treatment of stage IIB and IIC melanoma. Find out why this matters and hear Drs. Jason Luke and Tara Mitchell break down the latest data on treating stage IIB and IIC melanoma with adjuvant immunotherapy.

In this episode, Banu Arun, MD; Allison Butts, PharmD, BCOP; and Marissa Marti-Smith, MSN, APRN, AGNP-C, AOCNP, discuss the role of BRCA testing and adjuvant olaparib in early breast cancer, including their experiences and challenges with implementing recent data. This overview will include discussion of:  Data supporting the use of adjuvant PARP inhibition in early breast cancer and impact on BRCA testing and clinical practice The multidisciplinary role in ensuring that BRCA testing is completed for eligible patients Barriers to implementing BRCA testing and adjuvant olaparib in clinical practice and methods to overcome them Administration of adjuvant olaparib with other available adjuvant systemic therapiesTolerability of single-agent PARP inhibitors  Presenters:Banu Arun, MDProfessor, Breast Medical Oncology Director, Clinical Cancer Genetics University of Texas MD Anderson Cancer Center Houston, Texas  Allison Butts, PharmD, BCOPPharmacist Manager, Oncology Director, PGY2 Oncology Residency Program UK HealthCare Assistant Adjunct ProfessorUK College of Pharmacy Lexington, Kentucky Marissa Marti-Smith, MSN, APRN, AGNP-C, AOCNPNurse Practitioner Breast OncologyTexas Oncology Baylor Sammons Cancer Center Dallas, Texas  Content supported by educational grants from AstraZeneca and Merck Sharp & Dohme Corp. Link to full program:https://bit.ly/42VeUMM

Featuring perspectives from Dr D Ross Camidge, Dr Justin Gainor, Prof Benjamin Solomon and Prof Solange Peters, including the following topics: •      Evolving Understanding and Management of Non-Small Cell Lung Cancer (NSCLC) with Targeted Mutations (0:00) •      Adjuvant Therapy for Patients with NSCLC with Targetable Mutations (11:17) •      Family Planning for Patients with Cancer (23:50) •      Optimal Identification of ALK-Positive Metastatic NSCLC — Dr Camidge (30:33) •      Selection of First-Line Treatment for ALK-Positive NSCLC — Dr Gainor (49:22) •      Sequencing and Selection of Therapy for Relapsed/Refractory ALK-Positive NSCLC — Prof Peters (1:23:33) •      Managing Side Effects of ALK Tyrosine Kinase Inhibitors (TKIs) — Prof Solomon (1:39:14) •      Case: A woman in her early 40s with Stage IIIB ALK-positive NSCLC who received alectinib for more than 4 years — Dr Gainor (1:59:37) •      Case: A woman in her mid 50s who remains in complete response with lorlatinib after 4 years — Prof Solomon (2:03:52) •      Case: A woman in her early 60s with Stage IV NSCLC with ALK translocation who received lorlatinib followed by alectinib — Prof Peters (2:10:18) •      Case: A woman in her late 60s with ALK-positive NSCLC who continues to receive brigatinib after discontinuation of alectinib due to concerns of drug-induced pneumonitis — Dr Camidge (2:15:44) •      Case: A woman in her late 40s with NSCLC with an ALK fusion who received multiple ALK TKIs — Dr Gainor (2:21:11) •      Case: A man in his early 30s with ALK-positive NSCLC and brain metastases who continues to receive lorlatinib after 6 years — Prof Solomon (2:26:33) CME information and select publications

Dr. Rick Greene and Dr. Fadi Dahdaleh discuss the effect of operative approach on overall readiness to commence adjuvant therapy in patients with pancreatic ductal adenocarcinoma undergoing pancreaticoduodenectomy, hypothesizing that minimally invasive pancreaticoduodenectomy improves rates and time to return to intended oncologic therapy compared with open pancreaticoduodenectomy. Dr. Dahdaleh is author of “Surgical Approach does not Affect Return to Intended Oncologic Therapy Following Pancreaticoduodenectomy for Pancreatic Adenocarcinoma: A Propensity-Matched Study.” Dr. Dahdaleh is an attending surgical oncologist at Northshore-Edward-Elmhurst Health in Chicago and adjunct clinical assistant professor of surgery at Rush Medical College, Chicago, IL.

Proceedings from a daylong symposium hosted in partnership with Florida Cancer Specialists, featuring key clinical presentations and papers in melanoma. Featuring perspectives from Prof Georgina Long, including the following topics: Neoadjuvant and Adjuvant Therapy for Melanoma (0:00) Update on the Management of Metastatic Melanoma (19:23) CME information and select publications

Ibrahim Halil Sahin, MD, a medical oncologist specializing in gastrointestinal oncology and an assistant professor at the University of Pittsburgh Medical Center, Hillman Cancer Center, spoke with CancerNetwork® about his manuscript titled Minimal Residual Disease–Directed Adjuvant Therapy for Patients With Early-Stage Colon Cancer: CIRCULATE-US, which was recently published in the journal ONCOLOGY®. In the article, Sahin and his colleagues explored postoperative circulating tumor DNA dynamics in early-stage colon cancer and investigated escalation and de-escalation approaches using ctDNA status as a surrogate for minimal residual disease status. Don't forget to subscribe to the “Oncology Peer Review On-The-Go” podcast on Apple Podcasts, Spotify, or anywhere podcasts are available. 

CME credits: 2.25 Valid until: 12-10-2023 Claim your CME credit at https://reachmd.com/programs/cme/what-are-the-data-supporting-adjuvant-therapy-in-melanoma/14377/ tbd

CME credits: 2.25 Valid until: 12-10-2023 Claim your CME credit at https://reachmd.com/programs/cme/what-is-the-rationale-for-neoadjuvant-and-adjuvant-therapy-in-melanoma/14375/ tbd

In this episode of BackTable Urology, Dr. Aditya Bagrodia speaks with urologist Dr. Karim Bensalah from the Universitaire de Rennes and medical oncologist Dr. Rana McKay from UC San Diego about adjuvant therapy for advanced kidney cancer. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- SHOW NOTES First, the doctors discuss when to bring up adjuvant therapy. All three doctors agree that having the discussion early with patients is helpful to the patient and other specialties involved if the cancer is expected to be aggressive after reviewing initial imaging. Dr. Bensalah usually waits until the final pathology results arrive in order to determine the specifics of the adjuvant therapy treatment and refer his kidney cancer patients to medical oncology. He does not use nomograms if the patient does not ask for specific rates of recurrence. However, Dr. McKay uses nomograms often. Next, the doctors discuss different oncological factors that may convince them to start their patients on adjuvant therapy, such as a large tumor size, advanced tumor stage/grade, an IVC thrombus, extrarenal metastases, and nodal involvement. Additionally, patients with multiple comorbidities and elderly patients may benefit from adjuvant therapy. Both Dr. Bagrodia and Dr. McKay agree that genomic sequencing of tumors is not helpful in making the decision to start adjuvant therapy, as there needs to be more research around this topic. Dr. Bensalah then explains the difference between approval and billing of tyrosine kinase inhibitors (TKI) in Europe. Finally, the doctors discuss different clinical trials centered around the TKI Pembrolizumab (Keytruda). Dr. McKay notes that there have been very few positive trials and that she is reluctant to put her patients under a year of toxicity if there is a chance of overtreatment. Although many people have few mild side effects, severe side effects, such as diabetes, colitis, and fingernail necrosis, can be observed. Finally, the doctors discuss the importance of generating more research on the response of non clear cell renal carcinomas to adjuvant therapy. Currently, all these cancers are classified as one category but have different histology and response to therapies. --- RESOURCES Register for the 2022 International Kidney Cancer Society Symposium: https://www.kcameetings.org/2022-ikcs-north-america/

Hot Topics and Controversies in Adjuvant Therapy for Early-Stage, EGFR-Mutant NSCLC

Hot Topics and Controversies in Adjuvant Therapy for Early-Stage, EGFR-Mutant NSCLC

Hot Topics and Controversies in Adjuvant Therapy for Early-Stage, EGFR-Mutant NSCLC

Hot Topics and Controversies in Adjuvant Therapy for Early-Stage, EGFR-Mutant NSCLC

Adjuvant Therapy for Patients With Resected Melanoma: Finessing Care to Improve Survival in High-Risk Patients

Featuring perspectives from Dr Elizabeth Plimack and Prof Thomas Powles, including the following topics: Advances in Renal Cell Carcinoma — Thomas Powles, MBBS, MRCP, MD  Introduction (0:00) Adjuvant Therapy in Renal Cell Carcinoma (RCC) (8:05) First-Line Treatment of Metastatic RCC (15:16) Belzutifan for von Hippel-Lindau-Associated RCC (29:38) Non-Clear Cell RCC (34:57) Urothelial Bladder Carcinoma — Elizabeth R Plimack, MD, MS Non-Muscle-Invasive Bladder Cancer (NMIBC) (37:47) Adjuvant and Neoadjuvant Treatments for NMIBC (44:38) Sequencing Therapies for Metastatic Urothelial Bladder Cancer (57:54) CME information and select publications

Adjuvant therapy: Its Effectiveness In IVF Explained Is adjuvant therapy ethical in IVF? Does it really produce results? Does the evidence support using adjuvant therapies? In this episode, Prof discusses recent controversies around adjuvant therapies and whether or not they are effective. Did you find this episode useful? Can you think of someone else who would benefit from listening to this episode? Please do share it with them.