Podcasts about BRCA2

Love the episode? Send us a text!In this episode of Breast Cancer Conversations, I, Laura Carfing, founder of survivingbreastcancer.org, delve into the critical topic of fertility preservation and genetic counseling for breast cancer patients. Joined by Alejandra Bernal, a genetic counseling student at the University of Pittsburgh, and Melissa Bourdius , a hereditary cancer counselor, we explore the intersection of cancer treatment, fertility, and genetics.Alejandra shares insights from her research on how patients are informed about the risk of infertility due to cancer treatments and the role genetic counselors can play in this process. She highlights the importance of asking the right questions and involving a multidisciplinary team to ensure patients receive comprehensive information about their options.Melissa discusses the genetic aspects of cancer, explaining how mutations in genes like BRCA1 and BRCA2 can increase cancer risk and affect family planning decisions. She emphasizes the importance of genetic counseling in helping patients understand their risks and make informed decisions about their treatment and future family planning.It's all here for you in today's episode! Resources:https://www.facingourrisk.org/support/insurance-paying-for-care/screening-and-prevention/fertility-preservation/overviewhttps://www.allianceforfertilitypreservation.org/fertility-risks-from-treatment/https://www.thechickmission.org/  Information about grants and advocacyhttps://worththewaitcharity.com/resources/patient-education/   Has practical patient resourcesSURVIVINGBREASTCANCER.ORGAttend a free virtual SurvivingBreastCancer.org event:https://www.survivingbreastcancer.org/eventsFollow us on InstagramSurvivingBreastCancer.org: https://www.survivingbreastcancer.org/Breast Cancer Conversations: https://www.instagram.com/breastcancerconversations/About SurvivingBreastCancer.org: SurvivingBreastCancer.org, Inc. (SBC) is a federally recognized 501(c)(3) non-profit virtual platform headquartered in Boston with a national and global reach. Through education, community, and resources, SurvivingBreastCancer.org supports women and men going through breast cancer. We provide a sanctuary of strength, compassion, and empowerment, where those diagnosed with cancer unite to share their stories, learn invaluable coping strategies to manage wellness and mental health, and find solace in the unbreakable bond that fuels hope, resilience, and the courage to conquer adversity.Support the show

Dr. Rohan Garje shares the updated recommendations for the ASCO guideline on systemic therapy for patients with metastatic castration-resistant prostate cancer. He discusses the systemic therapy options for patients based on prior therapy received in the castration-sensitive and non-metastatic castration-resistant settings. He emphasizes personalizing treatment choices for each individual, considering patient-specific symptoms and signs, treatment-related toxicities, potential drug interactions, cost, and access. He also reviews recommendations on response assessment. The conversation wraps up with a discussion of potential future updates to this guideline, as the guideline transitions into a “living guideline” on mCRPC. Read the full guideline update, “Systemic Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer: ASCO Guideline Update”. Transcript This guideline, clinical tools, and resources are available at www.asco.org/genitourinary-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology.      Brittany Harvey: Hello and welcome to the ASCO Guidelines Podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Rohan Garje from Miami Cancer Institute Baptist Health South Florida, lead author on, “Systemic Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer: ASCO Guideline Update.” Thank you for being here today, Dr. Garje. Dr. Rohan Garje: Absolutely. Thank you so much for having me, Brittany. Brittany Harvey: And then before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Garje, who has joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then, to start on the content of this guideline, first, could you provide us an overview of the purpose of this guideline update? Dr. Rohan Garje: Sure. So ASCO has guidelines for prostate cancer and the specific guideline which we have updated for metastatic castrate-resistant prostate cancer was originally published in 2014. It's almost a decade. It's been a long time due for an update. Over the last decade, we have seen a lot of advances in the treatment of prostate cancer, specifically with regards to genomic testing, newer imaging modalities, and also the treatment landscape. Now we have newer options based on genomic targets such as PARP inhibitors, we have radiopharmaceuticals, a newer variant of chemotherapy, and also some specific indications for immunotherapy which were not addressed previously. Because all these advances have been new, it was really important for us to make an update. In 2022, we did make a rapid update with lutetium-177, but these additional changes which we have seen made it an appropriate time frame for us to proceed with a newer guideline. Brittany Harvey: Absolutely. It's great to hear about all these advances in the field to provide new options. So I'd like to next review the key recommendations from this guideline. So let's start with the overarching principles of practice that the panel outlined. What are these key principles? Dr. Rohan Garje: As a group, all the panel members came up with some ground rules: What are necessary for all our patients who are being treated for metastatic CRPC? First, the founding aspect was a definition for what is metastatic CRPC. So we defined metastatic CRPC as castrate level of testosterone with evidence of either new or progressive metastatic disease on radiological assessments or patients who have two consecutive rising PSAs in the setting of existing metastatic disease. We also emphasized on the need for germline and somatic testing for patients with metastatic prostate cancer at an earliest available opportunity because it is critical to select appropriate treatment and also right treatment for patients at the right time. And we actually have a concurrent guideline which addresses what genes to be tested and the timing. The other principles are patients should continue to receive androgen deprivation therapy or undergo surgical castration to maintain castrate level of testosterone. Now the key aspect with these guidelines is personalizing treatment choices. As you can see the evolution of treatment options for prostate cancer, the drugs that were initially developed and approved for prostate cancer were primarily in castrate-resistant settings, but now most of these drugs are being utilized in castrate-sensitive. So, when these patients develop castration resistance, the challenges are there are no appropriate particular drug-specific guidelines they meet. So, it's very important for the clinicians to be aware of what treatments have been received so far prior to castration resistance so that they can tailor the treatment to patient specific situations. In addition, prior to choosing a therapy, it is important for the physicians to consider patient specific symptoms or signs, treatment-related toxicities, potential drug interactions, cost, and also access to the drugs. There may be multiple treatment options available for the patients, but for a patient specific scenario, there may be a drug that may be more promising than the others. So, it is important to tailor the drug choices based on patients' unique circumstances. The panel also recommends to early integrate palliative and supportive care teams for symptom management and also discuss goals of care with the patient as each patient may have unique needs and it's important for physicians to address those concerns upfront in the care. The panel also suggests patients to receive RANK ligand inhibitors such as denosumab or bisphosphonates such as zoledronic acid to maintain the bone strength to prevent skeletal-related events. Finally, I would like to also emphasize this point about the lack of randomized clinical trial data for optimal sequencing of therapies for patients with metastatic CRPC. As I previously alluded, we have taken into account all ongoing clinical trials, prior published data, and came up with a format of preferred drugs based on prior treatments and, I think, by following these several clinical principles which I just mentioned, we can optimally choose and utilize best treatments for patients with metastatic CRPC. Brittany Harvey: Absolutely. These principles that you just outlined are important for optimal patient care, and then I want to touch on one of those things. You talked importantly about the treatments received so far. So in the next set of recommendations, the role of systemic therapy was stratified by the prior therapy received in the castration-sensitive and non-metastatic castration-resistant setting. So starting with what does the panel recommend for patients who are previously treated with androgen deprivation therapy alone in these previous settings and whose disease has now progressed to metastatic castration-resistant prostate cancer? Dr. Rohan Garje: There are multiple treatment options based on prior treatment received. So for patients who received only ADT for their castration-sensitive disease, the panel strongly urges to get HRR testing to check for homologous recombinant repair related changes, specifically for BRCA1 and BRCA2 mutations, because we have three studies which have really shown significant clinical benefit for patients who have BRCA1 and BRCA2 mutations with drugs such as the combination of talazoparib and enzalutamide or olaparib with abiraterone or niraparib with abiraterone. Unless we test for those mutations, we'll not be able to give these agents upfront for the patients. In the HRR testing, if patients have HRR alterations but they are in genes which are non-BRCA, the guideline panel recommends to utilize talazoparib and enzalutamide based combination therapies. Now, if they don't have HRR alterations then there are multiple treatment choices available. It could either include androgen receptor pathway inhibitors such as abiraterone with prednisone. We could also consider docetaxel chemotherapy. The alternate choices for androgen receptor pathways include enzalutamide or the newer agents such as apalutamide and docetaxel. So, as you can see there are multiple options available, but the panel definitely emphasizes to test for HRR testing because this gives patients access to more precision therapies at this point. There may be various scenarios where a unique drug may be available for a specific patient situation. For example, patients who have very limited disease burden and may have one or two metastatic lesions, after a multidisciplinary discussion, targeted local therapies such as radiation or potentially surgery could also be offered. In select patients who have very indolent disease where they are castrate-resistant based on slow rising PSA, low-volume disease or asymptomatic disease can consider sipuleucel-T. And in patients who have bone-only metastatic disease, we could also consider radium-223, which is primarily now utilized for patients who have symptomatic bone disease. Brittany Harvey: Great. I appreciate you reviewing all those options and talking about how important it is to tailor treatment to the individual patient. So then the next category of patients, what is recommended for those who have been previously treated with ADT and an androgen receptor pathway inhibitor and whose disease has now progressed to metastatic castration-resistant prostate cancer? Dr. Rohan Garje: So for patients who received ADT along with an androgen receptor pathway inhibitor, which we consider would be a most common cohort because most patients now in castration-sensitive setting are receiving androgen receptor pathway inhibitor. It was different in the past where five or six years back ADT alone was the most common treatment, but fortunately, with enough awareness and education, treatment choices have improved. Patients are now receiving ADT and ARPI as the most common choice of drug. Once again, at this point the panel emphasizes to consider HRR testing in there is enough data for us to suggest that patients who have alterations in the HRR pathway definitely will benefit with the PARP inhibitor. You know the multiple options, but specifically we speak about olaparib. And then if they are HRR-negative, we prefer patients receive agents such as docetaxel or if they are intolerant to docetaxel, consider cabazitaxel chemotherapy, options such as radium-223, and if they have a specific scenario such as MSI-high or mismatch repair deficiency, pembrolizumab could also be considered. The panel also discussed about the role of a second ARPI agent. For example, if patients progressed on one androgen receptor pathway inhibitor, the second androgen receptor pathway inhibitor may not be effective and the panel suggests to utilize alternate options before considering androgen receptor pathway inhibitor. There may be specific scenarios where a second ARPI may be meaningful, specifically, if alternate choices are not feasible for the concern of side effects or toxicities or lack of access, then a potential ARPI could be considered after progression on ARPI, but the panel definitely encourages to utilize alternate options first. Brittany Harvey: Great. Thank you for outlining those options as well for those patients. So then the next category, what is recommended for patients who have been previously treated with ADT and docetaxel? Dr. Rohan Garje: For patients who received ADT and docetaxel and were never treated with androgen receptor pathway inhibitors, the panel again emphasizes on HRR testing. If they have BRCA1 and 2 mutations, the combination therapies of talazoparib with enzalutamide, olaparib with abiraterone, or niraparib with abiraterone are all good choices. If they don't have BRCA mutations but they have other HRR mutations, the panel suggests to potentially utilize talazoparib with enzalutamide. And if they do not have any HRR alterations, the options could include androgen receptor pathway inhibitors such as abiraterone or enzalutamide. I want to emphasize that these are preferred options, but not the only options. As you can see, there are multiple options available for a particular clinical situation - so the ability of the physicians to access particular combinations, the familiarity of those drugs or the patient's unique situation where they have other medications which can potentially interact with a choice of agents. So I think based on access, based on cost and patients' concurrent illness with potential drug interactions can make one particular combination of therapy better over the other options. Brittany Harvey: Absolutely. That's key to keep in mind that access, contraindications, and cost all play a role here. So then the next set of recommendations. What are the key recommendations for patients who have previously been treated with ADT, an androgen receptor pathway inhibitor, and docetaxel who now have mCRPC? Dr. Rohan Garje: Yes. In this group, the options remain, again, broad. We utilize PSMA imaging here specifically and if they are positive on PSMA imaging, lutetium-177 is a good option. If they do not have PSMA-positive disease on PSMA imaging but if they have HRR alterations, olaparib could be utilized. And if they are negative on PSA imaging, they don't have HRR alterations, then alternate options could include cabazitaxel, radium-223. And if they have MSI-high or deficiency in mismatch repair, pembrolizumab could be utilized in this setting. Brittany Harvey: Thank you for outlining those options as well. So then next the panel addressed treatment options for de novo or treatment emergent small cell neuroendocrine carcinoma of the prostate. What are those key recommendations? Dr. Rohan Garje: Yes. This is a very high unmet need group because there are limited clinical trials, especially prospective clinical trials addressing treatment options for this group. Most of our current guidelines are always an extrapolation from lung small cell cancer based guidelines, but the panel recommends to utilize cisplatin or carboplatin along with etoposide as a preferred choice for this group. Also, an alternate option of carboplatin along with cabazitaxel could be considered for this cohort. The panel also encourages participation in clinical trials. There are numerous trials ongoing now in smaller phase studies and I think it's important for patients to consider these trials as well, because this will give them access to newer agents with potential biological targets. In addition to these agents in specific scenarios or potentially case by case basis, because we don't have prospective data, so we have made it as a select case by case basis to consider adding immunotherapy along with platinum-based chemotherapy followed by maintenance immunotherapy, which is currently a standard of care in small cell lung cancer. But the data is so limited in prostate cancer, so the panel suggested that it has to be a case by case basis only. The alternate options also include lurbinectedin, topotecan, tarlatamab upon progression on platinum-based chemotherapy. Brittany Harvey: Yes. It's important to have these recommendations in these unique situations where there is really a lack of data. So then the final set of recommendations I'd like to cover, what does the panel recommend for how clinicians should assess for response while patients are on systemic therapy and what scans are recommended for this response assessment? Dr. Rohan Garje: Yes. Again, this is another strong emphasis of the panel for global assessment of the patients. Traditionally, patients and physicians per se are heavily reliant on PSA as an accurate marker for response. This is in fact true in earlier phases of prostate cancer either in castrate-sensitive setting or localized prostate cancer setting. But as patients evolve into castrate-resistant, we don't want to heavily rely on PSA alone as a marker of response. The panel suggests to incorporate clinical response, radiological response, and also include PSA as a component, but not just rely primarily on PSA. So the panel also suggests that patients should get a bone scan and a CT scan every three to six months while on treatment to assess for appropriate response or for progression. And now one key important aspect, we are all aware about the evolving role of PSMA-based imaging with several of these new agents that are currently available. We do acknowledge these scans definitely have an important role in the care for patients with metastatic prostate cancer. Currently, the utility is primarily to select patients for lutetium-based therapy and also in situations where the traditional scans such as technitium 99 bone scan or CT scan are equivocal, then a PSMA-based imaging can be helpful. Now we are also aware that there are newer studies coming up, prospective data coming up for the role of PSMA-based imaging for response assessment. We are hoping to update the guidelines if we get access to newer data, but currently we have not recommended the utility of PSMA-based imaging for response assessments. Brittany Harvey: Understood. And I appreciate you describing where there is data here and where there's a lack of data to currently recommend. And we'll look forward to future updates of this guideline. Coming back to – at the start you mentioned how much has changed since the last guideline update. So Dr. Garje, in your view, what is the importance of this update and how will it impact both clinicians and patients with metastatic castration-resistant prostate cancer? Dr. Rohan Garje: The updated guidelines are designed to have a significant impact on clinical practice and also patient outcomes by providing clinicians with a comprehensive evidence-based framework for managing patients with metastatic CRPC. And also, by using these guidelines can make informed decisions, can select therapies tailored to patients' unique genomic status, clinical situation, where they are in the course of the cancer based on what they received previously. Also utilizing these guidelines, we can potentially improve patient outcomes, improve survival, and importantly have efficient use of healthcare resources. Brittany Harvey: Absolutely. We're always looking for ways to improve patient outcomes and survival. I want to wrap us up by talking a little bit about the outstanding questions in this field. So earlier you had mentioned about prospective data to come about PSMA PET scans, but what other outstanding questions are there for patients with metastatic castration-resistant prostate cancer? And what evidence is the panel looking forward to for future updates? Dr. Rohan Garje: We do have now rapidly evolving data specifically about the utility of the radiopharmaceutical lutetium-177 prior to chemotherapy. We are hoping that with newer data we can make some changes to the guideline based on that. We are also looking at newer drugs that are coming up in the pipeline, for example, androgen receptor degraders. We are looking at data that might potentially help based on bispecific T-cell engagers and newer radiopharmaceuticals. So I think in the next few years, we will definitely update all the guidelines again. But this time we are trying to do it more proactively. We are following a newer model. We are calling it as ‘living guidelines' where we are actually utilizing week by week updates where we look at the literature and see if there is any potential practice impacting change or publication that comes up. And we are trying to incorporate those changes as soon as they are available. That way patients and practicing physicians can get the latest information available through the guidelines as well. Brittany Harvey: That's great to hear. Yes, we'll await this data that you mentioned to continuously update this guideline and continue to improve patient outcomes for the future. So Dr. Garje, I want to thank you so much for your time to update this guideline. It was certainly a large amount of recommendations, and thank you for your time today, too. Dr. Rohan Garje: Thank you so much for having me here. And it's always nice talking to you. Brittany Harvey: And finally, thank you to our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/genitourinary-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. 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.

Send us a textGot it From My Momma heads to the heart of New York City for a powerful and deeply personal conversation inside the Fox News headquarters. Host Jennifer Vickery Smith sits down with Kayleigh McEnany—former White House Press Secretary and current co-host of Outnumbered on Fox News—for the first installment in a special series focused on faith and family.In this compelling episode, Kayleigh opens up about her journey through motherhood, the values that ground her, and her time working closely with President Donald Trump. She also shares the emotional and courageous decision to undergo a preventative double mastectomy after testing positive for the BRCA2 gene—a choice rooted in strength, love, and faith.This inspiring conversation offers a glimpse into the moments that have defined her most.PRESENTED BY HEROES BEAUTY - LOOK GOOD. FEEL GOOD. DO GOOD. www.heroesbeauty.com MOMMA20 for 20% off your purchase of clean, conscious cosmetics and beauty care! COAT DEFENSEwww.coatdefense.comMOMMA15 for 15% off BAREFACED SKINCAREwww.barefaced.comMOMMA15 for 15% off www.gotitfrommymomma.tvThank you to our generous Got It From My Momma podcast friends! This episode is brought to you by: HARPER COLLINS CHRISTIAN PUBLISHING DEVOTIONS BOOKS - Grace for the Moment for Moms & Jesus Calling for Moms https://amzn.to/3DQ8GWL SUITSHOP PROM https://shrsl.com/4utgu WEDDING GROUP https://shrsl.com/4utgw CODE: GIFMM for a free tie! BAREFACED SKINCAREwww.barefaced.comUse MOMMA15 for 15% off your first purchase! TEXT a Skincare Specialist at 25169 for complimentary consults and to answer any skin questions.COAT DEFENSEwww.coatdefense.comInstagram @coat_defenseUse MOMMA15 for 15% off Got it From My Momma on the WEBwww.gotitfrommymomma.tv(Become an Insider!)Host- Jennifer Vickery Smith@jvickerysmith on Instagram WATCH podcast episodes on YouTube @gotitfrommymommapodcast

Emily Voreas was diagnosed at 33 with Stage IIIb breast cancer, and also carries the BRCA2 gene. Emily has a Masters in Elementary Education and currently works as a reading interventionist. In this episode she reads her poem “Where does the story end?” from the 2024 “Family” issue of Wildfire Journal. Her poem is about four generations of women and cancer. April and Emily will discuss family cancer legacies, fertility, aesthetic flat closure, and the evolving advocacy in each generation of breast cancer. More about Emily: https://www.instagram.com/flatnfierce/Purchase the “Family” issue of Wildfire Magazine: https://www.wildfirecommunity.org/shop/p/family24Buy the Wildfire book Igniting the Fire Within: Stories of Healing, Hope & Humor, Inside Today's Young Breast Cancer Community: https://www.amazon.com/dp/B0BJVJ629F?ref_=pe_3052080_397514860Get the free Wildfire “Hot Flashes” email newsletter: https://www.wildfirecommunity.org/newsletter?rq=newsletterLearn about Wildfire writing workshops: https://www.wildfirecommunity.org/workshopsShop Wildfire merch & more: https://www.wildfirecommunity.org/shop*Free* Get Wildfire and The Burn freebies here: https://www.wildfirecommunity.org/freeMore about Wildfire Magazine: https://www.wildfirecommunity.orghttps://www.instagram.com/wildfire_bc_magazine/https://www.facebook.com/wildfirecommunityInformation on submitting your story for consideration to be published in Wildfire Magazine: https://www.wildfirecommunity.org/submissions

Just before her 38th birthday, Lauren Yerkes learned she had breast cancer. Genetic testing would reveal she had the BRCA2 inherited gene mutation that made her at higher risk of developing breast and ovarian cancers. Her experience made her want to educate people about inherited genetic mutations because she had no idea at the time that she was at risk. Lauren is here today to share her story, the preventative measures she has taken for her health and how she is giving back to the breast cancer community.

Many people believe that breast cancer is primarily caused by genetics, but did you know that only 5-10% of cases are linked to inherited mutations like BRCA1, BRCA2, and CHEK2? The truth is, your overall health and risk of recurrence are influenced by key biological processes such as detoxification, methylation, and inflammation—and these are things you can actively support with your nutrition and lifestyle choices. In this episode of Better Than Before Breast Cancer, I break down how these processes impact your health, how to recognize the signs of imbalance in your body, and why a low-carbohydrate diet can be a powerful tool in regulating glucose, insulin, and inflammation. I also explain why nutrition isn't about restriction—it's about giving your body the support it needs to function at its best. You'll learn:✔️ Why genetics are only part of the breast cancer risk equation✔️ How detoxification, methylation, and inflammation work together to protect your body✔️ Common signs that these processes may not be working efficiently✔️ How blood sugar regulation impacts detox, inflammation, and cancer risk✔️ How a low-carb, nutrient-dense diet supports healing and reduces recurrence risk✔️ Simple, actionable steps to support your body's detox, inflammation, and methylation pathways This episode will empower you to understand your unique genetic blueprint and how to make lifestyle changes that align with your body's needs. It's not about fear—it's about taking control of your health and making choices that truly support healing. Resources & Links:

ROMA (ITALPRESS) - “Il carcinoma ovarico si manifesta spesso in stadio avanzato e fino a pochi anni fa si controllava solo con chirurgia e chemioterapia. La recente disponibilità dei PARP inibitori ha rivoluzionato l'approccio sistemico e diagnostico. La genetica molecolare è fondamentale per individuare le pazienti che possono rispondere a questa terapia”. Lo ha detto Massimo Barberis, Senior Consultant in Patologia Molecolare presso l'Istituto Europeo di Oncologia, intervenuto a The Watcher Talk Salute, il format di Urania TV.“L'identificazione di alterazioni nei geni BRCA1 e BRCA2, sia a livello germinale che tumorale, è stato il primo parametro predittivo positivo - ha aggiunto Barberis -. Attraverso studi bioinformatici si è definito un indice di instabilità genetica che indica il potenziale di risposta delle pazienti. Oggi esistono diversi test per valutare questi parametri. Quando osserviamo un'alterazione di BRCA sul tumore, dobbiamo considerare se sia di tipo germinale o solo tumorale, perché un'alterazione germinale può avere implicazioni anche sulla famiglia.”fsc/gtr(Fonte video: Utopia Studios)

ROMA (ITALPRESS) - “Il carcinoma ovarico si manifesta spesso in stadio avanzato e fino a pochi anni fa si controllava solo con chirurgia e chemioterapia. La recente disponibilità dei PARP inibitori ha rivoluzionato l'approccio sistemico e diagnostico. La genetica molecolare è fondamentale per individuare le pazienti che possono rispondere a questa terapia”. Lo ha detto Massimo Barberis, Senior Consultant in Patologia Molecolare presso l'Istituto Europeo di Oncologia, intervenuto a The Watcher Talk Salute, il format di Urania TV.“L'identificazione di alterazioni nei geni BRCA1 e BRCA2, sia a livello germinale che tumorale, è stato il primo parametro predittivo positivo - ha aggiunto Barberis -. Attraverso studi bioinformatici si è definito un indice di instabilità genetica che indica il potenziale di risposta delle pazienti. Oggi esistono diversi test per valutare questi parametri. Quando osserviamo un'alterazione di BRCA sul tumore, dobbiamo considerare se sia di tipo germinale o solo tumorale, perché un'alterazione germinale può avere implicazioni anche sulla famiglia.”fsc/gtr(Fonte video: Utopia Studios)

ROMA (ITALPRESS) - “Oggi sappiamo che il vantaggio in termini di sopravvivenza dato dagli inibitori PARP alle pazienti con mutazione BRCA1 o BRCA2 si osserva anche in altre pazienti con deficit di ricombinazione omologa, ampliando la platea di beneficiarie dal 20% a quasi il 50% delle pazienti con carcinoma ovarico.” Lo ha detto Nicola Normanno, Direttore Scientifico IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, intervenuto a The Watcher Talk Salute, il format di Urania TV.“Abbiamo assistito a una progressiva riduzione della mortalità per carcinoma ovarico, coincidente con l'introduzione di questi farmaci - ha aggiunto Normanno -. Dati recenti mostrano anche una riduzione dell'incidenza della malattia, probabilmente dovuta all'individuazione delle famiglie ad alto rischio tramite test genetici e alla possibilità di intervenire con chirurgia preventiva e diagnosi precoce. Investire in test e nuove tecnologie per diagnosi sempre più precise è fondamentale per migliorare la prevenzione e il trattamento della malattia"fsc/gtr(Fonte video: Utopia Studios)

ROMA (ITALPRESS) - “Oggi sappiamo che il vantaggio in termini di sopravvivenza dato dagli inibitori PARP alle pazienti con mutazione BRCA1 o BRCA2 si osserva anche in altre pazienti con deficit di ricombinazione omologa, ampliando la platea di beneficiarie dal 20% a quasi il 50% delle pazienti con carcinoma ovarico.” Lo ha detto Nicola Normanno, Direttore Scientifico IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, intervenuto a The Watcher Talk Salute, il format di Urania TV.“Abbiamo assistito a una progressiva riduzione della mortalità per carcinoma ovarico, coincidente con l'introduzione di questi farmaci - ha aggiunto Normanno -. Dati recenti mostrano anche una riduzione dell'incidenza della malattia, probabilmente dovuta all'individuazione delle famiglie ad alto rischio tramite test genetici e alla possibilità di intervenire con chirurgia preventiva e diagnosi precoce. Investire in test e nuove tecnologie per diagnosi sempre più precise è fondamentale per migliorare la prevenzione e il trattamento della malattia"fsc/gtr(Fonte video: Utopia Studios)

Between 5-10% of breast and 20-25% of ovarian cancers are inherited. The majority of hereditary breast and ovarian cancer cases are caused by deleterious mutations (variants) in the BRCA1 and BRCA2 genes, which normally prevent cancer through protecting and repairing our DNA. Genetic testing is used to identify pathogenic BRCA carriers who would subsequently benefit from personalized screening, preventative and management plans. However, its widespread implementation has resulted in a significant increase in findings of variants of uncertain significance (VUS) – DNA sequence variants with uncertain effects on disease risk. VUSs pose a critical clinical challenge as they limit clinicians' ability to effectively interpret genetic test results. For upcoming interviews check out the Grad Chat webpage on Queen’s University School of Graduate Studies & Postdoctoral Affairs website.

Hormonal birth control increases breast cancer risk in women with a BRCA1 mutation, but not women with a BRCA2 mutation. Levonorgestrel IUDs increase risk, but how much? The long-term risk of breast cancer coming back — recurring — as metastatic disease has gone down in the last 20 years, but younger women still have a higher risk than older women. What does all this mean? Breastcancer.org Professional Advisory Board member Dr. Kathy Miller discusses the details of these studies and how they may affect you. Listen to the episode to hear Dr. Miller discuss these studies: hormonal birth control ups risk of breast cancer in women with a BRCA1 mutation levonorgestrel IUDs increase risk breastfeeding after breast cancer seems safe the long-term risk of late, distant recurrence has gone down but age affects that risk

fWotD Episode 2832: Prostate cancer Welcome to Featured Wiki of the Day, your daily dose of knowledge from Wikipedia’s finest articles.The featured article for Tuesday, 4 February 2025 is Prostate cancer.Prostate cancer is the uncontrolled growth of cells in the prostate, a gland in the male reproductive system below the bladder. Abnormal growth of prostate tissue is usually detected through screening tests, typically blood tests that check for prostate-specific antigen (PSA) levels. Those with high levels of PSA in their blood are at increased risk for developing prostate cancer. Diagnosis requires a biopsy of the prostate. If cancer is present, the pathologist assigns a Gleason score, and a higher score represents a more dangerous tumor. Medical imaging is performed to look for cancer that has spread outside the prostate. Based on the Gleason score, PSA levels, and imaging results, a cancer case is assigned a stage 1 to 4. A higher stage signifies a more advanced, more dangerous disease.Most prostate tumors remain small and cause no health problems. These are managed with active surveillance, monitoring the tumor with regular tests to ensure it has not grown. Tumors more likely to be dangerous can be destroyed with radiation therapy or surgically removed by radical prostatectomy. Those whose cancer spreads beyond the prostate are treated with hormone therapy which reduces levels of the androgens (male sex hormones) that prostate cells need to survive. Eventually cancer cells can grow resistant to this treatment. This most-advanced stage of the disease, called castration-resistant prostate cancer, is treated with continued hormone therapy alongside the chemotherapy drug docetaxel. Some tumors metastasize (spread) to other areas of the body, particularly the bones and lymph nodes. There, tumors cause severe bone pain, leg weakness or paralysis, and eventually death. Prostate cancer prognosis depends on how far the cancer has spread at diagnosis. Most men diagnosed have tumors confined to the prostate; 99% of them survive more than 10 years from their diagnoses. Tumors that have metastasized to distant body sites are most dangerous, with five-year survival rates of 30–40%.The risk of developing prostate cancer increases with age; the average age of diagnosis is 67. Those with a family history of any cancer are more likely to have prostate cancer, particularly those who inherit cancer-associated variants of the BRCA2 gene. Each year 1.2 million cases of prostate cancer are diagnosed, and 350,000 die of the disease, making it the second-leading cause of cancer and cancer death in men. One in eight men is diagnosed with prostate cancer in his lifetime and one in forty dies of the disease. Prostate tumors were first described in the mid-19th century, during surgeries on men with urinary obstructions. Initially, prostatectomy was the primary treatment for prostate cancer. By the mid-20th century, radiation treatments and hormone therapies were developed to improve prostate cancer treatment. The invention of hormone therapies for prostate cancer was recognized with the 1966 Nobel Prize to Charles B. Huggins and the 1977 Prize to Andrzej W. Schally.This recording reflects the Wikipedia text as of 00:39 UTC on Tuesday, 4 February 2025.For the full current version of the article, see Prostate cancer on Wikipedia.This podcast uses content from Wikipedia under the Creative Commons Attribution-ShareAlike License.Visit our archives at wikioftheday.com and subscribe to stay updated on new episodes.Follow us on Mastodon at @wikioftheday@masto.ai.Also check out Curmudgeon's Corner, a current events podcast.Until next time, I'm neural Aria.

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)  

Dr. Evan Yu presents the new evidence-based guideline on genetic testing for metastatic prostate cancer. He discusses who should receive germline and somatic testing with next-generation sequencing technologies, what samples are preferred for testing, and the therapeutic & prognosistc impacts of genetic testing. Dr. Yu emphasizes the need for awareness and refers to areas of active investigation and future research to improve personalized therapies for patients with metastatic prostate cancer.  Read the full guideline, “Germline and Somatic Genomic Testing for Metastatic Prostate Cancer: ASCO Guideline” at www.asco.org/genitourinary-cancer-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/genitourinary-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-24-02608 Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Evan Yu from the University of Washington and Fred Hutchinson Cancer Center, lead author on “Germline and Somatic Genomic Testing for Metastatic Prostate Cancer: ASCO Guideline”. Thank you for being here today, Dr. Yu. Dr. Evan Yu: Thanks for having me on. Brittany Harvey: Great. Then before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the entire guideline, including Dr. Yu, who has joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then, Dr. Yu, to start us off on the content of this guideline, could you first provide an overview of both the purpose and scope of this guideline? Dr. Evan Yu: Yeah, absolutely. So I think the one key thing to recognize is that prostate cancer is the highest incidence of all cancers in males. Additionally, it's the second highest cause of mortality in males, and that's about 35,000 deaths in 2024. So with that being said and done, it's a disease where we need to do better. And part of that is recognizing that we now have many targeted therapies, precision medicine type of therapies, but unlike a lot of other cancers out there, prostate cancer patients are not always getting sequencing, next generation DNA sequencing, let's say, to identify both inherited and also spontaneously develop what we call somatic mutations in their tumor. And I suspect that's partially because other cancers like breast cancer, we're so used to- in the first line, you present the patient, you throw out their estrogen receptor status, progesterone receptor status, HER2, ER/PR HER2; in lung cancer it's EGFR, ALK, ROS1, etc. In things like prostate cancer, things like BRCA2 have major important patient treatment implications and potentially family counseling and downstream cascade testing implications. But it hasn't made their way into that first-line presentation yet. And for that reason, there are some studies out there that show that testing in the community may be as low as 15% of patients with metastatic prostate cancer. We want to bring awareness to that and hopefully increase testing down the road so that we can better help our patients with metastatic prostate cancer. Brittany Harvey: Absolutely. It's important to get these targeted therapies to the patients who can benefit most. Using that context, I'd like to next review the key recommendations of this guideline across the six clinical questions that the panel addressed. So, starting with: Who should receive germline testing with next generation sequencing technologies? Dr. Evan Yu: Yeah. We think that it's common enough that everyone with metastatic prostate cancer should receive germline genetic testing. And the reason for that is there have been studies that have looked at this and have shown that 12% of men with metastatic prostate cancer have some sort of inherited germline mutation in a gene, mostly DNA repair genes. But 12% have something that is inherited and that loved ones, first degree relatives, siblings, offspring might have also inherited. Now, most of these are in the DNA repair genes, but that being said and done, there's not only treatment implications for the patient, where there are newer drugs that that patient could get treated with, but other loved ones that might have inherited these gene mutations, that these things can cause other cancers as well - not just prostate cancer, but breast cancer, endometrial cancer, ovarian cancer, pancreatic cancer. So, it's very important to test, with as high of an incidence as 12%, to test, and if you identify it in a patient, it's our job to talk to the patient about it and talk to them about the pros and cons of family counseling and talking to their loved ones and potentially having their loved ones get tested. Because if they test positive, then their doctors may want to know and may screen them very, very aggressively and differently for a whole host of other cancers. And the whole idea is you find the cancer very early and cure the patients before the cancer really takes hold and has the ability to spread so we can save a lot of lives down the road. Brittany Harvey: Absolutely. This germline testing is important not just for the patient, but has wider implications for their families as well, as you mentioned. So then, beyond those recommendations for germline testing, which patients should receive somatic testing with next-generation sequencing technologies? Dr. Evan Yu: So let's talk a little bit about somatic testing. So germline again, as we know, is inherited. The patient inherited it in every single cell in their body, then it becomes very easy, many of these are cancer predispositions for them to lose the other allele and then to have biallelic loss and then develop the cancer. Now, somatic just means it spontaneously occurred. Certainly, it's not going to occur in every cell in the body, but you can get one hit, lose one allele and then lose the other allele. And if that gene is truly carcinogenic and leading to that cancer, then that can have implications potentially for treatment as well. So we recommend that all patients with metastatic prostate cancer also undergo somatic next-generation sequencing testing. We recognize that at this point in time it's only those with metastatic castration-resistant prostate cancer or hormone-resistant prostate cancer, which is a later disease state where there are drugs that may target those mutations, for instance, like PARP inhibitors, but that early identification for a patient population that's fit and that can benefit from these therapies makes sense so that you know it's in place already and you have your treatments outlined and mapped out for the future. So we recommend it for everybody - somatic testing also for everyone with metastatic prostate cancer. Brittany Harvey: Understood. And then when patients are receiving that somatic testing, what is recommended for somatic testing? Primary tumor archival tissue? Fresh metastatic biopsy tissue? Or circulating tumor DNA testing? Dr. Evan Yu: We recommend that in the initial setting when you're first diagnosed, that archival tissue samples are fine and preferred. But circulating tumor DNA is good when there's no accessible archival tissue, or if the archival tissue, let's say, is very old and it's been sitting around for a long time, or you can't get it anymore because it's many years back when maybe a patient had a prostate needle biopsy. So if it's not accessible, then we recommend ctDNA. We believe that is preferred and also that ctDNA is recommended in a situation where you can't easily biopsy a metastatic site. Sometimes it's just not in a safe area to go after. Sometimes it's just a small lesion. So in general, we recommend tissue when available, and when we think that the tissue sample will yield clean results, if not, then we recommend doing ctDNA at that point in time. Brittany Harvey: So you have described who should get germline and somatic genomic testing. But what are the therapeutic impacts of this germline or somatic testing for single gene genetic variants? Dr. Evan Yu: We pulled this panel together and we met like every single month for like 12 months straight, and part of it was to review the literature. And as part of this literature review, we were able to pull a whole bunch of different trials. I think there was like 1713 papers we identified in the literature search. Eventually, we narrowed it down because with ASCO, we want to present the data with the highest level evidence, level 1 evidence, randomized controlled prospective data. And after reviewing 1713 papers, we narrowed it down to 14 papers. With those 14 papers, if you look at it, there are a lot of things that we think may have implications for treatment or prognosis, but we didn't feel was the highest level of evidence that we could support. So the things that have the highest level of evidence that we can support are certain DNA repair gene alterations, especially BRCA2, and treatment with PARP inhibitors because there are many PARP inhibitor prospective trials that show progression-free survival benefit and even overall survival benefit. And so that's the type of study that achieved the level of evidence that we could include. So I would say BRCA1 and BRCA2 highest level of evidence and PARP inhibitor use also is included in that. Brittany Harvey: Understood. I appreciate you reviewing those therapeutic options. So then, the last clinical question, which you just touched on briefly, but what are the prognostic impacts of germline and/or somatic testing? Dr. Evan Yu: Whenever you do testing, especially if you use panel testing, you find a lot of information. There's a lot of different mutations and some of which are VUSs (variants of unknown significance) where we don't quite know what it means yet, but we can track that, especially if it's germline. But with somatic, we find lots of things that have implications, but maybe just not treatment implications. A perfect example is p53. p53 is one of the most common tumor suppressor gene mutations on all cancers, but in prostate cancer they can occur and they can usually occur late, although there can even be germline inherited p53 alterations. There's no treatment that targets p53 right now, but we know that if you have a p53 mutation that those patients may have more aggressive disease and that prognostic information is important to give to the patient. And I think it's important for future clinical trial design and direction. So we do not recommend making treatment recommendations or changes based on these prognostic only biomarkers at this point in time. But we do recommend that, based on this, we can design intensification trials for those patients who have these poor risk biomarkers and de-intensification trials for patients who may have a good risk biomarker. So for instance, SPOP is a gene where we think these patients may have better outcomes, they might respond better to certain hormonal therapies like abiraterone. I say might because the level of evidence isn't quite there. But what I would say is that these prognostic only biomarkers, we just don't think they cut the mustard yet to be able to make treatment decisions. But we do think that they can drive counseling for the patient and potential selection and trial design for the future to say, “Okay. This is a patient population that has a more aggressive cancer. We need to be more aggressive in treating these patients.” “This patient population might have a less aggressive cancer. Maybe we can de-intensify and say side effects and quality of life may be better for the patients.” Brittany Harvey: Definitely. It's important for thinking through how to personalize care for these patients. So then you've talked about this a little bit in talking through the recommendations, but could you expand on what is the importance of this guideline and how it will impact both clinicians and patients with metastatic prostate cancer? Dr. Evan Yu: Yeah, I think the number one thing is awareness. I think the data's out there and people that are in my field, they know this. But by evidence of the fact that it's not first-line presentation lingo that everyone's talking about things like BRCA status, it means it hasn't necessarily disseminated all the way through. So it's increasing awareness of the fact that both germline and somatic alterations can occur and that these may have impacts on the patient for their treatment and their prognosis, and basically to increase testing for the future. I really think that in the future, there'll be other reasons that we may want to serially even retest and we may find that there may be mutations that develop as mechanisms of resistance that might guide therapy down the road. So we need to get people to start doing this for everyone with metastatic prostate cancer, because someday we might be doing it not just once, but over and over again. Brittany Harvey. Absolutely. We hope this guideline reaches a wide audience and that these recommendations can be put into practice. Finally, you've talked about how not all the data in the field has yet risen to the level of evidence that made it into the guidelines. So what are the outstanding questions in future research areas for both germline and somatic genomic testing for metastatic prostate cancer? Dr. Evan Yu: It was in our discussion, but it clearly- it's not common enough for there to be randomized prospective trials that would reach that level of evidence to make it in this guideline recommendation. But we all know that for any solid tumor, you can get mismatched repair deficiency, microsatellite instability leading to hypermutation or high tumor mutational burden. And that happens in maybe 3 to 5% of patients with metastatic prostate cancer as well. There is evidence and data that these patients can potentially benefit from immunotherapies like pembrolizumab. But again, it's just not common enough for there to be those randomized prospective controlled trials out there. But we mention it because we know it's FDA-approved across all the tumor types, so we felt like we have to mention it because that's something that has treatment implications for the patient. But also, I alluded to this earlier, I think an area of active investigation is the tried and true number one driver of prostate cancer, which is androgen receptor. Testosterone binds to androgen receptors, stimulates it. That's how androgen deprivation therapy works. That's how abiraterone and the amides like enzalutamide, apalutamide, darolutamide, that's how they all work. But even beyond that, we're starting to identify that maybe 15%, 20% of patients with metastatic castration resistant prostate cancer have androgen receptor mutations. And there are newer classes of therapies like androgen receptor degraders like CYP11A1 antagonist that lead to complete adrenal annihilation of other steroid hormones that might promiscuously stimulate these androgen receptor mutants. These things develop as mechanisms of resistance, and in the future, we might want to serially test- and that's an active area of investigation in the future, to say you've been treated, let's say, with androgen deprivation therapy and abiraterone for years. There are certain mutations that might develop as a resistance mechanism. We might need to serially test somebody because you didn't have that mutation earlier on, but later in the disease course you might. And then there might be a new drug X out there that we would want to use. Again, we need the data, we need the randomized prospective controlled trials, but they're happening out there. And somewhere down the road we may rewrite this guideline and have a lot more recommendations to add to it. Brittany Harvey: Yes, we'll look forward to more research in this field to better provide targeted therapies for patients with metastatic prostate cancer across the treatment paradigm. And we'll look forward to report outs from those trials that you mentioned. So I want to thank you so much for your work to develop this guideline and thank you for your time today, Dr. Yu. Dr. Evan Yu: Thank you so much. It's wonderful to be here today. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/genitourinary-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   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.  

*Trigger Warning: This episode discusses cancer risk, genetic testing, and preventative surgeries, which may be emotionally heavy for some listeners.*Hello, everyone! This week I'm talking with Jade, a dedicated career woman, wife, mother, and passionate advocate, to explore her deeply personal journey with the BRCA2 genetic mutation. From receiving life-changing news to navigating difficult choices, Jade shares how this revelation has empowered her to become a voice for cancer prevention and early detection.In this episode:Jade's emotional journey after receiving a BRCA2 diagnosisHow genetic testing can empower proactive health decisionsThe importance of support groupsWhy genetic testing matters for both women and men The psychological toll of genetic testing and the need for therapyDifferent options to explore before and after genetic testingThank you so much for listening!  Don't forget to share on your social media and tag me if you loved this episode!ResourcesFORCE - Facing Hereditary Cancer Empowered: https://www.facingourrisk.org/Corewell Dearborn's Genetic Counseling: https://www.beaumont.org/services/genetics/general-adult-geneticsFind it Early Act: https://www.votervoice.net/mobile/FORCE/Campaigns/106840/RespondConnect with Jade!Instagram: @JadeNicoleOrtizSupport the showConnect with Rachel!Instagram: @The_Rachel_MaineWebsite: https://linktr.ee/WellnessSexpertiseYouTube: YouTube.com/@OwningYourSexualSelfFacebook: Rachel MaineEmail: therachelmaine@gmail.com

This week we're sharing a favorite episode from the archives as we take a break from our regular podcast schedule to celebrate the New Year. Production assistant Monica Haro selected this episode from December 2021 to reshare. Enjoy!Tova Wolking is an attorney from Oakland, California. She was diagnosed at age 43 with Stage III, hormone positive breast cancer. She also carries the BRCA2 gene. In this episode, Tova reads her piece “Swim” from Wildfire Magazine's 2021 “Bay Area Young Survivors” issue. In the wake of Tova's mom passing away, breast cancer took root in her body. This is the story of one woman asking how to find the key to unlocking her own grief about her breast cancer when her mother took so many of those answers with her when she died. Note of warning for sensitive listeners, this episode touches upon loss and suicide. More about Bay Area Young Survivors: https://bayareayoungsurvivors.org/members/Get the “Bay Area Young Survivors” issue here: https://www.wildfirecommunity.org/shop/p/digital-bays21Buy the Wildfire book Igniting the Fire Within: Stories of Healing, Hope & Humor, Inside Today's Young Breast Cancer Community: https://www.amazon.com/dp/B0BJVJ629F?ref_=pe_3052080_397514860Get the free Wildfire “Hot Flashes” email newsletter: https://www.wildfirecommunity.org/newsletter?rq=newsletterLearn about Wildfire writing workshops: https://www.wildfirecommunity.org/workshopsShop Wildfire merch & more: https://www.wildfirecommunity.org/shop*Free* Get Wildfire and The Burn freebies here: https://www.wildfirecommunity.org/freeMore about Wildfire Magazine: https://www.wildfirecommunity.orghttps://www.instagram.com/wildfire_bc_magazine/https://www.facebook.com/wildfirecommunityInformation on submitting your story for consideration to be published in Wildfire Magazine: https://www.wildfirecommunity.org/submissions

Liz & Becca tackle the controversial topic of breast cancer and BRCA gene mutations. They break down the science behind BRCA1 and BRCA2, the truth about genetic predisposition, and why these genes don't have to define your future. From lifestyle changes and diet to safer testing methods and informed consent, this episode equips you with the knowledge to make empowered decisions. Whether you're navigating genetic testing, considering preventive measures, or just curious about breast cancer risk, this episode provides practical insights and a dose of much-needed hope.

This week we're sharing a favorite episode from the archives as we take a little holiday break from our regular podcast schedule. Production assistant Monica Haro selected this episode from December 2021 to reshare. Enjoy!Erica Fitch was 12 when her mom was diagnosed with breast cancer. Two decades later at 30, she was diagnosed with DCIS: stage 0, estrogen positive breast cancer when her own daughter was 2. She carries the BRCA2 mutation. Her story today is about growing up with intimate knowledge of illness and the parallels when you face it yourself. And how to write about deeply personal stories that have been sewn into the fabric of your identity. Erica reads her piece “Memories in Color: Four Generations” from Wildfire Magazine's 2020 “Family” issue, where she uses the structure of color to explore and write the hard stories in our lives. More about Erica: https://www.instagram.com/beeing_erica/More about color symbolism: https://www.writersdigest.com/prompts/the-color-of-ideas-color-associations-writing-promptGet the “Family” issue here: https://www.wildfirecommunity.org/shop/p/digital-body21Buy the Wildfire book Igniting the Fire Within: Stories of Healing, Hope & Humor, Inside Today's Young Breast Cancer Community: https://www.amazon.com/dp/B0BJVJ629F?ref_=pe_3052080_397514860Get the free Wildfire “Hot Flashes” email newsletter: https://www.wildfirecommunity.org/newsletter?rq=newsletterLearn about Wildfire writing workshops: https://www.wildfirecommunity.org/workshopsShop Wildfire merch & more: https://www.wildfirecommunity.org/shop*Free* Get Wildfire and The Burn freebies here: https://www.wildfirecommunity.org/freeMore about Wildfire Magazine: https://www.wildfirecommunity.orghttps://www.instagram.com/wildfire_bc_magazine/https://www.facebook.com/wildfirecommunityInformation on submitting your story for consideration to be published in Wildfire Magazine: https://www.wildfirecommunity.org/submissions

Breast cancer diagnoses in younger women (under 50) have been steadily increasing over the past two decades, with a notable rise in recent years. From 2010 to 2019, there was an 8% increase in breast cancer diagnoses in women under 50. During this age, the early 40s, breast cancer is more aggressive and more challenging to detect early. With that in mind, what are the markers to watch for and preventive strategies to ensure you and your family won't develop breast cancer?In this episode, Dr. Stephanie Nielsen is joined by Alison Myers, founder of AIVM Consultants, a distinguished figure in the realm of personal growth and business development – a visionary whose unique blend of experience, insight, and unconventional methods have marked a pioneering presence in the coaching and consulting landscape. Together, they discuss the importance of looking into family history, lifestyle choices, and the importance of genetic testing in order to explore common genetic markers such as BRCA1 and BRCA2 mutations. They dive deeper into this by looking into the case of Olivia Munn to look into how advanced screening led to her diagnosis and what you can do better as compared to a mastectomy.▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬If you wish to learn more about Alison Myers and AIVM Consultants, you may do so through the following link: https://aivmconsultants.com/▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬Keep yourself up to date on The DNA Talks Podcast! Follow our socials below:The DNA Talks Podcast Instagram https://www.instagram.com/dnatalkspodcast/Dr. Stephanie Nielsen's website https://www.wishinguwellness.com/▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬Music: Inspiring Motivational Background by Stock-Waveshttps://www.stock-waves.com/https://protunes.net/Video Link:  https://www.youtube.com/watch?v=pbwVDTn-I0o&list=PLQtpqy3zeTGB7V5lkhkfBVaiZyrysv_fG&index=5▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬Music: Peaceful Corporate by Stock-Waveshttps://protunes.net/Video Link:  https://www.youtube.com/watch?v=I34bTKW8ud0&list=PLQtpqy3zeTGB7V5lkhkfBVaiZyrysv_fGMedical Disclaimer: The information provided in this communication is for general informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here. If you think you may have a medical emergency, call your doctor or 911 immediately.

In this episode of The Luke Coutinho Show, I am excited to bring you an insightful discussion with Dr. Rajiv Bhatt, an experienced surgical oncologist at HCG Cancer Center, Vadodara. Dr. Rajiv specializes in all major cancer resections, function preserving & conservation surgeries for cancer, minimally invasive oncology surgeries (MIOS), and complex surgeries for recurrent cancers.  Join me as we uncover: Advances and insights in breast cancer care: Importance of tumor biology, lymphatic system, environmental estrogens (xenoestrogens), gut health, lifestyle, and more in improving cancer treatment The role of emotional health in breast cancer care: Correlation with chronic stress, suppressed emotions, and childhood trauma.  The importance of screening: Prioritizing regular screenings, mammograms for breast cancer, or even simple clinical examinations Epigenetics and breast cancer risk management: Understanding BRCA1 and BRCA2 genes, challenges of genetic testing, and emerging technologies Liquid biopsies, breast cancer progression, and Tamoxifen use: Science behind liquid biopsies, cancer biology, and risks and guidelines for Tamoxifen use And much more…

In this JCO Precision Oncology Article Insights episode, Miki Horiguchi summarizes two articles: “Germline Susceptibility to Renal Cell Carcinoma and Implications for Genetic Screening,” by Dr. Kate I. Glennon et al. published on August 01, 2024, and "Incidental Pathogenic Variants in Renal Cell and Urothelial Carcinoma: Is It Time for Universal Screening?” by Dr. Salvador Jaime-Casas, et al. published on August 01, 2024. TRANSCRIPT Miki Horiguchi: Hello and welcome to JCO Precision Oncology Article Insights. I'm your host Miki Horiguchi, an ASCO Journal's Editorial Fellow. Today, I'll be providing summaries of the article titled, "Germline Susceptibility to Renal Cell Carcinoma and Implications for Genetic Screening,” by Dr. Kate Glennon and colleagues. In the accompanying editorial titled, “Incidental Pathogenic Variants in Renal Cell and Urothelial Carcinoma: Is It Time for Universal Screening?” by Dr. Salvador Jaime-Casas and colleagues. Renal cell carcinoma (RCC) exhibits distinct clinical characteristics across its histological subtypes. Clear cell RCC accounts for approximately 75% of cases while the remaining non-clear cell RCC encompasses a diverse group of histology. Although a family history has been known to double the risk for RCC, genetic susceptibility, particularly across different histological subtypes and defined operations, has not been investigated well. Dr. Glennon and colleagues sought to identify risk genes for RCC within the Canadian population and investigate their clinical significance in comparison to cancer-free control populations. The authors conducted targeted sequencing of 19 RCC related genes and 27 cancer predisposition genes for 960 RCC patients in Canada. DNA samples were collected through the Ontario Tumour Bank between 2005 and 2019. For comparisons across histological subtypes, the cohort was divided into 759 patients with clear cell RCC and 201 patients with non-clear cell RCC, including all histological subtypes other than clear cell RCC. Non-cancer control data were obtained from a publicly available database which included over 118,000 cases from the European population. A total of 39 different germline pathogenic variants were identified in 56 patients representing 5.8% of the Canadian cohort. There was no significant difference in the overall number of germline pathogenic variants between the two groups. The most commonly identified germline pathogenic mutations were CHEK2, ATM/BRCA2 and MITF in the clear cell RCC group, and FH and CHEK2 in the non-clear cell RCC group. Compared to the non cancer control data, germline pathogenic variants in CHEK2 and ATM were significantly associated with an increased risk of developing clear cell RCC, while those in FH were significantly associated with non clear cell RCC. According to the bivariate association analysis between the presence of germline pathogenic variants and clinical characteristics, patients with metastatic RCC were strongly associated with pathogenic variants in BRCA1, BRCA2, and ATM. No other significant associations were observed. The authors then evaluated variations in germline pathogenic variants among RCC patients across the world using similar studies conducted in Canada, Japan, the United Kingdom, and the United States. Specifically, they compared the gene burden for significantly mutated genes in each of the cohorts against all other cohorts combined. Compared to the other cohorts, RCC patients from Japan were enriched for pathogenic variants in TP53 and depleted for pathogenic variants in CHEK2. The United States cohorts showed higher frequencies of patients with pathogenic variants in BAP1 and FH genes compared to other cohorts. In contrast, RCC patients from Canada and the United Kingdom were not enriched for any specific genes when compared with the other cohorts. After characterizing germline susceptibility to RCC, the authors evaluated how many of the RCC patients in the Canadian cohort did not meet existing referral criteria for genetic screening based on current clinical guidelines, aiming to help refine these guidelines. Among the 56 RCC patients with identified germline pathogenic variants in the Canadian cohort, 73% did not meet the referral criteria for genetic screening under current Canadian guidelines. The authors also applied the UK guidelines and the US American College of Medical Genetics guidelines to the same 56 RCC patients. Under these criteria, 80% and 64%, respectively, were not eligible for genetic screening. In an exploratory analysis, the authors examine the impact of raising the Asia onset threshold from less than 45 years to less than 50 years. This revision captured an additional five patients with pathogenic variants. In addition to more inclusive genetic screening guidelines, the study results suggest that expanding the current list of genes to include additional relevant genes such as BRCA1, BRCA2, CHEK2 and ATM could help identify more RCC patients who are affected by rare germline pathogenic variants in Canada. The authors concluded that these revisions would enable the identification of a higher number of at-risk patients and improve the management of RCC patients. In the associated editorial accompanying this research article, Dr. Salvador Jaime-Casas and colleagues emphasized that the findings from Dr. Glennon and colleagues' study are particularly worrisome as most RCC patients with incidental pathogenic variants are not being referred for genetic screening. Building on results from previous studies, the authors suggested the need to revisit and update the current screening guidelines for RCC patients. The authors also highlighted findings from other studies showing the prevalence of pathogenic variants in CHECK2, BRCA1, and BRCA2 at up to 6% in RCC patients and 11% in upper tract urothelial carcinoma patients. They noted that these rates are comparable to those of ovarian cancer and pancreatic cancer, which already have universal screening guidelines. The authors also discuss some challenges. While the prevalence of pathogenic variants is crucial for evaluating the impact of germline genetic testing, it's only one factor in devising screening guidelines for RCC and urothelial carcinoma. They emphasize the need for robust clinical trials to evaluate therapeutics targeting these pathways, as well as the importance of characterizing incidental pathogenic variants to guide patient selection for these trials. Thank you for listening to JCO Precision Oncology Article Insights and please tune in for the next topic. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at 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.

Jennifer Bringle is a freelance writer and editor who was diagnosed at 37 with Stage II, hormone positive breast cancer. She also has the BRCA2 genetic mutation. Jennifer lives in North Carolina with her husband, young son and special needs cat. In this episode, Jennifer reads her essay “Bra Hunting” from Wildfire Magazine's 2024 “Body” issue. Jennifer's essay is about bra shopping after breast cancer surgery told through the lens of buying bras throughout her life. April and Jennifer will talk about the possibility of more reconstruction surgeries in the future, cancer stealing the pleasure of dressing your body, and finding new joy in writing about the past. They will also discuss the people we encounter along the way in our cancer experience. Jennifer will also share her writing process and tips. More about Jennifer:https://jenniferbringle.com/https://www.instagram.com/jbhandy78/More about our episode sponsor: Less Radical Podcast https://cancerculture.substack.com/podcasthttps://open.spotify.com/episode/4mMdQpSdVr9kKSGXTfYLmoPurchase the “Body” issue of Wildfire Magazine: https://www.wildfirecommunity.org/shop/p/digital-body24Buy the Wildfire book Igniting the Fire Within: Stories of Healing, Hope & Humor, Inside Today's Young Breast Cancer Community: https://www.amazon.com/dp/B0BJVJ629F?ref_=pe_3052080_397514860Get the free Wildfire “Hot Flashes” email newsletter: https://www.wildfirecommunity.org/newsletter?rq=newsletterLearn about Wildfire writing workshops: https://www.wildfirecommunity.org/workshopsShop Wildfire merch & more: https://www.wildfirecommunity.org/shop*Free* Get Wildfire and The Burn freebies here: https://www.wildfirecommunity.org/freeMore about Wildfire Magazine: https://www.wildfirecommunity.orghttps://www.instagram.com/wildfire_bc_magazine/https://www.facebook.com/wildfirecommunityInformation on submitting your story for consideration to be published in Wildfire Magazine: https://www.wildfirecommunity.org/submissions

In this episode we discuss a research study that focuses on Black women who tested positive for a pathogenic variant associated with an increased risk for breast cancer. You can find the Journal of Genetic Counseling webpage via onlinelibrary.wiley.com or via the National Society of Genetic Counselors website. Please note that the terminology used refers to women to reflect the language used in the paper, and all genders can have a risk to develop breast cancer. Segment 1: “A qualitative study of Black breast cancer previvors' and survivors' experiences after positive genetic testing” Malika Sud (she/her) is a genetic counselor who specializes in fetal genetics and rare disease diagnosis. She works at the Manton Center at Boston Children's Hospital, where her projects focus on discovering genetic causes of rare disease, improving access to genetic testing/counseling, and support around perinatal loss. She also cares for people with high-risk pregnancies at the Maternal Fetal Care Center at Boston Children's Hospital. Malika's work is informed by her community activism and lived experience as a woman of color - she is a longtime advocate for reproductive justice and strives to center marginalized voices healthcare and research. She teaches at the Boston University Genetic Counseling Program and serves on the NSGC J.E.D.I. Stewardship Committee in an effort to make the genetic counseling field more inclusive for patients and colleagues. Malika's Twitter handle is @malikasud   Erika Stallings is an attorney and writer based in Jersey City, NJ. In 2014 she learned that she carried a BRCA2 mutation and underwent a preventative mastectomy that same year. Since undergoing genetic counseling and testing she has worked to raise awareness of hereditary cancer with a specific focus on raising awareness in minority communities. Her writing about her experience with hereditary cancer as well as her work on health inequities has been published in NPR, O Magazine, The Cut, Jezebel and The New York Times. She is active on social media at the handle quidditch424 on X."  In This Episode We Discuss: - The origins of the study and the reasoning behind choosing this specific topic. - Erika's involvement as a patient advocate and how the team's diverse backgrounds shaped the research approach. - The five key themes uncovered in the study, with relevant participant quotes shared. - Insights on how healthcare providers can improve support for Black women with genetic results indicating higher breast cancer risk. - Discussion of the study's potential impact on future research and changes in clinical practice.   Stay tuned for the next new episode of DNA Dialogues! In the meantime, listen to all our episodes Apple Podcasts, Spotify, streaming on the website, or any other podcast player by searching, “DNA Dialogues”.    For more information about this episode visit dnadialogues.podbean.com, where you can also stream all episodes of the show. Check out the Journal of Genetic Counseling here for articles featured in this episode and others.    Any questions, episode ideas, guest pitches, or comments can be sent into DNADialoguesPodcast@gmail.com.    DNA Dialogues' team includes Jehannine Austin, Naomi Wagner, Khalida Liaquat, Kate Wilson, and DNA Today's Kira Dineen. Our logo was designed by Ashlyn Enokian. Our current intern is Sydney Arlen.

In this JCO Precision Oncology Article Insights episode, Mitchell Elliot summarizes the article “Talazoparib in Patients With Solid Tumors With BRCA1/2 Mutation: Results From the Targeted Agent and Profiling Utilization Registry Study” by Dr. Jordan Srkalovic et al.  published on June 12th, 2024. TRANSCRIPT Mitchell Elliott: Hello, welcome to JCO Precision Oncology Article Insights. I'm your host Mitchell Elliott, an ASCO Journals Editorial Fellow. Today I'll be providing a summary of the article titled, “Talazoparib in Patients With Solid Tumors With BRCA1/ 2 Mutation: Results From the Targeted Agent and Profiling Utilization Registry Study,” by Dr. Jordan Srkalovic et al. The Targeted Agent and Profiling Utilization Registry Study is a phase 2 basket trial evaluating the anti-tumor activity of commercially available targeted agents in patients with advanced cancer and genomic alterations known to be drug targets. Results of a cohort of patients with various solid tumors with germline or somatic BRCA1 and 2 mutations treated with talazoparib are reported. BRCA1 is involved in both non homologous end joining, and homologous recombination, while BRCA2 primarily facilitates homologous recombination. These mutations are present in a range of cancers including breast, ovarian and pancreatic cancers, making them key targets for therapies that inhibit poly (ADP-ribose) polymerase or PARP, a family of proteins critical for DNA repair. PARP inhibitors like talazoparib have shown promise in treating cancers with BRCA mutations as they prevent tumors from repairing DNA damage, thus promoting cell death. Many PARP inhibitors are standard of care in both early and advanced cancers. Talazoparib was previously FDA approved for BRCA related HER2 negative breast cancer and prostate cancer. The TAPUR study aims to investigate the effectiveness of talazoparib and other types of solid tumors with BRCA1 and 2 mutations to expand its potential therapeutic applications. Eligible patients had to meet both general and drug specific criteria for inclusion in the study. General eligibility required participants to have advanced or metastatic solid tumors measurable by the RECIST version 1.1 criteria, a performance status of 0 to 2 based on the Eastern Cooperative Oncology Group Scale, and a genomic target identified through certified laboratory testing. Patients with germline or somatic BRCA1 or 2 mutations were eligible, but the genomic test did not always differentiate between these types of mutations. Additional criteria included being age 18 years or older, using effective contraception and avoiding sperm donation at the set period. Exclusion criteria included patients with HER2 negative breast cancer, prior PARP inhibitor treatments, or certain cardiovascular conditions. The study also excluded patients with recent major surgeries, coagulopathy and serious medical conditions, but there were no criteria related to prior platinum therapies. Patients received 1 milligram of talazoparib daily until disease progression, unacceptable toxicity, or other reasons for discontinuation. The primary endpoint of the study was disease control which was defined by achieving either objective response or stable disease lasting at least 16 weeks as assessed by the RECIST criteria. Secondary endpoints included objective response, progression free survival, overall survival, duration of response, duration of stable disease, and safety. The study enrolled 28 eligible patients with 20 different solid tumors that had BRCA1/2 alterations between December 2019 and September 2021 across 19 clinical sites with most patients, about 89%, enrolled from community-based locations in the United States. The most common tumor type was non-small cell lung cancer accounting for 18% of cases. All patients were included in both the safety and efficacy analyses including three with HER2 negative breast cancer and somatic BRCA alterations. Of the 28 patients, nine had tumors with BRCA1 alterations, 16 had BRCA2 alterations and three had both BRCA1 and BRCA2 alterations. Additionally, 64% of patients had tumors with coalterations and at least one DNA damage repair gene. In the study, one patient achieved a complete response, nine patients had partial response and six patients had stable disease for at least 16 weeks. The overall disease control rate was 57% with an objective response of 36%. The study rejected the null hypothesis of a 15% disease control rate with high statistical significance with a p-value of less than 0.001. The median progression free survival was 24 weeks and median overall survival was 71 weeks. Interestingly, among the 19 patients who received prior platinum-based chemotherapy, 5, or about 26%, had a partial response and 4 had stable disease while on talazoparib. While platinum therapy exposure can be associated with BRCA reversion mutations, it is notable that these patients achieve stable disease with PARP inhibitor treatment. 46% of the 28 patients experienced grade 3 - 5 adverse events or serious adverse events that were possibly related to talazoparib. 14% of patients had possible drug related serious adverse events which included conditions such as anemia, neutropenia, leukopenia, nausea and vomiting. More severe grade 4 or 5 events included anemia, neutropenia, thrombocytopenia, leukopenia, hyponatremia, and increased level of the aspartate aminotransferase and bilirubin. In conclusion, this study demonstrates that talazoparib shows significant antitumor activity in patients with advanced solid tumors carrying both BRCA1 and BRCA2 mutations, even in cancers beyond those for which PARP inhibitors are currently FDA approved. The disease control and objective response rates indicate promising results in heavily pretreated patients who have no standard treatment options left. The findings suggest that PARP inhibitors like telazoparib could be effective in a broad range of cancers, including non-small cell lung cancer, mesothelioma and hepatocellular carcinoma where PARP inhibitors are not yet approved. This could pave the way for expanding the use of these drugs in precision oncology. While talazoparib showed efficacy, the study also reported a notable incidence of grade 3 to 5 adverse events, highlighting the need for careful management of side effects, particularly in heavily pretreated patients. The study calls for further research, particularly in randomized controlled trials to confirm the efficacy of talazoparib in other cancers beyond what is currently approved. It also suggests investigating the effect of DNA damage repair gene alterations and exploring combinations of PARP inhibitors with other targeted therapies. Additionally, further studies are needed to understand the potential differences in response between BRCA1 and BRCA2 mutations. Thank you for listening to JCO Precision Oncology Article Insights and please tune into the next topic. Don't forget to give us a rating and review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at www.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.      

Our DNA is made up of 3000 million letters of code. They make up genes within our DNA and are responsible for how cells in our body grow and multiply. But what happens when something in that code goes wrong? Welcome to another episode of That Cancer Conversation, a podcast from Cancer Research UK that brings together the science and the stories behind cancer. In this episode, Sophie will be looking at the human genome and explore how changes in our DNA can increase our risk of getting cancer. Prof Mike Stratton, former director of the Wellcome Sanger Institute and a pioneer in cancer genetics, helps unpack this question and tells us how he and his team persevered to find the second BRCA gene (BRCA2) and its mutation. It's been 30 years since the discovery of the first BRCA gene, BRCA1. Sophie sits down with Maria, her sister, Chrissy, and their mother, all who were tested positive for the BRCA2 gene mutation. They discuss their cancer stories and how the life-changing discovery of the BRCA genes has affected them as a family. Read more cancer stories on Cancer NewsYou can donate to Cancer Research UK here Hosted on Acast. See acast.com/privacy for more information.

Jessica Ordonez, certified genetic counselor and Medical Science Liaison at Myriad Genetics explains genetics' role in breast cancer and how the MyRisk® with RiskScore® tests can help you better understand your 5-year and lifetime risk. You'll learn what you need to know about different kinds of genetic factors, including the impact of changes in genes like BRCA1, BRCA2, CHEK2, and others. Uncover the fallacy that you aren't at risk if you don't have “the BRCA gene.” We'll also discuss how a genetic counselor can guide you if your results show a high lifetime risk. If you have a family history of cancer or are simply curious about your genetic health, this episode offers insights into genetic testing, risk factors, and empowering yourself with knowledge.For more resources, visit our website: SheMDpodcast.comFollow us across social media: @SheMDpodcastSponsor:Knowing your family's history of cancer is the first step to understanding your own cancer risk and may qualify you for the MyRisk Hereditary Cancer Test with RiskScore hereditary cancer test. It's easy, accurate and covered by most insurers. Learn more at GetMyRisk.com, https://myriad.ws/getmyriskIN THIS EPISODE: [1:06] Jessica describes the role of a genetic counselor and a medical science liaison[2:51] Discussion of genetic markers and BRCA1 and BRCA2 genes[13:41] The difference between gene mutations and variants of uncertain significance[23:16] Explanation of the CHEK2 gene[27:11] How would a genetic counselor counsel a woman whose genetic test comes back with a high lifetime riskRESOURCES:Myriad Genetics InstagramGet MyRisk WebsiteGUEST BIOGRAPHY: Jessica Ordonez is a certified genetic counselor and Medical Science Liaison at Myriad Genetics. She holds diplomate status with the American Board of Genetic Counseling and is an active member of the National Society of Genetic Counselors and the Florida Association of Genetic Counselors.Jessica completed her undergraduate and graduate studies at the University of Michigan, earning a Bachelor's in Cell & Molecular Biology and Spanish Literature and a Master's in Genetic Counseling. With over a decade of experience as a clinical genetic counselor, she has provided care in pediatric, adult, and cancer genetics clinics within academic and private hospital settings, focusing on Spanish-speaking patients.As a Medical Science Liaison, Jessica educates clinicians across Florida on hereditary cancer and reproductive genetics. She is involved in several company projects at Myriad, specifically leading a needs assessment for patient-facing Spanish resources to enhance inclusiveness and equity in care.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

“I see myself as an educator first and foremost,” said Bridget Oppong, MD, an OSUCCC-James surgical oncologist who specializes in breast cancer surgery at the Stefanie Spielman Comprehensive Breast Center and is also the deputy director of the James Center for Cancer Health Equity. In this episode, Oppong shares her wealth of knowledge about the importance of self-examinations and breast cancer screenings; advances in surgery, chemotherapy and immunotherapy; radiation; and outreach programs to underserved communities in Columbus and throughout Ohio. “Early detection is saving lives,” she said. “The five-year survival rate for early-stage breast cancer is over 90 percent … [and for women diagnosed with later-stage breast cancer that has metastasized] we can manage their breast cancer and they can still live a long life.” Self-examinations and annual mammogram screenings are the key to early detection. “I always advocate for self-examinations,” said Oppong, who described how often and what to look for during a self exam. “And if you notice anything different, bring it to medical attention immediately, to your primary-care physician or oncologist.” The recommended age for women to begin annual mammograms is 40. “But if you have a family history of breast cancers or any cancers at an early age, I recommend starting mammograms five to 10 years earlier,” Oppong said. “For example, if your sister was diagnosed with breast cancer at 35, I want you to get started at 30 at the latest.” The average age for diagnosis of breast cancer is about 60, but Oppong said more younger women are being diagnosed in recent years. She also explained the significance of the BRCA1 and BRCA2 (the breast cancer inherited mutations) and how having this mutation increases the breast-cancer risk and means starting mammograms earlier and adding MRIs for some patients. She also described how breast feeding can reduce a women's risk of developing breast cancer. As for treatment, “we have seen awesome advances in all three modalities: surgery, medical (such as chemotherapy and immunotherapy) and radiation,” Oppong said. She described some of the advances in surgery, including the nipple-sparing surgery she performs and how she works with plastic surgeons. Oppong is passionate about and determined to reach out to underserved communities. “The advancements are real and are amazing and our focus is to make sure that all women and men have equitable access to all levels of cancer care from screenings all the way through to survivorship.”

How are cancer, obesity, and diabetes linked? How do diet and lifestyle trump genetic factors in preventing cancer? Actress Angelina Jolie famously had both of her breasts removed in 2013 after finding that she carried the BRCA1 (breast cancer gene 1) mutation, which signals higher risk of breast cancer. “But that's a very crude way of treating the problem,” says Dr. Jason Fung, author of “The Cancer Code,” about the step taken by many women carrying BRCA1 or BRCA2 mutations. Physician and nephrologist (kidney health specialist) Dr. Fung is a leading voice on dietary means to counter chronic disease, including obesity, type 2 diabetes, and cancer. “You haven't targeted the [BRCA] gene ... [instead] you've gone back to the ... growth paradigm and simply cut off the entire tissue,” he says. Dr. Fung joins Vital Signs with Brendon Fallon to present a new lens to see cancer—beyond the “growth paradigm,”which views cancer as a disease of excessive growth, and the “genetic paradigm,” which focuses on cancer's genetic mutations. The new paradigm highlights environmental factors, including what we eat, over genetic factors in preventing and treating cancer. The obesity link to 13 different types of cancer bears testament to this. “And of course, obesity ... doesn't change your genes,” says Dr. Fung. “What it does is it provides that fertile soil for cancer to grow.” We reveal everyday factors that feed cancer and probe whether environment trumps genetics on the cancer risk front for “Cancer Code PART 2” on Vital Signs. ⭕️ Watch in-depth videos based on Truth & Tradition at Epoch TV

Send us a textCurious about how genetic testing can transform your health journey? Join us for a compelling conversation with Dahlia Attia-King, founder and CEO of Panacea, as we uncover the power of predictive genetic testing. Discover how advancements in genetic research, such as the BRCA1 and BRCA2 genes, are not only revolutionizing our understanding of risks for diseases like cancer and heart disease but also empowering individuals to make informed health decisions. We promise you'll walk away with a deeper insight into the role genetics plays in healthcare and the actionable steps you can take to harness this knowledge.Dahlia shares her inspiring journey from aspiring medical student to trailblazing healthcare innovator, revealing the personal motivations behind Panacea's mission to make genetic testing accessible and actionable. We'll explore the technical differences between direct-to-consumer and clinical genetic testing, with a spotlight on technologies like microarray and next-generation sequencing (NGS). Learn about the significant barriers to access, such as insurance coverage and physician hesitancy, and how Panacea is breaking down these obstacles to bring advanced genetic testing directly to the public.Our discussion is enriched with insights from expert genetic counselors, emphasizing the importance of comprehensive clinical guidance alongside genetic testing. We'll also delve into the critical aspects of data privacy, certifications like CLIA and CAP, and the importance of understanding genetic test results. This episode is a must-listen for anyone interested in the future of preventive healthcare, providing a holistic view of how genetic testing can be a powerful tool in managing and mitigating health risks.Panacea's Website: www.seekpanacea.comDiscount Code: DRNOSEWORTHY20You can listen to the Inflammation Nation podcast on Apple Spotify and all other major podcast platform You can also watch on YouTube. Check out my online store for self-learning/DIY programs for thyroid, gut health and detox. You can use this form to reach out and request an Initial ConsultationVisit my LabShop store to self-order the same tests I use with my one-on-one coaching clients. https://labs.rupahealth.com/store/storefront_3GMxe4pSOCIAL LINKSInstagramFacebookTikTok

Join us for an enlightening webinar with Dr. Allison DePersia, MD, a leading medical oncologist specializing in clinical cancer genetics at Endeavor Health's Mark R. Neaman Center for Personalized Medicine. Dr. DePersia, a valued member of the High Risk Breast team, brings her extensive expertise in hereditary cancer syndromes, cancer risk, and screening to this important discussion. In this webinar, Dr. DePersia will provide critical insights into: Key insights on hereditary cancer syndromes How genetics affect your risk for pancreatic cancer The genetic risk of melanoma BRCA2 and CDKN2A genes' broader implications Recommended screenings for those at risk This session is designed to empower you with knowledge and practical advice to help protect yourself and your family from cancer. Co-hosted by: Rolfe Pancreatic Cancer Foundation and Cancer Wellness Center. Disclaimer: The information provided in this webinar is for educational purposes only and should not be considered medical advice. For personalized medical guidance and to discuss your specific health concerns, please consult your healthcare provider.

We all know mitochondria is “the powerhouse of the cell” thanks to middle school science class, but when does that mean when we're talking about our overall health and longevity? In this episode, I dive into the fascinating world of mitochondrial health with Dr. Steven Gundry and Dr. Andrew Salzman. We discuss how optimizing mitochondrial function through diet, exercise, and light exposure can dramatically improve your health and energy levels. Plus, we explore the impacts of chronic inflammation, leaky gut, and environmental toxins on our mitochondria and overall well-being. View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman's Weekly Longevity Journal Full-length episodes of these interviews can be found here: 4 Non-Negotiables To Boost Energy And Optimize Your Mitochondria Sick And Tired Of Being Sick And Tired? How To Reclaim Your Energy How Supplementing With NMN Can Increase NAD levels, Energy, Reduce Inflammation, And Improve Insulin Resistance After a distinguished surgical career as a professor and chairman of cardiothoracic surgery at Loma Linda University, Dr. Gundry changed his focus to curing modern diseases via dietary changes. He is the author of New York Times bestseller The Plant Paradox, The Plant Paradox Cookbook, The Plant Paradox Quick & Easy,andThe Longevity Paradox,along with national bestsellersThe Plant Paradox Family Cookbook, The Energy Paradox,Dr. Gundry's DietEvolution,andUnlocking the Keto Code, and has had more than three hundred articles published in peer-reviewed journals on using diet and supplements to eliminate heart disease, diabetes, autoimmune disease, and multiple other diseases. He just released his latest book,Gut Check: Unleash the Power of Your Microbiome to Reverse Disease and Transform Your Mental, Physical, and Emotional Health. Dr. Andrew Salzman is a physician, inventor, professor, and biomedical entrepreneur. Dr. Salzman received his medical degree from Harvard University and has spent decades in drug discovery and development, raising over $165M in NIH grants for research. In addition to 50 patents, Dr. Salzman is credited with a breakthrough discovery in cellular DNA repair, which led to the world's first clinical application for successfully treating breast cancer caused by mutations in BRCA1 and BRCA2 genes. Millions of patients are benefiting from discoveries by Dr. Salzman in areas including mitochondrial health, gastrointestinal microbiota, damage caused by inflammation and oxidative stress to human cells and DNA, autoimmune disease, and cancer. This episode is brought to you by Pendulum, Cozy Earth, and SleepMe. Pendulum is offering listeners 20% off their first membership order at pendulumlife.com/farmacy. Discount applied at checkout. Right now, you can save 40% when you upgrade to Cozy Earth sheets. Just head over to CozyEarth.com. Customize your sleep with ChiliPad. Visit sleep.me/DRHYMAN and save up to $315 with code DRHYMAN. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this powerful episode, host Abigail sits down with Katrina Craiker, a stage 2B invasive ductal carcinoma breast cancer survivor. Katrina shares her journey of being diagnosed at just 27 years old, shortly after losing her mother-in-law to pancreatic cancer. She opens up about her initial symptoms, the challenging diagnostic process, and her treatment plan, which included chemotherapy, surgery, and radiation. Katrina also discusses her BRCA2 positive genetic mutation and the impact it had on her outlook for the future. This raw and honest conversation highlights the unique challenges young cancer survivors face and the importance of genetic testing in cancer treatment and prevention. Don't forget to rate and review the podcast on Spotify and Apple Podcasts, and follow us on Instagram at @canceractuallysuckspod for more inspiring content! To share your story in a future episode, email us at canceractuallysucks@gmail.com.

In today's episode, host, Laura Carfang speaks with breast cancer survivor Briana Rickertsen. Briana was diagnosed with invasive ductal carcinoma in July 2020 at age 35. She underwent chemotherapy, surgery, radiation, and additional treatments due to a HER2 positive tumor. Briana discovered she has a BRCA2 mutation, leading to further preventive measures, including ovary removal.Pre-Diagnosis, Briana was an active person, engaging in activities like yoga, cycling, hiking, and running.  During Treatment Briana used the Peloton app daily for mental health and physical activity, adapting her routine based on her energy levels and treatment schedule. Post-Treatment, Briana emphasizes the importance of movement in managing fatigue and overall well-being, advocating for small, consistent efforts.Timestamps: [00:03:23] Breast cancer diagnosis in 30s.[00:09:44] Bone health and treatment decisions.[00:11:45] Discussing fertility options during treatment.[00:14:17] Genetic testing and surprises.[00:19:01] Coping through daily exercise.[00:23:41] Exercise in cancer treatment.[00:25:18] The power of walking during treatment.[00:29:15] Exercise dosing in cancer treatment.[00:34:24] Strength training for beginners.[00:38:06] Lymphedema and strength training.[00:41:13] Weightlifting and health journey.[00:45:03] Finding joy in exercise.[00:45:53] Reframing approach to daily activities.Support the Show.

This week on the podcast, Dr Louise is joined by Dr Corinne Menn, a New York-based, board-certified OB-GYN and North American Menopause Society Certified Menopause Practitioner, with more than 20 years of experience caring for women. When she was 28, Corinne was diagnosed with breast cancer. Following her BRCA2+ diagnosis, she underwent multiple surgeries and chemotherapy then navigated pregnancy and menopause plus longer term survivorship issues. Corinne received support from the Young Survival Coalition, an organisation that advocates for women under 40 with breast cancer, and worked with her oncologists to manage her pregnancy, menopause and treatment options. She feels passionately that women who have or have had breast cancer receive individualised care and treatment for their cancer and menopause symptoms, and shares three tips to help with quality of life:    Do not minimise your menopausal symptoms, your hot flushes, your night sweats, sleep etc. So whether you use hormonal therapy or non-hormonal medications, make sure you get help and can sleep so you function better and breaking the vicious cycle of spiralling menopausal symptoms. Please do not neglect vaginal sexual health. Again, if you can preserve a little bit of that, it can stop a negative cycle of suffering, of urinary tract infections and relationship and intimacy issues. Scheduling time to have a separate appointment with your oncologist and your GYN. Come prepared. Listen to Louise's podcast. Listen to Menopause in Cancer podcast and Instagram page. Be empowered because you and your quality of life are worth it. You can follow Corinne on Instagram at @drmennobgyn Click here to find out more about Newson Health.  

Featuring perspectives from Dr Floor J Backes, Dr Mansoor Raza Mirza, Dr Ritu Salani, Dr Angeles Alvarez Secord and Dr Brian M Slomovitz, with cases presented by Dr Eric H Lee, Dr Priya Rudolph and Dr Lyndsay J Willmott, moderated by Dr Secord, including the following topics: Up-Front Treatment for Advanced Ovarian Cancer (OC) — Dr Salani Introduction (0:00) Case: A woman in her mid 60s with dementia who has peritoneal carcinomatosis with OC — Eric H Lee, MD, PhD (3:00) Case: A woman in her mid 40s with advanced OC undergoes immediate cytoreduction — Lyndsay J Willmott, MD (9:52) Current Management of Relapsed/Refractory (R/R) OC; Promising Novel Agents and Strategies Under Investigation — Dr Backes Case: A woman in her late 40s with a BRCA2 germline mutation and high-grade serous OC — Priya Rudolph, MD, PhD (26:44) Case: A woman in her mid 50s with platinum-sensitive recurrent OC who had not received a prior PARP inhibitor — Dr Willmott (33:35) First-Line Therapy for Advanced Endometrial Cancer (EC) — Dr Mirza Case: A woman in her early 60s diagnosed with endometrioid cancer presents with abdominal pain 2 years later — Dr Rudolph (49:44) Case: A woman in her early 70s with microsatellite instability-high, mismatch repair-deficient Stage IV carcinosarcoma — Dr Willmott (56:44) Current Therapeutic Options for R/R EC; Novel Investigational Strategies — Dr Slomovitz Case: A woman in her early 60s with a history of serous endometrial cancer (EC) presents with recurrent disease 2 years later — Dr Rudolph (1:12:44) Case: A woman in her late 70s with EC develops a cough 2 years after initial treatment — Dr Lee (1:19:50) Role of HER2-Targeted Therapy in the Management of Advanced OC, EC and Other Gynecologic Cancers — Dr Secord Case: A woman in her late 60s with endometrioid adenocarcinoma is admitted with abdominal distention — Dr Rudolph (1:34:55) Case: A woman in her mid 30s with mucinous adenocarcinoma of the ovary is later diagnosed with a liver metastasis — Dr Lee (1:41:02) CME information and select publications

Ms. Charité Ricker, MS, CGC and Dr. Nadine Tung, MD, FASCO share updates from the new ASCO guideline on selection of germline genetic testing panels in patients with cancer. They discuss highlights on family history collection, when and how multigene panel germline genetic testing should be used, which genes are generally recommended for testing, and how germline genetic testing interfaces with somatic genetic testing. Ms. Ricker and Dr. Tung also note the importance of the guideline and the impact of these new recommendations on clinicians and patients with cancer. Read the full guideline, “Selection of Germline Genetic Testing Panels in Patients with Cancer: ASCO Guideline” at www.asco.org/molecular-testing-and-biomarkers-guidelines. TRANSCRIPT GDL 24E13 This guideline, clinical tools, and resources are available at www.asco.org/molecular-testing-and-biomarkers-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO.24.00662  Brittany Harvey: Hello and welcome to the ASCO Guidelines Podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one at asco.org/podcasts My name is Brittany Harvey, and today I'm interviewing Dr. Nadine Tung, a medical oncologist from Beth Israel Deaconess Medical Center in Boston, and Ms. Charité Ricker, a cancer genetic counselor with the Norris Comprehensive Cancer Center at the University of Southern California and Los Angeles General Medical Center, co-chairs on, “Selection of Germline Genetic Testing Panels in Patients with Cancer: ASCO Guideline.” Thank you for being here, Ms. Ricker and Dr. Tung. Dr. Nadine Tung: Pleasure.  Ms. Charité Ricker: Thank you. Brittany Harvey: Then, before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Tung and Ms. Ricker, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes.   So then, to start us off first, Dr. Tung, could you provide us a broad overview of both the purpose and scope of this guideline? Dr. Nadine Tung: Sure. A main impetus for creating the guideline is that oncologists are increasingly being tasked with ordering genetic testing for hereditary cancer risk for their cancer patients. More and more now, they may find themselves sending the test and then seeking guidance from genetic experts to interpret the result. And these panels range from focused tests with just a few genes to comprehensive ones that include over 100 genes. So it can be very overwhelming for an oncologist to be able to understand ordering these tests and explaining them to their patients. So, we believe that it was important to offer some guidance and direction on the use of these multigene panels. Brittany Harvey: Thank you for setting the stage for this guideline and the recommendations that come from it.   So then, Ms. Ricker, this guideline addresses four overarching clinical questions. I'd like to review the recommendations based on each of those questions for our listeners. So starting with that first question, what is the importance of family history collection in the setting of germline multigene panel testing and which elements of family history are the most important? Ms. Charité Ricker: Thanks. As a genetic counselor, this is probably one of my favorite questions. I love the opportunity we have to sit with families and really dig into family history. But family history collection can be overwhelming and a big lift sometimes in busy clinics where genetics is not the focus. So, what we tried to do was to break down the key elements of what components of family history are most relevant to informing which test to do, and also the interpretation of those test results. And I like to think about the key pieces of family history as being the who, what, and when of somebody's family cancer history. Who was diagnosed with cancer within their close relatives? And usually we're most focused on first and second degree relatives. So parents, siblings, grandparents, aunts, and uncles. But sometimes relevant history might go into third degree relatives like cousins or more distant. So the who being who has cancer on both sides of the family? And then the what: what kind of cancer was it? Or where did that cancer begin? And the when: how old was that individual at the time they were diagnosed? Often we ask patients maybe not to fixate on the exact age, but to give us a sense. So was this somebody who was diagnosed young, in their 20s or 30s or older, in their 60s or 70s? Because that at least gives us a ballpark around what might be relevant for understanding the genes that should be included on somebody's test.  When we are thinking about the purpose of this history, as Dr. Tung said, often the range of multigene panels might be from a few very focused genes to a very broad panel. Family history can help us understand if we need to step beyond the very focused genes that might be relevant for the patient's history of cancer and include other genes that might be indicated based on that family history. So I think about the role that family history has at the time of identifying which test to do and then its role when interpreting what those results mean for the patient and their family. Again, Dr. Tung touched on the fact that we are often testing very large panels. However, we still don't know everything. And so a negative genetic test result does not mean that somebody does not have additional cancer risk. And family history becomes our kind of guiding star for understanding if there is still a need to change the cancer screening and prevention management for that individual and their family members. Brittany Harvey: Absolutely. Those are key points to understanding the important role of family history for each individual patient.  So then moving to the next clinical question, Dr. Tung, what does the panel recommend regarding when and how multigene panel germline testing should be used, when germline genetic testing is indicated? Dr. Nadine Tung: Well, anytime multiple genes need to be tested, as Ms. Ricker said, because of the patient's own personal cancer history, or their family history of cancer and close relatives, it's appropriate to consider a multi-gene panel. And in truth, we rarely ever just order one gene these days. Perhaps we do if there's a known gene like a BRCA gene in the family, and a relative just wants to know if they have that. But it's not all that common. And to be clear, as Ms. Ricker is going to cover a bit later, we are recommending that the appropriate minimal panel at least include the genes relevant to the patient's own cancer and the cancers in their relatives.  But it's worth thinking about what are some of the pros and cons of ordering genes beyond that, beyond the patient's own cancer or their relatives? Well, for pros, since a patient's awareness of their family history may be incomplete, testing for a larger number of cancer risk genes does ensure that significant pathogenic variants won't be overlooked. And sometimes, even if the family history is well known, pathogenic variants in important cancer risk genes can be found even when the family history would not have prompted testing for them. But it is important for clinicians to appreciate that bigger isn't necessarily better. Some larger panels may include genes for which management of pathogenic variants is not entirely clear and that can create anxiety or unnecessary screening. And if the clinician receiving the information is not well informed about the significance of the finding, that can lead to unnecessary treatment and sometimes even unnecessary surgeries.   And I'd add one final point that clinicians must have a system for communicating reclassification of these variants, the ones with uncertain significance that we call VUS. Because as the number of genes tested increases, so does the likelihood of encountering these VUS. So I would say those are some of the main points about when to use the panel and when to think about larger or smaller panels. Brittany Harvey: Yes, I appreciate you reviewing both the pros and cons of expanding the genes included in multi-gene panel testing and the importance of variants of uncertain significance.   So then Dr. Tung just touched on this, but speaking of minimal panels and which genes should be included, Ms. Ricker, what are the recommendations on which genes are generally recommended for germline genetic testing? Ms. Charité Ricker: I think this is one of the harder questions that our group took on as we were working on this guideline. I don't think there is a one size fits all and one easy answer to this question. However, we chose to approach it by selecting the more common solid tumors that oncologists see in their clinics and the ones where the role of genetic testing is most well defined, as well as some very rare tumors where they're kind of easy. So we know that all individuals with certain types of cancers, even though they are rare, should merit genetic testing regardless of age of diagnosis, family history.  And so as we approached it, and I really appreciate ASCO's support in helping us develop some tools and tables that hopefully will be important aids for clinicians who are trying to make these decisions, we took the approach of, as Dr. Tung mentioned, selecting kind of a minimal set of recommended genes where most individuals who are informed in this area would agree that if nothing else was done, these genes should be done, but then also acknowledged that there is an expanding understanding about the impact of certain genes on cancer risk, and so then also provided a kind of a next level if somebody wanted to be more expansive, what we would recommend less strongly, but would be reasonable to consider. Then I think the other last piece that the committee felt was important to acknowledge is that given how common, in comparison to some of these genetic conditions that we work with, pathogenic variants in BRCA1 and BRCA2 can be, and also the important clinical impact of those genes along with the genes associated with Lynch syndrome, we felt that those were important to think about in the setting of all cancer patients. So if you're approaching a panel and thinking about what genes to include, looking at that kind of minimally recommended based on the patient's personal and family history, maybe the next level, which might include some additional genes that we have included in kind of the less strongly recommended category for those tumor types. And then consideration of the BRCA1 and 2 genes and genes associated with lynch syndrome, if they weren't already encapsulated by your other personal and family history considerations. Brittany Harvey: Definitely. This was a big lift for the panel to tackle, and the tools and tables that you mentioned are all available online with the publication in the Journal of Clinical Oncology. So listeners who are looking for more specifics on that can definitely refer to those tools and tables there.  Dr. Tung, the last clinical question: which patient should be offered germline genetic testing, who will have or who have previously had somatic genetic testing? Dr. Nadine Tung: Identifying which genes identified through the tumor testing should trigger germline testing is really important for assessing our patients' future risk of cancer and their relatives. So during the development of our guidelines, the ASCO expert panel became aware that the ESMO Precision Medicine Working group had updated their recommendations for this topic, namely germline testing in response to tumor test findings. And these recommendations were based on the Memorial Sloan Kettering IMPACT registry, which consists of nearly 50,000 tumors and paired germline testing. Given the sheer volume of that data and the methods that ESMO used, our group decided to use that as a framework to develop our recommendations. The ASCO guideline provides a list of genes that, if found in the tumor, a pathogenic variant in those genes may prompt germline testing.  And we offered or proposed two different approaches. The first approach, which is broad and perhaps simplest, involves doing germline testing if a pathogenic variant is found in any of the genes listed. But then we offer a conservative approach to test the germline for all highly actionable genes, like BRCA1 and 2, or lynch genes that are found in a tumor, but for less actionable genes, testing the germline only if the pathogenic variant is found in a tumor relevant to that gene. So, for example, ATM, if found in breast cancer or pancreatic cancer, would trigger germline testing with this approach, but not if found in lung cancer, whereas with the permissive first approach, you would simply test the germline if any pathogenic variant is found in any of the genes on the list. This latter, more conservative approach, while less sensitive for identifying every germline pathogenic variant, increases the likelihood that a pathogenic variant found in the tumor will actually be germline. That approach considers the limited resources available, such as genetic counselors, and respects trying not to overwhelm a system already stressed. Brittany Harvey: Thank you for reviewing both of those approaches and to you both for discussing all of the recommendations included in this guideline.   Finally, to wrap us up, in your view, Ms. Ricker, what is the importance of this guideline and how will it impact both clinicians and patients with cancer? Ms. Charité Ricker: I hope that this guideline can open the door for more expansive and appropriate utilization of germline genetic testing. For me, I think about, from both the clinical and patient side, for example, all ovarian cancer patients have had a recommendation for germline genetic testing for many years. Nonetheless, data from multiple research studies has shown us that ovarian cancer patients still are not being tested universally, and this has important implications for their treatment plans and for their family members. And so even in the setting where genetic testing, if I can use the phrase, has been simple in that it didn't require family history, it didn't require even a specific age criteria, it was just broad, testing is not utilized as much as it should be, and then you step into the world of more complex decision making around genetic testing for other tumor types. And so we hope that this provides a framework to simplify that decision making process for providers to increase appropriate utilization.   And then from the patient perspective, I also think about the lack of access of genetic testing in underrepresented communities and minoritized patient populations where there's many barriers that patients face in accessing genetic services. And so if we can help reduce the barriers for this piece of the genetic testing process, my hope is that that opens up better avenues for access to testing, not just for patients with certain tumor types, but for all patients from all communities and backgrounds. Brittany Harvey: Yes, those are key points. We hope that this guideline helps all patients access the appropriate testing to better inform their cancer prevention and treatment.  So I want to thank you both so much for your work on this comprehensive guideline on germline genetic testing and all of the work that you put into it. And thank you for your time today. Ms. Ricker and Dr. Tung,  Dr. Nadine Tung: Thank you. Ms. Charité Ricker: It was a pleasure to be here. Thank you. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines Podcast. To read the full guideline, go to www.asco.org/molecular-testing-and-biomarkers-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.    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.

Jaclyn Chung of San Diego is a licensed marriage & family therapist who was diagnosed at 33 with breast cancer and the BRCA2 gene. In this episode, Jaclyn reads her essay “The Aftermath: Facing Lymphedema” from the 2021 “Grief & Acceptance” issue of Wildfire. Jaclyn's piece is about dealing with the effects of lymphedema resulting from cancer treatment. April and Jaclyn will talk about the evolving stages of acceptance and grief, update on Jaclyn's lymphedema journey, lymphedema and pregnancy, and holding both reality and hope at the same time. They will also discuss what Jaclyn's biggest challenge has been in her survivorship currently, and what role writing plays in her survivorship today. Connect with Jaclyn: https://www.jaclynchung.com/https://www.instagram.com/sumnercatherine/Purchase the “Grief & Acceptance” issue here: https://www.wildfirecommunity.org/shop/p/mbc23If you liked this episode, you might like this one too:Writing Stories in Lymphedema with Desi Maldonadohttps://player.captivate.fm/episode/0cc3a053-d550-4ed1-97ea-b0f4d687c3f4Buy the Wildfire book Igniting the Fire Within: Stories of Healing, Hope & Humor, Inside Today's Young Breast Cancer Community: https://www.amazon.com/dp/B0BJVJ629F?ref_=pe_3052080_397514860Get the free Wildfire “Hot Flashes” email newsletter: https://www.wildfirecommunity.org/newsletter?rq=newsletterLearn about Wildfire writing workshops: https://www.wildfirecommunity.org/workshopsShop Wildfire merch & more: https://www.wildfirecommunity.org/shop*Free* Get Wildfire and The Burn freebies here: https://www.wildfirecommunity.org/freeMore about Wildfire Magazine: https://www.wildfirecommunity.orghttps://www.instagram.com/wildfire_bc_magazine/https://www.facebook.com/wildfirecommunityInformation on submitting your story for consideration to be published in Wildfire Magazine: https://www.wildfirecommunity.org/submissions

BUFFALO, NY- June 5, 2024 – A new research paper was published in Oncotarget's Volume 15 on June 3, 2024, entitled, “Synergistic cytotoxicity of histone deacetylase and poly-ADP ribose polymerase inhibitors and decitabine in pancreatic cancer cells: Implications for novel therapy.” Histone deacetylase inhibitors (HDACi) can modulate the acetylation status of proteins, influencing the genomic instability exhibited by cancer cells. Poly (ADP ribose) polymerase (PARP) inhibitors (PARPi) have a direct effect on protein poly (ADP-ribosyl)ation, which is important for DNA repair. Decitabine is a nucleoside cytidine analogue, which when phosphorylated gets incorporated into the growing DNA strand, inhibiting methylation and inducing DNA damage by inactivating and trapping DNA methyltransferase on the DNA, thereby activating transcriptionally silenced DNA loci. In this new study, researchers Benigno C. Valdez, Apostolia M. Tsimberidou, Bin Yuan, Yago Nieto, Mehmet A. Baysal, Abhijit Chakraborty, Clark R. Andersen, and Borje S. Andersson from The University of Texas MD Anderson Cancer Center explored various combinations of HDACi and PARPi +/− decitabine (hypomethylating agent) in pancreatic cancer cell lines BxPC-3 and PL45 (wild-type BRCA1 and BRCA2) and Capan-1 (mutated BRCA2). “[...] we explored various combinations of HDACis and PARPis, with or without decitabine, in pancreatic cancer cell lines.” The combination of HDACi (panobinostat or vorinostat) with PARPi (talazoparib or olaparib) resulted in synergistic cytotoxicity in all cell lines tested. The addition of decitabine further increased the synergistic cytotoxicity noted with HDACi and PARPi, triggering apoptosis (evidenced by increased cleavage of caspase 3 and PARP1). The 3-drug combination treatments (vorinostat, talazoparib, and decitabine; vorinostat, olaparib, and decitabine; panobinostat, talazoparib, and decitabine; panobinostat, olaparib, and decitabine) induced more DNA damage (increased phosphorylation of histone 2AX) than the individual drugs and impaired the DNA repair pathways (decreased levels of ATM, BRCA1, and ATRX proteins). The 3-drug combinations also altered the epigenetic regulation of gene expression (NuRD complex subunits, reduced levels). “This is the first study to demonstrate synergistic interactions between the aforementioned agents in pancreatic cancer cell lines and provides preclinical data to design individualized therapeutic approaches with the potential to improve pancreatic cancer treatment outcomes.” DOI - https://doi.org/10.18632/oncotarget.28588 Correspondence to - Apostolia M. Tsimberidou - atsimber@mdanderson.org Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28588 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

This is Real Talk, a podcast conversation where we're digging deep into breast cancer and the realities patients and survivors face every day. We're talking openly and honestly about just how difficult breast cancer can be, from being diagnosed to selecting the right treatment plan, to living day to day with metastatic breast cancer, and life after treatment ends. In today's episode, we're learning how a BRCA2 gene mutation has affected a family–both directly and indirectly. It is my pleasure to welcome Nikki, her mom, Anita, and her sister, Kim, to the conversation. Nikki is a three-time cancer survivor, and the only one in your family who has had cancer. Nikki was diagnosed the first time with uterine cancer at the age of 31, and six years later, diagnosed with breast cancer and underwent genetic testing. That's when she learned she had inherited a BRCA2 genetic mutation, increasing the risk of cancers.

GDP Script/ Top Stories for Mar 29th       Publish Date:  Mar 29th           From the Ingles Studio Welcome to the Gwinnett Daily Post Podcast. Today is Friday, March 29th and Happy heavenly Birthday to MLB HOF Cy Young. ***03.29.24 – BIRTHDAY – CY YOUNG*** I'm Bruce Jenkins and here are your top stories presented by Curiosity Lab Bike Race. Two Teens Arrested After Illegal Street Race In Gwinnett Corps of Engineers raising fees at its Lake Lanier parks and boat launches Singleton Road Residents Getting Their Own Pocket Park, Greenway Trail All of this and more is coming up on the Gwinnett Daily Post podcast, and if you are looking for community news, we encourage you to listen daily and subscribe! Break 1: CURIOSITY LAB BIKE RACE   STORY 1: Two Teens Arrested After Illegal Street Race In Gwinnett Two teens were arrested for fleeing from an illegal street racing event in Gwinnett, striking patrol cars in the process. John Anthony Pritchett, 19, faces multiple charges including aggravated assault, kidnapping, and possession of firearms during felonies. Dryan Dradarius Vereen, 18, faces obstruction charges. The incident occurred on March 23, with officers responding to gunshots and people fleeing the scene. Pritchett's stolen Dodge Charger collided with a patrol car, leading to a chase and eventual crash. Firearms were found in the vehicle, reported stolen from DeKalb County. Two female passengers claimed they were unable to exit the vehicle. Fortunately, no officers were injured. STORY 2: Corps of Engineers raising fees at its Lake Lanier parks, boat launches The U.S. Army Corps of Engineers' Mobile District announced a fee increase for using corps-run parks and boat ramps at Lake Lanier. Day use and boat launching fees will rise from $5 to $8 this summer. This adjustment aims to sustain recreational facilities' quality and is part of a broader initiative across all USACE-managed properties. The increase applies specifically to corps-run facilities and excludes those managed by other entities like the Georgia Department of Natural Resources. While the fee hike was approved last year, its implementation was postponed to aid local communities recovering from the pandemic's economic impact. The Corps assures visitors of continued commitment to quality recreation and facility maintenance, inviting inquiries about the fee adjustment. STORY 3: Singleton Road Residents Getting Their Own Pocket Park, Greenway Trail Gwinnett County officials are addressing a lack of nearby recreational options for residents near Indian Trail-Lilburn Road by breaking ground on Singleton Park and a greenway trail. The park, funded by various sources including sales tax funds and grants, aims to provide accessible green space and play amenities. Expected to open in late 2025, it will feature a playground, restroom, and picnic areas. The three-quarter-mile greenway trail will connect Singleton and Dickens Roads, eventually linking to Bryson Park as part of the county's broader greenway trails plan. While promoting walkability, officials also highlight accessibility via public transit. Residents anticipate the park's convenience and benefits, particularly for families in the area lacking outdoor play options.   We have opportunities for sponsors to get great engagement on these shows. Call 770.874.3200 for more info. We'll be right back   Break 2: TOM WAGES   STORY 4: Bill banning puberty blockers for minors languishes alongside other culture war measures During the 2024 Legislative session, two bills concerning transgender issues failed to pass the Georgia House. The bills aimed to restrict transgender children's access to sports teams, restrooms, and puberty-blocking drugs. Despite passing the Senate, the House did not vote on these measures. The bills reflected broader cultural divides, with Republicans supporting them and Democrats opposing. House Speaker Jon Burns emphasized the importance of timing and prioritization in addressing social issues. Proponents of the bills, like Sen. Ben Watson, argued that banning puberty blockers would prevent irreversible decisions for minors. However, opponents, including transgender advocates, highlighted the positive impact of such treatments on mental health and identity affirmation. Another bill addressing student athletes' mental health was also stalled, leaving room for potential reconsideration in future sessions. STORY 5: Immigration crackdown, election law changes go to the governor as other hot-button proposals fizzle The 2024 Legislative session concluded with a flurry of activity, including the failure of several contentious bills. Despite passing the Senate, bills banning puberty blockers for minors and legalizing sports betting did not receive House approval. The last-minute session also saw the passage of bills related to road renaming and property tax relief. However, controversial measures such as an election overhaul and immigration enforcement bills were approved. Additionally, a proposal for a statue honoring Justice Clarence Thomas and efforts to protect the Okefenokee Swamp from mining faced setbacks. While the session ended without certain bills progressing, discussions on key issues, such as Medicaid expansion and environmental protection, are expected to continue.   We'll be back in a moment   Break 3: INGLES 10 – HENRY CO SHERIFFS OFFICE     STORY 6: Targeting immune cells offers hope for preventing breast cancer Researchers at Cambridge University have identified a new pathway for preventing breast cancer by targeting immune cell exhaustion in healthy women with BRCA1 or BRCA2 gene mutations. These mutations increase the risk of breast and ovarian cancer. The study found that immune cells in breast tissue of these women show signs of malfunction, unable to clear out damaged cells that could develop into cancer. This discovery could lead to using existing immunotherapy drugs as early intervention to prevent breast cancer, offering an alternative to risk-reducing surgery. The research, published in Nature Genetics, suggests a potential preventative treatment accessible to all women.   STORY 7: Scientists bust myth that eggs are bad for your heart A new study debunks the myth that eggs are bad for heart health, suggesting concerns about cholesterol levels are unnecessary. The PROSPERITY trial involved 140 patients with or at risk for cardiovascular disease who consumed 12 or more fortified eggs weekly. Results showed no adverse effects on blood cholesterol, with reductions in LDL cholesterol and other heart health markers observed in the fortified egg group. Researchers emphasize that eggs' bad reputation may stem from confusion about egg yolk cholesterol and suggest examining overall dietary habits. They encourage heart disease patients to discuss heart-healthy diets with their doctors.   We'll have final thoughts after this.   Break 4: ATL HEALTH FAIR   Signoff – Thanks again for hanging out with us on today's Gwinnett Daily Post podcast. If you enjoy these shows, we encourage you to check out our other offerings, like the Cherokee Tribune Ledger Podcast, the Marietta Daily Journal, the Community Podcast for Rockdale Newton and Morgan Counties, or the Paulding County News Podcast. Read more about all our stories and get other great content at Gwinnettdailypost.com. Did you know over 50% of Americans listen to podcasts weekly? Giving you important news about our community and telling great stories are what we do. Make sure you join us for our next episode and be sure to share this podcast on social media with your friends and family. Add us to your Alexa Flash Briefing or your Google Home Briefing and be sure to like, follow, and subscribe wherever you get your podcasts. Produced by the BG Podcast Network   Show Sponsors: ingles-markets.com wagesfuneralhome.com henrycountysheriffga.gov gcpsk12.org/about-us/careers acc.org/ATLHealthFair   #NewsPodcast #CurrentEvents #TopHeadlines #BreakingNews #PodcastDiscussion #PodcastNews #InDepthAnalysis #NewsAnalysis #PodcastTrending #WorldNews #LocalNews #GlobalNews #PodcastInsights #NewsBrief #PodcastUpdate #NewsRoundup #WeeklyNews #DailyNews #PodcastInterviews #HotTopics #PodcastOpinions #InvestigativeJournalism #BehindTheHeadlines #PodcastMedia #NewsStories #PodcastReports #JournalismMatters #PodcastPerspectives #NewsCommentary #PodcastListeners #NewsPodcastCommunity #NewsSource #PodcastCuration #WorldAffairs #PodcastUpdates #AudioNews #PodcastJournalism #EmergingStories #NewsFlash #PodcastConversationsSee omnystudio.com/listener for privacy information.

Knowing your family's medical history is important and can save lives. “When we think of family history in terms of cancer genetics [and inherited genetic mutations], we think about a broad spectrum of relatives, more than just your parents and siblings,” said Leigha Senter, MS, CGC, a James licensed genetic counselor. “We ask about grandparents and aunts and uncles and cousins and that can inform us about how likely you have a hereditary predisposition for cancer.” Ohio State and the James have one of the largest and most advanced genetic counseling programs in the country. “We have 12 genetic counselors on the faculty supporting the cancer program and we have genetic counselors who specialize in specific types of cancer,” Senter said. In this episode, Senter discusses the two most common types of inherited genetic mutations that increase the cancer risk: the Breast Cancer gene (BRCA1 and BRCA2) that increases the risk of breast cancer as well as ovarian, pancreas and prostate cancer; and Lynch Syndrome, which increases the risk of colorectal cancer as well as uterine cancer. “The average woman has a 12 percent chance over the course of their lifetime of developing breast cancer,” Senter said. “Those with [BRCA1 and BRCA2] have anywhere from a 50 to 80 percent chance.” Uncovering inherited genetic mutations leads to earlier and more frequent screenings that can detect cancer in its earliest and most treatable stages. In the case of patients with Lynch Syndrome, earlier and more frequent colonoscopies “can actually prevent a cancer from happening,” Senter said. Cascade testing is one of Senter's specialties. “Someone in every family is always the first to test positive for an inherited genetic mutation,” she said. “The next step is to help them share this information with as many family members as possible. This is cascade testing and is where are real potential to help people is.”

BUFFALO, NY- February 28, 2024 – A new #research paper was #published in Oncotarget's Volume 15 on February 22, 2024, entitled, “Prevalence and spectrum of germline BRCA1 and BRCA2 in a cohort of ovarian cancer patients from the Salento peninsula (Southern Italy): a matter of preventive health.” In this new exploratory and descriptive study, researchers Elisabetta De Matteis, Maria Rosaria Tumolo, Paolo Tarantino, Mariangela Ciccarese, Tiziana Grassi, Francesco Bagordo, Maria Rita De Giorgio, Emanuele Rizzo, and Graziana Ronzino from Vito Fazzi Hospital, University of Salento, Strategic Regional Agency for Health and Social of Puglia, and University of Bari Aldo Moro aimed to characterize the deleterious BRCA1 and BRCA2 variants evaluated by genetic testing in a group of Ovarian cancer patients living in the Salento peninsula (Southern Italy). From June 2014 to July 2023, patients with histologically confirmed high-grade serous carcinoma, fallopian tube, or primary peritoneal cancer who were referred to Lecce Familial Cancer Clinic were considered. BRCA-mutation genetic testing was performed on these patients. Socio-demographic data and cancer epidemiology were assessed, and Next Generation Sequencing and Sanger DNA sequencing were performed. The median age at the diagnosis of 332 ovarian cancer patients collected was 57 years. The pedigree analyses showed that 28.6% had familial cases and 39.7% had sporadic cases. Of the 319 patients submitted to genetic testing, 29.8% were carriers of BRCA1/2 mutation, 75.8% at BRCA1 and 24.2% at BRCA2 gene. Of the 21 BRCA1 mutations, the variant c.5266dupC was the most frequent alteration (28.4%). With respect to BRCA2, 13 mutations were found and the variant c.9676delT was the most frequently recorded (6.3%). “This study reveals that the prevalence of germline mutations in the BRCA1 and BRCA2 genes was higher than reported by other studies. A broader understanding of the prevalence and role of BRCA mutations in development, response to treatment, and prognosis represents an exciting and developing area of ovarian cancer treatment and prevention.” DOI - https://doi.org/10.18632/oncotarget.28561 Correspondence to - Maria Rosaria Tumolo - mariarosaria.tumolo@unisalento.it Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28561 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, ovarian cancer, BRCA1, BRCA2, mutation About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh Media Contact MEDIA@IMPACTJOURNALS.COM 18009220957

Hereditary breast cancer is a significant concern, with BRCA1 and BRCA2 mutations accounting for many inherited breast cancer cases. However, a 2018 survey by ACCC revealed the underutilization of BRCA testing, showcasing a significant gap in care. In this podcast, Joy Larsen Haidle, Genetic Counselor at North Memorial Health Cancer Center in Robbinsdale, Minnesota, and Lillie Shockney, University Distinguished Service Professor of Breast Cancer, Professor of Surgery at Johns Hopkins University School of Medicine in Baltimore, Maryland, delve into the topic of BRCA mutation testing within breast cancer care, highlighting care gaps and opportunities for improvement that were identified in the 2023 ACCC BRCA Testing Reassessment Survey.      “There are treatments that are specific for women who carry a BRCA1 or BRCA2 gene that have metastatic disease. So, by not testing them, they are not receiving the benefit of specific drugs that have been developed, that only work, for BRCA1 and BRCA2 gene mutation carriers who have advanced disease.” Lillie Shockney, RN, BS, MAS, HON- ONN-CG     “In the past 4 years in particular, the ability for patients to reach out and see a genetic counselor via telehealth has rapidly improved access for providers across the country.” Joy Larsen Haidle, MS, LCGC   Joy Larsen Haidle, MS, LCGC Genetic Counselor North Memorial Health Cancer Center Robbinsdale, MN    Lillie D Shockney, RN., BS., MAS, HON- ONN-CG University Distinguished Service Professor of Breast Cancer, Professor of Surgery Johns Hopkins University School of Medicine Baltimore, MD   Resources:   2021 ACCC Presentation on Genetic Counseling Rates at ASCO ACCC 2018 Survey Summary Report

When faced with the shadows of hereditary cancer, Elizabeth Olson, a certified life coach, steps into the light with unwavering courage, sharing the deeply personal account of her BRCA2 journey. This episode takes you through the highs and lows of Elizabeth's story, as she opens up about confronting her genetic destiny after her mother's early diagnosis with breast cancer. Her tale is one of incredible resilience and the profound impact of genetic testing. It's an intimate exploration of the emotional path one must navigate when deciding on preventative surgeries, such as a double mastectomy, and the subsequent journey through reconstruction—a path marked by both emotional and physical transformations.This conversation extends beyond just one woman's story—it's a call to awareness about the importance of early screening and genetic testing, especially as breast cancer diagnoses in younger women are on the rise. Elizabeth's narrative, infused with both the gravity and grace of her experiences, is a source of inspiration and information for listeners navigating their own health journeys. It's a heartfelt reminder of the strength found in vulnerability and the empowerment that comes from informed choices. Join us as we share Elizabeth's ongoing saga, one that she promises to revisit with us, offering updates that are sure to enlighten and inspire.Connect with Elizabeth: IG: @__elizabetholson__Email: eo.abundantlifeco@gmail.comWebsite: https://www.abundantlifeco.co/Blog: https://www.abundantlifeco.co/blog-1For more information on BRCA Testing please visit: https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheetConnect with Leslie: Follow on IG: @yourjoyfulorderstyle Email: lmartinez@yourjoyfulorder.com to schedule- Speaking Events, Interviews or Life Coaching Sessions Shop my Journal (Gratitude, Goals & Prayer Journal) on Amazon:https://a.co/d/09Djvaw Read Blog Here: https://www.yourjoyfulorder.com/blog/

Drs. Neeraj Agarwal and Jeanny Aragon-Ching discuss several key abstracts to be presented at the 2024 ASCO GU Cancers Symposium, including sequencing versus upfront combination therapies for mCRPC in the BRCAAway study, updates on the CheckMate-9ER and CheckMate-214 trials in ccRCC, and a compelling real-world retrospective study in mUC of patients with FGFR2 and FGFR3 mutations. TRANSCRIPT Dr. Neeraj Agarwal: Hello, everyone, and welcome to the ASCO Daily News Podcast. I'm Dr. Neeraj Agarwal, your guest host of the podcast today. I am the director of the Genitourinary Oncology Program and a professor of medicine at the University of Utah's Huntsman Cancer Institute, and editor-in-chief of ASCO Daily News. I am delighted to welcome Dr. Jeanny Aragon-Ching, a genitourinary oncologist and the clinical program director of Genitourinary Cancers at the Inova Schar Cancer Institute in Virginia. Today, we will be discussing key posters and oral abstracts that will be featured at the 2024 ASCO Genitourinary Cancer Symposium, which is celebrating 20 years of evolution in GU oncology this year.  You will find our full disclosures in the transcript of this podcast, and disclosures of all guests on the podcast at asco.org/DNpod.  Jeanny, it's great to have you on the podcast today to highlight some key abstracts for our listeners ahead of the GU meeting. Dr. Jeanny Aragon-Ching: Thank you so much, Neeraj. It's an honor to be here. Dr. Neeraj Agarwal: Jeanny, as you know, this year we are celebrating the 20th anniversary of the ASCO GU Cancers Symposium, and judging from this year's abstracts, it's clear that this meeting continues to play a major role in advancing GU cancer research. Dr. Jeanny Aragon-Ching: Indeed, Neeraj. This year's abstracts reflect the important strides we have made in GU cancers. So, let's start with the prostate cancer abstracts. What is your takeaway from Abstract 19 on BRCAAway, which will be presented by Dr. Maha Hussein, and of which you are a co-author? As our listeners know, several PARP inhibitor combinations with second-generation androgen receptor pathway inhibitors, or ARPIs, have recently been approved as first-line treatment for patients with metastatic castrate-resistant prostate cancer, or metastatic CRPC, and the question of sequencing PARP inhibitors and ARPIs instead of combining them has emerged. From that perspective, the results of the BRCAAway trial are very important. Can you tell us a little bit more about this abstract, Neeraj?  Dr. Neeraj Agarwal: I totally agree with you, Jeanny. The BRCAAway study attempts to answer the crucial questions regarding sequencing versus upfront combination of therapies in the mCRPC setting. It is a phase 2 trial of abiraterone versus olaparib versus abiraterone with olaparib in patients with mCRPC harboring homologous recombination repair mutations. Enrolled patients had mCRPC disease and no prior exposure to PARP inhibitors or ARPIs or chemotherapy in the mCRPC setting and had BRCA1 or BRCA2 or ATM mutations. As previously mentioned, these patients were randomized to 3 arms: abiraterone monotherapy at 1000 milligrams once daily, or olaparib monotherapy at 300 milligrams twice daily, or the combination of abiraterone and olaparib. The primary endpoint was progression-free survival per RECIST 1.1 or Prostate Cancer Working Group 3-based criteria or clinical assessment or death, so, whichever occurred first was deemed to be progression.   Secondary endpoints included measurable disease response rates, PSA response rate, and toxicity. This was a relatively small trial with 21 patients in the combination arm, 19 patients in the abiraterone monotherapy arm, and 21 patients in the olaparib monotherapy arm. It should be noted that 26% of patients had received docetaxel chemotherapy in the hormone-sensitive setting, and only 3% of patients had any prior exposure to an ARPI, and these were darolutamide or enzalutamide or in the non-metastatic CRPC setting.  The results are very interesting. The median progression-free survival was 39 months in the combination arm, while it was 8.4 months in the abiraterone arm and 14 months in the olaparib arm. An important finding that I would like to highlight is that crossover was also allowed in the monotherapy arms. Of the 19 patients receiving abiraterone, 8 crossed over to receive olaparib, and of the 21 patients receiving olaparib, 8 crossed over to the abiraterone arm. The median PFS from randomization was 16 months in both groups of patients who received abiraterone followed by olaparib or those who received olaparib followed by abiraterone. This is striking when compared to 39 months in patients who started therapy with the combination therapy of abiraterone with olaparib. Dr. Jeanny Aragon-Ching: Thank you so much for that wonderful summary, Neeraj. So the key message from this abstract is that combining olaparib and abiraterone upfront seems to be associated with improvement in PFS compared to just sequencing those agents. Dr. Neeraj Agarwal: Exactly, Jeanny. I would like to add that these results are even more important given that in real-world practice, only half of the patients with mCRPC receive a second-line treatment. Based on these results, upfront intensification with a combination of an ARPI plus a PARP inhibitor in the first-line mCRPC setting seems to have superior efficacy compared to sequencing of these agents. Dr. Jeanny Aragon-Ching: Thank you so much. Now, moving on to a different setting in prostate cancer, there were a couple of abstracts assessing transperineal biopsy compared to the conventional transrectal biopsy for the detection of prostate cancer. So let's start with Abstract 261. Neeraj, can you tell us a little bit more about this abstract? Dr. Neeraj Agarwal: Sure, Jeanny. So, in Abstract 261 titled "Randomized Trial of Transperineal versus Transrectal Prostate Biopsy to Prevent Infection Complications," Dr. Jim Hugh and colleagues led a multicenter randomized trial comparing these 2 approaches, so, transperineal biopsy without antibiotic prophylaxis with transrectal biopsy with targeted prophylaxis in patients with suspected prostate cancer. The primary outcome was post-biopsy infection. Among the 567 participants included in the intention-to-treat analysis, no infection was reported with the transperineal approach, while 4 were detected with the transrectal approach, with a p-value of 0.059. The rates of other complications, such as urinary retention and significant bleeding, were very low and similar in both groups. The investigators also found that detection of clinically significant cancer was similar between the 2 techniques and concluded that the transperineal approach is more likely to reduce the risk of infection without antibiotic prophylaxis. Dr. Jeanny Aragon-Ching: So the key takeaway from this abstract sounds like office-based transperineal biopsy is well-tolerated and does not compromise cancer detection, along with better antibiotic stewardship and health care cost benefits.  Moving on to Abstract 273, also comparing these two approaches, what would be your key takeaway message, Neeraj?  Dr. Neeraj Agarwal: In this Abstract 273, titled "Difference in High-Risk Prostate Cancer Detection between Transrectal and Transperineal Approaches," Dr. Semko and colleagues found that the transperineal biopsy based on MRI fusion techniques was also characterized by a higher possibility of detecting high-risk prostate cancer and other risk factors as well, such as perineural and lymphovascular invasion or the presence of cribriform pattern, compared to the conventional transrectal method. Dr. Jeanny Aragon-Ching: Thank you, Neeraj. So we can see that the transperineal approach is gaining more importance and could be associated with more benefits compared to the conventional methods.   Let's now switch gears to kidney cancer, Neeraj. Dr. Neeraj Agarwal: Sure, Jeanny. Let's start by highlighting Abstract 361, which discusses patient-reported outcomes of the LITESPARK-005 study. So what can you tell us about this abstract, Jeanny?  Dr. Jeanny Aragon-Ching: Thank you, Neeraj. So as a reminder to our listeners, based on the LITESPARK-005 trial, it was a Phase 3 trial looking at belzutifan, which is an inhibitor of hypoxia inducible factor 2 alpha or I'll just call HIF-2 alpha for short, was very recently approved by the FDA as a second-line treatment option for patients with advanced or metastatic clear cell renal cell carcinoma after prior progression on immune checkpoint and antiangiogenic therapies. The title of Abstract 361 is "Belzutifan versus Everolimus in Patients with Previously Treated Advanced RCC: Patient-Reported Outcomes in the Phase 3 LITESPARK-005 Study," and this will be presented by Dr. Tom Pells at the meeting. At a median follow-up of 25.7 months, the median duration of treatment with belzutifan was 7.6 months, while it was only 3.9 months with everolimus. At the time of data cutoff date for the second interim analysis, 22.6% of patients remained on belzutifan while only 5% remained on everolimus. In the quality of life questionnaires, the time of deterioration to various quality of life scores, as assessed by standardized scales, was significantly longer in patients randomized to the belzutifan arm compared to those in the everolimus arm. Also, patients in the everolimus arm had worse physical functioning scores. Dr. Neeraj Agarwal: Yes, Jeanny. In addition to the improved outcomes associated with belzutifan, patient-reported outcomes indicate better disease-specific symptoms and better quality of life among patients treated with belzutifan compared to everolimus. This is great news for patients with advanced renal cell carcinoma.  Now, Jeanny, can you please tell us about the two abstracts that reported longer follow-up of CheckMate 9ER and CheckMate 214 trials in untreated patients with advanced or metastatic renal cell carcinoma? Dr. Jeanny Aragon-Ching: Yes, Neeraj. So you are referring to Abstracts 362 and 363. Let's start with Abstract 362. This abstract reports the results after a median follow-up of 55 months in the CheckMate 9ER trial, comparing the combination of nivolumab and cabozantinib to sunitinib in patients with advanced RCC without any prior treatment, so first-line therapy. The primary endpoint was PFS per RECIST 1.1 as assessed by an independent central review. So there were key secondary outcomes including overall survival (OS), objective response rates, and safety. Consistent with prior analysis at a median follow-up time of 18.1 and 44 months, the combination of nivolumab and cabozantinib at a median follow up of 55.6 months continues to show a significant reduction in the risk of progression or death by 42% and in the risk of death by 23% compared to sunitinib.  Dr. Neeraj Agarwal: And Jeanny, what can you tell us about the efficacy results of this combination by IMDC risk categories? Dr. Jeanny Aragon-Ching: Similar to prior results in patients with intermediate to poor risk IMDC risk category, the combination treatment maintained significant efficacy and reduced the risk of progression or death by 44% and the risk of death by 27%. To put it simply, the update now shows a 15-month improvement in overall survival with the cabozantinib-nivolumab combination compared to sunitinib, which is amazing. Also, in patients with favorable IMDC risk group, which represented truly a small number of patients in the trial, there was a strong trend for improvement of outcomes as well. I would like to point out that no new safety concerns were identified. Dr. Neeraj Agarwal: So, it looks like the key message from this abstract is that with longer follow-up, the combination of nivolumab and cabozantinib maintains a meaningful long-term efficacy benefit over sunitinib, supporting its use for newly diagnosed patients with advanced or metastatic renal cell carcinoma.   Let's move on to Abstract 363, which compares nivolumab with ipilimumab to sunitinib in first-line advanced renal cell carcinoma. What would you like to tell us about this abstract, Jeanny? Dr. Jeanny Aragon-Ching: Yes, Neeraj. The title of this abstract is "Nivolumab plus Ipilimumab versus Sunitinib for the First-Line Treatment of Advanced RCC: Long-Term Follow-Up Data from the Phase 3 CheckMate 214 Trial." In this abstract, Dr. Tannir and colleagues report outcomes with the longest median follow-up in first-line advanced RCC setting for any clinical trial. So the median follow-up now is about 18 months. The primary endpoints were OS, PFS, and objective response rates, as assessed by an independent review according to RECIST 1.1 criteria in the intermediate to poor risk IMDC risk group, which is the intent-to-treat (ITT) analysis, while secondary outcomes included the same outcomes in the ITT population of patients. Although the progression-free survival was similar in both arms, the combination of nivolumab-ipilimumab reduced the risk of death by 28% compared to sunitinib in the ITT population of patients. When stratifying the results by IMDC risk groups, the combination arm of nivolumab-ipilimumab showed significant improvement in the intermediate to poor risk group, but there was no difference in the favorable risk group. But in the study, no new safety signals were identified. Dr. Neeraj Agarwal: Thank you, Jeanny, for such a comprehensive description of the results of these two studies. I'd like to add that the median overall survival of patients with metastatic renal cell carcinoma in the ITT population in the CheckMate 214 trial has now reached 53 months, which would have been unimaginable just a decade ago. This is wonderful news for our patients. So the key takeaway from these two abstracts would be that immune checkpoint inhibitor-based combinations remain the backbone of first-line advanced renal cell carcinoma treatment.  Dr. Jeanny Aragon-Ching: Absolutely, Neeraj. This is wonderful news for all of our patients, especially for those who are being treated for first-line therapy.  Now, let's move on to the bladder cancer abstracts. We have two exciting abstracts from the UNITE database. What are your insights on Abstract 537, titled "Outcomes in Patients with Advanced Urethral Carcinoma Treated with Enfortumab Vedotin After Switch-Maintenance of Avelumab in the UNITE Study"? Dr. Neeraj Agarwal: As our listeners know, enfortumab vedotin is an antibody-drug conjugate that binds to a protein called Nectin 4 expressed on bladder cancer cells. In this abstract, Dr. Amanda Nizam and colleagues describe outcomes in 49 patients receiving third-line enfortumab vedotin after prior progression on platinum-based therapy and maintenance avelumab. At a median follow-up of 8.5 months, the median progression-free survival was 7 months and the median overall survival was 13.3 months with enfortumab vedotin in this treatment-refractory setting, the objective response rates were 54%. The message of this study is that enfortumab vedotin is an effective salvage therapy regimen for those patients who have already progressed on earlier lines of therapies, including platinum-based and immunotherapy regimens. Dr. Jeanny Aragon-Ching: Thank you, Neeraj, for that comprehensive review.  I want to focus on another patient population in the UNITE database, which is the use of fibroblast growth factor receptor (FGFR) alterations. Can you tell us more about the sequencing now of erdafitinib and enfortumab vedotin in these patients with metastatic urothelial cancer, as discussed in Abstract 616? Dr. Neeraj Agarwal: Sure, Jeanny. As a reminder, erdafitinib is a fibroblast growth factor receptor kinase inhibitor approved for patients with locally advanced or metastatic urothelial carcinoma harboring FGFR2 or FGFR3 alterations after progression on platinum-based chemotherapy. However, the optimal sequencing of therapies in these patients is unclear, especially with enfortumab vedotin being approved in the salvage therapy setting and now in the frontline therapy setting.  So in this retrospective study, all patients with metastatic urothelial carcinoma had FGFR2 or FGFR3 alterations. Dr. Cindy Jiang and colleagues report outcomes in 24 patients receiving enfortumab vedotin after erdafitinib, 15 patients receiving erdafitinib after enfortumab vedotin, and 55 patients receiving enfortumab vedotin only. This is a multicenter national study. Interestingly, patients receiving both agents had a longer overall survival in a multivariate analysis, regardless of the treatment sequencing, than patients receiving enfortumab vedotin alone or only with a hazard ratio of 0.52. The objective response rate of enfortumab vedotin in the enfortumab vedotin monotherapy arm was 49%. When these agents were sequenced, the objective response with enfortumab vedotin was 32% after erdafitinib and 67% when used before erdafitinib. Dr. Jeanny Aragon-Ching: Thank you so much, Neeraj. I think these are important real-world data results, but I would like to point out that larger and prospective studies are still needed to confirm these findings, especially regarding the outcome of erdafitinib after enfortumab vedotin, particularly when the latter is used in the first-line setting. Dr. Neeraj Agarwal: I totally agree, Jeanny. Now, let's discuss some abstracts related to disparities in the management of patients with genitourinary cancers.  Dr. Jeanny Aragon-Ching: Sure, actually, I would like to discuss 2 abstracts related to disparities in patients with prostate cancer. So the first one, Abstract 265, titled "Patient-Provider Rurality and Outcomes in Older Men with Prostate Cancer." In this study, Dr. Stabellini, Dr. Guha and the team used a SEER Medicare-linked database that included more than 75,000 patients with prostate cancer. The primary outcome was all-cause mortality, with secondary outcomes included prostate cancer-specific mortality. The investigators showed that the all-cause mortality risk was 44% higher in patients with prostate cancer from rural areas who had a provider from a non-metropolitan area compared to those who were in a metropolitan area and had a provider also from a metropolitan area. Dr. Neeraj Agarwal: Those are very important data and highlight the healthcare disparities among the rural population with prostate cancer that still exist.  So what is your key takeaway from Abstract 267, titled "Rural-Urban Disparities in Prostate Cancer Survival," which is a population-based study? Dr. Jeanny Aragon-Ching: Of course. This abstract discusses, actually, a very similar issue regarding access to healthcare among rural versus urban patients. In this study, Dr. Hu and Hashibe and colleagues and team at the Huntsman Cancer Institute assessed all-cause death and prostate cancer-related death risk in a retrospective study in which patients with prostate cancer based on rural versus urban residencies looked at 18,000 patients diagnosed with prostate cancer between 2004 and 2017. 15% lived in rural counties. Similar to the prior abstract we talked about, patients living in rural areas had about a 19% higher risk of all-cause mortality and a 21% higher risk of prostate cancer-specific mortality in comparison to patients living in urban areas. Dr. Neeraj Agarwal: So Jeanny, we can say that both of these abstracts, led by different groups of investigators, highlight that patients with prostate cancer living in rural areas have inferior survival outcomes compared to those living in urban areas, and it is time to focus on the disparities experienced by the rural population with prostate cancer.  Dr. Jeanny Aragon-Ching: Yeah, absolutely Neeraj. I concur with your thoughts.  So, any final thoughts before we wrap up the podcast today? Dr. Neeraj Agarwal: Yes, before concluding, Jeanny, I want to express my gratitude for your participation and the valuable insights you have shared today. Your contributions are always appreciated, and I sincerely thank you for taking the time to join us today.   As we bring this podcast to a close, I would like to highlight the significant advances happening in the treatment of patients with genitourinary cancers during our upcoming 2024 ASCO GU meeting. Many studies featuring practice-impacting data will be presented by investigators from around the globe. I encourage our listeners to not only participate at this event to celebrate these achievements, but to also play a role in disseminating these cutting-edge findings to practitioners worldwide. By doing so, we can collectively maximize the benefit for patients around the world.  And thank you to our listeners for joining us today. You will find links to the abstracts 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 very much.  Disclaimer: The purpose of this podcast is to educate and inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guest speakers express their own opinions, experience, and conclusions. Guest statements on the podcast do not necessarily reflect the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  Find out more about today's speakers:     Dr. Neeraj Agarwal  @neerajaiims  Dr. Jeanny Aragon-Ching    Follow ASCO on social media:     @ASCO on Twitter     ASCO on Facebook     ASCO on LinkedIn       Disclosures:      Dr. Neeraj Agarwal:       Consulting or Advisory Role: Pfizer, Bristol-Myers Squibb, AstraZeneca, Nektar, Lilly, Bayer, Pharmacyclics, Foundation Medicine, Astellas Pharma, Lilly, Exelixis, AstraZeneca, Pfizer, Merck, Novartis, Eisai, Seattle Genetics, EMD Serono, Janssen Oncology, AVEO, Calithera Biosciences, MEI Pharma, Genentech, Astellas Pharma, Foundation Medicine, and Gilead Sciences    Research Funding (Institution): Bayer, Bristol-Myers Squibb, Takeda, Pfizer, Exelixis, Amgen, AstraZeneca, Calithera Biosciences, Celldex, Eisai, Genentech, Immunomedics, Janssen, Merck, Lilly, Nektar, ORIC Pharmaceuticals, Crispr Therapeutics, Arvinas     Dr. Jeanny Aragon-Ching:    Honoraria: Bristol-Myers Squibb, EMD Serono, Astellas Scientific and Medical Affairs Inc., Pfizer/EMD Serono  Consulting or Advisory Role: Algeta/Bayer, Dendreon, AstraZeneca, Janssen Biotech, Sanofi, EMD Serono, MedImmune, Bayer, Merck, Seattle Genetics, Pfizer, Immunomedics, Amgen, AVEO, Pfizer/Myovant, Exelixis,   Speakers' Bureau: Astellas Pharma, Janssen-Ortho, Bristol-Myers Squibb, Astellas/Seattle Genetics. 

Ripped from the pages of the popular Wildfire Magazine anthology, Igniting the Fire Within, we've curated this special mini podcast for you. Each Friday, hear a new bite-sized episode. Featuring “just the stories” from the book read by the authors. Think of this as your dynamic audiobook version of Igniting the Fire Within. Enjoy! This episode features April Stearns reading “Don't Call Me a Survivor” by Brooke Perry.In memory of Brooke Perry. Diagnosed at Diagnosed at 30. IDC, Stage IV de novo, ER+, PR+, BRCA2+.Buy the Wildfire book Igniting the Fire Within: Stories of Healing, Hope & Humor, Inside Today's Young Breast Cancer Community: https://www.amazon.com/dp/B0BJVJ629F?ref_=pe_3052080_397514860https://player.captivate.fm/episode/2f68419c-85ec-4ce0-8a11-3d9b903f431aGet the free Wildfire email newsletter: https://www.wildfirecommunity.orgLearn about Wildfire writing workshops: https://www.wildfirecommunity.org/workshopsShop Wildfire merch & more: https://www.wildfirecommunity.org/shopSend your voice recording testimonial to editor@wildfirecommunity.org*Free* Get Wildfire and The Burn freebies here: https://www.wildfirecommunity.org/freeFollow Wildfire Magazine:https://www.instagram.com/wildfire_bc_magazine/https://www.facebook.com/wildfirecommunity

KSQD 11-08-2023: Go to Santa Cruz Cancer Benefit group (sccbg.org) for Pancreatic Cancer information and awareness event in Santa Cruz on Nov. 19; The physiology of the pancreas; Prognosis for pancreatic cancer is poor; Genetic mutations, smoking, obesity and diabetes are major risk factors; The difficulties of early or any diagnosis of pancreatic cancer; Jaundice is an indicator, but only one out of 5 have the cancer; Lab tests are not very predictive, but circulating tumor DNA holds hope for detection; Can shingles vaccination help prevent dementia?More about genetic influences such as Brca1, Brca2 and KRAS genes; Can shingles vaccination help prevent dementia?

"I spent my whole childhood obsessing over really wanting boobs. And now, at 38, these two things that I've had a pretty tumultuous relationship with... Once we finally learned to get along, we find ourselves back on shaky ground, and dare I say, breaking up for good?" It's been about a month since we last caught up. Now, I'm back, walking [messily] through my emotions as I get ready for my double mastectomy surgery on Monday, July 3. I have some updates since that last chat, including the surprising results of my genetic testing (BRCA2 positive, which brought up a whole bunch of feelings), my hopes and plans for the Ali on the Run Show while I'm recovering, and what I'm afraid of right now (everything?). And from the bottom of my very full, very grateful, very overwhelmed heart, thank youfor the support and kindness. I've been completely floored by the contributions to the GoFundMe, and I will spend the rest of my entire life in gratitude. We've got this. SPONSOR: New Balance. Click here to shop New Balance's latest releases for the season. (The SuperComp Trainer is my favorite shoe!) Follow Ali: Instagram @aliontherun1 Join the Facebook group Twitter @aliontherun1 Support on Patreon Subscribe to the newsletter SUPPORT the Ali on the Run Show! If you're enjoying the show, please subscribe and leave a rating and review on Apple Podcasts. Spread the run love. And if you liked this episode, share it with your friends!

This episode is brought to you by Rupa Health, BiOptimizers, Mitopure, and AquaTru.⁣⁣NAD has been popping up everywhere, and for good reason. It's a fundamental driver of our health and longevity, and we're now learning how boosting NAD levels might offset and improve the effects of aging. On today's episode, I'm excited to talk to Dr. Andrew Salzman all about NAD—how it is a key component involved in mitochondrial production, and is a critical substrate for several enzymes, including sirtuins, which play key roles in healthy aging, weight management, metabolic syndrome, and metabolism.Dr. Salzman is a physician, inventor, professor, and biomedical entrepreneur. Dr. Salzman received his medical degree from Harvard University and has spent decades in drug discovery and development, raising over $165M in NIH grants for research. In addition to 50 patents, Dr. Salzman is credited with a breakthrough discovery in cellular DNA repair, which led to the world's first clinical application for successfully treating breast cancer caused by mutations in BRCA1 and BRCA2 genes. Millions of patients are benefiting from discoveries by Dr. Salzman in areas including mitochondrial health, gastrointestinal microbiota, damage caused by inflammation and oxidative stress to human cells and DNA, autoimmune disease, and cancer.This episode is brought to you by Rupa Health, BiOptimizers, Mitopure, and AquaTru.Rupa Health is a place where Functional Medicine practitioners can access more than 3,000 specialty lab tests from over 35 labs. You can check out a free, live demo with a Q&A or create an account a RupaHealth.com.BiOptimizers is offering my listeners 10% off Sleep Breakthrough. If you buy two or more you'll get a free bottle of Magnesium Breakthrough. This is a limited-time offer. Go to sleepbreakthrough.com/hyman and use the code hyman10. Get 10% off Mitopure at timelinenutrition.com/drhyman and use code DRHYMAN10 at checkout.Right now, my podcast listeners can access the AquaTru water filter for as low as $249. That's $100 off the normal price. All you have to do is go to drhyman.com/filter, and you can get this special, exclusive price.Here are more details from our interview (audio version / Apple Subscriber version):How NAD helps us produce energy (5:00 / 3:04) The science behind how NAD impacts health and longevity (10:08 / 8:15) The role NAD plays in maintaining health (16:27 / 13:26) NAD's multiple functions (23:46 / 21:18) Preserving NAD levels (30:34 / 27:47) Where NAD is made in the body (34:53 / 30:35) How NAD benefits sleep (41:17 / 37:04) Do NMN and NAD cause cancer? (47:12 / 42:57) Research on NMN in humans (50:23 / 46:07) The difference between NMN and NR (1:00:54 / 51:55) Learn more about Wonderfeel Youngr NMN. Hosted on Acast. See acast.com/privacy for more information.