Podcasts about Carcinoma

Dr. Fiorinda Muhaj discusses the management of low-risk BCC.

This DermSurgery Digest bonus content aptly named “At the Microscope” shares the latest research and techniques in dermatopathology. In this episode, contributors review Endocrine Mucin ProducingSweat Gland Carcinoma (EMPSGC). Contributors to this podcast include Naomi Lawrence, MD, Dermatologic Surgery Digital Content Editor; Ashley Elsensohn, MD, MPH, DermSurgery Digest at the Microscope co-host; Christine Ahn, MD; Jeff Gardner, MD; Marina K. Ibraheim, MD; and Michael P. Lee, MD. Articles featured in this episode include:  ·        “TRPS1 Expression in Endocrine Mucin-Producing Sweat Gland Carcinoma: Diagnostic Utility and Pitfalls” The American Journal of Dermatopathology·        “Utility of Insulinoma-Associated Protein 1 (INSM1) and Mucin 2 (MUC2) Immunohistochemistry in the Distinction of Endocrine Mucin-Producing Sweat Gland Carcinoma From Morphologic Mimics” The American Journal of Dermatopathology·        “Endocrine Mucin-Producing Sweat Gland Carcinoma: Emerging Evidence of Multicentric Cutaneous Origin and Occasional Concurrence With Analogous Breast Tumors” The American Journal of Dermatopathology·        “An Update on Endocrine Mucin-producing Sweat Gland Carcinoma” The American Journal of Surgical Pathology  Your feedback is encouraged. Please contact communicationstaff@asds.net.

Beth Lehman went through a tumultuous year in 2020.  Thanks to heavy drinking, she was diagnosed with cirrhosis, then basal cell carcinoma, a type of skin cancer, followed by hepatocellular carcinoma, a form of liver cancer.  She underwent radioactive embolization in order to get a liver transplant.  Beth said the two-hour operation wasn't so tough, but the after-effects were difficult, including nausea and vomiting.  Then she experienced a procedure to get rid of the skin cancer on her right temple.  She says between her physical and emotional recovery, she advocates for cancer patients and is happier than ever.   Beth's alcohol consumption had soared to four or five bottles of wine a day.  In 2020, she began to have a buildup of fluid in her stomach, known as ascites.  For a long time, she avoided consulting a doctor, suspecting a doctor would tell her to quit drinking; but when ascites asserted itself, she sought medical attention.  She was diagnosed with cirrhosis.  Upon further examination, five tumors were discovered in her liver, which led to a diagnosis of hepatocellular carcinoma, a form of liver cancer.   This diagnosis came after another diagnosis of basal cell carcinoma, but the skin cancer had to take back seat to the liver cancer.   Beth said her care team first had to determine whether the cancer had spread beyond her liver.  Thankfully, it hadn't.  In order to complete a liver transplant, doctors wanted to execute radioactive embolization, in which radiation beads would be injected into her arteries through her wrist or groin and targeted at the tumors.  However, for that to happen, the tumors had to be 2cm, but her largest tumor was 1.87cm.  Incredibly, Beth's care team told her to go home and let the tumors grow so they would be large enough for it to go through with the radioactive embolization.   Once the tumors grew, Beth went through the procedure, also known as Y-90.  She had to go through the procedure a second time.  Usually, a second procedure comes eight to twelve weeks after the first procedure.  Beth's second procedure came just four weeks later.  She said she was awake during each procedure, each lasted about two hours, but the toughest part was post-treatment, as she had a great amount of radiation in her body, so much that upon returning home, she had to be sequestered from her husband and her pet cats. Once she recovered from her liver transplant, she had her skin cancer treated.  She said her doctors had to go seven layers deep to get all the cancer, but they did such an outstanding job that her incision is not visible.   Beth Lehman once had a lucrative IT position, but these days she works as an advocate for cancer patients, especially liver cancer patients and says she is happier than ever.   Additional Resources:   Support Groups:   The American Liver Foundation https://www.liverfoundation.org   Beth's Nonprofit, The Liver Circle https://www.thelivercircle.org   Beth's Personal Page with Her Story: https://www.bethlehmanliver.com          

JCO PO author Dr. Foldi at UPMC Hillman Cancer Center and University of Pittsburgh School of Medicine shares insights into the JCO PO article, "Personalized Circulating Tumor DNA Testing for Detection of Progression and Treatment Response Monitoring in Patients With Metastatic Invasive Lobular Carcinoma of the Breast." Host Dr. Rafeh Naqash and Dr. Foldi discuss how serial ctDNA testing in patients with mILC is feasible and may enable personalized surveillance and real-time therapeutic monitoring. TRANSCRIPT Dr. Rafeh Naqash: Hello, and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I am your host, Dr. Rafeh Naqash, podcast editor for JCO Precision Oncology and Associate Professor at the OU Health Stephenson Cancer Center at the University of Oklahoma. Today, we are thrilled to be joined by Dr. Julia Foldi, Assistant Professor of Medicine in the Division of Hematology-Oncology at University of Pittsburgh School of Medicine and the Magee-Womens Hospital of the UPMC. She is also the lead and corresponding author of the JCO Precision Oncology article entitled "Personalized Circulating Tumor DNA Testing for Detection of Progression and Treatment Response Monitoring in Patients with Metastatic Invasive Lobular Carcinoma of the Breast." At the time of this recording, our guest's disclosures will be linked in the transcript. Julia, welcome to our podcast, and thank you for joining us today. Dr. Julia Foldi: Thank you so much for having me. It is a pleasure. Dr. Rafeh Naqash: Again, your manuscript and project address a few interesting things, so we will start with the basics, since we have a broad audience that comprises trainees, community oncologists, and obviously precision medicine experts as well. So, let us start with invasive lobular breast carcinoma. I have been out of fellowship for several years now, and I do not know much about invasive lobular carcinoma. Could you tell us what it is, what some of the genomic characteristics are, why it is different, and why it is important to have a different way to understand disease biology and track disease status with this type of breast cancer? Dr. Julia Foldi: Yes, thank you for that question. It is really important to frame this study. So, lobular breast cancers, which we shorten to ILC, are the second most common histologic subtype of breast cancer after ductal breast cancers. ILC makes up about 10 to 15 percent of all breast cancers, so it is relatively rare, but in the big scheme of things, because breast cancer is so common, this represents actually over 40,000 new diagnoses a year in the US of lobular breast cancers. What is unique about ILC is it is characterized by loss of an adhesion molecule, E-cadherin. It is encoded by the CDH1 gene. What it does is these tumors tend to form discohesive, single-file patterns and infiltrate into the tumor stroma, as opposed to ductal cancers, which generally form more cohesive masses. As we generally explain to patients, ductal cancers tend to form lumps, while lobular cancers often are not palpable because they infiltrate into the stroma. This creates several challenges, particularly when it comes to imaging. In the diagnostic setting, we know that mammograms and ultrasounds have less sensitivity to detect lobular versus ductal breast cancer. When it comes to the metastatic setting, conventional imaging techniques like CT scans have less sensitivity to detect lobular lesions often. One other unique characteristic of ILC is that these tumors tend to have lower proliferation rates. Because our glucose-based PET scans depend on glucose uptake of proliferating cells, often these tumors also are not avid on conventional FDG-PET scans. It is a challenge for us to monitor these patients as they go through treatment. If you think about the metastatic setting, we start a new treatment, we image people every three to four cycles, about every three months, and we combine the imaging results with clinical assessment and tumor markers to decide if the treatment is working. But if your imaging is not reliable, sometimes even at diagnosis, to really detect these tumors, then really, how are we following these patients? This is really the unique challenge in the metastatic setting in patients with lobular breast cancer: we cannot rely on the imaging to tell if patients are responding to treatment. This is where liquid biopsies are really, really important, and as the field is growing up and we have better and better technologies, lobular breast cancer is going to be a field where they are going to play an important role. Dr. Rafeh Naqash: Thank you for that easy-to-understand background. The second aspect that I would like to have some context on, to help the audience understand why you did what you did, is ctDNA, tumor informed and non-informed. Could you tell us what these subtypes of liquid biopsies are and why you chose a tumor informed assay for your study? Dr. Julia Foldi: Yes, it is really important to understand these differences. As you mentioned, there are two main platforms for liquid biopsy assays, circulating tumor DNA assays. I think what is more commonly used in the metastatic setting are non-tumor informed assays, or agnostic assays. These are generally next-generation sequencing-based assays that a lot of companies offer, like Guardant, Tempus, Caris, and FoundationOne. These do not require tumor tissue; they just require a blood sample, a plasma sample, essentially. The next-generation sequencing is done on cell-free DNA that is extracted from the plasma, and it is looking for any cell-free DNA and essentially, figuring out what part of the cell-free DNA comes from the tumor is done through a bioinformatics approach. Most of these assays are panel tests for cancer-associated mutations that we know either have therapeutic significance or biologic significance. So, the results we receive from these tests generally read out specific mutations in oncogenic genes, or sometimes things like fusions where we have specific targeted drugs. Some of the newer assays can also read out tumor fraction; for example, the newest generation Guardant assay that is methylation-based, they can also quantify tumor fraction. But the disadvantage of the tumor agnostic approach is that it is a little bit less sensitive. Opposed to that, we have our tumor informed tests, and these require tumor tissue. Essentially, the tumor is sequenced; this can either be whole exome or whole genome sequencing. The newer generation assays are now using whole genome sequencing of the tumor tissue, and a personalized, patient-specific panel of alterations is essentially barcoded on that tumor tissue. This can be either structural variants or it can be mutations, but generally, these are not driver mutations, but sort of things that are present in the tumor tissue that tend to stay unchanged over time. For each particular patient, a personalized assay, if you want to call it a fingerprint or barcode, is created, and then that is what then is used to test the plasma sample. Essentially, you are looking for that specific cancer in the blood, that barcode or fingerprint in the blood. Because of this, this is a much more sensitive way of looking for ctDNA, and obviously, this detects only that particular tumor that was sequenced originally. So, it is much more sensitive and specific to that tumor that was sequenced. You can argue for both approaches in different settings. We use them in different settings because they give us different information. The tumor agnostic approach gives us mutations, which can be used to determine what the next best therapy to use is, while the tumor informed assay is more sensitive, but it is not going to give us information on therapeutic targets. However, it is quantified, and we can follow it over time to see how it changes. We think that it is going to tell us how patients respond to treatment because we see our circulating tumor DNA levels rise and fall as the cancer burden increases or decreases. We decided to use the tumor informed approach in this particular study because we were really interested in how to determine if patients are having response to treatment versus if they are going to progress on their treatment, more so than looking for specific mutations. Dr. Rafeh Naqash: When you think about these tumor informed assays and you think about barcoding the mutations on the original tumor that you try to track or follow in subsequent blood samples, plasma samples, in your experience, if you have done it in non-lobular cancers, do you think shedding from the tumor has something to do with what you capture or how much you capture? Dr. Julia Foldi: Absolutely. I think there are multiple factors that go into whether someone has detectable ctDNA or not, and that has to do with the type of cancer, the location, right, where is the metastatic site? This is something that we do not fully understand yet: what are tumors that shed more versus not? There is also clearance of ctDNA, and so how fast that clearance occurs is also something that will affect what you can detect in the blood. ctDNA is very short-lived, only has a half-life of hours, and so you can imagine that if there is little shedding and a lot of excretion, then you are not going to be detecting a lot of it. In general, in the metastatic setting, we see that we can detect ctDNA in a lot of cases, especially when patients are progressing on treatment, because we imagine their tumor burden is higher at that point. Even with the non-tumor informed assays, we detect a lot of ctDNA. Part of this study was to actually assess: what is the proportion of patients where we can have this information? Because if we are only going to be able to detect ctDNA in less than 50 percent of patients, then it is not going to be a useful method to follow them with. Because this field is new and we have not been using a lot of tumor informed assays in the metastatic setting, we did not really know what to expect when we set out to look at this. We did not know what was going to be the baseline detection rate in this patient population, so that was one of the first things that we wanted to answer. Dr. Rafeh Naqash: Excellent. Now going to this manuscript in particular, what was the research question, what was the patient population, and what was the strategy that you used to investigate some of these questions? Dr. Julia Foldi: So, we partnered with Natera, and the reason was that their Signatera tumor-informed assay was the first personalized, tumor-informed, really an MRD assay, minimal residual disease detection assay. It has been around the longest and has been pretty widely used commercially already, even though some of our data is still lacking. but we know that people are using this in the real world. We wanted to gather some real-world data specifically in lobular patients. So, we asked Natera to look at their database of commercial Signatera testing and look for patients with stage 4 lobular breast cancer. The information all comes from the submitting physicians sending in pathologic reports and clinical notes, and so they have that information from the requisitions essentially that are sent in by the ordering physician. We found 66 patients who were on first-line or close to first-line endocrine-based therapies for their metastatic lobular breast cancer and had serial collections of Signatera tests. The way we defined baseline was that the first Signatera had to be sent within three months of starting treatment. So, it is not truly baseline, but again, this is a limitation of looking at real-world data is that you are not always going to get the best time point that you need. We had over 350 samples from those 66 patients, again longitudinal ctDNA samples, and our first question was what is the baseline detection rate using this tumor informed assay? Then, most importantly, what is the concordance between changes in ctDNA and clinical response to treatment? That is defined by essentially radiologic response to treatment. Dr. Rafeh Naqash: Interesting. So, what were some of your observations in terms of ctDNA dynamics, whether baseline levels made a difference, whether subsequent levels at different time points made a difference, or subsequent levels at, let us say, cycle three made a difference? Were there any specific trends that you saw? Dr. Julia Foldi: So, first, at baseline, 95 percent of patients had detectable ctDNA, which is, I think, a really important data point because it tells us that this can be a really useful test. If we can detect it in almost all patients before they start treatment, we are going to be able to follow this longitudinally. And again, these were not true baseline samples. So, I think if we look really at baseline before starting treatment, almost all patients will have detectable ctDNA in the metastatic setting. The second important thing we saw was that disease progression correlated very well with increase in ctDNA. So, in most patients who had disease progression by imaging, we saw increase in ctDNA. Conversely, in most patients who had clinical benefit from their treatment, so they had a response or stable disease, we saw decrease in ctDNA levels. It seems that what we call molecular response based on ctDNA is tracking very nicely along with the radiographic response. So, those were really the two main observations. Again, this is a small cohort, limited by its real-world nature and the time points that ctDNA assay was sent was obviously not mandated. This is a real-world data set, and so we could not really look at specific time points like you asked about, let us say, cycle three of therapy, right? We did not have all of the right time points for all of the patients. But what we were able to do was to graph out some specific patient scenarios to illustrate how changes in ctDNA correlate with imaging response. I can talk a little bit about that. Dr. Rafeh Naqash: That was going to be my question. Did you see patients who had serial monitoring using the tumor informed ctDNA assay where the assay became positive a few months before the imaging? Did you have any of those kinds of observations? Dr. Julia Foldi: Yes, so I think this is where the field is going: are we able to use this technology to maybe detect progression before it becomes clinically apparent? Of course, there are lots of questions about: does that really matter? But it seems like, based on some of the patient scenarios that we present in the paper, that this testing can do that. So, we had a specific scenario, and this is illustrated in a figure in the paper, really showing the treatment as well as the changes in ctDNA, tumor markers, and also radiographic response. So, this particular patient was on first-line endocrine therapy and CDK4/6 inhibitor with palbociclib. Initially, she had a low-level detectable ctDNA. It became undetectable during treatment, and the patient had a couple of serial ctDNA assays that were negative, so undetectable. And then we started, after about seven months on this combination therapy, the ctDNA levels started rising. She actually had three serial ctDNA assays with increasing level of ctDNA before she even had any imaging tests. And then around the time that the ctDNA peaked, this patient had radiographic evidence of progression. There was also an NGS-based assay sent to look for specific mutations at that point. The patient was found to have an ESR1 mutation, which is very common in this patient population. She was switched to a novel oral SERD, elacestrant, and the ctDNA fell again to undetectable within the first couple months of being on elacestrant. And then a very similar thing happened: while she was on this second-line therapy, she had three serial negative ctDNA assays, and then the fourth one was positive. This was two months before the patient had a scan that showed progression again. Dr. Rafeh Naqash: And Julia, like you mentioned, this is a small sample size, limited number of patients, in this case, one patient case scenario, but provides insights into other important aspects around escalation or de-escalation of therapy where perhaps ctDNA could be used as an integral biomarker rather than an exploratory biomarker. What are some of your thoughts around that and how is the breast cancer space? I know like in GI and bladder cancer, there has been a significant uptrend in MRD assessments for therapeutic decision making. What is happening in the breast cancer space? Dr. Julia Foldi: So, super interesting. I think this is where a lot of our different fields are going. In the breast cancer space, so far, I have seen a lot of escalation attempts. It is not even necessarily in this particular setting where we are looking at dynamics of ctDNA, but in the breast cancer world, of course, we have a lot of data on resistance mutations. I mentioned ESR1 mutation in a particular patient in our study. ESR1 mutations are very common in patients with ER-positive breast cancer who are on long-term endocrine therapy, and ESR1 mutations confer resistance to aromatase inhibitors. So, that is an area that there has been a lot of interest in trying to detect ESR1 mutations earlier and switching therapy early. So, this was the basis of the SERENA-6 trial, which was presented last year at ASCO and created a lot of excitement. This was a trial where patients had non-tumor-informed NGS-based Guardant assay sent every three to six months while they were on first-line endocrine therapy with a CDK4/6 inhibitor. If they had an ESR1 mutation detected, they were randomized to either continue the same endocrine therapy or switch to an oral SERD. The trial showed that the population of patients who switched to the oral SERD did better in terms of progression-free survival than those who stayed on their original endocrine therapy. There are a lot of questions about how to use this in routine practice. Of course, it is not trivial to be sending a ctDNA assay every three to six months. The rate of detection of these mutations was relatively low in that study; again, the incidence increases in later lines of therapy. So, there are a lot of questions about whether we should be doing this in all of our first-line patients. The other question is, even the patients who stayed on their original endocrine therapy were able to stay on that for another nine months. So, there is this question of: are we switching patients too early to a new line of therapy by having this escalation approach? So, there are a lot of questions about this. As far as I know, at least in our practice, we are not using this approach just yet to escalate therapy. Time will tell how this all pans out. But I think what is even more interesting is the de-escalation question, and I think that is where tumor informed assays like Signatera and the data that our study generated can be applied. Actually, our plan is to generate some prospective data in the lobular breast cancer population, and I have an ongoing study to do that, to really be able to tease out the early ctDNA dynamics as patients first start on endocrine therapy. So, this is patients who are newly diagnosed, they are just starting on their first-line endocrine therapy, and measure, with sensitive assays, measure ctDNA dynamics in the first few months of therapy. In those patients who have a really robust response, that is where I think we can really think about de-escalation. In the patients whose ctDNA goes to undetectable after just a few weeks of therapy with just an endocrine agent, they might not even need a CDK4/6 inhibitor in their first-line treatment. So, that is an area where we are very interested in our group, and I know that other groups are looking at this too, to try to de-escalate therapy in patients who clear their ctDNA early on. Dr. Rafeh Naqash: Thank you so much. Well, lots of questions, but at the same time, progress comes through questions asked, and your project is one of those which is asking an interesting question in a rarer cancer and perhaps will lead to subsequent improvement in how we monitor these individuals and how we escalate or de-escalate therapy. Hopefully, we will get to see more of what you are working on in subsequent submissions to JCO Precision Oncology and perhaps talk more about it in a couple of years and see how the space and field is moving. Thanks again for sharing your insights. I do want to take one to two quick minutes talking about you as an investigator, Julia. If you could speak to your career pathway, your journey, the pathway to mentorship, the pathway to being a mentor, and how things have shaped for you in your personal professional growth. Dr. Julia Foldi: Sure, yeah, that is great. Thank you. So, I had a little bit of an unconventional path to clinical medicine. I actually thought I was going to be a basic scientist when I first started out. I got a PhD in Immunology right out of college and was studying not even anything cancer-related. I was studying macrophage signaling in inflammatory diseases, but I was in New York City. This was right around the time that the first checkpoint inhibitors were approved. Actually, some of my friends from my PhD program worked in Jim Allison's lab, who was the basic scientist responsible for ipilimumab. So, I got to kind of first-hand experience the excitement around bringing something from the lab into the clinic that actually changed really the course of oncology. And so, I got very excited about oncology and clinical medicine. So, I decided to kind of switch gears from there and I went back to medical school after finishing my PhD and got my MD at NYU. I knew I wanted to do oncology, so I did a research track residency and fellowship combined at Yale. I started working early on with the breast cancer team there. At the time, Lajos Pusztai was the head of translational research there at Yale, and I started working with him early in my residency and then through my fellowship. I worked on several trials with him, including a neoadjuvant checkpoint inhibitor trial in triple-negative breast cancer patients. During my last year in fellowship, I received a Conquer Cancer Young Investigator Award to study estrogen receptor heterogeneity using spatial transcriptomics in this subset of breast cancers that have intermediate estrogen receptor expression. From there, I joined the faculty at the University of Pittsburgh in 2022. So, I have been there about almost four years at this point. My interests really shifted slowly from triple-negative breast cancers towards ER-positive breast cancers. When I arrived in Pittsburgh, I started working very closely with some basic and translational researchers here who are very interested in estrogen signaling and mechanisms of resistance to endocrine therapy, and there is a large group here interested in lobular breast cancers. During my training, I was not super aware even that lobular breast cancer was a unique subtype of breast cancers, and that is, I think, changing a little bit. There is a lot more awareness in the breast cancer clinical and research community about ILC being a unique subtype, but it is not even really part of our training in fellowship, which we are trying to change. But I have become a lot more aware of this because of the research team here and through that, I have become really interested also on the clinical side. And so, we do have a Lobular Breast Cancer Research Center of Excellence here at the University of Pittsburgh and UPMC, and I am the leader on the clinical side. We have a really great team of basic and translational researchers looking at different aspects of lobular breast cancers, and some of the work that I am doing is related to this particular manuscript we discussed and the next steps, as I mentioned, a prospective study of early ctDNA dynamics in lobular patients. I also did some more clinical research work in collaboration with the NSABP looking at long-term outcomes of patients with lobular versus ductal breast cancers in some of their older trials. And so, that is, in a nutshell, a little bit about how I got here and how I became interested in ILC. Dr. Rafeh Naqash: Well, thank you for sharing those personal insights and personal journey. I am sure it will inspire other trainees, fellows, and perhaps junior faculty in trying to find their niche. The path, as you mentioned, is not always straight; it often tends to be convoluted. And then finding an area that you are interested in, taking things forward, and being persistent is often what matters. Dr. Julia Foldi: Thank you so much for having me. It was great. Dr. Rafeh Naqash: It was great chatting with you. And thank you for listening to JCO Precision Oncology Conversations. 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.  

What do you do when metastatic urothelial cancer responds dramatically to systemic therapy? In this episode of BackTable Urology, Dr. Abhinav Khanna (Mayo Clinic) speaks with host Dr. Daniel Roberson about the growing question of consolidative surgery after enfortumab vedotin plus pembrolizumab. They discuss how EV-pembro has reshaped treatment expectations, why unexpected complete or near-complete responses are prompting tumor board debates about cystectomy, and how careful multidisciplinary decision-making guides which patients may be considered for surgery. --- SYNPOSIS The conversation reviews early outcomes showing high rates of pathologic downstaging and the possibility that many patients may avoid additional systemic therapy after surgery, while emphasizing this approach is not yet standard of care. Dr. Khanna highlights coordination with medical oncology, radiology, and pathology, postoperative considerations, and the potential future role of biomarkers such as ctDNA. Ultimately, the episode underscores the need for clinical trials and thoughtful patient selection as clinicians navigate integrating surgery into an evolving systemic therapy landscape. --- TIMESTAMPS 00:00 - Introduction02:19 - The Evolution of Urothelial Carcinoma Treatment05:23 - Rationale for Consolidative Surgery12:32 - Patient Selection Criteria15:23 - Surgical Approach and Considerations23:58 - Pathologic Findings31:34 - The Role of Radiation39:38 - Biomarkers44:10 - Prospective Trials and Future Directions53:06 - Guidance for Urologists --- RESOURCES Consolidative Surgery for Advanced Urothelial Carcinoma Following Induction Enfortumab Vedotin and/or Immune Checkpoint Inhibitor Therapy: A Multicenter Analysishttps://pubmed.ncbi.nlm.nih.gov/40425390/ Enfortumab Vedotin and Pembrolizumab in Untreated Advanced Urothelial Cancerhttps://www.nejm.org/doi/full/10.1056/NEJMoa2312117 Standard or Extended Lymphadenectomy for Muscle-Invasive Bladder Cancerhttps://www.nejm.org/doi/abs/10.1056/NEJMoa2401497

Dr. Fiorinda Muhaj discusses the risk factors for developing BCC, and how it is diagnosed.

In today's OncClub episode, we spoke with Ramy Sedhom, MD; Ryan Chow, MD; and Ronac Mamtani, MD, MSCE, about a pragmatic real-world question in advanced urothelial carcinoma: Can upfront dose reduction of enfortumab vedotin-ejfv (Padcev) improve tolerability, particularly neuropathy and treatment interruption, without compromising clinical outcomes in patients with bladder cancer? Dr Sedhom is co-lead of Geriatric Oncology at the Penn Cancer Service Line; associate director of the Penn Center for Cancer Care Innovation; and clinical director of Medical Oncology, co-lead of Psychosocial Oncology Services, division chief of the Palliative Care Division, and a clinical assistant professor of medicine (hematology-oncology) at Penn Medicine Princeton Health in Plainsboro, New Jersey. Dr Chow is an internal medicine resident at Penn Medicine in Philadelphia, Pennsylvania. Dr Mamtani is section chief of Genitourinary Cancers at Penn Medicine and an associate professor of medicine (hematology-oncology) at the Hospital of the University of Pennsylvania. 

AI Collaborative simulated case scenario discussions on Testicular Carcinoma to have an immersive and transformational learning experience. This is one of the lessons in my Advanced Online Surgery Masterclass on Scrotal Swellings.

Is the era of cisplatin over, or are we simply becoming more precise about who benefits from it? As perioperative strategies in bladder cancer continue to evolve, emerging tools like circulating tumor DNA (ctDNA) are playing a bigger role in how clinicians assess recurrence risk and tailor treatment. In this episode of BackTable Tumor Board, host Alan Tan, medical oncologist at Vanderbilt-Ingram Cancer Center, is joined by bladder cancer experts Dr. Amanda Nizam and Dr. Brad McGregor to discuss recent advances in the diagnosis and treatment of urothelial carcinoma. --- SYNPOSIS The doctors examine the evolving management of muscle-invasive bladder cancer (MIBC), including the role of neoadjuvant and adjuvant therapies, the integration of immunotherapy, and the recent approval of enfortumab vedotin plus pembrolizumab. The discussion explores the rapidly changing perioperative landscape, the prognostic utility of ctDNA, and how biomarkers such as HER2 and FGFR are influencing treatment selection across disease states. They also address bladder preservation strategies, management of treatment-related toxicities, and the importance of multidisciplinary coordination. The episode concludes with a forward-looking discussion on emerging therapies and the potential to improve cure rates in bladder cancer. --- TIMESTAMPS 00:00 - Introduction01:44 - Overview of Bladder Cancer Treatment04:54 - Patient Staging and Treatment Goals10:12 - Bladder Preservation vs. Radical Cystectomy16:39 - Emerging Trials and Future Directions22:40 - ctDNA and Precision Medicine33:50 - Metastatic Disease and Biomarker Strategies42:16 - Managing Neuropathy in Metastatic Treatment48:44 - HER2 and FGFR in Bladder Cancer54:15 - Future Directions in Bladder Cancer Treatment --- RESOURCES EV-302/303 Trialhttps://newsroom.astellas.com/2023-12-15-PADCEV-R-enfortumab-vedotin-ejfv-with-KEYTRUDA-R-pembrolizumab-Approved-by-FDA-as-the-First-and-Only-ADC-Plus-PD-1-to-Treat-Advanced-Bladder-Cancer NIAGARA Regimenhttps://www.nejm.org/doi/full/10.1056/NEJMoa2408154 KEYNOTE-905 Studyhttps://www.annalsofoncology.org/article/S0923-7534(25)04894-X/fulltext

Rare diseases like renal medullary carcinoma demand earlier awareness, stronger advocacy, and faster specialist-driven care because delays can be deadly.In this episode, Tanisha Washington, the mother of Jelani Washington and a family advocate, shares her son's sudden diagnosis and passing from renal medullary carcinoma (RMC), a rare and highly aggressive kidney cancer strongly linked to sickle cell trait. She recounts his first symptoms, abdominal pain and severe blood in the urine, and how imaging revealed a kidney mass that set off a rapid and overwhelming medical journey.Tanisha describes the urgency of Jelani's treatment, which included kidney removal and intensive chemotherapy, and reflects on how little clinical familiarity exists with RMC. She highlights the critical role played by MD Anderson specialists and explains how limited research, scarce awareness, and delayed recognition worsen outcomes, particularly in Black communities.She also discusses warning signs families may dismiss, the importance of second opinions and self-advocacy, and the need for greater education about sickle cell trait–related risks. The episode closes with the family's creation of the Jelani Washington Seeds of Hope Foundation, which offers grief support and promotes healing initiatives centered on hope, remembrance, and growth.Tune in and learn how awareness, early detection, and insistence on care can save lives.ResourcesConnect with Tanisha Washington on LinkedIn here.Visit the Jelani Washington Seeds of Hope Foundation website.Learn more about Jelani's story in the news here.Watch Jelani's testimony video here.

In this episode of the Pediatric and Developmental Pathology, our hosts Dr. Mike Arnold (@MArnold_PedPath) and Dr. Jason Wang speak with Dr. Lauren Miller (@LJMiller_MD), a 4th year AP/CP Pathology Resident at the University of Michigan; Dr. Amer Heider (@amerheider), Pediatric and Perinatal Pathologist at the University of Michigan; and Dr. Lina Shao, Cytogeneticist and Clinical Professor at the University of Michigan.   Hear about Pathology at the University of Michigan (https://www.pathology.med.umich.edu/) and training in Pediatric Pathology (https://www.pathology.med.umich.edu/index.php?t=page&id=1396). Find out how they triage tissue from pediatric cancers, and how that approach led to their article in Pediatric and Developmental Pathology: A Novel GLCCI1::BRAF Fusion With Independent MYC and MYCN Amplifications in Pediatric Pancreatic Acinar Cell Carcinoma   Learn more about Pathology at the University of Michigan on social media: X: @UMichPath Insta: umichpath Facebook: University of Michigan Department of Pathology   Featured public domain music: Summer Pride by Loyalty Freak

Mind Webs || (001) Carcinoma Angels (Norman Spinrad) || 1970s-1990sBroadcast from WHA Radio in Madison, Wisconsin: : : : :You can donate to show your support for my podcast and the time I put into creating and posting every week. Donations are through my duane.media PayPal account:https://www.paypal.com/donate/?hosted_button_id=MSL7S8FKCSL94My other podcast channels include: MYSTERY x SUSPENSE -- DRAMA X THEATER -- COMEDY x FUNNY HA HA -- VARIETY X ARMED FORCES -- THE COMPLETE ORSON WELLES.Subscribing is free and you'll receive new post notifications. Thank you for your support.https://otr.duane.media | Instagram @duane.otr#scifiradio #oldtimeradio #otr #radiotheater #radioclassics #bbcradio #raybradbury #twilightzone #horror #oldtimeradioclassics #classicradio #horrorclassics #xminusone #sciencefiction #duaneotr:::: :

Please visit answersincme.com/KEC860 to participate, download slides and supporting materials, complete the post test, and get a certificate. Presented by Jonathan E. Rosenberg, MD and Dayna A. Leis, NP. In this activity, experts in genitourinary oncology management discuss evidence-based first-line approaches for advanced urothelial carcinoma (UC) and share practical strategies to recognize and manage adverse events (AEs) through coordinated, multidisciplinary care. Upon completion of this activity, participants should be better able to: Review guideline-recommended first-line systemic treatments for patients with advanced UC; Identify AEs among patients receiving preferred first-line systemic treatment for advanced UC; and Outline multidisciplinary strategies to optimize care for patients receiving preferred first-line systemic treatment for advanced UC.

Dr. Fiorinda Muhaj discusses how patients with BCC can follow up after treatment, and how to help prevent future BCC occurrences.

In this episode you are hearing a highly interactive engrossing podcast on Carcinoma Head of the Pancreas. They highlight epidemiology, etiopathogenesis, clinical features, investigations, staging, treatment, post-op complications and prognosis.

You are listening to the highly interactive engrossing audio podcast on Periampullary carcinoma. They highlight epidemiology, etiopathogenesis, clinical features, types, investigations, staging, treatment, post-op complications and prognosis.

Host: Brian P. McDonough, MD, FAAFP Guest: Matthew Galsky, MD Five years after treatment, the impact of adjuvant nivolumab still holds strong in high-risk muscle invasive urothelial carcinoma. Join Drs. Brian McDonough and Matthew Galsky as they review the CheckMate 274 trial's long-term data, which show sustained disease-free survival and highlight ctDNA's potential as a marker for residual disease. These findings reinforce nivolumab's role in the evolving standard of care and may support more personalized post-surgical strategies. Dr. Galsky is a Professor of Medicine and the Director of Genitourinary Medical Oncology at the Icahn School of Medicine at Mount Sinai in New York.

In this episode of the Pediatric and Developmental Pathology, our hosts Dr. Mike Arnold (@MArnold_PedPath) and Dr. Jason Wang speak with Professor Matthew J. Murray of the Department of Pathology and the Department of Paediatric Haematology and Oncology at the University of Cambridge, Cambridge, UK; Consultant Pediatric Pathologist Claire Trayers of the Department of Histopathology at Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; and Consultant Pediatric Oncologist Charlotte Burns of the Department of Paediatric Haematology and Oncology at Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. Hear about how persistence and a serum biomarker for a miRNA helped identify a NUT carcinoma as we talk about their work and their article in Pediatric and Developmental Pathology: Mediastinal NUT Carcinoma With Raised Serum Alpha-Fetoprotein Mimicking a Malignant Germ Cell Tumor: Suspicion Raised Due to Negative Serum miR-371a-3p Levels   Featured public domain music: Summer Pride by Loyalty Freak

Does having darker skin really protect you from skin cancer? Can you imagine getting a Pap smear every single day for 21 years just to help your husband’s research? And, what do you do if your vagina involuntarily “clenches” during sex. In this episode, we speak to Professor Georgina Long, Medical Director of Melanoma Institute Australia (MIA) and 2024 Australian of the Year, to decode Australia’s complicated relationship with the sun. We talk about the "ABCDE" rule for checking your moles, whether darker skin tones are at less risk of melanoma and why you should be taking photos of your skin spots.Plus, in Med School, Claire and Dr Mariam pay tribute to the unsung heroines of medical history - from the wife of Dr. Papanicolaou (who underwent daily pap smears for 21 years ) to Anarcha Westcott, the enslaved woman known as the 'mother of modern gynecology', who endured 30 experimental surgeries without anaesthesia.And, in our Quick Consult, Dr Mariam helps a listener named Sarah who is struggling with Vaginismus. We break down exactly what this condition is, why it is a physical reflex rather than "just in your head" and the multidisciplinary team you need to help reclaim your sex life.THE END BITS All your health information is in the Well Hub. If you've been putting off a skin check, this is your sign to book it. For more information on sun safety, visit the Cancer Council. We understand that conversations about cancer can be difficult, whether you're navigating your own diagnosis, supporting a loved one, or remembering someone you've lost. If today's episode has brought up difficult feelings, please reach out. The Cancer Council offers a confidential support line staffed by specialist nurses, and you can call them on 13 11 20. For more specific information on the topics we discussed today, organisations like the Cancer Council, the Australian Skin Cancer Foundation, and the Melanoma & Skin Cancer Advocacy Network (MSCAN) provide dedicated advocacy, education and community support for patients impacted by all forms of skin cancer. And if you just need to talk to someone immediately, you can always call Lifeline on 13 11 14. Remember to be kind to yourself, and please don't hesitate to seek support. GET IN TOUCH Sign up to the Well Newsletter to receive your weekly dose of trusted health expertise without the medical jargon. Ask a question of our experts or share your story, feedback, or dilemma - you can send it anonymously here, email here or leave us a voice note here. Ask The Doc: Ask us a question in The Waiting Room. Follow us on Instagram and Tiktok. Support independent women’s media by becoming a Mamamia subscriber CREDITS Hosts: Claire Murphy and Dr Mariam Guest: Professor Georgina Long Senior Producers: Claire Murphy and Sally Best Audio Producer: Scott Stronach Video Producer: Julian Rosario Social Producer: Elly Moore Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander cultures.Information discussed in Well. is for education purposes only and is not intended to provide professional medical advice. Listeners should seek their own medical advice, specific to their circumstances, from their treating doctor or health care professional. +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++Support the show: https://www.mamamia.com.au/mplus/See omnystudio.com/listener for privacy information.

Today's Case A 37-year-old female presents to her primary care physician with a palpable breast mass. She says she felt the mass about 2 weeks ago while taking a shower. She did not note any pain or change in the size of the mass during her last menstruation. She is married and without children and has no significant medical or surgical history. Today's Reader Kada Fehlman is an Internal Medicine Resident at Huntington Health Cedars-Sinai. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠The Dr. Raj Podcast⁠⁠ ⁠⁠Dr. Raj on Twitter⁠⁠ ⁠⁠Dr. Raj on Instagram⁠⁠ Want more board review content? ⁠⁠USMLE Step 1 Ad-Free Bundle⁠⁠ ⁠⁠Crush Step 1⁠⁠ ⁠⁠Step 2 Secrets⁠⁠ ⁠⁠Beyond the Pearls⁠⁠ ⁠⁠The Dr. Raj Podcast⁠⁠ ⁠⁠Beyond the Pearls Premium⁠⁠ ⁠⁠USMLE Step 3 Review⁠⁠ ⁠⁠MedPrepTGo Step 1 Questions⁠⁠ ⁠⁠MedPrepTGo Step 2 Questions⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Editor in Chief Cecelia E. Schmalbach, MD, MSc, is joined by senior author John P. Dahl, MD, PhD, MBA, and Associate Editor Marissa Ryan, MD, to discuss their findings in "TI-RADS and Bethesda Classification System Correlate With Predicting Pediatric Papillary Thyroid Carcinoma," which was published in the October 2025 issue of Otolaryngology–Head and Neck Surgery.  Click here to read the full article.

When Abby Fish, who was still under the age of 2 in the summer of 2025 was diagnosed with the Pediatric Brain Cancer Choroid Plexus Carcinoma, her mom Amelia and her dad Joel were told how rare and difficult this cancer was. When they then found out that Abby also had the genetic condition Li Fraumeni to go along with her Brain cancer, they were told that the chances of her surviving until she was at least 5 years old were less than 12 percent. After hearing that, they found the Burzynski Clinic in Houston Texas, and that Dr. Burzynski had treated a young woman named Kaityln who is now 25 years old, and had suffered from both the same cancer and same genetic condition that Abby has. Abby is now following the same treatment path that Kaitlyn did.

Our host, Dr. Celina Nahyun Jo, explores how identifying middle neck lymph node involvement can reshape clinical decision-making for nasopharyngeal carcinoma. Joined by Dr. Heejun Kang, they breaks down how this imaging finding could refine risk groups and potentially shift treatment intensity for certain patients. MRI-based Middle Neck Involvement in Stage N1–N2 Nasopharyngeal Carcinoma: A Marker for Risk Stratification. Qin and Jiang et al. Radiology 2025; 316(2):e243399. Middle Neck Involvement: New Layer of Risk Stratification in Nasopharyngeal Carcinoma. Jabehdar Maralani and Kang. Radiology 2025; 316(2):e252512.

In 2019, Jonathan Gegerson sought medical attention went he felt a lump on the right side of his neck.  After a couple of scans and a biopsy, he was diagnosed with salivary duct carcinoma, a rare form of head and neck cancer.  Jonathan survived, but not before enduring 67 sessions of radiation, 12 cycles of chemotherapy (carboplatin, taxol, herceptin) and seven surgeries.  He still undergoes a targeted therapy on a monthly basis, and the surgery has affected his speech and his diet, but Jonathan has resumed an active lifestyle that includes skiing and hiking.   Jonathan Gegerson thought his health was outstanding.  He was an active skier and liked to hike up Colorado's 14ers (mountains whose peaks exceed 14,000 feet), but was perplexed when he discovered a lump on the right side of his neck.   He did not waste any time seeking medical attention and went to his primary care physician.  She conducted a physical examination and asked if Jonathan had recently undergone a root canal or some dental procedure that could result in an infection.  When he said no, the doctor sent Jonathan to an oncologist, who called for a CT scan, a PET scan and a biopsy.  That's when he was diagnosed with head and neck cancer, even though at the time doctors could not specify what type of head and neck cancer.   His doctor in Colorado said Jonathan would need to undergo surgery, followed by radiation treatment and chemotherapy.  When Jonathan learned his care team had no experience with dealing with his type of cancer, he sought a second opinion from MD Anderson in Houston, Texas.  The doctors at MD Anderson suggested the same regimen, but Jonathan switched to them because they had experience dealing with salivary duct carcinoma.   His care team told him his treatment would result in a tightening of his face and would affect his speech, in addition to his ability to chew and swallow.   The chemotherapy regimen included carboplatin, taxol and herceptin.  He said the chemo left him weak and tired, especially two days after each round of treatment.  This, he said, was very frustrating because he was accustomed to being active.  During this time, the best he could do was go on short walks.   When Jonathan experienced a recurrence, he was placed on a targeted therapy of kadcyla and herceptin.  He eventually achieved survivorship but must continue to be on a monthly targeted therapy of unhertu and herceptin.   Jonathan Gegerson says his health is approximately 75 percent of what it was before his diagnosis, but he feels he blessed that he is living, is back to hiking and skiing, and hopes to continue skiing until he is 90 years old.   Additional Resources: Jonathan's Book: "Perspective C," available on Amazon and Kindle  https://a.co/d/4iW9BQ6      

Keratinocyte carcinomas, which include basal cell carcinoma and squamous cell carcinoma, are common forms of skin cancer. Approximately 5.4 million keratinocyte carcinomas are diagnosed in the US annually. Author Mackenzie R. Wehner, MD, MPhil, of the University of Texas MD Anderson Cancer Center joins JAMA Associate Editor David Simel, MD, MHS, to discuss treatment of these types of nonmelanoma skin cancer. Related Content: Keratinocyte Carcinoma ----------------------------------- JAMA Editors' Summary

This week, Riff Worship celebrates 25 years of Electric Wizard's nihilistic masterpiece, Dopethrone! We're joined by special guests John Hoffman (STOMACH, Weekend Nachos) and David Stepanavicius (Atræ Bilis, Fulci Rots) to explore the band's rural Dorset roots as well as the tumultuous events and hazy recording sessions that forged tracks like “Barbarian” and “Funeralopolis.” Please join us as we discuss the album that redefined doom metal for the 21st century!Recommendations:STOMACH - LOW DEMONAtræ Bilis - AumicideEyehategod - Take as Needed for PainHenry: Portrait of a Serial Killer (1986)Carcinoma (2014)Brainscan (1994)Luciferion - The ApostateUsipian - Dead Corner of the EyeWith the Dead - With the DeadRamesses - We Will Lead You To Glorious TimesPsychomania (1973)Follow STOMACHInstagram: https://www.instagram.com/stomachdoom/Follow Weekend NachosFacebook: https://www.facebook.com/weekendxnachosInstagram: https://www.instagram.com/weekendnachos2004/Follow Atræ BilisFacebook: https://www.facebook.com/atraebilisInstagram: https://www.instagram.com/atraebilis/Follow Fulci RotsInstagram: https://www.instagram.com/fulcirots/Follow Riff WorshipInstagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/riffworshippod/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Twitter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://x.com/RiffWorshipPod⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/@RiffWorshipPod⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Check out our Official Playlists:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Riffs on Repeat (Spotify)⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Riffs on Repeat (YouTube Music)⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Hits from the Crypt (Apple)⁠

Elevate your nasopharyngeal cancer (NPC) care. Top experts deliver 10 clinical pearls on new standards in immunotherapy, radiation, and surveillance. Credit available for this activity expires: 9/30/26 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/top-10-clinical-pearls-outlining-optimal-care-nasopharyngeal-2025a1000pwu?ecd=bdc_podcast_libsyn_mscpedu

How has nasopharyngeal carcinoma (NPC) care evolved? Explore pivotal immunotherapy data, new treatment guidelines, and community care strategies to optimize patient outcomes. Credit available for this activity expires: 09/29/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/coming-together-community-discussing-nasopharyngeal-2025a1000pm8?ecd=bdc_podcast_libsyn_mscpedu

In this new episode of Speaking of SurgOnc, Dr. Rick Greene discusses with Dr. Faina Nakhlis the upgrade rate to ductal carcinoma in situ or invasive cancer following excision for patients diagnosed with flat epithelial atypia on core biopsy, as reported in the article, "Incidence of Adjacent Synchronous Ipsilateral Infiltrating Carcinoma and/or Ductal Carcinoma In Situ in Patients Diagnosed with Flat Epithelial Atypia by Core Needle Biopsy (TBCRC 034).”

Dr Jonathan Strosberg from Moffitt Cancer Center in Tampa, Florida, discusses recent updates on available and novel treatment strategies for extrapulmonary neuroendocrine carcinoma. CME information and select publications here.

Featuring an interview with Dr Jonathan Strosberg, including the following topics: Overview of extrapulmonary neuroendocrine carcinoma (NEC) (0:00) Treatment strategies for extrapulmonary NEC (10:26) Targeting DLL3 in extrapulmonary NEC (18:49) Early clinical data with obrixtamig for extrapulmonary NEC (21:56) Additional investigational agents for extrapulmonary NEC (25:44) Case: A woman in her mid 50s with poorly differentiated metastatic NEC of unknown primary (27:20) Case: A man in his early 60s with poorly differentiated metastatic esophageal NEC (32:30) Clinical management of well-differentiated NEC (36:58) CME information and select publications  

Dr Jonathan Strosberg from Moffitt Cancer Center in Tampa, Florida, discusses recent updates on available and novel treatment strategies for extrapulmonary neuroendocrine carcinoma. CME information and select publications here.

Dr Jonathan Strosberg from Moffitt Cancer Center in Tampa, Florida, discusses recent updates on available and novel treatment strategies for extrapulmonary neuroendocrine carcinoma. CME information and select publications here.

Featuring a slide presentation and related discussion from Dr Jonathan Strosberg, including the following topics: Overview of the classification, grading and incidence of neuroendocrine carcinoma (NEC) (0:00) Overview of mutational profile, biomarker assessments and prognosis of NEC (3:45) Current treatment paradigm for extrapulmonary NEC (8:59) DLL3 as an emerging target biomarker in extrapulmonary NEC (17:46) Novel therapeutic agents under investigation for extrapulmonary NEC (23:05) CME information and select publications

En este episodio de NETWise, continuamos centrándonos en el carcinoma neuroendocrino, una forma rara y agresiva de cáncer neuroendocrino. Si bien en el episodio anterior exploramos el diagnóstico y el tratamiento, este debate se centra en los desafíos únicos que enfrentan los cuidadores. Cuidar a una persona con carcinoma neuroendocrino puede ser increíblemente intenso debido […] The post Episodio 3: Cuidando al Cuidador del Carcinoma Neuroendocrino appeared first on NETRF.

Ductal carcinoma in situ (DCIS) represents a clinical crossroads in breast surgery—balancing the risks of over-treatment with the need to prevent invasive cancer. With new data from active monitoring trials, the pressure is on for surgeons to personalize care. Tune in to this essential episode to stay ahead of the curve on DCIS management and to hear expert insights from two leading breast surgical oncologists. Hosts: - Rashmi Kumar, MD, PhD Resident, University of Michigan General Surgery Residency Program Twitter/X: @RashmiJKumar - Melissa Pilewskie, MD Attending Breast Surgical Oncologist, Co-Director of the Weiser Family Center for Breast Cancer, Michigan Medicine Twitter/X: @MPilewskie -  Stephanie Downs-Canner, MD Attending Breast Surgical Oncologist & Physician-Scientist, Memorial Sloan Kettering Cancer Center, Program Director of the Breast Surgical Oncology Fellowship Training Program Twitter/X: @SDownsCanner Learning Objectives: - Define DCIS and explain its significance as a precursor to invasive breast cancer. - Discuss challenges in diagnosing and risk-stratifying DCIS. - Review current standards for surgical and adjuvant management of DCIS. - Understand the implications of new research, including the COMET trial, for low-risk DCIS. - Evaluate patient-centered strategies for managing DCIS and preventing over-treatment. References: - Worni M, Akushevich I, Greenup R, et al. Trends in Treatment Patterns and Outcomes for Ductal Carcinoma In Situ. J Natl Cancer Inst. 2015;107(12):djv263. PubMed - Francis A, Thomas J, Fallowfield L, et al. Addressing overtreatment of screen detected DCIS; the LORIS trial. Eur J Cancer. 2015 Jan;51(16):2296-303. PubMed - Elshof LE, Tryfonidis K, Slaets L, et al. Feasibility of a non-surgical management strategy for low-grade DCIS: The LORD study. Eur J Cancer. 2015;51(12):1497–1510. PubMed - Toss MS, et al. Ductal carcinoma in situ (DCIS): current management and future directions. Cancer Treat Rev. 2020;90:102091. PubMed - Comparative Effectiveness of Surgery versus Active Monitoring for Low-Risk DCIS (COMET) Trial Results. Early COMET Results: King TA, et al. Surgical excision versus active monitoring for low-risk ductal carcinoma in situ (DCIS): 2-year results of the COMET randomized trial. J Clin Oncol. 2024; e2400110. PubMed Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Do you know where immunotherapy fits in the treatment paradigm of squamous cell anal carcinoma? Credit available for this activity expires: 9/3/26 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002850?ecd=bdc_podcast_libsyn_mscpedu

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from August 16-22 2025.

En este episodio de NETWise, profundizamos en uno de los tipos más agresivos de cáncer neuroendocrino: el carcinoma neuroendocrino. Si bien muchos tumores neuroendocrinos son de crecimiento lento y controlables con el tiempo, el carcinoma neuroendocrino es diferente: se desarrolla rápidamente y requiere atención especializada inmediata. Le guiaremos a través de la información esencial sobre […] The post Episodio 2: Carcinoma Neuroendócrino 101 appeared first on NETRF.

In our conversation, Dr Akhave discussed the addition of toripalimab (Loqtorzi), a PD-1 inhibitor, to the NCCN Guidelines following its launch in the United States. Supported by data from the phase 3 JUPITER-02 trial (NCT03581786), toripalimab is now incorporated into frontline therapy for patients with recurrent metastatic or de novo metastatic Epstein–Barr virus (EBV)–positive NPC, in combination with gemcitabine and cisplatin. He explained how this regimen has produced substantial improvements in progression-free survival (PFS), nearly tripling median PFS compared with chemotherapy alone, while maintaining a manageable safety profile.

Program notes:0:44 Flu consequences for young children1:44 Fulminant course2:44 16 kids of total unvaccinated3:10 HPV, T-cell receptor signaling and SCC4:10 Unresectable disease5:10 Thought virus facilitated6:10 Target in recurrent or metastatic disease6:26 Nonpharmacologic intervention in older adults to improve cognition7:26 More intensive program a little better8:26 Eat better, exercise more and use your mind9:15 Polygenic risk score for obesity10:15 Explained variance in cohorts11:15 At birth adds a bit of value12:08 End

In this episode, we review the high-yield topic ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Esophageal Carcinoma⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Oncology section at ⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets

To have your question featured in a future video, please email: questions@morses.tv Please include at least: Age, Weight and as much history as possible.

UCSF's Dr. Cornelia Ding demystifies the prostate cancer pathology report and explains how to read and understand it. The report contains five key sections: patient information, diagnosis and comments, gross description, and any addendums or amendments. It serves multiple purposes—as a medical, legal, and clinical communication tool—and often contains technical language not written for patients. Dr. Ding walks through important terminology such as Gleason score, Grade Groups, and specific diagnostic patterns like intraductal carcinoma, emphasizing how each affects risk assessment and treatment planning. Patients are encouraged to focus on the diagnosis and comment sections and to discuss any unclear details with their doctors. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40797]

UCSF's Dr. Cornelia Ding demystifies the prostate cancer pathology report and explains how to read and understand it. The report contains five key sections: patient information, diagnosis and comments, gross description, and any addendums or amendments. It serves multiple purposes—as a medical, legal, and clinical communication tool—and often contains technical language not written for patients. Dr. Ding walks through important terminology such as Gleason score, Grade Groups, and specific diagnostic patterns like intraductal carcinoma, emphasizing how each affects risk assessment and treatment planning. Patients are encouraged to focus on the diagnosis and comment sections and to discuss any unclear details with their doctors. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40797]

The recently released 9th version of the AJCC staging system for nasopharyngeal carcinoma includes several critical updates to optimize the impact of imaging-based staging. In this AJR Conversation, Neuroradiology Imaging Section Editor Carlos Zamora, MD, PhD, speaks with Alok Bhatt, MD, and Pranjal Rai, MD, about their team's recently published article on the 9th version's key modifications and clinical implications.

In today's episode, supported by Coherus BioSciences, we had the pleasure of speaking with Michael Dennis, MD, about recent updates to the nasopharyngeal carcinoma treatment paradigm. Dr Dennis is a physician at Dana-Farber Cancer Institute; as well as an instructor in medicine at Harvard Medical School, both in Boston, Massachusetts. In our exclusive interview, Dr Dennis discussed the latest National Comprehensive Cancer Center guideline updates for the treatment of patients with nasopharyngeal carcinoma; practice-informing data from the phase 3 JUPITER-02 trial (NCT03581786), which investigated first-line toripalimab-tpzi (Loqtorzi) plus chemotherapy in patients with recurrent or metastatic nasopharyngeal carcinoma; and ongoing developments in the locally advanced treatment setting.

In this episode of NETWise, we continue our focus on neuroendocrine carcinoma, a rare and aggressive form of neuroendocrine cancer. While our previous episode explored diagnosis and treatment, this discussion centers on the unique challenges faced by caregivers. Caring for someone with neuroendocrine carcinoma can be incredibly intense due to the cancer's rapid progression and […] The post NETWise Episode 47: Care for the Neuroendocrine Carcinoma Caregiver appeared first on NETRF.

In this episode of NETWise, we're diving into one of the more aggressive forms of neuroendocrine cancer: neuroendocrine carcinoma (NEC). While many neuroendocrine tumors are slow-growing and manageable over time, NEC is different—fast-moving and requiring swift, specialized care. We'll guide you through the essential information about NEC, including: What neuroendocrine carcinoma is and how it […] The post NETWise Episode 46: Understanding Neuroendocrine Carcinoma appeared first on NETRF.

About this episode: For some people with a high risk of ovarian cancer, a standard approach has been full removal of the reproductive organs. But new research points to a far less invasive procedure called a salpingectomy, or removal of the fallopian tubes, as a potential “game changer” in ovarian cancer. In this episode: understanding high grade serous carcinoma—the most common type of ovarian cancer—the lack of screening tools, and why fallopian tube removal isn't yet available to more people. Guest: Dr. Rebecca Stone is an OBGYN, a professor in the Johns Hopkins Medicine Department of Gynecology and Obstetrics, and the director of The Kelly Gynecologic Oncology Service. Host: Stephanie Desmon, MA, is a former journalist, author, and the director of public relations and communications for the Johns Hopkins Center for Communication Programs, the largest center at the Johns Hopkins Bloomberg School of Public Health. Show links and related content: A Game-Changer for Ovarian Cancer—Johns Hopkins Medicine Salpingectomy for ectopic pregnancy reduces ovarian cancer risk—JNCI Cancer Spectrum Salpingectomy for the Primary Prevention of Ovarian Cancer: A Systematic Review—NIH Transcript information: Looking for episode transcripts? Open our podcast on the Apple Podcasts app (desktop or mobile) or the Spotify mobile app to access an auto-generated transcript of any episode. Closed captioning is also available for every episode on our YouTube channel. Contact us: Have a question about something you heard? Looking for a transcript? Want to suggest a topic or guest? Contact us via email or visit our website. Follow us: @‌PublicHealthPod on Bluesky @‌JohnsHopkinsSPH on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed