Podcasts about clinical research division

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Best podcasts about clinical research division

Latest podcast episodes about clinical research division

Oncology Peer Review On-The-Go
S1 Ep151: Key CAR T and Transplantation Presentations From The 2025 Tandem Meeting

Oncology Peer Review On-The-Go

Play Episode Listen Later Mar 3, 2025 56:47


CancerNetwork®, in collaboration with The American Society for Transplantation and Cellular Therapy (ASTCT), organized an X Space hosted by Rahul Banerjee, MD, FACP, an assistant Professor in the Clinical Research Division at the Fred Hutchinson Cancer Center in Seattle, Washington, and Shernan Holtan, MD, the chief of Blood and Marrow Transplantation and professor of Medicine at Roswell Park Comprehensive Cancer Center.  The conversation took place during the 2025 Tandem Meeting and highlighted many significant presentations and posters on CAR T-cell therapies and transplantation, Banerjee's and Holtan's respective areas of expertise. The following trials were discussed: LBA1 - Phase II Multicenter Trial of Idecabtagene Vicleucel (Ide-cel) Followed By Lenalidomide Maintenance for Multiple Myeloma Patients with Sub-Optimal Response after an Upfront Autologous Hematopoietic Cell Transplantation: Top Line Results from the BMT CTN 1902 Clinical Trial1 “This [study] is nice because it merges 2 worlds. It's like a tandem—but not really a tandem—because you're not doing 2 transplants back-to-back. You're doing a transplant followed by CAR T-cell therapy,” said Banerjee. Abstract 50 - CAR T Cell Therapy in Early Relapsed/Refractory Large B-Cell Lymphoma: Real World Analysis from the Cell Therapy Consortium2 “In a relatively small cohort, [investigators] found no difference in 9-month survival whether someone got their [CAR T cells] in second-line therapy vs third-line therapy from a statistical perspective. If you look at the curves, it looks like there is a potential benefit to second-line therapy, but there was not enough statistical power to determine a difference,” said Holtan. Poster 340 - CD83 Expression By Human Breast Cancer Mediates Effective Killing By CAR T3 “If there's a way to do [the therapy] armored and have a paracrine delivered in real time—and not given to the whole body—[so] the patient [would] have all the adverse effects and cytokine release syndrome release on their own…that would be awesome,” stated Banerjee.  Poster 317 - Risk Factors for Immune Effector Cell-Associated Enterocolitis (IEC-colitis) in Patients with Relapsed Myeloma Treated with Ciltacabtagene Autoleucel (cilta-cel)4 “From the best that we can tell, ironically, corticosteroids aren't the fix that we want them to be [for immune effector cell-associated colitis]…We were like ‘Diarrhea, whatever. Let's give some steroids and treat it like gut graft-versus-host-disease,' but these patients [didn't] respond as well [to that],” said Banerjee. Poster 572 - Post-CAR-T Driving Restrictions Appear Unnecessary after Week 4: Data from the US Multiple Myeloma Immunotherapy Consortium5 “Patients and their caregivers [who have] put their life aside for 4 weeks just to get through CAR T-cell therapy and the Risk Evaluation and Mitigation Strategies requirements are now being told ‘You're free to go, but you can't drive for 4 weeks, which means you can't get your own groceries or…go to doctor's appointments by yourself.' Basically, we argue…that this [requirement] is not evidence-based,” stated Banerjee.  Presentation 58 - Physical Function Measures Identify Non-Hodgkin Lymphoma Patients at High Risk of Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) and 1-Year Mortality after Chimeric Antigen Receptor T (CAR-T) Cell Therapy6 “This [presentation] highlights that even within a high [CAR-HEMATOTOX group], those patients were at extraordinarily high risk of not benefitting from CAR T-cell therapy, and these tests are so simple to do. It's going to be interesting to see if others can reproduce this,” said Holtan. Poster 618 - Comparison of Outcomes after Hematopoietic STEM Cell Transplantation (HCT) for Myelodysplastic Syndrome (MDS) Patients Older or Younger THAN 65 YEARS Old. a Retrospective Analysis of the Latin America Registry7 “My personal hope for this space is that our field can come up with more novel conditioning regimens such that we can ablate the marrow without causing those gastrointestinal toxicities or other organ toxicities [while] doing that so effectively that we don't even need maintenance therapies for a lot of conditions,” stated Holtan. Presentation 39 - Determinants of Immune Suppression Discontinuation in the Modern Era: A CIBMTR Analysis of 18,642 Subjects8 “I'm going to make a provocative prediction for the next paper [approximately 10 years from now]. I predict that steroids won't be the first-line therapy for acute or chronic graft-versus-host-disease,” Holtan said. Poster 516 - Patient Experiences with Chronic Graft-Versus-Host Disease and Its Treatment in the United States: A Retrospective Social Media Listening Study9 “We can still work together to make life as good as we possibly can [for patients], to improve physical function, to take away some of this mental distress, and then work together for advocacy too. [We can] help with peer support, help with resources, and help relieve some of that misunderstanding in the community,” stated Holtan. References 1.        Garfall AL, Pasquini MC, Bai L, et al. Phase II multicenter trial of idecabtagene vicleucel (ide-cel) followed by lenalidomide maintenance for multiple myeloma patients with sub-optimal response after an upfront autologous hematopoietic cell transplantation: top line results from the BMT CTN 1902 clinical trial. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Abstract LBA-1. 2.        Rojek AE, Ahmed N, Gomez-Llobell M, et al. CAR T cell therapy in early relapsed/refractory large B-cell lymphoma: real world analysis from the cell therapy consortium. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Abstract 50. 3.        Betts BC, Davilla ML, Linden AM, et al. CD83 expression by human breast cancer mediates effective killing by CAR T. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 340. 4.        Chang Lim KJ, Chhabra S, Corraes ADMS, et al. Risk factors for immune effector cell-associated enterocolitis (IEC-colitis) in patients with relapsed myeloma treated with ciltacabtagene autoleucel (cilta-cel). Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 317. 5.        Banerjee R, Richards A, Khouri J, et al. Post-CAR-T driving restrictions appear unnecessary after week 4: data from the US multiple myeloma immunotherapy consortium. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 572. 6.        Herr M, McCarthy P, Jacobsen H, et al. Physical function measures identify non-Hodgkin lymphoma patients at high risk of immune effector cell-associated neurotoxicity syndrome (ICANS) and 1-year mortality after chimeric antigen receptor T (CAR-T) cell therapy. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Presentation ID 58. 7.        Duarte FB, Garcia YDO, Funke VAM, et al. Comparison of outcomes after hematopoietic STEM cell transplantation (HCT) for myelodysplastic syndrome (MDS) patients older or younger THAN 65 YEARS Old. A retrospective analysis of the Latin America registry. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 618. 8.        Pidala J, DeFlilipp Z, DeVos J, et al. Determinants of immune suppression discontinuation in the modern era: a CIBMTR analysis of 18,642 subjects. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Presentation ID 39. 9.        Cowden M, Derrien-Connors C, Holtan S, et al. Patient experiences with chronic graft-versus-host disease and its treatment in the United States: A retrospective social media listening study. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 516.

OncLive® On Air
S12 Ep18: Neoadjuvant MVAC/Pembrolizumab Generates Unprecedented pCR Rates in Non-Urothelial MIBC: With Chandler Park, MD; Petros Grivas, MD, PhD; and Ruben Raychaudhuri, MD

OncLive® On Air

Play Episode Listen Later Feb 26, 2025 20:33


In this episode of Oncology Unplugged, a podcast series from OncLive and MedNews Week, podcast host Chandler Park, MD, a medical oncologist at Norton Cancer Institute in Louisville, Kentucky, was joined by Petros Grivas, MD, PhD; and Ruben Raychaudhuri, MD, to talk about a pilot trial investigating neoadjuvant accelerated methotrexate, vinblastine,doxorubicin, and cisplatin (aMVAC) plus pembrolizumab (Keytruda) in patients with non-urothelial muscle-invasive bladder cancer, findings from which were presented at the 2025 Genitourinary Cancers Symposium. Dr Grivas is clinical director of the Genitourinary Cancers Program and a professor in the Clinical Research Division at Fred Hutchinson Cancer Center, as well as a professor in the Division of Hematology and Oncology at the University of Washington School of Medicine in Seattle. Dr Raychaudhuri is an assistant professor in the Clinical Research Division at Fred Hutchinson Cancer Center, as well as an assistant professor in the Division of Hematology and Oncology at the University of Washington School of Medicine. In their exclusive conversation, Drs Park, Grivas, and Raychaudhuri discussed key efficacy and safety findings from this study; the need for conducting dedicated research in bladder cancer patient populations with variant histologies; and the potential of biomarkers, such as HER2 expression, to improve the bladder cancer treatment paradigm in the future.

OncLive® On Air
S12 Ep7: Blinatumomab-Based Regimens Enhance and Refine the B-ALL Treatment Paradigm: With Ryan Cassaday, MD

OncLive® On Air

Play Episode Listen Later Jan 23, 2025 19:06


In today's episode, supported by Amgen, we had the pleasure of speaking with Ryan Cassaday, MD, an associate professor in the Clinical Research Division at the Fred Hutchinson Cancer Center and an associate professor in the Division of Hematology and Oncology at the University of Washington School of Medicine in Seattle, Washington.  In our exclusive interview, Dr Cassaday discussed insights from several trials investigating blinatumomab (Blincyto) in patients with B-cell acute lymphoblastic leukemia (B-ALL) that were reported at the 2024 ASH Annual Meeting, including subgroup analyses of the phase 3 ECOG-ACRIN E1910 trial (NCT02003222). He also shared how findings from the phase 3 AALL1731 trial (NCT03914625) of blinatumomab plus chemotherapy in children with newly diagnosed B-ALL may be extrapolated to the adult B-ALL patient population. 

OncLive® On Air
S11 Ep43: Zanubrutinib Leads the Way for Advancements in CLL Management: With Mazyar Shadman, MD, MPH

OncLive® On Air

Play Episode Listen Later Dec 19, 2024 14:58


In today's episode, supported by BeiGene, we had the pleasure of speaking with Mazyar Shadman, MD, MPH, about updates in zanubrutinib (Brukinsa)–focused research in chronic lymphocytic leukemia (CLL) that were presented at the 2024 ASH Annual Meeting. Dr Shadman is an associate professor in the Clinical Research Division and the medical director of Cellular Immunotherapy at the Fred Hutchinson Cancer Center in Seattle, Washington. In our exclusive interview, Dr Shadman discussed key findings and implications from several clinical trials investigating zanubrutinib as monotherapy and in combination with agents such as obinutuzumab (Gazyva), sonrotoclax (BGB-11417), and venetoclax (Venclexta) in patients with CLL and other B-cell malignancies.

CCO Oncology Podcast
A Cancer Conversation: Optimizing the Care of Patients With CLL Through a Deeper Understanding of BTK Inhibitor Resistance

CCO Oncology Podcast

Play Episode Listen Later Sep 30, 2024 32:48


In this episode, listen to Matthew S. Davids, MD, MMSc​, and Lindsey Roeker, MD, discuss BTK inhibitor resistance and how it shapes treatment choices for patients with CLL, including:Contemporary treatment paradigms for patients with CLLSafety and efficacy of current regimensMolecular testing, including when and how to test for BTK inhibitor resistanceConsidering BTK inhibitor resistance when sequencing therapy Program faculty:Matthew S. Davids, MD, MMSc​Associate Professor of Medicine​Harvard Medical School​Leader, Lymphoma Program​Dana-Farber/Harvard Cancer Center​Director of Clinical Research​Division of Lymphoma​Dana-Farber Cancer Institute​Boston, Massachusetts​​Lindsey Roeker, MD​Assistant Attending​CLL Program Director​Department of Medicine​Memorial Sloan Kettering Cancer Center​New York, New YorkResources:To review a CME-certified text activity and download slides associated with this podcast discussion, please visit the program page.

ASTCT Talks
Managing Secondary Cancer Risks After CAR T-Cell Therapy in Multiple Myeloma Subgroups

ASTCT Talks

Play Episode Listen Later Sep 3, 2024 18:21


In a special co-branded episode between Oncology On the Go and the American Society for Transplantation and Cellular Therapy (ASTCT)'s program ASTCT Talks, Rahul Banerjee, MD, FACP, and Noopur Raje, MD, discussed the risk of secondary malignancies in patients with multiple myeloma who receive CAR T-cell therapy. Banerjee is an assistant professor in the Clinical Research Division of Fred Hutchinson Cancer Center and an assistant professor in the Division of Hematology and Oncology at the University of Washington. Raje is the director of the Center for Multiple Myeloma at Massachusetts General Hospital Cancer Center and a professor of medicine at Harvard Medical School. Banerjee and Raje spoke in the context of prior advisories from the FDA on the potential development of secondary T-cell malignancies in patients who receive CAR T-cell therapy for hematologic cancers. Specifically, the agency required a boxed warning for secondary T-cell malignancy risks for BCMA- or CD19-targeting therapies in April 2024.1 The conversation also touched upon reports of secondary malignancies in cases and trials such as CARTITUDE-1 (NCT04181827), in which second primary cancers were highlighted in 9 patients who received treatment with ciltacabtagene autoleucel (Carvykti).2 Considering these reports and warnings, Banerjee and Raje emphasized shared treatment decision-making with patients after assessing the risks and benefits of CAR T-cell therapy compared with other agents like bispecific antibodies. They also reviewed optimal strategies for monitoring and referring patients based on the incidence of certain toxicities. “[Treatment with] CAR T cells requires planning, and we need to have good control of the disease. We need to have 4 to 6 weeks of a lead time to get these effective treatments to our patients, so early referral is a good idea,” Raje said. “[For example], if you see chronic diarrhea in someone that is way out of the window of what you would expect, referring back to the CAR T-cell center is important so that we don't miss some of these toxicities.” References FDA requires boxed warning for T cell malignancies following treatment with BCMA-directed or CD19-directed autologous chimeric antigen receptor (CAR) T cell immunotherapies. News release. FDA. April 18, 2024. Accessed August 22, 2024. https://tinyurl.com/5n8pm5ca San-Miguel J, Dhakal B, Yong K, et al. Cilta-cel or standard care in lenalidomide-refractory multiple myeloma. N Engl J Med. 2023;389(4):335-347. doi:10.1056/NEJMoa2303379

Oncology Peer Review On-The-Go
S1 Ep125: Managing Secondary Cancer Risks After CAR T-Cell Therapy in Multiple Myeloma Subgroups

Oncology Peer Review On-The-Go

Play Episode Listen Later Sep 2, 2024 18:21


In a special co-branded episode between Oncology On the Go and the American Society for Transplantation and Cellular Therapy (ASTCT)'s program ASTCT Talks, Rahul Banerjee, MD, FACP, and Noopur Raje, MD, discussed the risk of secondary malignancies in patients with multiple myeloma who receive CAR T-cell therapy. Banerjee is an assistant professor in the Clinical Research Division of Fred Hutchinson Cancer Center and an assistant professor in the Division of Hematology and Oncology at the University of Washington. Raje is the director of the Center for Multiple Myeloma at Massachusetts General Hospital Cancer Center and a professor of medicine at Harvard Medical School. Banerjee and Raje spoke in the context of prior advisories from the FDA on the potential development of secondary T-cell malignancies in patients who receive CAR T-cell therapy for hematologic cancers. Specifically, the agency required a boxed warning for secondary T-cell malignancy risks for BCMA- or CD19-targeting therapies in April 2024.1 The conversation also touched upon reports of secondary malignancies in cases and trials such as CARTITUDE-1 (NCT04181827), in which second primary cancers were highlighted in 9 patients who received treatment with ciltacabtagene autoleucel (Carvykti).2  Considering these reports and warnings, Banerjee and Raje emphasized shared treatment decision-making with patients after assessing the risks and benefits of CAR T-cell therapy compared with other agents like bispecific antibodies. They also reviewed optimal strategies for monitoring and referring patients based on the incidence of certain toxicities. “[Treatment with] CAR T cells requires planning, and we need to have good control of the disease. We need to have 4 to 6 weeks of a lead time to get these effective treatments to our patients, so early referral is a good idea,” Raje said. “[For example], if you see chronic diarrhea in someone that is way out of the window of what you would expect, referring back to the CAR T-cell center is important so that we don't miss some of these toxicities.”  References 1. FDA requires boxed warning for T cell malignancies following treatment with BCMA-directed or CD19-directed autologous chimeric antigen receptor (CAR) T cell immunotherapies. News release. FDA. April 18, 2024. Accessed August 22, 2024. https://tinyurl.com/5n8pm5ca  2. San-Miguel J, Dhakal B, Yong K, et al. CIlta-cel or standard care in lenalidomide-refractory multiple myeloma. N Engl J Med. 2023;389(4):335-347. doi:10.1056/NEJMoa2303379 

Oncology Peer Review On-The-Go
S1 Ep91: HER2CLIMB-02 Trial Shows ‘Interesting Data' in HER2+ Breast Cancer

Oncology Peer Review On-The-Go

Play Episode Listen Later Jan 9, 2024 12:33


In a recent conversation with CancerNetwork®, Sara A. Hurvitz, MD, FACP, senior vice president and director of the Clinical Research Division at Fred Hutch Cancer Center and head of the Division of Hematology and Oncology at the University of Washington Department of Medicine, discussed new treatment options for patients with metastatic HER2-positive breast cancer.  In the discussion, Hurvitz highlighted findings from the phase 3 HER2CLIMB-02 trial (NCT03975647), which assessed the efficacy and safety of tucatinib (Tukysa) plus ado-trastuzumab emtansine (Kadcyla; T-DM1) in patients with HER2-positive breast cancer, specifically those with brain metastases.  Patients enrolled in this trial experienced a significant improvement in progression-free survival (PFS) with the tucatinib-based regimen. Data presented at the 2023 San Antonio Breast Cancer Symposium (SABCS) highlighted that the median time to disease progression or death was 9.5 months (95% CI, 7.4-10.9) and 7.4 months (95% CI, 5.6-8.1 in the experimental arm and placebo arm, respectively (HR, 0.76; 95% CI, 0.61-0.95; P = .0163). In patients with brain metastases, the median time to disease progression or death was 7.8 months (95% CI, 6.7-10.0) and 5.7 months (95% CI, 4.6-7.5) in the experimental arm and placebo arm, respectively (HR, 0.64; 95% CI, 0.46-0.89). Investigators reported that toxicity in the experimental arm was generally manageable and reversible. “This was a study that only enrolled patients who were naive to trastuzumab deruxtecan [T-DXd; Enhertu],” Huvitz said. “We know that T-DXd has substantial improvements in PFS and survival, so having so many patients receive this [agent] after progression is certainly going to impact our ability to observe survival differences. About 15% of patients in each arm also went on to receive tucatinib. These are pretty exciting results for our patients, especially those with brain metastases. This study did enroll, as I said, patients with brain metastases, who comprised 44% or so of the entire population enrolled in this study. These are interesting data, and we'll see if this regimen is ultimately approved.” Reference Hurvitz SA, Loi S, O'Shaughnessy J, et al. HER2CLIMB-02: randomized, double-blind phase 3 trial of tucatinib and trastuzumab emtansine for previously treated HER2-positive metastatic breast cancer. Presented at the 2023 San Antonio Breast Cancer Symposium; December 5-9, 2023; San Antonio, TX. Session GS01-10.

JCO Precision Oncology Conversations
Representativeness of Lung-MAP Participants

JCO Precision Oncology Conversations

Play Episode Listen Later Dec 20, 2023 24:47


 JCO PO author Dr. Mary Redman shares insights into her JCO PO article, “Representativeness of Patients Enrolled in the Lung Cancer Master Protocol (Lung-MAP)” Host Dr. Rafeh Naqash and Dr. Redman discuss the background of LungMAP and how it was developed to accelerate drug development and biomarker-driven therapies in lung cancer. Dr. Redman shares the initiatives undertaken to increase participant diversity in LungMAP and invites junior investigators to get involved in the project. 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'm your host, Dr. Rafeh Naqash, Social Media Editor for JCO Precision Oncology and Assistant Professor at the OU Stevenson Cancer Center. Today I'm delighted to be joined by Dr. Mary Redman, Professor of the Clinical Research Division at the Fred Hutch Cancer Center and also Senior Author of the JCO Precision Oncology article, “Representativeness of Patients Enrolled in the Lung Cancer Master Protocol” or the Lung-MAP. Our guest disclosures will be linked in the transcript. Dr. Rafeh Naqash: Dr. Redman, welcome to the podcast, and thank you for joining us today. Dr. Mary Redman: Thank you very much for the invitation. Dr. Rafeh Naqash: And for the sake of this podcast, we'll just use each other's first names. If that's okay with you. Dr. Mary Redman: Please. Dr. Rafeh Naqash: And since you and I know each other through the lung working group, we've worked on some things, or planning to work on some things, this article was something that I came across recently that you published with some very well-known folks in the field of lung cancer. And I wanted to utilize the first few minutes of this discussion to understand what was the background behind Lung-MAP because I think it's very important for people to understand why this kind of an approach was started in the first place and how it has successfully created a mechanism for master protocol. So, if you could dive a little deeper into that for us, since you've been there, you've done that, and it would help our listeners understand the genesis or the origination of this whole process of Lung-MAP. Dr. Mary Redman: Happy to do so. So, Lung-MAP, the original concept goes back to February of 2012. And in February of 2012, the Thoracic Malignancy Steering Committee, the FDA and the NCI had a workshop. And the focus of the workshop was how we could accelerate drug development in lung cancer, and in particular, how we could accelerate biomarker driven therapies within lung cancer. And the outcome of that meeting was that master protocols or studies that set up infrastructures to evaluate multiple therapies, all within one infrastructure, were the way to go. And so born out of that, there were three master protocols. The Lung-MAP trial, the ALCHEMIST trials to evaluate studies in adjuvant therapy setting, and then the MATCH trial, which, of course, isn't just in lung cancer, it looks across different cancer types and looks on biomarker targets that transcend across.  So, when the Lung-MAP trial was being thought of, the idea was that while in non-squamous, non-small cell lung cancer, we had seen some advances with targeted therapies, that squamous cell lung cancer had essentially no targeted therapies that had been successfully evaluated. And therefore, there was an unmet need that squamous cell lung cancer being a more aggressive form of lung cancer than non-squamous lung cancers, and in particular in the second line setting, after patients had received platinum-based therapy, there was pretty much nothing other than docetaxel.  And so, the study was initially conceived of by Vassiliki Papadimitrakopoulou, who was at MD Anderson at the time and Roy Herbst who we had at Yale. And so therefore, we thought second line squamous cell lung cancer was an unmet need and that we could potentially have targeted therapies, given now that we had the genome atlas, the TCGA understanding of what all the potential biomarkers or targets that exist in squamous cell cancer. Concurrently, we also had the developments and improvements in next-gen sequencing. So, the technology improved for us to be able to detect these different genomic alterations that were present in these cancers. So, all of that together - an unmet need of an aggressive cancer, a better understanding of the biology and the potential to have these targeted therapies - led to the development of Lung-MAP. But in addition, what we had seen and I think most of you who have studied cancers across the country know, patients who live in urban areas or are financially more well off are more able to access therapies, whereas patients who are less well off, more rural areas, and then just in general, different race ethnicities, didn't have the access that other patients from other settings had. And so, when we conceived of Lung-MAP, it wasn't just about meeting the unmet need in terms of treatment, it was also about an unmet need in terms of accessibility of these types of studies for all types of patients who get lung cancer. And so, utilizing the National Clinical Trials Network system that has sites all over the country, I think there's something like 2500 sites around the country, which include community oncology sites and of course academic sites.  Dr. Rafeh Naqash: Excellent. Thank you so much Mary, for explaining that. Now, as you highlighted, this dates back to 2011-2012, when things were just picking up from a broad sequencing platform standpoint, rather than limited gene testing, which has been more and more, there's been more and more uptick of NGS, especially in the space of lung cancer. So, you and several others came up with this idea and eventually implemented it. And there's a significant process of thinking about something and implementing something. So, what were some of the challenges that you encountered in this process and successfully circumvented or dealt with appropriately over these years, some of the lessons or some of the processes that you were able to understand and navigate around. Dr. Mary Redman: We could spend the next hour probably talking on that topic. Anytime that you're setting up a big infrastructure, and I really do think the best way to describe Lung-MAP and a master protocol is that it's an infrastructure because the goal is to set up something where we can bring in new studies and so that everything is modular. And you complete one study, you add a new one. Things can be added while things are ongoing. And by things, I mean studies evaluating investigational therapies.   And so, anytime you're setting up an infrastructure that's never been done before, well, first of all, the complexities of different partners that had never worked together, so just understanding how best to work together, the infrastructure in terms of how to build it within our systems, the statistical and data management center had many complexities. The infrastructure in terms of how our systems at the statistical and data management center spoke to the NCI had challenges. How the NCI evaluated this protocol that had all these different studies that were coming and going.  The studies oftentimes involved therapies that were very new in their development. And so oftentimes you'd have some new safety signal that came up which required a rapid amendment. And how do you do that when you have this infrastructure, and you don't want to stop one thing for other studies to be moving forward. And that because it's a public-private partnership and the pharmaceutical partners that are partially supporting financially and scientifically, some of these studies, learning to work with them, they have a little bit more say because they are more financially involved with the studies than a study that's typically funded by the NCI. And maybe the company is only supplying drug. So, contracting had its challenges, budgets, how do we actually budget things appropriately in this new infrastructure? I talked about all of that. And then a challenge about running such a study is how do you educate the sites so that when they're approaching patients, how can they talk to a patient about, “You're going to have your tissues submitted to be tested, and then on the basis of that tumor testing you're going to be assigned to get to an investigational treatment study.” And how do you describe all of that? Dr. Rafeh Naqash: So definitely lots of lessons and experiences that you and your team have had. And the way I describe or look at Lung-MAP is one of those success stories that has redefined the way to run clinical trials from an NCTN and a SWOG cognitive group network standpoint. And going to this paper that you have published in this, your Precision Oncology, there's one aspect of clinical trials where we are always very focused on responses and survival and other clinical outcomes data. And then there is this important component that you and your team have looked at is, what is the distribution of the different kind of clinical trial participants? What kind of people are we getting in? What kind of people are we trying to cater to, and what is the unmet need gap that we still have not completely met? Could you tell us how this project started, the idea behind this project, and then some of the results that you can highlight for us today? Dr. Mary Redman: So, Lung-MAP also has a company advisory board, and we meet with them either quarterly or biannually. And one of the conversations that we were having with our industry partners or collaborators was especially after the FDA came out with some of their work saying, we think it's really important that industry does better that they enroll a more representative patient population in their studies. You see some of these studies in lung cancer with 1% or a very small percentage of Black participants, for example, whereas the US population has significantly higher levels. And so, one of the major objectives, as I said about Lung-MAP, was to enroll a more representative patient population to provide access. And as part of these conversations, we kept saying, “Well, we've done a better job.” And I was thinking, well, we actually could evaluate how we have done. And so, in thinking about that, I proposed within some of the researchers that are part of the SWOG Statistical and Data Management Center that we look at this question in particular, I approached Dr. Riha Vaidya, who is here at Fred Hutch with me, and she's a Health Economist with this idea. And she was very excited to look at this. And my initial thought was just to look at race, ethnicity, gender. And she took it one step further where she wanted to look at not only that, but also area deprivation index and then rural versus urban. So, getting at some of those other very important aspects of representativeness when we think about patient populations. And so that was how it came about.  Dr. Rafeh Naqash: Going back to some of the interesting things that you and the authors have done, is not only looked at the gender, age, but also looked at the socio-demographic representativeness. Now, there's definitely some things that you guys looked at and that Lung-MAP study did better on, and some things where maybe there's more room for improvement. Could you highlight some of those results for us today? Dr. Mary Redman: Happily. And one thing I think that it's important if one goes and looks at this paper, and as I talk through the results, so Lung-MAP opened to enrolling patients in June of 2014. And from June of 2014 to January of 2019, we exclusively enrolled patients with squamous cell histology. And then in 2019, we expanded the study to enroll all histologic types of non-small cell lung cancer. And so, in this paper that's published here in JCO Precision Oncology, we compare our patient population and Lung Map to other patients enrolled within advanced non-small cell lung cancer trials. So that's all-histologic types. And then we compared it to the SEER population, the US population evaluated by SEER. And that also is all histologic types of non-small cell lung cancer.  And so, one of the major results, as you pointed out, is that while we did well in certain areas, for example, we did not enroll as many females as the other SWOG trials and then the US population. And I think that is probably, I would attribute all of that to being the case that squamous cell lung cancer patients tend to be more male than female. So therefore, those results, I don't know that if we looked at only the data since 2019, we might actually see that we were comparable. Going through the results, as you were just asking about, compared to previous SWOG trials, we did better in terms of enrolling older patients, not as well as the SEER data. Some of the challenge is I'm not 100% clear that we'll ever be able to get perfectly there, in part because Lung-MAP, for the majority of the time, only enrolled patients who had performance status 0 or 1, and older patients tend to have higher performance status, and so they might just not have been eligible. And I do think, especially with these investigational treatments, particularly with immunotherapies, for safety reasons, we do need to enroll patients with performance status 0 or 1. We talked about the female sex versus male sex percentages and that our numbers were smaller. But if you look at SWOG trials versus SEER trials, they're pretty much identical numbers. So, I think that if we just looked at the later part of Lung-MAP, you'd see that they match. In terms of race ethnicity, the earlier part of Lung-MAP, we enrolled close to 15% of patients of nonwhite race or ethnicity. Historically, SWOG trials were slightly higher, but in the US population, it's around 21.5%, based on this year's data. And so, we did better than industry sponsored trials. So, if you look at those data, but there's definitely room for improvement. And that just in part, has to do with getting more sites, better outreach, more education, and better access.  And so, I think we have an accrual enhancement committee that does include patient advocacy groups. And I think that that is just going to be an area that we need to continue to work on. And then, as you mentioned, that we did better in terms of enrolling more patients from rural areas. We enrolled more patients from socioeconomically deprived neighborhoods, and more patients that were using Medicaid or no insurance for those who are under 65. Dr. Rafeh Naqash: Absolutely. I think those are very important results. Me, as somebody who sees people on clinical trials, both phase I and late phase, of the questions that I get commonly asked if somebody refers a patient from the community is, “Am I going to be treated on a placebo?” It's one of those common things. And the second question ends up being like, “Is my insurance going to cover some of the costs associated?” And I think understanding those concepts, whether it's from an educational standpoint or a financial barrier standpoint, is extremely important in clinical trials because at the end of the day, these are things that people use as metrics for enrolling or not enrolling themselves on a clinical trial. There are certain aspects or sensitivities associated with enrolling people, let's say, of Native American ethnicity or American Indian ethnicity, where outreach is extremely important. From a Lung-MAP standpoint, could you talk about some of the outreach initiatives that are being implemented or have already been implemented to potentially help decrease this gap of representation?  Dr. Mary Redman: I think that one of the major- and this isn't exactly outreach, but to start out with one of the things that we have, in addition, I mentioned that we had an accrual enhancement committee. We also have a site coordinators committee. And when we set up the site coordinators committee, we make certain that we have representation from the geographic regions within the country and different types of sites. And the major goal for our site coordinators committee is to give us input about how it is to implement Lung-MAP within their own institutions. And so, we want to be able to overcome any type of barriers or perceived barriers that are out there, and we want to hear it directly from those people who are working closely to enroll the patients. And so that's been a key part of everything that we've done. And so, part of that is that we've just developed educational materials. We have modified the protocol based on input that we've received from them. So that's, I think, been a major approach that we have used to try to reach more patients.  We do have a newsletter that we put out. The accrual enhancement committee has also contacted different sites to really have more conversations, one on one, just more, I guess, almost like focus type groups where you try to understand, really understanding what's coming on, what are the challenges from their perspectives. And then we've had webinars where we try, and we've had hundreds of attendees for these webinars, where we let the sites have direct access to those of us who are running the study to ask their questions. So those have been our major approaches. And I think that we're always trying to figure out how we can do better.  Dr. Rafeh Naqash: I agree with you, and I think as both physicians, providers, and the clinical trial staff as such become more and more cognizant of increasing diversity, these conversations end up happening earlier and earlier in an individual's patient's journey, where trying to see feasibility, trying to see financial aspects, getting a patient enrolled on a clinical trial gets evaluated earlier and earlier. And hopefully, with some of the measures that the SWOG or the Lung-MAP group is implementing, these percentages will see more spike in the long run for better clinical trial enrollment approach. So, Mary, now going to the science part of Lung-MAP for maybe some of the fellows or the investigators, early career investigators, who might be listening to this podcast, could you briefly explain what is the process of getting involved in Lung-MAP? Because for me, as a junior faculty a few years back, I was a fellow, and I remember at that point I hardly had any knowledge of corporate groups. SWOG, for example, was one of those that I'd heard about, but didn't necessarily know how to get involved. So, for trainees, for junior faculty, could you briefly say, what's the process? What does it involve? How would somebody propose something to Lung-MAP?  Dr. Mary Redman: Yeah, thank you for that question. And I really do hope that this actually is a way to get people to understand, and we'd love to have more engagement from more junior faculty and that's a major objective for the study. Because this infrastructure is in place, we are actually well suited to be able to mentor and bring junior faculty in. And so, the process is basically, you contact any of us that are in leadership within Lung-MAP and talk to us and we'll see if we can figure out a way. If you have an idea of a new study, wonderful. Our drug selection committee chair is Saima Waqar. She's a member of ASCO as well. I mean, one could find her and send her a note. The study chairs for Lung-MAP are Hoss Borghaei and Karen Reckamp. You can send them a note. You can send me an email, maryredman@fredhutch, and we will make certain that you are engaged and brought into the direct conversations that would lead to something.  So, it would be wonderful to have more junior faculty proposing ideas and leading sub studies, being a sub study chair. Each of our sub studies, as I mentioned before, are conducted independently, and then you are responsible for the development, conduct of the trial and writing of the paper and presenting. And so, we want all of that to happen. But we also would love to have ideas. If you think of this infrastructure as just being an amazing resource of data, we are happy to and would love to receive proposals for data analysis that could result in publication and presentation as well. So, if there's something that somebody sees as a question that they think we could answer, again, contact any of us and we will happily figure out a way how to work with you. We have a great team and a lot of capacity to be able to work with new people.   Dr. Rafeh Naqash: Thanks, Mary. And for all those listeners, trainees listening, you did get Mary's email, so try to send her an email, and hopefully she won't be complaining that there was a lot of requests. But I think all things considered, the Lung-MAP is a great data resource. As you mentioned, it's a great resource for junior investigators who are trying to build a career around clinical trials, precision medicine, and it's also a great resource, as you've shown, regarding diversity equity research from a clinical trial standpoint. So, I think it has all the components that are needed to run and create some interesting questions and answer those questions using the data set.  So now, Mary, going to the last part of the discussion here, one of the key components, we try to ask a few questions of the investigator, which in this case is yourself. Could you tell us briefly about your career trajectory, how you ended up doing what you're doing now, and what are some of the things that you've learned from and maybe advice to all the junior people listening to this podcast?  Dr. Mary Redman: Wow. Okay. Well, so if you hadn't already guessed, I'm a biostatistician. I started out in mathematics as an undergrad and then learned about biostatistics and thought that it sounded perfect for me. After I finished my doctorate, I did a year of postdoc and was starting to look for faculty positions. And if you haven't already inferred, I am a Seattle native. And so, when a position became available at the Fred Hutchinson Cancer Center here in Seattle, I applied for it, and the job happened to be with the SWOG Statistical Center. And so, you probably already guessed as well that I got the job. And so, I have been here at Fred Hutch since 2005. And when I joined Fred Hutch and the SWOG Statistical Center, which is co-located here and at Cancer Research and Biostatistics, just a mile west across Lake Union here in Seattle, the person who had been the lead statistician for the Lung Cancer Committee in SWOG, John Crowley, he was also the director of the SWOG Statistical Center and had been doing that for over 20 years, and he was ready to take some things off of his plate. And so, when I joined, they thought that I would be a great fit for the lung committee, in part because I had shown an ability to work with vibrant personalities, let's just say, which the lung community has in spades.  And so, when I started in the lung committee, David Gandara was the chair of the lung committee. And so, I worked for many, many years very closely with David, and we established a very close and really wonderful working relationship. And I learned a lot from him. I learned a lot from a lot of the other lung cancer researchers in the country and around the world. I pretty quickly became involved with the International Association for the Study of Lung Cancer and have attended most of the World Congress on Lung Cancer meetings and have gotten to know people around there. So as a biostatistician, obviously, I enjoy my mathematical and statistical skills, but I also just really enjoy learning and thinking about what I can bring to the problem where I come from a certain point of view and I love collaborating with the other people doing clinical research, in particular in lung cancer. And basically, my focus has always been on doing the best to answer our questions the most efficiently and effectively so that we can move the field forward and help people live longer. Dr. Rafeh Naqash: Thank you so much, Mary, for your time and giving us insights into your professional and personal journey. Also, thank you for listening to this 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/podcast. 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.    

The EMJ Podcast: Insights For Healthcare Professionals
Bonus Episode: Real-World Experience of Biosimilar Medicines in Oncology

The EMJ Podcast: Insights For Healthcare Professionals

Play Episode Listen Later Jul 19, 2023 27:33


In this episode, moderator George Cooper, sits down with the brilliant minds of Professor Stacey Cohen and Dr. Jeff Sharman. Together, they delve into the fascinating world of Monoclonal Antibody Biosimilars and their significant impact on the field of Oncology, with a particular focus on Lymphoma and Colorectal Cancer.   Join us as our expert panel explores the utilization of Monoclonal Antibody Biosimilars in the treatment of these cancers, shedding light on their efficacy and safety. Drawing from their extensive experience and knowledge, Professor Cohen and Dr. Sharman also share their insights on the prevailing attitudes towards this approach, while highlighting the key aspects of the current consensus within the medical community. This episode also offers a glimpse into the future prospects of Monoclonal Antibody Biosimilars, including the anticipated uptake and potential advancements in the field.     Professor Stacey Cohen Associate Professor at the Clinical Research Division, Fred Hutch Cancer Centre as well as an Associate Professor at the Division of Oncology, University of Washington.   Professor Cohen is a specialized medical oncologist focusing on GI cancers, including colon, rectal, early-onset, and hereditary types. Her research explores the influence of genetics on treatment choices, encompassing hereditary gene alterations, tumor genetic changes, and novel disease markers. Dr. Cohen aims to personalize treatment decisions for her patients and the wider cancer community, maximizing efficacy while minimizing side effects. She values establishing enduring patient relationships and participating in collaborative decision-making processes.   Doctor Jeff P Sharman Director of Research at the Willamette Valley Cancer Institute as well as the Medical Director of Hematology Research for The US Oncology Network.   Dr. Sharman, the research director at the Willamette Valley Cancer Institute and the medical director of hematology research for The US Oncology Network, possesses extensive knowledge and expertise in the latest scientific advancements across various cancer types. His notable contributions to treatment progress and extensive publication history in esteemed scientific journals, such as the New England Journal of Medicine, Journal of Clinical Oncology, and Blood, highlight his expertise. Through his research program in Eugene, he has garnered global recognition in diverse cancer fields and presented his findings at major conferences in the US, Asia, and Europe. Dr. Sharman's research has facilitated WVCI's access to exciting new areas of research, including immunotherapy, targeted therapy, and personalized medicine.     This podcast was funded by an educational grant from Pfizer, who has had no input to the creation of this educational podcast.

The Cancer History Project
Fred Appelbaum on the genesis of bone marrow transplantation and Don Thomas's Nobel-prize-winning discoveries

The Cancer History Project

Play Episode Listen Later May 19, 2023 39:25


In this episode, Frederick Appelbaum, executive vice president, professor in the Clinical Research Division, and Metcalfe Family/Frederick Appelbaum Endowed Chair in Cancer Research at Fred Hutchinson Cancer Center, speaks with Alexandria Carolan, associate editor with the Cancer History Project. Delving deep into Thomas's role in discovering bone marrow transplantation and its role in curing hematologic cancers, Appelbaum, who became Thomas's mentee and collaborator, wrote “Living Medicine: Don Thomas, Marrow Transplantation, and the Cell Therapy Revolution.” “If it hadn't been told, and if the story had been lost to history, I just thought that would be a tragedy,” Appelbaum said to The Cancer Letter. “We've gone from a setting where Don and just one or two other people were the only ones that thought marrow transplantation was even possible in the 1950s, to today, where there are 100,000 transplants performed worldwide every year and 40 million people have signed up and registered to be potential stem cell donors.” A transcript of this recording appears on the Cancer History Project.

Cancer.Net Podcasts
Genetic Testing for Bladder Cancer, with Petros Grivas, MD, PhD, and Marianne Dubard-Gault, MD, MS

Cancer.Net Podcasts

Play Episode Listen Later Mar 23, 2023 23:36


ASCO: You're listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the voice of the world's oncology professionals. 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. Guests' statements on this 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. Cancer research discussed in this podcast is ongoing, so data described here may change as research progresses. In this podcast, Cancer.Net Specialty Editor Dr. Petros Grivas talks to Dr. Marianne Dubard-Gault about what people with bladder cancer should know about genetics and genetic testing, including what information genetic testing can provide, how it can inform bladder cancer treatment, and what to expect when meeting with a genetic counselor. Dr. Grivas is a medical oncologist at Seattle Cancer Care Alliance, clinical director of the Genitourinary Cancers Program, and professor at the University of Washington School of Medicine. He is also an associate member of the Clinical Research Division at Fred Hutchinson Cancer Research Center. Dr. Dubard-Gault is the medical director of the Cancer Genetics Program at Fred Hutchinson Cancer Research Center and an assistant professor at the University of Washington School of Medicine.   View disclosures for Dr. Grivas and Dr. Dubard-Gault at Cancer.Net. Dr. Grivas: Hello, I'm Dr. Petros Grivas. I'm a medical oncologist and serving as the clinical director of the Genitourinary Cancers Program and professor at the University of Washington Fred Hutchinson Cancer Center. I'm very excited and thrilled today to discuss with one of the amazing leaders in the field of cancer genetics, Dr. Marianne Dubard-Gault, who is my colleague here at UW Fred Hutchinson and has been such a wonderful human being and advocate for her patients and also really a key opinion leader in the field of genetics and the implementation in patient care. Dr. Dubard-Gault, welcome, and I will let you introduce yourself. Dr. Dubard-Gault: Thank you very much, Dr. Grivas, and it's a pleasure to be here. So thank you for the invitation. I am Dr. Marianne Dubard-Gault. I am a trained oncology doctor and a trained genetics doctor, and my focus now, as Dr. Grivas mentioned, is in the cancer genetics world where I help people either get genetic testing in the first place and/or their family members have interventions for their screening and early detection. I'm also an assistant professor at Fred Hutchinson Cancer Center in Seattle, Washington, and then at the University of Washington on the other side. And I lead the Cancer Genetic Survey Center at Fred Hutchinson Cancer Center. And I have no disclosures. Dr. Grivas: Thank you so much, Marianne, and again, thank you for helping our patients. And I'm really, really excited today because it's a very important topic, not frequently discussed. And I really, really wanted to make this happen, and thanks to Cancer.Net for helping us getting the word out there. I have no relevant disclosures in this topic. My disclosures are listed on the ASCO website. And Marianne, I will start us off by asking you, just for the audience to set the stage, can you define what we call “genetics”? What exactly are we referring to? Dr. Dubard-Gault: Yes, that's actually very important. That's probably the first thing that happens in the clinic when we talk to patients is, what is genetics anyway, right? So genetics is the study of the DNA or the genetic makeup that we all have. And that makes a person who they are, right? So looking into the genetic makeup to make sense of it and inform treatment or other interventions. Dr. Grivas: Thank you much, Marianne. And I think it's so important again for our patients to understand the definitions here. So let me ask you, can you define the difference between a genetic mutation versus genetic alteration? How would you explain that to a patient? Dr. Dubard-Gault: I think about them in a similar way. So, to me, a genetic mutation or alteration is a spot in your DNA. So there's a long stretch of letters, and there's a spot in there that either was copied or wasn't copied properly over. And so that leads to a command that kind of not being executed properly. And so an example of that would be if I gave you the 2 words “red” and “bed,” those 2 words would mean totally different things in your mind. And so if you were supposed to hear “red” and you heard “bed,” then downstream will be a different outcome. Dr. Grivas: Thank you so much, Marianne. And this is very important because for the audience as you pointed out nicely, the genetic code, the DNA translates a message, alright, that becomes a protein and eventually a function of the cell. So if that code, if that message is misspelled, it can lead to different altered and changed-up protein for the cell. That has implications and can potentially predispose someone to cancer. So if we can also help the audience understanding the differences between what we call “somatic genetic mutations” and “germline mutations.” Dr. Dubard-Gault: Absolutely. And this is also something that comes up every time because they're part of the same groups of things overall, right? So somatic means tissue or tumor. And germline, or hereditary, sometimes you'll hear that word interchangeably means inherited or hereditary or part of the genetic makeup or the code that you were born with. So different parts of our body have different genetic mutations. And that is why even with 2 identical twins, they won't have the same moles on their skin, or they won't have the same medical conditions, even if they have exactly the same genetic code. And it's exactly the same for a person who has a tumor, right? The DNA or the genetic makeup they were born with will stay exactly the same as they grow older, but the genetic makeup their tumor has as the tumor grows can change and make more or have more mutations. So testing different parts of the body will help tease out which ones of the mutations are located where? Is it in a tumor only? Is it in the genetic makeup you were born with or is it part of that transition between the 2? Dr. Grivas: Thank you, Marianne. I think this is great when we explain to the patients what exactly mutations, alterations, means, and the difference between a somatic tumor testing, as you said, mostly to help define treatment options. And what you very nicely discussed are germline testing, looking at hereditary predisposition to cancer that can impact the patient and also family members and the broader family. And one kind of take-home message may be for our audiences, when someone is about to see an oncologist or their provider, is greatly helpful if they can do quote-unquote "their homework" and try to understand and delineate and capture as much as possible regarding the family history. And sometimes it's hard, especially when you go to distant relatives, cousins, nephew, nieces, it's more difficult, but it can help a lot and inform that discussion and whether a referral to a genetic counselor or geneticist is relevant. So that's what we try to do with nurse navigation these days to help inform people with cancer before their appointment how they can maximize to capture that information, it can be helpful to them and for the provider. And the next question, Marianne, is how common are these genetic germline mutations in people with bladder cancer? Dr. Dubard-Gault: I think the answer is still out there. We don't have the complete answer today. We don't know all the genes that are implicated in bladder cancer today. So given that, we probably don't have the full or complete answer as to how many people with bladder cancer would have it. But kind of to get close to the answer, as close as we can possibly be today, I think it depends on the group of patients with bladder cancer that you test, but I would probably give a 1 in 10 people with bladder cancer would have an inherited genetic mutation. Dr. Grivas: And that's very helpful Marianne. And of course, varies, of course, across the different scenarios and the family history as you mentioned, the age of cancer diagnosis. And sometimes it's interesting in patients with urothelial carcinoma, cancer in the upper urinary tract, like renal pelvis, kidney problems, or ureter, there seems to be some higher frequency of germline mutations in that as opposed to bladder cancer. Of course, it can happen in that scenario, but seems to be some higher frequency in the upper tract cases, is that right? Dr. Dubard-Gault: I agree. Not all cancers are created equal, right? In the bladder, that's probably also true. So depending on where it starts, the type of cells that are involved, and how the person was born with certain genetic predispositions, it may very well affect how all of these are linked together in one line of event versus maybe something that happened randomly or occurred that we don't have a one specific answer or a combination of answers. Dr. Grivas: That's a great point. And obviously, there are the huge impacts that we discussed to help prevent cancers in the bladder family. Cancer prevention mode, I call it, when I explain to the patients before they see you. And also, some patients are also asking, in addition to that family benefit in my brother's family, is there any potential impact on the treatment selection for the bladder cancer? Any comment? Dr. Dubard-Gault: Yes, I do believe there is actually more today than ever before, especially with the new medications that have come around, right? So sometimes a genetic mutation will happen in the DNA or the code that is important for repairing the code of the DNA, or sometimes it will happen in an area that helps boost the immune system or the response to the cancer cells by the immune system. So in that case, if we find a genetic mutation, then we can use a chemotherapy that concentrates or targets that area that's not working well and fix it, right? So that's one really important area. And then another area, and Dr. Grivas, I know you've done a lot more clinical trials and studies that involve the DNA that makes new blood vessels for feeding the tumor. And in that case, you can use a chemotherapy that would block the body from making those new blood vessels and basically shut off the feeding system to the tumors. And so that way, the genetic testing can also help the patient find a therapy that would work better for them. Dr. Grivas: That's a great discussion. And we're doing many clinical trials to test this hypothesis. This assumption kind of practice, and we try to look at particular therapies that might be relevant in the context of a germline mutation. And those clinical trials are very promising. And I always encourage our patients to consider subsequent trials. And the other aspect of it, as you said very nicely, is that a patient who may have some changes in the code encoding some enzymes, some proteins that repair the DNA, this can cause some more mutations. And in this particular scenario, there may be a much higher response to immunotherapy. That immunotherapy may help shrink those tumors with what we call more unstable genomes. So that's very interesting to see that across tumor types, to your point. The other question is if someone is referred to genetic counseling, how can they be better prepared for their appointment? Dr. Dubard-Gault: I think the most important thing that I would say is to really embrace it and go. Because it's often something that makes people worried that they have a genetic predisposition in the family, and they may not necessarily be ready to hear it or want to have as much information, especially being diagnosed with a cancer at the time. And so really embrace it and go for the genetic visit because it is something that could be very useful and bring information not only to you as a person for your own treatment, and/or then for your siblings or relatives for them to have access to interventions they would not have otherwise. Dr. Grivas: What question do you think people should ask their providers? How can they better prepare for the visit with the provider overall regarding the topic we are discussing today? Dr. Dubard-Gault: That's also very important because as much information as you can gather is really important. So, if possible, gathering as much information about your family history as you can, as Dr. Grivas mentioned. And sometimes you can't have all the information, some grandparents died, they did not share the information about their cancer diagnosis because they didn't want to upset the family. Sometimes you have no information on one side of the family because you don't know who your father's parents are, for example, or a certain relative may be OK now and they have cancer later on, and you will probably not have that information, right? We can still do the genetic test knowing that some of this information is missing. So keeping in mind that as much information as you can get is good. And if we have a lot, that's helpful, and if we don't, we will kind of factor that in our conversation. And a few other tips I would keep in mind is the timing of the testing matters. Sometimes doing the testing earlier in the process is a good thing because it takes a little while for the results to come back. That's a sophisticated test that takes usually 3 to 4 weeks. There are many different types of genetic testing; that's also very important. You may very well have more than 1 genetic test, as Dr. Grivas mentioned. The test on the tumor, the test on your genetic makeup from a blood sample or a saliva sample. I mean, keeping in mind-- I think the third one that's really important is keeping in mind that when we do the genetic test, the results may implicate other people in the family straight away. And I'll share an example of this because this comes up in my clinic very often. So I met a brother not so long ago who had bladder cancer. No exposures, no smoking, nothing to point to a risk of bladder cancer for him, but his sister had uterine cancer earlier on before the age of 40, and then had colon cancer as a second primary cancer. And the test came back with the genetic predisposition we talked about, Lynch syndrome. And this diagnosis basically explained his cancer diagnosis on why he had an unstable genome in his tumor. And his sisters, both of his sister's cancer. So by proxy by testing him, we tested not only him, but his sister as well, even if we'll do the sisters confirmation tests, we know the sister is likely positive for this. Dr. Grivas: Thank you so much, Marianne. The very useful information. Again, the positive impact and benefit for the broader family. What happens during and after the initial meeting with the genetic counselor or the geneticist? Dr. Dubard-Gault: Well, I love genetic counselors, I think they're very helpful. And I work with them on a day-to-day basis. So, what they'll do is they'll sit down with you either in person or telemedicine or telehealth from the comfort of your own home or on the phone. I don't like the phone as much as I like the interpersonal connection with a person. But they'll help you draw out your family tree, put all the people in the family on the page together to kind of see and share a pattern. They'll talk a little bit more about the different types of genetic testing one person could have. And then they'll facilitate getting the genetic test that is best for you and your family. And so that really is the most important piece because they'll work with your oncology doctors and other doctors to come up with the best option. And the one that matches the family story. And then if you're in person, you could even provide a sample, either a blood sample or a saliva sample, right there. And then the authorization and all goes through, and then the results usually will come back a few weeks later. And then the genetic counselor or myself as a genetics doctor will sit down with you when the results come back to review what they mean, not only what the actual test says, but what they mean specifically for your treatment, and/or for yourself or your screening and interventions later on, and/or your family members, if they need to be tested themselves or what needs to happen for them. And then you can obviously be referred to a specialist like Dr. Grivas or others for a colonoscopy or for thyroid ultrasound or some other tests that may be needed for these screening interventions in the future. Dr. Grivas: Great points. And as you mentioned before, it's important for the patients who see the provider to discuss their family history-- close and distant family history as much as they can, and they can even ask whether they need to see genetic counselors. Sometimes the patients can remind a busy provider how important that is and ask for a referral, it's definitely important to ask the provider.  Very quickly, Marianne, you mentioned before the value of testing for both the patient and the broader family in terms of what we call cascade testing and cancer prevention. You mentioned the example in your patient, can you very briefly comment on that and what is the value here again for the patient and the family? Dr. Dubard-Gault: Absolutely. And sometimes someone with a genetic predisposition, so someone born with a genetic predisposition to cancer, can be at risk of more than 1 cancer in their lifetime. So sometimes, when they're diagnosed with the cancer, we find this genetic predisposition to said cancer, but it may come with other cancers as well, just like the bladder cancer and uterine cancer and colon cancer. And this may not be something a person would want to hear when they're diagnosed with cancer, but it is good information that will stay there for the future as they go through the treatment for having interventions done, right? So it's good information to talk about with their doctors so their doctors can order the colonoscopy or different screening protocol. We'll recognize a certain intervention like removing the uterus of someone in the family so they would reduce their risk of uterine cancer. And obviously, genetic mutations tend to be shared in the family. It's most likely something was inherited in the family rather than new in a person. So each person who's positive for a genetic predisposition, we think about their siblings, their children, their nieces and nephews, and those people may have exactly the same genetic predisposition or mutation, and they may be at risk of the same kinds of cancers. And that's the reason why they would get this information to be eligible for other screenings as well. And interventions. Dr. Grivas: Very important, and very useful for the patient. Before we wrap up, Marianne, can you comment a little bit on barriers to testing, out-of-pocket costs, culture, trust, literacy, busy practice, competing priorities? Dr. Dubard-Gault: Yes, absolutely. I think the main ones are awareness that bladder cancer can be a genetic cancer. It's really rare, but it can be. And so keeping that in mind, because then if you're not even referred or that doesn't come to mind, it may not get us to doing this genetic testing. The diagnosis of cancer is a lot to take in, right? So it may not be the right time to do it right away, but keeping that in mind for the future is also important. The cost. Sometimes the generic testing isn't covered by Medicare, unless there are specific criteria that we talked about, a family history of specific type or early diagnosis and all these things. And the genetic counselor will really help push to find as much information as possible to get the test covered. And there are lower-cost options out there. And I think the last 2 are really the privacy of the results. People worry that this information will be shared outside of health care, and/or sharing themselves this information with their family members when they're probably or maybe not ready to disclose their cancer diagnosis. So I find that that's maybe less or lower on the list, but in order to keep in mind as well. Dr. Grivas: Thank you, Marianne. Maybe the last 2 very quick questions for you. Germline testing and options and value of counseling. I know you have touched upon that already. But did you have any departing thoughts on that part on the value on the patient and the family and any other considerations, for example, DNA biobank, etc.? Dr. Dubard-Gault: Absolutely. So, I find that meeting with the genetic counselor, even after you've had genetic testing and the results are back, is a valuable thing to do. And not necessarily right away, but later on down the road, right? So because this field, the genetics field, advances rapidly, it's possible someone will be testing again or there are more genes or more mutations out there we weren't testing for a few years ago that we would test again. So keeping in mind, we can test again. And that meeting with the genetic counselor is always useful even if you have heard a little bit about it already. And then the DNA biobanking piece, if that's a service that's available to you, keeping your DNA for the future, when the technology is not advanced yet, is very important because we know for sure the knowledge will change and will bring new treatments and new options for screening and interventions, so keeping the DNA for the future is very useful. Dr. Grivas: That's a great point. And because technology is evolving very fast, the methodologies are changing, many times we have the information and genetics team, and counselors and geneticists try to keep track and follow those people who are tested to see if any of the information may potentially make a mutation that was of a certain significance-- something that may be significant down the road as more information are coming in. And because of this rapidly evolving nature of information, it is good for people with cancer and also any affected family members to stay in touch periodically and follow up with the genetics team. Maybe the last question for you, Marianne, is if you have any take-home message for our people, our audience today so they can remember going forward. Dr. Dubard-Gault: Information is power. It really is. And having this information helps your doctors bring the best treatment to the tumor that you have and not somebody else's, right? And for the family, that may bring an answer that was longed for really generations before you, and that would help not only have this information, but take it forward and say, "You know what? I'm going to do something about it because we can." So to me, that's the reason I transitioned careers, and that's the message that I want to keep sharing. Dr. Grivas: What a great message by Dr. Dubard-Gault. And now we're trying hard to involve and engage genetic counselors and geneticists to our multidisciplinary clinics. And bladder cancer is a great model for multidisciplinary approach, and we try to engage them earlier. So we need more of you, Dr. Dubard-Gault. We need more geneticists and genetic counselors. And with your background in oncology, it's fantastic to work with you. Thanks again for a great discussion. Thanks again to Cancer.Net for all they do for the mission of patient education and of course ASCO. And thanks to the audience for your attention today. Thank you. Dr. Dubard-Gault: Thank you for inviting me. ASCO: Thank you, Dr. Grivas and Dr. Dubard-Gault. Learn more about genetic testing and cancer at www.cancer.net/genetics.  Cancer.Net Podcasts feature trusted, timely, and compassionate information for people with cancer, survivors, and their families and loved ones. Subscribe wherever you listen to podcasts for expert information and tips on coping with cancer, recaps of the latest research advances, and thoughtful discussions on cancer care. And check out other ASCO Podcasts to hear the latest interviews and insights from thought leaders, innovators, experts, and pioneers in oncology. Cancer.Net is supported by Conquer Cancer, the ASCO Foundation, which funds lifesaving research for every type of cancer, helping people with cancer everywhere. To help fund Cancer.Net and programs like it, donate at CONQUER.ORG/Donate.

The Medicine Mentors Podcast
Why Ever Not? With Dr. Nancy Davidson

The Medicine Mentors Podcast

Play Episode Listen Later Feb 23, 2023 15:54


Nancy Davidson, M.D., serves as the Executive Vice President for Clinical Affairs and Senior Vice President and Professor of the Clinical Research Division at the Fred Hutchinson Cancer Center at the University of Washington, where she heads the Division of Medical Oncology. She is the past President of both the American Society of Clinical Oncology (ASCO) and the American Association for Cancer Research (AACR). She is a recipient of a number of prestigious awards including the ASCO Gianni Bonadonna Breast Cancer Award and the NCI Rosalind E. Franklin Award and was recently inducted into the Giants of Cancer Care. “I don't think I can ever be a professor at Johns Hopkins,” said Dr. Davidson when she was a junior faculty to her mentor Dr. Martin Abeloff. He responded with three words she has taken to heart since: “Why ever not?” Tune into a conversation with Dr. Nancy Davidson, world-renowned breast cancer researcher and past president of both ASCO and AACR, on pushing beyond doubts and uncertainties, preserving the ‘One Community' mindset as we work in teams, and embracing the most effective mentoring relationship: Bidirectional. Pearls of Wisdom:   1. The central theme of our careers should be the patient. With every setback, failure, challenge, lost opportunity, and professional strife, we should try to reorient ourselves and bring our focus back to the patient's healthcare. 2. Mentorship is bidirectional. We will provide mentorship to people, but if we're smart and we listen well, some of the people that we are so-called mentors for will be teaching us all along the way. 3. Why ever not? An important question when we doubt ourselves. There is an element of resilience and recovery; not everything will go swimmingly in our career, but taking what we can learn from it will help us move forward. 4. All of us are looking for growth, but one thing that is essential is seizing the moment, and that involves saying yes and jumping on the opportunity when many times we are taught to say no.

ASTCT Talks
Titans of Transplant: Dr. Rainer Storb

ASTCT Talks

Play Episode Listen Later Sep 13, 2022 42:22


In the next installment of ASTCT's Titans of Transplant series, Dr. Rainer Storb, one of the pioneers who established allogeneic, or donor, blood stem cell transplantation as a cure for diseases like leukemia and aplastic anemia, is interviewed by Dr. Masumi Ueda. About Dr. Storb Rainer Storb, MD, serves as Professor and Head of Transplantation Biology Program Clinical Research Division at Fred Hutch. About Dr. Ueda Masumi Ueda, MD, serves as Associate Professor in the Clinical Research Division of the Fred Hutchinson Cancer Center and the Division of Medical Oncology at University of Washington School of Medicine and assistant medical director of inpatient blood and marrow transplantation at University of Washington Medical Center and Fred Hutchinson Cancer Center Hospital The Titans of Transplant series seeks to recognize, celebrate and chronicle the physicians, researchers, pharmacists, nurses, social workers and more who were on the frontlines of the early days of transplant.

DNA Today: A Genetics Podcast
#199 Prostate Cancer Genetics with Heather Cheng

DNA Today: A Genetics Podcast

Play Episode Listen Later Aug 26, 2022


We have two special announcements!Next episode we will be celebrating a decade of DNA Today! That's right, we released our first episode on September 1st, 2012. It also coincides with our 200th episode. We want to mark these milestones with you on the show. So send in your favorite episode. You can write it, or better yet, record a voice memo sharing your favorite episode and why you enjoy listening to the show. After all, our podcast would not be possible without you loyal listeners. That's why we want to celebrate together! Send in your voice memo or written message about your fav episode of DNA Today to info@dnapodcast.com. Deadline is August 27th.Thank you to all you listeners for nominating us in the Podcast Awards, you did it! We have officially been nominated. It's year number 6 being nominated and it might be our third time winning the Best Science and Medicine Podcast Award. BUT that's only going to happen if you check your email inbox for an email from The Podcast Awards with the subject line, “Podcast Awards Final Slate Voting”'. If you got this email you are one of the few that were selected to be a voter. It's imperative that you vote! There is a hyperlink to click to get to the voting page. You do have to quickly log back in. Once you do, select DNA Today in the “Science and Medicine category”, select your other fav podcasts and then Hit the “Save Nominations” button. It's that easy. You have until September 10th to do this, but please do it now if you got the email so you don't forget! In this episode we are educating you about prostate cancer as we are on the cusp of prostate cancer awareness month starting next week. Joining us for this discussion is Dr. Heather Cheng, Director of the Prostate Cancer Genetics Clinic at the Seattle Cancer Care Alliance, Assistant Professor in the Division of Medical Oncology at the University of Washington School of Medicine, and Associate Professor in the Clinical Research Division at the Fred Hutchinson Cancer Research Center. She focuses on improving the care of patients with prostate and bladder cancers. An expert in prostate cancer genetics, she is studying ways to use genetics to guide the care of prostate cancer patients and their family members who may also be at high risk for the disease.On This Episode We Discuss:The prevalence of prostate cancerSigns of hereditary prostate cancer in family historyProstate Cancer Registry of Outcomes and Germline Mutations (PROMISE)The goals of PROMISEWho is eligible to enroll in PROMISE and what is requiredThe most common genes that are identified as having a pathogenic variantCurrent treatments available for people with prostate cancerThe lifetime risk of prostate cancerTo learn more about the PROMISE study, visit the study website and check out thisarticle!You can keep up with our guest, Heather Cheng on Twitter, and LinkedIn, and stay up to date with the latest developments in prostate cancer research by following the Prostate Cancer Foundation on Twitter and ​​LinkedIn, and Instagram.Next episode of DNA Today on September 2nd, 2022, we are celebrating 200 episodes and 10 years of the show! New episodes are released on Fridays. In the meantime, you can binge all our other episodes on Apple Podcasts, Spotify, streaming on the website, or any other podcast player by searching, “DNA Today”. Episodes since 2021 are also recorded with video which you can watch on our YouTube channel. DNA Today is hosted and produced by Kira Dineen. Our social media lead is Corinne Merlino. Our video lead is Amanda Andreoli. See what else we are up to on Twitter, Instagram, Facebook, YouTube and our website, DNApodcast.com. Questions/inquiries can be sent to info@DNApodcast.com. PerkinElmer Genomics is a global leader in genetic testing focusing on rare diseases, inherited disorders, newborn screening, and hereditary cancer. Testing services support the full continuum of care from preconception and prenatal to neonatal, pediatric, and adult. Testing options include sequencing for targeted genes, multiple genes, the whole exome or genome, and copy number variations. Using a simple saliva or blood sample, PerkinElmer Genomics answers complex genetic questions that can proactively inform patient care and end the diagnostic odyssey for families. Learn more at PerkinElmerGenomics.com. (SPONSORED)

Science & Chill
Episode 29: Intermittent Fasting with Dr. Stephen Anton

Science & Chill

Play Episode Listen Later Apr 12, 2021 76:27


In this episode of the podcast, I speak with Dr. Stephen Anton.   Dr. Anton is a leading authority on Intermittent Fasting and Chief of the Clinical Research Division at the University of Florida's Department of Aging and Geriatric Research.   In this episode, we cover everything from the basics of intermittent fasting and time restricted feeding, to the specific cellular benefits that come from fasting. We also discuss a bit on how fasting and the ketogenic diet are similar but also some of the distinct benefits that come from each. If you're interested in intermittent fasting or time restricted feeding or want to learn more about the physiology of this topic, I think you're going to really enjoy this episode.    Links - Links to listen on Apple Podcasts and Spotify - DrStephenAnton.com - Follow Dr. Anton on Instagram - Follow Dr. Anton on Twitter   Podcast links - Sign up for my Physiology Friday newsletter  - Become a podcast supporter on Patreon - Donate to the podcast - Get your FREE LMNT sample pack

university chief anton intermittent fasting clinical research division geriatric research
Oncology Overdrive
Finding Your Own Way with Julie Gralow, MD

Oncology Overdrive

Play Episode Listen Later Nov 19, 2020 46:04


Julie Gralow, MD, is a well-respected and internationally renowned breast oncologist. In this episode, Gralow discusses her journey in oncology, the ASCO Global Oncology Task Force and the importance of finding your own way in medicine. Intro :14 About Gralow :27 The interview 1:49 What has been your journey to become the very well-respected internationally renowned breast oncologist you are today? 2:21 How did you find yourself in that aspect of the field and also marry in your interest in mobile oncology? 4:31 Were there times where you faced barriers you weren’t going to be able to overcome? 13:13 How did you feel and what did you think when you led the ASCO Global Oncology Task Force? 16:15 What are some of the high points that came out of the ASCO Global Oncology Task Force report? 19:20 Did you focus on how the COVID-19 pandemic affected oncology management in this task force or in any of your global oncology work? 26:30 Did you find that social media was a useful tool throughout the last 9-10 months navigating the pandemic? 30:11 Realizing the benefits of social media as a medical professional and avoiding “doom scrolling” 34:00 Do you have one pearl for the audience? 41:47 How to find Julie Gralow 43:11 Where does Gralow see her future career going? 44:22   Julie Gralow, MD is the Jill Bennett Endowed professor of Breast Medical Oncology and professor of global health at the University of Washington School of Medicine, professor in the Clinical Research Division at the Fred Hutchinson Cancer Research Center, and director of Breast Medical Oncology at the Seattle Cancer Care Alliance. We’d love to hear from you! Send your comments/questions to Dr. Jain at oncologyoverdrive@healio.com. Julie Gralow can be reached on Twitter @jrgralow and by email at pink@uw.edu. Follow us on Twitter @HemOncToday @ShikhaJainMD. Disclosures: Jain reports she is a paid freelance writer for Lippincott. Gralow reports no relevant financial disclosures.

Targeted Talks
S1 Ep4: Prostate Cancer Sees Surge of PARP Inhibition Strategies

Targeted Talks

Play Episode Listen Later Oct 15, 2020 24:08


In season 1, episode 4 of Targeted Talks, Michael Schweizer, MD, associate professor. Clinical Research Division, Fred Hutchinson Cancer Research Center, spoke with fellow oncologist, Winston Tan, MD, medical oncologist and professor of medicine, Mayo Clinic, about the ever-changing treatment landscape for prostate cancer.

Scientific Sense ®
Dr.Pierre Etienne, co-Director of the Alzheimer’s disease prevention program at McGill University

Scientific Sense ®

Play Episode Listen Later May 24, 2020 56:27


COVID-19, clinical trial processes, pharmaceutical R&D, vaccine development, use of preventative medications, Alzheimer's disease, PTSD After obtaining his medical degree in Belgium in 1972, Pierre Etienne moved to McGill University, where he did postgraduate work in neurochemistry. There he directed a program on the biochemical, physiological, and neuropathological basis of Alzheimer's disease. After a brief passage in experimental medicine at Ciba-Geigy (now Novartis), he went back to McGill in 1987, dividing his time between the Montreal Neurological Institute and the Allan Memorial Institute. In 1989 he joined Pfizer as Director of Experimental Medicine, responsible for all Phase 2 A programs for US and Japan discovered compounds. In 2003, he became CEO of PhageTech, Inc., a privately-held biotechnology company based in Montreal, Canada. PhageTech exploited a proprietary platform based on phage-bacterial intracellular interactions to research and develop new classes of synthetic antibiotics. Phagetech later became Targanta Therapeutics that went public on NASDAQ (TARG) in the summer of 2008. In December 2009, he started a new life as a physician at the Douglas Institute. In July 2011, he was appointed Director of the Clinical Research Division. He is the co-Director of the Alzheimer’s disease prevention program (Stop-AD). --- Send in a voice message: https://anchor.fm/scientificsense/message Support this podcast: https://anchor.fm/scientificsense/support

Marrow Masters
Without a Family Match, Am I Out of Options?

Marrow Masters

Play Episode Listen Later Nov 26, 2019 20:24


This episode features Dr. Effie Petersdorf, a member of the Clinical Research Division, Fred Hutchinson Cancer Research Center; Professor, Division of Oncology and Department of Medicine, University of Washington School of Medicine, and Attending Physician, Seattle Cancer Care Alliance.This episode will focus on the many transplant options available to people, whether it is a family member or a non-family member. Listeners will learn more about how this all works. It will give hope to so many in need of a transplant.This one covers it all!HLA tissue types explainedLearn about the success rate as it related to how common the patient's HLA tissue type.Learn about 10 out of 10 matches; 9 out of 10 matches, etc.Haplo transplant explainedCord blood transplant covered at lengthA poignant (unmatched) patient story sure to give hopeA cord blood transplant involves shipping the frozen units to the transplant center when the patient is ready to receive them.Major advances in related donor, unrelated donor and cord blood transplantation have occurred throughout the past several decades, and have significantly improved the chances for patients to receive life-saving therapy for blood disorders.If a patient does not have a match in the family, there are 3 sources of stem cells for transplantation these days: mismatched family members, unrelated donors, and cord blood units.Many resources available including: Be The Match and the World Marrow Donor Association websites.For additional resources from the National Bone Marrow Transplant Link, visit us online at nbmtlink.org or call us at 800-546-5268.This season of Marrow Masters is sponsored by the nbmtLINK, Seattle Genetics, and our esteemed link partners.

The Stem Cell Podcast
Ep. 147: “Targeted Repair in Blood Stem and Progenitor Cells” Featuring Dr. Jennifer Adair

The Stem Cell Podcast

Play Episode Listen Later Jul 23, 2019 83:04


Guest: Dr. Jennifer Adair is an Assistant Member in the Clinical Research Division at Fred Hutchinson Cancer Research Center. Her lab uses a combination of cell biology, molecular biology, chemistry, engineering, nanomedicine and bioinformatics to…

STEM-Talk
Episode 68: Steve Anton talks about diet, exercise, intermittent fasting and lifestyle interventions to improve health

STEM-Talk

Play Episode Listen Later Jul 17, 2018 67:34


What’s the best way to eat and the right way to exercise to ensure a healthy lifespan? Our guest today is Dr. Stephen Anton, a psychologist who has spent his career researching how lifestyle factors can influence not only obesity, but also cardiovascular disease and other metabolic conditions. Steve is an associate professor and the chief of the Clinical Research Division in the Department of Aging and Geriatric Research at the University of Florida. In today’s episode, we talk to Steve about his work in developing lifestyle interventions designed to modify people’s eating and exercise behaviors in an effort to improve their healthspan and lifespan. One of Steve’s best-known papers appeared in the Obesity Journal titled “Flipping the Metabolic Switch.” The study looked at intermittent fasting and suggested that the metabolic switch into ketosis represents an evolutionary conserved trigger point that has the potential to improve body composition in overweight individuals. Topics we cover in today’s interview include: The increasing prevalence of metabolic syndrome associated with aging. Why so many hospital health and wellness programs fail. How fasting and intermittent energy restriction promote autophagy. The relationship between muscle quality, body fat and health. How age-related loss of muscle function and mass leads to sarcopenia. Effects, risks and benefits of testosterone supplementation in older men. Optimal exercise methods for long-term health. Therapeutic approaches that potentially can help avert systemic inflammation associated with aging. Steve’s study that looked at the effects of popular diets on weight loss. Controversies surrounded calorie restriction as a strategy to enhance longevity. Show notes: 2:30: Steve talks about growing up in Tampa and playing sports as a kid. 3:53: Dawn asks Steve about his decision to attend Florida State after high school. 4:17: Dawn comments on how Steve bounced between medicine, business, and psychology before finally deciding to major in psychology. She asks if having two parents who were also psychologists played a role in his decision. 5:24: Ken asks about Steven’s experience pursuing his Ph.D. at the University of Florida. 6:28: Dawn brings up that Steve became a fellow of behavioral medicine at the Pennington Biomedical Research Center in Baton Rouge, La. She mentions that Pennington has one of the nation’s premier programs in obesity metabolism and diabetes. She asks if that was the reason he decided on Pennington. 9:33: Dawn asks what prompted Steve to return to the University of Florida. 10:08: Ken asks what is driving the increased prevalence of metabolic syndrome that’s associated with advanced age. 11:19: Dawn brings up how hospitals have tried to promote health and wellness programs for decades, but notes how hospitals are designed to treat people who are sick and injured rather than delivering lifestyle interventions. She asks if Steve can give a summary of what he has learned in looking at ways to deliver interventions. 13:23: Dawn mentions that the traditional treatment and management approaches for type 2 diabetes are relatively ineffective and only reverse the disease in about one percent of the cases. 15:02: Ken mentions that Jeff Volek, STEM-Talk Guest on episode 43, has been a pioneer in researching type 2 diabetes. 16:49: Dawn points out that she and Ken had an in-depth conversation with Dr. Mark Matson about autophagy on episode seven of STEM-Talk. Matson also discussed fasting, and intermittent energy restriction and how it promotes autophagy, which is often described as the body’s innate recycling system. Dawn asks if Steve can elaborate a little on this process. 18:02: Dawn mentions that Steve has written about muscle quality and body composition and the risk of metabolic diseases and functional decline. She asks about the relationship between muscle quality,

Managed Care Cast
Addressing Financial Toxicity With Navigators and Better Conversations Around Decision Making

Managed Care Cast

Play Episode Listen Later Jun 5, 2018 9:44


Health literacy in the United States is low to begin with, and health financial literacy is even lower. The changing health insurance system is partly to blame. A few decades ago, health insurance covered everything. Now, patients have a lot more financial responsibility, and they don’t always understand it. In cancer, health financial literacy is particularly important since treatment can be so costly. This episode of Managed Care Cast includes conversations with a few experts in the field: Yousuf Zafar, MD, MHS, of the Duke Cancer Institute; Clara Lambert, BBA, OPN-CG, chair of the Association of Community Cancer Centers Financial Advocacy Network Advisory Committee; Todd Yezefski, MD, senior fellow in the Clinical Research Division at the Fred Hutchinson Cancer Research Center and Division of Medical Oncology at the University of Washington; and Michele McCourt, senior director of the CancerCare Co-Payment Assistance Foundation. Read more: A Descriptive Study of Patients Receiving Foundational Financial Assistance Through Local Specialty Pharmacies: www.ajmc.com/journals/supplement/2018/the-patient-assistance-safety-net-how-many-need-help-how-many-are-helped/a-descriptive-study-of-patients-receiving-foundational-financial-assistance-through-local-specialty-pharmacies Impact of Trained Oncology Financial Navigators on Patient Out-of-Pocket Spending: www.ajmc.com/journals/supplement/2018/the-patient-assistance-safety-net-how-many-need-help-how-many-are-helped/impact-of-trained-oncology-financial-navigators-on-patient-outofpocket-spending Policy Improvement Areas to Reduce Financial Hardship: www.ajmc.com/conferences/pan-2018/policy-improvement-areas-to-reduce-financial-hardship Addressing Financial Concerns at the Outset to Improve Patient Outcomes: www.ajmc.com/conferences/pan-2018/addressing-financial-concerns-at-the-outset-to-improve-patient-outcomes

Ri Science Podcast
Colour and Cancer; Scorpions and Surgery - Ri Science Podcast #8

Ri Science Podcast

Play Episode Listen Later Jan 9, 2017 57:31


Henry Marsh, author of the bestseller Do No Harm, and Jim Olson, paediatric oncologist from Seattle Children’s Hospital, share their experiences in medicine. Is it possible to light up a cancer cell in the brain? Could scorpion venom be the answer? Dr Jim Olson, Paediatric Haematology Oncology Specialist at Seattle Children's Hospital and a member of the Clinical Research Division at the Fred Hutchinson Cancer Research Center, is developing a radical new technique in the field of fluorescent image-guided surgery, Tumor Paint, that has the potential to transform the way tumors are removed from the brain - by using a special paint the make the cancerous areas glow. Dr Henry Marsh is a leading British neurosurgeon whose pioneering work in brain tumour surgery has been the subject of major award-winning BBC documentaries. His extraordinary memoir, Do No Harm: Stories of Life, Death and Brain Surgery, is an international best-seller, nominated for eight major UK literary prizes and the Sky Arts South Bank Show 2015 Award recipient for Literature and PEN Ackerley Prize. He was made a CBE in 2010.