Podcasts about dana farber cancer institute

Cancer treatment and research institution in Boston, US

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JAMA Clinical Reviews: Interviews about ideas & innovations in medicine, science & clinical practice. Listen & earn CME credi

Early-onset gastrointestinal cancers, typically defined as occurring in patients younger than age 50, are increasing worldwide. A recent JAMA Review summarizes current data on early-onset colorectal, pancreatic, and esophagogastric cancers. Coauthor Kimmie Ng, MD, MPH, of Dana-Farber Cancer Institute joins JAMA Deputy Editor Kristin Walter, MD, MS to discuss. Related Content: Early-Onset Gastrointestinal Cancers Screening for Helicobacter pylori to Prevent Gastric Cancer First-Line Sugemalimab Plus Chemotherapy for Advanced Gastric Cancer

All Talk Oncology Podcast
How An Oncologist Is Changing Sarcoma Care for Young Adults

All Talk Oncology Podcast

Play Episode Listen Later Jul 15, 2025 51:25


What happens when cancer strikes in your 20s or 30s? How do you navigate life-changing diagnoses during the most formative years of your life? In this powerful episode of All Talk Oncology, Kenny Perkins speaks with Dr. Venkataraman, a young adult cancer specialist at Dana-Farber Cancer Institute, who is deeply committed to caring for patients with rare cancers like sarcoma. From the emotional trauma of delayed diagnoses to the complexities of survivorship, Dr. V shares how he supports patients not just through treatment—but through rediscovering their lives afterward. Key topics discussed: Why young adults are often diagnosed late—and what we can do about it How sarcoma differs from other cancers and why it's so misunderstood Treatment challenges: surgery, radiation, chemotherapy, and their impact Why survivorship care is just as important as treatment The mental health struggles cancer patients rarely talk about The role of personalized care: meeting patients where they are Advances in sarcoma research, clinical trials, and treatment protocols Empowering patients to take charge of their own journey Creative outlets for physicians: how Dr. V uses reflective writing to process the emotional weight of oncology   Immortalize your voice by being an ALL TALK ONCOLOGY GUEST! Just fill-out this FORM.   SOCIAL MEDIA LINKS: All Talk Oncology: Instagram & Facebook JOIN OUR FREE COMMUNITY: Facebook Community WEBSITE: https://www.alltalkoncology.com

Fathers Of The Future
Season V Experience #102 From Big Cat to Mufasa with Jesse Goldsmith

Fathers Of The Future

Play Episode Listen Later Jul 14, 2025 74:30


In this inspiring episode of the Fathers of the Future Podcast, host Luke Kayyem sits down with his coaching client and friend, Jesse Mufasa Goldsmith, to discuss Jesse's remarkable transformation. Previously known as "Big Cat," a nickname tied to his 385-pound frame and party-heavy lifestyle, Jesse shares how he shed 135 pounds, embraced sobriety, and completed the Boston Marathon. The journey began 18 months ago after a serendipitous meeting with Luke on a golf course, followed by a pivotal moment of hitting rock bottom. Jesse's story highlights his shift from a self-destructive identity to one of resilience and purpose, embodied in his new persona, "Mufasa," inspired by his commitment to being a strong, protective father to his daughter, Sophie.Jesse recounts key milestones, including adopting intermittent fasting, quitting alcohol, and training for two half-marathons and the Boston Marathon, all while overcoming a relapse and battling physical and mental challenges. With Luke's guidance, Jesse rebuilt his confidence, rekindled his competitive drive as a commercial real estate broker, and inspired his family and colleagues. The episode culminates in Jesse's emotional Boston Marathon finish, a testament to his dedication and the support of his community, leaving listeners with a powerful message about transformation, legacy, and inspiring others.Guest: Jesse Mufasa Goldsmith, commercial real estate broker at Newmark, former college tennis player, and father to Sophie.Key Themes:Identity Shift: From "Big Cat," a persona tied to excess and self-destruction, to "Mufasa," symbolizing strength and protection for his daughter.Transformation Journey: Losing 135 pounds naturally, quitting alcohol, and completing the Boston Marathon.Rock Bottom Moment: A wake-up call during a daddy-daughter trip in Salt Lake City, leading to sobriety and commitment to change.Coaching Impact: Luke Kayyem's non-judgmental approach helped Jesse rebuild his life through small, consistent changes.Boston Marathon: Ran for the Dana-Farber Cancer Institute, raising $17,000, and finished in 5:27:55, just two minutes before the sweep.Highlights:Meeting Luke on a golf course in Flagstaff, facilitated by mutual friend Riyadh Naza.Overcoming a relapse during a golf trip, recommitting to sobriety and training.Emotional family reunion in Boston, with Jesse's parents, wife, and daughter supporting him.Upcoming documentary, Road to Boston, focusing on mental health awareness, set for release around July 4, 2025, on YouTube.Resources:Luke Kayyem's Website: https://www.lukekayyem.com/Schedule a Call with Luke: https://www.lukekayyem.com/scheduleLuke's Facebook: https://www.facebook.com/lukekayyemLuke's Instagram: https://www.instagram.com/lukekayyem

Physician's Weekly Podcast
HER2+ Horizons: Debates and Decisions in Metastatic Breast Cancer: Episode 1

Physician's Weekly Podcast

Play Episode Listen Later Jul 14, 2025 16:14


First-Line Therapy—Has the Standard of Care Shifted for Good?In this episode, Dr. Sara Tolaney, of Dana-Farber Cancer Institute, discusses how DESTINY-Breast09 is redefining first-line treatment in HER2-positive metastatic breast cancer. She explores whether T-DXd plus pertuzumab should replace the long-standing THP regimen, the future role of induction-maintenance strategies, and open questions on optimal therapy duration.   Let us know what you thought of this week's episode on Twitter: @physicianswkly Want to share your medical expertise, research, or unique experience in medicine on the PW podcast? Email us at editorial@physweekly.com! Thanks for listening!

OBR Peer-Spectives
Game-Changers and Paradigm Shifts: ASCO 2025 Data Shake Up Breast Cancer Care

OBR Peer-Spectives

Play Episode Listen Later Jul 14, 2025 10:37


From a “game-changer” in triple-negative disease to broader paradigm shifts and practice changes, the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting was pivotal for breast cancer care, says Sara M. Tolaney, MD, MPH, chief of the Division of Breast Medical Oncology at the Dana-Farber Cancer Institute in Boston, Massachusetts. Dr. Tolaney broke down some of the top data at ASCO 2025 with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles, California, and Steven Spielberg Family Chair in Hematology-Oncology. She singled out findings from the ASCENT-04 trial, the plenary session on SERENA-6, and the DESTINY-Breast09 trial. “I think it's been a very exciting ASCO for breast cancer overall, with just so much exciting data,” Dr. Tolaney concluded.

Hematologic Oncology Update
Non-Hodgkin Lymphoma — Proceedings from a Session Held During the 2025 ASCO Annual Meeting

Hematologic Oncology Update

Play Episode Listen Later Jul 10, 2025 119:42


Dr Jeremy Abramson from Massachusetts General Hospital in Boston, Dr Joshua Brody from the Tisch Cancer Institute in New York, New York, Dr Christopher Flowers from The University of Texas MD Anderson Cancer Center in Houston, Dr Ann LaCasce from Dana-Farber Cancer Institute in Boston, Massachusetts, and Dr Tycel Phillips from City of Hope Comprehensive Cancer Center in Duarte, California, discuss patient cases and provide their perspectives on clinical datasets informing the care of patients with non-Hodgkin lymphoma. CME information and select publications here.

OncLive® On Air
S13 Ep25: FDA Approval Insights: Darolutamide for Metastatic Castration-Sensitive Prostate Cancer: With Alicia Morgans, MD, MPH; and Neal Shore, MD, FACS

OncLive® On Air

Play Episode Listen Later Jul 3, 2025 16:41


In today's episode, supported by Bayer, we had the pleasure of speaking with Alicia Morgans, MD, MPH, and Neal Shore, MD, FACS, about the FDA approval of darolutamide (Nubeqa) plus androgen deprivation therapy for patients with metastatic castration-sensitive prostate cancer (mCSPC). Morgans is the medical director of the survivorship program at Dana-Farber Cancer Institute; as well as an associate professor of medicine at Harvard Medical School, both in Boston, Massachusetts. Shore is the medical director of the Carolina Urologic Research Center. In our exclusive interview, Drs Morgans and Shore discussed the significance of this approval; key efficacy, safety, and quality of life data from the pivotal phase 3 ARANOTE trial (NCT04736199); and how this regulatory decision both opens doors for the treatment of more patients and raises questions about the optimal role of darolutamide in the management of mCSPC. 

VJOncology Podcast
Lung cancer highlights from ASCO 2025 with Joao Victor Alessi and Alessandro Di Federico

VJOncology Podcast

Play Episode Listen Later Jul 3, 2025 10:01


Join esteemed experts Joao Victor Alessi, Hospital Sírio-Libanês, Sao Paolo, Brazil, and Alessandro Di Federico, Dana-Farber Cancer Institute, Boston, MA,... The post Lung cancer highlights from ASCO 2025 with Joao Victor Alessi and Alessandro Di Federico appeared first on VJOncology.

Adis Journal Podcasts
A Podcast on Integrating Genetic Testing for Homologous Recombination Repair Gene Alterations in Patients with Prostate Cancer in the USA: a Multidisciplinary Approach to Overcoming the Obstacles

Adis Journal Podcasts

Play Episode Listen Later Jun 29, 2025 21:19


In this podcast, Dr. Brittany M. Szymaniak from the Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Dr. Alicia K. Morgans from the Dana-Farber Cancer Institute, Boston, MA, USA, and Dr. Neal D. Shore from the Carolina Urologic Research Center, Myrtle Beach, SC, USA, aim to identify obstacles to testing for homologous recombination repair (HRR) gene alterations in patients with prostate cancer that healthcare professionals encounter in day-to-day clinical practice, as well as discuss ways to potentially overcome them. This podcast is published open access in Targeted Oncology and is fully citeable. You can access the original published podcast article through the Targeted Oncology website and by using this link: https://link.springer.com/article/10.1007/s11523-025-01159-z. All conflicts of interest can be found online. Open Access This podcast is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The material in this podcast is included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

JAMA Medical News: Discussing timely topics in clinical medicine, biomedical sciences, public health, and health policy

Kimmie Ng, MD, MPH, a JAMA associate editor and associate chief of the Division of Gastrointestinal Oncology at the Dana-Farber Cancer Institute, shares highlights from the American Society of Clinical Oncology's annual meeting, including new research on diet, exercise, and cancer survival and the best time of day for treatment. Related Content: Lifestyle and Cancer Survival, the Best Time of Day for Treatment, and More—Highlights From ASCO

Prostate Cancer Update
Prostate Cancer  — Proceedings from a Session Held During the 2025 ASCO Annual Meeting

Prostate Cancer Update

Play Episode Listen Later Jun 26, 2025 116:26


Dr Neeraj Agarwal from the University of Utah Huntsman Cancer Institute in Salt Lake City, Dr Andrew J Armstrong from Duke Cancer Institute in Durham, North Carolina, Dr Himisha Beltran from Dana-Farber Cancer Institute in Boston, Massachusetts, Dr Fred Saad from the University of Montreal Hospital Center in Québec, Canada, and Dr Rana R McKay from the UC San Diego Moores Cancer Center discuss recent updates on available and novel treatment strategies for prostate cancer. CME information and select publications here.

レアジョブ英会話 Daily News Article Podcast
Exercise boosts survival rates in colon cancer patients, study shows

レアジョブ英会話 Daily News Article Podcast

Play Episode Listen Later Jun 26, 2025 2:28


A three-year exercise program improved survival in colon cancer patients and kept the disease at bay, a first-of-its-kind international experiment showed. With the benefits rivaling some drugs, experts said cancer centers and insurance plans should consider making exercise coaching a new standard of care for colon cancer survivors. Until then, patients can increase their physical activity after treatment, knowing they are doing their part to prevent cancer from coming back. “It's an extremely exciting study,” said Dr. Jeffrey Meyerhardt of Dana-Farber Cancer Institute, who wasn't involved in the research. It's the first randomized controlled trial to show a reduction in cancer recurrences and improved survival linked to exercise, Meyerhardt said. Prior evidence was based on comparing active people with sedentary people, a type of study that can't prove cause and effect. The new study—conducted in Canada, Australia, the United Kingdom, Israel and the United States—compared people who were randomly selected for an exercise program with those who instead received an educational booklet. “This is about as high a quality of evidence as you can get,” said Dr. Julie Gralow, chief medical officer of the American Society of Clinical Oncology (ASCO). “I love this study because it's something I've been promoting but with less strong evidence for a long time.” The findings were featured at ASCO's annual meeting in Chicago and published by the New England Journal of Medicine. Academic research groups in Canada, Australia and the U.K. funded the work. Researchers followed 889 patients with treatable colon cancer who had completed chemotherapy. Half were given information promoting fitness and nutrition. The others worked with a coach, meeting every two weeks for a year, then monthly for the next two years. Coaches helped participants find ways to increase their physical activity. After eight years, the people in the structured exercise program not only became more active than those in the control group but also had 28% fewer cancers and 37% fewer deaths from any cause. There were more muscle strains and other similar problems in the exercise group. This article was provided by The Associated Press.

PhenoTips Speaker Series: A Genetics Podcast
Kimberly Zayhowski, Diane Koeller, and Josephine Giblin on Gender Affirming Cancer Genetic Counseling

PhenoTips Speaker Series: A Genetics Podcast

Play Episode Listen Later Jun 26, 2025 61:07 Transcription Available


An international panel of cancer genetic counselors with research and advocacy interests in LGBTQ+ affirming care, NHS Bristol's Josephine Giblin, Dana-Farber Cancer Institute's Diane Koeller, and Boston University School of Medicine's Kimberly Zayhowski, discuss:Risk considerations for trans and gender diverse cancer genetic counseling patientsCreating safe and inclusive environments in cancer genetic counselingProtecting patients during times of unprecedented legislationResources and methods to support trans and gender diverse patientsHosted by DNA Today's Kira Dineen.Resources and further reading:Navigating sexual orientation and gender identity data privacy concerns in United States genetics practicesNSGC Policy Statement: Distinguishing Sex and Gender to Reduce HarmTGD CanScreen ProjectCanadian Resource: Queering CancerCoppaFeel: UK patient resource with gender based language selection

IMPACT Medicom
Highlights from EHA/ICML 2025: International Perspective on CLL

IMPACT Medicom

Play Episode Listen Later Jun 26, 2025 40:45


In this podcast episode, we discuss clinical trial updates in chronic lymphocytic leukemia from the 2025 European Hematology Association annual congress in Milan, Italy and the 18th International Conference on Malignant Lymphoma in Lugano, Switzerland. The discussion involves an analysis of the data from abstracts investigating combination and novel therapies for the treatment of CLL.Our Host:Dr. Constantine Tam is Head of Lymphoma Service at Alfred Health and Professor of Haematology at Monash University in Melbourne, Australia. Prior to joining Alfred, Dr. Tam completed a Leukemia Fellowship at MD Anderson Cancer Centre in Houston, Texas and served as Disease Group Lead for Low Grade Lymphoma and CLL at Peter MacCallum Cancer Centre & Royal Melbourne Hospital for over 10 years. He is the global lead for the BTK inhibitor zanubrutinib, overseeing its development from the first human dosed to international licensing studies. He also played key roles in the first global study of ibrutinib and venetoclax in CLL and the pivotal study of Tisagenlecleucel in diffuse large B-cell lymphoma.Our guests:Dr. John Gribben is Consultant Hematologist and Medical Oncologist at the Barts Cancer Institute, Barts NHS Trust and Professor in Medical Oncology at The London School of Medicine, Queen Mary University of London, in London, UK. Dr. Gribben trained in Haematology at University College London and in Medical Oncology at the Dana-Farber Cancer Institute, Harvard Medical School, where he remained on the faculty for 17 years before returning to the UK. Dr. Gribben serves on many international committees, including as Chair of the international workshop for NHL, co-Chair of the international workshop for CART, and founding member of the CLL Research Consortium. He also serves as an executive board member of the European Hematology Association, where he previously served as President from 2019-2021.Dr. Stephan Stilgenbauer is professor of medicine and Medical Director of the Comprehensive Cancer Center Ulm (CCCU), Head Early Clinical Trials Unit (ECTU), and Head Division of CLL Dept. of Internal Medicine III at Ulm University, Germany. He received his medical training at Heidelberg Medical School, Germany, and was trained in internal medicine and hematology-oncology at the Universities of Heidelberg and Ulm. He spent a postdoctoral fellowship at the German Cancer Research Center (DKFZ) in Heidelberg. His research focus is on the molecular pathogenesis and evolution as well as development of novel treatment strategies in hematological malignancies.If you enjoyed our podcast episode, please review and subscribe. For other medical education content, visit our website at: https://www.impactmedicom.com (https://www.impactmedicom.com/)

GrowthCap Insights
Top Healthcare Investor: Berkshire Partners' Chris Hadley

GrowthCap Insights

Play Episode Listen Later Jun 25, 2025 30:14


In this episode, we speak with Chris Hadley, Managing Director at Berkshire Partners, a 100% employee-owned investor in private and public equity. The private equity team invests in well-positioned, growing companies across business & consumer services, healthcare, industrials, and technology & communications. Founded in 1986, Berkshire is currently investing from its Fund XI, which closed in 2024 with $7.8 billion in commitments. The firm has completed over 150 investments and is known for partnering closely with management teams to drive growth across market cycles. A leader within the firm's healthcare investment team, Chris has demonstrated exceptional leadership and strategic insight over his 27-year tenure. Known for his unique ability to build trust and foster collaboration, he has earned the respect of peers and portfolio company management teams alike, and was recognized by GrowthCap as a Top Healthcare Investor of 2025. Chris supports Dana-Farber Cancer Institute and McLean Hospital. I am your host, RJ Lumba. We hope you enjoy the show. If you like the episode, click to follow.

Hematologic Oncology Update
IDH-Mutant Low-Grade Glioma — An Interview with Dr Patrick Y Wen on Current and Future Management Strategies

Hematologic Oncology Update

Play Episode Listen Later Jun 24, 2025 54:07


Dr Patrick Wen from the Dana-Farber Cancer Institute in Boston, Massachusetts, discusses the current and future management of IDH-mutant gliomas. CME information and select publications here.

Help and Hope Happen Here
Cedar Connell and his mom Kiki will talk about Cedar's diagnosis of B Cell Acute Lymphoblastic Leukemia when he was 15 years old in 2022 and will be completing his treatment this summer.

Help and Hope Happen Here

Play Episode Listen Later Jun 23, 2025 60:13


Cedar Connell was 15 years old when he found himself on his way to Lurie Children's Hospital in Chicago to begin his treatment for B Cell Acute Lymphoblastic Leukemia in 2022. Cedar and his mom Kiki will talk about the difficult treatment that he went through, including his move from Chicago to the Dana Farber Cancer Institute in Boston in 2023. Cedar is now getting ready to do his part for the Leukemia and Lymphoma Society as TEAM CONNELLSLLS will be getting ready for a 31 day challenge beginning on July 1st and ending on August 1st to exercise 3 miles each day for that time period, in the hope that they raise 35,000.

OncLive® On Air
S13 Ep19: Long-Term Data Underscore the Enduring Efficacy of PD-1 Inhibition in Nasopharyngeal Carcinoma: With Michael Dennis, MD

OncLive® On Air

Play Episode Listen Later Jun 23, 2025 15:55


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

ASCO Daily News
Breast Cancer Research Poised to Change Practice From ASCO25

ASCO Daily News

Play Episode Listen Later Jun 23, 2025 31:39


Dr. Allison Zibelli and Dr. Rebecca Shatsky discuss advances in breast cancer research that were presented at the 2025 ASCO Annual Meeting, including a potential new standard of care for HER2+ breast cancer, the future of ER+ breast cancer management, and innovations in triple negative breast cancer therapy. Transcript Dr. Allison Zibelli: Hello and welcome to the ASCO Daily News Podcast. I'm Dr. Allison Zibelli, your guest host of the podcast today. I'm an associate professor of medicine and a breast medical oncologist at the Sidney Kimmel Comprehensive Cancer Center at Jefferson Health. There was a substantial amount of exciting breast cancer data presented at the 2025 ASCO Annual Meeting, and I'm delighted to be joined by Dr. Rebecca Shatsky today to discuss some of these key advancements. Dr. Shatsky is an associate professor of medicine at UC San Diego and the head of breast medical oncology at the UC San Diego Health Moores Cancer Center, where she also serves as the director of the Breast Cancer Clinical Trials Program and the Inflammatory and Triple-Negative Breast Cancer Program.  Our full disclosures are available in the transcript of this episode. Dr. Shatsky, it's great to have you on the podcast today. Dr. Rebecca Shatsky: Thanks, Dr. Zibelli. It's wonderful to be here. Dr. Allison Zibelli: So, we're starting with DESTINY-Breast09, which was trastuzumab deruxtecan and pertuzumab versus our more standard regimen of taxane, trastuzumab pertuzumab for first-line treatment of metastatic HER2-positive breast cancer. Could you tell us a little bit about the study? Dr. Rebecca Shatsky: Yeah, absolutely. So, this was a long-awaited study. When T-DXd, or trastuzumab deruxtecan, really hit the market, a lot of these DESTINY-Breast trials were started around the same time. Now, this was a global, randomized, phase 3 study presented by Dr. Sara Tolaney from the Dana-Farber Cancer Institute of Harvard in Boston. It was assessing essentially T-DXd in the first-line setting for metastatic HER2-positive breast cancer in addition to pertuzumab. And that was randomized against our standard-of-care regimen, which was established over a decade ago by the CLEOPATRA trial, and we've all been using that internationally for at least the past 10 years. So, this was a large trial, and it was one-to-one-to-one of patients getting T-DXd plus pertuzumab, T-DXd alone, or THP, which mostly is used as docetaxel and trastuzumab and pertuzumab every three weeks for six cycles. And this was in over 1,000 patients; it was 1,159 patients with metastatic HER2-positive breast cancer. This was a very interesting trial. It was looking at the use of trastuzumab deruxtecan, but patients were started on this treatment for their first-line metastatic HER2-positive breast cancer with no end date to their T-DXd. So, it was, you know, you were started on T-DXd every 3 weeks until progression. Now, CLEOPATRA is a little bit different than that, though, as we know. So, CLEOPATRA has a taxane plus trastuzumab and pertuzumab. But generally, patients drop the taxane after about six to seven cycles because, as we know, you can't be really on a taxane indefinitely. You get pretty substantial neuropathy as well as cytopenias, other things that end up happening. And so, in general, that regimen has sort of a limited time course for its chemotherapy portion, and the patients maintained after the taxane is dropped on their trastuzumab and their pertuzumab, plus or minus endocrine therapy if the investigator so desires. And the primary endpoint of the trial was progression-free survival by blinded, independent central review (BICR) in the intent-to-treat population. And then it had its other endpoints as overall survival, investigator-assessed progression-free survival, objective response rates, and duration of response, and of course, safety. As far as the results of this trial, so, I think that most of us key opinion leaders in breast oncology were expecting that this was going to be a positive trial. And it surely was. I mean, this is a really, really active drug, especially in HER2-positive disease, of course. So, the DESTINY-Breast03 data really established that, that this is a very effective treatment in HER2-positive metastatic breast cancer. And this trial really, again, showed that. So, there were 383 patients that ended up on the trastuzumab plus deruxtecan plus pertuzumab arm, and 387 got THP, the CLEOPATRA regimen. What was really interesting also to note of this before I go on to the results was that 52% of patients on this trial had de novo metastatic disease. And that's pretty unusual for any kind of metastatic breast cancer trial. It kind of shows you, though, just how aggressive this disease is, that a lot of patients, they present with de novo metastatic disease. It's also reflecting the global nature of this trial where maybe the screening efforts are a little bit less than maybe in the United States, and more patients are presenting as later stage because to have a metastatic breast cancer trial in the United States with 52% de novo metastatic disease doesn't usually happen. But regardless, the disease characteristics were pretty well matched between the two groups. 54% of the patients were triple positive, or you could say hormone-positive because whether they were PR positive or ER positive and PR negative doesn't really matter in this disease. And so, the interim data cutoff was February of this year, of 2025. So, the follow-up so far has been about 29 months, so the data is still really immature, only 38% mature for progression-free survival interim analysis. But what we saw is that T-DXd plus pertuzumab, it really improved progression-free survival. It had a hazard ratio that was pretty phenomenal at 0.56 with a confidence interval that was pretty narrow of 0.44 to 0.71. So, very highly statistically significant data here. The progression-free survival was consistent across all subgroups. Overall survival, very much immature at this time, but of course, the trend is towards an overall survival benefit for the T-DXd group. The median durable response with T-DXd plus pertuzumab exceeded 3 years. Now, importantly, though, I want to stress this, is grade 3 or above treatment-emergent adverse events occurred in both subgroups pretty equally. But there were 2 deaths in the T-DXd group due to interstitial lung disease. And there was a 12.1% adjudicated drug-induced interstitial lung disease/pneumonitis event rate in the T-DXd group and only 1%, and it was grade 1-2, in the THP group. So, that's really the caveat of this therapy, is we know that a percentage of patients are going to get interstitial lung disease, and that some may have very serious adverse events from it. So, that's always something I keep in the back of my mind when I treat patients with T-DXd. And so, overall, the conclusions of the trial were pretty much a slam dunk. T-DXd plus pertuzumab, it had a highly statistically significant and clinically meaningful improvement in progression-free survival versus the CLEOPATRA regimen. And that was across all subgroups for first-line metastatic HER2-positive breast cancer here. And so, yeah, the data was pretty impressive. Just to go into the overall response rate, because that's always super important as well, you had 85.1% of patients having a confirmed overall RECIST response rate in the T-DXd plus pertuzumab group and a 78.6 in the CLEOPATRA group. The complete CR rate, complete response was 15.1% in the T-DXd group and 8.5 in the CLEOPATRA regimen. And it was really an effective regimen in this group, of course. Dr. Allison Zibelli: So, the investigators say at the end of their abstract that this is the new standard of care. Would you agree with that statement? Dr. Rebecca Shatsky: Yeah, that was a bold statement to make because I would say in the United States, not necessarily at the moment because the quality of life here, you have to think really hard about. Because one thing that's really important about the DESTINY-Breast09 data is that this was very much an international trial, and in many of the countries where patients enrolled on this, they were not able to access T-DXd off trial. And so, for them, this means T-DXd now or potentially never. And so, that is a really big difference whereas internationally, that may mean standard of care. However, in the US, patients have no issues accessing T-DXd in the second- or third-line settings. And right now, it's the standard of care in the second line in the United States, with all patients basically getting this second-line therapy except for some unique patients where they may be doing a PATINA trial regimen, which we saw at San Antonio Breast Cancer in 2024 of the triple-positive patients getting hormonal therapy plus palbociclib, which had a really great durable response. That was super impressive as well. Or there is the patient that the investigator can pick KADCYLA because the patient really wants to preserve their hair or maybe it's more indolent disease. But the quality of life on T-DXd indefinitely in the first-line setting is a big deal because, again, that CLEOPATRA regimen allows patients to drop their chemotherapy component about five to six months in. And with this, you're on a drug that feels very chemo-heavy indefinitely. And so, I think there's a lot more to investigate as far as what we're going to do with this data in the United States because it's a lot to commit a patient in the first-line metastatic setting. These de novo metastatic patients, some of them may be cured, honestly, on the HER2-targeting regimen. That's something we see these days. Dr. Allison Zibelli: So, very interesting trial. I'm sure we'll be talking about this for a long time.  So, let's move on to SERENA-6, which was, I thought, a very interesting trial. This trial took patients with ER positive, advanced breast cancer after six months on an AI (aromatase inhibitor) and a CDK4/6 inhibitor. They did ctDNA every two to three months, and when they saw an ESR1 mutation emerge, they changed half of the patients to camizestrant plus CDK4/6 and kept the other half on the AI plus CDK4/6. Can you talk about that trial a little bit, please? Dr. Rebecca Shatsky: Yeah, so this was a big trial at ASCO25. This was presented as a Plenary Session. So, this was camizestrant plus a CDK4/6 inhibitor, and it could have been any of the three, so palbo, ribo, or abemaciclib in the first-line metastatic hormone-positive population, and patients were on an AI with that. They were, interestingly, tested by ctDNA at baseline to see if they had an ESR1 mutation. So, that was an interesting feature of this trial. But patients had to have already been on their CDK4/6 inhibitor plus AI for at least 6 months to enroll. And then, as you mentioned, they got ctDNA testing every 2 to 3 months. This was also a phase 3, double-blind, international trial. And I do want to highlight again, international here, because that's important when we're considering some of this data in the U.S. because it influences some of the results. So, this was presented by Dr. Nick Turner of the Royal Marsden in the UK. So, just a little bit of background for our listeners on ESR1 mutations and why they're important. This is the most common, basically, acquired resistance mutation to patients being treated with aromatase inhibitors. We know that treatment with aromatase inhibitors can induce this. It makes a conformational change in the estrogen receptor that makes the estrogen receptor constitutively active, which allows the cell to signal despite the influence of the aromatase inhibitor to decrease the estrogen production so that the ligand binding doesn't matter as much as far as the cell signaling and transcription is concerned. And camizestrant, you know, as an oral SERD, just to explain that a little bit too; these are estrogen receptor degraders. The first-in-class of a selective estrogen receptor degrader to make it to market was fulvestrant. And that's really been our standard-of-care estrogen degrader for the past 25 years, almost 25 years. And so, a lot of us are just looking for some of these oral SERDs to replace that. But regardless, they do tend to work in the ESR1-mutated population. And we know that patients on aromatase inhibitors, the estimates of patients developing an ESR1 mutation, depending on which study you look at, somewhere between 30% to 50% overall, patients will develop this mutation with hormone-positive metastatic breast cancer. There is a small percentage of patients that have these at baseline without even treatment of an aromatase inhibitor. The estimates of that are somewhere between 0.5 and up to 5%, depending on the trial you look at and the population. But regardless, there is a chance someone on their CDK4/6 inhibitor plus AI at 6 months' time course could have had an ESR1 mutation at that time. But anyway, so they got this ctDNA every 2 to 3 months, and once they were found to develop an ESR1 mutation, the patients were then switched to the oral SERD. AstraZeneca's version of the oral SERD is camizestrant, 75 mg daily. And then their type of CDK4/6 inhibitor was maintained, so they didn't switch the brand of their CDK4/6 inhibitor, importantly. And that was looked at then for progression-free survival, but these were patients with measurable disease by RECIST version 1.1. And the data cut off here was November of 2024. This was a big trial, you know, and I think that that's influential here because this was 3,256 patients, and that's a lot of patients. So, they were all eligible. And then 315 patients ended up being randomized to switch to camizestrant upon presence of that ESR1 mutation. So, that was 157 patients. And then the other half, so they were randomized 1:1, they continued on their AI without switching to an oral SERD. That was 158 patients. They were matched pretty well. And so, their baseline characteristics, you know, the two subgroups was good. But this was highly statistically significant data. I'm not going to diminish that in any way. Your hazard ratio was 0.44. Highly statistically significant confidence intervals. And you had a median progression-free survival in those that switched to camizestrant of 16 months, and then the non-switchers was 9.2 months. So, the progression-free survival benefit there was also consistent across the subgroups. And so, you had at 12 months, the PFS rate was 60.7% for the non-treatment group and 33.4% in the treatment group. What's interesting, though, is we don't have overall survival data. This is really immature, only 12% mature as far as overall survival. And again, because this was an international trial and patients in other countries right now do not have the access to oral SERDs that the United States does, the crossover rate, they were not allowed to crossover, and so, a very few patients, when we look at progression-free survival 2 and ultimately overall survival, were able to access an oral SERD in the off-trial here and in the non-treatment group. And so, that's really important as far as we look at these results. Adverse events were pretty minimal. These are very safe drugs, camizestrant and all the other oral SERDs. They have some mild toxicities. Camizestrant is known for something weird, which is called photopsia, which is some flashing lights in the periphery of the eye, but it doesn't seem to have any serious clinical significance that we know of. It has a little bit of bradycardia, but it's otherwise really well tolerated. You know, I hate to say that because that's very subjective, right? I'm not the one taking the drug. But it doesn't have any serious adverse events that would cause discontinuation. And that's really what we saw in the trial. The discontinuation rates were really low. But overall, I mean, this was a positive trial. SERENA-6 showed that switching to camizestrant at the first sign of an ESR1 mutation on CDK4/6 inhibitor plus AI improved progression-free survival. That's all we can really say from it right now. Dr. Allison Zibelli: So, let's move on to ASCENT-04, which was a bit more straightforward. Sacituzumab govitecan plus pembrolizumab versus chemotherapy plus pembrolizumab in PD-L1-positive, triple-negative breast cancer. Could you talk about that study? Dr. Rebecca Shatsky: Yeah, so this was also presented by the lovely Sara Tolaney from Dana-Farber. And this study made me really excited. And maybe that's because I'm a triple-negative breast cancer person. I mean, not to say that I don't treat hundreds of patients with hormone- positive, but our unmet needs in triple negative are huge because this is a disease where you have got to throw your best available therapy at it as soon as you can to improve survival because survival is so poor in this disease. The average survival with metastatic triple-negative breast cancer in the United States is still 13-18 months, and that's terrible. And so, for full disclosure, I did have this trial open at my site. I was one of the site PIs. I'm not the global PI of the study, obviously. So, what this study was was for patients who had had at least a progression-free survival of 6 months after their curative intent therapy or de novo metastatic disease. They were PD-L1 positive as assessed by the Dako 22C3 assay of greater than or equal to a CPS score of 10. So, that's what the KEYNOTE-355 trial was based on as well. So, standard definition of PD-L1 positive in breast cancer here. And basically, these patients were randomized 1:1 to either their sacituzumab govitecan plus pembrolizumab, day 1 they got both therapies, and then day 8 just the saci, as is standard for sacituzumab. And then the other group got the KEYNOTE-355 regimen. So, that is pembrolizumab with – your options are carbogem there, paclitaxel or nab-paclitaxel. And it's up to investigator's decision which upon those they decided. They followed these patients for disease progression or unacceptable toxicity. It was really an impressive trial in my opinion because we know already that this didn't just improve progression-free survival, because survival is so poor in this disease, of course, we know that it improved overall survival. It's trending towards that very much, and I think that's going to be shown immediately. And then the objective response rates were better, which is key in this disease because in the first-line setting, you've got a lot of people who, especially your relapsed TNBC that don't respond to anything. And you lose a ton of patients even in the first-line setting in this disease. And so, this was 222 patients to chemotherapy and pembro and 221 to sacituzumab plus pembro. Median follow-up has only been 14 months, so it's still super early here. Hazard ratio so far of progression-free survival is 0.65, highly statistically significant, narrow confidence intervals. And so, the median duration of response here for the saci group was 16.5 months versus 9.2 months. So, you're getting a 7-month progression-free survival benefit here, which in triple negative is pretty fantastic. I mean, this reminds me of when we saw the ASCENT data originally come out for sacituzumab, and we were all just so happy that we had this tool now that doubled progression-free and overall survival and made such a difference in this really horrible disease where patients do poorly. So, OS is technically immature here, but it's really trending very heavily towards improvement in overall survival. Importantly, the treatment-related adverse events in this, I mean, we know sacituzumab causes neutropenia, people who are experienced with this drug know how to manage it at this point. There wasn't any really unexpected treatment-related adverse events. You get some people with sacituzumab who have diarrhea. It's usually pretty manageable with some Imodium. So, it was cytopenias predominantly in this disease in this population that were highlighted as far as adverse events. But I'm going to be honest, like I was surprised that this wasn't the plenary over the SERENA-6 data because this, in my mind, there we have a practice-changing trial. I will immediately be trying to use this in my PD-L1 population because, to be honest, as a triple-negative breast cancer clinical specialist, when I get a patient with metastatic triple-negative breast cancer who's PD-L1 positive, I think, "Oh, thank God," because we know that part of the disease just does better in general. But now I have something that really could give them a durable response for much longer than I ever thought possible when I started really heavily treating this disease. And so, this was immediately practice-changing for me. Dr. Allison Zibelli: I think that it's pretty clear that this is at least an option, if not the option, for this group of patients. Dr. Rebecca Shatsky: Yeah, the duration of responses here was – it's just really important because, I mean, I do think this will make people live longer. Dr. Allison Zibelli: So, moving on to the final study that we're going to discuss today, neoCARHP (LBA500), which was neoadjuvant taxane plus trastuzumab, pertuzumab, plus or minus carbo(platin) in HER2-positive early breast cancer. I think this is a study a lot of us have been waiting for. What was the design and the results of this trial? Dr. Rebecca Shatsky: I was really excited about this as well because I'm one of those people that was waiting for this. This is a Chinese trial, so that is something to take note of. It wasn't an international trial, but it was a de-escalation trial which had become really popular in HER2-positive therapy because we know that we're overtreating HER2-positive breast cancer in a lot of patients. A lot of patients we're throwing the kitchen sink at it when maybe that is not necessary, and we can really de-escalate and try to personalize therapy a little bit better because these patients tend to do well. So, the standard of care, of course, in HER2-positive curative intent breast cancer with tumors that are greater than 2 cm is to give them the TCHP regimen, which is docetaxel, carboplatin, trastuzumab, and pertuzumab. And that was sort of established by several trials in the NeoSphere trial, and now it's been repeated in a lot of different studies as well. And so, that's really the standard of care that most people in the United States use for HER2-positive curative intent breast cancer. This was a trial to de-escalate the carboplatin, which I was super excited about because many of us who treat this disease a lot think carbo is the least important part of the therapy you're giving there. We don't really know that it's necessary. We've just been doing it for a long time, and we know that it adds a significant amount of toxicity. It causes thrombocytopenia, it causes severe nausea, really bad cytopenias that can be difficult in the last few cycles of this to manage. So, this trial was created. It randomized patients one to one with stage 2 and 3 HER2-positive breast cancer to either get THP, a taxane, pertuzumab, trastuzumab, similar to the what we do in first-line metastatic HER2-positive versus the whole TCHP with a carboplatin AUC of 6, which is what's pretty standard. And it was a non-inferiority trial, so important there. It wasn't to establish superiority of this regimen, which none of us, I think, were looking for it to. And it was a modified intent-to-treat population. And so, all patients got at least one cycle of this to be assessed as a standard for an intent-to-treat trial. And so, they assumed a pCR rate of about 62.8% for both groups. And, of course, it included both HER2-positive triple positives and ER negatives, which are, you know, a bit different diseases, to be honest, but we all kind of categorize them and treat them the same. And so, this trial was powered appropriately to detect a non-inferiority difference. And so, we had about 380 patients treated on both arms, and there was an absolute difference of only 1.8% of those treated with carbo versus those without. Which was fantastic because you really realized that de-escalation here may be something we can really do. And so, the patients who got, of course, the taxane regimen had fewer adverse events. They had way fewer grade 3 and 4 adverse events than the THP group. No treatment-associated deaths occur, which is pretty standard for- this is a pretty safe regimen, but it causes a lot of hospitalizations due to diarrhea, due to cytopenias, and neutropenic fever, of course. And so, I thought that this was something that I could potentially enact, you know, and be practice-changing. It's hard to say that when it's a trial that was only done in China, so it's not necessarily the United States population always. But I think for patients moving forward, especially those with, say, a 2.5 cm tumor, you know, node negative, those, I'd feel pretty comfortable not giving them the carboplatin here. Notes that I want to make about this population is that the majority were stage 2 and not stage 3. They weren't necessarily your inflammatory HER2-positive breast cancer patients. And that the taxane that was utilized in the trial is a little different than what we use in the United States. The patients were allowed to get nab-paclitaxel, which we don't have FDA approval for in the first-line curative intent setting for HER2-positive breast cancer in the United States. So, a lot of them got abraxane, and then they also got paclitaxel. We tend to use docetaxel every 3 weeks in the United States. So, just to point out that difference. We don't really know if that's important or not, but it's just a little bit different to the population we standardly treat. Dr. Allison Zibelli: So, are there patients that you would still give TCHP to? Dr. Rebecca Shatsky: Yeah, great question. I've been asked that a lot in the past like week since ASCO. I'd say in my inflammatory breast cancer patients, that's a group I do tend to sometimes throw the kitchen sink at. Now, I don't actually use AC in those because I know that that was the concern, but I think the TRAIN-2 trial really showed us you don't need to use Adriamycin in HER2-positive disease unless it's like refractory. So, I don't know that I would throw this on my stage 3C or inflammatory breast cancer patients yet because the majority of this were not stage 3. So, in your really highly lymph node positive patients, I'm a little bit hesitant to de-escalate them from the start. This is more of a like, if there's serious toxicity concerns, dropping carbo is absolutely fine here. Dr. Allison Zibelli: All right, great.  Thank you, Dr. Shatsky, for sharing your valuable insights with us on the ASCO Daily News Podcast today. Dr. Rebecca Shatsky: Thanks so much, Dr. Zibelli and ASCO Daily News. I really want to thank you for inviting me to talk about this today. It was really fun, and I hope you find my opinions on some of this valuable. And so, I just want to thank everybody and my listeners as well. Dr. Allison Zibelli: And thank you to our listeners for joining us today. You'll find the links to all the abstracts discussed today in the transcript of this episode. Finally, if you like this podcast and you learn things from it, please take a moment to rate, review, and describe because it helps other people find us wherever you get your podcasts. Thank you again. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. More on today's speakers Dr. Allison Zibelli Dr. Rebecca Shatsky @Dr_RShatsky Follow ASCO on social media:  @ASCO on Twitter  @ASCO on Bluesky  ASCO on Facebook  ASCO on LinkedIn   Disclosures: Dr. Allison Zibelli: No relationships to disclose Dr. Rebecca Shatsky: Consulting or Advisory Role: Stemline, Astra Zeneca, Endeavor BioMedicines, Lilly, Novartis, TEMPUS, Guardant Health, Daiichi Sankyo/Astra Zeneca, Pfizer Research Funding (Inst.): OBI Pharma, Astra Zeneca, Greenwich LifeSciences, Briacell, Gilead, OnKure, QuantumLeap Health, Stemline Therapeutics, Regor Therapeutics, Greenwich LifeSciences, Alterome Therapeutics  

Breast Cancer Update
IDH-Mutant Low-Grade Glioma — An Interview with Dr Patrick Y Wen on Current and Future Management Strategies

Breast Cancer Update

Play Episode Listen Later Jun 23, 2025 54:07


Dr Patrick Wen from the Dana-Farber Cancer Institute in Boston, Massachusetts, discusses the current and future management of IDH-mutant gliomas. CME information and select publications here.

The Immunology Podcast
Ep. 107: “Immune Cell Manipulation” Featuring Dr. Rizwan Romee

The Immunology Podcast

Play Episode Listen Later Jun 17, 2025 71:33


Dr. Rizwan Romee is a Oncologist at the Dana-Farber Cancer Institute and Associate Professor at Harvard Medical School, where his research focuses on genetically manipulating NK cells to enhance their anti-tumor function. He talks about advances and challenges in engineering NK cells for cancer therapy. He also discusses using E. coli to deliver immune-activating cytokines to tumors.

Backstage @ Upstage
ALL IN THE FAMILY Is Lung Cancer Inherited?

Backstage @ Upstage

Play Episode Listen Later Jun 10, 2025 37:10


HOST: Hildy Grossman, CO-HOST: Jordan Rich GUESTS: Jaclyn LoPiccolo, MD, Ph.D., Pasi Janne, MD, Ph.D., Dana Farber Cancer Institute and Jill Feldman, EGFR Resisters Hildy opens with a powerful anecdote about an early Upstage Lung Cancer Board member whose mother, grandmother, and aunt all had lung cancer. She endured months of allergy and antibiotic treatments … Continue reading ALL IN THE FAMILY Is Lung Cancer Inherited? →

OncLive® On Air
S13 Ep11: Collaborative Structural Reforms Represent a Way Forward for Oncology Innovations: With Elizabeth Mittendorf, MD, PhD, MHCM

OncLive® On Air

Play Episode Listen Later Jun 9, 2025 9:48


In today's episode, we sat down for part 2 of our discussion with Elizabeth Mittendorf, MD, PhD, MHCM, the 2026-2027 president-elect of the American Society of Clinical Oncology (ASCO). Dr Mittendorf holds numerous leadership roles, including the Robert and Karen Hale Distinguished Chair in Surgical Oncology and vice chair for research in the Department of Surgery at Brigham and Women's Hospital; co-leader of the Breast Program and director of the Breast Immuno-Oncology Program at the Dana-Farber Brigham Cancer Center; co-leader of the Parker Institute for Cancer Immunotherapy at the Dana-Farber Cancer Institute; and a professor of surgery at Harvard Medical School, all in Boston, Massachusetts. In this discussion, Dr Mittendorf shared how ASCO is strategically preparing to address the long-term implications of proposed federal research funding cuts. She emphasized the significant return on investment generated by sustained NIH support, underscoring its role in fostering scientific innovation and stimulating the broader economy. She also advocated for structural reforms to be developed collaboratively with researchers, institutions, and policymakers to ensure continued progress in oncology is maintained, particularly in underfunded areas, such as prevention research. Dr Mittendorf also previewed her broader vision for ASCO, including expanding global collaboration and advancing equitable access to cancer care. She noted that these efforts will be complemented by continued emphasis on multidisciplinary care delivery and mentorship, which she discussed in more detail in part one of our conversation.

New England Journal of Medicine Interviews
NEJM Interview: Amar Kelkar on NIH indirect-cost coverage and U.S. medical research.

New England Journal of Medicine Interviews

Play Episode Listen Later Jun 4, 2025 7:55


Amar Kelkar is a physician at the Dana-Farber Cancer Institute and an instructor in medicine at Harvard Medical School. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. A.H. Kelkar. U.S. Research Leadership at a Crossroads — The Impact of Reducing NIH Indirect-Cost Coverage. N Engl J Med 2025;392:2081-2084.

Nightside With Dan Rea
Nightside News Update 6/3/25

Nightside With Dan Rea

Play Episode Listen Later Jun 4, 2025 36:55 Transcription Available


We kicked off the program with four news stories and different guests on the stories we think you need to know about!Rappell Boston - 100 People To Brave The Side of One of Cambridge's Biggest Buildings to Fight Epilepsy on Saturday, June 14, 2025. Josh Drew - Director of Development at Epilepsy Foundation New England and is in charge of the Rappel Event talked with Dan about the event.Boulder, Colorado antisemitic attack that injured a dozen. Adam Katz - president of Foundation to Combat Antisemitism checked in.Is sunscreen toxic? The war on sunscreen! Timothy Rebbeck, a professor of cancer prevention at Dana-Farber Cancer Institute has the answer.At-Home Heart Attacks and Cardiac Deaths on the Rise Since COVID-19 Pandemic, a recent study finds. Dr. Jason Wasfy – author of the published study on this & director of Outcomes Research at the Massachusetts General Hospital Cardiology Division and a faculty member at the Mongan Institute at Massachusetts General Hospital checked in.Listen to WBZ NewsRadio on the NEW iHeart Radio app and be sure to set WBZ NewsRadio as your #1 preset!

Breast Cancer Update
Breast Cancer: Additional Perspectives — Year in Review Series on Relevant New Datasets and Advances

Breast Cancer Update

Play Episode Listen Later Jun 4, 2025 61:12


Dr Ian Krop from Yale Cancer Center in New Haven, Connecticut, and Dr Sara Tolaney from Dana-Farber Cancer Institute in Boston, Massachusetts, summarize major treatment advances over the past year and review relevant ongoing clinical trials for patients with breast cancer. CME information and select publications here.

OncLive® On Air
S13 Ep9: Multidisciplinary Collaboration and Mentorship Lay the Foundation for a New Chapter of ASCO Leadership: With Elizabeth Mittendorf, MD, PhD, MHCM

OncLive® On Air

Play Episode Listen Later Jun 2, 2025 12:53


In today's episode, we had the pleasure of speaking with Elizabeth Mittendorf, MD, PhD, MHCM, the 2026 president-elect of ASCO. Dr Mittendorf is the Robert and Karen Hale Distinguished Chair in Surgical Oncology and the vice chair for research in the Department of Surgery at the Brigham and Women's Hospital; co-leader of the Breast Program and director of the Breast Immuno-Oncology Program at the Dana-Farber Brigham Cancer Center; co-leader of the Parker Institute for Cancer Immunotherapy at the Dana-Farber Cancer Institute; and a professor of surgery at Harvard Medical School, all in Boston, Massachusetts.  In our exclusive interview, Dr Mittendorf discussed her priorities for advancing oncology practice and improving patient outcomes during her presidency. These include multidisciplinary cancer care, workforce well-being, leveraging artificial intelligence to enhance efficiency, and addressing global cancer care. She also emphasized the importance of mentorship and sponsorship for early career professionals, highlighting her personal experience with multiple mentors and her commitment to supporting the next generation of oncology professionals. 

ASCO Daily News
Day 3: Top Takeaways From ASCO25

ASCO Daily News

Play Episode Listen Later Jun 1, 2025 9:24


Dr. John Sweetenham shares highlights from Day 3 of the 2025 ASCO Annual Meeting, including new research for the treatment of advanced renal cell carcinoma and 2 studies on novel approaches in non-small cell lung cancer. Transcript Dr. John Sweetenham: Hello, I'm Dr. John Sweetenham, the host of the ASCO Daily News Podcast, with my takeaways on selected abstracts from Day 3 of the 2025 ASCO Annual Meeting. Today's selection features studies addressing the treatment of advanced renal cell carcinoma and 2 studies exploring novel approaches in non-small cell lung cancer. My disclosures are available in the transcript of this episode. The first abstract is number 4505. This study, led by Dr. Toni Choueiri of the Dana-Farber Cancer Institute, describes the final analysis of the CheckMate 214 trial, which compared the combination of nivolumab and ipilimumab with sunitinib for the first-line treatment of advanced renal cell carcinoma. The ipi-nivo combination is approved for the frontline treatment of intermediate and poor-risk advanced renal cell carcinoma based on the primary analysis of the CheckMate 214 trial, which demonstrated a higher response rate and longer overall survival compared with sunitinib. Today's presentation provided the final safety and efficacy results for the trial with long-term follow-up of more than 9 years.  The intent-to-treat (ITT) population in this trial comprised 550 patients randomized to nivo and ipi versus 546 who received sunitinib. The final analysis showed sustained long-term benefit for the combination therapy. Patients given nivolumab plus ipi had a 29% reduction in the risk for death compared with sunitinib. For patients with intermediate or poor-risk disease, there was a 31% reduction in the risk of death.   The probability of remaining in response through 8 years was more than doubled with nivolumab plus ipilimumab versus sunitinib in the ITT population at 48% versus 19%, and in the intermediate and poor-risk population at 50% versus 23%. The other important observation is that patients with favorable-risk disease appeared to have a 20% reduction in the risk for death at 9 years and more durable responses. This suggests a possible delayed benefit for ipi and nivo in this group since these differences were not seen in the earlier analysis.   No new safety signals emerged with longer follow-up, and the results confirm the use of ipi and nivo as a standard front-line combination therapy in this disease. Since this combination has been in widespread use for some years, the results are not surprising although the subgroup analysis suggesting benefit in favorable-risk patients is likely to inform practice in the future.   Today's second abstract is number is 8506, which was presented by Dr. Tony Mok from the Chinese University of Hong Kong, describing results from the phase 3 HERTHENA-Lung02 trial. This trial compared the antibody-drug conjugate patritumab deruxtecan with platinum-based chemotherapy in patients with EGFR-mutated advanced non-small cell lung cancer following a third-generation tyrosine kinase inhibitor (TKI).  Patritumab deruxtecan, also known as HER3-DXd, comprises a fully human anti-HER3 IgG3 monoclonal antibody conjugated to a topoisomerase 1 inhibitor payload, and showed activity in a previous phase 2 trial in patients relapsing after EGFR TKI and chemotherapy.   In this phase 3 study, this agent was compared with platinum-based chemotherapy in eligible patients with an EGFR-activating mutation who had previously received 1 or 2 EGFR TKIs, at least one of which was a third-generation drug, with relapse or progression after this therapy. Five hundred and eighty-six patients were enrolled, with progression-free survival as the primary endpoint.  The primary analysis showed a 9-month progression-free survival of 29% for the experimental arm compared with 19% for platinum-based chemotherapy, for a hazard ratio of 0.77 and a P value of 0.011. With higher progression-free survival rates at 6 months and 12 months, HER3-DXd also had a better objective response rate (35.2% versus 25.3%) compared with platinum-based chemotherapy (PBC), and HER3-DXd also extended intracranial progression-free survival compared with PBC in patients with brain metastases, with a hazard ratio of 0.75. Grade 3 or more treatment-related adverse events occurred in 73% of patients treated with HER3-DXd and 57% of patients who received PBC. HER3-DXd had a higher rate of grade or more 3 thrombocytopenia, and drug-related interstitial lung disease occurred in 5% of patients in the HER3-DXd arm.   The follow-up will need more time to mature since no overall survival data are currently available, but definitely an agent to watch with interest. Moving on to today's final abstract, 8500, was presented by Dr. Pasi Jänne from the Dana-Farber Cancer Institute, describing results from the phase 2 portion of the KRYSTAL-7 study. This study is exploring the use of a potent KRAS inhibitor, adagrasib, in combination with pembrolizumab in patients with advanced or metastatic KRASG12C- mutated non-small cell lung cancer.  Adagrasib has already received accelerated approval in the U.S. for previously treated locally advanced or metastatic NSCLC with a KRASG12C mutation. A previous report from the KRYSTAL-7 study demonstrated encouraging activity in combination with pembrolizumab in the frontline setting for this patient group who also had more than 50% expression of PD-L1. The presentation today described efficacy and safety data for this drug combination across all PD-L1 expression levels.  One hundred and forty-nine patients with a median age of 67 years were treated with the combination, 104 of whom had PD-L1 expression level results available, representing the so-called biomarker population in this trial. The overall response rate for the entire study population was 44%. In the biomarker population, the overall response rate ranged from 36% in those with less than 1% PD-L1 expression to 61% for those with more than 50% expression. For all patients, the median response duration was just over 26 months, and the median progression-free and overall survival rates were 11 and 18.3 months respectively.    For the biomarker population, the median progression-free and overall survival were highest in those patients with more than 50% PD-L1. No new safety issues emerged from this analysis; the most frequent toxicities were nausea, diarrhea, and increases in transaminases. Immune-related toxicities included pneumonitis, hypothyroidism, and hepatitis. These are important results and the results of the phase 3 portion of KRYSTAL-7, which compares first-line therapy with adagrasib plus pembro versus pembro alone in the KRASG12C mutated/PD-L1 more than 50% group, will be informative. For those patients with lower levels of PD-L1 expression, the authors suggest that the treatment escalation may be beneficial, possibly including the addition of chemotherapy.  That concludes today's report. Thanks for listening and I hope you will join me again tomorrow to hear more top takeaways from ASCO25. If you value the insights that you hear on the ASCO Daily News Podcast, please remember to rate, review, and subscribe wherever you get your podcasts.  Disclaimer:  The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  Find out more about today's speaker:    Dr. John Sweetenham    Follow ASCO on social media:     @ASCO on Twitter    @ASCO on Bluesky    ASCO on Facebook    ASCO on LinkedIn     Disclosures:   Dr. John Sweetenham:    No relationships to disclose

Nightside With Dan Rea
NightSide News Update 5/30/25

Nightside With Dan Rea

Play Episode Listen Later May 31, 2025 41:23 Transcription Available


We kicked off the program with four news stories and different guests on the stories we think you need to know about!Zach Doell - editor of vehicle testing at U.S. News with U.S. News & World Report's 2025 Best Cars for Teens.Jerry Greenfield – Co-founder of Ben & Jerry's Ice Cream joined Dan to discuss the 42nd annual Jimmy Fund Scooper Bowl at Boston City Hall Plaza. Funds raised support Dana-Farber Cancer Institute.Dorchester Day this Sunday – Celebrating everything Dorchester with Jack Doherty – owner of College Hype.Jonathan Gulliver - MassDOT Highway Administrator with a heads up on the Newton-Weston Bridge Replacement Project Weekend Closures for Bridge Work – First closure begins tonight May 30th: from 9 p.m. to 5 a.m. on June 2. The second closure is set for 9 p.m. on June 20 to 5 a.m. on June 23.Listen to WBZ NewsRadio on the NEW iHeart Radio app and be sure to set WBZ NewsRadio as your #1 preset!

Caregiver Connection Podcast
Everything You Know About Breast Cancer Is Half the Story

Caregiver Connection Podcast

Play Episode Listen Later May 29, 2025 50:59


In this powerful bonus episode, host Charlotte Bayala joins forces with Bob Coughlin and Paul Kidwell of In Sickness: Men and the Culture of Caregiving to shine a much-needed spotlight on male breast cancer.  Survivors Arvind Natarajan and Steve DelGardo share their raw, real journeys: from diagnosis delays and cultural silence to reclaiming strength through humor, information, and advocacy.  Dr. Leone of Dana-Farber Cancer Institute brings essential insight on the medical side, explaining the gaps in research, care, and support for men.  Whether you're a caregiver, survivor, or someone who loves a man in your life, this episode will change how you think about breast cancer and why silence is no longer an option.

Breast Cancer Update
5-Minute Journal Club Issue 8 with Dr Rinath M Jesselsohn: Reviewing the Role of Oral SERDs in the Management of ER-Positive Metastatic Breast Cancer

Breast Cancer Update

Play Episode Listen Later May 28, 2025 13:48


Dr Rinath Jeselsohn from the Dana-Farber Cancer Institute in Boston, Massachusetts, discusses recent developments with oral SERDs in the management of ER-positive metastatic breast cancer. CME information and select publications here.

Hematologic Oncology Update
Non-Hodgkin Lymphoma — An Interview with Dr Jennifer Crombie on the Use of Bispecific Antibodies

Hematologic Oncology Update

Play Episode Listen Later May 20, 2025 49:54


Dr Jennifer Crombie from the Dana-Farber Cancer Institute in Boston, Massachusetts, reviews available and investigational CD20 x CD3 targeted bispecific antibodies for the treatment of follicular and diffuse large B-cell lymphomas. CME information and select publications here.

Breast Cancer Update
5-Minute Journal Club Issue 7 with Dr Rinath M Jesselsohn: Reviewing the Role of Oral SERDs in the Management of ER-Positive Metastatic Breast Cancer

Breast Cancer Update

Play Episode Listen Later May 19, 2025 17:35


Dr Rinath M Jeselsohn from the Dana-Farber Cancer Institute in Boston, Massachusetts, discusses recent developments with oral SERDs in the management of ER-positive metastatic breast cancer. CME information and select publications here.

ASCO Guidelines Podcast Series
Symptom Management for Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors Guideline

ASCO Guidelines Podcast Series

Play Episode Listen Later May 9, 2025 19:20


Dr. Kimberly Perez and Dr. Jaydira Del Rivero discuss the new guideline from ASCO on symptom management for well-differentiated GEP-NETs. They share the latest recommendations on managing symptoms related to hormone excess, including carcinoid syndrome and carcinoid heart disease, managing symptoms of functioning pancreatic neuroendocrine tumors, and also palliative interventions. Dr. Perez and Del Rivero share how to use this guideline in concert with the systemic therapy for tumor control in metastatic well-differentiated GEP-NETs guideline, and hope for the future for the treatment of gastroenteropancreatic neuroendocrine tumors. Read the full guideline, “Symptom Management for Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors: ASCO Guideline.” Transcript This guideline, clinical tools, and resources are available on ASCO.org. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in JCO Oncology Practice.        Brittany Harvey: Hello and welcome to the ASCO Guidelines Podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Kim Perez from Dana-Farber Cancer Institute and Dr. Jaydira Del Rivero from the Center for Cancer Research at the National Cancer Institute, co-chairs on “Symptom Management for Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors: ASCO Guideline.” Thank you for being here today, Dr. Del Rivero and Dr. Perez. Dr. Kim Perez: Thank you. Dr. Jaydira Del Rivero: Thank you so much for the invitation. Brittany Harvey: And then before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Perez and Dr. Del Rivero, who have joined us here today, are available online with the publication of the guideline in JCO Oncology Practice, which is linked in the show notes. So then to jump into the content here, first Dr. Del Rivero, could you provide an overview of the scope and purpose of this guideline? Dr. Jaydira Del Rivero: Yeah. Thank you so much. Well, first, we really wanted to thank ASCO for allowing us to develop these guidelines for the management of gastroenteropancreatic neuroendocrine tumors. I do want to mention that there is also another set of guidelines that I was very fortunate also to co-chair with Dr. Perez on the systemic management of gastroenteropancreatic neuroendocrine tumors. But when discussing these guidelines as well as with the different panelists, experts in this type of disease, we also realized that the management of these tumors are quite complex, not only from the management of the disease progression, but at the same time, management of the symptoms related to the hormone excess. And because of that, we like to thank ASCO for allowing us to then not only have a discussion on the systemic management of these tumors, but at the same time develop recommendations for the symptoms related to the different hormones that these neuroendocrine tumors may produce. These guidelines are for the management of grade 1 to grade 3 metastatic gastroenteropancreatic neuroendocrine tumors. These guidelines include the management of the different aspects and the symptoms related to hormone excess, such as carcinoid syndrome, carcinoid heart disease, how to manage carcinoid crisis, as well as the different symptoms and how to manage the functional pancreatic neuroendocrine tumors and as well as provide recommendations in the different treatments for these tumor types, not only from the systemic management but also from the surgical management as well as for liver-directed therapy options and the different aspects in terms of the palliative care of these patients to improve not only the symptoms related to the hormone excess caused by these tumors, but as well as to improve the quality of life. Brittany Harvey: Absolutely. And I appreciate that overview. And yes, we'll link the guideline on the Systemic Therapy for Tumor Control for Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors in the show notes for our listeners so that they can refer to that companion guideline as well. So then you just described the several different categories of recommendations that this guideline covers on symptom management. So, Dr. Perez, I'd like to start reviewing some of those key recommendations of that guideline. So, starting with what are the key recommendations for carcinoid syndrome and carcinoid heart disease? Dr. Kim Perez: Thank you Brittany. Yeah, I also want to thank ASCO for inviting us to do this podcast today. Just to start, I think these guidelines will really add to what's available in the literature to provide a kind of a quick look for the community provider to manage carcinoid-related symptoms. I think the highlights that I would point out are we've all been using somatostatin analogs for the last few decades to manage symptoms, but with the newer treatments that are now available, we tried to highlight what does the literature support in regards to PRRT, what does the literature support in regards to using systemic therapy for disease management, but also the benefits that you will get from a symptom management perspective using other modalities. I think the highlight really is it's a multidisciplinary approach. We are now considering surgery and embolization or interventional radiology as a critical piece. And I think the third that I'd highlight is the fact that sometimes we get too focused on carcinoid syndrome and the symptoms will actually, may result from other things. And the highlight in the algorithms that we've provided is what other things cause carcinoid-related diarrhea. And let's not forget about that because we will find ourselves treating and patients getting very frustrated with persistence of symptoms when in actuality, we should be treating something else that is causing a very similar symptom. For carcinoid heart disease, I think there are more and more guidelines that are now available to provide guidance there, but I think the major advances are that we should be utilizing heart assessment with echocardiogram with lab values such as BMP. But also critical to this is consulting with our cardiology colleagues and making sure that we're identifying heart related issues that are resulting from hormone excess sooner than later because interventions on the earlier side can really make a significant impact on quality of life and associated comorbidities and mortality. Brittany Harvey: Thank you for reviewing those key points for both carcinoid syndrome and carcinoid heart disease symptom management. So then the next set of recommendations. Dr. Del Rivero, what are the key highlights for symptom management of functioning pancreatic neuroendocrine tumors? Dr. Jaydira Del Rivero: Yes, it's very important to recognize the symptoms related to hormone excess due to pancreas neuroendocrine tumors. Up to 10% of pancreas neuroendocrine tumors may produce different hormones. Among those hormones can be insulin, gastrin, glucagon, somatostatin. So it's important to know and understand that based on what a neuroendocrine tumor is, they may produce different types of hormones. The importance of these guidelines is to also recognize some of these symptoms and how to address that, because it's not necessarily in these tumor types besides the management of metastatic disease, and know the different options that we recommend for metastatic disease from the systemic therapy, such as chemotherapy or targeted therapies or PRRT. It's important to recognize the symptoms because based on the symptoms we may recommend a different approach. That's something that is important to acknowledge and recognize. Moreover, in certain functional pancreas neuroendocrine tumors, as Dr. Perez mentioned, is a multidisciplinary approach. And it's important to also discuss these different cases with your endocrinologist. You may need to have an experienced endocrinologist to manage, for example, the excess of insulin. And also discuss your cases with a surgeon and interventional radiologist because some of these approaches can certainly improve the symptoms related to hormone excess. I understand that sometimes medical oncologists in the communities may not have access to the multidisciplinary approach or have the different teams that can manage these tumors, and that's the reason why with these guidelines we wanted to establish the understanding of different symptoms associated with the hormone excess to these neuroendocrine tumors as well as how to manage this. For example, in the case of insulinoma, I think for the medical oncologist it is important to know that the everolimus is an option to be used for these tumors, not only to manage tumor progressions related to this tumor type at the same time, because everolimus as a side effect causes hyperglycemia, that can also improve some of the symptoms related to the excess of insulin besides the somatostatin agonist. I think these recommendations will allow the medical oncologist to recognize the symptoms and based on what the symptoms cause, then you can have a different approach that could be added to the systemic therapies options as well. Brittany Harvey: Yes, beyond systemic therapy, it's important to be recognizing symptoms to provide an individualized approach for every single patient. So then, following that overview of symptom management for functioning pancreatic neuroendocrine tumors, Dr. Perez, what is recommended regarding palliative interventions for patients with gastroenteropancreatic neuroendocrine tumors? Dr. Kim Perez: Yeah, great question. So I think what's unique to neuroendocrine tumors is that the palliative approach really mirrors what we would be doing for symptom management. Some of these patients are living a very long time with carcinoid related symptoms. And so the approach that we take for the carcinoid symptom control is going to mirror the palliative piece of it. I think for those who develop a burden of disease related symptoms, I think it mirrors what we do across the board for all cancer-related complications. And so I think what we attempted to highlight here and included one of our colleagues who focuses specifically on the field of palliative care and neuroendocrine tumors, was to never really lose sight of what we've been doing to care for symptom management throughout the patient's journey and to always rereview the etiology of the symptoms, ensure that we don't focus solely on carcinoid-related issues, but also the symptom management that we would apply to all patients with cancer-related burden symptoms. Brittany Harvey: Definitely. I think that's a helpful approach to consider when thinking about how to manage these palliative interventions as well. So then Dr. Del Rivero, what should clinicians know as they implement these symptom management recommendations? Dr. Jaydira Del Rivero: Yes, thank you so much for that question. As we have discussed in the last 10 or 15 minutes, we have discussed the different approaches on the management of gastroenteropancreatic neuroendocrine tumors. Clinicians, I think it's important to know that neuroendocrine tumors is a quite complex disease because we're not only addressing the management of tumor growth, but we're also addressing the management of the symptoms related to hormone excess and the complexity associated with that. When medical oncologists or clinicians implement these recommendations it's to understand what symptoms these tumors may cause related to the hormone excess but at the same time, how do we approach those symptoms? As Dr. Perez said that I think is very important is to recognize the different types of diarrhea. It doesn't mean that if the patient has worsening diarrhea, it doesn't mean that this is related to disease progression. So it's important to recognize so that way you can address that, because the type of diarrheas can be related because of the lanreotide or somatostatin agonist, it could be because of the prior surgery. I think it's important to recognize those in order to address the symptom. And the same with the gastroenteropancreatic neuroendocrine tumors. It's important to know what hormones they produce because there are different measurements that may be added to the systemic management of these tumors. I think that there are two aspects here, and that's the reason why these guidelines were implemented in the sense that not only we're going to manage disease progression of these tumors, or how do we manage the metastatic disease of these tumors, but at the same time, how do we manage the symptoms related to the hormone excess and the different complications. Moreover, I think, as we discussed earlier, we need to manage these tumors in a multidisciplinary approach. And something very important is not like one size fits all, because the treatment recommendations, it will depend on different characteristics in terms of the tumor presentations. And hormone excess is one of the important aspects to recognize so that way we can implement these recommendations that will definitely help the quality of life of these patients. Brittany Harvey: Absolutely. And using these guidelines in concert with the systemic therapy guidelines is key. And then beyond this impact for clinicians that Dr. Del Rivero has just outlined, Dr. Perez, what does this new guideline mean for patients with gastroenteropancreatic neuroendocrine tumors? Dr. Kim Perez: Yeah, I think that's an important highlight of this guideline. It really gives patients a voice. I think it recognizes the fact that these symptoms can go unmanaged or mismanaged or just missed, and patients commonly will come in feeling very frustrated and feeling very ill. And I think it will provide them a means to open up a conversation with their providers and say, “Hey, this is what I'm experiencing. Let's talk about what's available. How does this apply to me?” And I think that can be very empowering. I think it's really hard nowadays with so many sources and resources online and patients are really left wondering what are the bullet points that they should be bringing to their clinician appointments? And I think that these guidelines provide them a good framework for those discussions. Brittany Harvey: Yes, bringing these discussion points for patients is very important to be able to have those resources. And we have some patient resources and information available on the website for this guideline and we can link that in the show notes for listeners. So then you've both touched on the importance of this guideline for improving quality of life and we continue to see advancements in this field. So Dr. Del Rivera, what are the outstanding questions regarding symptom management and tumor control for gastroenteropancreatic neuroendocrine tumors? Dr. Jaydira Del Rivero: I have to say whenever somebody asks me that question, the word that I will say is I feel hopeful, because more than 10 years ago we didn't have that many options for gastroenteropancreatic neuroendocrine tumors. And it has been in the last decade or so that there has been more developments in the management of these tumors as well as the understanding of the symptoms related to these tumors. But that said, yes, we do need more therapies for gastroenteropancreatic neuroendocrine tumors. Of the treatment options that we have, we all know in the field that even though we have disease control by using the different options for the systemic management of gastroenteropancreatic neuroendocrine tumors, we need options where we can achieve an objective response, especially for these tumor types. But there is a significant volume of disease and we see a lot of these patients with gastroenteropancreatic neuroendocrine tumors. And now where the field is going is to make some of these therapies more effective, to develop more therapies as well. For example, immunotherapies, a different type of immunotherapy understand the tumor immune microenvironment of these tumors in order to develop therapies as well. From the antibody drug conjugates, I think that's a new way to also address or treat these tumor types, understanding about the different markers found on these tumors that way they can be addressed in different ways. Now with the development of new therapies, I think that's something that can help us as well not only have disease control and as well as having an objective response, but having a better objective response can certainly also help with the symptoms related to hormone excess too. In terms of other therapies, I think some of the issues that we encounter are like the refractory carcinoid diarrhea and how do we manage this. We do have therapies that can help us control the diarrhea in the refractory settings, such as telotristat. Telotristat is one of the newer medications that can help us control the refractory diarrhea. But that said, despite this, that we still encounter situations where it's sometimes difficult to control. I think in those situations it will be good to understand more about the biology of these tumors as well and how we manage. If there is a different time or how do we implement these options. I think there is so much to learn. But that said, I feel we're in hopeful times. We're understanding more about these tumors so that way we can help us develop better therapies not only to have control of the tumor growth as well having control of the symptoms. And it's the same with the pancreas neuroendocrine tumors in the metastatic setting. Sometimes it may be difficult to control this hormone excess. But understanding these and having therapies that can achieve more of an objective response, I think that will definitely help us more and manage these patients. But one aspect I want to mention, and Dr. Perez also mentioned as well, the fact that we have these guidelines that help us understand about the different symptoms related to hormone excess and how to address it, I think is very important because having symptoms related to hormone excess can be detrimental to the quality of life on patients with neuroendocrine tumors that may necessarily be related to disease progression and having this information is so important. And I'm hopeful for the different therapies. There's different clinical trials ongoing for neuroendocrine tumors and especially in the field of PRRT. And a lot of more information will come with the different alpha-PRRT and combination therapy. So more information to come in the next couple of years. So this is, in my opinion, hopeful times for this field. Brittany Harvey: It's great to hear that you're hopeful for all the developments in this field and we'll look forward to the development and discovery of new therapies and further research and then, hopefully incorporate those updates into guidelines in the future. So I want to thank you both so much for your work to develop these guidelines and thank you for your time today. Dr. Del Rivero and Dr. Perez. Dr. Jaydira Del Rivero: Thank you so much for having us. Dr. Kim Perez: Thank you. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/gastrointestinal-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

Blood Cancer Talks
Episode 59. Management of Systemic Mastocytosis with Dr. Daniel DeAngelo

Blood Cancer Talks

Play Episode Listen Later May 8, 2025 63:18


In this episode, we discussed the management of systemic mastocytosis with Dr. Daniel DeAngelo from the Dana Farber Cancer Institute. Here are the key studies we discussed:Midostaurin https://www.nejm.org/doi/10.1056/NEJMoa1513098?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200www.ncbi.nlm.nih.govAvapritinibEXLPORER study: https://www.nature.com/articles/s41591-021-01538-9PATHFINDER study: https://www.nature.com/articles/s41591-021-01539-8Bezuclastinib: APEX trial: https://ashpublications.org/blood/article/144/Supplement%201/659/530240/Apex-Part-1-Updated-Assessment-of-BezuclastinibHSCT for Advanced SM: https://ascopubs.org/doi/10.1200/JCO.2014.55.2018

Public Health Review Morning Edition
900: How ASTHO Provides Value, Crisis Comms Webinar

Public Health Review Morning Edition

Play Episode Listen Later May 6, 2025 6:23


Jeffrey Ekoma, ASTHO Senior Director for Government Affairs, explains how he came to ASTHO and how his team provides value for members; Vish Viswanath, Professor of Health Communication and Population Sciences at the Harvard T.H. Chan School of Public Health and the Dana-Farber Cancer Institute, explains how an upcoming ASTHO webinar will prepare you to be a better crisis communicator; the Association of Immunization Managers, is celebrating its 25-year anniversary; and Jeff Brown, Acting Commissioner of Health for the State of New Jersey, is ASTHO's newest member. ASTHO Webinar: Don't Panic! A Panel on How to be an Effective Crisis Communicator Association of Immunization Managers Web Page: AIM 2024 Annual Report ASTHO Web Page: New Jersey | Jeff Brown  

Breast Cancer Update
Breast Cancer — Year in Review Series on Relevant New Datasets and Advances

Breast Cancer Update

Play Episode Listen Later May 6, 2025 59:31


Dr Rebecca Dent from National Cancer Centre Singapore and Dr Nancy Lin from Dana-Farber Cancer Institute in Boston, Massachusetts, discuss important efficacy and safety data from 2024 related to the management of localized and advanced breast cancers. CME information and select publications here.

Hematologic Oncology Update
Chronic Lymphocytic Leukemia — Year in Review Series on Relevant New Datasets and Advances

Hematologic Oncology Update

Play Episode Listen Later May 3, 2025 59:14


Dr Jennifer R Brown from Dana-Farber Cancer Institute in Boston and Prof Paolo Ghia from IRCCS Ospedale San Raffaele in Milano, Italy, summarize clinically relevant research findings and datasets over the past year regarding the treatment of chronic lymphocytic leukemia. CME information and select publications here.

Driven By Insight
Dr. Ben Ebert, President and CEO of Dana-Farber Cancer Institute

Driven By Insight

Play Episode Listen Later May 1, 2025 59:48


When it comes to breakthroughs in medical research, the future is closer than you think. Willy was joined by one of the most influential voices in oncology, Dr. Ben Ebert, President and CEO of Dana-Farber Cancer Institute. They explored Dana-Farber's strategy for navigating threats to medical funding and research, competition and collaboration in the medical field, how Dana-Farber attracts world-class talent, cutting-edge new technologies (including blood biopsies), the transformative potential of AI in early detection and accelerating breakthroughs, Dr. Ebert's hope for the next five years, and so much more. Learn more about your ad choices. Visit megaphone.fm/adchoices

Your Healthiest Healthy with Samantha Harris
Feed Your Brain, Fuel Your Mood with guest expert Dr. Uma Naidoo

Your Healthiest Healthy with Samantha Harris

Play Episode Listen Later Apr 30, 2025 31:58


Feed Your Brain, Fuel Your Mood!with guest expert Dr. Uma NaidooLife gets busy, and grabbing something quick feels like a win. But what if those convenient bites are actually messing with more than just your waistline?They're messing with your mind, too.When we think about it, any shift away from the standard American diet (you know, the one packed with fast food, processed snacks, and sugar bombs) is a move in the right direction. Most people talk about these foods being bad for your body, but what about your brain?Turns out, the way you eat could be one of the most powerful ways to take care of your mental health — starting today.In this episode, you will learn:How Food Affects Mental Health (Not Just Physical Health!) Why Whole Foods Are Better Than Processed Ones Eating the Rainbow: How Colorful Fruits and Veggies Boost Health The Gut-Mood Connection: A Happy Gut Equals a Happier Mind Are You Eating Enough to Fuel Your Brain? Where to Find Fiber in Your Diet Who Should Be Careful with Fiber for Gut Health America's Fiber Deficiency: What You Should Know How Antioxidants Fight Stress in Your Cells Boosting Mental Health with Spices Essential Foods for a Healthy Mind and Body How Food Can Help Prevent Inflammation What Your Gut Needs for a Happier Brain How Antioxidants Protect Your Brain The Dangers of Processed Foods on Mental Health How Gut Health Affects Emotional Regulation and Stress The Power of Phytonutrients: How Colorful Foods Support a Healthier Mind… And much more.About our guest expert:Dr. Uma Naidoo is a nutritional psychiatrist and serves as the director of nutritional & lifestyle psychiatry at Massachusetts General Hospital. She is on the faculty at Harvard Medical School. Dr. Naidoo trained at the Harvard Longwood Psychiatry Residency Training Program, and completed a consultation liaison fellowship at Brigham & Women's Hospital and Dana-Farber Cancer Institute.Dr. Naidoo studied nutrition, and she also graduated from the Cambridge School of Culinary Arts as a professional chef. She was awarded her culinary school's most coveted award, the MFK Fisher Award for Innovation. Dr. Naidoo is regarded nationally and internationally as a pioneer in the field of nutritional psychiatry, having founded the first US hospital-based clinical service in this area.She is the author of This is Your Brain on Food: An Indispensable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD, and More. With her passion for food and nutritional psychiatry, she will share her expertise on the integration of food, mental health, and medicine.Instagram: https://www.instagram.com/drumanaidoo/Website: https://www.dailydoselife.com/meal-plans****************************************Get Jumping!! Rebounder Workouts = Cardio without ImpactI loooove my rebounder mini-trampoline workouts. Why? Efficient cardio without high-impact hurting my joints + the bonus of improving lymphatic flow.It's a great 1-2 punch to get a high energy, low-impact sweat on with the added benefit of using the trampoline as a step, bench and other uses to allow for building muscle (especially when you add-on...

Patient from Hell
The Microbiome's Impact on Colorectal Cancer Development + Survivorship Cancer Survivorship

Patient from Hell

Play Episode Listen Later Apr 30, 2025 50:10


In this episode of The Patient From Hell, host Samira Daswani speaks with Dr. Sara Char about her journey into oncology, the evolution of cancer biology, and the significant role of the microbiome in colon cancer. They discuss the complexities of cancer survivorship, the effectiveness of different methods of delivering survivorship care plans, and the importance of colonoscopy in monitoring colorectal cancer. The conversation also delves into the impact of diet on cancer risk, emphasizing the need for a comprehensive understanding of dietary patterns rather than focusing solely on individual foods. In this conversation, Dr. Sara Char discusses various aspects of survivorship care for colorectal cancer patients, focusing on dietary recommendations, exercise, and the emotional challenges faced during the transition from active treatment to survivorship. The dialogue emphasizes the importance of balancing nutrition, understanding the role of GLP-1 agonists, and the need for a supportive care team. Additionally, the conversation highlights the unique mental health needs of survivors and the significance of providing patients with a roadmap for their cancer journey.About Our Guest:Dr. Sara Char is a hematology and oncology fellow at Dana-Farber Cancer Institute. She specializes in the care of patients with gastrointestinal cancers with a specific interest in young-onset colorectal cancer. Her research explores the molecular underpinnings of diet and lifestyle factors implicated in colorectal cancer development and progression. Dr. Char received her M.D. from Tufts University School of Medicine and completed her residency training in internal medicine at Massachusetts General Hospital, where she also served as chief resident. Outside of work, she is a self-identified foodie and devoted dog-mom. Resources & Links:This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features the PCORI research study here: https://pubmed.ncbi.nlm.nih.gov/34302474/ - ‘Simplifying Survivorship Care Planning: A Randomized Controlled Trial Comparing 3 Care Plan Delivery Approaches'Chapter Codes00:00 Exploring the Microbiome and Colon Cancer05:59 The Transition to Survivorship Care11:57 Understanding Adherence in Survivorship Plans17:49 The Role of Colonoscopy in Survivorship24:06 Dietary Patterns and Cancer Risk25:04 Inflammatory Diet and Health Outcomes28:11 Dietary Recommendations for Cancer Survivors30:34 Exercise and Body Composition in Cancer Care31:59 Managing GI Issues with GLP-1 Agonists34:43 Navigating Multidisciplinary Care35:50 The Transition from Active Treatment to Survivorship38:08 Mental Health Challenges Post-Treatment41:41 The Need for Psycho-Oncology Support46:47 The Importance of Patient Education and ResourcesConnect with Us:Enjoyed this episode? Make sure to subscribe, rate, and review! Follow us on Instagram, Facebook, or Linkedin @mantacares and visit our website at mantacares.com for more episodes and updates.Disclaimer:All content and information provided in connection with Manta Cares is solely intended for informational and educational purposes only. This content and information is not intended to be a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.This episode was supported by an award from the Patient-Centered Outcomes Research Institute.

Patient from Hell
The Rise of Young-Onset Colorectal Cancer: Environmental Factors and Screening Strategies

Patient from Hell

Play Episode Listen Later Apr 23, 2025 43:03


In this episode, Dr. Tejas Jayakrishnan discusses the rising incidence of young onset colorectal cancer (CRC) and the potential environmental factors contributing to this trend. The conversation delves into the importance of screening protocols, the challenges faced in early detection, and the role of education in increasing awareness and understanding of cancer risks. Dr. Jayakrishnan emphasizes the need for tailored approaches in patient care, particularly for younger patients, and highlights ongoing research efforts aimed at improving outcomes in this demographic.About Our Guest:Dr. Thejus Jayakrishnan is a gastrointestinal medical oncologist at Dana-Farber Cancer Institute and Brigham and Women's Hospital, and an Instructor in Medicine at Harvard Medical School. Originally from India, he completed his medical training in New Delhi and continued his journey through residency in Pittsburgh and oncology fellowship at Cleveland Clinic.Dr. Jayakrishnan's research explores why some people develop cancers like colorectal cancers at a younger age. He studies how metabolism, gut bacteria, and genetics contribute to these patterns, with the goal of developing better tools for screening and treatment.In the clinic, he treats patients with all types of gastrointestinal cancers and works closely with Dana-Farber's Young-Onset Colorectal Cancer Center. His focus is on translating scientific discoveries into meaningful improvements in care through clinical trials. Outside of work, he's an avid cyclist, outdoor enthusiast, and lover of books and movies.Resources & Links:This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features the PCORI research study here: https://pubmed.ncbi.nlm.nih.gov/30578103/ - ‘Impact of including quantitative information in a decision aid for colorectal cancer screening: A randomized controlled trial'Chapter Codes:00:00 - Understanding Young Onset Colorectal Cancer10:03 - Screening Protocols and Challenges19:50 - The Role of Education in Cancer Awareness30:04 - Future Directions in Colorectal Cancer ResearchConnect with Us:Enjoyed this episode? Make sure to subscribe, rate, and review! Follow us on Instagram, Facebook, or Linkedin @MantaCares and visit our website at MantaCares.com for more episodes and updates.Disclaimer:All content and information provided in connection with Manta Cares is solely intended for informational and educational purposes only. This content and information is not intended to be a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.This episode was supported by an award from the Patient-Centered Outcomes Research Institute. 

ASTCT Talks
Understanding Cutaneous GVHD: Clinical Insights and Care Strategies

ASTCT Talks

Play Episode Listen Later Apr 18, 2025 26:33


Welcome to the fourth episode of ASTCT Talks' exclusive 8-part series, supported by an educational grant from Sanofi US. In this episode, former ASTCT President Dr. Corey Cutler sits down with Dr. Connie R. Shi from the Cutaneous Oncology Program at Dana-Farber Cancer Institute. They discuss Dr. Shi's recent article, Cutaneous Chronic Graft-Versus-Host Disease: Clinical Manifestations, Diagnosis, Management, and Supportive Care.Tune in as they explore the complexities of cutaneous GVHD, including acute and chronic presentations, diagnostic challenges and skin-directed treatment strategies such as topical steroids and phototherapy. They also cover key considerations for recognizing and diagnosing cutaneous GVHD in patients of all skin tones and managing long-term complications like skin cancer risk.

Parenting Autism
E137: Bryce Shares Highlights including His Ambulance Emergency in Boston

Parenting Autism

Play Episode Listen Later Apr 13, 2025 61:40


In this episode, Bryce joins us at the end of the podcast to talk about our trip to Boston, an airshow visit, and his gold medal at Special Olympics Basketball Regionals. We also update the listeners with good news from Sandy's visit at the Dana Farber Cancer Institute along with other highlights since the last podcast episode.  It's important to share how life continues in this new season of our autism journey. We know we are not the only parents who have had a health crisis or other unexpected personal change that has impacted their parenting. We continue to trust the Lord and His plan for us as we take one day at a time. You can reach out directly to us if you want to purchase a signed edition of our book, "PARENTING AUTISM: The Early Years." We have several Author copies available.  Bryce is a funny, mechanical, HAPPY little guy who was diagnosed with autism at age two and is now eleven years old. His pure joy makes this world a much better place!We are humbled and honored to follow our calling and be Autism Ambassadors while helping others understand our world a little more than they did before listening to the podcast. We also feel called to bring light to a community that has experienced dark days after the "diagnosis". (Luke 1:79) You can follow us on our Parenting Autism Youtube Channel (Parenting Autism Show) and our Facebook & Instagram pages to see stories, pictures, and videos of our autism journey. You can also contact us through Facebook, Instagram, or by email: parentingautism@att.net.NOTE: Most of our Social Media content is on our YouTube channel @parentingautismpodcastSupport the show

ASCO Guidelines Podcast Series
Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer Guideline Update

ASCO Guidelines Podcast Series

Play Episode Listen Later Apr 10, 2025 20:51


Dr. Ko Un “Clara” Park and Dr. Mylin Torres present the latest evidence-based changes to the SLNB in early-stage breast cancer guideline. They discuss the practice-changing trials that led to the updated recommendations and topics such as when SLNB can be omitted, when ALND is indicated, radiation and systemic treatment decisions after SLNB omission, and the role of SLNB in special circumstances. We discuss the importance of shared decision-making and other ongoing and future de-escalation trials that will expand knowledge in this space. Read the full guideline update, “Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: ASCO Guideline Update” at www.asco.org/breast-cancer-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/breast-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-25-00099       Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Ko Un "Clara" Park from Brigham and Women's Hospital, Dana-Farber Cancer Institute, and Dr. Mylin Torres from Glenn Family Breast Center at Winship Cancer Institute of Emory University, co-chairs on “Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: ASCO Guideline Update.” Thank you for being here today, Dr. Park and Dr. Torres. Dr. Mylin Torres: Thank you, it's a pleasure to be here. Brittany Harvey: And before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Torres and Dr. Park, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. To start us off, Dr. Torres, what is the scope and purpose of this guideline update on the use of sentinel lymph node biopsy in early-stage breast cancer? Dr. Mylin Torres: The update includes recommendations incorporating findings from trials released since our last published guideline in 2017. It includes data from nine randomized trials comparing sentinel lymph node biopsy alone versus sentinel lymph node biopsy with a completion axillary lymph node dissection. And notably, and probably the primary reason for motivating this update, are two trials comparing sentinel lymph node biopsy with no axillary surgery, all of which were published from 2016 to 2024. We believe these latter two trials are practice changing and are important for our community to know about so that it can be implemented and essentially represent a change in treatment paradigms. Brittany Harvey: It's great to hear about these practice changing trials and how that will impact these recommendation updates. So Dr. Park, I'd like to start by reviewing the key recommendations across all of these six overarching clinical questions that the guideline addressed. So first, are there patients where sentinel lymph node biopsy can be omitted? Dr. Ko Un "Clara" Park: Yes. The key change in the current management of early-stage breast cancer is the inclusion of omission of sentinel lymph node biopsy in patients with small, less than 2 cm breast cancer and a negative finding on preoperative axillary ultrasound. The patients who are eligible for omission of sentinel lymph node biopsy according to the SOUND and INSEMA trial are patients with invasive ductal carcinoma that is size smaller than 2 cm, Nottingham grades 1 and 2, hormone receptor-positive, HER2-negative in patients intending to receive adjuvant endocrine therapy, and no suspicious lymph nodes on axillary ultrasound or if they have only one suspicious lymph node, then the biopsy of that lymph node is benign and concordant according to the axillary ultrasound findings. The patients who are eligible for sentinel lymph node biopsy omission according to the SOUND and INSEMA trials were patients who are undergoing lumpectomy followed by whole breast radiation, especially in patients who are younger than 65 years of age. For patients who are 65 years or older, they also qualify for omission of sentinel lymph node biopsy in addition to consideration for radiation therapy omission according to the PRIME II and CALGB 9343 clinical trials. And so in those patients, a more shared decision-making approach with the radiation oncologist is encouraged. Brittany Harvey: Understood. I appreciate you outlining that criteria for when sentinel lymph node biopsy can be omitted and when shared decision making is appropriate as well. So then, Dr. Torres, in those patients where sentinel lymph node biopsy is omitted, how are radiation and systemic treatment decisions impacted? Dr. Mylin Torres: Thank you for that question. I think there will be a lot of consternation brought up as far as sentinel lymph node biopsy and the value it could provide in terms of knowing whether that lymph node is involved or not. But as stated, sentinel lymph node biopsy actually can be safely omitted in patients with low risk disease and therefore the reason we state this is that in both SOUND and INSEMA trial, 85% of patients who had a preoperative axillary ultrasound that did not show any signs of a suspicious lymph node also had no lymph nodes involved at the time of sentinel node biopsy. So 85% of the time the preoperative ultrasound is correct. So given the number of patients where preoperative ultrasound predicts for no sentinel node involvement, we have stated within the guideline that radiation and systemic treatment decisions should not be altered in the select patients with low risk disease where sentinel lymph node biopsy can be omitted. Those are the patients who are postmenopausal and age 50 or older who have negative findings on preoperative ultrasound with grade 1 or 2 disease, small tumors less than or equal to 2 cm, hormone receptor-positive, HER2-negative breast cancer who undergo breast conserving therapy. Now, it's important to note in both the INSEMA and SOUND trials, the vast majority of patients received whole breast radiation. In fact, within the INSEMA trial, partial breast irradiation was not allowed. The SOUND trial did allow partial breast irradiation, but in that study, 80% of patients still received whole breast treatment. Therefore, the preponderance of data does support whole breast irradiation when you go strictly by the way the SOUND and INSEMA trials were conducted. Notably, however, most of the patients in these studies had node-negative disease and had low risk features to their primary tumors and would have been eligible for partial breast irradiation by the ASTRO Guidelines for partial breast treatment. So, given the fact that 85% of patients will have node-negative disease after a preoperative ultrasound, essentially what we're saying is that partial breast irradiation may be offered in these patients where omission of sentinel node biopsy is felt to be safe, which is in these low risk patients. Additionally, regional nodal irradiation is something that is not indicated in the vast majority of patients where omission of sentinel lymph node biopsy is prescribed and recommended, and that is because very few of these patients will actually end up having pathologic N2 disease, which is four or more positive lymph nodes. If you look at the numbers from both the INSEMA and the SOUND trial, the number of patients with pathologic N2 disease who did have their axilla surgically staged, it was less than 1% in both trials. So, in these patients, regional nodal irradiation, there would be no clear indication for that more aggressive and more extensive radiation treatment. The same principles apply to systemic therapy. As the vast majority of these patients are going to have node-negative disease with a low risk primary tumor, we know that postmenopausal women, even if they're found to have one to three positive lymph nodes, a lot of the systemic cytotoxic chemotherapy decisions are driven by genomic assay score which is taken from the primary tumor. And therefore nodal information in patients who have N1 disease may not be gained in patients where omission of sentinel lymph node biopsy is indicated in these low risk patients. 14% of patients have 1 to 3 positive lymph nodes in the SOUND trial and that number is about 15% in the INSEMA trial. Really only the clinically actionable information to be gained is if a patient has four or more lymph nodes or N2 disease in this low risk patient population. So, essentially when that occurs it's less than 1% of the time in these patients with very favorable primary tumors. And therefore we thought it was acceptable to stand by a recommendation of not altering systemic therapy or radiation recommendations based on omission of sentinel nodes because the likelihood of having four more lymph nodes is so low. Dr. Ko Un "Clara" Park: I think one thing to add is the use of CDK4/6 inhibitors to that and when we look at the NATALEE criteria for ribociclib in particular, where node-negative patients were included, the bulk majority of the patients who were actually represented in the NATALEE study were stage III disease. And for stage I disease to upstage into anatomic stage III, that patient would need to have pathologic N2 disease. And as Dr. Torres stated, the rate of having pathologic N2 disease in both SOUND and INSEMA studies were less than 1%. And therefore it would be highly unlikely that these patients would be eligible just based on tumor size and characteristics for ribociclib. So we think that it is still safe to omit sentinel lymph node biopsy and they would not miss out, if you will, on the opportunity for CDK4/6 inhibitors. Brittany Harvey: Absolutely. I appreciate you describing those recommendations and then also the nuances of the evidence that's underpinning those recommendations, I think that's important for listeners. So Dr. Park, the next clinical question addresses patients with clinically node negative early stage breast cancer who have 1 or 2 sentinel lymph node metastases and who will receive breast conserving surgery with whole breast radiation therapy. For these patients, is axillary lymph node dissection needed? Dr. Ko Un "Clara" Park: No. And this is confirmed based on the ACOSOG Z0011 study that demonstrated in patients with 1 to 3 positive sentinel lymph node biopsy when the study compared completion axillary lymph node dissection to no completion axillary lymph node dissection, there was no difference. And actually, the 10-year overall survival as reported out in 2017 and at a median follow up of 9.3 years, the overall survival again for patients treated with sentinel lymph node biopsy alone versus those who were treated with axillary lymph node dissection was no different. It was 86.3% in sentinel lymph node biopsy versus 83.6% and the p-value was non-inferior at 0.02. And so we believe that it is safe for the select patients who are early stage with 1 to 2 positive lymph nodes on sentinel lymph node biopsy, undergoing whole breast radiation therapy to omit completion of axillary lymph node dissection. Brittany Harvey: Great, I appreciate you detailing what's recommended there as well. So then, to continue our discussion of axillary lymph node dissection, Dr. Torres, for patients with nodal metastases who will undergo mastectomy, is axillary lymph node dissection indicated? Dr. Mylin Torres: It's actually not and this is confirmed by two trials, the AMAROS study as well as the SENOMAC trial. And in both studies, they compared a full lymph node dissection versus sentinel lymph node biopsy alone in patients who are found to have 1 to 2 positive lymph nodes and confirmed that there was no difference in axillary recurrence rates, overall survival or disease-free survival. What was shown is that with more aggressive surgery completion axillary lymph node dissection, there were higher rates of morbidity including lymphedema, shoulder pain and paresthesias and arm numbness, decreased functioning of the arm and so there was only downside to doing a full lymph node dissection. Importantly, in both trials, if a full lymph node dissection was not done in the arm that where sentinel lymph node biopsy was done alone, all patients were prescribed post mastectomy radiation and regional nodal treatment and therefore both studies currently support the use of post mastectomy radiation and regional nodal treatment when a full lymph node dissection is not performed in these patients who are found to have N1 disease after a sentinel node biopsy. Brittany Harvey: Thank you. And then Dr. Park, for patients with early-stage breast cancer who do not have nodal metastases, can completion axillary lymph node dissection be omitted? Dr. Ko Un "Clara" Park: Yes, and this is an unchanged recommendation from the earlier ASCO Guidelines from 2017 as well as the 2021 joint guideline with Ontario Health, wherein patients with clinically node-negative early stage breast cancer, the staging of the axilla can be performed through sentinel lymph nodal biopsy and not completion axillary lymph node dissection. Brittany Harvey: Understood. So then, to wrap us up on the clinical questions here, Dr. Park, what is recommended regarding sentinel lymph node biopsy in special circumstances in populations? Dr. Ko Un "Clara" Park: One key highlight of the special populations is the use of sentinel lymph node biopsy for evaluation of the axilla in clinically node negative multicentric tumors. While there are no randomized clinical trials evaluating specifically the role of sentinel lymph nodal biopsy in multicentric tumors, in the guideline, we highlight this as one of the safe options for staging of the axilla and also for pregnant patients, these special circumstances, it is safe to perform sentinel lymph node biopsy in pregnant patients with the use of technetium - blue dye should be avoided in this population. In particular, I want to highlight where sentinel lymph node biopsy should not be used for staging of the axilla and that is in the population with inflammatory breast cancer. There are currently no studies demonstrating that sentinel lymph node biopsy is oncologically safe or accurate in patients with inflammatory breast cancer. And so, unfortunately, in this population, even after neoadjuvant systemic therapy, if they have a great response, the current guideline recommends mastectomy with axillary lymph node dissection. Brittany Harvey: Absolutely. I appreciate your viewing both where sentinel lymph node can be offered in these special circumstances in populations and where it really should not be used. So then, Dr. Torres, you talked at the beginning about how there's been these new practice changing trials that really impacted these recommendations. So in your view, what is the importance of this guideline update and how does it impact both clinicians and patients? Dr. Mylin Torres: Thank you for that question. This update and these trials that inform the update represent a significant shift in the treatment paradigm and standard of care for breast cancer patients with early-stage breast cancer. When you think about it, it seems almost counterintuitive that physicians and patients would not want to know if a lymph node is involved with cancer or not through sentinel lymph node biopsy procedure. But what these studies show is that preoperative axillary ultrasound, 85% of the time when it's negative, will correctly predict whether a sentinel lymph node is involved with cancer or not and will also be negative. So if you have imaging that's negative, your surgery is likely going to be negative. Some people might ask, what's the harm in doing a sentinel lymph node biopsy? It's important to recognize that upwards of 10% of patients, even after sentinel lymph node biopsy will develop lymphedema, chronic arm pain, shoulder immobility and arm immobility. And these can have a profound impact on quality of life. And if there is not a significant benefit to assessing lymph nodes, particularly in someone who has a preoperative axillary ultrasound that's negative, then why put a patient at risk for these morbidities that can impact them lifelong? Ideally, the adoption of omission of sentinel lymph node biopsy will lead to more multidisciplinary discussion and collaboration in the preoperative setting especially with our diagnostic physicians, radiology to assure that these patients are getting an axillary ultrasound and determine how omission of sentinel lymph node biopsy may impact the downstream treatments after surgery, particularly radiation and systemic therapy decisions, and will be adopted in real world patients, and how clinically we can develop a workflow where together we can make the best decisions for our patients in collaboration with them through shared decision making. Brittany Harvey: Absolutely. It's great to have these evidence-based updates for clinicians and patients to review and refer back to. So then finally, Dr. Park, looking to the future, what are the outstanding questions and ongoing trials regarding sentinel lymph node biopsy in early-stage breast cancer? Dr. Ko Un "Clara" Park: I think to toggle on Dr. Torres's comment about shared decision making, the emphasis on that I think will become even more evident in the future as we incorporate different types of de-escalation clinical studies. In particular, because as you saw in the SOUND and INSEMA studies, when we de-escalate one modality of the multimodality therapy, i.e., surgery, the other modalities such as radiation therapy and systemic therapy were “controlled” where we were not de-escalating multiple different modalities. However, as the audience may be familiar with, there are other types of de-escalation studies in particular radiation therapy, partial breast irradiation or omission of radiation therapy, and in those studies, the surgery is now controlled where oftentimes the patients are undergoing surgical axillary staging. And conversely when we're looking at endocrine therapy versus radiation therapy clinical trials, in those studies also the majority of the patients are undergoing surgical axillary staging. And so now as those studies demonstrate the oncologic safety of omission of a particular therapy, we will be in a position of more balancing of the data of trying to select which patients are the safe patients for omission of certain types of modality, and how do we balance whether it's surgery, radiation therapy, systemic therapy, endocrine therapy. And that's where as Dr. Torres stated, the shared decision making will become critically important. I'm a surgeon and so as a surgeon, I get to see the patients oftentimes first, especially when they have early-stage breast cancer. And so I could I guess be “selfish” and just do whatever I think is correct. But whatever the surgeon does, the decision does have consequences in the downstream decision making. And so the field really needs to, as Dr. Torres stated earlier, rethink the workflow of how early-stage breast cancer patients are brought forth and managed as a multidisciplinary team. I also think in future studies the expansion of the data to larger tumors, T3, in particular,reater than 5 cm and also how do we incorporate omission in that population will become more evident as we learn more about the oncologic safety of omitting sentinel lymph node biopsy. Dr. Mylin Torres: In addition, there are other outstanding ongoing clinical trials that are accruing patients right now. They include the BOOG 2013-08 study, SOAPET, NAUTILUS and the VENUS trials, all looking at patients with clinical T1, T2N0 disease and whether omission of sentinel lymph node biopsy is safe with various endpoints including regional recurrence, invasive disease-free survival and distant disease-free survival. I expect in addition to these studies there will be more studies ongoing even looking at the omission of sentinel lymph node biopsy in the post-neoadjuvant chemotherapy setting. And as our imaging improves in the future, there will be more studies improving other imaging modalities, probably in addition to axillary ultrasound in an attempt to accurately characterize whether lymph nodes within axilla contain cancer or not, and in that context whether omission of sentinel lymph node biopsy even in patients with larger tumors post-neoadjuvant chemotherapy may be done safely and could eventually become another shift in our treatment paradigm. Brittany Harvey: Yes. The shared decision making is key as we think about these updates to improve quality of life and we'll await data from these ongoing trials to inform future updates to this guideline. So I want to thank you both so much for your extensive work to update this guideline and thank you for your time today. Dr. Park and Dr. Torres. Dr. Mylin Torres: Thank you. Dr. Ko Un "Clara" Park: Thank you. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/breast-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

Breast Cancer Update
Breast Cancer — An Interview with Dr Adrienne G Waks on Recent Trial Updates

Breast Cancer Update

Play Episode Listen Later Apr 8, 2025 54:56


Dr Adrienne G Waks from Dana-Farber Cancer Institute in Boston, Massachusetts, reviews recent trial updates and their significance for the management of breast cancer. CME information and select publications here.

Real Pink
Episode 326: Choices To Lower Breast Cancer Risk

Real Pink

Play Episode Listen Later Apr 7, 2025 22:07


Everyone is at risk of breast cancer. Some are more at risk than others due to hereditary factors – such as a family history of cancers – and lifestyle choices that affect our overall health. Knowing your risk of breast cancer can help you decide what steps to take to lower your risk. Joining me today is Dr. Jennifer Ligibel, a Susan G. Komen Scholar and Komen grantee, Professor of Medicine at Harvard Medical School, Senior Physician at the Dana-Farber Cancer Institute and an expert on the impact of lifestyle factors, cancer risk and outcomes. Through more than a dozen lifestyle intervention trials, Dr. Ligibel has evaluated the impact of exercise, weight loss, fitness, body composition and quality of life in cancer patients and survivors.

DENNIS ANYONE? with Dennis Hensley
Filmmaker Roshan Sethi ("A Nice Indian Boy"): "Love Occurs In The Context Of Your Family"

DENNIS ANYONE? with Dennis Hensley

Play Episode Listen Later Apr 3, 2025 37:53


Dennis connects via Zoom with Roshan Sethi, director of the new film A Nice Indian Boy, which is about and Indian-American doctor named Naveen (Roshan's real-life boyfriend Karan Soni) who falls who falls for a photographer named Jay (Jonathan Groff), who is white but who was adopted and raised by Indian-American parents. Complications ensue when Naveen brings Jay home to meet his family. Roshan talks about the film's origins as a stage play, directing his real life boyfriend Karan Soni in love scenes with Jonathan Groff and the movie's theme of negotiating life after coming out and how big or small do you want to play in terms of being your true self. Roshan also talks about his second career as a doctor and how he works several months a year at the Dana Farber Cancer Institute in Boston, Massachusetts. Other topics include: what gay life is like in India, being mentored by indie mainstay Mark Duplass, how Jonathan Groff leads from love all the time, not being allowed to watch Hollywood movies growing up and the moment from making A Nice Indian Boy that he knows he'll never forget.

Nightside With Dan Rea
NightSide News Update 3/28/25

Nightside With Dan Rea

Play Episode Listen Later Mar 29, 2025 40:38 Transcription Available


We kicked off the program with four news stories and different guests on the stories we think you need to know about!Ryan Leak – Author & Keynote Speaker explained to Dan How To Work With Complicated People… The Dana Farber Marathon Challenge - goal of raising $8.5 million for the Claudia Adams Barr Program in Innovative Basic Cancer Research at Dana-Farber Cancer Institute in Boston. Jack Fultz - 1976 Boston Marathon® Men's Open Division Champion, has served as the team's training advisor since the DFMC's inception checked in with Dan.World's best two-wheel racers converging on Gillette Stadium in Foxborough for one action-packed race on Saturday, April 5, 2025. With Tristan Lane - 450SX Class racer.Your Pet Can Meet the Easter Bunny This Weekend in Massachusetts! Lauren Dalis – Simon Mall Team Member- Director of Marketing and Business Development at Burlington Mall shared the details. Listen to WBZ NewsRadio on the NEW iHeart Radio app and be sure to set WBZ NewsRadio as your #1 preset!

The Doctor's Art
Virtue and Good Medicine | John Rhee, MD, MPH

The Doctor's Art

Play Episode Listen Later Mar 26, 2025 55:18


There is something uniquely haunting about many neurological diseases. These conditions often don't only affect the body — they reshape the very foundation of who we are, our memories, our personalities, our language. When the brain begins to fail, the boundary between illness and identity start to blur; the person we know begins to fade even before their life has ended. In this episode, we are joined by John Rhee, MD, MPH, a neuro-oncologist and palliative care physician at Dana-Farber Cancer Institute and Harvard Medical School, whose work sits at the intersection of science, suffering, and the soul. He cares for patients with brain tumors and neurodegenerative diseases, conditions that challenge our deepest assumptions about selfhood, dignity, and what it means to live a meaningful life. Dr. Rhee is also the co-founder and executive director of The Hippocratic Society, a community of clinicians that aims to cultivate virtues that characterize good medical practitioners and ideals that make medicine a sacred profession. Over the course of our conversation, we talk about suffering — not just physical pain, but the existential kind. We explore how the brain anchors our identity, how its decline confronts us with profound questions, how medical education can improve by training doctors to be more reflective in their work, why an element of spirituality remains critical to medicine, what it means to accompany someone through decline, and more.In this episode, you'll hear about: 3:00 - Dr. Rhee‘s path to medicine6:30 - The general scope of focus for a neuro-oncologist 16:07 - Understanding the brain from both medical and existential perspectives 26:36 - The mission of The Hippocratic Society40:45 - Why “virtue” is central to the focus of The Hippocratic Society 49:34 - How to get involved with The Hippocratic SocietyVisit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor's Art Podcast 2025