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Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of Wild Card Weekend and preview of the Divisional Playoff Round of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Divisional RoundHouston @ Kansas City - Sat-3:30pmPittsburgh OffseasonFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 18 and preview of Wild Card Weekend of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Wild Card WeekendHouston vs Los Angeles Chargers - Sat-3:30pmPittsburgh @ Baltimore - Sat-7pmFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 17 and preview of week 18 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 18Houston @ Tennessee - Sun-12pmPittsburgh vs Cincinnati - Sat-7pmFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 16 and preview of week 17 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 14Houston vs Baltimore - 3:30pmPittsburgh vs Kansas City - 12pmFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 15 and preview of week 16 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 14Houston @ Kansas City - 12pmPittsburgh @ Baltimore - 3:30pmFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 14 and preview of week 15 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 14Houston vs Miami 12pmPittsburgh @ Philadelphia - 3:25pmFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 13 and preview of week 14 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 14Houston Bye WeekPittsburgh vs Cleveland - 12pmFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcaston which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 12 and preview of week 13 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 11Houston @ Jacksonville 12pm Pittsburgh @ Cincinnati 12pmFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcaston which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Dr. Linda Duska and Dr. Domenica Lorusso discuss the practice-changing results of the phase 3 ENGOT-cx11/GOG-3047/KEYNOTE-A18 study, which evaluated pembrolizumab plus chemoradiotherapy as treatment for previously untreated, high-risk, locally advanced cervical cancer. TRANSCRIPT Dr. Linda Duska: Hello, I'm Linda Duska, your guest host of the ASCO Daily News Podcast today. I'm a professor of obstetrics and gynecology and serve as the associate dean for clinical research at the University of Virginia School of Medicine. On today's episode, we'll be discussing a new standard of care for previously untreated, high- risk locally advanced cervical cancer. This follows the ENGOT-cx11/GOG-3047/KEYNOTE-A18 study, which I will be referring to as KEYNOTE-A18 for the rest of this podcast, which demonstrated that pembrolizumab plus chemoradiotherapy improved both progression-free and overall survival compared to chemoradiotherapy alone. I was a co-author of this study, and I'm delighted to be joined today by the study's lead investigator, Dr. Domenica Lorusso, for today's discussion. She is also a professor of obstetrics and gynecology. She's at Humanitas University Rosano and the director of the Gynecologic Oncology Unit at the Humanitas Hospital San Pio in Milan, Italy. Our full disclosures are available in the transcript of this episode. Dr. Lorusso, it's great to be speaking with you today. Dr. Domenica Lorusso: Thank you, Linda. It's a great pleasure to be here. Thank you. Dr. Linda Duska: So I was hoping you could start us out with some context on the challenges associated with treating patients with high-risk, locally advanced cervical cancer. Dr. Domenica Lorusso: Yes. I have to make a disclosure because in my experience as a gynecologist, cervical cancer patients are the most difficult patients to treat. This is a tumor that involves young patients [who often have] small kids. This is a very symptomatic tumor. More than 50% of patients report pain. Sometimes the pain is difficult to control because there is an infiltration of the pelvic nerves and also a kind of vaginal discharge, so it's very difficult to treat the tumor. Since more than 25 years, we have the publication of 5 randomized trials that demonstrate that when we combine platinum chemotherapy to radiation treatment, we increase overall survival by 6%. This is the new standard of care – concurrent chemoradiation plus brachytherapy. This is a good standard of care because particularly modern, image-guided radiotherapy has reported to increase local control. And local control in cervical cancer translates to better overall survival. So modern radiotherapy actually is able to cure about 75% of patients. This is what we expect with chemoradiation right now. Dr. Linda Duska: So what are the key takeaways of A18? This is a really exciting trial, and you've presented it a couple of times. Tell us what are the key takeaways that you want our listeners to know. Dr. Domenica Lorusso: Linda, this is our trial. This is a trial that we did together. And you gave me the inspiration because you were running a randomized phase 2 trial exploring if the combination of pembrolizumab to concurrent chemoradiation was able to give signals of efficacy, but also was feasible in terms of toxicity. There were several clinical data suggesting that when we combine immunotherapy to radiotherapy, we can potentially increase the benefit of radiotherapy because there is a kind of synergistic effect between the two strategies. Radiotherapy works as a primer and immunotherapy works better. And you demonstrated that it was feasible to combine immunotherapy to concurrent chemoradiation. And KEYNOTE-A18 was based on this preliminary data. We randomized about 1,060 patients to receive concurrent chemoradiation and brachytherapy or concurrent chemoradiation and brachytherapy in combination with pembrolizumab followed by pembrolizumab for about two years. Why two years? Because in more than 80% of cases, recurrence in this patient population occurred during the first two years. So the duration of treatment was based on the idea to provide protection to the patient during the maximum time of risk. And the trial had the two primary endpoints, progression free and overall survival, and met both the endpoints, a significant 30% reduction in the risk of progression that was confirmed. At the 3-year follow up, the observation was even better, 0.68. So 32% reduction in the risk of progression. And more importantly, because this is a curative setting, 33% reduction in the risk of death was reported in the experimental arm when pembro was combined with chemoradiation. Dr. Linda Duska: That's amazing. I wanted to ask you, a prior similar study called CALLA was negative. Why do you think A18 was positive? Dr. Domenica Lorusso: Linda, there are several discussions about that. I had the possibility to discuss several times with the PI of CALLA, Brad Monk. The idea of Brad is that CALLA was negative because of using durvalumab instead of PD-1 inhibitor, which is pembrolizumab. I do not have exactly the same impression. My idea is that it's the kind of patient population enrolled. The patient population enrolled in KEYNOTE-A18 was really a high-risk population; 85% of that patient were node positive, where the definition of node positivity was at least 2 lymph nodes in the pelvis with a short diameter of 1.5. So, we are very confident this patient was node-positive, 55% at the grade 3 and 4 diseases. So this is really a high-risk population. I remember at the first presentation of CALLA, I was honored to discuss the CALLA trial when it was first presented at IGCS a few years ago. And when I received the forest plot of Calla, it was evident to me that in patients with stage III and node positive there was a signal of efficacy. And we have a huge number of patients with node positive. So in my opinion this is the reason why KEYNOTE-A18 is positive. Dr. Linda Duska: Yeah, I agree with you. I've thought about it a lot and I think you're right about that. The INTERLACE trial results were recently published. How should we interpret these results in the context of A18? Dr. Domenica Lorusso: So it's very difficult to compare the 2 trials. First of all, in terms of population. The population enrolled in INTERLACE is a low-risk, locally advanced but low risk population; 76% were stage II, 10% were stage I, 60% were node-negative patients. So, first of all, the population is completely different. Second is the type of radiotherapy that was provided. INTERLACE is a 10-year long trial, but in 10 years the quality and the technique of radiotherapy completely changed. Only 30% of patients in INTERLACE received what we call the modern image-guided brachytherapy, which is important because it provides local control and local control increases overall survival. And third, we read the paper. I'm not a methodologist, but there are some methodological biases in the paper. All the statistical design of the trial was based on PFS, but PFS was evaluated at physician description. And honestly, I never saw a trial that had no pre-specified timeline for radiological evaluation. It's very difficult to evaluate progression in cervical cancer because the fibrosis related to radiotherapy changes the anatomy in the pelvis. And I think that the radiological evaluation is important to address if the patient is progressing or not. Particularly, because the conclusion of CALLA is that the PFS was mainly in favor of distant metastasis. So really, it's difficult for me to understand how distant metastasis may be evaluated with the vagina visit. So really, it's very difficult to compare the two trials, but I have some concerns. And also because of toxicity in the study, unfortunately 30% of patients did not complete concurrent chemoradiation because of residual toxicity due to induction chemotherapy. So I wanted to be sure in the context of modern radiotherapy, if really induction chemo adds something to modern radiotherapy. Dr. Linda Duska: Well, I have two more questions for you. As we move immunotherapy into the front line, at least for these high risk locally advanced cervical cancer patients that were eligible for A18, what does that mean then for hopefully those few that develop recurrence in terms of second line therapy? Dr. Domenica Lorusso: Well, Linda, this is a very important question. We do not have data about immuno after immuno, but I would not completely exclude this hypothesis because in KEYNOTE-A18, the patient received treatment for a well-defined time period. And for those patients not progressing during immunotherapy, I really guess if there is a space for the reintroduction of immunotherapy at the time of recurrence. In this moment we have 30% of patients in KEYNOTE-A18 in the control arm that receive immunotherapy after progression, but still we have 11% of patients that receive immunotherapy in combination with concurrent chemoradiation and then receive, again, immunotherapy in later line of therapy. I think we need to collect these data to capture some signals and for sure we have the new drug. We have antibody drug conjugate. The trials are ongoing exploring the role of antibody drug conjugate, particularly in immune pretreated patients. So I think this is a very interesting strategy. Dr. Linda Duska: I was going to ask you, “What are the next steps,” but I think you already answered that question. You talked about the second line. If you were going to redesign a study in the frontline, what would it look like? Dr. Domenica Lorusso: Probably one question that I would like to answer – there are two questions in my opinion in KEYNOTE-A18 – one is induction immunotherapy. Linda, correct me if I'm wrong, you reported very interesting data about the immune landscape change when you use induction immunotherapy. And I think this is something that we need to explore in the future. And the second question is the duration of maintenance. Because, again, we decided for two years based only on the epidemiology of recurrence, but I guess if one year may be enough. Dr. Linda Duska: I think this sequencing question is really important, that the induction immunotherapy was actually GY017. I can't take credit for that, but I think you're right. I think the sequencing question is really important. Whether you need the concurrent IO or not is an important question. And then to your point about the 2 years, the length of the need for maintenance therapy is a question that we don't know the answer to. So there are lots of really important questions we can continue to ask. I want to thank you so much for sharing your valuable insights with us on the podcast today. You're always so thoughtful about this particular study and cervix cancer in general and also for your great work to advance the care for patients with GYN cancers. Dr. Domenica Lorusso: Thank you, Linda. It's our work - we progress together. Dr. Linda Duska: Yes. And we thank the patients as well. The over 1,000 patients that went on this trial during a pandemic. Right? Dr. Domenica Lorusso: Absolutely. Without their generosity and their trust, we would not be able to do this trial. Dr. Linda Duska: So we're very grateful to them and we thank our listeners for your time today. If you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcasts. Thank you all. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Follow today's speakers: Dr. Linda Duska @Lduska Dr. Domenica Lorusso Follow ASCO on social media: @ASCO on Twitter ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Linda Duska: Consulting or Advisory Role: Regeneron, Inovio Pharmaceuticals, Merck, Ellipses Pharma Research Funding (Inst.): GlaxoSmithKline, Millenium, Bristol-Myers Squibb, Aeterna Zentaris, Novartis, Abbvie, Tesaro, Cerulean Pharma, Aduro Biotech, Advaxis, Ludwig Institute for Cancer Research, Leap Therapeutics Patents, Royalties, Other Intellectual Property: UptToDate, Editor, British Journal of Ob/Gyn Dr. Domenica Lorusso: Consulting or Advisory Role: PharmaMar, AstraZeneca, Clovis Oncology, GSK, MSD, Genmab, Seagen, Immunogen, Oncoinvest, Corcept, Sutro Biopharma, Novartis, Novocure, Daiichi Sankyo/Lilly Speakers' Bureau: AstraZeneca, Clovis, GSK, MSD, ImmunoGen, Seagen Research Funding (Inst.): PharmMar, Clovis, GSK, MSD, AstraZeneca, Clovis Oncology, Genmab, Seagen, Immunogen, Incyte, Roche, Pharma&, Corcept Therapeutics, Alkermes Travel, Accommodations, Expenses: AstraZeneca, Clovis, GSK, Menarini
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 11 and preview of week 12 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 11Houston vs Tennessee 12pm SunPittsburgh @ Cleveland 7:15pm TNFFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcaston which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Domenica Lorusso to discuss KEYNOTE-A18 Overall Survival Results: Pembrolizumab and Chemoradiotherapy. Dr. Domenica Lorusso, MD, PhD, directs the Gynaecological Oncology Unit at Humanitas Hospital, Milan, and holds a Full Professorship in Obstetrics and Gynaecology at Humanitas University, Rozzano, Milan. She has led/participated in approximately 250 phase I-IV clinical trials. Currently overseeing more than 60 studies as Principal Investigator, Dr. Lorusso also chairs the Clinical Trials Committee of the MITO Group. She serves on the Board of Directors of the GCIG and is an active member of ENGOT, where she chairs the Gynecological Cancer Academy. Additionally, she sits on the Board of Directors of the ESGO. With around 300 international oncology publications and contributions to national and international treatment guidelines, her primary objectives are to ensure optimal patient care, foster clinical research, and advance international collaborations and education in the field. Highlights: In a phase 3 trial (ENGOT-cx11/GOG-3047/KEYNOTE-A18), pembrolizumab added to chemoradiotherapy significantly improved progression-free survival and overall survival for patients with locally advanced, high-risk cervical cancer. Patient Group: 1060 patients with FIGO 2014 stage IB2–IVA cervical cancer from 30 countries were randomized to receive pembrolizumab with chemoradiotherapy or placebo with chemoradiotherapy. Overall Survival: At a median follow-up of 29.9 months, the 36-month overall survival rate was 82.6% in the pembrolizumab group versus 74.8% in the placebo group, with a hazard ratio for death of 0.67 (95% CI 0.50–0.90; p=0.0040). Safety Profile: Grade 3 or higher adverse events were reported in 78% of pembrolizumab-treated patients versus 70% in the placebo group, with higher rates of potentially immune-mediated adverse events in the pembrolizumab group (39% vs. 17%). Conclusion: These findings confirm pembrolizumab plus chemoradiotherapy as an effective and potentially new standard of care for locally advanced cervical cancer.
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 10 and preview of week 11 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 11Houston @ Dallas 7:15pm MNFPittsburgh vs Baltimore 12pmFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcaston which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 9 and preview of week 10 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 10Houston vs Detroit 7:20pm SNFPittsburgh @ Washington 12pm Follow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcaston which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 8 and preview of week 9 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 9Houston @ NY Jets 7:15pm TNFPittsburgh Bye WeekFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcaston which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 7 and preview of week 8 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 7Houston vs Indianapolis 12pmPittsburgh vs NY Giants 7:15pm MNFFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcaston which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 6 and preview of week 7 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Week 7Houston @ Green Bay 12pmPittsburgh vs NY Jets 7:20pmFollow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcaston which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Dr. Shannon Westin and her guest, Dr. Brian Slomovitz discuss the article “Pembrolizumab or Placebo Plus Adjuvant Chemotherapy With or Without Radiotherapy For Newly Diagnosed, High-Risk Endometrial Cancer: Results in Mismatch Repair-Deficient Tumors” recently published in the JCO and presented at the 2024 International Gynecologic Cancer Society. TRANSCRIPT The guest's disclosures can be found in the transcript. Dr. Shannon Westin: Hello, and welcome to another episode of JCO After Hours, the podcast where we get in depth on manuscripts and literature published in the Journal of Clinical Oncology. I'm your host, Shannon Westin, gynecologic oncologist and JCO Social Media Editor by trade. I am thrilled because we are going to be talking about gynecologic cancer today. So, this is my jam. And specifically, we're going to be talking about a manuscript that's a simultaneous publication in the Journal of Clinical Oncology and presented at the Annual Meeting of the International Gynecologic Cancer Society on October 16, 2024. And this is “Pembrolizumab or Placebo, Plus Adjuvant Chemotherapy, With or Without Radiotherapy for Newly Diagnosed High Risk Endometrial Cancer: Results in Mismatch Repair Deficient Tumors.” This is affectionately the KEYNOTE-B21 trial, also known as the GOG-3053 trial and the ENGOT-en11 trial. And we are joined today by the primary author in this manuscript, Dr. Brian Slomovitz, who is the Director of Gynecologic Oncology at Mount Sinai Medical Center in Miami Beach, Florida, and the clinical trial advisor in uterine cancer for the Gynecologic Oncology Group foundation. Welcome, Brian. Dr. Brian Slomovitz: Hey, thanks, Shannon, so much. It's a pleasure to be here. And thanks for giving us the opportunity to discuss this trial. Dr. Shannon Westin: Yes, it's a great trial and I'm so excited to talk about it. And I think we'll start just because this is a broad group that listens to this podcast, they're not all GYN oncologists, experts like yourself, so can you just level set a little bit and speak a bit about the incidence and mortality of endometrial cancer overall and the recent trends in this disease? Dr. Brian Slomovitz: Yeah, sure. So, and it is nice to speak about gynecologic cancers, as we know, endometrial cancer was and still is the most common of all gynecologic cancers. The numbers are going up. Right now, there's about 65,000 to 70,000 cases each year in the US diagnosed with endometrial cancer. The numbers are going up. A lot of its obesity related, some other factors, but as the population gets less healthy, those are some of the risk factors for the disease. The thing that, however, is quite surprising is that we're seeing the deaths due to endometrial cancer going up as well, while for other diseases, we're making slow, steady steps to try to decrease the mortality we're actually seeing an increase in mortality. And the most discouraging point, Shannon, as you know is the number of deaths from endometrial cancer is going to outnumber the number of deaths from ovarian cancer if it hasn't done it already. I mean, now's the time. So, we really need to come up with better treatment strategies to everything to decrease the incidence of disease, to help with prevention, but for those poor women who are diagnosed, to come up with better treatment options so we don't have to keep this increasing trend in mortality. Dr. Shannon Westin: Absolutely. And I think some of that is related and we don't need to get on a soapbox here, but the amount of funding that goes towards research in endometrial cancer, and of course you, you have been leading the way and really trying to get a ton of trials in this space and getting our industry partners and our government partners to really support this. So really just commending you on how much you've worked on, on this area. And to that end, we've had a huge renaissance with immunotherapy and endometrial cancer, a lot of really big trials. Why don't you give the audience a rundown of where, so far, this seems to be best utilized for people with endometrial cancer? Dr. Brian Slomovitz: Thanks for that. And as you sort of alluded to, it's been a revolution, really, with immunotherapy. We started off at immunotherapy looking at microsatellite instability or the dMMR patients. What we found is similar to other disease sites in the second and third line setting that we saw good activity with the single agent checkpoints, pembrolizumab dostarlimab, that's based on the earlier KEYNOTE data and the GARNET trial. Really, a landmark study in the second line was Vicki Makker and her colleagues put pembrolizumab and lenvatinib combination for those patients with the cold tumors. Not the dMMRs or MSI Highs, but the proficient mismatch repair. And that study in a second line setting found that it was better than chemotherapy for an overall survival advantage. So right there, we know that it works in the second line setting in the dMMR population, and we got an indication in the PMR population saying that immunotherapy works in all women with endometrial cancer at some point, then we really had the groundbreaking trials. And Shannon, thank you. You are the leader on one of the four trials that happened, to DUO-E, AtTEnd, GY018 and RUBY trial, all very similar studies showing that the combination of immunotherapy with chemotherapy in the first line, metastatic or recurrent setting had a better outcome for patients than if given chemotherapy alone. That actually led to amazing things. We had three of those drugs have FDA approvals, pembrolizumab for all comers, dMMR and PMMR in the first line metastatic setting with chemotherapy; Dostarlimab, PMR, dMMR in the first line or metastatic with chemotherapy. And Shannon, in your study, I think we still have to learn a lot from your study. DUO-E, chemotherapy plus minus dostarlimab. And you also added a PARP inhib, and those patients with a PARP did better. So I'm really looking forward to your data, to the subgroup analysis to figure out which of those patients, depending on the biomarker, do better with PARP therapy. And right now, you have a dMMR FDA indication. But who knows? The future is really exciting to see- to be splitters, not lumpers. And I really want to see how that data pans out. And so that's how it came into the first and second line setting and that led us really to come up with the idea for this trial to put it into the adjuvant setting. Dr. Shannon Westin: Right. And so, I think this would be really important because we're so ingrained in this. We see this on the day to day. Can you kind of tease out a little bit what's different about those patients that would be treated in that advanced recurrent setting versus the patients that would be potentially treated in this B21 study? Dr. Brian Slomovitz: Yeah, so the first step, we demonstrated the efficacy in patients that really the treatment options were an unmet need. In the second line setting, we didn't have good treatment options. Those are the patients with measurable disease, with symptomatic disease giving immunotherapy. And not only did we see the efficacy, which was better, but we also were able to give it with limiting the side effects as seen with chemotherapy, which is nice. And then we know that the first line therapy, traditionally for endometrial cancer with carboplatin paclitaxel, response rates about 50%, progression free survival about a year, really something that we needed to improve upon. So, adding immunotherapy to the platinum backbone therapy really demonstrated an advantage. But now what we want to do is we want to see if we could prevent, in the high-risk patients, those without disease, what can we do to help prevent the disease from recurring and help patients live longer without really the need for really lifesaving types of treatments? We want to prevent it from recurring. Dr. Shannon Westin: Yeah, I think that's essential. We know that if we can sit on that prevention side and kind of invest all the time and effort that we need to upfront, that really does yield the longer survival. So why don't you just walk through the overall design of this trial, please? Dr. Brian Slomovitz: Yeah. So, this was an all-comers trial, meaning in individuals that had high risk endometrial cancer, high risk for recurrence, that included, in endometrial cancer, we have aggressive histologic subtypes, serous histologies, clear cell histologies, any stage, as long as there was some myometrial invasion. We also, for the first time, included patients looking at the molecular subclassifications. So, if there was a P53 mutation and they were stage 1 with myometrial invasion, they were included. And then in all comers, any patients with stage 3 or up to 4a disease, as long as the surgery was for a curative intent, and they had no residual disease after surgery, then they were allowed to enroll into this trial. One of the things is that this is the first time we've done an adjuvant trial this large. I think one of the reasons that helped us succeed in doing a trial like this is that we left radiation as investigator's choice, because a lot of times going into a trial like this, people feel strongly, we know our radiation oncology colleagues, rightfully so, feel that radiation could help prevent disease from coming back. And we also have the camp that says they don't need radiation. We took that question out of this study. We let investigators decide whether or not they're going to get radiation. It was for patients to get chemotherapy, who are going to normally get chemotherapy for their high-risk disease and randomize them to chemotherapy plus placebo or chemotherapy plus pembrolizumab, a PD-1 inhibitor, in order to see if we could prevent the disease from coming back. Dr. Shannon Westin: And the primary results of this study were just presented at ESMO and published in the Annals of Oncology. Can you give us just a quick overview of what that was, what they found? Dr. Brian Slomovitz: Yep. So, we enrolled 1100 patients. The primary objective of the study was to look at the ITT population, progression free survival and overall survival. And the overall study was negative. Okay, so the hazard ratio in the ITT population was 1.02, not demonstrating a benefit of adding pembrolizumab in this population. I would say disappointing, but at the same point, something that we could really learn a lot from and somewhere that we know that in the whole population, we need to come up with better strategies to help prevent recurrence of disease, better adjuvant treatment strategies. But there's also information that we learned from this trial and that we're reporting on that we're actually super excited about and we feel may be game changing. Dr. Shannon Westin: Yeah. So, let's go to that. This is the good news. Your manuscript in the JCO, thank goodness you published it here, was focused on that subset of mismatch repair deficient. So, tell us what you found. Dr. Brian Slomovitz: So, in this study, we found that the first stratification factor was dMMR versus pMMR. Now, in the pMMR group, those patients had further stratification factors, but dMMR by itself was a stratification factor. Amongst those patients that had dMMR tumors, we found the hazard ratio to be 0.31 benefiting those patients who received pembrolizumab in the adjuvant setting. Really something that when we look at the treatment studies, the GY018s, the RUBYs, the atTEnds, the DUO-Es, in a dMMR setting, we see a similar hazard ratio of 0.3, 0.4. But to get that hazard ratio, which was statistically significant, obviously, is something that we were quite pleased with and something that we felt was worthy of reporting further. I will say it was a pre-specified endpoint. We didn't allocate alpha to it. So, at the beginning, it was a pre-specified endpoint, but at the same time even though we didn't specify alpha towards that outcome, it still, we feel is clinically meaningful and can definitely add to affect the standard of care and the management of these patients. Dr. Shannon Westin: Yeah. I'm very intrigued to see what kind of people do with this. It makes sense, mechanistically, it makes sense if there was a population that was going to benefit, if not everybody does, this is the group that will. I mean, do you feel like there's enough data? What are you going to do? FDA approval aside, obviously, those kinds of things. But how do you feel about this? Is this something you're going to offer to your patients? Dr. Brian Slomovitz: The first answer is yes. I think it's something that I would like to offer my patients. As you know, we need one of two things: we either need an FDA approval or for a lot of our payers required to be in the NCCN listings. I don't serve on the committee. I have no influence on NCCN. I'm excited to see how they'll respond to not only the Annals article, but obviously in today's release of the JCO article, I hope that they'll look upon it favorably. It's a drug that we're used to giving. Pembrolizumab, we have a lot of experience with it. It's interesting. We didn't see any new safety signals, Shannon. Dr. Shannon Westin: Yeah, I was going to ask - that's great. Dr. Brian Slomovitz: There was nothing, nothing additional that we found in this trial. So, I feel that it can definitely improve the outcome of those patients, in my view, with high risk for recurrence, treating pembrolizumab in this setting. Dr. Shannon Westin: Yeah, I think it's important, of course, to look at the safety. What about quality of life? Any new findings there? Dr. Brian Slomovitz: Yeah, we did that quality of life as part of the phase 3 trial. No difference between the two arms. No difference between the two arms. When we looked at a couple of the other analyses, we found that the benefit is the same on stage 3, 4 tumors. We saw that the benefit was there as well. So, there were less patients in the stage 1, 2 group. But I think really, for all comers, for the patient population, I would definitely consider giving pembrolizumab, again, for those patients with a deficient mismatch repair. Dr. Shannon Westin: It's really exciting, and I think you mentioned some of the statistical limitations. Anything else that gives you pause about the study or things you wish you did better? I know we always like to armchair quarterback ourselves after we do these kinds of studies. Dr. Brian Slomovitz: Yeah, it's interesting. When we designed the study years ago, we used the best information we had at that time to come up with the study design, and we're happy with it, and we really don't think that we could have done it much better. I should say, this was a great partnership that we had here between the GOG, ENGOT and with sponsor Merck, Toon Van Gorp was the lead PI of the global trial. When he gave me the good opportunity to present it at the IGCS and to be the lead author on this, it was really a great partnership. And when we came up with a trial years ago, it was the best trial that we thought at that time. And based on the information now, I think it's really something that we're excited about these results, even though the overall trial was negative. Dr. Shannon Westin: Yeah, I agree with you. I think it's interesting, it's informative to think about, “Well, what would we do now or then if we knew what we knew now?” But still, you design the trial the best way you can. I think the results are super intriguing. I'm hopeful at the way they'll be reviewed. I agree I don't have any inside information about the NCCN committee, but I do hope that they'll consider the overarching data to support immunotherapy and mismatch repair deficiency and the findings of this study. And then I guess the last question I would just ask, as you're an expert here, what are you looking forward to seeing coming next in this space? What's the stuff you're intrigued about in endometrial cancer? Dr. Brian Slomovitz: I think, Shannon, you and I have talked about this for a while. I think we're getting really close to eliminating chemotherapy for some of the patients who suffer from this disease. So, I'm not sure if we'll do a follow up to this trial, but I think a logical type of follow up would be to see: what if we just took away chemotherapy altogether and we did pembro in the adjuvant setting, pembrolizumab versus chemotherapy? We don't have that trial in the adjuvant setting, but actually, we completed accrual of that trial in the recurrent setting and we're anxiously awaiting those results. That's KEYNOTE-C93, where in the dMMR population we studied pembrolizumab versus carboplatin paclitaxel. How those results may translate into this setting, I'm not sure. Right now, it's exciting what we have, but yeah. And I think future is bright for this. Just to highlight, in the two arms, there's 140 patients approximately in each arm; there were 25 recurrences in those patients who received placebo. Only eight recurrences in those that received pembrolizumab. Really, when we talk about numbers, it's really remarkable and it shows you the benefit it really had on the patients. Dr. Shannon Westin: Well, this was great. It flew by, as it always does when I'm having conversations with you. I just really want to thank you again for taking the time to share your knowledge with our listeners. Dr. Brian Slomovitz: Thanks, Shannon. Dr. Shannon Westin: And listeners. Thank you all for taking the time to hear about endometrial cancer. Again, this was “Pembrolizumab or Placebo, Plus Adjuvant Chemotherapy, With or Without Radiotherapy for Newly Diagnosed High Risk Endometrial Cancer Results in Mismatch Repair Deficient Tumors.” And this was the JCO After Hours. If you loved what you heard, please check out wherever you get your podcast to see what else we have to offer. Have an awesome day. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 5 and preview of week 6 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Follow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcaston which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Ignace Vergote to discuss Tisotumab Vidotin in Second- & Third-Line Recurrent Cervical Cancer. Prof. Vergote was Chairman of the Department of Gynaecology and Obstetrics at the Catholic University Leuven from 2003-2020. He published more than 1050 papers on gynecologic cancer in peer-reviewed journals, and his work was cited more than 90,000 times. He served as President of IGCS, ESGO, EORTC-GCG and ENGOT. Highlights: Patients with recurrent cervical cancer with progression after platinum/paclitaxel, combined if possible with bevacizumab and anti-PD-(L)1 therapy, have a dismal prognosis The antibody-drug -conjugate tisotumab vedotin showed a statistically significant and clinically meaningful improvement in overall survival, demonstrating a 30% reduction in the risk of death compared with standard of care chemotherapy Consistent benefit in progression-free survival and confirmed response were also observed and supportive of the observed overall survival benefit with tisotumab vedotin The safety profile of tisotumab vedotin was manageable and tolerable, and consistent with previous experience Based on these data, tisotumab vedotin should be considered a potential new standard of care for patients with recurrent cervical cancer who have progressed after first-line systemic therapy
El Dr. Efraín Salas, oncólogo médico de Guadalajara, Jalisco, México, junto con el Dr. Raúl Márquez, oncólogo médico de Madrid, España, presentan un resumen de los estudios que consideran más relevantes en el ámbito de los tumores ginecológicos expuestos durante el Congreso de ESMO 2024. Cérvix ENGOT-cx11/GOG-3047/KEYNOTE-A18 INTERLACE BEATcc Endometrio ENGOT-en11/GOG-3053/KEYNOTE-B21 ENGOT-en9/LEAP-001 TROPHAMET Ovario BrUOG 354 PRIMA/ENGOT-OV26/GOG-3012 ATHENA-COMBO ICON9 EUDARIO/ENGOTov-48 Fecha de grabación: 25 de septiembre de 2024. Todos los comentarios emitidos por los participantes son a título personal y no reflejan la opinión de ScienceLink u otros. Se deberá revisar las indicaciones aprobadas en el país para cada uno de los tratamientos y medicamentos comentados. Las opiniones vertidas en este programa son responsabilidad de los participantes o entrevistados, ScienceLink las ha incluido con fines educativos. Este material está dirigido a profesionales de la salud exclusivamente.
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 4 and preview of week 5 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Follow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcaston which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
In this episode, listen to Ana Oaknin, MD, PhD and Alexandra Leary, MD, PhD, share their clinical insights and takeaways on key updates and new data presented for ovarian, endometrial, and cervical cancer at the ESMO 2024 annual congress including:Phase III PRIMA/ENGOT-OV26/GOG-3012 Final OS Results: Niraparib as First-Line Maintenance in Advanced Ovarian CancerATHENA COMBO/GOG-3020/ENGOT-ov45: Rucaparib With or Without Nivolumab Maintenance in Newly Diagnosed Ovarian CancerPhase II PICCOLO Trial of Mirvetuximab Soravtansine in Recurrent Platinum-Sensitive Ovarian Cancer With High-FRα ExpressionPhase III KEYNOTE-B21/GOG-3053 Study of Adjuvant Chemotherapy With or Without Radiotherapy With or Without Pembrolizumab in Patients With Newly Diagnosed Endometrial Cancer or Carcinosarcoma After Curative Surgery With no Residual DiseasePhase III KEYNOTE-A18 Overall Survival Results: Pembrolizumab Plus Concurrent Chemoradiation in High-Risk Locally Advanced Cervical Cancer Program faculty:Ana Oaknin, MD, PhDHead of Gynaecologic Cancer ProgrammeDepartment of Medical OncologyVall d' Hebron University HospitalVall d'Hebron Institute of Oncology Barcelona, SpainAlexandra Leary, MD, PhDCo-Director, Department of Medical OncologyMedical Oncologist, GynecologyTeam Leader, Gynecologic Translational Research Lab, Institut Gustave RoussyParis, FranceResources:To download the slides associated with this podcast discussion, please visit the program page.
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football with a recap of week 3 and preview of week 4 of Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Follow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football recap of week 2 and preview of week 3 Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Follow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest Co-Host: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football recap of week 1 and preview of week 2 Pittsburgh Steelers and Houston Texans football.You won't want to miss this one!!!Follow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Send us a textSpecial Guest: Douglas HasemanTha512footdr sits down with Douglas Haseman live from the studio of life or death to talk everything football.You won't want to miss this one!!!Follow Douglas Haseman on Instagram and twitter:https://www.instagram.com/howidougie/?hl=enAnd follow his band Byrd Law on Instagram:https://www.instagram.com/byrdlawmusic/?hl=enBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
Wes Nelson is FINALLY on the POD!We talk our craziest ADHD purchases, how to become besties with a music legend & returning to Love Island?!Listen to the FULL PODCAST and follow us on:Spotify - https://open.spotify.com/show/4UjhcQP...Apple Podcasts - https://podcasts.apple.com/us/podcast...Tiktok - https://www.tiktok.com/@chloevsthewor...Instagram - https://www.instagram.com/chloevsthew...Chloe: https://www.instagram.com/chloeburrows/?hl=enGot a Dilemma for Chloe?: chloevstheworldsumbissions@gmail.comIf you'd like to work with us email the studio on: workwithchloevstheworld@fellasstudios.com Hosted on Acast. See acast.com/privacy for more information.
In this episode, listen to Floor J. Backes, MD, and Angeles Alvarez Secord, MD, MHSc, share their clinical insights and takeaways on new data presented for endometrial, ovarian, and cervical cancers presented at the 2024 annual meetings of the Society of Gynecologic Oncology and American Society of Clinical Oncology including:RUBY Part 1 Subgroup Analyses by MRR Status: Addition of dostarlimab to platinum-based therapy followed by dostarlimab maintenance in advanced endometrial cancerRUBY Part 2: Survival outcomes with addition of dostarlimab to platinum-based therapy followed by dostarlimab plus niraparib maintenance in advanced endometrial cancerSurvival Analyses From Phase III NRG GY018: Carboplatin plus paclitaxel with or without pembrolizumab as frontline treatment for patients with advanced endometrial cancerDUO-E: First-line therapy with carboplatin plus paclitaxel plus bevacizumab and durvalumab followed by maintenance with bevacizumab, durvalumab, and olaparib in newly diagnosed endometrial cancerLong-term Follow-up From SIENDO: PFS in TP53 wild-type and preliminary survival by molecular subgroups in patients with endometrial cancer and complete or partial response after ≥12 weeks of first line taxane/carboplatinSubgroup Analyses From the Randomized Phase III MIRASOL: Mirvetuximab soravtansine vs investigator's choice of chemotherapy in FR
Special Guest: Trent Albert & Bill StevensonTha512footdr sits down with Trent Albert and Bill Stevenson live from the studio of life or death to talk everything Sopranos.You won't want to miss this one!!!Follow Trent Albert (Below The Belt Boxing)https://www.instagram.com/belowthebeltboxing/Follow Bill Stevenson and Blood Pumpshttps://www.instagram.com/billy_tears/https://www.instagram.com/bloodpumps/Listen to Blood Pumpshttps://linktr.ee/BloodpumpsBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on.Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos[Blues, Funk, and Jazz with Tha512footdr]Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Domenica Lorusso to discuss the KEYNOTE A18 clinical trial. Dr. Domenica Lorusso, MD, PhD, directs the Gynaecological Oncology Unit at Humanitas Hospital, Milan, and holds a Full Professorship in Obstetrics and Gynaecology at Humanitas University, Rozzano, Milan. She has led/participated in approximately 250 phase I-IV clinical trials. Currently overseeing more than 60 studies as Principal Investigator, Dr. Lorusso also chairs the Clinical Trials Committee of the MITO Group. She serves on the Board of Directors of the GCIG and is an active member of ENGOT, where she chairs the Gynecological Cancer Academy. Additionally, she sits on the Board of Directors of the ESGO. With around 300 international oncology publications and contributions to national and international treatment guidelines, her primary objectives are to ensure optimal patient care, foster clinical research, and advance international collaborations and education in the field. Highlights: - Concurrent chemoradiation plus brachiterapy represent the standard of care treatment in locally advanced cervical cancer providing up to 70% 5 years OS - Modern radiotherapy technique (IMRT and VMAT) has reported to further increase OS and reduce toxicity - Immunotherapy has reported to increase OS in advanced or recurrent cervical cancer when compared to standard treatment - Immunotherapy in combination with concurrent high quality chemoradiation in the treatment of locally advanced high risk cervical cancer further increase PFS and OS with respect to standard chemoradiotherapy and should be considered the new standard of care - The combination appears manageable and no substanciad additional toxicity has been reported
Special Guest: DJ M-1Tha512footdr sits down with DJ M-1 via the internets to talk the origin of DJ M-1 , creative process, east coast hip hop, boom bap, a sandwich is a sandwich is a sandwich, the ins and outs of Dublin Ireland, travel, sneakers, question from the podcast hotline, dj gear, record talk, the album of the week, and much more.You won't want to miss this one!!!Follow DJ M-1:https://linktr.ee/djm1tracksBe sure to Subscribe to and Rate the podcast on which ever podcast platform you enjoy the podcast on. Please follow Tha Dr on Instagram @tha512footdr.https://www.instagram.com/tha512footdr/?hl=enGot a question for Tha512footdr and show guests???Call into the podcast question hotline and have your question heard and answered on the air. (512) 900-9226NOW ON YOUTUBEhttps://www.youtube.com/playlist?list=PL0CrpxZvy0yQ_klMMtdagdPauRoH10fLRListen to Controlled Chaos [Blues, Funk, and Jazz with Tha512footdr] Sundays 12pm-1pm CT on KLKT 107.9 FM Radio Lockhartand online at https://www.klkt.org/Follow and Play Chess with @Tha512footdr onhttps://www.chess.comMAKE SURE TO TELL A FREAK OR A GEEK ABOUT THE PODCAST!!Tha Dr's Orders Podcast is a Life or Death Studios Production .And thank you to YOU the Freaks and Geeks!!!
In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Domenica Lorusso to discuss the survival analysis of the PAOLA1 trial. Dr. Domenica Lorusso, MD, PhD, directs the Gynaecological Oncology Unit at Humanitas Hospital, Milan, and holds a Full Professorship in Obstetrics and Gynaecology at Humanitas University, Rozzano, Milan. She has led/participated in approximately 250 phase I-IV clinical trials. Currently overseeing more than 60 studies as Principal Investigator, Dr. Lorusso also chairs the Clinical Trials Committee of the MITO Group. She serves on the Board of Directors of the GCIG and is an active member of ENGOT, where she chairs the Gynecological Cancer Academy. Additionally, she sits on the Board of Directors of the ESGO. With around 300 international oncology publications and contributions to national and international treatment guidelines, her primary objectives are to ensure optimal patient care, foster clinical research, and advance international collaborations and education in the field. Highlights: Bevacizumab plus olaparib has reported to increase PFS and OS in advanced stage III-IV, newly diagnosed, high grade serous and endometrioid HRD positive ovarian cancer in the maintenance setting Exploratory analysis suggest that the advantage is particularly high in low risk patients (stage III withour residual tumor at primary surgery) where a 5-year OS more than 90% has been reported suggesting some of these patients may be cured In the HRp population the combination of olaparib-bevacizumab did non increase PFS and OS in comparison to bevacizumab alone The toxicity profile of the combination is in line with what expected with the single drugs
In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Professor Em. Ignace Vergote to discuss innovaTV205. Prof. Vergote was Chairman of the Department of Gynaecology and Obstetrics at the Catholic University Leuven from 2003-2020. He published more than 1050 papers on gynecologic cancer in peer-reviewed journals, and his work was cited more than 90,000 times. He served as President of IGCS, ESGO, EORTC-GCG and ENGOT. Highlights: Tissue factor is almost always highly expressed in cervical carcinoma and can be targeted by tisotumab vedotin (TV), an antibody-drug conjugate. TV combined with bevacizumab, carboplatin, or pembrolizumab demonstrated manageable safety and encouraging antitumor activity in treatment-naive and previously treated recurrent/metastatic cervical cancer. The results show that the combination of TV with current treatments may improve outcomes and provide novel treatment options for patients with first or later recurrences and/or primary metastatic cervical cancer.
In a conversation with CancerNetwork® prior to the FDA approval of pembrolizumab (Keytruda) plus chemoradiotherapy in FIGO stage III to IVA cervical cancer, Jyoti S. Mayadev, MD, spoke about how the regimen's approval would be a “major step” for the aforementioned population and how she planned to integrate it into her care.1 Mayadev, a board-certified radiation oncologist and professor of radiation medicine and applied sciences at the University of California, San Diego School of Medicine, stated that the approval would be a “huge win” with respect to progression-free survival (PFS) based on supporting findings from the phase 3 KEYNOTE-A18 trial (NCT04221945). According to data presented at the 2023 Annual Global Meeting of the International Gynecologic Cancer Society (IGCS), treatment with pembrolizumab plus chemoradiotherapy produced a significant PFS benefit compared with chemoradiation alone (HR, 0.70; 95% CI, 0.55-0.89; P = .0020).2 Additionally, findings from a subgroup analysis highlighted that the PFS benefit with the pembrolizumab-based combination extended to those with FIGO stage III to IVA disease (HR, 0.58; 95% CI, 0.42-0.80).1 Mayadev also described the tolerability and quality-of-life benefits associated with the pembrolizumab combination in the KEYNOTE-A18 trial. Additionally, she stated that potential next steps for research may involve integrating adaptive technology to potentially reduce toxicity following chemoradiation among patients with cervical cancer. “Uptake of any new agent requires a multidisciplinary team approach. It requires workflows,” Mayadev said regarding her strategy for adopting the newly approved regimen in her clinic. “For our particular institution, we would somewhat seamlessly go into the FDA approval. At the same time, we would try to help others in the community. We, as a scientific global community for gynecologic oncology and radiation oncology, will come together and start to incorporate how we can move forward with the FDA approval.” References 1. FDA approves pembrolizumab with chemoradiotherapy for FIGO 2014 stage III-IVA cervical cancer. News release. January 12, 2024. Accessed January 15, 2024. https://bit.ly/3NZNGPb 2. Lorusso D, Xiang Y, Hasegawa K, et al. ENGOT-cx11/GOG-3047/KEYNOTE-A18: A randomized, double-blind, phase 3 study of pembrolizumab plus chemoradiotherapy for high-risk locally advanced cervical cancer. Presented at 2023 Annual Global Meeting of the International Gynecologic Cancer Society; November 5-7, 2023; Seoul, South Korea. Abstract SE004/1614.
In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Professor Em. Ignace Vergote to discuss the SIENDO Trial. Prof. Vergote was Chairman of the Department of Gynaecology and Obstetrics at the Catholic University Leuven from 2003-2020. He published more than 1050 papers on gynecologic cancer in peer-reviewed journals and his work was cited more than 88,000 times. He served as President of IGCS, ESGO, EORTC-GCG and ENGOT. Highlights: Selinexor inhibits Exportin-1, resulting in reactivation of Tumor Suppressor Proteins (especially p53) in the nucleus. This leads to selective killing of cancer cells. The ENGOT-EN5/GOG-3055/SIENDO was a randomized phase III double-blind trial comparing maintenance selinexor with placebo, after response on chemotherapy in patients with advanced or first recurrence of endometrial cancer. Median PFS in the ITT population was 5.7 versus 3.8 months (not significant). Long-term PFS in TP53wt patients was 27.4 months and 5.3 months (HR 0.41) and in TP53wt/pMMR patients not reached and 4.9 months (HR: 0.32) for selinexor and placebo, respectively. Selinexor is very promising in patients with advanced/recurrent TP53wt endometrial cancer and is further investigated in this population in the ongoing ENGOT-EN20/GOG-3083/XPORT-042 study.
As Oncology for the Inquisitive Mind's coverage of ESMO 2023 winds down, we bring some of the best presentations covering gynaecological cancer. An area of oncology that in many cases remains mired in the pre-immunotherapy and pre-targeted therapy ages, ESMO brought some much-needed positive trials in the areas of cervical cancer, as well as an interesting (albeit negative) study of the PARP-inhibitor olaparib that highlights some of the more practical challenges of running an international phase 3 study. As always, outcomes can always improve, but any progress in this very important area is always a welcome development.Studies discussed in this episode (subscription may be required):A randomised phase III trial of induction chemotherapy followed by chemoradiation compared with chemoradiation alone in locally advanced cervical cancer: The GCIG INTERLACE trial https://esmocongress.esmo.org/esmo/esmo2023/en-GB/presentation/639091innovaTV 301/ENGOT-cx12/GOG-3057: A global, randomized, open-label, phase III study of tisotumab vedotin vs investigator's choice of chemotherapy in 2L or 3L recurrent or metastatic cervical cancer https://esmocongress.esmo.org/esmo/esmo2023/en-GB/presentation/639430Overall survival (OS) outcomes from NRG-GY004, a phase III study comparing single-agent olaparib or combination cediranib and olaparib to platinum (Plat) based chemotherapy in recurrent plat sensitive ovarian cancer (OvCa) https://esmocongress.esmo.org/esmo/esmo2023/en-GB/presentation/639154For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of Music Unlimited: https://pixabay.com/users/music_unlimited-27600023/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice. Hosted on Acast. See acast.com/privacy for more information.
In this "Podcast Takeover," Dr. Lidia Schapira guest hosts to discuss with Dr. Shannon Westin her own JCO paper, which reports on the DUO-E Trial. Dr. Ramez Eskander also joins in this lively discussion. TRANSCRIPT The guest on this podcast episode has no disclosures to declare. Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast where we get in depth on manuscripts published in the Journal of Clinical Oncology. I am your host, Shannon Westin, Social Media Editor of the JCO and Gynecologic Oncologist by trade. And actually, I'm super excited today because we are going to have a podcast takeover because we are discussing my own work, which was simultaneously presented at the European Society of Medical Oncology 2023 Congress and published in the Journal of Clinical Oncology on October 21st, 2023. And this was the DUO-E trial, “Durvalumab Plus Carboplatin/Paclitaxel Followed by Maintenance Durvalumab With or Without Olaparib as First-Line Treatment for Advanced Endometrial Cancer.” Because we're discussing this work and we wanted you to have an unbiased podcast discussion, Dr. Lidia Schapira, who is a Professor of Medical Oncology at Stanford University and an Associate Editor of JCO and the Art of Oncology podcast host, is going to take over this podcast and really just pepper me with questions about this exciting work. Welcome, Dr. Schapira. Dr. Lidia Schapira: Thank you so much. It's such a pleasure to be with you. Dr. Shannon Westin: And before I turn over the reins, I also want to introduce one of my colleagues, who's going to be providing quite a bit of insight on this topic, Dr. Ramez Eskander, who is Professor of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Diego. And you will know he's the principal investigator of the GY-018 study, which established pembrolizumab and chemotherapy as the new standard of care in endometrial cancer. Welcome, Ramez. Dr. Ramez Eskander: Thank you. Thank you, Dr. Westin. It's a pleasure to be here. And congratulations again to you and your study team for this exceptional work. Dr. Shannon Westin: Thank you. And congratulations to you. Dr. Schapira, thank you for being here and please do take it away. Dr. Lidia Schapira: So let's start by having you tell us a little bit about the standard of care for women with endometrial cancer and advanced endometrial cancer prior to this study. Ramez, I'm going to direct this question to you first. Dr. Ramez Eskander: For many years, actually since about 2012, carboplatin and paclitaxel, which ironically is a chemotherapy backbone really across all of our gynecologic tumors, emerged as the preferred doublet chemotherapy regimen for the management of advanced-stage metastatic or recurrent endometrial cancer. It evolved through a series of different clinical trials, in fact taking us from whole abdominal radiation, systemic chemotherapy, comparing single agents to doublets and then triplet regimen of TAP to carboplatin and paclitaxel, which ultimately, then, following the presentation of GOG Protocol 209 and its publication, as the chemotherapy backbone, being carboplatin and paclitaxel. And it's been that way for many, many years. Dr. Lidia Schapira: And how effective is the regimen? Dr. Ramez Eskander: The response rates to carboplatin and paclitaxel are actually quite reasonable in the patients who have advanced-stage disease, particularly if they haven't had prior systemic chemotherapy. Response rates in the 50% to 60% range. The issue is that the responses tend to be limited and disease recurrence is an expectation in these patients who have advanced-stage disease. And so that really highlighted the importance of trying to continue to advance therapeutic opportunities in these patients to improve long-term outcomes. Dr. Lidia Schapira: As we think about improved long-term outcomes, we're thinking about a better treatment and also a kinder treatment, perhaps one that is also less toxic. Can you talk a little bit about the population of women with endometrial cancer? Are these older women? Do they have comorbidities? Dr. Ramez Eskander: What we're seeing is, interestingly, there has been an evolution a bit in this space. Historically, we used to think about endometrial cancer as—the phrases we used to use are type I and type II. These type I tumors, we would say, are estrogen-driven malignancies; they tend to be seen in overweight or obese patients. And we would identify them in a theoretically younger patient population. And then we had these type II, or what we termed estrogen-independent malignancies, that we would see in an older patient population. Of course, with obesity came metabolic syndrome and other cardiovascular comorbidities, etc. But really, that narrative has evolved dramatically, and that's really something that will be highlighted in, I think, our discussion of these studies today, where the nomenclature that we used to historically use has evolved because of our understanding of the molecular characterization of this disease. So we've really gone away from that, and now we understand that we're seeing all of these different heterogeneous endometrial cancer types amongst patients of different ages, different comorbidities, different races and ethnicities. And so it's created a more complex picture for us. But certainly, there are comorbidities that these patients face, and that's important as we look to identify treatments strategies that are both effective and tolerable. Dr. Lidia Schapira: My final question before we jump into this very exciting study is about the Cancer Genome Atlas work. Can you tell us how that's changed the thinking and the design of the studies? Dr. Ramez Eskander: It was a seminal publication, really, back in 2012/2013 looking at an assessment of endometrial cancers to try and determine whether or not all of these "endometrial cancers" that we used to enroll on a single study are similar or divergent. And it's important because the study I referenced that really established the standard of care, GOG Protocol 209, as carboplatin and paclitaxel, there was no real consideration of molecular characterization at all. We enrolled all patients onto this study without thinking about these variables, of course, because it was designed, conducted, and completed before the TCGA data emerged. But what we learned from the TCGA is there appeared to be four distinct molecular subgroups. There were the POLE-mutated patient population. There was the mismatch repair deficient or MSI-high endometrial cancer population. There was the copy number-high or what we say are the p53-mutated. And then the last cohort was called the NSMP (no specific molecular profile). But now, that's even evolved; some people term it TP53 wild type. That's a bit of even a heterogeneous cohort amongst itself. So we're going to take these subsets, independent of POLE and an MSI-high, and we're going to look at TP53 or copy number-high, and that will probably be divvied out further, and the NSMP, and that will probably be subdivided. But really, it gave us these four components, which has then evolved. Many of you may have heard of the ProMisE algorithm or ProMisE Plus, which looked to take the data from TCGA so that we can start to really look at it in clinical practice. So it's really revolutionized how we think about these patients, how we think about the disease, and how we design trials. Dr. Shannon Westin: And I just want to add to that because I think that it's so important, what Ramez said about the way we were developing trials, the way we were designing trials. We knew that these classifiers—we were learning these classifiers are prognostic. Now what we're really trying to hone in on is how predictive they are. And certainly, one of the major classifiers that we're going to talking about today is mismatch repair status, and that is most definitely predictive of response to therapies. But we're still learning about the other classifiers and how we might adjust the way we treat people, even deescalating care for certain patients. That is still being proven in clinical trials, although we suspect that it's going to be borne out as other clinical trials report. Dr. Lidia Schapira: It's a perfect segue to this current trial. Tell us a little bit about the objectives and the design of DUO-E. Dr. Shannon Westin: As Ramez said, the standard of care was chemotherapy. And so we wanted to see if there was a way to improve outcomes for these women with advanced and recurrent endometrial cancer in a really clinically relevant, meaningful fashion for patients. And so we knew that this TCGA classifier, the mismatch repair, was so important, and we thought that the addition of immunotherapy to chemotherapy would most certainly work in that population but could even work in the entire population because, generally, endometrial cancer seems to be a little bit more responsive to immunotherapy and to activation of the immune system than, say, some of our other gynecologic malignancies. And so we set out to see what the addition of durvalumab, which is a PDL-1 inhibitor, would add to chemotherapy. And this was two chemo as well as followed by durvalumab maintenance. But even further, we had some really kind of exciting science data from our lab that said that if we combined a PARP inhibitor with immunotherapy that we could accentuate on the response to therapy and we could get more benefit. And there's kind of a lot behind that, but essentially, what we thought was that the damage that's caused by the PARP inhibitors would create an activation of different immuno-pathways, like STING pathway and activating cytokine release, and that we would get this synergistic activity. So one of the other objectives was to see if the addition of the olaparib, the PARP inhibitor, to durvalumab in that maintenance setting could even further improve benefit. So we had a dual primary endpoint looking at progression-free survival, so the amount of time people live without their cancer coming back. And that endpoint was first, the durvalumab-alone arm to control, and then the second portion of that was the durvalumab/olaparib arm back to control. Dr. Lidia Schapira: So before you tell us about the results, tell us a little bit about the study itself. I mean, I was very impressed that you did it in so many different locations. Tell us about that effort. Dr. Shannon Westin: This was a huge collaborative effort both with the GOG Foundation, the Gynecologic Oncology Group Foundation, as well as ENGOT, which is our European colleagues that do amazing clinical trials. But in addition to that, we really worked very closely with our industry partner to really make sure we spanned the globe. And so we had groups from all over the world that participated and really were exceptional. The care that was taken and the hard work that went into this type of study across the world really can't be overstated. We were very lucky to have a wonderful infrastructure group. We met weekly for a long time, just keeping an eye on the data and making sure that everything was as positive as possible and, of course, that we were watching the outcomes of the patients very closely and making sure that there was no evidence of harm or issue. And so it really did take a village, truly, to run this study and to ensure that at the end of it, we got really great data that we can trust. Dr. Lidia Schapira: So tell us the results. Dr. Shannon Westin: So DUO-E was positive for both of its primary endpoints, which was very thrilling. So for the first analysis, which is the durva-alone arm to control, we saw a reduction in the risk of progression of 29%, so a hazard ratio of 0.71. And then the addition of olaparib seemed to further enhance this benefit, so a 45% reduction in the risk of progression for a hazard ratio of 0.55. But what's really exciting is our follow-up time was pretty long; it was about 17 months, so we were able to look at a couple of different analyses, including an 18-month landmark analysis where we saw approximately 50% of the patients were still alive progression free at 18 months, as compared to only 21% of patients being alive progression free in the control arm. So there was a doubling in that progression-free survival time point at 18 months, which is thrilling. Dr. Lidia Schapira: So Ramez, as an expert in the field, what was your reaction when you read or heard these results? Dr. Ramez Eskander: It's exciting, honestly. So we have gone a long time without seeing really significant successes in the endometrial cancer space, a testament to the fact that we hadn't yet developed our understanding of how we could move this needle forward. But Dr. Westin and the DUO-E team conducted an exceptional clinical trial, as you mentioned, international study, rational and important hypothesis to adjudicate. And what we saw here was both now we had other studies—the RUBY trial, the GY018 trial, the AtTEnd—and now here DUO-E, which added this hypothesis of PARP maintenance in addition to checkpoint to try to augment response and consistent, really provocative data, exciting, in line with what we've seen and hopefully will continue to drive the science in this space, most importantly. Dr. Lidia Schapira: So let me ask you a follow-up question to that. What kind of scientific questions are in the air now as a result of this trial and what the trial found? Dr. Ramez Eskander: Oh, goodness. Shannon and I could both take this, I'm sure. But I think in the dMMR population, we recognize that there's a ton of data that is supportive of the fact that these tumors are immune responsive, particularly in dMMR endometrial cancer, whether it's an epigenetic promoter hypermethylation, or a mismatch repair gene mutation. I think the data has emerged that immunotherapy is here to stay for these patients in the newly diagnosed advanced stage, even chemo naïve, who need adjuvant therapy. The pMMR population, this is where we're seeing more and more questions emerge because we realize that that may be a cohort of different cancers. And I'll let Shannon speak to this briefly, but even the incorporation of the PARP inhibitor, in addition to the checkpoint, there's a biologic rationale for combining those two together to augment response. And to see the benefit in that trial—arm three and arm two, we can look at descriptively and look at the differences, but who are those patients? Where is the PARP and the checkpoint most effective? How do we expand that to a larger population of patients potentially? These are questions that emerged because, as Dr. Weston will allude to, I know we also talk about HRR mutations, which are captured, but we even have a lot to understand about that in endometrial cancer, where we've had more research in the ovarian cancer space. Dr. Shannon Westin: Being mindful of time, because I have, like, 1,000 hypotheses that have been generated by this study, which, I think, shows it's a great study, right? Because you get some answers, and as our colleague Brad Monk says, “The only definitive study is the negative studies.” This most certainly was not that. But just kind of expanding on what Ramez said, the interesting thing about DUO-E is that really the biggest benefit for the combination of the durvalumab and olaparib was in that mismatch repair proficient group. And I personally thought that we were going to see accentuation of the impact in the mismatch repair deficient group based on the science, but that just wasn't borne out by the data. It doesn't seem that the combination has that much to add in that mismatch repair deficient group. And when we tease out the mismatch repair proficient group, I think that's where a lot of interesting information is going to come because, to Ramez's point, we're going to tease out: Is it driven by the P53-mutant population? Is it driven by the population that has homologous recombination deficiency? How do we even measure homologous recombination deficiency in endometrial cancer? So I'm super excited about what we found and how that may help us to make those decisions for the patient in front of us. The other thing I think needs to be made mention of—and this was something we saw in DUO-E as well as AtTEnd—we had a large population of patients that were recruited in Asia, 30%. Interestingly, when we look at the forest plot, that group doesn't seem to benefit as much from the addition of the olaparib. So we really need to tease out what's different about that population because what Nicoletta Colombo presented around AtTEnd, it looked like they didn't benefit from the atezolizumab either in that study. So there's clearly something different about that population, and we have a really big opportunity to look at that since we had such a large proportion of patients that were enrolled there. So that's another, I think, really intriguing question. Dr. Lidia Schapira: So how does this fit in the context of endometrial cancer treatment, and what are we going to do with patients in the clinic? I'd love to hear both of your perspectives, starting with you, Ramez. Dr. Ramez Eskander: It's an evolving answer, to say the least. What we can say definitively is that we have a United States FDA approval for the regimen of dostarlimab plus carboplatin and paclitaxel in the mismatch repair deficient, advanced-stage/recurrent or metastatic patient cohort. And again, that's because the magnitude of benefit that we saw in the RUBY trial, which looked at that, was actually analogous to what we saw in 018, AtTEnd, and DUO-E, again, consistently highlighting the benefit of the IO and the dMMR. We have yet to see how this is going to evolve the landscape in the larger patient population, which is the pMMR patient population. And it may be that based on the data that we have, we will see immunotherapy plus carboplatin and paclitaxel as the new standard of care in the pMMR cohort, or it may not. That's yet to be defined. And I think Dr. Westin will add to this, but I think that's also going to depend on the perception of how we view the cohort. Is it one group of patients? Are we going to have to think about subsets within the pMMR population? That is an active conversation. Dr. Shannon Westin: I would just add, having treated patients on this combo regimen with the durvalumab and olaparib, I have multiple patients that still remain on study, and this—we're looking at three and four years out. I just never saw anything like that before with standard chemotherapy, so there's definitely something here. So I want to know who those patients are, who benefits really the best from the combination, and who could we just give the immunotherapy to and get that same benefit. So we obviously always want people to live as long as possible. That's the bottom line. But we don't want to overtreat. And so I think balancing that is really important. Dr. Ramez Eskander: The point that was made earlier: We have yet, aside from MMR response to checkpoint, within the pMMR population, we understand that there may be subsets, but we have yet to prospectively validate that these molecular cohorts within the pMMR population are truly defining response to a particular therapeutic strategy. So we have to be cautious not to limit the treatment opportunities for these patients without having the data that we need to do so because, as Dr. Westin mentioned, for us—whether it was the Gy018 trial, the RUBY, the DUO-E trial—what we saw is there are pMMR patients who have a dramatic response even though they are “biomarker negative.” They're pMMR, they're TMB low, they're not POLE mutated, but yet they still derive a dramatic benefit. And so that goes back to the hypothesis about why we're even combining checkpoint with chemotherapy in which, for example, in lung cancer, there's been established success and approval. So I think we're all eager to see these strategies emerge as treatment opportunities for the pMMR patients as we work to still develop additional effective opportunities. Dr. Lidia Schapira: So, based on all of this and sort of the new twists on the scientific hypotheses that are now generated, what are the next steps? Dr. Shannon Westin: Well, I think we have to see if these drugs are available for patients. So looking at things like compendium listing and regulatory approvals obviously is going to be very important. But from the things that I can control, we are looking at the different molecular subtypes and understanding the different mutation status and trying to tease out who may be driving the biggest benefits so that we can help advise and make sure that we're doing the right thing for the patients. Dr. Lidia Schapira: And wearing my supportive care hat, I have to ask you, Shannon, about the tolerability. We often find that the quality of life and studies come out after, sometimes months or years after, the original trials are published. So let me take this opportunity to ask you now: How did women tolerate these drugs? Dr. Shannon Westin: The bottom line, Lidia, is, as expected, when you add additional drugs, you see additional side-effects. I think the good thing is that we're very comfortable with immunotherapy and we're very comfortable with PARP inhibition in gynecology because we have had access to these agents and so we know how to manage the toxicities. And so, from a standpoint of incidence, there was a higher incidence of grade three and higher adverse events in the group that had durvalumab/olaparib. But this was primarily driven by anemia, which is as expected and is usually pretty time-limited at the start of olaparib. From a long-term standpoint, there was a slightly higher proportion of patients that discontinued therapy, but it actually wasn't as much as I was worried about. So we saw a 19% discontinuation rate in the group that was just the control arm, and that went up to 24% in the dual arm, so definitely higher, but not that much higher. And when we moved to maintenance, which is really where—that's where the arm becomes unique, it was much lower at about 12%. And so that's exciting to me, that patients were able to stay on a drug and were able to tolerate it. And then, to your other point, we do have a very nice patient-reported outcomes plan, and that is actually being analyzed as we speak with the hope of presenting it at the next major meeting, our Society of GYN Oncology meeting in March. So not right away, but I think in a pretty timely fashion, we'll have those data. Dr. Lidia Schapira: Congratulations, Shannon, on leading and presenting this wonderful study. So it's been a real pleasure to chat with the two of you. Dr. Ramez Eskander: Thank you. Dr. Shannon Westin: Thanks so much, Lidia. I really appreciate it. Thanks, Ramez, for being here. And I will just say thank you to all of our listeners. We really hope you enjoyed this episode of JCO After Hours, where we discussed the DUO-E trial, which is a phase III trial evaluating durvalumab plus carboplatin/paclitaxel followed by maintenance durvalumab with or without olaparib as first-line treatment for advanced endometrial cancer. And again, please do enjoy this publication that was online at the Journal of Clinical Oncology on October 21st, 2023. And do check out our other podcast offerings wherever you get your podcasts. Have a wonderful day. 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.
Are you afraid of the dark? How about ghosts or zombies? If these spooky terrors don't send a shiver down your spine tune into this chilling Will's Birdbrain episode to discover something truly terrifying – the possibility of extinction! In true classic horror movie fashion, this is a drive-in double feature episode showcasing two birds of the day and a very special guest, uncle Jared, host of Ghostlore of Hawaii: Paranormal Paradise! The Ghostlore of Hawaii is a paranormal-themed podcast covering Hawaii's ghost stories, folklore, ancient mythology, and true crime. First, Will and Jared learn about the Nene, Hawaii's state bird. The nene was once abundant on the islands of Hawaii before disaster struck… Next up the common myna swoops in to share the spotlight, bringing with it a trail of destruction. Both birds call Hawaii home today but can they learn to coexist? Will and Jared then compare the history of these resident birds to the people of Hawaii, yesterday and today. How has the culture of Hawaii changed over the years? What shocking threats loom over the heads of residents? To close us out Jared shares a terrifying story from his show, Ghostlore of Hawaii, which can be found wherever you get your podcasts (trigger warning: self-harm). Happy Halloweeeeeen!! Want to support these two independent podcasters? Consider joining the Ghostlore of Hawaii's Patreon for bonus episodes, supplemental show updates, and more! https://www.patreon.com/ghostloreofhawaiiGhostlore: https://www.ghostloreofhawaii.com/Be sure to check out the Will's Birdbrain Instagram account for complementary episode photos and videos, plus many other awesome bird photos/stories! https://www.instagram.com/wills_birdbrain/?hl=enGot a favorite bird you'd like to hear discussed on the Podcast? Shoot Will an email and let him know what you'd like to hear, share a birding story, or just say what's up! Email inquiries - willsbirdbrain@gmail.comWill's Birdbrain has merch! Consider grabbing a sticker or two of your favorite common bird! Proceeds will go straight into funding more episodes and spreading the joy of birding!Shop - https://www.etsy.com/shop/WillsBirdbrain?ref=simple-shop-header-name&listing_id=1361667746Love the show, consider supporting me on Patreon! Your support and interest is extremely helpful and encouraging! The goal of the Podcast is to share the love of birds, so be sure to share with your friends and family too. Together let's show some love to these common critters that so often get overlooked. I cannot do it without you.Click the link to sign up: https://www.patreon.com/willsbirdbrainHuge shout out to Kayta, Catherine, Josh, Shane, Margi, and Karene for being Patrons and keeping the common critters in mind!Support the show
Ornithology. Herpetology. Mammalogy. When you hear these words what do you think of? You're probably aware of the meaning behind the suffix “ology,” meaning “the study of,” which may make you think these words solely refer to rigorous scientific study, test tubes and all. What if I told you an ology such as ornithology, the study of birds, doesn't have to be so alien. Joining Will is Meg, a socioecological researcher and scientist whose work has taken her far and wide exploring the connection between people and nature, and creatures and nature. This episode explores a common yet awe-inspiring, giant bird- the great blue heron! GBH are adored throughout North America for their ability to transport people back to the prehistoric era and experience what it may have been like to witness dinosaurs. Will and Meg discuss some quirky facts about heron nesting, confusingly similar subspecies, and a whole lot of other cool, herony facts! After learning about the GBH it's easy to see how a tiny spark of interest in the scientific world, or birds, can ignite a lifelong passion for learning! Great blue herons are key indicator species- species with a lot of data on them which can be used to gauge the health of an ecosystem. What kind of DIY research can you conduct relating to this important bird? Be sure to check out the Will's Birdbrain Instagram account for complementary episode photos and videos, plus many other awesome bird photos/stories! https://www.instagram.com/wills_birdbrain/?hl=enGot a favorite bird you'd like to hear discussed on the Podcast? Shoot Will an email and let him know what you'd like to hear, share a birding story, or just say what's up! Email inquiries - willsbirdbrain@gmail.comWill's Birdbrain has merch! Consider grabbing a sticker or two of your favorite common bird! Proceeds will go straight into funding more episodes and spreading the joy of birding!Shop - https://www.etsy.com/shop/WillsBirdbrain?ref=simple-shop-header-name&listing_id=1361667746Love the show, consider supporting me on Patreon! Your support and interest is extremely helpful and encouraging! The goal of the Podcast is to share the love of birds, so be sure to share with your friends and family too. Together let's show some love to these common critters that so often get overlooked. I cannot do it without you.Click the link to sign up: https://www.patreon.com/willsbirdbrainHuge shout out to Kayta, Catherine, Josh, Shane, Margi, and Karene for being Patrons and keeping the common critters in mind!Support the show
Owls are possibly the most mysterious of all birds. They have captivated the minds of man for thousands of years, resulting in countless myths and legends about their peculiar behavior. Perhaps the most mysterious of all owls is also the most common owl and the most widespread landbird in the world, the barn owl!Join Will and Leslie, a budding birder, as they discuss why you should give a "hoot" about the barn owl. These curious critters are deadly killing machines, but that doesn't mean they aren't facing their own challenges of human making. Come learn about the barn owl's almost supernature senses, social behaviors, threats they face, and more!Leslie adds to the spookiness with stories from her Tejano/Mesoamerican background, including the story of the infamous lechuza, the shapeshifting owl-witch. Turn on your nightlight and hug the comforter extra tight this episode as owl's more bizarre and eerie cultural legends are discussed. Be sure to check out the Will's Birdbrain Instagram account for complementary episode photos and videos, plus many other awesome bird photos/stories! https://www.instagram.com/wills_birdbrain/?hl=enGot a favorite bird you'd like to hear discussed on the Podcast? Shoot Will an email and let him know what you'd like to hear, share a birding story, or just say what's up! Email inquiries - willsbirdbrain@gmail.comWill's Birdbrain has merch! Consider grabbing a sticker or two of your favorite common bird! Proceeds will go straight into funding more episodes and spreading the joy of birding!Shop - https://www.etsy.com/shop/WillsBirdbrain?ref=simple-shop-header-name&listing_id=1361667746Love the show, consider supporting me on Patreon! Your support and interest is extremely helpful and encouraging! The goal of the Podcast is to share the love of birds, so be sure to share with your friends and family too. Together let's show some love to these common critters that so often get overlooked. I cannot do it without you.Click the link to sign up: https://www.patreon.com/willsbirdbrainHuge shout out to Kayta, Catherine, Josh, Shane, Margi, and Karene for being Patrons and keeping the common critters in mind! Support the show
Did you know? Will's Birdbrain not only celebrates the common birds you may see every day but the common people you see everyday as well! Over the course of the podcast my guests and I have highlighted specific ways you can live and breathe birding simply by existing. From making movies featuring birds to studying them professionally, everyone can use their experience to uplift the voice of the voiceless. This sentiment can be applied to the supplemental theme of Will's Birdbrain as well- birding is for everyone! This episode is about making noise, something today's bird of the day is very good at doing! Joining me is Dara Wilson, a conservation communications specialist who has used her voice to make the world of birding a better place for marginalized people in her community. Dara is a naturalist, science educator, and co-chair of the Black Birders Week Advisory Group. Together Will and Dara discuss a bird you hear would likely hear before you see- the blue jay! These chatty rabble-rousers are much more than meets the eye, and can teach us a thing or two about helping the friends around us. Want to watch Will's discussion with black podcasters during Black Birders' Week as mentioned in this episode? Check the link here: https://www.youtube.com/watch?v=YBl3hBftA3Y&list=PL3NlhCdvgOprn4XbEKO8EEu4ob-ZdpqUB&index=7Be sure to check out the Will's Birdbrain Instagram account for complementary episode photos and videos, plus many other awesome bird photos/stories! https://www.instagram.com/wills_birdbrain/?hl=enGot a favorite bird you'd like to hear discussed on the Podcast? Shoot Will an email and let him know what you'd like to hear, share a birding story, or just say what's up! Email inquiries - willsbirdbrain@gmail.comWill's Birdbrain has merch! Consider grabbing a sticker or two of your favorite common bird! Proceeds will go straight into funding more episodes and spreading the joy of birding!Shop - https://www.etsy.com/shop/WillsBirdbrain?ref=simple-shop-header-name&listing_id=1361667746Love the show, consider supporting me on Patreon! Your support and interest is extremely helpful and encouraging! The goal of the Podcast is to share the love of birds, so be sure to share with your friends and family too. Together let's show some love to these common critters that so often get overlooked. I cannot do it without you.Click the link to sign up: https://www.patreon.com/willsbirdbrainDon't forget to keep up with the common critters!Support the show
The content of this bonus episode was described as "my manifesto." I believe birding is for everyone- not just black folk, not just white folk, or able bodied people, or otherwise. I was prompted to write this episode after attending a birding event in Maine as the only young person of color, an oh so familiar experience for me. This episode not only describes the challenges non-white, non-retiree birders face, but how we together can make birding more accessible and inclusive. With the help of dedicated nonprofits and old fashioned teamwork, Thank you so much for supporting my passion for getting young people of color outdoors! Shout out to my buddies from the Maine Maritime Museum, Luke, Sarah, and Paul! Their work (mentioned in this episode) is a great example of a positive step forward for inclusion, accountability, and action. Will's Birdbrain will return with more birdbrained facts in no time! Be sure to check out the Will's Birdbrain Instagram account for complementary episode photos and videos, plus many other awesome bird photos/stories! https://www.instagram.com/wills_birdbrain/?hl=enGot a favorite bird you'd like to hear discussed on the Podcast? Shoot Will an email and let him know what you'd like to hear, share a birding story, or just say what's up! Email inquiries - willsbirdbrain@gmail.comWill's Birdbrain has merch! Consider grabbing a sticker or two of your favorite common bird! Proceeds will go straight into funding more episodes and spreading the joy of birding!Shop - https://www.etsy.com/shop/WillsBirdbrain?ref=simple-shop-header-name&listing_id=1361667746Love the show, consider supporting me on Patreon! Your support and interest is extremely helpful and encouraging! The goal of the Podcast is to share the love of birds, so be sure to share with your friends and family too. Together let's show some love to these common critters that so often get overlooked. I cannot do it without you.Click the link to sign up: https://www.patreon.com/willsbirdbrainDon't forget to keep up with the common critters!
Do you ever wish you could tackle that never-ending to-do list in record time? Us too! In this episode, Carl Richards chats with Dr. Mike Van Thielen and they explore tricks and strategies for slashing your to-do list in half. Whether you're a busy professional, a parent juggling a million things, or just someone who wants more free time, we've got your back. Tune in and let's chat about the art of getting things done faster and smarter."Dr. Mike Van Thielen is a health and wellness expert, best selling author, international keynote and motivational speaker, and world record holder. He has been involved in optimal health practices, anti-aging and regenerative medicine, sports performance, nutrition, and supplementation for over three decades.As a top swimmer in his native Belgium, he gained interest in optimizing health and athletic performance. Dr. Van Thielen graduated from the University of Brussels (Belgium) in 1993 witha bachelor's degree in physical education and in 1995 with a master's degree in physical therapy. He served as the assistant coach and physical therapist for Belgian Olympic swimmers in preparation for the 1996 Olympic Games in Atlanta. Besides being well-versed in various health applications, Dr. Mike Van Thielen also holds various business and marketing certifications. He has vast business experience and a proven record of establishing and developing successful business operations.Dr. Mike has owned multiple anti-aging clinics in central and northeast Florida and developed a successful system to create customer loyalty that boosted new customer referrals and resulted in retaining more than 90% of existing customers. In 2008, he founded a company that certified health care professionals in health and wellness programs, sensible weight loss, and natural non-invasive cosmetic procedures, and trained over 1,000 professionals in just 5 years. Dr. Mike sold the business in 2014 and has since dedicated himself to biohacking and bioregenerative medicine applications.Connect with Mike:http://www.clarigenz.comFollow Mike on social media:Facebookhttps://www.facebook.com/clarigenzInstagramhttps://www.instagram.com/clarigenz/?hl=enGot a comment, idea for a topic, or would you like to be a featured guest on Speaking of Speaking? Reach out to Carl: askcarl@carlspeaks.ca And check out the website for more tips: https://carlspeaks.ca/Book Carl for your next summit, podcast, or live event:https://carlspeaks.ca/contact-carl/If you're a coach, consultant, subject matter expert or speaker and are looking to start your own podcast, Carl and his team can help you strategize a show that fits your brand and your budget. Head on over to Podcast Solutions Made Simple to get started:https://podcastsolutionsmadesimple.comand, don't forget to check out the brand new podcast! It's a podcast all about podcasting. So if getting into the podcast space keeps alluding you , this is the show for you! If you're a seasoned podcaster, this is the show for you! Check it out here:https://podcastsolutionsmadesimple.buzzsprout.com/Give it a listen, give us a rating, leave us a comment, and subscribe to the show wherever you get your podcast!
In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez, is joined by Professor Andrea du Bois. Prof du Bois completed his medical degree in 1987 at the University of Freiburg, Germany. He subsequently trained in general surgery at Krankenhaus Wolfach Personalwohnheim and gynaecology and obstetrics at the University of Freiburg, leading to his registration as Fellow for Gynaecology and Obstetrics in 1993. In 1993, Prof. du Bois became a Consultant in the Department of Gynaecology and Obstetrics at St. Vincentius-Kliniken, Karlsruhe. He then served as Director of the Department of Gynaecology and Gynaecologic Oncology, Horst-Schmidt-Kliniken, Wiesbaden (1999-2010) before taking up his current roles as Director of the Department of Gynaecology and Gynaecologic Oncology at Kliniken Essen-Mitte, and Associate Professor at Johannes Gutenberg University of Mainz, Germany. Prof. du Bois has been the Principal Investigator of several pivotal and practice-changing international clinical trials in gynaecological oncology. He founded the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) Study Group in 1993 and co-founded the European Network of Gynaecological Oncological Trial groups (ENGOT) in 2007. He has previously been a member of the German Guideline Committee for guidelines in breast, cervical, and ovarian cancer, Chairman of the German quality assurance programme for ovarian cancer (QS-OVAR), and member of the Gynecological Cancer InterGroup (GCIG) executive board and European Society of Gynaecological Oncology (ESGO) council. Prof. du Bois has been Chairman and a member of the Scientific Committee of the Ovarian Cancer Consensus Conference of the GCIG, and served as a member of the Scientific Committee of the 1st European Society of Medical Oncology (ESMO)-ESGO Ovarian Cancer Consensus Conference 2018. Prof. du Bois is a member of the American Society of Clinical Oncology (ASCO), ESGO, International Gynecologic Cancer Society (ISGC), German Cancer Society, and AGO. He has authored more than 500 publications with more than 33,500 citations, and has a Google Scholar h index of 86. Prof. du Bois has received multiple honours and awards in recognition for his work, including the Arthur Walpole Award (German Cancer Society, 2006), Ernst Wertheim Award (Austrian Society of Gynecologic Oncology, 2006), MD Anderson Madrid Lifetime Award (2016), Wilhelm-Warner Prize for Cancer Research (2019), German Cancer Prize (Deutsche Krebsgesellschaft, 2020) and honorary membership of the German Society for Gynecology and Obstetrics (2020); 2021 he received the ESGO Lifetime Achievement Award (European Society of Gynaecological Oncology).
Squiz Kids is an award-winning, free daily news podcast just for kids. Give us ten minutes, and we'll give you the world. A short podcast that gives kids the lowdown on the big news stories of the day, delivered without opinion, and with positivity and humour.‘Kid-friendly news that keeps them up to date without all the nasties' (A Squiz Parent)This Australian podcast for kids easily fits into the daily routine - helping curious kids stay informed about the world around them.Fun. Free. Fresh. LINKSRed panda falls from the sky … sort ofhttps://www.news.com.au/technology/science/animals/adelaide-zoo-red-pandas-dramatic-rescue-after-missing-for-two-days/news-story/89a5f791317af22f4907a13e4b78fc1fWant to hear Squiz Kids Shortcuts + Squiz The World podcasts? Teachers: Squiz Kids for Schools - Free 30 Day Trial: https://www.squizkids.com.au/squiz-kids-for-schools/Parents: Squiz Kids Apple Subscriber Content - Free Trial: https://podcasts.apple.com/au/podcast/squiz-kids/id1494238283Squiz Kids Instagram:https://www.instagram.com/squizkids/?hl=enGot a birthday coming up and you want a shout-out? Send us an email at squizkids@thesquiz.com.au
Squiz Kids is an award-winning, free daily news podcast just for kids. Give us ten minutes, and we'll give you the world. A short podcast that gives kids the lowdown on the big news stories of the day, delivered without opinion, and with positivity and humour.‘Kid-friendly news that keeps them up to date without all the nasties' (A Squiz Parent)This Australian podcast for kids easily fits into the daily routine - helping curious kids stay informed about the world around them.Fun. Free. Fresh. LINKSEverybody do the sploot: https://www.forbes.com/sites/brucelee/2022/08/11/can-splooting-help-beat-the-heat-heres-why-squirrels-are-heat-dumping/?sh=4649b24451f8Listen to the Squiz Kids Shortcut on the Circle of Life ..Want to hear Squiz Kids Shortcuts + Squiz The World podcasts? Teachers: Squiz Kids for Schools - Free 30 Day Trial: https://www.squizkids.com.au/squiz-kids-for-schools/Parents: Squiz Kids Apple Subscriber Content - Free Trial: https://podcasts.apple.com/au/podcast/squiz-kids/id1494238283Squiz Kids Instagram:https://www.instagram.com/squizkids/?hl=enGot a birthday coming up and you want a shout-out? Send us an email at squizkids@thesquiz.com.au
Squiz Kids is an award-winning, free daily news podcast just for kids. Give us ten minutes, and we'll give you the world. A short podcast that gives kids the lowdown on the big news stories of the day, delivered without opinion, and with positivity and humour.‘Kid-friendly news that keeps them up to date without all the nasties' (A Squiz Parent)This Australian podcast for kids easily fits into the daily routine - helping curious kids stay informed about the world around them.Fun. Free. Fresh. LINKSRoger Federer's tear-jerker adhttps://www.youtube.com/watch?v=57RpNFLTAZUListen to the Squiz Kids Shortcut on the Circle of Life ..Want to hear Squiz Kids Shortcuts + Squiz The World podcasts? Teachers: Squiz Kids for Schools - Free 30 Day Trial: https://www.squizkids.com.au/squiz-kids-for-schools/Parents: Squiz Kids Apple Subscriber Content - Free Trial: https://podcasts.apple.com/au/podcast/squiz-kids/id1494238283Squiz Kids Instagram:https://www.instagram.com/squizkids/?hl=enGot a birthday coming up and you want a shout-out? Send us an email at squizkids@thesquiz.com.au
Squiz Kids is an award-winning, free daily news podcast just for kids. Give us ten minutes, and we'll give you the world. A short podcast that gives kids the lowdown on the big news stories of the day, delivered without opinion, and with positivity and humour.‘Kid-friendly news that keeps them up to date without all the nasties' (A Squiz Parent)This Australian podcast for kids easily fits into the daily routine - helping curious kids stay informed about the world around them.Fun. Free. Fresh. LINKSSerena Williams - the GOAT: https://www.youtube.com/watch?v=YOG7kFR8Hp8Frankenstein's Monster: https://www.theguardian.com/artanddesign/2022/aug/09/frankenstein-monster-movie-prop-v-and-a-museum-battle?CMP=Share_iOSApp_OtherWant to hear Squiz Kids Shortcuts + Squiz The World podcasts? Teachers: Squiz Kids for Schools - Free 30 Day Trial: https://www.squizkids.com.au/squiz-kids-for-schools/Parents: Squiz Kids Apple Subscriber Content - Free Trial: https://podcasts.apple.com/au/podcast/squiz-kids/id1494238283Squiz Kids Instagram:https://www.instagram.com/squizkids/?hl=enGot a birthday coming up and you want a shout-out? Send us an email at squizkids@thesquiz.com.au
Squiz Kids is an award-winning, free daily news podcast just for kids. Give us ten minutes, and we'll give you the world. A short podcast that gives kids the lowdown on the big news stories of the day, delivered without opinion, and with positivity and humour.‘Kid-friendly news that keeps them up to date without all the nasties' (A Squiz Parent)This Australian podcast for kids easily fits into the daily routine - helping curious kids stay informed about the world around them.Fun. Free. Fresh. LINKSStar, or Salami? https://www.vice.com/en/article/akeemk/chorizo-james-webb-space-telescopeWant to hear Squiz Kids Shortcuts + Squiz The World podcasts? Teachers: Squiz Kids for Schools - Free 30 Day Trial: https://www.squizkids.com.au/squiz-kids-for-schools/Parents: Squiz Kids Apple Subscriber Content - Free Trial: https://podcasts.apple.com/au/podcast/squiz-kids/id1494238283Squiz Kids Instagram:https://www.instagram.com/squizkids/?hl=enGot a birthday coming up and you want a shout-out? Send us an email at squizkids@thesquiz.com.au
Squiz Kids is an award-winning, free daily news podcast just for kids. Give us ten minutes, and we'll give you the world. A short podcast that gives kids the lowdown on the big news stories of the day, delivered without opinion, and with positivity and humour.‘Kid-friendly news that keeps them up to date without all the nasties' (A Squiz Parent)This Australian podcast for kids easily fits into the daily routine - helping curious kids stay informed about the world around them.Fun. Free. Fresh. LINKSWorld Dog Surfing Championshipshttps://www.abc.net.au/news/2022-08-08/world-dog-surfing-championships-california/101311504Mexico's miniature frogshttps://www.bbc.com/news/science-environment-62271380Want to hear Squiz Kids Shortcuts + Squiz The World podcasts? Teachers: Squiz Kids for Schools - Free 30 Day Trial: https://www.squizkids.com.au/squiz-kids-for-schools/Parents: Squiz Kids Apple Subscriber Content - Free Trial: https://podcasts.apple.com/au/podcast/squiz-kids/id1494238283Squiz Kids Instagram:https://www.instagram.com/squizkids/?hl=enGot a birthday coming up and you want a shout-out? Send us an email at squizkids@thesquiz.com.au