Study of blood, the blood-forming organs, and blood diseases
How does a 1500 IU fixed dose of Kcentra stack up to FDA-approved variable dosing for reaching a specific INR target? Let's talk about it. Click HERE to leave a review of the podcast!Subscribe HERE!References:All references for Episode 78 are found on my Read by QxMD collectionDisclaimer: The information contained within the ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution, seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of, any medical institutions, educational facilities, or other healthcare programs.Support the show
In this week's episode new research suggesting that, in patients with transplant-eligible multiple myeloma, adding daratumumab to first-line combination regimens may be a more cost effective strategy than saving it for second-line use. We'll also review the work of researchers who applied base-editing technology to develop a complex and potent CAR T cell product for potential “off-the-shelf” use in patients with T-cell leukemias and other CD7-positive malignancies. Finally, we'll review a paper that elucidates the role of SETBP1 mutations in chronic neutrophilic leukemia, pointing the way toward a potential multi-pronged therapeutic approach to this rare myeloproliferative neoplasm.
Dr. Jackie Damen is a currently a Principal Scientist in Scientific Support for Hematology at STEMCELL Technologies, and was previously the Director of Contract Assay Services. She talks about the company's culture and growth, and how in her role, she teaches scientists and helps them conduct their experiments. She also discusses systems for drug screening and discovery, opportunities in industry, and her affinity for microscopy and photography.
Juan Pablo Alderuccio, MD, assistant professor of medicine in the Division of Hematology, Department of Medicine at the Sylvester Comprehensive Cancer Center of the University of Miami Miller School of Medicine in Florida, spoke with CancerNetwork® about his review published in the journal ONCOLOGY® titled, Current Treatments in Marginal Zone Lymphoma. In the article, Alderuccio explored current approaches to the diagnosis and treatment of marginal zone lymphoma. He also touched on his strategies for treating localized versus advanced disease and novel emerging strategies clinicians practicing in the community should be aware of. Don't forget to subscribe to the “Oncology Peer Review On-The-Go” podcast on Apple Podcasts, Spotify, or anywhere podcasts are available.
In this episode of Hematopoiesis, Dr. Alexis Caulier has exciting conversations with three experts in the field about how early bench work on the genetic regulation of fetal hemoglobin led to the development of bedside gene therapies. Dr. David Nathan revisits the beneficial role of fetal hemoglobin to improve the clinical manifestations of hemoglobinopathies. Dr. Vijay Sankaran (@bloodgenes) highlights the great impact of studying gene regulatory networks in developing innovative gene therapies, and Dr. Courtney Fitzhugh (@CourtneyFitzhu1) emphasizes the importance and the specificities of clinical trials for innovative therapies.Music: “Somebody New” RYYZN (www.toneden.io/ryyzn/post/somebody-new-copyright-free). Licensed under Creative Commons: By Attribution 3.0 creativecommons.org/licenses/by/3.0/.
In this week's episode we'll discuss the factors influencing the development of immune thrombocytopenia after administration of the ChAdOx1 nCov-19 vaccine, learn about the genomic features underlying anti-CD19 CAR T-cell treatment failure in lymphoma, and introduce a new predictive model for risk assessment before CAR T-cell therapy for large B-cell lymphoma.
As we see an increasing number of culturally diverse patients in our practices, there is no doubt of the importance of cultural competency in medicine. Specific circumstances and miscommunications have been well documented. But how can we develop an eye to see where a patient’s values and worldview may differ from our own? We will review an approach to cultural competency highlighted by medical missions case studies.
Analizamos junto a colegas hematólogos las guías de la Sociedad Americana de Hematología para el tratamiento de la Enfermedad Tromboembólica Venosa: TVP y TEP Ortel TL et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv (2020) 4 (19): 4693–4738. https://doi.org/10.1182/bloodadvances.2020001830 Invitados: Dra. Luz Hermila González Figueroa. Hematología pediátrica con alta especialidad en hemostasia y trombosis. Dr. Noé Benjamín Vega Tapia. Hematología de adultos. Anfitriones: Dr. Rodrigo Garza Herrera Dra. Davinia Elizabeth Sámano Saucedo
In this week's episode we review a novel approach to generating autologous CD7-specific CAR T therapy for patients with T-cell malignancies that overcomes a key limitation: target-driven fratricide. We'll also learn about new research pinpointing a key subset of exhausted CD4+ T cells in B- ALL, which also provides a rationale for combining tyrosine kinase inhibitors and PD-L1 blockers to reverse exhaustion and enhance leukemia clearance. Finally, we'll discuss studies in a mouse model of acute ischemic stroke, showing that inhibiting phosphorylation of a tight junction protein in endothelial cells reduces risk of intracranial hemorrhage after treatment with recombinant tissue plasminogen activator.
ASCO: You're listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the voice of the world's oncology professionals. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guests' statements on this podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so data described here may change as research progresses. In the Research Round Up series, ASCO experts and members of the Cancer.Net Editorial Board discuss the most exciting and practice-changing research in their field and explain what it means for people with cancer. In today's episode, our guests will discuss new research in multiple myeloma, breast cancer, and cancer in adults 60 and over that was presented at the 2022 ASCO Annual Meeting, held June 3-7. First, Dr. Sagar Lonial discusses a study on treatment for newly-diagnosed multiple myeloma in people under 65. Dr. Lonial is a professor of Hematology and Medical Oncology at Winship Cancer Institute at Emory University, where he also serves as Department Chair. He is also the Cancer.Net Associate Editor for Myeloma. View Dr. Lonial's disclosures at Cancer.Net. Dr. Lonial: Hello, I'm Dr. Sagar Lonial from the Winship Cancer Institute of Emory University in Atlanta, Georgia. And today I'm going to discuss one of the Plenary abstracts at ASCO 2022, which was the DETERMINATION study, again, presented at the ASCO Annual Meeting. For the sake of disclosure, I just want to make sure I list that I was an investigator on this study. I also have consulting relationships with Takeda, Celgene, BMS, Janssen, and other companies that have agents in the context of multiple myeloma. So the reason I want to talk about this study today is I think it's a really important study that was designed over a decade ago to really ask the question, with a really powerful induction regimen that uses what we now call the RVd regimen, lenalidomide with bortezomib and dexamethasone, do you really still need to have high-dose therapy and autologous transplant as part of the treatment approach? And so the trial was a very simple randomized trial that everybody received RVd induction. And then there was a randomization between early transplant and then going on to consolidation and continuous lenalidomide maintenance versus no transplant going on to consolidation and lenalidomide maintenance. So both arms actually received continuous lenalidomide maintenance, which is really one of the important endpoints of this study overall. And the reason I say that is there was a smaller study done in France a few years previous to this where patients only received 1 to 2 years of lenalidomide maintenance. And in that trial, clearly the use of transplant was better. And the remission duration for the group that received the transplant was about 48 months. So the question was, with continuous lenalidomide maintenance, can you make that longer? So randomized trial, over 600 patients were randomized between these 2 arms. And the follow-up now is somewhere around 7 years in total. And what was demonstrated both in the ASCO Annual Meeting as well as in the paper that came out at the same time in the New England Journal of Medicine was that the remission duration was clearly longer in the group that had the transplant than the group that did not, even with both arms receiving continuous lenalidomide maintenance. And it was almost 66 months in the group that received the transplant, 21 months longer, almost 2 years longer than the group that did not receive the transplant. And so I think this is really important because what it says is that even in an era of really good induction therapy, transplant continues to offer significant benefit in terms of progression-free survival. Now, the reason progression-free survival is so important in this study is that we know that no time is more sensitive for treatment of myeloma than that first time we treat the patient. And so prolonging that first remission is really important because the disease is at its most sensitive at that time point. Now, there were questions about overall survival. Should we see an overall survival benefit? And I'll tell you, A, this trial was never designed to measure an overall survival benefit. And, B, the median survival for myeloma patients is now between 10 and 15 years on average. And so with only 7 year follow-up, it seems to me unrealistic to expect this to have a survival benefit at this early time point. So rather than saying there's no difference in overall survival, I think it's a fair statement to say at the short follow-up we have, there is no difference in survival. But I actually don't think survival is the right endpoint for newly diagnosed myeloma trials in fit patients because we do have so many important treatments to discuss. Now, there was also discussion about adverse events. Obviously, the quality of life during the transplant dropped a little bit. Not a big surprise. That lasted about 2 to 3 weeks, and then quickly, by 3 months out, returned back to baseline for almost every patient in the study. Additionally, there was a concern about second primary malignancies. If you look at this data, it's really no different than what we saw in the French study. There was a slightly higher risk of second primary malignancy, but we know that this is the case not only in myeloma, but in patients who receive alkylate-based therapy. And despite that, the progression-free survival was 2 years longer in the group that received the transplant than the group that did not. So I think, in summary, this is really an important trial because there are many groups that are making the case that perhaps we don't need transplant in this modern era of myeloma therapy. And I think that it's important to recognize that what we're looking at are not short-term endpoints. We're not looking at early MRD (minimal residual disease) negativity. What we're looking at is really ultimate measurement of clinical benefit, which to me is prolonging that first remission as long as you can. And so this trial clearly demonstrates that for young, fit patients, transplant continues to offer significant benefit, almost 2 years of benefit with continuous lenalidomide maintenance. And while there's a push to say perhaps we can think about which patients may or may not need a transplant, honestly, as clinicians, we're not good enough to make that prediction. And what I think is really important is that we not lose sight of trying to prolong that first remission with the best tools that we have. And I think even in this modern era of 2022, high-dose therapy and autologous transplant continues to be one of those tools, and we want to use it to maximize the duration of that first remission. So thank you again for listening to this brief summary of the DETERMINATION trial presented at the 2022 ASCO Annual Meeting and published in the New England Journal of Medicine. ASCO: Next, Dr. Norah Lynn Henry discusses new treatment advances for people with metastatic breast cancer, as well as 2 studies in early-stage breast cancer. Dr. Henry is an Associate Professor in the University of Michigan's Division of Hematology/Oncology in the Department of Internal Medicine and is the Breast Oncology Disease Lead at the Rogel Cancer Center. She is also the Cancer.Net Associate Editor for Breast Cancer. View Dr. Henry's disclosures at Cancer.Net. Dr. Henry: Hi. I'm Dr. Lynn Henry, a breast cancer oncologist from the University of Michigan Rogel Cancer Center. Welcome to this quick summary of updates in breast cancer from the 2022 ASCO Annual Meeting. I have no conflicts of interest for any of the trials that I will talk about. First, I'm going to give a very brief overview of the types of breast cancer, then talk about some research that was presented on both metastatic and early-stage breast cancer. As a reminder, there are multiple kinds of breast cancer. Some breast cancers are called hormone receptor-positive or estrogen receptor-positive and are stimulated to grow by the hormone estrogen. We typically treat those cancers first with antiestrogen treatments, which block estrogen or lower estrogen levels. Other breast cancers are called “HER2 positive.” These are often more aggressive cancers, but because they have extra copies of HER2, they often respond to treatments that block HER2. Finally, there are breast cancers that don't have hormone receptors or very much HER2. These are called triple-negative breast cancer and are also often aggressive cancers. One of the biggest stories from the ASCO Annual Meeting was the results of the DESTINY-Breast04 trial. In this trial, researchers studied a type of medication called trastuzumab deruxtecan, which is also called Enhertu. This drug is a combination of the anti-HER2 antibody, trastuzumab, plus a chemotherapy drug, and the antibody targets the drug to the cancer sort of like a guided missile. Trastuzumab deruxtecan is currently routinely used to treat patients with metastatic HER2-positive breast cancer. Now, the interesting thing is there was already data from studies that suggested that this drug might also work against breast cancers that have some HER2 receptors on the surface of their cells, but not so many that they meet the true definition of being HER2 positive. For the DESTINY-04 study, patients' tumors had to have either 1+ or 2+ HER2, which some people called “HER2 low,” and could be either estrogen receptor positive or negative. Two thirds of the patients were treated with trastuzumab deruxtecan, and the other one-third were treated with 1 of 4 different standard chemo regimens that their physician thought was the best treatment option for them. Treatment with trastuzumab deruxtecan was shown to lengthen the time people were able to remain on treatment. Importantly, it was also shown to increase the overall survival of patients compared to standard chemotherapy by more than 6 months for patients with estrogen receptor-positive cancer and by more than 10 months for patients with estrogen receptor-negative cancer. Since this is a drug that we currently use to treat patients with other types of cancer, we actually know a lot about its side effects. One key toxicity is it can cause a very severe inflammation of the lungs in a very small subset of patients. So this is something that we have to watch for very carefully. Otherwise, it is a relatively well-tolerated drug, especially compared to standard chemotherapy. The main side effects are nausea and fatigue. Another clinical trial presented at ASCO called TROPiCS-02 also studied a drug that is currently used to treat a different type of breast cancer. In this case, the drug is sacituzumab govitecan, also called Trodelvy. It is also a combination of an antibody that is targeted against cancer cells plus a chemotherapy drug. Sacituzumab govitecan is currently approved to treat metastatic triple-negative breast cancer. In the TROPiCS-02 trial, however, it was tested to see how effective it is for treating hormone receptor-positive, HER2-negative metastatic breast cancer. All of the patients enrolled in this trial had already been treated with antihormone therapy medications as well as at least 2 chemotherapy regimens. Half of the patients were randomized to treatment with sacituzumab govitecan, and the other half were treated with 1 of 4 standard chemotherapy drugs that their physician thought was the best for them. Those patients who were treated with sacituzumab govitecan had a longer time on average that the treatment worked compared to those who received standard chemo. They also had improved quality of life based on responses that the participants themselves provided on questionnaires. Although the overall benefit was rather modest, this drug may represent a new treatment option for patients with hormone receptor-positive, HER2-negative metastatic breast cancer, although at this time it isn't yet approved for treatment of this type of breast cancer. Both of these are examples of being able to take drugs that have been shown to treat 1 type of cancer and potentially expand it so that they can be used to benefit more patients with breast cancer. These drugs are also being tested to see if they are beneficial for treating early-stage breast cancer. So we await more hopefully very exciting results in the future. To switch gears a little bit, I'll now talk about another study I found interesting. This one is in the setting of early-stage breast cancer. So typically, radiation therapy is recommended after lumpectomy since it reduces the likelihood of cancer returning in the breast. However, questions have arisen about how much benefit radiation is actually providing for some patients whose risk of having cancer return in the breast is really low to start with. Therefore, these patients may be at risk of the side effects of radiation as well as other risks, such as financial problems, without actually getting much benefit from the treatment. Therefore, this trial, called LUMINA, evaluated whether radiation therapy was beneficial after lumpectomy for patients who have small, low-risk breast cancers and no lymph node involvement. The trial included 500 women who were at least 55 years of age with invasive ductal cancers that were no more than 2 centimeters in size. They had to be estrogen receptor-positive, HER2-negative, either grade 1 or 2, and Ki-67 low. Everyone had to be planning to take antihormone therapy for at least 5 years. During the 5-year follow-up period, a total of 10 patients out of 500, about 2.3% of all patients, had their cancer return in the breast. The researchers therefore concluded that for patients with this type of very low-risk breast cancer, it is reasonable to omit radiation therapy and just take endocrine therapy. Similar results have previously been shown for patients over the age of 70 with small lymph node-negative low-risk cancers, but this trial expands that option to patients who are as young as 55. Finally, I will touch briefly on the updated results from the ABCSG-18 clinical trial. So this trial enrolled postmenopausal women with early-stage estrogen receptor-positive breast cancer who are being treated with aromatase inhibitor therapy. Aromatase inhibitors are known to cause reductions in bone density. This trial therefore evaluated a medication called denosumab, also called Prolia, which is used to treat osteoporosis. Participants were randomized to treatment every 6 months with either denosumab or a placebo. They found that the patients who were treated with denosumab were half as likely to have a bone fracture. Importantly, patients treated with denosumab also had an improvement in bone density despite taking the aromatase inhibitor medicine, whereas those who received placebo had a decrease in their bone density over time. The other very interesting thing from this study is that patients who received treatment with denosumab were less likely to have their breast cancer return or to develop a new cancer during the 8-year follow-up period. So it's actually already recommended that postmenopausal patients with all types of early-stage breast cancer consider treatment with a different type of bone strengthening medicine called a bisphosphonate as part of their breast cancer treatment. The goal is to further reduce their risk of cancer returning. These new results will now lead experts to debate whether to also include denosumab as a potential additional breast cancer treatment option, not just to help protect people's bone density. There were a lot of other research findings presented that were related to treatment for both early-stage and metastatic breast cancer at the meeting. Importantly, we got glimpses of the many new drugs on the horizon for treatment of breast cancer, and we eagerly await the results of large, randomized trials so that the drugs that work can be used to care for patients with breast cancer. But for now, that's it for this quick summary of important research from the 2022 ASCO Annual Meeting. Stay tuned to Cancer.Net for future updates from upcoming breast cancer conferences. Thank you. ASCO: Thank you, Dr. Henry. Finally, Dr. Shakira Grant discusses 3 studies that looked at cancer in people 60 or older. This field is also known as geriatric oncology. Dr. Grant is an Assistant Professor in the Divisions of Hematology and Geriatric Medicine at the University of North Carolina at Chapel Hill and a board-certified Geriatric Hematologist/Oncologist. View Dr. Grant's disclosures at Cancer.Net. Dr. Grant: Hi, everyone. I am Dr. Shakira Grant. And I'm an assistant professor at the University of North Carolina at Chapel Hill. I'm also a clinician scientist with a focus on social disparities and how they influence the health and aging of older adults with cancer, primarily multiple myeloma. And for today's talk, I have no relevant conflicts of interest to disclose. It's such a pleasure to be able to talk today about the ASCO 2022 geriatric oncology and presenting key studies, which I believe were really practice-changing or really set up the foundation for informing future research directions. And to start us off, I wanted to start us with abstract 12012 by Dr. Mackenzie Fowler. And this was presented based on the University of Alabama at Birmingham's actual research group. And the title of their presentation was “Rural-Urban Disparities in Geriatric Assessment Impairments and Mortality Among Older Adults with Cancer.” And this was the result of a large registry study, predominantly patients with gastrointestinal cancer-- so cancers such as liver cancer, colon cancer. And what the authors really wanted to do here was to explore if whether or not living in a rural location, for example, is associated with having an impairment based on what people report in their ability to function at home, their quality of life. And they also wanted to see whether or not where you live, meaning a rural location, whether that can be associated with how long you are expected to live or your overall survival. So this was really a study that took patients who were truly older. There were patients who were above the age of 60. As I mentioned, these were patients predominantly with cancers of the liver, the colon, and the pancreas. And patients completed a baseline, what we call a geriatric assessment, to try to assess their overall or global health. And on these assessments, patients are asked questions about how they would rate their physical function and their quality of life. And what the authors found here is that in general, when patients lived in rural areas, this was associated with patients self-reporting more functional deficits, meaning that they reported that they had impairments in the ability to function at home from a physical perspective. They also had impairments in quality of life—so how you rate your general life and how you're doing from a day-to-day basis. And this was impaired if you lived in a rural residence. And then, importantly, this study also showed that living in a rural location—and, again, this study was centered in Alabama—that that was also associated with a reduced overall survival, meaning that people were found in rural areas to live a shorter life with these cancers compared to those who live in non-rural places or, as we call it, urban. And I think why I chose this particular study is because it's one of the first studies using a large data set of almost 1,000 patients that they have enrolled and really looking at the idea of the physical environment, so where a person lives, and how that really interacts with everything else to influence the health of an individual. And this study, I believe, really lays the foundation for an area of work in geriatric oncology where we are moving away from just thinking about the older adult, but we're also thinking about the older adult and the other identities. So we're really considering the sociocultural influence. So we think about race. We think about socioeconomic status, income. But now, we're also including the physical environment. And that is where people are living and spending the majority of their time. And that is in this study classified as rural-urban residency. So for this study, overall, I would say that this is really moving the field forward in a direction where we're moving away from just looking at just older adults, but we're thinking about older adults and all of the other stressors that they face, especially when they live in the community and how that impacts their health. The next study that I wanted to highlight was a study that was performed by Dr. Heidi Klepin at Atrium Health, Wake Forest Baptist. And this was a study that looked at evaluating the association between an electronic health record-embedded frailty measure and survival among patients with cancer. Again, this was an older adult population. It was just over 500 patients involved, and patients were over the age of 65. They had a new diagnosis of the most common cancers, which are lung cancer, colon cancer, and breast cancer. And the good thing about this particular study is that it sought to use data that is readily captured in the electronic health record to characterize a patient as fit, prefrail, and frail. So why is that important for the geriatric oncology community and even beyond is when we're dealing with older adults, we're always thinking about ways in which we can actually characterize their fitness and their ability to hence tolerate their therapies, being chemotherapy, and how likely they are to die if they're having these functional impairments. And so importantly, what this study showed was that in their sample, they found that up to 17% of people were characterized as frail using this index. And the significance of this finding is that when they looked at how long people were likely to live with these cancers, breaking it down according to if you were fit, prefrail, or frail, those who were frail had the shortest overall survival. So it means the time from which they were diagnosed until they die was much shorter than any of the other categories. And that equated to a difference between those who were fit and those who were prefrail of 10 months for those who were frail for overall survival and more than 54 months for those who were actually considered to be fit. So this is really, really important because what we are seeing is that if you are really fit, you are living on average with these cancers—the overall survival, at least for their institution, was more than 54 months. But then as you move across that spectrum of fitness, we're actually seeing that your survival decreases significantly. And so why is this important? So this is important because it's one of the first studies that is actually looking to operationalize the frailty measure for us to be able to potentially use and adapt into other health systems using data that we already collect. So it's no longer burdensome on patients to try to fill out additional forms or for other staff to be involved and collect this data. And this data is showing us that there is an association with this particular frailty index and the ability to predict overall survival-- so, again, a critical study in the geriatric oncology population looking at patients with the 3 most common types of cancer, which are lung cancer, colon cancer, and breast cancer, and really showing us that there is a way potentially to operationalize how we characterize the fitness level of an older adult and then using that data not just to say, "Yes, this person is frail," but for us in real-time to see results where we can see that there is a significant difference in terms of overall survival. Importantly, this is going to be a study where we continue to watch closely the developments over the next few years, especially as the authors and the research team note that their next steps involve looking at how to study how these frailty measures, or the frailty scores that people get when they come in and they're at baseline, how this changes throughout the course of treatment. And that has a lot of implications because now, we have the potential to start thinking about using a frailty-adapted approach to caring for older adults with cancer. What that means is when you're getting your treatment and we are following these scores, as we see things changing, this may be an indicator to us that, "Hey, we need to make some modifications in response to these frailty measures to make sure that our older adult population is able to tolerate their chemotherapies and have maximum benefit while also enjoying a good quality of life." So finally, I want to highlight this third study. And this was a study that was presented by Dr. Etienne Brain. And. Dr. Etienne Brain was also this year's B.J. Kennedy Award recipient. And each year ASCO recognizes the B.J. Kennedy Award recipient as an outstanding investigator who has made significant contributions in the area of research and clinical care of older adults with cancer. In this particular study, Dr. Etienne presented on behalf of his team the final results from a study that was looking at using endocrine therapy with or without chemotherapy for older adult women, so characterized as those who were over the age of 70, with a diagnosis of estrogen receptor-positive, HER2-negative breast cancer. And the importance for this study is that the question they sought to examine was whether or not patients who are in this age range still derive a benefit from receiving chemotherapy in addition to endocrine therapy. And what this study really showed is that there was no survival difference. Meaning when they looked at the data for 4 years, those who got chemotherapy plus endocrine therapy lived just as long as those who also just got endocrine therapy alone. And why this is important is because when you think about giving chemotherapy to an older adult population, as oncologists, we are always weighing the risks and the benefits associated with treatment. So we're always thinking about how tolerable is this drug likely to be? We want to minimize side effects because, at the end of the day, our goal is to treat the cancer, but we also want to focus in on the outcomes that matter most to the older adult population. And in general, these are things like maintaining your mobility, maintaining your mentation, maintaining good quality of life. And so we really want to make sure that we're balancing those risks. And this is why this particular study showing that with chemotherapy or without chemotherapy added to endocrine therapy, there seems to be no survival difference. This could be a way in which we move the field forward in thinking about a select group of patients with breast cancer and whether or not those patients truly need that extra toxicity or burden associated with using chemotherapy or whether endocrine therapy is enough. So with that, I will say across these 3 studies, even though they study different things-- we saw 1 study that looked at the intersectionality between older adults in terms of their chronological age but now starting to examine the influence of physical or social context and how that influences the health and outcomes for individuals with primarily gastrointestinal cancer. We also looked at the development of an electronic frailty index in patients with 3 most common solid tumors - lung cancer, colon, and breast cancer - and found that by using this frailty index collecting readily available data, that there was an association with predicting overall survival. And we saw that those who were characterized as frail had one of the shortest overall survivals. And then finally, in this study, looking at endocrine therapy alone versus chemotherapy and endocrine therapy, we saw that there was no survival difference again in an older adult population. And so what we are seeing here is a theme emerging as the importance of comprehensive evaluations of older adults and the importance also of these measures, when integrated across the research continuum, that they are useful in terms of predictive prognostic abilities and really lay the foundation for future research. So with that, I want to thank you for your time and thank you for listening. ASCO: Thank you, Dr. Grant. You can find more research from recent scientific meetings at www.cancer.net. Cancer.Net Podcasts feature trusted, timely, and compassionate information for people with cancer, survivors, and their families and loved ones. Subscribe wherever you listen to podcasts for expert information and tips on coping with cancer, recaps of the latest research advances, and thoughtful discussions on cancer care. And check out other ASCO Podcasts to hear the latest interviews and insights from thought leaders, innovators, experts, and pioneers in oncology. Cancer.Net is supported by Conquer Cancer, the ASCO Foundation, which funds lifesaving research for every type of cancer, helping people with cancer everywhere. To help fund Cancer.Net and programs like it, donate at CONQUER.ORG/Donate.
In this week's episode we first review new work revealing the critical role of the tension-sensitive cation channel PIEZO1 in the transendothelial migration of leukocytes. We'll also review new research suggesting that CD8+ T-cells dimly expressing the CD4 antigen are increased in patients with various forms of secondary HLH, a finding that may have diagnostic, prognostic, and therapeutic significance. Finally, we'll review a large, genome-wide association study identifying the ABO O blood group as a novel risk factor for heparin-induced thrombocytopenia—a finding that could have implications for prediction of this syndrome and for the management of related conditions.
ASCO: You're listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the voice of the world's oncology professionals. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guests' statements on this podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so data described here may change as research progresses. The beginning of the COVID-19 pandemic brought with it confusion, fear, and uncertainty for most people around the globe. These feelings were often heightened for people with cancer as they experienced disruptions or changes in care, such as following greater safety precautions at their treatment centers, having their appointments shifted to televisits, and facing delays in recommended cancer screenings. As a response to the COVID-19 pandemic, Cancer.Net developed several resources for people with cancer, including its post “Coronavirus and COVID-19: What People With Cancer Need to Know,” written by Dr. Merry Jennifer Markham. After publishing this post on March 3, 2020, Dr. Markham reviewed and updated the post for 650 days straight to make sure people with cancer were receiving the most up-to-date and relevant information about COVID-19. The post went on to receive the Award of Distinction from the eHealthcare Awards in the Best COVID-19 Pandemic Related Communications category and was translated into Spanish, Portuguese, Russian, and Arabic. In this podcast, ASCO's Chief Medical Officer, Dr. Julie Gralow talks with Dr. Markham about her role in creating information for people with cancer throughout the pandemic, how the pandemic has shifted her perspective, and where she sees the future of the pandemic response headed. Dr. Gralow: Hello. I'm Dr. Julie Gralow, ASCO's Chief Medical Officer. Today, I'm talking with Dr. Merry Jennifer Markham, an ASCO volunteer and the Cancer.Net Associate Editor for Gynecologic Cancers. Cancer.Net is the patient information website of ASCO. Dr. Markham is also chief of the University of Florida, Division of Hematology and Oncology, a clinical professor in the University of Florida College of Medicine, and the associate director for medical affairs at the University of Florida Health Cancer Center. Dr. Markham played a key role in ensuring that ASCO provides up-to-date information about COVID-19 for patients, survivors, and caregivers through Cancer.Net. Since March 2020, she devoted a remarkable amount of time and energy to this endeavor, including a stretch of 650 straight days of reviewing and updating our patient information about coronavirus. Wow. That's true dedication, Merry Jennifer. So I would like to kick it off to you, Merry Jennifer. First of all, thank you so much for everything you've done during these past couple of years in keeping our Cancer.Net website up to date for patients during these incredibly challenging times. I'm looking forward to having a conversation with you about all of this. Dr. Markham: Thank you so much. It's been an honor and a pleasure. And the Cancer.Net team has been just fantastic to work with. Dr. Gralow: Great. Glad to hear it. So Merry Jennifer, when you suggested that ASCO provide some patient-focused content on COVID and cancer, did you think we'd still be talking about this 2 years later? Dr. Markham: Oh, I had no idea what to expect. No. I think I, like many of us, thought that this would be a very time-limited event and maybe by the Christmas time of 2020, that we would be done. We were all, of course, disappointed to learn that that was not how a pandemic plays out, but I definitely had no idea what my one email to the group would lead to. Dr. Gralow: What do you remember about March of 2020? Dr. Markham: It was a really scary time and a very uncertain time. None of us really knew what was going to come. We were watching how the pandemic or just the viral infection was playing out at the time in other countries, but really, we're not sure what was going to happen to our patients. And I was coming off a stint, I believe - the timing is a bit of a blur - on the communications committee for ASCO. And communications is something that I am passionate about, cancer communication with patients and with other colleagues. And I recall being in clinic and answering questions from patients. And really, it felt like there needed to be some broader level of communication that our patients could refer to you but also colleagues and people around the world. That's what I remember. And I remember reaching out and saying, "Hey, I wonder if maybe ASCO should do something." I didn't intend to volunteer myself to do something, but somebody needed to jump in, and I was ready. Dr. Gralow: Well, I was still practicing at the time, and I know all the different questions that we were getting. It was such a confusing time. We didn't have information. It was changing on a daily basis. I'm impressed that you thought that we were going to be dealing with this maybe even until the end of 2020 because I was thinking, "Oh, 3 or 4 weeks. We can all quarantine for 3 or 4 weeks. Right?" And here we are more than 2 years later. So you worked on the content for 650 days straight. I mean, every single day for 650 days, you looked to make sure that what we had on there was accurate, and now we backed off a little. But you're still looking at the content a couple of times a week. How has that level of focus on COVID-19 affected your perception and experience of the pandemic? Dr. Markham In the very beginning, the content was really updated daily. I think something was changing on a daily basis. And so it became part of my morning habit, first thing in the morning with a cup of coffee if I had time for that, to read whatever was happening in the news that day and just paying attention to where we were headed, knowing that there would be changes. In the beginning, there was not enough masks, so we weren't recommending everyone “Go out and buy surgical masks." And then the policies changed on that as we had plenty of masks and then, of course, vaccines and so on and so forth. I think I felt, like many people, a loss of control when the pandemic happened. Right? I think that so many people felt the sense of loss and the sense of uncertainty. And it reminded me actually of what patients with cancer probably experience with a new diagnosis, the sense of loss and uncertainty for what the future holds. And I think like many of my patients who really want to dive in deep to the research of their own cancer and treatment course, it actually gave me a sense of comfort to delve deep into the facts of what we were learning on a daily basis about COVID. Having that knowledge at my fingertips and being able to put it into layman's terms really did help me, I think, not become emotionally tied up in all of the sadness of the pandemic and the loss of travel and the loss of being able to be with loved ones. So for me, it was a little bit of a coping mechanism, I think. I didn't realize that at the time, but in hindsight, I really think it was. Dr. Gralow: So becoming a true expert in COVID and cancer was your coping mechanism. That's interesting because you were the leading authority here on what everyone was recommending. Do you have any particular moments, good or bad, that really stand out for you from those early days? Dr. Markham: I think what stands out the most is we focus so much on science as practitioners of oncology and in these health professions and as scientists. And I remember being very disappointed and hurt whenever I encountered someone, whether it was a patient or a family member or a colleague or-- not colleague but acquaintance, perhaps, who didn't believe that this was a real thing. And I was really pouring my heart and soul into the work of providing patient education on this and trying to do the same in my own clinic and with my own family members. And to have people brush it off as a non-thing, it was hurtful, and it was also just very disappointing as a physician and scientist. Dr. Gralow: And things were changing fast. Now, you yourself ended up with a COVID diagnosis at the end of 2021. Did that personal experience change the way you viewed ASCO's roles in supporting people with cancer throughout the pandemic? Dr. Markham: So I was minimally symptomatic, which was really thanks to science and thanks to the vaccines and having boosters. So number 1, it was very mild. But like many people who have a diagnosis that's new to them, I was nervous. And so I did feel reassured, though, because I had a pretty good understanding of what was happening and what was going to happen, and I knew that I was protected because of the vaccine and boosters. But it can be a scary time, and I think that it just gave me a little more insight into what people who I've taken care of, who have cancer and then have experienced a COVID diagnosis, have felt. Unlike my patients with cancer, I'm not immunocompromised, so I felt pretty comfortable. But it can certainly be scary. And I did have that appreciation for-- not just the infection but having to isolate myself from my family, I think that really was the hardest part and the inconvenience of it. Dr. Gralow: Well, I'm glad you just had a mild case, and hopefully, you have no residual symptoms. But it is interesting when you have, either within your family or yourself, a personal confrontation, either with COVID or with cancer, that it gives you a different perspective. Dr. Markham: Absolutely. That is so true. Dr. Gralow: So we're now 2-plus years into the pandemic. I know you don't have a crystal ball, and I know we've thought we were on the downswing and things picked up again. But where do you see this going? I mean, not just COVID itself but public health, immunizations, the whole pandemic awareness. Where do you see this going in the U.S. and worldwide? We've had the flu coming around every season. We didn't wear masks. We have vaccines. Not everybody got vaccines. What are we going to learn from all of this, and where do you see the future will be? Dr. Markham: I think that one of the major learning experiences that all of us who are in medicine and health care and those in health communication and health policy-- what we have learned is that science communication really does matter, and it's hard to do it in a very rapid-fire pace and do it well. But I think we've all seen examples of how communication around factual data and removing misinformation is actually critical. I would love to see this pandemic go away, but I think that what we've seen over the last couple of years with the new variants coming out, it's clear that we're not going to have 99% of our population vaccinated. I think, really, on all fronts, vaccination uptake is not that high. So there will be people who are either unable or unwilling or who will defer getting vaccinated. And unfortunately, this will lead to these waves of new variants coming like the current variant that is circulating. But I do think that there is hope. One of the reasons that a lot of my patients delayed getting vaccines in the beginning-- many of mine did, but there were some holdouts who really were not comfortable getting vaccinated. There is now more time. And so we do have more safety data, and we know that the vaccinations are safe against-- the COVID vaccinations are safe. So I think that I have seen more patients in those last 6 months become vaccinated. They were holdouts initially, and now more are doing it. And I'm hopeful that this trend will continue. I do think there are pockets where we are seeing vaccination rates start to pick up again. I don't know. I'm happy to keep reviewing content, though, and updating. The updates have become a little less frequent, which is great. I love when our focus on updating is really on new therapies and new vaccines and new vaccine sequences and schedules. So I think we're in a fairly stable place - knock on wood - right now. Dr. Gralow: In our immunocompromised population, which is only a subset of all of our patients with cancer, do you think we'll see more mask wearing in the future? Dr. Markham: I do. I do think that actually this is one area where we, as a culture, have probably begun to shift in the United States and especially among people who have a personal risk or a family member with a risk factor that might increase their chances of severe COVID. Just a personal anecdote. I traveled internationally for the first time since COVID a couple of weeks ago, and my entire family, all vaccinated and boosted, wore our masks, as it's the federal requirement to do so on planes. However, we landed in an international location where that was not a requirement. None of us wanted to take our masks off. We felt more comfortable, and I saw a lot of people who also remained masked even though it was not a requirement. So I do think there's a shift in this culture. I'm as tired of the masks as anyone, but it really does have a protective measure and is, I think, important, especially for our patients who have a weakened immune system or other medical risk factors for developing COVID or other infectious diseases. Dr. Gralow: So kind of in closing, you did such tremendous work for ASCO, for our patients with these regular updates. But what's the experience meant to you as an ASCO member and a member of the oncology community? Dr. Markham: I joined ASCO when I was a fellow, and I was taught the importance of our organization by my faculty members and my mentors. And as soon as I realized I could, I volunteered to serve on ASCO committees and task forces. And it has been one of the most rewarding parts of my career. And it's something that I encourage junior faculty and fellows to do as well. ASCO is such a leading voice. It is the leading voice for oncology care globally. And just the opportunity to contribute something back has really meant the world to me. It's been an honor to be able to do this work. Dr. Gralow: Well, on behalf of ASCO, I want to thank you again for all of your commitment to this. We're thrilled to have you as a volunteer, and we will continue to call on you as a volunteer. Really appreciate that. And I do know that throughout the COVID-19 pandemic, a lot of what ASCO was posting, a lot of the webinars we had, etc., were being used around the world. And you contributed majorly to that as well. So for that, I thank you. And I thank all of our listeners. This has been Julie Gralow and Merry Jennifer Markham talking about our Cancer.Net COVID-19 information that Merry Jennifer tirelessly led daily, essentially, for a couple of years. So thank you so much for that. It's been great talking to you. Dr. Markham: Thank you. ASCO: Thank you, Dr. Gralow and Dr. Markham. Find all of Cancer.Net's resources on COVID-19 and cancer at www.cancer.net/covid19. Cancer.Net Podcasts feature trusted, timely, and compassionate information for people with cancer, survivors, and their families and loved ones. Subscribe wherever you listen to podcasts for expert information and tips on coping with cancer, recaps of the latest research advances, and thoughtful discussions on cancer care. And check out other ASCO Podcasts to hear the latest interviews and insights from thought leaders, innovators, experts, and pioneers in oncology. Cancer.Net is supported by Conquer Cancer, the ASCO Foundation, which funds lifesaving research for every type of cancer, helping people with cancer everywhere. To help fund Cancer.Net and programs like it, donate at CONQUER.ORG/Donate.
Discover insights on predictive and prognostic markers, emerging efficacy and safety data, strategies to optimize tolerability for patients receiving novel therapies for mantle cell lymphoma (MCL), and more in this case-based activity presented by John Leonard, MD, the Richard T. Silver Distinguished Professor of Hematology and Medical Oncology at Weill Cornell Medicine. Listen now! Click here to claim CME/NCPD/CPE credit: https://bit.ly/3cy6PrK
Today's episode will be focusing on what you need to know to ace the hematology questions on your IM boards. 6% of the ABIM exam is hematology which includes erythrocyte, leukocyte and platelet disorders, coagulation disorders, transfusion medicine, and heme malignancies. We are going to discuss some common vignettes & high yield points.
WATCH THE VIDEO WEBCAST HERE: https://youtu.be/5TYFsjh91Tw Listen in as our host, Dr. Brenda Weigel from the University of Minnesota, is joined by Dr. Robbie Majzner - an Assistant Professor of Pediatrics in the Division of Hematology and Oncology at Stanford University's School of Medicine. Dr. Majzner goes into great detail about his recent clinical trial on GD2-CAR T cell therapy for H3K27M-mutated Diffuse Midline Gliomas - the findings, the process, and what the future holds. You can read more about Dr. Majzner's study here: https://www.nature.com/articles/s41586-022-04489-4 Have any thoughts? Questions? Ideas for future topics? Email us at TWIPO@solvingkidscancer.org. Subscribe to TWIPO to get notifications of new uploads. Want to listen to TWIPO's past episodes? Visit www.solvingkidscancer.org/podcast
This podcast, presented by Mikkael Sekeres, MD, Chief of the Division of Hematology at the University of Miami Health System, will focus on predictive and prognostic markers for myelodysplastic syndromes (MDS), emerging data on novel therapies, and strategies to optimize safety and tolerability for patients with this disease. Listen now to earn free CME/NCPD/CPE! Claim credit here: https://bit.ly/3yI6GJo
In this week's episode we'll compare the long-term outcomes of ibrutinib-rituximab combination therapy versus FCR chemoimmunotherapy in chronic lymphocytic leukemia, discuss the role of procoagulant platelet sentinels in inflammatory bleeding, and learn more about variants in the SERPINC1 gene encoding antithrombin that cause severe thrombophilia.
In this episode we take a deep dive into thalassemia- discussing the types, aetiology ,work up and treatment. This episode was written by Dr. Catherine Lovatt (Internal Medicine Resident) and reviewed by Dr. Madeleine Verhovsek (Hematology) and Dr. Daniel Brandt Vegas (General Internal Medicine). Infographic by Jessica Nguyen. This episode was supported by Spatula Foods. Enjoy elevated cuisine every day with high-quality dishes you can cook yourself in just 10 minutes. Go to https://www.spatulafoods.com and use promo code INTERN for $40 off your first box- this will help support our podcast! Support the show
Video for this podcast: https://mehlmanmedical.com/audio-qbank-hy-usmle-q-520-hematology Main website: https://mehlmanmedical.com/ Instagram: https://www.instagram.com/mehlman_medical/ Telegram private group: https://mehlmanmedical.com/subscribe/ Telegram public channel: https://t.me/mehlmanmedical Facebook: https://www.facebook.com/mehlmanmedical Podcast: https://anchor.fm/mehlmanmedical Patreon: https://www.patreon.com/mehlmanmedical
The revolution in cancer survival rates has created a new field in medicine called cardio-oncology, in which heart specialists work closely with cancer doctors to maximize care and minimize cardiovascular risks from treatments such as chemotherapy. UT Southwestern cardio-oncologist Dr. Vlad Zaha and Dr. Suzanne Conzen, Chief of the Division of Hematology and Oncology, explain how this bridge between cancer and heart care provides long-term benefits patients.
In the third episode of this Hematopoiesis Women in Hematology three-part series, Dr. Becky Zon (@beckyzon) has a conversation with Director of the Haematology Clinical Trials Unit at St. Vincent's Hospital in Australia Dr. Nada Hamad (@nadahamad). Dr. Hamad shares her experiences as a lymphoma/bone marrow transplant/cellular therapies clinician, President of the ANZTCT, an intersectional feminist, and Vogue magazine star. Music: “Somebody New” RYYZN (www.toneden.io/ryyzn/post/somebody-new-copyright-free). Licensed under Creative Commons: By Attribution 3.0 creativecommons.org/licenses/by/3.0/.
Today we'll learn more about the risk of subsequent malignancies in patients treated with genetically modified immune effector cells, discuss how p53 immunohistochemistry can be a global readout for TP53 alterations in AML, and uncover the role of CD19-negative CD22-positive B-cell progenitors in immune escape from CD19-directed therapies.
Cory Penn, DVM, received his DVM from the University of Missouri College of Veterinary Medicine after receiving his Bachelor of Science from Eastern Illinois University. He is currently the Senior Veterinary Diagnostic Platform Lead for VETSCAN IMAGYST with Zoetis Global Diagnostics. This episode of The Vet Blast Podcast is sponsored by Zoetis.
Dr Loretta Nastoupil from The University of Texas MD Anderson Cancer Center in Houston, Texas, discusses recent advances and future directions in the treatment of patients with follicular lymphoma. CME information and select publications here (http://www.researchtopractice.com/OncologyToday22FollicularLymphoma).
Alvin and German conduct a great conversation with SUNY Professor Emeritus of Pathology, Gregory A Threatte, '69. After Colgate, he received his medical degree from the SUNY, Upstate MedicalUniversity in 1973. He served an internship in Medicine at Upstate, and a residency in Anatomic Pathology at the Western Pennsylvania Hospital in Pittsburgh. He was a Resident and Chief Resident inClinical Pathology at the University of California, San Francisco and then a Hematology research fellow at the Lawrence Berkeley National Laboratory. He was appointed to the faculty as an Assistant Professor of Pathology at Georgetown University in 1981 In 1986 he returned to Upstate Medical University as the Deputy to the President for Minority Affairs and Associate Professor, later rising to the rank of Professor and then Chair. He established the Diversity programming that led to Upstate being cited by Black Issues in Higher Education for being the 10th leading producer of African American Physicians in 1994. He has received the SUNY President's Award for the Advancement of Affirmative Action, the SUNY President's Award for Excellence in Teaching, and numerous other teaching awards. He served for 9 years on the Board of Trustees of Colgate University.