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Join our scientific team in the discussion of the 3 most clinically impactful papers of the month, the crème de la crème of our weekly top picks.This month we're discussing:Early Discontinuation of Aspirin after PCI in Low-Risk Acute Myocardial InfarctionDOI: https://doi.org/10.1056/NEJMoa2508808Digitoxin in Patients with Heart Failure and Reduced Ejection FractionDOI: https://doi.org/10.1056/NEJMoa2415471Efficacy and safety of single-anastomosis duodeno-ileal bypass with sleeve gastrectomy versus Roux-en-Y gastric bypass in France (SADISLEEVE): results of a randomised, open-label, superiority trial at 2 years of follow-upDOI: https://doi.org/10.1016/S0140-6736(25)01070-0Dapagliflozin in Patients Hospitalized for Heart Failure: Primary Results of the DAPA ACT HF-TIMI 68 Randomized Clinical Trial and Meta-Analysis of Sodium-Glucose Cotransporter-2 Inhibitors in Patients Hospitalized for Heart FailureDOI: https://doi.org/10.1161/CIRCULATIONAHA.125.076575Scientific team:Ricardo Ladeiras Lopes, Mário Santos and João Sérgio NevesDiscover Medical Portfolio App weekly top picks - the latest and most relevant papers, curated by our team of experts! https://linktr.ee/medicalportfolioapp
“All of these TKIs [tyrosine kinase inhibitors] inhibit BCR-ABL1 in some way, shape, or form. When BCR-ABL1 is mutated, it has uncontrolled tyrosine kinase activity, leading to rapid cell proliferation. When we then inhibit that BCR-ABL1 that's been mutated, we disrupt this abnormal signaling pathway that drives CML [chronic myeloid leukemia] cell proliferation and survival, ultimately leading to decreased cancer cell growth, increased apoptosis or cell death, and potentially inducing a disease remission,” Samantha Maples, PharmD, BCOP, clinical pharmacy specialist supervisor for hematology and cellular therapy at Allegheny Health Network in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the BCR-ABL1 inhibitor drug class. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by September 5, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learner will report an increase in knowledge related to the use of BCR-ABL1 inhibitors in the treatment of CML. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Pharmacology 101 series Episode 322: Nursing Strategies to Reduce Readmission Rates for Patients With Cancer Episode 215: Navigate Updates in Oral Adherence to Cancer Therapies ONS Voice articles: Adherence to Oral Anticancer Medication Combination Therapy Shows Promise for Chronic Myeloid Leukemia The Case of the Medication Modification The Case of the Safety Session ONS course: Safe Handling Basics Clinical Journal of Oncology Nursing articles: Targeted Drug Therapies: Beyond Blood Counts and Chemistries Oncology Nursing Forum articles: Adherence and Coping Strategies in Outpatients With Chronic Myeloid Leukemia Receiving Oral Tyrosine Kinase Inhibitors Fear of Progression in Outpatients With Chronic Myeloid Leukemia on Oral Tyrosine Kinase Inhibitors Other ONS resources: Biomarker Database Financial Toxicity Huddle Card Tyrosine Kinase Inhibitors Huddle Card Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation Oral Anticancer Medication Learning Library National Comprehensive Cancer Network National Comprehensive Cancer Network patient resources To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “The IRIS study led to the approval of the BCR-ABL1 and TKI, imatinib, for CML in 2001 and completely changed the landscape of CML treatment. Then came the second-generation BCR-ABL1 TKIs: dasatinib in 2006, quickly followed by nilotinib in 2007. Thereafter came our second-generation, bosutinib, and our first approved third-generation TKI, ponatinib, both in 2012, which was a huge milestone as ponatinib overcomes resistance to the T315 I mutation, which no previously approved TKIs worked against.” TS 2:16 “The newest approved TKI, asciminib, is an allosteric inhibitor that binds to a different pocket on the BCR-ABL kinase via allosteric binding to the ABL myristoyl pocket. It's what's called a STAMP inhibitor, where STAMP stands for ‘specifically targeting the ABL myristoyl pocket.' And while all the TKIs target the BCR-ABL1 binding site, they can also inhibit different off-target kinases. And these differences in off-target inhibition are responsible for some of the different toxicities we see among the TKIs.” TS 4:51 “As a class, common toxicities include nausea; vomiting; diarrhea; cardiac toxicities, including cardiac arrhythmias and congestive heart failure; metabolic abnormalities such as hypercholesterolemia and hypertriglyceridemia; nephrotoxicity; hepatic toxicity; hemorrhaging and bleeding; as well as cytopenia. Individually, some of these agents are more likely to cause certain side effects compared to others, and there are unique toxicities associated with certain TKIs.” TS 8:10 “We've moved to using preemptive loperamide [in our clinic] for the first three days of starting treatment, because it's really hard to get patients to continue to take a medication if they have such severe diarrhea that they end up in the hospital or they're unable to leave their house. A lot of times, we will proactively give patients antiemetics and loperamide to help with the nausea, vomiting, and diarrhea. And then we can back off to an as-needed basis once they've been established on treatment. We can also use medications to help manage long-term complications that can require supportive care, such as statin therapy for high cholesterol, levothyroxine for hypothyroidism, anticoagulants for any venous thromboembolism, and antihypertensive medications for managing any new or worsening high blood pressure.” TS 12:44 “We are continually seeing these agents expand their indications to different lines of therapy, as well as more TKIs being approved for acute lymphoblastic leukemia. For example, asciminib just got approved in the frontline setting within the last year, whereas previously it was only approved in relapsed refractory setting. Last year, imatinib was the first BCR-ABL1 TKI to come out with a commercially supplied suspension option as well, which is huge in the pediatric space and [for] our adult patients who are unable to swallow tablets for other clinical reasons.” TS 21:22 “There is more information being published on the safe discontinuation of these medications with treatment-free remissions, and more information is coming out about who would be eligible and who can have the option to stop these treatments instead of having a lifelong chronic condition requiring continuous treatment. We're seeing more patients in clinical practice be able to stop BCR-ABL1 treatment, which has been a great development in CML.” TS 25:29
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WEP865. CME/NCPD/CPE/AAPA/IPCE credit will be available until August 28, 2026.Playing the Right Sequence in mCRC: Practical Strategies for Integrating Multi-Kinase Inhibitors in Later Lines of Therapy In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and Colorectal Cancer Alliance. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WEP865. CME/NCPD/CPE/AAPA/IPCE credit will be available until August 28, 2026.Playing the Right Sequence in mCRC: Practical Strategies for Integrating Multi-Kinase Inhibitors in Later Lines of Therapy In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and Colorectal Cancer Alliance. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.Disclosure information is available at the beginning of the video presentation.
Dr Philip Smith, Digital and Education Editor of Gut and Honorary Consultant Gastroenterologist at the Royal Liverpool Hospital, Liverpool, UK interviews Professor Chengwei Tang and Associate Professor Zhiyin Huang from the Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China on the paper "Parecoxib sequential with imrecoxib for occurrence and remission of severe acute pancreatitis: a multicentre, double-blind, randomised, placebo-controlled trial" published in paper copy in Gut in September 2025. Please subscribe to the Gut podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3UOTwqS) or Spotify (https://spoti.fi/3Ifxq9p).
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WEP865. CME/NCPD/CPE/AAPA/IPCE credit will be available until August 28, 2026.Playing the Right Sequence in mCRC: Practical Strategies for Integrating Multi-Kinase Inhibitors in Later Lines of Therapy In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and Colorectal Cancer Alliance. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WEP865. CME/NCPD/CPE/AAPA/IPCE credit will be available until August 28, 2026.Playing the Right Sequence in mCRC: Practical Strategies for Integrating Multi-Kinase Inhibitors in Later Lines of Therapy In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and Colorectal Cancer Alliance. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.Disclosure information is available at the beginning of the video presentation.
Dr. Virginia Kaklamani, world renowned breast cancer specialist and researcher, visits with Healthcare Unfiltered EXPRESS to detail how this class of agents are used in metastatic and early stage breast cancer. A perfect guide for all clinicians.
In this episode, we discuss recent analysis showing significant disparities in SGLT-2 inhibitor prescriptions for people with type 2 diabetes in England. We also explore how our new draft recommendations for these medications could increase uptake with our three guests. They are: Dr Waqaar Shah, chair of the type 2 diabetes guideline committee; Dr Soon Song, consultant physician and diabetologist at Sheffield Teaching Hospitals NHS Foundation Trust; Dr Rahul Mohan, a GP and secretary of the Primary Care Diabetes Society. Learn more about: www.nice.org.uk/news/articles/wom…r-type-2-diabetes Read our draft guideline for type 2 diabetes medicines management: www.nice.org.uk/guidance/gid-ng10336/documents/450
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/WFS865. CME credit will be available until August 21, 2026.All Rise for Innovation in AML: Processing New Developments With Menin Inhibitors in Challenging AML Subtypes In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Johnson & Johnson, Kura Oncology, Inc., and Syndax.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/WFS865. CME credit will be available until August 21, 2026.All Rise for Innovation in AML: Processing New Developments With Menin Inhibitors in Challenging AML Subtypes In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Johnson & Johnson, Kura Oncology, Inc., and Syndax.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/WFS865. CME credit will be available until August 21, 2026.All Rise for Innovation in AML: Processing New Developments With Menin Inhibitors in Challenging AML Subtypes In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Johnson & Johnson, Kura Oncology, Inc., and Syndax.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/WFS865. CME credit will be available until August 21, 2026.All Rise for Innovation in AML: Processing New Developments With Menin Inhibitors in Challenging AML Subtypes In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Johnson & Johnson, Kura Oncology, Inc., and Syndax.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/WFS865. CME credit will be available until August 21, 2026.All Rise for Innovation in AML: Processing New Developments With Menin Inhibitors in Challenging AML Subtypes In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Johnson & Johnson, Kura Oncology, Inc., and Syndax.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/WFS865. CME credit will be available until August 21, 2026.All Rise for Innovation in AML: Processing New Developments With Menin Inhibitors in Challenging AML Subtypes In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Johnson & Johnson, Kura Oncology, Inc., and Syndax.Disclosure information is available at the beginning of the video presentation.
In this essential episode of Parallax, Dr Ankur Kalra welcomes Dr Shelley Zieroth, Professor of Medicine, clinician-scientist, and advanced heart failure and transplant cardiologist in Winnipeg, Canada. As we mark the 10-year anniversary of the landmark EMPA-REG OUTCOME trial, Dr Zieroth provides a comprehensive update on how SGLT2 inhibitors have revolutionized cardiovascular care. Dr Zieroth takes us through the remarkable journey from the initial 2015 trial that transformed SGLT2 inhibitors from anti-diabetic agents into cardiovascular powerhouses, delivering highly significant reductions in cardiovascular death and heart failure hospitalization. She explores how these medications have become fundamental pillars of cardio-kidney-metabolic medicine, with evidence spanning the entire ejection fraction spectrum. Dr Zieroth discusses prescribing these agents in heart failure - including the straightforward 10-mg daily dosing, monitoring strategies, and crucial patient selection criteria. She shares insights from the recent EMPULSE trial on safe in-hospital initiation, addresses important considerations for diabetic patients, and highlights key contraindications like indwelling catheters that clinicians must recognize. Beyond the basics, Dr Kalra and Dr Zieroth examine the evolving role of SGLT2 inhibitors in valvular disease and diastolic dysfunction, tackle the ongoing reimbursement challenges across different healthcare systems, and discuss the critical importance of multidisciplinary collaboration in the cardio-kidney-metabolic space. They also look ahead to exciting combination therapies on the horizon that promise to further advance heart failure prevention and treatment. Questions and comments can be sent to "podcast@radcliffe-group.com" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.
In this episode, Drs William J. Gradishar, Heather McArthur, and Joanne Mortimer address audience questions from a recent live event on the use of CDK4/6 inhibitors in patients with early and metastatic breast cancer, including:Genomic testing options for assessing risk of recurrenceAdjuvant treatment duration and holidays with CDK4/6 inhibitorsManaging renal toxicities, prophylaxis for DVT, and asymptomatic ILDCDK4/6 inhibitors with inavolisib and fulvestrantPresenters:William J. Gradishar, MD, FACP, FASCOBetsy Bramsen Professor of Breast OncologyRobert H. Lurie Comprehensive Cancer CenterNorthwestern UniversityChicago, IllinoisHeather McArthur, MD, MPH, FASCOProfessor, Department of Internal MedicineClinical Director, Breast Cancer ProgramKomen Distinguished Chair in Clinical Breast Cancer ResearchUT Southwestern Medical CenterDallas, TexasJoanne Mortimer, MD, FACP, FASCOVice Chair, Medical OncologyProfessor, Division of Medical Oncology & Experimental TherapeuticsAssociate Director for Education and TrainingBaum Family Professor of Women's CancersCity of Hope Comprehensive Cancer CenterDuarte, CaliforniaLink to full program:https://bit.ly/4osHLTm
Dr. Bradley Ong shares early insights from the EMERGE trial, presented at the American Headache Society's 67th Annual Scientific Meeting in June 2025. Show reference: https://headachejournal.onlinelibrary.wiley.com/doi/10.1111/head.14957
JCO PO author Dr. Alison M. Schram at Memorial Sloan Kettering Cancer Center shares insights into her JCO PO article, “Retrospective Analysis of BRCA-Altered Uterine Sarcoma Treated With Poly(ADP-ribose) Polymerase Inhibitors.” Host Dr. Rafeh Naqash and Dr. Schram discuss relevant genomic and clinical features of patients with BRCA-altered uterine sarcoma and the efficacy of PARPis in this population. TRANSCRIPT Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, podcast editor for JCO Precision Oncology and associate professor at the OU Health Stephenson Cancer Center. Today, we are excited to be joined by Dr. Alison Schram, Associate Attending Physician and Section Head of Oral Therapeutics with Early Drug Development and Gynecologic Medical Oncology Services at the Memorial Sloan Kettering Cancer Center, and the senior author of the JCO Precision Oncology article titled, "Retrospective Analysis of BRCA-Altered Uterine Sarcoma Treated With Poly(ADP-ribose) Polymerase Inhibitors." At the time of this recording, our guest's disclosures will be linked in the transcript. Dr. Schram, thank you for joining us today. I am excited to be discussing this very interesting, unique topic based on what you published in JCO PO. Dr. Alison Schram: Thank you for having me. Dr. Rafeh Naqash: What we like to do for these podcasts is try to make them scientifically interesting but at the same time, keep them at a level where our trainees and other community oncology professionals understand the implications of what you've published. So I'd like to start by asking you, what is leiomyosarcoma for those of us who don't necessarily know a lot about leiomyosarcoma, and what are some of the treatment options for these uterine sarcomas? Dr. Alison Schram: Uterine leiomyosarcoma is a rare subtype of uterine cancer, and it represents about 1% of all female cancers in the reproductive tract. This is a rare malignancy that arises from the myometrial lining of the uterus, and it is generally pretty aggressive. In terms of the standard therapy, the standard therapy for uterine leiomyosarcoma includes chemotherapy, generally combination chemotherapy, but despite a few regimens that tend to be effective, the duration of effectiveness is relatively short-lived, and patients with advanced uterine leiomyosarcoma eventually progress and require additional therapy. I will say that localized uterine leiomyosarcoma can be treated with surgery as well. Dr. Rafeh Naqash: Thank you for that description. Now, there are two aspects to what you published. One is the sarcoma aspect, the leiomyosarcoma, and the second is the BRCA mutation. Since we are a precision medicine journal, although we've discussed BRCA a couple of times before, but again, for the sake of our listeners, could you highlight some of the aspects of BRCA and PARP sensitivity for us? Dr. Alison Schram: Yes. So BRCA is a gene that's important for DNA repair, and BRCA mutations can be either inherited as a germline mutation, so one of your parents likely had a BRCA mutation and you inherited one copy. In patients who have an inherited BRCA mutation, the normal cells tend to have one abnormal copy of BRCA, but if a second copy in the cell becomes altered, then that develops into cancer. And so these patients are at increased risk of developing cancers. Specifically, they are at an increased risk of developing ovarian cancer, breast cancer, prostate cancer, pancreatic cancer, and a few others. These cancers are considered BRCA-associated tumors. Alternatively, some patients, more rarely, can develop BRCA-altered cancers completely sporadically. So it's a mutation that happens in the tumor itself, and that can lead to impaired DNA repair and promote cancer progression. And those patients are not, they don't have any inherited risk, but just a random event caused a BRCA mutation in the tumor. The reason this is important is because, in addition to it being potentially important for family members, there are certain treatments that are more effective in BRCA-altered cancers. And the main example is PARP inhibitors, which are small molecule inhibitors that inhibit the PARP enzyme, and there is what we call synthetic lethality. So PARP is important for DNA repair, for single-stranded DNA repair, BRCA is important for double-stranded DNA repair, and in a patient that has a cancer that has a BRCA mutation, that cancer becomes more reliant on single-stranded DNA repair. And if you inhibit it with a PARP inhibitor, the cancer cells are unable to repair DNA, and the cells die. So we call that synthetic lethality. PARP inhibitors are FDA approved in several diseases, predominantly the BRCA-associated diseases I mentioned: breast cancer, ovarian cancer, pancreatic cancer, and prostate cancer. Dr. Rafeh Naqash: That was very beautifully explained. Honestly, I've heard many people explain BRCA before, but you kind of put it in a very simple, easy to understand format. You mentioned this earlier describing germline or hereditary BRCA and somatic BRCA. And from what I gather, you had a predominant population of somatic BRCA, but a couple of germline BRCA as well in your patient population, which we'll go into details as we understand the study. You mentioned the second hit on the germline BRCA that is required for the other copy of the gene to be altered. In your clinical experience, have you seen outside of the study that you published, a difference in the sensitivity of PARP for germline BRCA versus a somatic BRCA that has loss of both alleles? Dr. Alison Schram: So we will get into what's unique about uterine sarcomas in just a minute. In uterine sarcomas, what we have found is that the BRCA mutations tend to be somatic and not germline, as you mentioned. That is in contrast to the other diseases we mentioned, where the vast majority of these tumors are in patients that have germline BRCA alterations. So one thing that's really unique about the uterine sarcoma population and our paper, I believe, is that it is demonstrating an indication for PARP inhibitors in a population that is not characterized by germline BRCA alterations, but truly these by somatic BRCA alterations. If you look at the diseases that PARP inhibitors are validated to be effective in, including the, you know, the ones I mentioned, the BRCA-associated tumors, there's some data in specific context that suggests that perhaps germline alterations are more sensitive to PARP inhibitors, but that's not universal, and it's really tricky to do because the genetic testing that we have doesn't always tell you if you have two hits or just one hit. So you need more complex genetic analysis to truly understand if there is what we call a biallelic loss. And sometimes it's not a second mutation in BRCA. Sometimes it's silencing of the gene by hypermethylation or epigenetics. Some of our clinical trials are now incorporating this data collection to really understand if biallelic loss that we can identify on more complex genetic testing predicts for better outcomes. And we think it's probably true that the patients that have biallelic loss, whether it be germline or somatic biallelic loss, are more likely to benefit from these treatments. That still needs to be tested in a larger cohort of patients prospectively. Dr. Rafeh Naqash: In your clinical experience, I know you predominantly use MSK-IMPACT, but maybe you've perhaps used some other NGS platforms, next-generation sequencing platforms. Have you noticed that these reports for BRCA alterations the report mentioning biallelic loss in certain cases? I personally don't- I do lung cancer, I do early-phase lung cancer as well, but I personally don't actually remember if I've seen a report that actually says biallelic loss. So after this podcast, I'm going to check some of those NGS reports and make sure I look at it. But have you seen it, or what would be a learning point for the listeners there? Dr. Alison Schram: Exactly. And they usually do not. They usually do not explicitly say, “This looks like biallelic loss,” on the reports. The exception would be if there's a deep deletion, then that implies both copies of the gene have been deleted, and so then you can assume that it's a biallelic loss. But oftentimes, when you see a frameshift alteration or a mutation, you don't know whether or not it's a biallelic loss. And you may be able to get some clues based on the variant allele frequencies, but due to things like whole genome duplication or more complex tumor genomics, it's not clear from these reports, and you really do need a more in-depth bioinformatic analysis to understand whether these are biallelic or not. So that is why I suggest that this really needs to be done in the context of a clinical trial, but there is definitely a theoretical rationale for reporting and treating patients with biallelic losses perhaps more so than someone who has a variant of unknown significance that seems to be monoallelic. The other tricky part, as I mentioned, is the fact that there could be epigenetic changes that silence the second copy, so that wouldn't be necessarily evident on a DNA report, and you would need more complex molecular testing to understand that as well. Dr. Rafeh Naqash: Sure. Now, going to your study, could you tell us what prompted the study, what was the patient population that you collected, and how did you go about this research study design? Dr. Alison Schram: It's actually a great story. I was the principal investigator for a clinical trial enrolling patients regardless of their tumor type to a combination of a PARP inhibitor and immunotherapy. And this was a large clinical trial that was being done as a basket study, as I mentioned, for patients that have either germline or somatic alterations with advanced solid tumors that had progressed on standard therapy. And the hypothesis was that the combination of a PARP inhibitor and immunotherapy would be synergistic and that there would be increased efficacy compared to either agent alone and that patients who had BRCA alterations were a sensitive population to test because of their inherent sensitivity to PARP inhibitors and perhaps their increased neoantigen burden from having loss of DNA repair. So this large study, it's been published, really did show that there was efficacy across several tumor types, but it didn't seem to clearly demonstrate synergy between the immunotherapy and the PARP inhibitor as compared to what you might expect from a PARP inhibitor alone, and in addition to a couple of cases, perhaps attributable to the immunotherapy. So maybe additive rather than synergistic efficacy. However, what really struck me looking at the data was that there were three patients with uterine leiomyosarcoma with BRCA deletions who had the best responses of anyone on the study. So incredible, durable responses. One of my patients with a complete response that continues to not have any evidence of cancer eight years after the initiation of this regimen. And for those of us that treat uterine leiomyosarcoma, this is unheard of. These patients generally, as I mentioned, respond, if they do respond to chemotherapy, it's generally short-lived and the cancer progresses. And so a complete response nearly a decade later turns heads in this field. The other interesting thing was that these uterine leiomyosarcoma patients had somatic alterations rather than a germline alteration with a second hit, and the diseases that are best validated for being responsive to PARP inhibitors include the BRCA-associated diseases, the ones that you're at increased risk for if you have a germline BRCA mutation, including breast, pancreas, prostate, and ovarian. And so it was very interesting that this disease type that seemed to be uniquely sensitive to PARP inhibitors with immunotherapy was also different in that patients with uterine leiomyosarcoma don't tend to have a high frequency of BRCA alterations, and in patients that are born with a BRCA alteration, there doesn't seem to be a clearly increased risk of uterine sarcomas. So this population really jumped out as a uniquely sensitive population that differed from the prior indications for PARP inhibitors. Given this patient and these couple of patients that we observed on the combination, in addition to some other case reports and case series that had started to come out in small numbers, we wanted to look back at our large cohort of patients at Memorial Sloan Kettering to see if we could really get a better sense of the numbers. How many patients at Sloan Kettering with uterine sarcomas have BRCA alterations? Are they generally somatic or germline? Are there unique features about these patients in terms of their clinical characteristics? How many of them have received PARP inhibitors, and if so, is this just luck that these three patients did so well, or is this really a good treatment option for patients with BRCA-altered uterine sarcomas? And so we did this retrospective analysis identifying the patients at Sloan Kettering who met these criteria. So in total, we found 35 patients with uterine sarcomas harboring BRCA alterations, and the majority were leiomyosarcoma, about 86% of them had leiomyosarcoma, which is interesting because there are other uterine sarcomas, but it does seem like BRCA alterations tend to be more often in the leiomyosarcomas. And 13 of these patients with uterine leiomyosarcoma were treated with PARP inhibitors in the recurrent or metastatic setting with about half of those patients having an overall response, so that's a significant tumor shrinkage that sustained, and a clinical benefit rate of 62%. And if we look at the patients that had these BRCA2 deep deletions, which was the patient I had that had this amazing response, the overall response rate jumped to 60% and the clinical benefit rate to 80%. And we defined clinical benefit rate as having maintained on the PARP inhibitor without evidence of progression at six months. So this is really impressive for patients with a difficult to treat disease. And we couldn't do a randomized controlled trial comparing it to chemotherapy, but looking retrospectively at outcomes on chemotherapy studies, this was very favorable, particularly because many of these patients were heavily pretreated. So to get a sense of, you know, how this might compare to chemotherapy, we tried to use patients as their own internal controls, and we looked at how long patients were maintained on the PARP inhibitor as compared to how long they were on the treatment just prior. And we used a ratio of 1.3 to say if they were on the PARP inhibitor for 1.3 times what their previous treatment was or longer, that is pretty clearly better, more of a benefit from that regimen. And the majority of patients did meet that bar. So 58% had a PFS ratio greater than 1.3, and the average PFS ratio was 1.9, suggesting, you know, you would expect the the later lines of therapy to actually not work as well, but this suggests that it's actually working better than the immediately prior line of therapy, to me, suggesting that this is truly a good treatment option for these patients. Dr. Rafeh Naqash: Very interesting. And you mentioned that individuals with tumors having deep deletions were probably more responsive. How did you figure out that there was biallelic loss or deep deletions? Was that part of an extended analysis that was done subsequently? Dr. Alison Schram: So the deletions reported on our report, if it's a biallelic deletion, that is the one biallelic molecular alteration that would be reported. So those are, by definition, biallelic, and I think that that may be one of the reasons that's a good biomarker. But also, what's interesting is that if you have both copies deleted of BRCA, you can't develop reversion mutations. So one of the the known mechanisms of resistance to PARP inhibitors in patients who have BRCA alterations are something called a reversion mutation where, if you have a frameshift alteration, for example, in BRCA that makes BRCA protein nonfunctional, you can develop a second mutation that actually puts the DNA back in frame, and a functional protein is now made. And so a mechanism of resistance to PARP inhibitors is actually reverting BRCA to a wild-type protein, and then BRCA's synthetic lethality no longer makes sense and is no longer effective. But if you've deleted both copies of BRCA, you don't have the ability to restore the function, and you can't develop reversion mutations. And that's perhaps why, you know, my patient and others have had these prolonged responses to PARP inhibitors because you don't have the same ability to develop that mechanism of resistance. Dr. Rafeh Naqash: I remember thinking a year and a half back, I had an individual with prostate cancer and with BRCA2, and using liquid biopsy, I had a reversion mutation that we caught. In your practice, have you seen the utility of doing the serial liquid biopsies in these individuals to catch these reversion mutations? Dr. Alison Schram: Yes, absolutely. And in patients that have the ability to develop a reversion mutation, serial cell-free DNA can catch it, but the caveat is that it doesn't always. So if you see an acquired reversion mutation in cell-free DNA, that can be helpful, particularly if you're planning on putting the patient on another line of therapy that might require a dysfunctional BRCA. So if you're putting them on a clinical trial with a PARP combination and the rationale is that they're sensitive because they don't have a functional BRCA, you would want to know if they developed a reversion mutation, and serial cell-free DNA can definitely identify these reversion mutations. Some of the major clinical trials in ovarian cancer have done serial cell-free DNA and have demonstrated the utility of that approach. The caveat is that some of these reversion mutations are not readily caught on cell-free DNA because they're more complex reversion mutations, or they're not, the part of the gene that develops the reversion mutation is not tiled on the panel. And so it doesn't always catch the reversion mutations. Also, depends on the cell-free DNA shedding, depends on the tumor volume and other factors. And we published a related paper of a patient, it was a really interesting case of a patient with prostate cancer who was on a PARP inhibitor and developed what appeared to be a single reversion mutation on one sample, had negative cell-free DNA, single reversion mutation in a tissue biopsy, and then developed disease progression. And we did an autopsy, and the patient kindly consented to an autopsy, and at the time of autopsy, there were 10 unique reversion mutations identified across 11 metastases. So almost each metastasis had a unique reversion mutation, and only one of them had been seen premortem on a tissue biopsy and not on a cell-free DNA. But that autopsy really drove home to me how much we're missing by doing clinical testing in real time and we really don't know the entire genomic complexity of our patients by doing single samples. And theoretically, cell-free DNA can catch DNA from all the metastases, so you might think that that would be a solution, and it definitely can catch reversion mutations that are not seen in a single biopsy, but you really need to do it all. I mean, you need to do the tissue biopsy sampling, you need to do cell-free DNA, and probably one cell-free DNA test is not enough. Dr. Rafeh Naqash: Thank you, again, for that very nice explanation. Now, one quick provocative question. I remember when I was training, the lab that I used to work in, they used to do a lot of phosphorylation markers for DNA damage response, like phospho NBS, RAD51. Have you seen anything of that sort on these biallelic BRCA mutations where tumors are responding, but they also have a very high signature on the phosphorylation side, and it may or may not necessarily correspond to HRD signatures, but have you noticed or done any of that analysis? Dr. Alison Schram: I think that it would be great to do that analysis. And some of the work we're doing now is actually trying to dig a little bit deeper in our cohort of patients to understand are these HRD-positive tumors? Does HRD positivity correlate with response to BRCA alterations? In terms of the functional assays, I would love to be able to do a functional assay in these samples. One of the challenges is that this was a retrospective study and many of the patients were previously treated as standard of care or off-label with these agents, and so we didn't have prospective tissue collection, and so we're really limited by the tissue that was collected as part of standard of care and the consent forms that the patient signed that allow us to do genomic and molecular testing on their samples. So, I think that is hopefully future work that we will do and others will do. Dr. Rafeh Naqash: Sure. Shifting gears to your career trajectory, I'd like to spend a couple of minutes there before we end the podcast. So Dr. Schram, you've obviously been a trailblazer in this space of drug development, early-phase trials. Can you give us a brief synopsis of your journey and how you've successfully done what you're doing and what are some of the things that drive you? Dr. Alison Schram: Well, thank you for saying that. I don't know if that's true, but I'll take the bait. I've been interested in oncology since college and was always very interested in not only the science of oncology but of course, treating patients. And in medical school, I did basic science research in a laboratory and it was very inspiring and made me want to do research in oncology in addition to clinical care. When I became an oncology fellow, I was presented with a very difficult question, which is, “Do you want to be a lab PI and be in the lab, or do you want to do clinical care and clinical research?” And I couldn't choose. I found a mentor who thankfully really had this amazing vision of combining the two and doing very early drug development, taking the data that was being generated by labs and translating it into patients at the earliest stage. So, you know, phase one drug development in molecularly targeted therapies. And so I became very interested as a fellow in early drug development and this ability to translate brand new molecular insights into novel drugs. And I joined the- at Sloan Kettering, there was the Early Drug Development, it was actually a clinic, it was called something different, and it was very fortuitous. My last year of fellowship, the clinic became its own service with the ability to hire staff at Sloan Kettering, and I was the first ever hire to our Early Drug Development Service. And that really inspired me to try and bring these drugs to patients and to really translate the amazing molecular insights that my colleagues here at Sloan Kettering are discovering, and you know, of course, at other institutions and in pharma. And you know, there 's been an amazing revolution in in drug development over the last several years, and I feel very grateful that I've been here for it. You know, I've been able to take the brilliant insights from my colleagues and put these drugs in patients, and I have the amazing privilege of watching patients in many cases that benefit from these treatments. And so I do mostly phase one drug development and molecularly targeted therapies, and truthfully, I am just very fortunate to be around such brilliant people and to have both patients and labs trust me to be able to deliver these new drugs to patients and hopefully develop better drugs that move forward through FDA approval and reach patients across the country. Dr. Rafeh Naqash: Thank you so much. That was very nicely put. And hopefully our trainees and junior faculty find that useful based on their own career trajectories. Thank you, Dr. Schram, for joining us today. Hopefully, we'll see more of your subsequent work in JCO PO. Thank you for giving us all these insights today. Dr. Alison Schram: Thank you for having me. Dr. Rafeh Naqash: Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Dr. Alison Schram Disclosures Consulting or Advisory Role Company: Mersana, Merus NV, Relay Therapeutics, Schrodinger, PMV Pharma ,Blueprint Medicines, Flagship Pioneering, Redona Therapeutics, Repare Therapeutics, Endeavor BioMedicines Research Funding Company: Recipient: Your Institution Merus, Kura, Surface Oncology, AstraZeneca, Lilly, Pfizer , Black Diamond Therapeutics, BeiGene, Relay Therapeutics, Revolution Medicines, Repare Therapeutics, PMV Pharma, Elevation Oncology, Boehringer Ingelheim Travel, Accommodations, Expenses Company: PMV Pharma
N/A interviewed by Mona Sadeghpour, MD, FAAD
“We're really using these in many, many types of malignancies. But you can see this class of drug, these monoclonal antibodies, the small molecule inhibitors, being used in colorectal cancer, ovarian cancer, renal cell carcinoma, brain cancers, hepatocellular, non-small cell lung cancer, gynecologic malignancies, so lots of different types of cancers where we're seeing these drugs used,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the vascular endothelial growth factor (VEGF) inhibitor drug class. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 8, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learner will report an increase in knowledge related to the use of VEGF inhibitors in the treatment of cancer. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Pharmacology 101 series Episode 303: Cancer Symptom Management Basics: Ocular Toxicities Episode 244: Cancer Symptom Management Basics: Cardiovascular Complications Episode 196: Oncologic Emergencies 101: Bleeding and Thrombosis Episode 161: Administer Bevacizumab Infusions With Confidence ONS Voice articles: Manage Afatinib's Adverse Events to Keep Patients on Treatment Oncology Drug Reference Sheet: Cabozantinib Oncology Drug Reference Sheet: Fruquintinib Patient Education Needs With Pazopanib Therapy for Soft Tissue Sarcoma ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Safe Handling of Hazardous Drugs (fourth edition) ONS courses: Safe Handling Basics Clinical Journal of Oncology Nursing article: Safety and Adverse Event Management of VEGFR-TKIs in Patients With Metastatic Renal Cell Carcinoma Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation ONS Oral Anticancer Medication Learning Library ONS Oral Anticancer Medication Toolkit IV Cancer Treatment Education Sheets Oral Chemotherapy Education Sheets To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Cancer cells are known to secrete factors that cause the formation of new blood vessels, and tumors need blood vessels to supply themselves with nutrients so that they can grow and metastasize. A lot of tumors overexpress these factors, so they had more of this ability to create new blood vessels. You may hear that term somewhere neo vascularization. … And also these factors can increase the permeability of blood vessels, so making them kind of leaky blood vessels. … So the thought behind it is being able to block the ability for this new blood vessel formation and to decrease that leakiness or permeability of those blood vessels.” TS 2:07 “These are drugs that are tyrosine kinase inhibitors. These are oral, small molecule drugs that are acting intracellular, so they are working within the cell to bind and prevent that downstream signaling of producing more blood vessels. So we have a number of small molecule drugs that fall into this class. Many of them target multiple types of receptors, VEGF being included, but also a lot of these drugs have other targets.” TS 7:58 “I would really say, number one, something that we very commonly see with this drug class is hypertension. Giving you an example of bevacizumab—If we look at any grade hypertension, this can be up to 67% of patients, so very common toxicity really spanning all of these agents. So something that we need to be monitoring closely for.” TS 13:24 “With that impaired wound healing, keeping that in mind, as we are planning for this agent, for patients and even sometimes with the minor surgical procedures, maybe a need for a short hold, and even for something like a catheter placement. I know and some of the providers I work with have a preference for holding for a short period of time around that as well.” TS 20:15 “I think one big area, and we've seen some of this just recently, and particularly in the hepatocellular setting, we're seeing combinations of using the VEGF inhibitor class with immunotherapy. And so I think we're going to continue to see that evolve. Even hearing about some bispecific antibodies that are in development, where they are targeting VEGF as well as PD-L1, so getting the immunotherapy and VEGF effects.” TS 24:44
Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Neil M. Iyengar, MD Due to their wild-type inhibition, first-generation PIK3CA inhibitors for HR+/HER2- advanced breast cancer were limited by significant toxicities, including hyperglycemia, rash, and diarrhea. But now, mutation-specific PIK3CA inhibitors could help improve tolerability and adherence as well as simplify dosing strategies—all while maintaining efficacy. To learn more about the efficacy and safety of current and emerging PIK3CA-targeted therapies, Dr. Charles Turck speaks with Dr. Neil Iyengar, Co-Director of the Breast Oncology Program and Director of Cancer Survivorship Service at Winship Cancer Institute at Emory University.
Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Neil M. Iyengar, MD Due to their wild-type inhibition, first-generation PIK3CA inhibitors for HR+/HER2- advanced breast cancer were limited by significant toxicities, including hyperglycemia, rash, and diarrhea. But now, mutation-specific PIK3CA inhibitors could help improve tolerability and adherence as well as simplify dosing strategies—all while maintaining efficacy. To learn more about the efficacy and safety of current and emerging PIK3CA-targeted therapies, Dr. Charles Turck speaks with Dr. Neil Iyengar, Co-Director of the Breast Oncology Program and Director of Cancer Survivorship Service at Winship Cancer Institute at Emory University.
A large observational study found small but potentially meaningful differences in cardiovascular safety among sulfonylureas compared to DPP-4 inhibitors in type 2 diabetes, with glipizide showing a statistically higher risk of MACE. A separate study revealed that over half of advanced-stage lung and colorectal cancer cases involved missed diagnostic opportunities, highlighting systemic delays in workups and follow-up. Finally, the EchoNext deep learning model accurately predicted structural heart disease from ECG data alone, outperforming cardiologists and showing potential for scalable, cost-effective screening. These findings underscore the importance of individualized treatment, earlier cancer detection, and AI-enabled cardiac diagnostics.
The Peptique is LIVE! Go to https://thepeptique.com/ to get all your research peptides .As a loyal listener use the discount code POD15 to get 15% off the entire line of products.Have questions? Feel free to reach out to me: tarawest@westwellnessatx.comWant to get started the right way, but don't know where to start. Email me tarawest@westwellnessatx.com to set up a 30 minute $100 session to get your personalized protocol. A special discount on your first order will be included. These spots fill up fast so schedule today!Want the free peptide guide? Email me tarawest@westwellnessatx.com and comment Guide and I'll shoot it right over!Follow me on instagram @westwellnessatxTakeaways: This podcast episode marks the 50th installment, showcasing significant growth and listener engagement. The primary focus of today's discussion centers on the relationship between NAD and cancer risk. NAD is crucial for cellular functions including energy production, DNA repair, and immune response. Current research presents mixed results regarding NAD's role in cancer, demanding further investigation and caution. NAD supplementation may not inherently cause cancer but could influence existing cancer cell behavior. Listeners are encouraged to conduct their own research and consider their personal health situations regarding NAD usage. Research Links NAD+ biology, aging, immunity, DNA repairCovarrubias et al. “NAD+ metabolism and its roles in cellular processes during ageing” (review). https://pmc.ncbi.nlm.nih.gov/articles/PMC7963035/ PMCGhanem et al. “Inhibitors of NAD+ Production in Cancer Treatment” (NAMPT/NAPRT review). https://pmc.ncbi.nlm.nih.gov/articles/PMC10889166/ PMCManickam et al. “Nampt: a new therapeutic target for modulating NAD metabolism in cancer and inflammation” (2025 review). https://cdnsciencepub.com/doi/10.1139/cjpp-2024-0400 Canadian Science PublishingExtracellular metabolism and cellular uptake (do IVs reach cells?)Gasparrini et al. “Enzymology of extracellular NAD metabolism” (ectoenzymes; NR/NMN/NAM import). https://pmc.ncbi.nlm.nih.gov/articles/PMC8038981/ PMCYusri et al. “The role of NAD+ metabolism and its modulation” (2025 review; NR via ENTs; NMN dephosphorylation; SLC12A8 debate). https://www.nature.com/articles/s44324-025-00067-0 NatureYaku et al. “NR and NMN: similarities and differences” (2025 perspective; NMN→NR conversion before uptake). https://www.science.org/doi/10.1126/sciadv.adr1538 ScienceHuman IV NAD+ / IV NR dataGrant et al. “A Pilot Study… during a 6-hour intravenous infusion of NAD+” (750 mg IV NAD+, plasma/urine...
Send us a textWelcome back Rounds Table Listeners! Today we have a solo episode with Dr. Mike Fralick. This week, he discusses a recently published trial exploring the simultaneous initiation of SGLT2 inhibitors and finerenone (a nonsteroidal mineralocorticoid receptor antagonist) in persons with chronic kidney disease and type 2 diabetes. Here we go!Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes (0:00 – 9:28).Calling keen trainees! (9:29 - 10:28)Trainees, med students, residents: The Rounds Table and Trial Files are looking for keen individuals to support our efforts.Trial Files is a free monthly newsletter on practice-changing trials, delivered straight to your inbox (https://trialfiles.substack.com/).Reach out to fralickmpf@gmail.com if you are interested in getting involved. Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods
In this episode, Eunice Wang, MD and Eytan Stein, MD explore the latest key clinical updates on menin inhibitors in AML. This episode unpacks evolving treatment strategies and what these developments mean for patient care.Presenters:Eytan M. Stein, MDChief, Leukemia ServiceDirector, Program for Drug Development in LeukemiaAssociate Attending PhysicianLeukemia Service, Department of MedicineMemorial Sloan Kettering Cancer CenterNew York, New YorkEunice S. Wang, MDChief, Leukemia ServiceProfessor of OncologyDepartment of MedicineRoswell Park Comprehensive Cancer CenterBuffalo, New YorkLink to full program: https://bit.ly/4f4an0O
In this episode, James Davis, PharmD, BCOP and Victoria Nachar, PharmD, BCOP summarize the latest key clinical updates on BTK inhibitors in CLL based on data recently presented at the annual ASCO and EHA meetings, including:The randomized phase III FLAIR trialThe randomized phase III SEQUOIA trialThe randomized phase III BRUIN CLL-321 trial Presenters:James Davis, PharmD, BCOPClinical Pharmacy Specialist, Malignant HematologyMUSC Hollings Cancer CenterAssistant ProfessorMUSC College of PharmacyCharleston, South CarolinaVictoria Nachar, PharmD, BCOPClinical Pharmacist Specialist, HematologyUniversity of Michigan Rogel Cancer CenterAnn Arbor, MichiganLink to full program: https://bit.ly/3H2EcSX
In this week's episode we'll learn more about the use of ruxolitinib plus dexamethasone to treat newly diagnosed patients with adult hemophagocytic lymphohistiocytosis; lysine-specific demethylase-1 inhibitors as a potential new class of therapies for sickle cell disease and other beta-globinopathies; and insights into clinical characteristics of patients with von Willebrand factor levels that are lower than normal but higher than those typically used to diagnose von Willebrand disease.Featured Articles:Ruxolitinib combined with dexamethasone for adult patients with newly diagnosed hemophagocytic lymphohistiocytosis in ChinaNovel, potent, and orally bioavailable LSD1 inhibitors induce fetal hemoglobin synthesis in a sickle cell disease mouse modelClinical phenotype and pathophysiological mechanisms underlying qualitative low VWF
In this episode, Dr. William Gradishar reviews key data on PARP inhibitors in breast cancer, including early insights from the OPERETTA and CompLEEment trials. He explores emerging combination strategies with immunotherapy and DNA-damaging agents, the potential to reduce chemotherapy use, and new tools to better identify candidates for targeted treatment. Let us know what you thought of this week's episode on Twitter: @physicianswkly Want to share your medical expertise, research, or unique experience in medicine on the PW podcast? Email us at editorial@physweekly.com! Thanks for listening!
“The proteasome itself, it really helps us unfold or get rid of misfolded proteins or degradations of different cells. We used to have garbage disposals in our sinks, and we used to put food product in there. If your garbage disposal is clogged, then everything backs up. So that's kind of what's really going on in the cell itself, is that I'm building up these unnecessary proteins that we should be getting rid of, and it actually causes apoptosis or cell death,” ONS member Daniel Verina, DNP, RN, ACNP-BC, nurse practitioner for the multiple myeloma program at Mount Sinai Medical Center in New York, NY, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about the proteasome inhibitor drug class. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.75 contact hours (including 40 minutes of pharmacotherapeutic content) of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by July 18, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learner will report an increase in knowledge related to the use of proteasome inhibitors in the treatment of cancer. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ Pharmacology 101 series ONS Voice article: AI Multiple Myeloma Model Predicts Individual Risk, Outcomes, and Genomic Implications ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Guide to Cancer Immunotherapy (second edition) Multiple Myeloma: A Textbook for Nurses (third edition) Clinical Journal of Oncology Nursing article: Optimizing Transitions of Care in Multiple Myeloma Immunotherapy: Nurse Roles Oncology Nursing Forum articles: Changes in Health-Related Quality of Life During Multiple Myeloma Treatment: A Qualitative Interview Study Facilitators of Multiple Myeloma Treatment: A Qualitative Study ONS Guidelines™ and Symptom Interventions Adherence to Oral Anticancer Medication Peripheral neuropathy ONS Hematology, Cellular Therapy, and Stem Cell Transplantation Learning Library American Society of Hematology International Myeloma Foundation Leukemia and Lymphoma Society Multiple Myeloma Research Foundation To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “When we look at the administration, we also want to make sure that we're looking at the blood counts, right? Because proteasome inhibitors are well known for causing thrombocytopenia and neutropenia. So making sure that the patients do meet eligibility for the treatment for that day, and do they have anemia or lower red blood cell counts. You want to make sure that, because of these therapies, that the patient has no symptoms or infections going into each therapy for that day.” TS 10:19 “[Bortezomib], interesting enough, it can cause hypotension, cardiac failure, and sometimes pulmonary edema. Switching that up a little bit, what makes it slightly different, carfilzomib … a lot of times we saw, even in the clinical trial, that there was a lot of hypertension or cardiomyopathies, or arrythmias that we saw with carfilzomib and different dosages that they have indicated from the FDA. So again, monitoring the hypertension … or heart failure.” TS 15:16 “We also want to keep in mind another adverse effect, and especially in myeloma—our patients come in the door already immunocompromised just by the disease state alone. But now I'm giving them therapies that can drop their neutrophil count, so neutropenia and thrombocytopenia, so they are at a higher risk of having serious infections, even including like pneumonia or having outbreaks of herpes zoster or shingles.” TS 16:50 “If the patient has shortness of breath or symptoms, hold the therapy. I think that's one of my biggest messages when it comes to cancer treatments and educating other healthcare providers, or even educating our patients and their caregivers or the care partners with them, is that we need to sometimes hold the therapy for safety.” TS 22:02 “I say keep a log, keep a book. Let me know when the symptoms happen. Are they happening the day of treatment? Are they happening two days later from the treatment? Are they happening a week later from the treatment? And being able to kind of guide which therapy is causing some of these adverse events or side effects alone. So, making them have calendars. When did you take the drug, when did you get your last infusion or your last [subcutaneous] injection? Always talk to your care team, whether it's in the academic center or next to your house in the community.” TS 26:17 “It's us learning how to listen to the patient going forward. We have tasks to do—we all have tasks to do in our lives—but we have to take a breath, be mindful who's in front of us, listen to them first, and then be able to talk to them and care for them upfront and see what the symptoms are. I think that's what we need to do. We have to take a breath in cancer.” TS 39:35
Please visit answersincme.com/KTK860 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, an expert in gastrointestinal cancers discusses strategies for treatment of patients with colorectal cancer using tyrosine kinase inhibitors. Upon completion of this activity, participants should be better able to: Identify patients with metastatic colorectal cancer (mCRC) who are suitable for tyrosine kinase inhibitor (TKI) treatment; Outline practical, patient-centered strategies to maximize quality of life in patients receiving later-line TKI treatment for mCRC; and Review approaches to manage adverse events associated with later-line TKI treatment for mCRC.
On this episode of Translating Proteomics, Parag, Andreas, and special guest Don Kirkpatrick answer questions submitted by the Translating Proteomics community. They cover:Needs in plasma proteomicsHow proteomics impacts drug development – with special guest Don Kirkpatrick Ph.D.!How lifestyle impacts the proteomeHow the Nautilus Proteome Analysis Platform is impacting tau and Alzheimer's disease researchReferencesShome et al., 2022 - Serum autoantibodyome reveals that healthy individuals share common autoantibodieshttps://www.sciencedirect.com/science/article/pii/S2211124722006489LaBaer Lab paper investigating autoantibody levels in plasma and their relationship to health.Sylman et al., 2018 - A Temporal Examination of Platelet Counts as a Predictor of Prognosis in Lung, Prostate, and Colon Cancer Patientshttps://www.nature.com/articles/s41598-018-25019-1Mallick lab paper investigating temporal changes in platelets and their associations with cancer biology.Krönke et al., 2014 - Lenalidomide causes selective degradation of IKZF1 and IKZF3 in multiple myeloma cellshttps://www.science.org/doi/10.1126/science.1244851Seminal paper describing selective protein degradation caused by lenalidomide.Fink and Ebert 2015 - The novel mechanism of lenalidomide activityhttps://ashpublications.org/blood/article/126/21/2366/34644/The-novel-mechanism-of-lenalidomide-activityReview of research elucidating the mechanisms of lenalidomide activityNdoja et al., 2025 - COP1 Deficiency in BRAFV600E Melanomas Confers Resistance to Inhibitors of the MAPK Pathwayhttps://www.mdpi.com/2073-4409/14/13/975Describe links between kinase inhibitor vemurafenib and changes in ETV transcription factor degradationSong et al., 2022 - RTK-Dependent Inducible Degradation of Mutant PI3Kα Drives GDC-0077 (Inavolisib) Efficacyhttps://aacrjournals.org/cancerdiscovery/article/12/1/204/675622/RTK-Dependent-Inducible-Degradation-of-Mutant-PI3KUse proteomics to discover that inavolisib acts through selective degradation of mutant PI3KαCanon et al., 2019 - The clinical KRAS(G12C) inhibitor AMG 510 drives anti-tumour immunityhttps://www.nature.com/articles/s41586-019-1694-1Covers the development of an inhibitor of KRAS mutant KRAS (G12C).Schneider et al., 2024 - Feeding gut microbes to nourish the brain: unravelling the diet-microbiota-gut-brain axishttps://www.nature.com/articles/s42255-024-01108-6Review on the gut-brain axisWebpage for Johanna Lampe's Lab at Fred Hutch Cancer Center
We talk with Abdullahi Jamiu, a graduate student at the Virginia Polytechnic Institute and State University in Blacksburg, VA, who studies how encephalitic alphaviruses modulate cellular transcription and antiviral responses to discover novel therapeutic targets.
UCSF oncologist Dr. Jonathan Chou discusses how genetics and genomics are transforming the diagnosis and treatment of prostate cancer. He explains how inherited and acquired mutations—especially in DNA repair genes like BRCA2—can impact both cancer risk and treatment decisions. Dr. Chou outlines how UCSF researchers use tumor and blood-based biopsies to identify key mutations and genomic features that help tailor care for each patient. Examples include how genomic scores can predict response to radiation and how targeted therapies like PARP inhibitors benefit patients with specific mutations. The talk highlights the growing role of precision medicine in guiding individualized treatment plans based on the unique genetic profile of each patient's cancer. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40798]
UCSF oncologist Dr. Jonathan Chou discusses how genetics and genomics are transforming the diagnosis and treatment of prostate cancer. He explains how inherited and acquired mutations—especially in DNA repair genes like BRCA2—can impact both cancer risk and treatment decisions. Dr. Chou outlines how UCSF researchers use tumor and blood-based biopsies to identify key mutations and genomic features that help tailor care for each patient. Examples include how genomic scores can predict response to radiation and how targeted therapies like PARP inhibitors benefit patients with specific mutations. The talk highlights the growing role of precision medicine in guiding individualized treatment plans based on the unique genetic profile of each patient's cancer. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40798]
UCSF oncologist Dr. Jonathan Chou discusses how genetics and genomics are transforming the diagnosis and treatment of prostate cancer. He explains how inherited and acquired mutations—especially in DNA repair genes like BRCA2—can impact both cancer risk and treatment decisions. Dr. Chou outlines how UCSF researchers use tumor and blood-based biopsies to identify key mutations and genomic features that help tailor care for each patient. Examples include how genomic scores can predict response to radiation and how targeted therapies like PARP inhibitors benefit patients with specific mutations. The talk highlights the growing role of precision medicine in guiding individualized treatment plans based on the unique genetic profile of each patient's cancer. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40798]
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/NVF865. CME credit will be available until June 29, 2026.Patient-Centric Frameworks in Desmoid Tumors: Integrating Emerging Science on Gamma Secretase Inhibitors for Progressive Disease In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, The Desmoid Tumor Research Foundation and Sarcoma Alliance for Research through Collaboration. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from SpringWorks Therapeutics, Inc.Disclosure information is available at the beginning of the video presentation.
CME in Minutes: Education in Rheumatology, Immunology, & Infectious Diseases
Please visit answersincme.com/ABT860 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, an expert in neurology discusses the clinical evidence for novel complement (C5) inhibitors in the treatment of generalized myasthenia gravis (gMG) and personalized multidisciplinary management strategies. Upon completion of this activity, participants should be better able to: Review the rationale for novel C5 inhibitors in the treatment of generalized myasthenia gravis (gMG); Describe the long-term clinical data of C5 inhibitors for the treatment of gMG; and Discuss strategies to personalize multidisciplinary management plans for patients with gMG.
Please visit answersincme.com/ABT860 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, an expert in neurology discusses the clinical evidence for novel complement (C5) inhibitors in the treatment of generalized myasthenia gravis (gMG) and personalized multidisciplinary management strategies. Upon completion of this activity, participants should be better able to: Review the rationale for novel C5 inhibitors in the treatment of generalized myasthenia gravis (gMG); Describe the long-term clinical data of C5 inhibitors for the treatment of gMG; and Discuss strategies to personalize multidisciplinary management plans for patients with gMG.
In this episode, Andrew F. Alexis, MD, MPH; Daniel C. Butler, MD; and Shawn G. Kwatra, MD, discuss IL-13 inhibition for treating patients with moderate to severe atopic dermatitis (AD), including:The available biologic therapies that specifically target IL-13Where these agents fall in the 2024 American Academy of Dermatology treatment algorithmHow these agents compare to other AD therapies like topical corticosteroids and oral JAK inhibitorsA detailed patient case to highlight take home pointsPresenterAndrew F. Alexis, MD, MPHProfessor of Clinical DermatologyWeill Cornell Medical College New York, New YorkDaniel C. Butler, MDAssistant Dean Student AffairsUniversity of Arizona College of Medicine – TucsonTucson, ArizonaShawn G. Kwatra, MDDr. Joseph W. Burnett Endowed Professor and Chair Department of DermatologyUniversity of Maryland School of MedicineBaltimore, MarylandProgram page:https://bit.ly/4kTP04D
In this episode, Daniel C. Butler, MD, and Shawn G. Kwatra, MD, discuss the practical considerations for using IL-13 inhibitors to treat patients with moderate to severe atopic dermatitis, including:Patient candidacy considerationsTreatment advancement strategies that go beyond topical therapiesThe importance of patient-centered care that address patients' fears and needsA detailed patient case to highlight take home pointsPresenterDaniel C. Butler, MDAssistant Dean Student AffairsUniversity of Arizona College of Medicine – TucsonTucson, ArizonaShawn G. Kwatra, MDDr. Joseph W. Burnett Endowed Professor and Chair Department of DermatologyUniversity of Maryland School of MedicineBaltimore, MarylandProgram page:https://bit.ly/4kTP04D
Trends and Innovations from Barcelona (6.20.2025) AI Advances axSpA Diagnosis with Multimodal MRI IL-17 Inhibitors in Psoriatic Arthritis IL-17 Inhibitors for Axial Spondyloarthritis New IL-17 Inhibition New Molecular Constructs
In this episode, we took a deep dive intro the landscape of menin inhibitors in AML with Dr. Eytan Stein from MSKCC. Here are the key trials and studies we discussed: ELN 2022 AML Classification https://ashpublications.org/blood/article/140/12/1345/485817/Diagnosis-and-management-of-AML-in-adults-2022Predictors of outcomes in adults with AML and KMT2A rearrangements: https://www.nature.com/articles/s41408-021-00557-6DOT1L inhibitor https://ashpublications.org/blood/article/131/24/2661/37193/The-DOT1L-inhibitor-pinometostat-reduces-H3K79AUGMENT 101: https://ascopubs.org/doi/10.1200/JCO.24.00826Menin inhibition with revumenib for NPM1-mutated relapsed or refractory acute myeloid leukemia: the AUGMENT-101 study: https://ashpublications.org/blood/article/doi/10.1182/blood.2025028357/537139/Menin-inhibition-with-revumenib-for-NPM1-mutatedKOMET-001: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00386-3/abstractSAVE trial: https://ashpublications.org/blood/article/144/Supplement%201/216/530724/Phase-I-II-Study-of-the-All-Oral-Combination-ofKOMET-007: https://library.ehaweb.org/eha/2025/eha2025-congress/4159213/harry.erba.ziftomenib.combined.with.intensive.induction.chemotherapy.2872B329.in.html?f=menu%3D6%2Abrowseby%3D8%2Asortby%3D2%2Amedia%3D3%2Ace_id%3D2882%2Aot_id%3D31560%2Amarker%3D5843%2Afeatured%3D19595MEN1 mutations: https://www.nature.com/articles/s41586-023-05755-9
Watch Here : https://www.youtube.com/watch?v=eI1Y7IFENIo Website: https://vigoroussteve.com/ Consultations: https://vigoroussteve.com/consultations/ eBooks: https://vigoroussteve.com/shop/ YouTube Channel: http://www.youtube.com/user/VigorousSteve/ Workout Clips Channel: https://www.youtube.com/channel/UCWi2zZJwmQ6Mqg92FW2JbiA Instagram: https://instagram.com/vigoroussteve/ TikTok: https://www.tiktok.com/@vigoroussteve Reddit: https://www.reddit.com/r/VigorousSteve/ PodBean: https://vigoroussteve.podbean.com/ Spotify: https://open.spotify.com/show/2wR0XWY00qLq9K7tlvJ000 Patreon: https://www.patreon.com/vigoroussteve
In today's episode, we had the pleasure of speaking with Alexey Danilov, MD, PhD, about current challenges and emerging treatment approaches for the management of leukemia and lymphoma that were published in a manuscript based on proceedings from the inaugural Bridging the Gaps in Leukemia, Lymphoma, and Multiple Myeloma Conference. Dr Danilov is the Marianne and Gerhard Pinkus Professor of Early Clinical Therapeutics, medical director of the Early Phase Therapeutics Program for the Systems Clinical Trials Office, co-director of the Toni Stephenson Lymphoma Center, and a professor in the Division of Lymphoma in the Department of Hematology & Hematopoietic Cell Transplantation at City of Hope in Duarte, California. In our exclusive interview, Dr Danilov highlighted recent advances and controversies in the treatment of select patients with hematologic malignancies. He noted chemotherapy-free regimens that are shifting treatment paradigms in mantle cell lymphoma, preferred and emerging BTK inhibitors for the management of chronic lymphocytic leukemia, and the evolution of CD19-directed CAR T-cell therapies for diffuse large B-cell lymphoma. Dr Danilov concluded by taking a forward glance at future developments like BTK degraders and novel CAR T-cell therapy targets.
Featuring perspectives from Dr Virginia F Borges, Ms Jamie Carroll, Mr Ronald Stein and Dr Seth Wander, including the following topics: Introduction (0:00) Role of CDK4/6 Inhibitors in Localized and Metastatic Hormone Receptor (HR)-Positive Breast Cancer (12:49) PI3K Inhibition as First-Line Treatment for HR-Positive, HER2-Negative Metastatic Breast Cancer (mBC) (38:24) Clinical Utility of AKT and PI3K Inhibitors in Progressive HR-Positive mBC (1:01:44) Current and Future Role of Oral Selective Estrogen Receptor Degraders in HR-Positive mBC (1:24:38) NCPD information and select publications
Episode 367: Pharmacology 101: PARP Inhibitors “We know that in cells that are proliferating very quickly, including cancer cells, single-strand DNA breaks are very common. When that happens, these breaks are often repaired by the PARP enzyme, and the cells can continue their replication process. If we block PARP, that repair cannot happen. So in blocking that, these single-strand breaks then lead to double-strand breaks, which ultimately is leading to cell apoptosis,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the PARP inhibitor drug class. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by June 13, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the use of PARP inhibitors in cancer care. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Pharmacology 101 series Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs Episode 232: Managing Fatigue During PARP Inhibitor Maintenance Therapy Episode 227: Biomarker Testing, PARP Inhibitors, and Oral Adherence During Ovarian Cancer Maintenance Therapy ONS Voice articles: PARP Inhibitors and Ovarian Cancer Genomics May Trick PARP Inhibitors to Treat More Cancers Oncology Drug Reference Sheet: Niraparib ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Safe Handling of Hazardous Drugs (fourth edition) ONS courses: Safe Handling Basics Clinical Journal of Oncology Nursing articles: PARP Inhibition: Genomics-Informed Care for Patients With Malignancies Driven by BRCA1/BRCA2 Pathogenic Variants Talazoparib Plus Enzalutamide in Patients With HRR-Deficient mCRPC: Practical Implementation Steps for Oncology Nurses and Advanced Practice Providers Oncology Nursing Forum article: Familiarity and Perceptions of Ovarian Cancer Biomarker Testing and Targeted Therapy: A Survey of Oncology Nurses in the United States Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation ONS Biomarker Database ONS Oral Anticancer Medication Learning Library ONS Oral Anticancer Medication Toolkit Oral Chemotherapy Education Sheets To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “The big toxicities here to watch for are primarily hematologic toxicities. It is one of those targeted therapies that does affect blood cell counts. So I'd say the blood cell count that is most commonly affected here is the hemoglobin. So, anemia very frequent complication that we see, probably a little bit more with olaparib compared with other drugs, but we see it as a class side effect. And we can also see neutropenia and thrombocytopenia with these agents, probably a little bit more with niraparib versus the others, but again, you can see it across all of these drugs.” TS 8:16 “We mentioned that rare risk of MDS and AML. This isn't a particularly scary thing if you talk to patients about it. Because of the rarity that we see this, it isn't something that we need to overemphasize, but I think careful monitoring of blood counts in is stressing the importance of that and early intervention here is very important.” TS 16:55 “This is a collaborative effort. And because of the home administration here, these patients do need to be followed very closely. So we are not laying eyes on them usually with the frequency that we do when we have patients actually coming into our infusion centers for treatments—so making sure that there is a plan for regular follow-up with these patients to ensure that they're getting that lab work done, that that's being looked at closely, that we're adjusting the dose if we need to based on that lab work, that we are managing the patient's fatigue. Again, that potentially dose reductions may be needed if patients are having that extreme fatigue.” TS 19:34 “I think one of those [misconceptions] could be that they're only effective in patients that have that BRCA1/2 mutation. And again, remember here that there is some data in particular disease states that we can use them and that they work in the absence of those mutations.” TS 25:12
Can we do more than prescribe pills to address men's sexual health complaints? In this episode of the BackTable Urology Podcast, men's health expert Dr. Mohit Khera from Baylor College of Medicine joins guest host Dr. Amy Pearlman for a deep dive into testosterone management and the full spectrum of erectile dysfunction therapies. --- SYNPOSIS The conversation covers daily tadalafil use, lifestyle optimization, and the nuanced role of off-label medications. Dr. Khera also highlights emerging technologies like the Tech Ring and radiofrequency treatments, alongside practical insights into semen analysis and hormonal health markers. Throughout, he emphasizes a holistic, patient-centered approach to sexual health—blending medical therapy with meaningful lifestyle change. This is a must-listen for general urologists, men's health specialists, and trainees looking to expand their toolkit in this evolving field. --- TIMESTAMPS 00:00 - Introduction02:13 - Erectile Dysfunction and Testosterone08:05 - Young Men's Health and Early Detection10:20 - Semen Analysis for Overall Health12:50 - Daily Tadalafil and Its Benefits16:40 - Proactive Sexual Health Management21:28 - Female Sexual Health25:16 - Treating Delayed Ejaculation28:53 - Psychogenic Erectile Dysfunction31:16 - Technology in Sexual Health35:54 - Lifestyle Modifications for Better Sexual Health41:55 - Resources and Referrals for Patients44:30 - Final Thoughts
Dr. Grant Tinsley joins the discussion as the body composition expert.Myostatin is a key regulator of muscle growth.Wendy Whippete the most jacked muscled up dogThe concern of GLP-1 receptor agonists and muscle mass loss.Overview of Courage trial looking at semaglutide and trevogrumab and lean mass lossUpcoming Believe trial coming out (bimagrumab and semaglutide)Exercise remains crucial for muscle health and function.MRI data from SURPASS MRI provides new insights into muscle volume changes.The combination of medications may have varying effects on muscle mass.Caution is advised regarding the long-term effects of new drugs.Clinical benefits of medications often outweigh concerns about muscle loss.Future research will explore the synergy between exercise and medication.Other docs who lift podcasts with Dr. Grant:Tirzepatide muscle lossLean mass loss and GLP-1 meds