POPULARITY
8 episodes with lancet oncol
3 episodes with lancet oncol
2 episodes with lancet oncol
3 episodes with lancet oncol
4 episodes with lancet oncol
4 episodes with lancet oncol
2 episodes with lancet oncol
4 episodes with lancet oncol
In de podcastserie proefschriften spreekt aios interne geneeskunde dr. Tessa Steenbruggen met promovendi. In deze aflevering spreekt zij met dr. Lisette Rozeman over haar proefschrift, getiteld: “Improving outcome of melanoma patients upon immunotherapy”. Lisette vertelt over de verschillende studies met immunotherapie, die zij samen met haar promotor prof. dr. Christian Blank heeft opgezet, gecoördineerd en geanalyseerd, en die de behandeling van patiënten met een melanoom significant hebben veranderd. Lisette heeft op 7 januari jl. haar proefschrift succesvol verdedigd aan de Universiteit van Leiden. Referenties Podcast: The fellow on call OPACIN: Blank CU, et al. Nature Medicine 2018;24:1655–6. OPACIN-neo: Rozeman EA, et al. Lancet Oncol 2019;20:948-60. SWOG 1801: Patel SP, et al. N Eng J Med 2023;388:813-23. NADINA: Blank CU, et al. N Eng J Med 2024;391:1696-708. IMPEMBRA: Rozeman EA, et al. J Immunother Cancer 2023;11:e006821. Sequentiële combinatietherapie: Reijers IL, et al. https://onlinelibrary.wiley.com/doi/10.1111/pcmr.12835 Antistoffen en toxiciteit 1: De Moel EC, et al. Cancer Immunol Res 2019;7:6-11. Antistoffen en toxiciteit 2: Borgers JS, et al. J Immunother Cancer 2024;12:e009215.
Voici le 8ème épisode de notre série de Podcast La Pause Dig' !
In de podcastserie proefschriften spreekt aios interne geneeskunde dr. Tessa Steenbruggen met promovendi. In deze aflevering spreekt zij met Anna van der Voort over haar proefschrift, getiteld “Tailoring systemic treatment in HER2-positive breast cancer.” Aan bod komen onder andere de resultaten van de TRAIN2- en TRAIN3-studie, en hoe de behandeling voor dit subtype borstkanker verder geoptimaliseerd kan worden. Anna zal op 13 juni september haar proefschrift verdedigen aan de Universiteit van Amsterdam bij prof. dr. Gabe Sonke en dr. Ritse Mann. Referenties Kuang RF. Yellow Faces. William Morrow; 2023. Van der Voort A, et al. JAMA Oncol 2021;7:978-84. Van der Voort A, et al. Lancet Oncol 2024;25:603-13. Van der Voort A, et al. Breast 2022;65:110-15.
While cancer survivorship rates continue to improve, there are CVD-related complications for patients before, during, and after cancer treatment. Guests Chelsea Kriesberg, DNP, CPNP-AC, CCRN, and Lisa Nodzon, PhD, APRN, AOCNP, describe the intersection of cancer and cardiovascular disease across the lifespan. Collaborative, team-based, and life-long care is illustrated in through a case-based discussion.Cardiovascular risk calculator: https://ccss.stjude.org/resources/calculators/cardiovascular-risk-calculator.htmlCardiac Disease in Childhood Cancer Survivors: Risk Prediction, Prevention, and Surveillance. Leerink, J, de Baat, E, Feijen, E. et al. Cardiac Disease in Childhood Cancer Survivors: Risk Prediction, Prevention, and Surveillance: JACC CardioOncology State-of-the-Art Review. J Am Coll Cardiol CardioOnc. 2020 Sep, 2 (3) 363–378.https://doi.org/10.1016/j.jaccao.2020.08.006Cardioprotective impacts of dexrazoxane: Lipshultz SE, Scully RE, Lipsitz SR, et al. Assessment of dexrazoxane as a cardioprotectant in doxorubicin-treated children with high-risk acute lymphoblastic leukaemia: long-term follow-up of a prospective, randomised, multicentre trial. Lancet Oncol. 2010 Oct;11(10):950-61. doi: 10.1016/S1470-2045(10)70204-7. Epub 2010 Sep 16. PMID: 20850381; PMCID: PMC3756093.Improving quality and quantity of life for childhood cancer survivors: Ehrhardt MJ, Krull KR, Bhakta N, et al. Improving quality and quantity of life for childhood cancer survivors globally in the twenty-first century. Nat Rev Clin Oncol. 2023 Oct;20(10):678-696. doi: 10.1038/s41571-023-00802-w. Epub 2023 Jul 24. PMID: 37488230.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: August 3, 2017 The most common primary brain tumor that occurs in adults, glioblastoma multiforme, comes with a life expectancy shorter than practically every other form of cancer. But thanks to novel treatment strategies, advanced neuroimaging, and biomarker research, we are learning more and more about how to improve the survival and the quality of life of patients who suffer from this terrible illness. Produced by James E Siegler and Neena Cherayil. Music by Axle, Coldnoise, Josh Woodward, and Kelly Latimer. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. REFERENCES Gately L, McLachlan SA, Dowling A, Philip J. Life beyond a diagnosis of glioblastoma: a systematic review of the literature. J Cancer Surviv 2017;11(4):447-52. PMID 28194640Grady D. Glioblastoma, John Mccain's Form of Brain Cancer, Carries Troubling Prognosis. New York Times, July 20, 2017.Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016;131(6):803-20. PMID 27157931Scutti S. Sen John McCain has aggressive brain tumor, surgically removed. CNN, July 19, 2017.Stupp R, Hegi ME, Mason WP, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 2009;10(5):459-66. PMID 19269895Hegi ME, Diserens AC, Gorlia T, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 2005;352(10):997-1003. PMID 15758010Thakkar JP, Dolecek TA, Horbinski C, et al. Epidemiologic and molecular prognostic review of glioblastoma. Cancer Epidemiol Biomarkers Prev 2014;23(10):1985-96. PMID 25053711Weller M, Wick W. Neuro-oncology in 2013: improving outcome in newly diagnosed malignant glioma. Nat Rev Neurol 2014;10(2):68-70. PMID 24419684 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.
Kristen K. Ciombor, MD, MSCI, an assistant professor in the Division of Hematology/Oncology in the Department of Medicine at the Vanderbilt University Medical Center, recently spoke at an Around the Practice discussion regarding updates in the world of metastatic colorectal cancer (CRC). In this episode of the ONCOLOGY® On the Go Podcast, she discusses treatment updates, molecular testing options, and emerging targets in CRC. Ciombor also highlighted ongoing research in the space, including the phase 3 BREAKWATER (NCT04607421)1 trial and the phase 3 MOUNTAINEER-03 (NCT05253651)2 trial. She also discussed some of the most important presentations from the 2023 European Society for Medical Oncology (ESMO) Congress, including those covering the phase 2 MOUNTAINEER study (NCT03043313)3 and the phase 3 KEYNOTE-811 trial (NCT03615326).4 Additionally, she spoke about her work in the phase 2 ECOG-ACRIN trial (NCT04751370) assessing neoadjuvant nivolumab (Opdivo) plus ipilimumab (Yervoy) in patients with microsatellite instability-high or mismatch repair deficient rectal cancer.5 “I'm hoping that we see more treatment options for patients [and that] we identify more patient subtypes that we can target and find actionable alterations for,” Ciombor said. References 1. Kopetz S, Grothey A, Yaeger R, et al. BREAKWATER: randomized phase 3 study of encorafenib (enco) + cetuximab (cetux) ± chemotherapy for first-line (1L) treatment (tx) of BRAF V600E-mutant (BRAFV600E) metastatic colorectal cancer (mCRC). J Clin Oncol. Published online May 28, 2021. doi:10.1200/jco.2021.39.15_suppl.tps3619 2. Bekaii-Saab TS, Van Cutsem E, Tabernero J, et al. MOUNTAINEER-03: phase 3 study of tucatinib, trastuzumab, and mFOLFOX6 as first-line treatment in HER2+ metastatic colorectal cancer—Trial in progress. J Clin Oncol. Published online January 24, 2023. doi:10.1200/jco.2023.41.4_suppl.tps261 3. Strickler JH, Cercek A, Siena S, et al. Tucatinib plus trastuzumab for chemotherapy-refractory, HER2-positive, RAS wild-type unresectable or metastatic colorectal cancer (MOUNTAINEER): a multicentre, open-label, phase 2 study. Lancet Oncol. Published online May 24, 2023. doi:10.1016/S1470-2045(23)00150-X 4. Janjigian YY, Kawazoe A, Bai Y, et al. embrolizumab plus trastuzumab and chemotherapy for HER2+ metastatic gastric or gastroesophageal junction (mG/GEJ) adenocarcinoma: Survival results from the phase III, randomized, double-blind, placebo-controlled KEYNOTE-811 study. Ann Oncol. 2023;34(suppl 2):S851-S852. doi:10.1016/j.annonc.2023.09.1424 5. Ciombor KK, Hong SC, Eng C, et al. EA2201: An ECOG-ACRIN phase II study of neoadjuvant nivolumab plus ipilimumab and short course radiation in MSI-H/dMMR rectal tumors. J Clin Oncol. Published online June 2, 2022. doi:10.1200/jco.2022.40.16_suppl.tps3644
Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of gastrointestinal stromal tumors (GISTs)! Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist and current HPB fellow at MD Anderson Connor Chick, MD (@connor_chick) is a Surgical Oncology fellow at Ohio State University. Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-6 General Surgery resident at Brooke Army Medical Center Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Learning Objectives: In this episode, we review the basics of gastrointestinal stromal tumors (GISTs), how to evaluate patients with presenting mass consistent with GIST, initial work-up, staging, and management. We discuss key concepts including the genetic background of these tumors and high-yield targeted therapies that are relevant both in direct patient care and board exams. Reference: Gold JS, Gönen M, Gutiérrez A, Broto JM, García-del-Muro X, Smyrk TC, Maki RG, Singer S, Brennan MF, Antonescu CR, Donohue JH, DeMatteo RP. Development and validation of a prognostic nomogram for recurrence-free survival after complete surgical resection of localised primary gastrointestinal stromal tumour: a retrospective analysis. Lancet Oncol. 2009 Nov;10(11):1045-52. doi: 10.1016/S1470-2045(09)70242-6. Epub 2009 Sep 28. PMID: 19793678; PMCID: PMC3175638. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our surgical oncology oral board exam review here: https://behindtheknife.org/premium/
In this episode, Anthony and Bernie chat with Chris Booth, MD, and Aaron "Papa Heme" Goodman, MD, to talk about the Common Sense Oncology movement! Join the Common Sense Oncology movement at this link (it's free!): https://commonsenseoncology.org/ Lancet Oncol paper: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(23)00319-4/fulltext
Sind die Inzidenzen von Krebserkrankungen bei Kinder während der Pandemie gestiegen oder wurden Kinder später diagnostiziert? Erste Befürchtungen haben sich zum Glück nicht bestätigt, kann Prof. Thomas Lehrnbecher, Leiter des Schwerpunktes Onkologie, Hämatologie und Hämostaseologie der Klinik für Kinder- und Jugendmedizin in Frankfurt, entwarnen. Möglich aber, dass hier noch nicht das letzte Wort gesprochen ist. Der Grundsatz „First, do no harm“ ließ die Behandler von krebskranken Kindern die Therapie zum Teil aussetzen, wenn sie COVID-positiv waren. Hören Sie in dieser spannenden Rückschau, welche Lehren wir für die Zukunft ziehen können – vor allem die, insgesamt genauer auf Kinder und Jugendliche zu blicken. Hilfreiche Informationen: ECIL 9 Leitlinien: Cesaro S, Ljungman P, Mikulska M et al. (2022) Recommendations for the management of COVID-19 in patients with haematological malignancies or haematopoietic cell transplantation, from the 2021 European Conference on Infections in Leukaemia (ECIL 9). Leukemia 36: 1467–1480. ECIL 9 Part 2. Revised Guidelines - Update on COVID 19 in Hematology-Oncology patients. 2022. https://www.ecil-leukaemia.com/en/resources/resources-ecil (aufgerufen 12. Februar 2023). Literatur: Mukkada S, Bhakta N, Chantada GL et al. (2021) Global characteristics and outcomes of SARS-CoV-2 infection in children and adolescents with cancer (GRCCC): a cohort study. Lancet Oncol 22: 1416–1426. Abu Shanap M, Sughayer M, Alsmadi O et al. (2022) Factors that predict severity of infection and seroconversion in immunocompromised children and adolescents with COVID-19 infection. Front Immunol 13: 919762. Heininger U, Laws H-J & Lehrnbecher T (2021) Impfen von Kindern und Jugendlichen bei Immundefizienz. Consilium Themenheft 02-2021, InfectoPharm Arzneimittel und Consilium GmbH, ISSN 2365-7618. Link zum Transkript: https://www.infectopharm.com/consilium/podcast/podcast-paediatrie/ Kontakte: Feedback zum Podcast? podcast@infectopharm.com Homepage zum Podcast: www.infectopharm.com/consilium/podcast/ Für Fachkreise: www.wissenwirkt.com und App „Wissen wirkt.“ für Android und iOS Homepage InfectoPharm: www.infectopharm.com Disclaimer: Der consilium – Pädiatrie-Podcast dient der neutralen medizinischen Information und Fortbildung für Ärzte. Für die Inhalte sind der Moderator und die Gäste verantwortlich, sie unterliegen dem wissenschaftlichen Wandel des Faches. Änderungen sind vorbehalten. Impressum: consilium ist eine Marke von InfectoPharm Arzneimittel und Consilium GmbH Von-Humboldt-Str. 1 64646 Heppenheim Tel.: 06252 957000 Fax: 06252 958844 E-Mail: kontakt@infectopharm.com Geschäftsführer: Philipp Zöller (Vors.), Michael Gilster, Dr. Markus Rudolph, Dr. Aldo Ammendola Registergericht: Darmstadt – HRB 24623 USt.-IdNr.: DE 172949642 Verantwortlich für den Inhalt: Dr. Markus Rudolph
In deze podcast bespreekt internist-oncoloog Koos van der Hoeven recente ontwikkelingen op het gebied van de behandeling van het niet-kleincellig longcarcinoom. Hij bespreekt met longarts Egbert Smit de resultaten van de CheckMate 9LA-studie die hebben geleid tot een nieuwe behandeloptie: eerstelijnsbehandeling van patiënten met gevorderd niet-kleincellig longcarcinoom met nivolumab plus ipilimumab in combinatie met twee cycli chemotherapie versus chemotherapie alleen. Daarnaast worden de PD-L1-expressie en de consequenties voor de behandeling besproken.Referenties 1. Nederlandse richtlijn Niet-kleincellig longcarcinoom. Te raadplegen via richtlijnendatabase.nl/richtlijn/niet_kleincellig_longcarcinoom 2. Hendriks LE, et al. Ann Oncol 2023;34:358-76. 3. Overleving bij stadium IV-NSCLC zonder TKI-gevoelige mutaties (IKNL 2023). Te raadplegen via iknl.nl/kankersoorten/longkanker/registratie/overleving 4. Reck M, et al. J Clin Oncol 2021;39:2339-49. 5. Jassem J, et al. J Thorac Oncol 2021;16:1872-82. 6. Hellmann MD, et al. N Engl J Med 2019;381:2020-31. 7. Paz-Ares L, et al. Lancet Oncol 2021;22:198-211. 8. Reck M, et al. ESMO Open 2021;6:100273. 9. Paz-Ares LG, et al. J Thorac Oncol 2023;18:P204-22. 10. Gandhi L, et al. N Engl J Med 2018;378:2078-92. 11. West H, et al. Lancet Oncol 2019;20:924-37. 12. Samenvatting van de productkenmerken van Opdivo® (nivolumab). Te raadplegen via www.ema.europa.eu/en/documents/product-information/opdivo-epar-product-information_en.pdf 13. Advies van de commissie BOM (2021). Te raadplegen via www.nvmo.org/bom/nivolumab-en-ipilimumab-gecombineerd-met-2-cycli-chemotherapie-als-eerstelijnsbehandeling-voor-gemetastaseerd-niet-kleincellig-longcarcinoom/ 14. Van den Heuvel M, et al. Medische Oncologie 2021.Disclosures Prof. dr. E. Smit: Personal financial interests: none. Institutional financial interests: fees have been paid to my institution for speaker engagements and attendance to advisory boards of AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Bayer, DSI, Eli Lilly, MSD, Merck, Novartis, Pfizer, Sanofi, Takeda, Regeneron, Roche Genentech, Roche Diagnostics. Research support: AstraZeneca, Bristol Myers Squibb, Merck, MSD. PI for clinical studies sponsored by Amgen, AstraZeneca, Bayer, Clovis, Cullingan, Eli Lilly, Merck, MSD, Novartis, PharmaMar, Roche Genentech, Takeda. Prof. dr. ir. J.J.M. van der Hoeven: Astellas, AstraZeneca, Bayer, BMS, Daiichi Sankyo, Gilead, Novartis, medisch directeur van Hartwig Medical Foundation, voorzitter Oncomid, lid Adviescollege VIG en lid RVT DICA. 7356-NL-2300020
De novo metastatic breast cancer represents 6% of all new breast cancer diagnoses. This figure has not changed at all over the past 20 years; however, systemic therapy options have evolved dramatically during this time and have significantly increased life expectancy for these patients. While surgical management of the primary tumor in the setting of metastatic disease has typically been reserved for palliative indications, surgeons are now being asked to consider resecting the primary tumor to potentially increase overall survival. In this episode, we will use a case study to examine the data that should inform our conversations and decisions when we encounter patients with metastatic breast cancer who are interested in having their primary tumor resected. Links: Khan, S.A., S. Schuetz, and O. Hosseini (2022). Primary-Site Local Therapy for Patients with De Novo Metastatic Breast Cancer: An Educational Review. Ann Surg Oncol; 29: 5811-5820. https://link.springer.com/article/10.1245/s10434-022-11900-x Khan, S.A. et al (2022). Early Local Therapy for the Primary Site in De Novo Stage IV Breast Cancer: Results of a Randomized Clinical Trial (E2108). J Clin Oncol; 40(9): 978-987. https://ascopubs.org/doi/10.1200/JCO.21.02006?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Badwe, R. et al (2015). Locoregional treatment versus no treatment of the primary tumor in metastatic breast cancer: an open-label randomized controlled trial. Lancet Oncol; 16: 1380-1388. https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00135-7/fulltext Fitzal, F. et al (2019). Impact of Breast Surgery in Primary Metastasized Breast Cancer: Outcomes of the Prospective Randomized Phase III ABCSG-28 POSYTIVE Trial. Ann Surg; 269(6): 1163-1169. https://journals.lww.com/annalsofsurgery/Abstract/2019/06000/Impact_of_Breast_Surgery_in_Primary_Metastasized.24.aspx Soran, A. et al (2018). Randomized Trial Comparing Resection of Primary Tumor with No Surgery in Stage IV Breast Cancer at Presentation: Protocol MF07-01. Ann Surg Oncol; 25: 3141-3149. https://link.springer.com/article/10.1245/s10434-018-6494-6 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other breast surgery episodes here: https://behindtheknife.org/podcast-category/breast/
MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: February 20, 2020 Immune checkpoint inhibitors have revolutionized cancer treatment. Unlike chemotherapy, which essentially includes cellular toxins that can cause widespread and unnecessary tissue damage, checkpoint inhibitors are used to train the body's natural immune system to fight off cancer. And while they are extraordinarily effective options for patients with malignant disease, they are not without risk. Every day, we are learning more and more about the autoimmune side effects of these novel therapies. This week on the BrainWaves Podcast, Dr. Justine Cohen (University of Pennsylvania) shares her experience managing patients with checkpoint inhibitor neurotoxicity. Produced by James E Siegler and Justine Cohen. Music courtesy of Jon Watts, Kai Engel, and Kevin McLeod--as well as a cameo appearance by the Checkpoints. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Bhatia S, Tykodi SS, Thompson JA. Treatment of metastatic melanoma: an overview. Oncology (Williston Park) 2009;23(6):488-96. PMID 19544689 Cohen JV, Buchbinder EI. The evolution of adjuvant therapy for melanoma. Curr Oncol Rep 2019;21(12):106. PMID 31768772 Cohen JV, Wang N, Venur VA, et al. Neurologic complications of melanoma. Cancer 2020;126(3):477-86. PMID 31725902 Graus F, Dalmau J. Paraneoplastic neurological syndromes in the era of immune-checkpoint inhibitors. Nat Rev Clin Oncol 2019;16(9):535-48. PMID 30867573 Hottinger AF. Neurologic complications of immune checkpoint inhibitors. Curr Opin Neurol 2016 ;29(6):806-12. PMID 27653290 Wick W, Hertenstein A, Platten M. Neurological sequelae of cancer immunotherapies and targeted therapies. Lancet Oncol 2016;17(12):e529-41. PMID 27924751 Zekeridou A, Lennon VA. Neurologic autoimmunity in the era of checkpoint inhibitor cancer immunotherapy. Mayo Clin Proc 2019;94(9):1865-78. PMID 31358366 Zubiri L, Allen IM, Taylor MS, et al. Immune-related adverse events in the setting of PD-1/L1 inhibitor combination therapy. Oncologist 2020;25(3):e398-404. PMID 32162817 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.
You have a patient who underwent local excision of a rectal cancer. Final pathology demonstrates a T2 lesion. What is the rate of local recurrence? Is excision alone sufficient? Should the patient undergo radical resection or should chemoradiation be offered? Tune in to find out! Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Jose Guillem MD, MPH, MBA as they discuss high yield papers discussing local excision for Rectal Cancer. You may follow along with the slides mentioned in this episode here: https://behindtheknife.org/video/journal-review-in-colorectal-surgery-local-excision-for-rectal-cancer/ Learning Objectives 1. Describe the features that increase risk of lymph node involvement in early stage rectal cancer 2. Discuss the different options for management of early-stage rectal cancer 3. Describe patient related factors that favor local excision of rectal cancer References: Kidane B, Chadi SA, Kanters S, Colquhoun PH, Ott MC. Local resection compared with radical resection in the treatment of T1N0M0 rectal adenocarcinoma: a systematic review and meta-analysis. Dis Colon Rectum. 2015 Jan;58(1):122-40. doi: 10.1097/DCR.0000000000000293. PMID: 25489704. Garcia-Aguilar J, Renfro LA, Chow OS, Shi Q, Carrero XW, Lynn PB, Thomas CR Jr, Chan E, Cataldo PA, Marcet JE, Medich DS, Johnson CS, Oommen SC, Wolff BG, Pigazzi A, McNevin SM, Pons RK, Bleday R. Organ preservation for clinical T2N0 distal rectal cancer using neoadjuvant chemoradiotherapy and local excision (ACOSOG Z6041): results of an open-label, single-arm, multi-institutional, phase 2 trial. Lancet Oncol. 2015 Nov;16(15):1537-1546. doi: 10.1016/S1470-2045(15)00215-6. Epub 2015 Oct 22. PMID: 26474521; PMCID: PMC4984260. Friel CM, Cromwell JW, Marra C, Madoff RD, Rothenberger DA, Garcia-Aguílar J. Salvage radical surgery after failed local excision for early rectal cancer. Dis Colon Rectum. 2002 Jul;45(7):875-9. doi: 10.1007/s10350-004-6320-z. PMID: 12130873. Nascimbeni R, Burgart LJ, Nivatvongs S, Larson DR. Risk of lymph node metastasis in T1 carcinoma of the colon and rectum. Dis Colon Rectum. 2002 Feb;45(2):200-6. doi: 10.1007/s10350-004-6147-7. PMID: 11852333. O'Neill CH, Platz J, Moore JS, Callas PW, Cataldo PA. Transanal Endoscopic Microsurgery for Early Rectal Cancer: A Single-Center Experience. Dis Colon Rectum. 2017 Feb;60(2):152-160. doi: 10.1097/DCR.0000000000000764. PMID: 28059911. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other colorectal episodes here: https://behindtheknife.org/podcast-category/colorectal/
De novo metastatic breast cancer represents 6% of all new breast cancer diagnoses. This figure has not changed at all over the past 20 years; however, systemic therapy options have evolved dramatically during this time and have significantly increased life expectancy for these patients. While surgical management of the primary tumor in the setting of metastatic disease has typically been reserved for palliative indications, surgeons are now being asked to consider resecting the primary tumor to potentially increase overall survival. In this episode, we will use a case study to examine the data that should inform our conversations and decisions when we encounter patients with metastatic breast cancer who are interested in having their primary tumor resected. Links: § Khan, S.A., S. Schuetz, and O. Hosseini (2022). Primary-Site Local Therapy for Patients with De Novo Metastatic Breast Cancer: An Educational Review. Ann Surg Oncol; 29: 5811-5820. https://link.springer.com/article/10.1245/s10434-022-11900-x § Khan, S.A. et al (2022). Early Local Therapy for the Primary Site in De Novo Stage IV Breast Cancer: Results of a Randomized Clinical Trial (E2108). J Clin Oncol; 40(9): 978-987. https://ascopubs.org/doi/10.1200/JCO.21.02006?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed § Badwe, R. et al (2015). Locoregional treatment versus no treatment of the primary tumor in metastatic breast cancer: an open-label randomized controlled trial. Lancet Oncol; 16: 1380-1388. https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00135-7/fulltext § Fitzal, F. et al (2019). Impact of Breast Surgery in Primary Metastasized Breast Cancer: Outcomes of the Prospective Randomized Phase III ABCSG-28 POSYTIVE Trial. Ann Surg; 269(6): 1163-1169. https://journals.lww.com/annalsofsurgery/Abstract/2019/06000/Impact_of_Breast_Surgery_in_Primary_Metastasized.24.aspx § Soran, A. et al (2018). Randomized Trial Comparing Resection of Primary Tumor with No Surgery in Stage IV Breast Cancer at Presentation: Protocol MF07-01. Ann Surg Oncol; 25: 3141-3149. https://link.springer.com/article/10.1245/s10434-018-6494-6 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other clinical challenges episodes here: https://behindtheknife.org/podcast-series/clinical-challenges/
In deze podcast kunt u luisteren naar een gesprek tussen nucleair geneeskundige prof. dr. Lioe-Fee de Geus-Oei en interventie-radioloog dr. Mark Burgmans, beiden uit het Leidsch Universitair Medisch Centrum, waarin zij praten over de plaats van transarteriële radio-embolisatie in de behandeling van hepatocellulair carcinoom. Tijdens dit gesprek nemen zij door wat de behandelopties zijn bij very early en early stage HCC, intermediate stage HCC en advanced stage HCC.Klik hier voor de podcast met prof. dr. Marnix Lam over de procedurele aspecten van geïndividualiseerde radio-embolisatie. Referenties BCLC-richtijn: Reig M, et al. J Hepatol 2022;76:681-93. Salem R, et al. Hepatology 2021;74:2342-52. Kim E, et al. Lancet Gastroenterol Hepatol 2022;7:843-50. Dhondt E, et al. Radiology 2022;303:699-710. Chow PK, et al. J Clin Oncol 2018;36:1913-21. Vilgrain V, et al. Lancet Oncol 2017;18:1624-36.
Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. An important component of treatment in lung cancer (and many other cancers) is the use of radiation. This week, we continue our discussion about the fundamentals of Radiation Oncology with our guest, Dr. Evan Osmundson. *We hear the terms “hypo-fractioned” and “hyper-fractionated” radiation. What do those mean?- Fractionation, that is breaking up the total dose of radiation into smaller ones, has allowed patients to tolerate the radiation better. The repeat exposure allows the healthy tissue to repair, whereas the tumor is not able to heal as well- Standard fractionation involves keeping the maximum dose per session at 1.8-2Gy/fraction. - Hyper-fractionation is when a patient gets multiple doses per day, each less than 2Gy. This is important in small cell lung cancer, where the standard dose of radiation is 1.5Gy twice daily- Hypo-fractionation os when larger doses are given in each session, typically larger than 2.5-3Gy, often 4-5Gy per fraction. This is analogous to SBRT. *With regards to SBRT, how do you determine the number of sessions? - Typically 3-5 sessions, and this is based on data run through their computer algorithm that allows the dose to be tumoricidal. - More sessions (more likely 5 sessions) if central tumor (
In unserer neuen Folge sprechen wir im schönen Greifswald über die Totale neoadjuvante Radiochemotherapie (TNT). Diesbezüglich haben wir uns die PRODIGE 23-Studie genau angeguckt und diese in den wissenschaftlichen Kontext gestellt. Viel Spaß Conroy T, Bosset JF, Etienne PL, et al. Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2021 May;22(5):702-715.
Nucleair geneeskundige prof. dr. Lioe-Fee de Geus-Oei uit het Leids Universitair Medisch Centrum bespreekt met nucleair geneeskundige dr. Tessa Brabander uit het Erasmus MC te Rotterdam radionuclidetherapie voor neuro-endocriene tumoren: PRRT. Tijdens dit gesprek bespreken zij welke PRRT's er zijn, de resultaten van de NETTER-1-studie, kwaliteit van leven, bijwerkingen, hoe de behandeling wordt uitgevoerd en nieuwe ontwikkelingen. Referenties Strosberg J, et al. N Engl J Med 2017;376:125-35. Strosberg JR, et al. Lancet Oncol 2021;22:1752-63.
In today's episode, we're going to talk about how precision medicine fits into thyroid cancer treatment guidelines. To answer our questions on this topic, we welcome the expertise of Dr. Lori Wirth. Dr. Wirth is Medical Director of the Center for Head and Neck Cancers at the Massachusetts General Hospital, and an Associate Professor in Medicine at Harvard Medical School. Funding statement: This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Eli Lilly has had no influence on the content of this education. References: Filetti S, Durante C, Hartl D, et al. Thyroid Cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2019; 30:1856-1883. National Comprehensive Cancer Network. Thyroid Carcinoma. (Version 3.2021-October 15, 2021). Available at: https://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf. Accessed January 16, 2022. Fleeman N, Houten R, Chaplin M, et al. A systematic review of lenvatinib and sorafenib for treating progressive, locally advanced or metastatic, differentiated thyroid cancer after treatment with radioactive iodine. BMC Cancer. 2019;19:1209. https://doi.org/10.1186/s12885-019-6369-7 Naoum GE, Morkos M, Kim B, Arafat W. Novel targeted therapies and immunotherapy for advanced thyroid cancers. Mol Cancer. 2018;17:51. Pekova B, Sykorova V, Mastnikova K, et al. NTRK fusion genes in thyroid carcinomas: Clinicopathological characteristics and their impacts on prognosis. Cancers.2021;13:1932. https://www.mdpi.com/2072-6694/13/8/1932 Pitoia F. Complete response to larotrectinib treatment in a patient with papillary thyroid cancer harboring an ETV6-NTRK3 gene fusion. Clin Case Rep. 2021;9:1905-1912. doi: 10.1002/ccr3.3900 VITRAKVI, Prescribing information. Bayer HealthCare Pharmaceuticals Inc. Revised: March 2021. ROZLYTREK, Prescribing information. Genentech USA, Inc. Revised: November 2021. Hong DS, DuBois SG, Kummar S, et al. Larotrectinib in patients with TRK fusion-positive solid tumours: a pooled analysis of three phase 1/2 clinical trials. Lancet Oncol. 2020;21:531-540. Chu YH, Dias-Santagata D, Farahani AA, et al. Clinicopathologic and molecular characterization of NTRK-rearranged thyroid carcinoma (NRTC). Mod Pathol. 2020;33:2186-2197. Doebele RC, Drilon A, Paz-Ares L, et al. Entrectinib in patients with advanced or metastatic NTRK fusion-positive solid tumours: integrated analysis of three phase 1–2 trials. Lancet Oncol. 2020;21:271-282. RETEVMA, Prescribing information. Lilly USA, LLC. Initial US approval: 2020. GAVRETO, Prescribing information. Genentech USA, Inc. and Blueprint Medicines Corporation. Revised: April 2021. Krajewska J, Kukulska A, Oczko-Wojciechowska M, Jarzab B. Recent advances in precision medicine for the treatment of medullary thyroid cancer. Expert Review of Precision Medicine and Drug Development. 2021;6(5): 307-315. https://doi.org/10.1080/23808993.2021.1964952 European Medicines Agency. Retsevmo. December 11, 2020. Accessed January 18, 2022. https://www.ema.europa.eu/en/medicines/human/EPAR/retsevmo European Medicines Agency. Gavreto. September 17, 2021. Accessed January 18, 2022. https://www.ema.europa.eu/en/medicines/human/EPAR/gavreto
Description: Metachronous colorectal liver metastasis (CRLM) is a complex clinical situation requiring multidisciplinary management. In this episode from the Hepato-Pancreato-Biliary team at Behind the Knife, we discuss a patient presenting with metachronous CRLM and how management may change with varying clinical scenarios. Learning Objectives: In this episode, we review the initial workup and pre-operative considerations in a patient presenting with metachronous CRLM. We discuss key aspects of resectability of CRLM, including physiologic and hepatic fitness, biology of the disease, and technical considerations. We review the timing and common regimens of systemic treatment for differing clinical scenarios, as well as when adjuncts to treatment may be useful (e.g., portal venous embolization). Finally, we highlight important aspects of intraoperative and postoperative management. Hosts: Timothy Vreeland, MD, FACS (@vreelant) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@usarmydoc24) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Beaumont Army Medical Center Connor Chick, MD (@connor_chick) is a PGY-5 General Surgery resident at Brooke Army Medical Center Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-4 General Surgery resident at Brooke Army Medical Center Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-3 General Surgery resident at Brooke Army Medical Center Links to Papers Referenced in this Episode: NCCN Guidelines for Colon Cancer https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf Mutation Status of RAS, TP53, and SMAD4 is Superior to Mutation Status of RAS Alone for Predicting Prognosis after Resection of Colorectal Liver Metastases. Clin Cancer Res. 2019 Oct 1;25(19):5843-5851. doi: 10.1158/1078-0432.CCR-19-0863. Epub 2019 Jun 20. PMID: 31221662; PMCID: PMC6774854. https://pubmed.ncbi.nlm.nih.gov/31221662/ Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol. 2013 Nov;14(12):1208-15. doi: 10.1016/S1470-2045(13)70447-9. Epub 2013 Oct 11. PMID: 24120480. https://pubmed.ncbi.nlm.nih.gov/24120480/ FOLFOXIRI plus bevacizumab versus FOLFIRI plus bevacizumab as first-line treatment of patients with metastatic colorectal cancer: updated overall survival and molecular subgroup analyses of the open-label, phase 3 TRIBE study. Lancet Oncol. 2015 Oct;16(13):1306-15. doi: 10.1016/S1470-2045(15)00122-9. Epub 2015 Aug 31. PMID: 26338525. https://pubmed.ncbi.nlm.nih.gov/26338525/ Phase II Randomized Trial of Sequential or Concurrent FOLFOXIRI-Bevacizumab Versus FOLFOX-Bevacizumab for Metastatic Colorectal Cancer (STEAM). Oncologist. 2019 Jul;24(7):921-932. doi: 10.1634/theoncologist.2018-0344. Epub 2018 Dec 14. PMID: 30552157; PMCID: PMC6656450. https://pubmed.ncbi.nlm.nih.gov/30552157/ Bevacizumab plus mFOLFOX-6 or FOLFOXIRI in patients with initially unresectable liver metastases from colorectal cancer: the OLIVIA multinational randomised phase II trial. Ann Oncol. 2015 Apr;26(4):702-708. doi: 10.1093/annonc/mdu580. Epub 2014 Dec 23. PMID: 25538173. https://pubmed.ncbi.nlm.nih.gov/25538173/ Recommended Additional Podcasts on CRLM: The AHPBA Podcast: 1. Episode 1: Dr. Jean Nicolas Vauthey - Colorectal Liver Metastases (https://podcasts.apple.com/us/podcast/episode-1-dr-jean-nicolas-vauthey-colorectal-liver/id1501441845?i=1000467381474) 2. Episode 12:Dr D'Angelica - Colorectal Liver Metastases and Hepatic Artery Infusion Pumps (https://podcasts.apple.com/us/podcast/episode-12-dr-dangelica-colorectal-liver-metastases/id1501441845?i=1000521718184) Behind the Knife: 1. Surgical Oncology-Hepatic Artery Infusion Pump (https://podcasts.apple.com/ye/podcast/surgical-oncology-hepatic-artery-infusion-pump/id980990143?i=1000525833877) Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
You are faced with a young patient with low rectal cancer who is a complete responder to neoadjuvant chemoradiotherapy. He asks if he should undergo surgical resection despite the absence of visible tumour. How do you approach such a question? Join Dr. Carole Richard, Dr. François Dagbert and Dr. Maher Al Khaldi in their conversation about the Watch and Wait strategy for rectal cancer, also known as the Organ Preservation strategy. Learning objectives - To understand the rationale for Watch and Wait Strategy and the proportion of patients who become complete clinical responders. - To explain how patients under the Watch and Wait Strategy protocol should be followed up and when to consider a patient a clinical nonresponder. - To understand the inclusion criteria for patients in the Watch and Wait Strategy References In order throughout the episode [1–3]: 1. Habr-Gama A, Perez RO, Nadalin W, Sabbaga J, Ribeiro U, Sousa AHS e, et al. Operative Versus Nonoperative Treatment for Stage 0 Distal Rectal Cancer Following Chemoradiation Therapy. Transactions Meet Am Surg Assoc. 2004;122(NA;):309–16. 2. Valk MJM van der, Hilling DE, Bastiaannet E, Kranenbarg EM-K, Beets GL, Figueiredo NL, et al. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study. Lancet. 2018;391(10139):2537–45. 3. Fernandez LM, Julião GPS, Figueiredo NL, Beets GL, Valk MJM van der, Bahadoer RR, et al. Conditional recurrence-free survival of clinical complete responders managed by watch and wait after neoadjuvant chemoradiotherapy for rectal cancer in the International Watch & Wait Database: a retrospective, international, multicentre registry study. Lancet Oncol. 2021;22(1):43–50. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
Adjuvant? Neoadjuvant? Short course? Long course? The treatment of rectal cancer treatment has come a long way. Tune in to learn more about Total Neoadjuvant Therapy (TNT) and the mysterious HOLY PLANE. Learning Objectives: 1. Describe the rationale for Total Neoadjuvant Therapy (TNT) for rectal cancer 2. Review the history of chemo and radiation therapy in treatment of rectal cancer 3. Describe total mesorectal excision References Bahadoer RR, Dijkstra EA, van Etten B et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol. 2021 Jan;22(1):29-42. doi: 10.1016/S1470-2045(20)30555-6. Epub 2020 Dec 7 https://doi.org/10.1016/S1470-2045(20)30555-6 Fokas E, Allgäuer M, Polat B et al. Randomized Phase II Trial of Chemoradiotherapy Plus Induction or Consolidation Chemotherapy as Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: CAO/ARO/AIO-12. J Clin Oncol. 2019 Dec 1;37(34):3212-3222. doi: 10.1200/JCO.19.00308 https://ascopubs.org/doi/10.1200/JCO.19.00308 Colorectal Surgery 2021-2022 Virtual Education Series Follow us on Twitter @CRSVirtualEd Email us: colorectal.educational.series@gmail.com www.crsvirtualed.org Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
You're faced with a challenging case of a patient with rectal cancer and synchronous liver lesion. Where do you start: chemotherapy, chemoradiotherapy, upfront surgery, liver first, rectum first? Join Drs. Carole Richard, François Dagbert and Maher Al Khaldi as they discuss the management of a patient with rectal cancer with a synchronous hepatic metastasis. Learning objectives In this episode, we discuss the workup of a rectal tumour associated with synchronous liver metastases, indications for resection of the hepatic lesion, neoadjuvant and adjuvant treatment modalities, survival benefit of resection and patient follow-up. Reference list: Moulton C-A, Gu C-S, Law CH, Tandan VR, Hart R, Quan D, et al. Effect of PET Before Liver Resection on Surgical Management for Colorectal Adenocarcinoma Metastases: A Randomized Clinical Trial. JAMA. 2014;311(18):1863–9. Bahadoer RR, Dijkstra EA, Etten B van, Marijnen CAM, Putter H, Kranenbarg EM-K, et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22(1):29–42.
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491203/ Artigo: Duffy SW, Vulkan D, Cuckle H, et al. Effect of mammographic screening from age 40 years on breast cancer mortality (UK Age trial): final results of a randomised, controlled trial. Lancet Oncol. 2020 Sep;21(9):1165-1172. doi: 10.1016/S1470-2045(20)30398-3. Epub 2020 Aug 12. Contato: bemdespercebido@gmail.com
Dr David Quinn from the University of Southern California in Los Angeles discusses the impact of COVID-19 on the management of cancer and the current challenges he is experiencing as a physician caring for patients at the front line of the pandemic. Additional resources * Lee LYW et al. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: A prospective cohort study. Lancet 2020;395(10241):1919-26. Abstract (https://pubmed.ncbi.nlm.nih.gov/32473682/) * Malek AE et al. Cancer and COVID-19. Lancet 2020;396(10257):1066-7. Abstract (https://pubmed.ncbi.nlm.nih.gov/33038963/) * Poortmans P et al. Cancer and COVID-19: What do we really know? Lancet 2020;395(10241):1884-5. Abstract (https://pubmed.ncbi.nlm.nih.gov/32479827/) * Xia Y et al. Risk of COVID-19 for patients with cancer. Lancet Oncol 2020;21(4):e180. Abstract (https://pubmed.ncbi.nlm.nih.gov/32142622/) * Yang F et al. Clinical characteristics and outcomes of cancer patients with COVID-19. _J Med Virol _2020;92(10):2067-73. Abstract (https://pubmed.ncbi.nlm.nih.gov/32369209/)
COVID-19 is more than just a threat to your physical health. Even if you are never infected, you may not be free of it. In today's program, we take lessons from prior pandemics and consider the sociocultural effects of a global infectious disease. Be advised, this one is of the "sentimental" variety. Produced by James E. Siegler. Music courtesy of Purple Planet Music, Meydn, Kevin MacLeod and Shane Ivers, which you can find at Silvermansound.com. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095-128. Fineberg HV. Pandemic preparedness and response--lessons from the H1N1 influenza of 2009. The New England journal of medicine. 2014;370:1335-42. Shanks GD. Insights from unusual aspects of the 1918 influenza pandemic. Travel Med Infect Dis. 2015;13:217-22. Armitage R and Nellums LB. COVID-19 and the consequences of isolating the elderly. Lancet Public Health. 2020;5:e256. Bonaccorsi G, Pierri F, Cinelli M, Flori A, Galeazzi A, Porcelli F, Schmidt AL, Valensise CM, Scala A, Quattrociocchi W and Pammolli F. Economic and social consequences of human mobility restrictions under COVID-19. Proc Natl Acad Sci U S A. 2020;117:15530-15535. Dinmohamed AG, Visser O, Verhoeven RHA, Louwman MWJ, van Nederveen FH, Willems SM, Merkx MAW, Lemmens V, Nagtegaal ID and Siesling S. Fewer cancer diagnoses during the COVID-19 epidemic in the Netherlands. Lancet Oncol. 2020;21:750-751. Jeffery MM, D'Onofrio G, Paek H, Platts-Mills TF, Soares WE, 3rd, Hoppe JA, Genes N, Nath B and Melnick ER. Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US. JAMA internal medicine. 2020;180:1328-1333. Rabinovitz B, Jaywant A and Fridman CB. Neuropsychological functioning in severe acute respiratory disorders caused by the coronavirus: implications for the current COVID-19 pandemic. Clin Neuropsychol. 2020:1-27. Santini ZI, Jose PE, York Cornwell E, Koyanagi A, Nielsen L, Hinrichsen C, Meilstrup C, Madsen KR and Koushede V. Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis. Lancet Public Health. 2020;5:e62-e70. Wong LE, et al. Where are all the patients? New Eng J Med (2020): Published online 14 May 2020. Available at https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0193.
FDA连续批准2个治疗胃肠道间质瘤的靶向药 Nature Review 肠易激综合征的中饮食疗法的循证医学证据和机制的见解Science子刊 生活方式和遗传因素使亚洲人易患胃癌阿伐普替尼（Avapritinib）胃肠道间质瘤（GIST）是胃肠道最常见的间叶细胞肿瘤，目前普遍认为是是由编码酪氨酸激酶受体蛋白基因（KIT）突变、或血小板源性生长因子受体 α（PDGFRα）基因激活突变所诱发。其中以KIT突变最常见，占80%；PDGFRα突变占10%，PDGFRα外显子18 D842V是最常见突变，与伊马替尼耐药相关；还有10%的患者缺少KIT或PDGFRα突变，称为野生型胃肠道间质瘤。阿伐普替尼（Avapritinib）是一种高效、选择性、口服生活性的KIT和PDGFRα抑制剂。2020年1月9日，FDA批准Avapritinib用于治疗经过基因检测确认的PDGFRα18外显子突变的不可切除（无法通过手术切除）或转移性（癌细胞扩散至身体其他部位）胃肠道间质瘤患者。《NAVIGATOR研究：阿伐普替尼治疗PDGFRα D842V基因突变的、晚期胃肠道间质瘤的研究》Lancet Oncology，2020年7月 (1)NAVIGATOR研究是一项两部分、开放标签、剂量递增和剂量扩大的1阶段研究。这篇文章对PDGFRA D842V突变的患者进行单独分析，并报道了研究结果。研究纳入无法手术切除的、胃肠道间质瘤患者，其中56人携带PDGFRα D842V突变，其中20位患者进入剂量递增组（即从30mg qd逐渐加量至最大耐受剂量），36位患者进入剂量扩大组（即使用最大耐受剂量）。最大耐受剂量为400mg qd，推荐剂量为300mg qd。中位随访15·9个月，在PDGFRα D842V突变的56名患者中，9%完全缓解，79%部分缓解。治疗相关严重不良反应最常见的是贫血。在30-400mg qd的剂量下，没有观察到药物毒性；600mg qd时，两名患者出现剂量相关的不良反应。结论：阿伐普替尼在晚期PDGFRα D842V突变的胃肠道间质肿瘤患者中具有初步的抗肿瘤活性。瑞普替尼（ripretinib） 瑞普替尼（ripretinib）是一种对广泛的KIT和PDGFRA基因突变激酶抑制剂。2020年5月，FDA批准瑞普替尼（ripretinib）用于晚期胃肠道间质瘤的四线治疗。《INVICTUS研究：瑞普替尼治疗晚期胃肠间质肿瘤的3期试验》Lancet Oncology，2020年7月 (2)这项双盲、随机、安慰剂对照的第三期研究中，纳入晚期、进展性胃肠间质肿瘤患者129人，既往均使用过伊马替尼、舒尼替尼和瑞格拉非尼在内的治疗。患者随机分入瑞普替尼 150mg qd或安慰剂组，随机分配到安慰剂组的患者在疾病进展时允许转到瑞普替尼组。双盲期，瑞普替尼组和安慰剂组的中位无进展生存期分别为6.3个月和1.0个月（风险比0.15，p < 0.0001）。最常见的严重不良反应包括脂肪酶升高、高血压、疲劳和低磷血症，两组发生率相似。结论：瑞普替尼显著提高晚期胃肠道间质瘤患者的无进展生存期。乙型肝炎急性和慢性乙型肝炎感染均刻有不同的临床表现。急性期，临床表现可从亚临床、或无黄疸型肝炎至黄疸型肝炎，有时还会出现爆发性肝炎（
FDA连续批准2个治疗胃肠道间质瘤的靶向药 Nature Review 肠易激综合征的中饮食疗法的循证医学证据和机制的见解Science子刊 生活方式和遗传因素使亚洲人易患胃癌阿伐普替尼（Avapritinib）胃肠道间质瘤（GIST）是胃肠道最常见的间叶细胞肿瘤，目前普遍认为是是由编码酪氨酸激酶受体蛋白基因（KIT）突变、或血小板源性生长因子受体 α（PDGFRα）基因激活突变所诱发。其中以KIT突变最常见，占80%；PDGFRα突变占10%，PDGFRα外显子18 D842V是最常见突变，与伊马替尼耐药相关；还有10%的患者缺少KIT或PDGFRα突变，称为野生型胃肠道间质瘤。阿伐普替尼（Avapritinib）是一种高效、选择性、口服生活性的KIT和PDGFRα抑制剂。2020年1月9日，FDA批准Avapritinib用于治疗经过基因检测确认的PDGFRα18外显子突变的不可切除（无法通过手术切除）或转移性（癌细胞扩散至身体其他部位）胃肠道间质瘤患者。《NAVIGATOR研究：阿伐普替尼治疗PDGFRα D842V基因突变的、晚期胃肠道间质瘤的研究》Lancet Oncology，2020年7月 (1)NAVIGATOR研究是一项两部分、开放标签、剂量递增和剂量扩大的1阶段研究。这篇文章对PDGFRA D842V突变的患者进行单独分析，并报道了研究结果。研究纳入无法手术切除的、胃肠道间质瘤患者，其中56人携带PDGFRα D842V突变，其中20位患者进入剂量递增组（即从30mg qd逐渐加量至最大耐受剂量），36位患者进入剂量扩大组（即使用最大耐受剂量）。最大耐受剂量为400mg qd，推荐剂量为300mg qd。中位随访15·9个月，在PDGFRα D842V突变的56名患者中，9%完全缓解，79%部分缓解。治疗相关严重不良反应最常见的是贫血。在30-400mg qd的剂量下，没有观察到药物毒性；600mg qd时，两名患者出现剂量相关的不良反应。结论：阿伐普替尼在晚期PDGFRα D842V突变的胃肠道间质肿瘤患者中具有初步的抗肿瘤活性。瑞普替尼（ripretinib） 瑞普替尼（ripretinib）是一种对广泛的KIT和PDGFRA基因突变激酶抑制剂。2020年5月，FDA批准瑞普替尼（ripretinib）用于晚期胃肠道间质瘤的四线治疗。《INVICTUS研究：瑞普替尼治疗晚期胃肠间质肿瘤的3期试验》Lancet Oncology，2020年7月 (2)这项双盲、随机、安慰剂对照的第三期研究中，纳入晚期、进展性胃肠间质肿瘤患者129人，既往均使用过伊马替尼、舒尼替尼和瑞格拉非尼在内的治疗。患者随机分入瑞普替尼 150mg qd或安慰剂组，随机分配到安慰剂组的患者在疾病进展时允许转到瑞普替尼组。双盲期，瑞普替尼组和安慰剂组的中位无进展生存期分别为6.3个月和1.0个月（风险比0.15，p < 0.0001）。最常见的严重不良反应包括脂肪酶升高、高血压、疲劳和低磷血症，两组发生率相似。结论：瑞普替尼显著提高晚期胃肠道间质瘤患者的无进展生存期。乙型肝炎急性和慢性乙型肝炎感染均刻有不同的临床表现。急性期，临床表现可从亚临床、或无黄疸型肝炎至黄疸型肝炎，有时还会出现爆发性肝炎（
Today I am talking to Dr Nick Burr, one of our Rising Stars in Gastroenterology, working in Leeds. You may recognise his name from some of the most influential papers written on the topic of ADR and PCCRC in the recent past. I've decided to ambush him with some difficult questions about our unhealthy obsession with ADR and see if I can convince him that the PCRCR rate is irrelevant to individual colonoscopists. I am armed with the references below to support my argument ! Karminski MF. Quality Indicators for Colonoscopy and the Risk of Interval Cancer. NEJM 2010;362:1795-803 Eide T. Risk of CRC in adenoma bearing individuals. Intern J Cancer 1986;38;173–6 Stryker S. Natural history of untreated colonic polyps. Gastroenterology 1987;93:1009–13 Pickhart PJ. Assessment of volumetric growth rates of small colorectal polyps with CT colonography: a longitudinal study of natural history. Lancet Oncol. 2013;14(8):711–20 Kuntz KM. A Systematic Comparison of Microsimulation Models of Colorectal Cancer: The Role of Assumptions about Adenoma Progression. Medical Decision making 2011;31(4):530-9 https://doi.org/10.1177/0272989X11408730 Djinbachian R. Rates of Incomplete Resection of 1- to 20-mm Colorectal Polyps: A Systematic Review and Meta-Analysis. Gastroenterology 2020;159(3):904-14 https://doi.org/10.1053/j.gastro.2020.05.018
FDA 连续批准2个治疗胆管癌的靶向药 Lancet 细胞海绵-三叶因子3监测法筛查Barrett食管Nature 胃肠道也有独立的神经系统培米加替尼（Pemigatinib）约20%的肝内胆管癌患者存在成纤维细胞生长因子受体（FGFR）2融合基因突变，培米加替尼（Pemigatinib）是一种选择性FGFR抑制剂。2020年4月，FDA批准培米加替尼治疗复发性的FGFR2基因融合或重排的局部晚期胆管癌。《FIGHT-202研究：培米加替尼治疗晚期胆管癌的临床研究》Lancet Oncology，2020年5月 (1)这个多中心、非盲、单臂、2阶段研究纳入FGFR2融合或重排的晚期胆管癌患者、其他FGF/FGFR基因突变的患者、和没有FGF/FGFR基因突变的患者肱146人。所有入组患者均接受培米加替尼治疗直到疾病进展、不可接受的毒性、撤回同意或医生决定。中位随访17·8个月，FGFR2融合或重排患者中35·5%达到客观缓解（其中3例完全缓解，35人部分缓解）。高磷酸盐血症是最常见的不良事件，49%的患者在研究期间死亡，最常见的原因是疾病进展，与治疗无关。结论：培米加替尼在以前治疗过的发生FGFR2融合或重排的胆管癌患者中均有一定疗效。艾伏尼布（ivosidenib）基因组分析表明，胆管癌中有13%的患者存在IDH1基因突变，艾伏尼布（ivosidenib）是一种新型的小分子靶向异柠檬酸脱氢酶1（IDH1）抑制剂。艾伏尼布2018年被FDA批准用于急性髓细胞性白血病的一线治疗，2020年4月批准用于胆管癌靶向治疗药物。《ClarIDHy研究：针对胆管癌异柠檬酸脱氢酶1（IDH-1）突变的新型靶向疗法的3期临床研究》Lancet Oncology，2020年8月 (2)胆管癌是一种对化疗敏感的癌症。尽管吉西他滨联合顺铂的一线化疗是标准治疗方案，但二线治疗却效果有限。这项国际性、双盲、安慰剂对照的、随机的、3期临床试验中，招募了185例携带IDH-1突变的胆管癌患者，其中大部分患者原发性肝内胆管癌（90%～95%）伴远处转移（92%～93%），随机接受艾伏尼布或安慰剂治疗。中位随访6.9个月时，艾伏尼布组的中位无进展生存期优于安慰剂组（2.7个月 vs 1.4个月，P
Quelles sont les différences entre un essai de non-infériorité et l’essai d’équivalence ? Qu’est-ce que les scores de propension et d’appariement ? Qu’est-ce qu’une méta-analyse ? Le Pr Jacques Irani (Kremlin Bicêtre) répond à toutes vos questions à l’aide d’exemples de la littérature urologique ! L’orateur n’a pas reçu de rémunération pour la réalisation de cet épisode.Pour aller plus loin :1.Lire ici : Grimm MO, van der Heijden AG, Colombel M, et al. Treatment of High-grade Non-muscle-invasive Bladder Carcinoma by Standard Number and Dose of BCG Instillations Versus Reduced Number and Standard Dose of BCG Instillations: Results of the European Association of Urology Research Foundation Randomised Phase III Clinical Trial "NIMBUS" [published online ahead of print, 2020 May 20]2.Lire ici : Vale CL, Burdett S, Rydzewska LHM, et al. Addition of docetaxel or bisphosphonates to standard of care in men with localised or metastatic, hormone-sensitive prostate cancer: a systematic review and meta-analyses of aggregate data [published correction appears in Lancet Oncol. 2016 Feb;173.Lire ici : Wallis CJD, Saskin R, Choo R, et al. Surgery Versus Radiotherapy for Clinically-localized Prostate Cancer: A Systematic Review and Meta-analysisCet épisode a été réalisé grâce au soutien institutionnel des laboratoires Bayer.« Certains données publiées peuvent ne pas avoir été validées par les autorités de santé françaises. La publication de ce contenu est effectué sous la seule responsabilité de l’éditeur et de son comité scientifique »Musique du générique : Via AudioNetworkResponsable projet AFUF : Dr Benjamin PradèreProduction : La Toile Sur Ecoute See acast.com/privacy for privacy and opt-out information.
FDA 连续批准2个治疗胆管癌的靶向药 Lancet 细胞海绵-三叶因子3监测法筛查Barrett食管Nature 胃肠道也有独立的神经系统培米加替尼（Pemigatinib）约20%的肝内胆管癌患者存在成纤维细胞生长因子受体（FGFR）2融合基因突变，培米加替尼（Pemigatinib）是一种选择性FGFR抑制剂。2020年4月，FDA批准培米加替尼治疗复发性的FGFR2基因融合或重排的局部晚期胆管癌。《FIGHT-202研究：培米加替尼治疗晚期胆管癌的临床研究》Lancet Oncology，2020年5月 (1)这个多中心、非盲、单臂、2阶段研究纳入FGFR2融合或重排的晚期胆管癌患者、其他FGF/FGFR基因突变的患者、和没有FGF/FGFR基因突变的患者肱146人。所有入组患者均接受培米加替尼治疗直到疾病进展、不可接受的毒性、撤回同意或医生决定。中位随访17·8个月，FGFR2融合或重排患者中35·5%达到客观缓解（其中3例完全缓解，35人部分缓解）。高磷酸盐血症是最常见的不良事件，49%的患者在研究期间死亡，最常见的原因是疾病进展，与治疗无关。结论：培米加替尼在以前治疗过的发生FGFR2融合或重排的胆管癌患者中均有一定疗效。艾伏尼布（ivosidenib）基因组分析表明，胆管癌中有13%的患者存在IDH1基因突变，艾伏尼布（ivosidenib）是一种新型的小分子靶向异柠檬酸脱氢酶1（IDH1）抑制剂。艾伏尼布2018年被FDA批准用于急性髓细胞性白血病的一线治疗，2020年4月批准用于胆管癌靶向治疗药物。《ClarIDHy研究：针对胆管癌异柠檬酸脱氢酶1（IDH-1）突变的新型靶向疗法的3期临床研究》Lancet Oncology，2020年8月 (2)胆管癌是一种对化疗敏感的癌症。尽管吉西他滨联合顺铂的一线化疗是标准治疗方案，但二线治疗却效果有限。这项国际性、双盲、安慰剂对照的、随机的、3期临床试验中，招募了185例携带IDH-1突变的胆管癌患者，其中大部分患者原发性肝内胆管癌（90%～95%）伴远处转移（92%～93%），随机接受艾伏尼布或安慰剂治疗。中位随访6.9个月时，艾伏尼布组的中位无进展生存期优于安慰剂组（2.7个月 vs 1.4个月，P
Pr Thierry Roumeguère : Les principes de la théranostique dans le cancer de la prostateQu’est-ce que la théranostique ? Quels-sont les effets secondaires ? Quelle place pour la théranostique au lutetium 177 dans le cancer de prostate ?Le Pr Thierry Roumeguère (CHU Erasme, Bruxelles) répond à toutes vos questions !L’orateur n’a pas reçu de rémunération pour la réalisation de cet épisode.Pour aller plus loin :Hofman MS, Violet J, Hicks RJ, Ferdinandus J, Thang SP, Akhurst T, et al. [(177)Lu]-PSMA-617 radionuclide treatment in patients with metastatic castration-resistant prostate cancer (LuPSMA trial): a single-centre, single-arm, phase 2 study. Lancet Oncol. 2018;19:825–33.Michael S Hofman et al. TheraP: A randomised phase II trial of 177Lu-PSMA-617 (LuPSMA) theranostic versus cabazitaxel in metastatic castration resistant prostate cancer (mCRPC) progressing after docetaxel: Initial results (ANZUP protocol 1603). Journal of Clinical Oncology 2020 38:15_suppl, 5500-5500https://ascopubs.org/doi/abs/10.1200/JCO.2020.38.15_suppl.5500Musique du générique : Via AudioNetworkResponsable projet AFUF : Dr Benjamin PradèreProduction : La Toile Sur Ecoute See acast.com/privacy for privacy and opt-out information.
Dr Paul Sargos : Radiothérapie postopératoire des cancers de la prostateQuel est le rationnel et l’historique de la radiothérapie postopératoire dans le cancer de prostate ? Quels sont les résultats marquants du GETG AFU 17 récemment publié dans Lancet Oncology ? Comment ces résultats s’intègrent-ils par rapport aux essai RADICALS, RAVES et la récente méta-analyse ?Le Dr Paul Sargos (Cancérologue radiothérapeute de l’institut Bergonie, Centre Régional de lutte contre le Cancer, Bordeaux) répond à toutes vos questions !L’orateur n’a pas reçu de rémunération pour la réalisation de cet épisode.Pour aller plus loin :Thompson IM, Tangen CM, Paradelo J, et al. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial. J Urol. 2009;181(3):956-962. doi:10.1016/j.juro.2008.11.032Bolla M, van Poppel H, Collette L, van Cangh P, Vekemans K, Da Pozzo L, de Reijke TM, Verbaeys A, Bosset JF, van Velthoven R, Maréchal JM, Scalliet P, Haustermans K, Piérart M; European Organization for Research and Treatment of Cancer. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet. 2005 Aug 13-19;366(9485):572-8. doi: 10.1016/S0140-6736(05)67101-2. PMID: 16099293.Wiegel T, Bartkowiak D, Bottke D, Bronner C, Steiner U, Siegmann A, Golz R, Störkel S, Willich N, Semjonow A, Stöckle M, Rübe C, Rebmann U, Kälble T, Feldmann HJ, Wirth M, Hofmann R, Engenhart-Cabillic R, Hinke A, Hinkelbein W, Miller K. Adjuvant radiotherapy versus wait-and-see after radical prostatectomy: 10-year follow-up of the ARO 96-02/AUO AP 09/95 trial. Eur Urol. 2014 Aug;66(2):243-50. doi: 10.1016/j.eururo.2014.03.011. Epub 2014 Mar 21. PMID: 24680359.Sargos P, Chabaud S, Latorzeff I, Magné N, Benyoucef A, Supiot S, Pasquier D, Abdiche MS, Gilliot O, Graff-Cailleaud P, Silva M, Bergerot P, Baumann P, Belkacemi Y, Azria D, Brihoum M, Soulié M, Richaud P. Adjuvant radiotherapy versus early salvage radiotherapy plus short-term androgen deprivation therapy in men with localised prostate cancer after radical prostatectomy (GETUG-AFU 17): a randomised, phase 3 trial. Lancet Oncol. 2020 Oct;21(10):1341-1352. doi: 10.1016/S1470-2045(20)30454-X. PMID: 33002438.Kneebone A, Fraser-Browne C, Duchesne GM, Fisher R, Frydenberg M, Herschtal A, Williams SG, Brown C, Delprado W, Haworth A, Joseph DJ, Martin JM, Matthews JHL, Millar JL, Sidhom M, Spry N, Tang CI, Turner S, Wiltshire KL, Woo HH, Davis ID, Lim TS, Pearse M. Adjuvant radiotherapy versus early salvage radiotherapy following radical prostatectomy (TROG 08.03/ANZUP RAVES): a randomised, controlled, phase 3, non-inferiority trial. Lancet Oncol. 2020 Oct;21(10):1331-1340. doi: 10.1016/S1470-2045(20)30456-3. PMID: 33002437.Vale CL, Fisher D, Kneebone A, Parker C, Pearse M, Richaud P, Sargos P, Sydes MR, Brawley C, Brihoum M, Brown C, Chabaud S, Cook A, Forcat S, Fraser-Browne C, Latorzeff I, Parmar MKB, Tierney JF; ARTISTIC Meta-analysis Group. Adjuvant or early salvage radiotherapy for the treatment of localised and locally advanced prostate cancer: a prospectively planned systematic review and meta-analysis of aggregate data. Lancet. 2020 Sep 28:S0140-6736(20)31952-8. doi: 10.1016/S0140-6736(20)31952-8. Epub ahead of print. PMID: 33002431.Parker CC, Clarke NW, Cook AD, Kynaston HG, Petersen PM, Catton C, Cross W, Logue J, Parulekar W, Payne H, Persad R, Pickering H, Saad F, Anderson J, Bahl A, Bottomley D, Brasso K, Chahal R, Cooke PW, Eddy B, Gibbs S, Goh C, Gujral S, Heath C, Henderson A, Jaganathan R, Jakobsen H, James ND, Kanaga Sundaram S, Lees K, Lester J, Lindberg H, Money-Kyrle J, Morris S, O'Sullivan J, Ostler P, Owen L, Patel P, Pope A, Popert R, Raman R, Røder MA, Sayers I, Simms M, Wilson J... See acast.com/privacy for privacy and opt-out information.
A lot can happen in two years. You might have matched into residency, graduated from fellowship, had a kid... Or several phase II trials in low grade glioma research could have been published. Since the original airing of this episode in May 2018, there have been a few updates in neuro-oncology. We'll cover some of the major ones this week in the BrainWaves podcast. Produced by James E. Siegler, Brian Nahed and Jorg Dietrich. Music courtesy of Ian Sutherland, Lovira, and Lee Roosevere. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES McGirt MJ, Chaichana KL, Attenello FJ, Weingart JD, Than K, Burger PC, Olivi A, Brem H and Quinones-Hinojosa A. Extent of surgical resection is independently associated with survival in patients with hemispheric infiltrating low-grade gliomas. Neurosurgery. 2008;63:700-7; author reply 707-8. Shaw EG, Wang M, Coons SW, Brachman DG, Buckner JC, Stelzer KJ, Barger GR, Brown PD, Gilbert MR and Mehta MP. Randomized trial of radiation therapy plus procarbazine, lomustine, and vincristine chemotherapy for supratentorial adult low-grade glioma: initial results of RTOG 9802. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2012;30:3065-70. Schiff D. Low-grade Gliomas. Continuum (Minneap Minn). 2017;23:1564-1579. Wen PY and Huse JT. 2016 World Health Organization Classification of Central Nervous System Tumors. Continuum (Minneap Minn). 2017;23:1531-1547. Bell EH, Zhang P, Fisher BJ, Macdonald DR, McElroy JP, Lesser GJ, Fleming J, Chakraborty AR, Liu Z, Becker AP, Fabian D, Aldape KD, Ashby LS, Werner-Wasik M, Walker EM, Bahary JP, Kwok Y, Yu HM, Laack NN, Schultz CJ, Gray HJ, Robins HI, Mehta MP and Chakravarti A. Association of MGMT Promoter Methylation Status With Survival Outcomes in Patients With High-Risk Glioma Treated With Radiotherapy and Temozolomide: An Analysis From the NRG Oncology/RTOG 0424 Trial. JAMA Oncol. 2018;4:1405-1409. van den Bent MJ, Klein M, Smits M, Reijneveld JC, French PJ, Clement P, de Vos FYF, Wick A, Mulholland PJ, Taphoorn MJB, Lewis J, Weller M, Chinot OL, Kros JM, de Heer I, Verschuere T, Coens C, Golfinopoulos V, Gorlia T and Idbaih A. Bevacizumab and temozolomide in patients with first recurrence of WHO grade II and III glioma, without 1p/19q co-deletion (TAVAREC): a randomised controlled phase 2 EORTC trial. Lancet Oncol. 2018;19:1170-1179. Fangusaro J, Onar-Thomas A, Young Poussaint T, Wu S, Ligon AH, Lindeman N, Banerjee A, Packer RJ, Kilburn LB, Goldman S, Pollack IF, Qaddoumi I, Jakacki RI, Fisher PG, Dhall G, Baxter P, Kreissman SG, Stewart CF, Jones DTW, Pfister SM, Vezina G, Stern JS, Panigrahy A, Patay Z, Tamrazi B, Jones JY, Haque SS, Enterline DS, Cha S, Fisher MJ, Doyle LA, Smith M, Dunkel IJ and Fouladi M. Selumetinib in paediatric patients with BRAF-aberrant or neurofibromatosis type 1-associated recurrent, refractory, or progressive low-grade glioma: a multicentre, phase 2 trial. Lancet Oncol. 2019;20:1011-1022. Bell EH, Zhang P, Shaw EG, Buckner JC, Barger GR, Bullard DE, Mehta MP, Gilbert MR, Brown PD, Stelzer KJ, McElroy JP, Fleming JL, Timmers CD, Becker AP, Salavaggione AL, Liu Z, Aldape K, Brachman DG, Gertler SZ, Murtha AD, Schultz CJ, Johnson D, Laack NN, Hunter GK, Crocker IR, Won M and Chakravarti A. Comprehensive Genomic Analysis in NRG Oncology/RTOG 9802: A Phase III Trial of Radiation Versus Radiation Plus Procarbazine, Lomustine (CCNU), and Vincristine in High-Risk Low-Grade Glioma. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2020:JCO1902983. Breen WG, Anderson SK, Carrero XW, Brown PD, Ballman KV, O'Neill BP, Curran WJ, Abrams RA, Laack NN, Levitt R, Galanis E, Buckner JC and Shaw EG. Final report from Intergroup NCCTG 86-72-51 (Alliance): a phase III randomized clinical trial of high-dose versus low-dose radiation for adult low-grade glioma. Neuro Oncol. 2020;22:830-837. Ullrich NJ, Prabhu SP, Reddy AT, Fisher MJ, Packer R, Goldman S, Robison NJ, Gutmann DH, Viskochil DH, Allen JC, Korf B, Cantor A, Cutter G, Thomas C, Perentesis JP, Mizuno T, Vinks AA, Manley PE, Chi SN, Kieran MW and Consortium NFCT. A Phase II Study of Continuous Oral mTOR Inhibitor Everolimus for Recurrent, Radiographic-Progressive Neurofibromatosis Type 1-Associated Pediatric Low-Grade Glioma: A Neurofibromatosis Clinical Trials Consortium Study. Neuro Oncol. 2020.
Em mais uma semana da nossa imersão em sarcomas, vamos discutir esse paper publicado na Lancet Oncol em 2017. Um estudo fase III randomizado, que avaliou o uso perioperatório de QT para o tratamento de SPM de alto grau, localizados em extremidades e tronco. A hipótese era a de que o uso de uma quimioterapia mais específica para o tratamento de certos subtipos histológicos de sarcomas acarretaria em uma maior sobrevida quando comparada com a terapia "padrão" com doxorrubicina e ifosfamida. Com um resultado surpreendente, o estudo foi fechado precocemente e teve seus resultados publicados a partir de uma análise interina de futilidade. Já pode imaginar o que aconteceu certo!? Não perca mais um episódio do Clinical Papers Podcast com Ranyell Spencer e Tiago Biachi! Para ter acesso ao paper na íntegra, acesse o link: https://www.ncbi.nlm.nih.gov/pubmed/28499583
Immune checkpoint inhibitors have revolutionized cancer treatment. Unlike chemotherapy, which essentially includes cellular toxins that can cause widespread and unnecessary tissue damage, checkpoint inhibitors are used to train the body’s natural immune system to fight off the cancer. And while they are extraordinarily effective options for patients with malignant disease, they are not without risk. Every day, we are learning more and more about the autoimmune side effects of these novel therapies. This week on the BrainWaves Podcast, Dr. Justine Cohen (University of Pennsylvania) shares her experience managing patients with checkpoint inhibitor neurotoxicity. Produced by James E. Siegler and Justine Cohen. Music courtesy of Jon Watts, Kai Engel, and Kevin McLeod--as well as a cameo appearance by the Checkpoints. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Bhatia S, Tykodi SS and Thompson JA. Treatment of metastatic melanoma: an overview. Oncology (Williston Park). 2009;23:488-96. Hottinger AF. Neurologic complications of immune checkpoint inhibitors. Curr Opin Neurol. 2016;29:806-812. Wick W, Hertenstein A and Platten M. Neurological sequelae of cancer immunotherapies and targeted therapies. Lancet Oncol. 2016;17:e529-e541. Cohen JV and Buchbinder EI. The Evolution of Adjuvant Therapy for Melanoma. Curr Oncol Rep. 2019;21:106. Cohen JV, Wang N, Venur VA, Hadfield MJ, Cahill DP, Oh K and Brastianos PK. Neurologic complications of melanoma. Cancer. 2019. Epub ahead of print. Graus F and Dalmau J. Paraneoplastic neurological syndromes in the era of immune-checkpoint inhibitors. Nat Rev Clin Oncol. 2019;16:535-548. Zekeridou A and Lennon VA. Neurologic Autoimmunity in the Era of Checkpoint Inhibitor Cancer Immunotherapy. Mayo Clinic proceedings. 2019;94:1865-1878. Zubiri L, Allen IM, Taylor MS, Guidon AC, Chen ST, Schoenfeld SR, Neilan TG, Sise ME, Mooradian MJ, Rubin KM, Leaf RK, Parikh AR, Faje A, Gainor JF, Cohen JV, Fintelmann FJ, Kohler MJ, Dougan M and Reynolds KL. Immune-Related Adverse Events in the Setting of PD-1/L1 Inhibitor Combination Therapy. Oncologist. 2019. Epub ahead of print.
Publicado na LANCET Oncol em 2018, o PORTEC-3 Trial avaliou o papel da QT (radiossensibilizante e adjuvante) para o tratamento de pacientes com tumor de endométrio de alto risco. O estudo teve como objetivo primário dois endpoints que seriam: Sobrevida global e Livre de falha (óbito por doença ou recorrência). Após os autores randomizarem mais de 650 mulheres, com um seguimento de 60.2 meses, o estudo foi considerado negativo para o benefício dessa estratégia mais “agressiva” vs. radioterapia no que se referiu, principalmente, a sobrevida global. Em especial, no final do episódio Ranyell e Tiago discutem o papel do médico na decisão compartilhada com os pacientes, além da necessidade de publicação de estudos negativos. Procure-nos nas redes sociais e faça parte desse projeto! Você está no Clinical Papers Podcast! Para ter acesso ao paper na íntegra, acesso o link: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30079-2/fulltext
Knowledge bomb: telomeres; what are they? How do they control our biological age? Dr. G’s best ways to keep young. Special Guest: Dr. Saman Faramarzi (Dr. Sam - https://www.instagram.com/dr.sam.nd/) is a Licensed Naturopathic Doctor and the founder of SAFA Life and Wellness, a concierge naturopathic clinic in Los Angeles, California. Dr. Sam likes to ask her patients how they want to FEEL, LIVE and BE every day. She then partners with her patients to help them achieve their health goals through the many modalities in her toolbox. Dr. Sam’s greatest joy is helping her patients become empowered to make choices to improve their health and change their lives. Heal Thy Self is a show based on empowerment. Empowerment of you, the viewer such that you can be your highest self on every level. Through knowledge, we will be giving you the information you need to make informed decisions. We lead you to water, you deep dive in. Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. and check out our YouTube Page with full video of every episode. (https://www.youtube.com/channel/UCztQQ--xORWtJCwHmaa_buA) Follow Doctor G on Instagram @doctor.g_ (https://www.instagram.com/doctor.g_) Citations: Oeseburg H, De boer RA, Van gilst WH, Van der harst P. Telomere biology in healthy aging and disease. Pflugers Arch. 2010;459(2):259-68.Shammas MA. Telomeres, lifestyle, cancer, and aging. Curr Opin Clin Nutr Metab Care. 2011;14(1):28-34.Ornish D, Lin J, Chan JM, et al. Effect of comprehensive lifestyle changes on telomerase activity and telomere length in men with biopsy-proven low-risk prostate cancer: 5-year follow-up of a descriptive pilot study. Lancet Oncol. 2013;14(11):1112-1120. --- Support this podcast: https://anchor.fm/heal-thy-self/support Learn more about your ad choices. Visit megaphone.fm/adchoices
William J. Gradishar, MD, of Feinberg School of Medicine and Northwestern Medicine in Chicago, chats with David H. Henry, MD, host of Blood & Cancer, to review some of the top breast cancer research presented at the 2019 annual meeting of the American Society of Clinical Oncology. Plus, in Clinical Correlation, Ilana Yurkiewicz, MD, of Stanford (Calif.) University, talks about dealing with help-seeking and help-rejecting patients. Show notes This episode discusses three randomized, controlled phase 3 trials that were presented at ASCO 2019: KRISTINE trial (abstract 500) Design: Patients with HER2-positive breast cancer were randomized to receive either neoadjuvant trastuzumab, pertuzumab, and chemotherapy (docetaxel, carboplatin) vs. trastuzumab emtansine plus pertuzumab. Primary endpoint: Pathological complete response rate. Secondary endpoints: Toxicity, event-free survival, invasive disease-free survival. Conclusion: Docetaxel, carboplatin, and trastuzumab plus pertuzumab resulted in a higher rate of pathological complete response than did trastuzumab emtansine plus pertuzumab, but was associated with more serious adverse events. PREDIX trial (abstract 501) Design: Patients with HER2 positive and hormone receptor positive breast cancer were randomized to receive either neoadjuvant trastuzumab emtansine monotherapy vs. docetaxel, trastuzumab, and pertuzumab. Primary endpoint: Pathological complete response rate. Secondary endpoints: Toxicity and quality of life. Conclusions: Trastuzumab emtansine monotherapy was better tolerated while maintaining comparable PCR rate as the group which received docetaxel, trastuzumab, and pertuzumab. TAILORx trial (abstract 503) Design: Patients with node-negative, estrogen receptor–positive breast cancer with an Oncotype DX recurrence score of 11-25 were randomized to receive either hormone therapy alone or hormone therapy together with combination chemotherapy. Primary endpoint: Rate of distant recurrence at 9 years. Conclusions: There was no benefit from chemotherapy for younger women (aged 50 years or younger) with a recurrence score of 16-20 and at low risk clinically (small tumor size and favorable histologic grade). Those age younger than age 50 years with a score of 16-20, but high risk clinically, may benefit from chemotherapy. Much of the benefit derived from chemotherapy was because of ovarian suppression. Using the recurrence score in combination with clinical risk stratification allows clinicians to identify more young women who can be spared chemotherapy, and more young women who may benefit from antiestrogen therapy. Show notes by Sugandha Landy, MD, a resident in the department of internal medicine, University of Pennsylvania, Philadelphia. References J Clin Oncol 37. 2019 May 20 (suppl; abstr 500). doi: 10.1200/JCO.2019.37.15_suppl.500. J Clin Oncol 37. 2019 May 20 (suppl; abstr 501). doi: 10.1200/JCO.2019.37.15_suppl.501. J Clin Oncol 37. 2019 May 20 (suppl; abstr 503). doi: 10.1200/JCO.2019.37.15_suppl.503. Lancet Oncol. 2018 Jan;19(1):115-26. N Engl J Med. 2019 Jun 20;380:2395-405. For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgehemonc David Henry on Twitter: @davidhenrymd Ilana Yurkiewicz on Twitter: @ilanayurkiewicz
Publicado ainda este ano de 2019, o FLOT 4 é um estudo onde os autores utilizaram fluorouracil, leucovorin, oxaliplatina e docetaxel para tratamento de adenocarcinoma de estômago e TEG. Após o MAGIC Trial (ECF/ECX), comentado no episódio 9 do nosso podcast, esse novo esquema de quimioterapia vem sendo adotado como o que há de mais eficaz e moderno para o tratamento dessa doença. O ganho de sobrevida com o FLOT 4 foi de 15 meses com o HR de 0.77. Percebam a evolução do tratamento se juntar-mos o MAGIC com FLOT 4: 13 + 15 meses = 28 meses de ganho em sobrevida global!! Incrível não!?!? Não perca esse mais novo episódio e saiba mais sobre toda essa história! Para saber mais sobre o estudo publicado na revista The Lancet Oncol, acesse o link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32557-1/fulltext
Neste episódio discutimos um paper publicado pelo Dr. Annemieke Cats em abril de 2018. Nele, o Dr Cats, de modo inovador, compara o esquema ECF de quimioterapia perioperatória vs. QT/RT como adjuvante pós terapia com ECF seguido de cirurgia para adenocarcinoma gástrico ou de TEG. É um estudo fase III, randomizado onde foram recrutados 788 pacientes oriundos de 56 hospitais da Holanda, Suécia e Dinamarca. Os pacientes foram recrutados entre janeiro de 2007 e abril de 2015. Com uma mediana de follow up de 61.4 meses, não houve diferença estatisticamente significativa de sobrevida entre os grupos (ECF perioperatória e RT/QT adjuvante). O estudo foi considerado negativo, tendo em vista que diferença estimada de 10% de sobrevida global a favor do braço QT/RT não foi atingida. Para saber mais sobre o estudo publicado na revista Lancet Oncol em abril de 2018, acesse o link: https://www.ncbi.nlm.nih.gov/pubmed/29650363
Nesse episódio do Geri Highlights, o Dr. Denis Szejnfeld entrevista o Dr. Guilherme Mariotti, que fala sobre as terapias ablativas focais para tumores prostáticos localizados. O Dr. Denis Szejnfeld é atualmente coordenador do Grupo de Estudos de Radiologia Intervencionista da SPR (Geri), em conjunto com os Drs. Antonio Rahal, Guilherme Cayres Mariotti e Guilherme Lopes Pinheiro Martins. Confira a agenda de reuniões do Geri em https://spr.org.br/grupos-de-estudos/geri-grupo-de-estudos-de-radiologia-intervencionista/ e participe online (https://spr.org.br/cursos-via-web/). Abaixo, seguem os artigos de referência dessa entrevista: - Mariotti GC, Costa DN, Pedrosa I, et al. Magnetic resonance/transrectal ultrasound fusion biopsy of the prostate compared to systematic 12-core biopsy for the diagnosis and characterization of prostate cancer: multi-institutional retrospective analysis of 389 patients. Urol Oncol 2016;34:416.e9-14. - Mariotti GC, Falsarella PM, Garcia RG et al Incremental diagnostic value of targeted biopsy using mpMRI-TRUS fusion versus 14-fragments prostatic biopsy: a prospective controlled study. Eur Radiol. 2017 https://doi.org/10.1007/s00330-017-4939-0 - H.U. Ahmed, R.G. Hindley, L. Dickinson, et al. Focal therapy for localised unifocal and multifocal prostate cancer: a prospective development study Lancet Oncol, 13 (2012), pp. 622-632 - Cordeiro, ER, Cathelineau, X, Thuroff, S, Marberger, M, Crouzet, S, De La Rosette, JJ. High‐intensity focused ultrasound (HIFU) for definitive treatment of prostate cancer. BJU Int 2012 - van der Poel HG, van den Bergh RCN, Briers E, et al. Focal therapy in primary & localised prostate cancer: the European Association of Urology position in 2018. Eur Urol 2018; 74:84–91.
Daniel G. Haller, MD, of the University of Pennsylvania, Philadelphia, joins Blood & Cancer host David H. Henry, MD, also of the University of Pennsylvania, to review the top research presented at ASCO GI 2019. Plus, in Clinical Correlation, Ilana Yurkiewicz, MD, of Stanford (Calif.) University shares the story of a patient who had no questions about the details of his treatment but needed answers about the “big picture.” Show Notes By Emily Bryer, DO, resident in the department of internal medicine, University of Pennsylvania, Philadelphia Phase 2 trial of pembrolizumab (Keytruda), chemotherapy, and trastuzumab (Herceptin) in gastric cancer: Patients had previously untreated HER2 IHC+ or FISH+ tumors. Patients received pembrolizumab, trastuzumab/CAPOX (capecitabine and oxaliplatin) or FOLFOX (folinic acid, fluorouracil, and oxaliplatin). Patients all had a 100% response rate, prompting an ongoing phase 3 trial (KEYNOTE-811). Third-line therapy for gastric cancer – TAGS, a phase 3 trial: supportive care vs. trifluridine plus tipiracil (Lonsurf): Gastrectomy did not affect outcome, safety, or pharmacokinetics. Neutropenia, a major toxicity, is manageable. Trifluridine and tipiracil are now a National Comprehensive Cancer Network Level 1 guideline for third-line therapy in patients with gastric cancer. Neoadjuvant chemotherapy in pancreatic cancer: Compared neoadjuvant gemcitabine and S1 (NAC-GS) with upfront surgery for patients with pancreatic ductal adenocarcinoma and planned resection. Saw a significant survival benefit (37 months) of NAC-GS over upfront surgery (26 months). Circulating tumor cells (CTC) in colorectal cancer: Studied patients with planned colonoscopies for colorectal screening. Took blood at the time of the procedure. Identified an absolute correlation with CTC and an increased disease burden in patients with colon cancer. Additional reading: Lancet Oncol. 2018 Nov;19(11):1437-48. Oncotarget. 2018 May 11;9(36):24561-71.
Chegamos ao terceiro episódio do Podcast Microbiando e nele discutimos um artigo que demonstra como bactérias que vivem na nossa pele podem produzir uma molécula que protege contra o câncer de pele. Esse artigo foi publicado na revista científica Science Advances em fevereiro de 2018 com o título “A commensal strain of Staphylococcus epidermidis protects against skin neoplasia”. No quadro Microlitros de Notícias: uma breve pipetada de novidades da Microbiologia e Imunologia, abordamos os seguintes assuntos: a atividade do leite materno no combate à células tumorais; a utilização de bactérias vampiras contra infecções bacterianas; a descoberta de uma enzima bacteriana capaz de degradar plásticos; e algumas dicas sobre a febre amarela. Na Filogenia da Ciência, iremos trazer a história de um pesquisador muito importante para nós do Instituto de Microbiologia, o professor Paulo de Góes. Tópicos comentados nesse episódio Microbiota Staphyloccocus epidermidis Atividade antimicrobiana Molécula 6-HAP Fármacos antitumorais Quimioterápico Tumores Prevenção do câncer de pele Leite materno no combate à células tumorais Bactérias vampiras contra infecções bacterianas Enzima bacteriana capaz de degradar plásticos Dicas sobre a febre amarela A vida de Paulo de Góes e do Instituto de Microbiologia/UFRJ Referências desse episódio Nakatsuji T, Chen TH, Butcher AM, Trzoss LL, Nam SJ, Shirakawa KT, Zhou W, Oh J, Otto M, Fenical W, Gallo RL. A commensal strain of Staphylococcus epidermidis protects against skin neoplasia. Sci Adv. 2018 Feb 28;4(2) Nakatsuji T, Chen TH, Narala S, Chun KA, Two AM, Yun T, Shafiq F, Kotol PF, Bouslimani A, Melnik AV, Latif H, Kim JN, Lockhart A, Artis K, David G, Taylor P, Streib J, Dorrestein PC, Grier A, Gill SR, Zengler K, Hata TR, Leung DY, Gallo RL. Antimicrobials from human skin commensal bacteria protect against Staphylococcus aureus and are deficient in atopic dermatitis. Sci Transl Med. 2017 Feb 22;9(378). Plitzko B1, Havemeyer A1, Kunze T1, Clement B2. The pivotal role of the mitochondrial amidoxime reducing component 2 in protecting human cells against apoptotic effects of the base analog N6-hydroxylaminopurine. J Biol Chem. 2015 Apr 17;290(16):10126-35. Galmarini CM, Mackey JR, Dumontet C. Nucleoside analogues and nucleobases in cancer treatment. Lancet Oncol. 2002 Jul;3(7):415-24. Review. James C. S. Ho, Aftab Nadeem e Catharina Svanborg. HAMLET – A protein-lipid complex with broad tumoricidal activity. Biochemical and Biophysical Research Communications. 482: 3, 15 January 2017. Ines Ambite. HAMLET, a new concept for cancer therapy. 2017. Shatzkes, K. et al. Predatory bacteria: a new therapeutic approach for a post-antibiotic era. Future Microbiology. Maio de 2017. Shatzkes, K. et al. Examining the efficacy of intravenous administration of predatory bacteria in rats. Scientific Reports. Maio de 2017. Shatzkes, K. et al. Examining the safety of respiratory and intravenous inoculation of Bdellovibrio bacteriovorus and Micavibrio aeruginosavorus in a mouse model. Nature. Março de 2015. Yoshida et al. A bacterium that degrades and assimilates poly(ethylene terephthalate). Science. Março de 2016 Austin, H. P. et al. Characterization and engineering of a plastic-degrading aromatic polyesterase. PNAS. Abril de 2018 Sobre o Podcast Microbiando A ideia do Microbiando é discutir artigos científicos de ponta em todas as áreas da microbiologia e imunologia. Vamos utilizar uma linguagem bem acessível para destrinchar esses artigos para vocês, mas sem perder o rigor científico e analítico necessário para essa tarefa. Além de discutir artigos nós teremos o quadro Microlitros de Notícias, onde nossos microbiologistas e imunologistas de plantão irão abordar pequenas reportagens e trazer novidades para vocês. No quadro filogenia da Ciência vamos contar um pouco sobre a vida de grandes personalidades que revolucionar...
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