Podcasts about medical oncology

Listen to JCO's Art of Oncology article, "Final Silence" by Dr. Ju Won Kim, who is an Assistant Professor at Korea University College of Medicine, Medical Oncology. The article is followed by an interview with Kim and host Dr. Mikkael Sekeres. Dr Kim explores the burden of silence when caring for dying patients. TRANSCRIPT Narrator: Final Silence, by Ju Won Kim  Dr. Mikkael Sekeres: Welcome back to JCO's Cancer Stories: The Art of Oncology. This ASCO podcast features intimate narratives and perspectives from authors exploring their experiences in oncology. I'm your host, Mikkael Sekeres. I am a Professor of Medicine and Chief of the Division of Hematology at the Sylvester Comprehensive Cancer Center, University of Miami. We are so thrilled to have joining us today, Dr. Ju Won Kim. She is Assistant Professor at Korea University College of Medicine, and she is here to discuss her Journal of Clinical Oncology article, "Final Silence." Ju Won, thank you for contributing to the Journal of Clinical Oncology and for joining us today to discuss your article. Dr. Ju Won Kim: Hello, Mikkael. It's really nice to be here. Thanks so much for inviting me. Dr. Mikkael Sekeres: It's so nice to have you here today also. Thank you for also taking time so late in the evening because our time difference is so huge. Dr. Ju Won Kim: Yeah, it's not that late. It's 9 o'clock in Seoul. 9:00 PM. Dr. Mikkael Sekeres: I wonder if I could start by asking you if you can tell us about yourself. Could you walk us through your career so far? Dr. Ju Won Kim: Yes. I am Ju Won Kim from Korea University in Seoul. I was born and also raised here and never really left from Seoul. I did my residency in internal medicine and fellowship in oncology at the same hospital, and now I'm an assistant professor there. So you could say I've spent my whole life on the same campus, just moving from one side of the hallway to another. Dr. Mikkael Sekeres: That's a beautiful way of describing it. Is that common in Korea for somebody to remain at the same institution for training and then to continue through your career? Dr. Ju Won Kim: It used to be common about a decade ago, but nowadays it is not that common. Most of my colleagues are from another campus or another hospital. Dr. Mikkael Sekeres: Well, I'm so curious, what is a typical week like for you? How many days do you spend seeing patients and how much time do you spend doing research or writing or have other responsibilities? Dr. Ju Won Kim: Usually, I spend four times for my outpatient clinic, but in Korea, there are so many cancer patients and so little number of medical oncologists. I usually treat so many patients in one clinic, like maybe 20 to 30 in one time. Dr. Mikkael Sekeres: Wow. Dr. Ju Won Kim: Yeah, that's a burden. Most of the time I spend treating my patients, and rest of them I use to spend for my research with my lab students, and maybe with my colleagues, and I have to write something like documents or some kind of medical articles. That is about 10 or 20% of my working time, I think. Dr. Mikkael Sekeres: Okay, okay. That makes sense. So, and do you specialize within oncology, or do you see any person who has cancer? Dr. Ju Won Kim: I'm a medical oncologist, and I used to treat breast cancer or biliary pancreatic cancer or some kind of liver cancer or rare cancer, maybe, also. Dr. Mikkael Sekeres: Okay, okay. It's such a long trip. Are you able to make it to the ASCO Annual Meeting in Chicago? Dr. Ju Won Kim: Actually, I've been Chicago for ASCO meeting just one time in this year. Actually, I gave birth to my son in March, and I was in the long vacation for my birth, and the last part of my birth vacation, I went to Chicago to participate in ASCO. It was a really good time. Dr. Mikkael Sekeres: Oh, fantastic. That's great. How about your own story as a writer? How long have you been writing narrative pieces and when did you start? Dr. Ju Won Kim: Actually, I've always thought of myself more as a reader than a writer. Reading was my comfort zone from childhood. Then I started a small book club with friends about 10 years ago, and we began writing short reflections after each meeting. That's how writing slowly became part of my routine. When reading feels heavy, I write. When writing feels tiring, I read. It's a rhythm that keeps me balanced. At first, it was only academic writing like medical articles, but a few years ago, I challenged myself to post one short reflection a month on my Instagram, usually a quote from a book and a few sentences on why it mattered to me. It was my life about writing. Dr. Mikkael Sekeres: That is really remarkable. So, did you take any formal writing classes at university? Dr. Ju Won Kim: Not really. It was just a hobby of my own. Dr. Mikkael Sekeres: It always impresses me when people come into writing organically like this, where they just discover it and start and don't have formal teaching because your writing is very, very good. Dr. Ju Won Kim: Oh, thank you. Dr. Mikkael Sekeres: And how do you find the time to read and write when you have a busy career, academic career, and you have a child? Dr. Ju Won Kim: It was my old routine that I used to read it before going to bed, from my bedside with a small light, I used to read some novels and get to sleep easily. But after I started to work as a medical oncologist, it was a very busy job as you know. I used to sleep more and not have time for reading. I try to read more when I get some free time. Dr. Mikkael Sekeres: I love how you talk about alternating reading and writing and how when one gets too heavy, you go to the other, and then you switch back. One of the most common pieces of advice I've heard from writers is to read more. Dr. Ju Won Kim: Yeah. Dr. Mikkael Sekeres: You can see how other people put thoughts together and the cadence of their writing, and also it inspires your mind to develop new ideas for writing. Dr. Ju Won Kim: Actually, the new idea also comes from the book, I think, when I came into a new book and the idea bangs up with me, so I started to write and that's an easy way to have some idea about writing. Dr. Mikkael Sekeres: I'm always impressed by people who are facile with languages and bilingual or trilingual. I think I'm unfortunately a hopeless monoglot. Dr. Ju Won Kim: Maybe you can try Korean. Dr. Mikkael Sekeres: I'd be embarrassed to even attempt it. When you read, do you read in Korean or do you read in English or other languages? Dr. Ju Won Kim: Definitely in Korean. Dr. Mikkael Sekeres: Okay, okay. And when do you find the space to write? Do you need to be alone at home in a special room or at a special desk, or do you write at work, or do you just find any time to write? Dr. Ju Won Kim: I usually don't have much time on my own because I have my baby now and some family gathers frequently. So, I always write every free time I'm trying to, any short free time in my work maybe. Dr. Mikkael Sekeres: If you feel comfortable doing so - this is a very heavy piece, and a lot of us have dealt with deaths of our own patients, of course, we see this unfortunately commonly in oncology, but many of us, myself included, have also dealt with patients or their family members who've committed suicide - can you tell us what prompted you to write this piece? Dr. Ju Won Kim: As an oncologist treating biliary and pancreatic cancers, I've witnessed many deaths, as you know. Most fade with time because I treat so many patients, but just one family stayed with me, I think. It was early in my career, just months after I started this specialty, and even 5 years later, I still think about them, the family I wrote about in the "Final Silence." The story eventually became the piece I wrote. Dr. Mikkael Sekeres: And what is it about them that caused you to think about them so much even years later? Dr. Ju Won Kim: I'm not sure. That's the only experience I came into someone's suicide so closely in my life, I think, and also it happened in my very early career. That's the impact. Dr. Mikkael Sekeres: It is amazing how certain patients stick with us even years or decades later, particularly when they're tied to an emotional response to illness, and that can be our patients' emotional response or our own. Can you talk some about Korean culture and how cancer is viewed? Is it discussed openly? Dr. Ju Won Kim: In Korea, death is still a quiet topic. Cancer equals death in many people's minds, and death equals grief. Even today, some families ask doctors not to tell their patients about the diagnosis, but Korea is aging so fast, so I see more older patients now, but culturally, we are still learning how to talk about dying openly. That's the big problem as a medical oncologist, especially treating biliary and pancreatic cancers. Dr. Mikkael Sekeres: I can just imagine. When you first meet a patient and their family is in the room, do you tell them that they have cancer, or do you need to check in with the family and with the patient how much they know about their diagnosis first? Dr. Ju Won Kim: Actually, I usually try to tell them there is a cancer, which can never be treated perfectly, because I used to treat patients with stage four, which is incurable, but I'm not sure is it okay to tell them that your life is about 3 months or 6 months or 1 year. It is not that okay for the Korean patients, especially the first time when they meet me in the clinic. I try to tell them about the truth just a few times later. Dr. Mikkael Sekeres: I think that's common. I think we do that in the United States also. We may not mention a number to patients during that very first meeting because when you're talking to somebody and once you mention that number, often people will shut down. They won't hear anything else that you say. And you need to build up a relationship and some trust with somebody and also get the sense how much they want to know about their cancer and their prognosis before entering that conversation. I've certainly had instances when I'm in a room with a patient, and that patient's spouse or children, and someone else in the room will say, "How long does Dad have to live?" And I've turned to my patient, "Dad", and said, "Is this a number that you want to know?" And the patient has said, "No, I don't." Dr. Ju Won Kim: Yeah, that happens. Dr. Mikkael Sekeres: So sometimes we have to be careful and check in and remind ourselves in the high emotions around a cancer diagnosis that our first responsibility is always to our patient and what they want to know about their diagnosis and their prognosis. Dr. Ju Won Kim: Do you have any opposite cases where patients really want to know the numbers? Dr. Mikkael Sekeres: Yeah, I do. And, you know, you can almost predict who that's going to be depending on what they did during their lives. Dr. Ju Won Kim: Yes. Dr. Mikkael Sekeres: So I have patients who are engineers or who have a math-based career like they're accountants and they'll come in and they write every number down and they want to know the number about their prognosis. I have other patients who are English professors and they want descriptively to know what the prognosis is but maybe don't want a number. So... Dr. Ju Won Kim: I think most Koreans want the number, the specific number. Yeah. Dr. Mikkael Sekeres: I'm curious, is cancer in a father or a son dealt with differently than cancer in a mother or a daughter? Dr. Ju Won Kim: I don't think there's much difference between sons and daughters, or maybe moms and dad, because every child is very precious in Korea now, but between husband and wives, I think the dynamic stands out. People often say when a husband gets cancer, the wife becomes his main caregiver, but when the wife gets cancer, sometimes the husband disappears. I've heard that from my colleagues, though not often in my own clinic. Now, what I do see is many middle-aged women who have been diagnosed with breast cancer, women coming to treatment alone, strong and very independent. Dr. Mikkael Sekeres: Interesting. So I was going to follow up by asking if you've seen that in your own clinic. Have you seen- is it more likely that your female patients who have a cancer diagnosis come to clinic alone but the male patients come with their spouse and with family support? Dr. Ju Won Kim: Yeah, it is not just because of their sex, but most of the breast cancer patients who are female are in good condition, but biliary pancreatic cancer male patients have very poor condition, so... Dr. Mikkael Sekeres: Ah... Dr. Ju Won Kim: Maybe, I think that's the problem. Dr. Mikkael Sekeres: Interesting. The part of your essay in which you describe the attempted suicide of your patient's daughter is absolutely chilling. How did that affect you? Have you ever had a patient attempt suicide before? Dr. Ju Won Kim: Yes, the event I wrote in my essay was extremely shocking for me, but it's the only experience I have. It wasn't my patient, but I've heard a few cases where someone in the hospital tried to take their own life. I haven't had that happen directly, but I've seen patients fall into deep depression or break down in tears. In those moments, I always suggest psychiatry nowadays. That used to be taboo in here, but the stigma is fading, and many patients actually feel better afterwards. I also check in with close family members because their mental state affects the patients, too. It's something I hope never to experience again. Dr. Mikkael Sekeres: It's so unsettling when that happens, and as I mentioned, I've had a patient who took his own life, and you go back and back and back to it to wonder if there's something you could have done to intervene quicker or to get that psychosocial support in place to help that patient so that you avoid it in the future. And, you know, you protect your patients and yourself. Dr. Ju Won Kim: Yeah, I try to. Dr. Mikkael Sekeres: Speaking of protecting, you write, and I'm going to quote you to you, "I told myself I was protecting her, that to burden her in her final hours with such unthinkable news would be cruel. But a deeper truth is that I was protecting myself. I didn't know how to say it. I didn't know how to bear the weight of her devastation on top of my own shock and helplessness, so I avoided it." Do we owe it to ourselves sometimes to protect ourselves from the pain we sometimes impart to our patients? Dr. Ju Won Kim: That reflection came from realizing how doctors sometimes say we are protecting patients from pain, but really, we are protecting ourselves, I think. It's human. We can't hold every piece of suffering we see. Setting emotional boundaries isn't weakness. It's survival. What matters is recognizing when it's self-protection and being honest about it later. Dr. Mikkael Sekeres: Well, I think something that really helps with that is being able to talk to our colleagues about times when this happens and recognize we're in a shared experience and that we have the support of our colleagues, and they recognize how hard it is to be the bearer of bad news to other people and to bring pain to them sometimes. Dr. Ju Won Kim: That really works. Dr. Mikkael Sekeres: Dr. Ju Won Kim, it has been such a pleasure having you on this show. Dr. Kim has written just a fabulous essay called "Final Silence" for JCO Art of Oncology. Thank you so much for sharing your article with us and for joining us today. Dr. Ju Won Kim: Yeah, thank you so much for the conversation. It was a pleasure talking with you. Dr. Mikkael Sekeres: If you've enjoyed this episode, consider sharing it with a friend or a colleague or leave us a review. Your feedback and support helps us continue to have these important conversations. If you're looking for more episodes and context, follow our show on Apple, Spotify, or wherever you listen and explore more from ASCO at asco.org/podcasts. Until next time, this has been Mikkael Sekeres for Cancer Stories. 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. Show Notes: Like, share and subscribe so you never miss an episode and leave a rating or review. Guest Bio:Dr Ju Won Kim is an Assistant Professor at Korea University College of Medicine, Medical Oncology.

Guest: Gerard A. Silvestri MD, MS, Master FCCP Guest: Mariam Alexander, MD, PhD Guest: Jessica S. Donington, MD, MSCR The 2025 European Society for Medical Oncology Congress and World Conference on Lung Cancer revealed significant updates in non-small cell lung cancer care. Learn more as Drs. Gerard Silvestri, Mariam Alexander, and Jessica Donington review new data on EGFR- and ROS1-targeted therapies, perioperative immunotherapy, and multidisciplinary strategies to expand resectability in stage III non-small cell lung cancer. Dr. Silvestri is a pulmonologist and the Hillenbrand Professor of Thoracic Oncology at the Medical University of South Carolina. Dr. Alexander is an Assistant Professor of Medical Oncology at the Medical University of South Carolina. Dr. Donington is a Professor in Surgery and Chief of the Section of Thoracic Surgery at the University of Chicago. This program is produced in partnership with the American College of Chest Physicians and is sponsored by AstraZeneca.

In Episode 33, Dr. Aly-Khan Lalani and Dr. Christoper Wallis sit down with Dr. Daniel Heng, Clinical Professor at the University of Calgary and Head of Medical Oncology at the Arthur J.E. Child Comprehensive Cancer Centre. Together, they explore the full landscape of mentorship and sponsorship in academic medicine, from what makes an exceptional mentee to how leaders identify and support rising talent.The View on GU with Lalani & Wallis integrates key clinical data from major conferences and high impact publications, sharing meaningful take home messages for practising clinicians in the field of genitourinary (GU) cancers. Learn more about The View on GU: theviewongu.caThis podcast has been made possible through unrestricted financial support by Novartis, Bayer, Astellas, Tolmar, Ipsen, J&J, Merck, Pfizer, Eisai and AbbVie.

In today's episode, we had the pleasure of speaking with Edward S. Kim, MD, MBA; and Jyoti Malhotra, MD, MPH, about the promise of IB6 as a therapeutic target in non–small cell lung cancer (NSCLC) management. Dr Kim is physician-in-chief of City of Hope Orange County, vice physician-in-chief of the City of Hope National Medical Center, and a professor in the Department of Medical Oncology & Therapeutics Research at City of Hope in Irvine, California. Dr Malhotra is interim division chief of Thoracic Medical Oncology, an associate professor in the Department of Medical Oncology & Therapeutics Research, and the director of Thoracic Medical Oncology at City of Hope. In our exclusive interview, Drs Kim and Malhotra discussed factors that make IB6 unique compared with other NSCLC biomarkers, the prevalence of IB6 expression among patients with lung cancer, and the rationale for investigating sigvotatug vedotin (formerly SGN-B6A) vs docetaxel in patients with previously treated NSCLC in the phase 3 Be6A Lung-01 trial (NCT06012435). 

Guests Dr. Andrea Necchi, Dr. Ashish Kamat and host Dr. Davide Soldato discuss JCO article "End Points for the Next-Generation Bladder-Sparing Perioperative Trials for Patients With Muscle-Invasive Bladder Cancer," focusing on the evolving treatment landscape of MIBC (muscle-invasive bladder cancer) and the need to properly design novel trials investigating non-operative management while including the incorporation of biomarkers and patient perspectives in clinical trials. TRANSCRIPT The disclosures for guests on this podcast can be found in the show notes. Dr. Davide Soldato: Hello and welcome to JCO After Hours, the podcast where we sit down with authors from some of the latest articles published in the Journal of Clinical Oncology. I am your host, Dr. Davide Soldato, medical oncologist at Ospedale San Martino in Genoa, Italy. Today we are joined by JCO authors Andrea Necchi, Associate Professor of Medical Oncology at University San Raffaele and Medical Oncology at Ospedale San Raffaele in Milan, Italy, and Ashish Kamat, Professor of Urologic Oncology and Cancer Research at University of Texas MD Anderson Cancer Center. Both Professor Necchi and Professor Kamat are internationally recognized experts in the field of genitourinary malignancy and particularly in bladder cancer. Today we will be discussing the article titled "Endpoints for the Next Generation Bladder-Sparing Perioperative Trials for Patients with Muscle-Invasive Bladder Cancer." So thank you for speaking with us, Professor Necchi and Professor Kamat. Dr. Andrea Necchi: Thank you, Davide, and thank you JCO for the opportunity. Dr. Ashish Kamat: Yeah, absolutely. It is a great honor and privilege to be discussing this very important article with you. So thank you for the invitation. Dr. Davide Soldato: The article that you just published in JCO reports the results of a consensus meeting that was held among experts in the field of genitourinary malignancy and particularly for bladder cancer. So the objective was really to define endpoints for a novel generation of trials among patients diagnosed with muscle-invasive bladder cancer. So my first question would be: what is the change in clinical practice and in clinical evidence that we have right now that prompted the start of such consensus in 2025? Dr. Andrea Necchi: So, we are living so many changes in the treatment paradigm of patients with muscle-invasive bladder cancer. In general, patients diagnosed with bladder cancer or urothelial cancer today, thanks to the advent of immunotherapy or immunotherapy combinations, and today thanks to the advent of novel antibody-drug conjugates like enfortumab vedotin in combination with immunotherapy that are actually changing the landscape of treatment of patients with metastatic disease and also are entering quite fast into the treatment paradigm of patients with organ-confined disease with a lot of clinical trials testing these combination therapies, neoadjuvantly or adjuvantly, before or after radical cystectomy. Having said that, by potentiating the efficacy of systemic therapy, an increasing number of patients that receive neoadjuvant therapy of any kind, at a certain point in time, result to have achieved a deep response to systemic therapy, evaluated radiologically with conventional imaging, CT scan or MRI, or with cystoscopy or with other urology-based techniques, urinary cytology, and so. And based on the fact that they achieve a complete response, so no residual viable disease after systemic therapy, they raise concern about the fact that they have to undergo surgery like radical cystectomy that is quite impactful for their quality of life and for the future of their lives after the surgery. So the point that the patients are raising, and the patients are raising this point, is primarily due to the efficacy of systemic therapy. And we have seen so many cases fortunately achieving a deep response. So the question about what to do with the patient that at a certain point, at the start with the commitment to radical cystectomy, but at a certain point in time change their mind towards something else if possible, depending on the fact that they have achieved a deep response, is something that is a question and is a need to which we have to provide data, information, and guidance in general to the patients. Dr. Davide Soldato: If we look at the population that the recommendations were formulated for, we are mainly speaking about patients who would be fit for cystectomy, and this is a very distinct population compared to those who are not fit for cystectomy, both from a medical oncology point of view but also from a urologic point of view in terms of surgery. So, can you explain a little bit to our listeners why you think that this distinction is critical and why you developed this recommendation especially for this population? Dr. Ashish Kamat: That is a very important distinction that you made. To build upon what Professor Necchi mentioned earlier, this question that we get from patients after neoadjuvant therapy or systemic therapy is not a new question. It has been something that they have been asking us for the last 20 or 30 years. "Do I really need to have my bladder taken out?" And patients who are especially not fit for surgery will sometimes say, "Do I need to have my bladder taken out? And if I cannot have my bladder taken out, am I going to just not have anything done?" Because the eligibility for radical cystectomy is also a moving target. Over the years with improvement in surgical technique, improvement in perioperative therapy, ERAS protocols, et cetera, it is really unusual for us to deny a patient the opportunity to have major surgery unless clearly they have very significant comorbid conditions. So I think this endeavor is more broadly encompassing of the patient population than what was evident in previous years. And I really want to give a shout out to Professor Necchi because what we did was, as part of the International Bladder Cancer Group and Professor Necchi is an integral part of the scientific advisory board, we broached this topic broadly during one of our discussions. And of course, Andrea always does this, he picks on a topic and then he says, "Okay, we need to discuss this really in detail," put together a multinational, multicenter collaborative group, but the driving force was our patients. Because our patients are constantly asking, "Do I need to lose my organ? Do I need to have radiation therapy?" which again, also, has a lot of side effects. So this was really to answer the question in today's day and age as to do we need to do local consolidation, and if so, in what way? It is not a new question, but we have newer therapies, newer technology, and better ways to answer this. So it is a much needed question that needs to be answered. And I think the distinction between non-surgical candidates and surgical candidates is a little bit blurred in today's day and age. Dr. Davide Soldato: What about the eligibility, for example, for cisplatin-based chemotherapy? Because I think that that is a very fundamental part of this type of strategy that we apply to patients with muscle-invasive bladder cancer. So we know that there are some caveats for proposing such treatment. And also this population was specifically defined inside this recommendation. Dr. Andrea Necchi: I think that the focus of our work is just to analyze what is happening after any type of systemic therapy the patient may get neoadjuvantly. So it is not actually a question of treatment eligibility or including cisplatin eligibility. This is an old question of today's practice and clinical trials. But regardless of what the patient received neoadjuvantly, the point that we have addressed in our consensus meeting was what to do next as a further step after systemic therapy or not. So basically we are- the consensus guidance includes all-comers, so patients to get any type of systemic therapy. So really non-selected based on specific features that determine a special eligibility to a special or a particular therapy. But an all-comer approach is always the winning approach for the translation to be in practice, an all-comer approach just focusing on what has happened after treatment and that we are assessing by the use of conventional imaging, MRI or CT, cystoscopy, urinary cytology, and trying to merge all together this information, all these features in a unique, shared, reliable definition of clinical complete response that could be used as a biomarker for the selection of newer therapies instead of pathological response that has been historically used, and maybe surrogate for the outcome, the long-term outcome and survival of these patients. Dr. Davide Soldato: A very specific point of the consensus was actually the definition of clinical complete response. As you were saying, this is actually a combination of several parameters including urinary cytology, the use of cross-sectional imaging, for example CT scan, but also the evaluation in cystoscopy of the bladder. Do you foresee any potential problems when applying this type of recommendation, not inside clinical trials, but in the context of routine clinical practice? Dr. Ashish Kamat: Absolutely. And that was the whole reason we had this consensus meeting. What happens nowadays in daily practice, and we see this every day at our center, we see patients referred to us. This definition or this sort of attempt to define clinical complete response is an ongoing issue. And urologists, medical oncologists, radiation oncologists are always looking to see, does my patient have a complete response? That definition and those paradigms have changed and evolved over the years. The FDA had a workshop many years ago looking at this very question. And it was to address the proposal that complete clinical response, which is a clinical definition, a clinical state, does this correlate with pathologic response? And with the technology and the systemic therapies we had then, the answer was 'no'. In fact, more patients got recurrent disease than did not get recurrent disease. And that is why, of course in the paper we mention the trials that looked at this question, the trials that evolved around this question. And I think the distinction between a clinical trial and daily practice is extremely important when we are looking at this definition per se. Because essentially what happens with this issue is that if the patient is not appropriately counseled, and if the physician does not do the appropriate clinical complete response assessment as Professor Necchi mentioned, right, cystoscopy, cytology, imaging, use of markers that are still in evolvement, we risk doing harm to the patient. So we caution in the paper too that this definition is not ready for prime time use. It is something that needs to be studied. It is a rigorous definition and currently we are recommending it for clinical trials. I am sure eventually it will trickle down into clinical practice, but that guidance was not the purpose of this consensus meeting. Dr. Davide Soldato: There are several parameters that are potentially evolving and could potentially enter inside of clinical practice. For example, you mentioned pelvic MRI and we have now very specific criteria, the VI-RADS criteria, we're able actually to diagnose and also to provide information. So along with these novel imaging techniques, we also know that there are novel biomarkers that could be explored, for example ctDNA and urinary DNA. So what I was wondering is, why were not these included inside the definition that you provide for clinical complete response? And do you think that, as we are designing these trials to potentially spare cystectomy for this patient, we should include these biomarkers very early so that we can actually provide better stratification for our patients and really propose this type of cystectomy-sparing strategy only to those where we are very confident that we have obtained a clinical complete response? Dr. Andrea Necchi: I would say you have just to wait. So a follow-up is ongoing and hard work is ongoing. At the time we met, at the time we established the meeting in mid-December last year, we had no information on the ctDNA data from major trials, with only a few exceptions. So we were just at the beginning of a story that was more than likely to change but still without numbers and without data from clinical trials. Now in just nine months or 10 months time, we have accumulated important data and newer data will be presented during just a few weeks and a few days regarding the ctDNA, circulating tumor DNA in particular, as a prognostic marker assessed baseline or assessed after neoadjuvant therapy. So the point is certainly well made and ctDNA is certainly well shaped to be incorporated in a future definition of clinical complete response. But you have to consider the fact that most of the data that we are accumulating related to ctDNA are about the post-cystectomy field or the metastatic field. So regarding neoadjuvant therapy, you know, we have neoadjuvant therapy in the context of bladder-sparing approach, basically we have no information. And the point that is emerging in our daily practice when using these biomarkers or in clinical trials, and the impression in general, is that it is a very strong biomarker associated with survival, but we absolutely do not know what is the performance of the test in the prediction of superficial bladder relapses, high-grade pTa relapse in the bladder that is left untouched in the patient. We are considering, and maybe it will be just a matter of further discussion, not just what is happening within the immediate endpoint of clinical CR, but also what is happening later with other survival endpoints. And for example, when looking at the type of events that we may see in this kind of bladder-sparing approaches, most of the events, also in the trials that have been published including the RETAIN study published in JCO, most of the events are related to superficial high-grade superficial non-muscle invasive relapses. So the ability to predict these types of events with ctDNA is completely unknown. Maybe, maybe other liquid biomarkers like urinary tumor DNA, utDNA, could be a bit better shaped in the prediction of this kind of events, you know. But we have still to build the story. So the question is good. The answer is yes, we will likely, more than likely incorporate liquid biomarkers in the definition, but we have to wait at least more data and more robust data in order to translate this information in routine practice, you know. Another consensus meeting is organized by IBCG and the same folks for November. This meeting will be primarily focused on the liquid biomarkers, the interpretation and use and approval and so of liquid biomarkers including bladder cancer. And we will likely be able to address all these, most of these open issues, so most of these points in the next meetings. Dr. Davide Soldato: In the consensus you say that probably clinical complete response is now ready to be included in early phase trials, so actually to test what is the efficacy of the regimens that is being evaluated inside of these trials. But you actually do very in-depth work of defining what are the most appropriate endpoints for later phase trials. So to be very specific, the phase three registrational trials that bring new regimens inside of this space. So I just wanted to hear a little bit about what was the definition for event-free survival, which you define as the most appropriate one for this type of trials. And as you were mentioning before, Professor Necchi, there is a very specific interest on the type of events that we observe, especially when we look at these superficial relapses inside of the bladder. So was this a very urgent matter of debate as we define which type of events should actually trigger event-free survival? And did you make a very thoughtful decision about why using this type of endpoint instead of others, for example metastasis-free survival? Dr. Ashish Kamat: Yeah, this was a matter of intense debate as you might imagine. And again, this is a moving target. So as Professor Necchi mentioned, we tend to partner with each other, our organizations, on having definitions of clinical complete response, biomarker, retreats, and then using that as a marker, and you might imagine this definition of what is appropriate event-free survival, what events matter to the patient, is something we have been talking about for two years. It was not just something that came up at the retreat. But at the retreat there was intense discussion. One of the things that we talked about was bladder-intact event-free survival because we are trying to spare the patient's bladder. And do we count bladder-intact event-free survival as something that is relevant? The patient advocates absolutely liked that, right? They wanted that. But then we also learned from some of the studies, for example from the RETAIN study, that the non-muscle invasive recurrences can actually lead to metastatic disease. It is not as benign when you have a patient with muscle-invasive bladder cancer that then develops a non-invasive tumor because maybe there is cancer growing underneath the surface that we don't detect when we look in the bladder. So a lot of those discussions were held, debated. It was a consensus. I have to say it was not 100% agreement on that particular definition, but it was broad consensus. And Andrea, do you want to clarify a little bit as to how we came about that consensus? Because I think this is a very important point we need to make. Dr. Andrea Necchi: We focused on a bit different definition of BI-EFS, Bladder-Intact Event-Free survival. Just stating EFS as an all-inclusive parameter including all type of high-grade relapse or progression or death that may happen to the patient. So that we were counting high-grade pTa, pT1, CIS relapses to the bladder and of course more deeper involvement in the muscle layer and so, and metastatic disease as a relapse. But the point is that as compared to the classical bladder-intact EFS definition of chemoradiation bladder-sparing approaches that is including muscle-invasive relapses only or death as events, we tried to be as inclusive as possible in order to be as much conservative as possible and to raise as higher the bar as possible for the success. And this is actually what the patients are asking us. So they are asking, "Okay, I can save my bladder, sparing radical cystectomy, but at which cost?" So in order to provide an answer, we have to be very, very cautious and be on the right shape, on the right position to say, "Okay, we have accomplished the most, the safest points, you know, by which you can proceed with the bladder-sparing." This is the first point. The other point is related to the MFS, metastasis-free survival that you have mentioned. For sure, it was recognized as a very important point for sure. But in the discussion was clear that our focus was in saving patients, curing the patient, and saving the bladder. Any single event, superficial event that may occur in the bladder-saving approaches of this kind may expose the patient to an extra risk of developing distant metastases, as it happened for example in the RETAIN study. So EFS defined as we have agreed and published, is actually a way of including or anticipating in a safest position the MFS. Because most or if not the entirety of the events of metastasis development in patients undergoing bladder-sparing after neoadjuvant systemic therapy were preceded by a superficial phase of disease relapse, you know. So I remember very, very few, or we can count just on the finger of one hand, the cases that have been reported in the literature developing de novo metastatic disease in the similar bladder-sparing approaches, in particular when using a maintenance immunotherapy strategy, you know, after they reach TURBT. So this is the reason why with all the limitation that Ashish has mentioned, with all the uncertainties that are still there, the nervousness that is still there, EFS, as defined in the protocol, as put in the paper, is to us at the moment is the safest way to use a primary endpoint in potentially registration trials of this kind with perioperative systemic therapy and response-adapted surgery. Dr. Ashish Kamat: And David, just to be absolutely clear for our listeners, right, so what was the event-free survival that we defined? Essentially it was a very inclusive definition. Event was defined as high-grade tumor persistence, recurrence, or progression during or after perioperative therapy, and receipt of any additional standard of care treatment including radical cystectomy, radiotherapy or even intravesical therapy. So this was done at the behest of our patient advocates because we really wanted to make a very robust definition that could be utilized appropriately as an adequate primary endpoint for both early and late phase bladder preservation trials. Dr. Davide Soldato: I think that it really highlights one of the points that I liked the most about this consensus is that it really incorporated the patient vision and a sort of shared decision making process when we are deciding how we want to design these trials that will explore this bladder-sparing surgery. And Professor Necchi mentioned something that I think will be also a very interesting question for trials that will be developed considering the activity of this combination that we are seeing right now, which is maintenance. Because right now our approach in the few cases where patients do not do any type of treatments after an induction with neoadjuvant treatments is basically represented by observation. So I was wondering if you think that the field will actually evolve to a sort of maintenance strategy even in patients that will achieve a complete clinical response? Dr. Andrea Necchi: We just mentioned briefly in the paper, this is a very important point that was touched during the discussion, and in particular was raised and discussed by FDA people participating in the meeting. And when looking at the data from the trials that were available and are still available thus far, we could provide a suggestion that maintenance immune therapy is the preferred approach in this kind of approach as it currently stands, as the data currently stand. Because the cleanest data towards the successful part of this journey is related to the studies that provided a kind of maintenance therapy, like the study with nivolumab or the RETAIN-2 study with maintenance immune therapy instead of RETAIN study that was just stopping treatment until surgery with MVAC chemotherapy. So in general the impression is that maintenance therapy may help in reducing the type of events, including the events that we incorporate in the EFS definition that we mentioned in the paper. The point that you mentioned is very important because on the other side we have a problem, a big problem of affordability and cost of the treatment. The de-escalation trials are an urgent need and represent a call for the studies. Unfortunately, as you mentioned, this is something that moves beyond the possibilities of this type of consensus because we don't have data and we have to accumulate data from clinical trials prior to saying, "Okay, certain patients could de-escalate therapy and stop therapy and some other not." So we are still at the very beginning. So we can do- we can discuss about this in the radical cystectomy paradigm but not in the bladder-sparing paradigm, you know. But this is for sure a point, a discussion point that will be taken, pretty well taken in one year or two year projection. Dr. Davide Soldato: I was wondering if in the consensus, considering that patient advocates and patient associations were also involved, did you decide to actually suggest the inclusion of patient-reported outcomes or the evaluation of shared decision-making in the development of this trial really as endpoints that should matter as much or as much as possible as event-free survival and clinical complete response? Dr. Ashish Kamat: Oh yeah, absolutely. We had patient advocates, we had the World Bladder Cancer Patient Coalition, Bladder Cancer Advocacy Network, patient representatives. And we always consider this. Shared decision-making is actually the impetus behind why these efforts have been launched, right? So it is the shared decision-making that is very, very important. It is the driving force behind what we do. And it is worth noting, for example, for the design of such studies, regulatory agencies consider response-based endpoints or overall survival as primary endpoints. But the patient advocates consider quality of life to be just as important, if not more important sometimes than overall survival numbers. Because patient advocates will say, "Well if I live longer but I'm miserable living longer, yes that works for regulatory agencies but doesn't work for us." So PROs clearly are very, very important. And, in fact, we just literally had a meeting in Houston, the IBCG meeting where PROs were a main point of what we discussed. So incorporating PROs in everything we do, not just this but everything we do, Dr. Necchi, myself, everybody involved in these fields realizes it is very, very important. So absolutely. Dr. Davide Soldato: I want to thank again Professor Necchi and Professor Kamat for joining us today. Dr. Andrea Necchi: Thank you. Dr. Ashish Kamat: It is our pleasure. Dr. Davide Soldato: Thanks again and we appreciate you sharing more on your JCO article titled "Endpoints for the Next Generation Bladder-Sparing Perioperative Trials for Patients with Muscle-Invasive Bladder Cancer." If you enjoy our show, please leave us a rating and review and be sure to come back for another episode. You can find all ASCO shows at asco.org/podcast. 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.

The National Institutes of Health have historically funded scientists to find cures for diseases and protect public health. NIH funding has led to the discovery of immune therapies for cancer, antiviral treatments and prevention of HIV, and ground-breaking research into memory loss and Alzheimer's disease. After a year of funding cuts and freezes that have rocked the medical research field to its core, we catch up with leading researchers at the University of California to talk about the impact this has had on their work and our ability to fight humanity's most puzzling illnesses. Guests: Monica Gandhi, infectious disease expert and professor of medicine at University of California San Francisco - she is the director of the UCSF Gladstone Center for AIDS Research and the medical director of the San Francisco General Hospital HIV Clinic, Ward 86 Pamela Munster, professor of medicine at the University of California San Francisco; co-director, Center for BRCA Research, Medical Oncology; distinguished professor in Hereditary Cancer Research Megan Molteni, science writer, STAT News Joel Spencer, associate professor of Bioengineering, University of California Merced - his lab uses funding from NIH to study the thymus, with implications for cancer treatment and healthy aging Learn more about your ad choices. Visit megaphone.fm/adchoices

Advances in molecular diagnostics are reshaping how cancer is detected, monitored, and treated, and liquid biopsy is becoming central to that progress. This simple blood draw can reveal key tumor biology at diagnosis and over time, providing timely insight and guiding more precise decisions throughout a patient's journey. Clinicians now face an important challenge: knowing what is actionable today and what is coming next so more patients can benefit from the promise of these advances.As we kick off Season 7, host and patient advocate Karan Cushman expands this season's focus on Bringing Precision Medicine to Everyone with a deeper look inside the science of liquid biopsy. The conversation features two leaders shaping the field: Dr. Christian Rolfo, Division Director of Medical Oncology at The James Comprehensive Cancer Center at Ohio State University, and Dr. Roberto Borea, Medical Oncologist and emerging investigator from the Rolfo Lab.Together, they break down the scientific momentum driving liquid biopsy forward, including tumor fraction, MRD-guided treatment strategies, resistance monitoring, fragmentomics, and the expanding frontier of early detection. They also discuss the barriers that continue to slow broader adoption, such as assay variability, limited standardization, reimbursement gaps, and operational challenges in community settings.In this episode, we cover:• How tumor fraction is emerging as a meaningful real-time biomarker• Where MRD-driven escalation and de-escalation strategies are heading• The current promise and limitations of early detection and MCED testing• What is required to standardize liquid biopsy across reporting, workflows, and clinical trialsEpisode 70 offers a clear look at the advances researchers are helping drive right now and what these developments could mean for clinicians, laboratories, and patients in the near future.This conversation builds on episode 69 with Dr. Kashyap Patel, who introduced the foundations of liquid biopsy and its role in accelerating treatment decisions. Combined, these two episodes offer clinicians and patients an overview of where the science and real-world applications stand now and where the field is headed next.

Episode 4 of our monthly GU Cast Journal Club and today we focus on two important papers in prostate cancer diagnostics and bladder cancer surgery. The PRECISION NEJM paper 2018 is a landmark publication which defined the role of mpMRI in early detection, and changed practice in many countries. The EB-StaR trial should also change practice after its European Urology 2024 publication, but has it??!We are delighted to welcome back our GU Cast Journal Club Editors, Dr Carlos Delgado (Melbourne, AUS), and Dr Elena Berg (Munich, GER), along with main GU Cast Hosts, Renu Eapen and Declan Murphy. A very lively discussion!! Links to papers below:1. MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis NEJM 20182. Transurethral En Bloc Resection Versus Standard Resection of Bladder Tumour: A Randomised, Multicentre, Phase 3 Trial Eur Urol 2024GU Cast Journal Club is supported by our Partner, MSD, through an unrestricted educational grant.Even better on our YouTube channelAbout GU Cast Journal Club:Each month, two papers are discussed, each of which are of importance to the GU Oncology community. These may be recent papers, or occasionally we will chose a classic landmark paper in GU Oncology. The objective is to draw attention to important papers in GU Oncology, and critique these in a robust manner. The key target audience is trainees working in Urology, Medical Oncology, Radiation Oncology, Nuclear Medicine, and diagnostic specialties such as Radiology and Pathology. But any of our regular audience are likely to enjoy this Journal Club series.

In today's episode, we had the pleasure of speaking with Kevin Kalinsky, MD, MS, FASCO, about the evolving treatment paradigm for hormone receptor (HR)–positive breast cancer post-CDK4/6 inhibition, as well as the need for more advanced therapies to improve patient outcomes in this setting. Dr Kalinsky is a professor and director in the Division of Medical Oncology of the Department of Hematology and Medical Oncology at Emory University School of Medicine, as well as the director of the Glenn Family Breast Center and the Louisa and Rand Glenn Family Chair in Breast Cancer Research at Winship Cancer Institute in Atlanta, Georgia. In our exclusive interview, Dr Kalinsky discussed combination therapies that have shown promise for the management of HR-positive breast cancer following endocrine therapy, factors influencing treatment selection for patients who have received prior CDK4/6 inhibition, best practices for genomic testing in this population, and breast cancer research highlights from the 2025 ESMO Congress.

Following a fruitful European Society of Medical Oncology (ESMO) Congress 2025 for gastrointestinal malignancies, CancerNetwork® organized an X Spaces discussion hosted by 3 experts. They were Nicholas J. Hornstein, MD, an assistant professor at the Donald and Barbara Zucker School of Medicine of Hofstra University and Northwell Health; Timothy Brown, MD, an assistant professor in the Department of Internal Medicine and the associate program director of the Hematology & Oncology Fellowship at UT Southwestern Medical Center; and Udhayvir S. Grewal, MD, an assistant professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. Each doctor focused on a specific disease type, highlighting the most important abstracts in colorectal cancer, pancreatic neuroendocrine tumors (NETs), and upper gastrointestinal cancers. The Phase 3 MATTERHORN Trial (NCT04592913) Results from MATTERHORN demonstrated that adding durvalumab (Imfinzi) to 5-fluorouracil, leucovorin (folinic acid), oxaliplatin, and docetaxel (FLOT) improved overall survival (OS) compared with FLOT plus placebo in patients with resectable gastric/gastroesophageal junction (GEJ) adenocarcinoma, regardless of pathological status.1 In the intention-to-treat population, the median OS was not reached in either arm, and the hazard ratio (HR) was 0.78 (95% CI, 0.63-0.96; P = .021). Notably, the improvement was observed regardless of PD-L1 status; in patients with PD-L1–positive disease, the HR was 0.79 (95% CI, 0.63-0.99), and in patients with PD-L1–negative disease, the HR was 0.79 (95% CI, 0.41-1.50). “This, I believe, will seal durvalumab plus FLOT as the standard of care for resectable [gastric/GEJ] cancers,” said Brown. The Observational ASPEN Study (NCT03084770) The ASPEN study showed that active surveillance was a safe approach for patients with low-grade, asymptomatic, nonfunctioning pancreatic neuroendocrine tumors (NETs) fewer than 2 centimeters in size.2 Of the 1000 patients enrolled in the trial, 20 patients died, of whom 18 underwent active surveillance and 2 underwent surgery. Nineteen of the deaths were unrelated to pancreatic NETs; 1 death in the surgery arm was related to a pancreatic NET. After surgery, 5 patients had disease relapse or progression. With a median follow-up of 42 months (IQR, 25-60), the OS analysis showed a P value of 0.530.  “This really settles the debate on whether or not to surgically operate on patients with a [pancreatic NET] size of [fewer] than 2 centimeters and shows that active surveillance is a safe option for these patients with pancreatic NETs [fewer] than 2 centimeters in size and non-functional NETs,” said Grewal.  Data From the Phase 2/3 FOxTROT (NCT00647530) and Phase 2 NICHE-2 (NCT03026140) Trials Neoadjuvant nivolumab (Opdivo) plus ipilimumab (Yervoy) achieved a clinically meaningful and statistically significant improvement in long-term outcomes, including responses and survival, compared with chemotherapy strategies in patients with mismatch repair deficient (dMMR) or microsatellite instability–high (MSI-H) locally advanced colon cancer.3 In NICHE-2, neoadjuvant nivolumab plus ipilimumab achieved a 3-year disease-free survival (DFS) rate of 100% compared with 80% (95% CI, 73%-85%) with all chemotherapy strategies in FOxTROT (P

On this episode, Dr. Keyur B. Thakar, MD, MPH, Medical Director of Hematology and Medical Oncology at Northwell's Phelps Hospital, joins the podcast to discuss his priorities for the year, including expanding access to advanced cancer care in Westchester. He shares insights on the benefits of lifestyle medicine and plant-based diets, and emphasizes the importance of thinking beyond treating disease to focus on prevention and long-term wellness.

Audio roundup of selected biopharma industry content from Scrip over the business week ended October 24, 2025. In this episode we focus on the most significant results presented at the European Society for Medical Oncology meeting in Berlin: Enhertu in early-stage breast cancer; Padcev/Keytruda in bladder cancer; Phase III wins for Pluvicto; Trodelvy and Datroway in breast cancer tussle; and Merck & Co. raises hopes in breast cancer. . Story links: https://insights.citeline.com/scrip/podcasts/scrips-five-must-know-things/quick-listen-scrips-five-must-know-things-EWX3A6U4TBE5NPDYXHIJSWDO3A/ This episode was produced with the help of AI text-to-voice and voice emulation tools. Playlist: soundcloud.com/citelinesounds/sets/scrips-five-must-know-things

Episode 3 of our monthly GU Cast Journal Club and today we focus on one classic paper in Urology, and one from recent times - the ERSPC randomised trial of screening in prostate cancer, and the NIAGARA trial evaluating peri-operative immunotherapy in muscle-invasive bladder cancer. We are delighted to welcome back our GU Cast Journal Club Editors, Dr Carlos Delgado (Melbourne, AUS), and Dr Elena Berg (Munich, GER), along with main GU Cast Hosts, Renu Eapen and Declan Murphy. Watch out for Declan getting all misty-eyed recalling when the ERSPC was published back in 2009 (the rest of the team are too young to remember this)! Links to papers below:1. Screening and Prostate-Cancer Mortality in a Randomized European Study NEJM 20092. Perioperative Durvalumab with Neoadjuvant Chemotherapy in Operable Bladder Cancer NEJM 2024GU Cast Journal Club is supported by our Partner, MSD, through an unrestricted educational grant.Even better on our YouTube channelAbout GU Cast Journal Club:Each month, two papers are discussed, each of which are of importance to the GU Oncology community. These may be recent papers, or occasionally we will chose a classic landmark paper in GU Oncology. The objective is to draw attention to important papers in GU Oncology, and critique these in a robust manner. The key target audience is trainees working in Urology, Medical Oncology, Radiation Oncology, Nuclear Medicine, and diagnostic specialties such as Radiology and Pathology. But any of our regular audience are likely to enjoy this Journal Club series.

With the introduction of checkpoint inhibitors into non-muscle invasive bladder cancer (NMIBC) management, who's on point for planning, administering, and optimizing combination therapies? Is it still the urologist, or does medical oncology play a more significant role now than it did before? In this episode of the BackTable 2025 NMIBC Creator Weekend™ series, host Dr. Bogdana Schmidt sits down with Dr. Tyler Stewart, medical oncologist from the University of California San Diego, to discuss the contemporary role of medical and surgical oncology in treating non-muscle invasive bladder cancer.---This podcast is supported by:Ferring Pharmaceuticalshttps://www.ferring.com/home-classic/people-and-families/uro-uro-oncology/bladder-cancer/---SYNPOSISThe conversation covers the efficacy and safety of checkpoint inhibitors like pembrolizumab, the importance of a multidisciplinary approach, and the challenges of balancing systemic and localized treatments. They also touch upon the potential future role of biomarkers in reducing invasive procedures and improving patient outcomes.---TIMESTAMPS00:00 - Introduction02:04 - The Role of Medical Oncologists in Bladder Cancer12:58 - Combination Therapies and Patient Outcomes21:18 - The CREST Study26:59 - Managing Adverse Events34:44 - Collaboration Between Urologists and Oncologists41:06 - Conclusion and Final Thoughts---RESOURCESCREST Trialhttps://www.nature.com/articles/s41591-025-03738-zCISTO Studyhttps://pubmed.ncbi.nlm.nih.gov/37980511/

This week we are so excited to have two incredible guests on the podcast to help us learn more about their areas of expertise, individual stories and help our community educate themselves on Breast Cancer + Women's Health. Dr. Deepa Halaharvi, DO, FACOS, is a fellowship-trained, board-certified breast surgeon and breast cancer survivor. She graduated from Kansas City University in 2008 and went on to complete her general surgery residency in 2013 at Doctor's Hospital in Columbus, Ohio.Dedicated to lifelong learning, Halaharvi continued to master her skills by focusing on breast surgical oncology through a fellowship program in 2014. Only eight months after completing her fellowship, she learned firsthand what it feels like to hear the words, “You have breast cancer.” Despite the different forms of crises, setback and illness, Halaharvi realized she had the courage and resiliency to keep going using her voice and experience to help her patients. Having seen both sides—as a breast cancer surgeon and a breast cancer patient—she has gained unique insight and perspective into what it is like to face breast cancer. She started The Breast Cancer Podcast, a YouTube channel and social media outlets to help educate others about body awareness and managing a breast cancer diagnosis. Halaharvi continues to challenge herself and others in learning new skills to achieve better outcomes and improve the patient experience.Dr. Shabana Dewani is board certified in Medical Oncology, Hematology, and Internal Medicine. She completed her residency in Internal Medicine at Wright State University and was appointed as Chief Resident. Dr. Dewani completed her combined fellowship in Oncology and Hematology at Wright State University. During her training, she received Special Award in Academic Excellence and was inducted into the medical honor society Alpha Omega Alpha.Dr. Dewani was a faculty member at the Ohio State University where she was rated among the top 10 percent of physicians in the nation for patient satisfaction. She participated in multiple clinical trials investigating different therapies to treat breast, gastrointestinal and hematologic cancers.Dr. Dewani is married, has two children and lives in Dublin, Ohio.

When cancer treatment ends, the world expects celebration. The bell is rung, and everyone around breathes a sigh of relief. But for many survivors, that moment marks not an ending, but a new, confusing beginning. The medical team steps back, the appointments stop, and a quiet question creeps in: now what? Survivorship is more than the absence of disease. It's the long, often lonely process of learning how to live again, in a body, mind, and identity forever changed. Fatigue lingers. Treatment dulls memory and focus. Sleep becomes elusive. And beneath it all is the fear: what if it comes back? But what if recovery after cancer isn't just about waiting for the next scan; it's about reclaiming control? Through lifestyle medicine, survivors can begin to rebuild their strength, calm their nervous system, and lower their risk of recurrence. What measures are important for the survivor phase of cancer care? Why is connection and community so important? In this episode, the Medical Director of the Mass General Cancer Center in Waltham, Dr. Amy Comander, returns. The pioneer in lifestyle medicine for survivorship joins us to share what true recovery looks like. She shares insights from her groundbreaking Paving the Path to Wellness program, and we talk about how to have a healthy life after the end of cancer treatment. Things You'll Learn In This Episode -Survivorship isn't just surviving Finishing treatment is only the beginning of recovery. How do survivors move from merely existing to truly thriving? -Movement as medicine Exercise doesn't just build strength; it improves outcomes and lowers recurrence risk. What type of movement makes the biggest impact after cancer? -Food over fear The right diet can reduce inflammation, support immunity, and ease anxiety about recurrence. What does the research actually say about the best foods for survivors, and which supplements to avoid? -The overlooked healing power of connection Support groups and social bonds can dramatically improve the quality of life and survival. Why is community one of the most potent yet underused forms of medicine? Guest Bio Dr. Amy Comander specializes in the care of women with breast cancer. Dr. Comander is Medical Director of the Mass General Cancer Center in Waltham, where she also serves as Director of Breast Oncology and Cancer Survivorship at the Mass General Cancer Center in Waltham and at Newton Wellesley Hospital. She is the director of Lifestyle Medicine at the Mass General Cancer Center and an Instructor in Medicine at Harvard Medical School. She received her undergraduate degree and a master's degree in Neuroscience at Harvard University. She received her medical degree from Yale University School of Medicine. She completed her Internal Medicine residency training and Hematology-Oncology fellowship training at Beth Israel Deaconess Medical Center and Harvard Medical School. She is board-certified in Hematology and Medical Oncology, and she is a Diplomat of the American Board of Lifestyle Medicine. Dr. Comander has a strong interest in improving the quality of life and outcome of cancer survivors through important lifestyle interventions, including physical activity, diet, and mind/body interventions. She promotes healthy lifestyles for both her active treatment patients as well as those in the survivorship phase of care. She has launched PAVING the Path to Wellness, a 12-week lifestyle medicine-based survivorship program for women with breast cancer. Connect with Dr. Comander on LinkedIn. Resources The MGH Cancer Center is recruiting cancer survivors with insomnia for two behavioral treatment trials testing the Survivorship Sleep Program, a cognitive behavioral therapy for insomnia (CBT-I) skills program developed at MGH (PI: Daniel Hall, PhD; NCBI - WWW Error Blocked Diagnostic ; NCBI - WWW Error Blocked Diagnostic ). Eligible patients may be in treatment, post-treatment, or living with advanced cancer. All procedures are remote. Compensation is provided. Patients may see our study flyer and MGB Rally website (Rally | Cognitive Behavioral Therapy for Cancer Survivors with Insomnia ). Structured Exercise after Adjuvant Chemotherapy for Colon Cancer | NEJM Healthy Eating Plate • The Nutrition Source 10 Cancer Prevention Recommendations About Your Host Hosted by Dr. Deepa Grandon, MD, MBA, a triple board-certified physician with over 23 years of experience working as a Physician Consultant for influential organizations worldwide. Dr. Grandon is the founder of Transformational Life Consulting (TLC) and an outspoken faith-based leader in evidence-based lifestyle medicine. Resources Feeling stuck and want guidance on how to transform your spiritual, mental and physical well being? Get access to Dr Deepa's 6 Pillars of Health video! Visit drdeepa-tlc.org to subscribe and watch the video for free. ‌ Work with Me Ready to explore a personalized wellness journey with Dr. Deepa? Visit drdeepa-tlc.org and click on "Work with Me" to schedule a free intake call. Together, we'll see if this exclusive program aligns with your needs! Want to receive a devotional every week From Dr. Deepa? Devotionals are dedicated to providing you with a moment of reflection, inspiration, and spiritual growth each week, delivered right to your inbox. Visit https://www.drdeepa-tlc.org/devotional-opt-in to subscribe for free. Ready to deepen your understanding of trauma and kick start your healing journey? Explore a range of online and onsite courses designed to equip you with practical and affordable tools. From counselors, ministry leaders, and educators to couples, parents and individuals seeking help for themselves, there's a powerful course for everyone. Browse all the courses now to start your journey. ​​TLC is presenting this podcast as a form of information sharing only. It is not medical advice or intended to replace the judgment of a licensed physician. TLC is not responsible for any claims related to procedures, professionals, products, or methods discussed in the podcast, and it does not approve or endorse any products, professionals, services, or methods that might be referenced. Check out this episode on our website, Apple Podcasts, or Spotify, and don't forget to leave a review if you like what you heard. Your review feeds the algorithm so our show reaches more people. Thank you!

Novo Nordisk dominated the news cycle this week, with more leadership changes as the Novo Foundation replaced the company's board, which will now be headed by former CEO Lars Rebien Sørensen. Meanwhile, President Donald Trump promised last week that Novo's Ozempic will cost about $150 when he and Centers for Medicare & Medicaid Services Administrator Mehmet Oz are done negotiating, though Oz clarified that said negotiations have not yet begun. Over in Berlin, the 2025 European Society for Medical Oncology featured presentations from Akeso and Summit Therapeutics on PD-1/VEGF inhibitor ivonescimab in first linenon-small cell lung cancer (NSCLC) and Exelixis' oralkinase inhibitor zanzalintini in colorectal cancer. In addition to reporting that ivonescimab “significantly improved” progression-free survival in first-line NSCLC, Summit said on a Q3 call Monday that it would submit a regulatory application with the FDA for the drug in second-line EGFR-mutatedNSCLC. In other cancer news, shares of Replimune soared after the FDA accepted its resubmitted biologics license applicationfor RP1 in advanced melanoma, nearly three months after its July rejection. Also on the regulatory front, the FDA named the first nine recipients of its Commissioner's National Priority Voucherprogram. Winners of the expedited review vouchers include Regeneron, Disc Medicine and Sanofi. The FDA agency also awarded its second-ever platform designation to Krystal Biotech—after granting the first such designation to Sarepta Therapeutics earlier this year for its AAV vector andthen rescinding it after the platform was linked to multiple deaths. Finally, Sandra Retzky, formerly director of the FDA's Office of Orphan Products Development, joins the lengthy leadership exodus at the agency this year. In BioPharm Executive, BioSpace look at how Johnson & Johnson weathered the erosion of its cornerstone drug Stelara. And is hair loss the new weight loss? Two biopharma companies—Veradermics and Pelage Pharmaceuticals—reeled in large financing rounds for their respective hair loss/regrowth programs. They're part of an uptick in mega rounds of late, butexperts say it's not a full biotech comeback just yet.

The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits.On this episode we have the caring Dr. Amy Comander :Quadruple board certified physician in Internal Medicine, Hematology, Medical Oncology & Lifestyle Medicine Breast oncologist and Director of Breast Oncology and Survivorship at the Massachusetts General Cancer Center Medical director of the Massachusetts General Cancer Center Instructor in medicine at Harvard Medical SchoolAuthorMarathon runner She shares:Her introduction into Lifestyle MedicineHer passion in improving the overall health and well-being of breast cancer survivors through lifestyle interventionsTools for breast cancer survivors and thrivers everywhere to live their best lives Patient transformationsMost recent published data on exercise oncologyPaving the Path to Wellness Group ProgramUsing running as a metaphor for life Power of social connection Newest book: Paving Your Path Through Breast Cancer and BeyondInformation for Dr. Comander:Book  (discount code: 25PAVINGBC)InstagramLinkedInInformation for Dr. Robyn Tiger & StressFreeMD:Check out StressFreeMD & CME offeringsGet the book: Feeling Stressed Is OptionalGet your 4 FREE stress relieving videosPhysicians: join our free private physicians-only Facebook groupRetreatsREVIVE! Lifestyle Medicine Well-Being Group CoachingPrograms on DemandPrivate 1:1 CoachingSchedule your FREE 30-Minute Stress Relief Strategy CallFollow me on Social Media: InstagramLinkedInFacebookTwitterPodcast websitePlease rate & Review the Show!Contactinfo@stressfreemd.net 

In a discussion with CancerNetwork®, Anne Chiang, MD, PhD, spoke about the current treatment landscape for those with small cell lung cancer (SCLC) as well as next steps for elevating the quality of care among patients. She began by outlining the evolution of therapeutic standards in the field, with atezolizumab (Tecentriq)- and durvalumab (Imfinzi)-based regimens emerging as key frontline strategies and lurbinectedin (Zepzelca) and tarlatamab-dlle (Imdelltra) demonstrating utility as second-line therapies.  Regarding novel treatments that may hold promise in the SCLC field, Chiang, an associate professor of medicine in the Section of Medical Oncology at Yale School of Medicine, highlighted her work on the phase 2 SWOG S2409 PRISM trial (NCT06769126). Here, Chiang and colleagues plan to collect tissue from more than 800 patients undergoing frontline induction therapy with chemoimmunotherapy to inform subsequent biomarker-directed treatment, which may help elucidate factors of disease heterogeneity in the process. The conversation also focused on considerations for improving the care of those with lung cancer in community-based settings, as Chiang emphasized spreading knowledge of therapeutic advances to a broader patient population. She noted that there is “still a bit of nihilism about the prognosis” of patients with SCLC, describing a need to further leverage the field's understanding of biology to impart the benefits of immunotherapy to more patients. Chiang also detailed the importance of employing patient-reported outcomes to hear directly from the patient, which may ensure their inclusion in the shared decision-making process and optimize strategies for mitigating potential adverse effects during treatment. “Understanding and leveraging the biology is important. We are going to need to understand how to sequence therapies, and that involves understanding which patients are at higher risk,” Chiang stated regarding future initiatives in the field. “We need to look at high-risk populations—for example, patients with brain metastases—and understand which therapies are especially useful for them.”

Dr. Hope Rugo and Dr. Giuseppe Curigliano discuss recent developments in the field of bispecific antibodies for hematologic and solid tumors, including strategies to optimize the design and delivery of the immunotherapy. TRANSCRIPT Dr. Hope Rugo: Hello and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I am your host, Dr. Hope Rugo. I am the director of the Women's Cancers Program and division chief of breast medical oncology at the City of Hope Cancer Center. I am also the editor-in-chief of the Educational Book. Bispecific antibodies represent an innovative and advanced therapeutic platform in hematologic and solid tumors. And today, I am delighted to be joined by Dr. Giuseppe Curigliano to discuss the current landscape of bispecific antibodies and their potential to reshape the future of precision oncology. Dr. Curigliano was the last author of an ASCO Educational Book piece for 2025 titled, "Bispecific Antibodies in Hematologic and Solid Tumors: Current Landscape and Therapeutic Advances." Dr. Curigliano is a breast medical oncologist and the director of the Early Drug Development Division and chair of the Experimental Therapeutics Program at the European Institute of Oncology in Milan. He is also a full professor of medical oncology at the University of Milan. You can find our disclosures in the transcript of this episode. Dr. Curigliano, Giuseppe, welcome and thanks for being here. Dr. Giuseppe Curigliano: Thanks a lot for the invitation. Dr. Hope Rugo: Giuseppe, I would like to first ask you to provide some context for our listeners on how these novel therapeutics work. And then perhaps you could tell us about recent developments in the field of bispecific antibodies for oncology. We are at a time when antibody-drug conjugates (ADCs) are all the rage and, trying to improve on the targeting of specific antigens, proteins, receptors in the field of oncology is certainly a hot and emerging topic. Dr. Giuseppe Curigliano: So, thanks a lot. I believe really it was very challenging to try to summarize all the bispecific antibodies that are under development in multiple solid tumors. So, the first thing that I would like to highlight is the context and the mechanism of action of bispecific antibodies. Bispecific antibodies represent a groundbreaking advancement in cancer immunotherapy, because these engineered molecules have the unique ability to target and simultaneously bind to two distinct antigens. That is why we call them bispecific. So typically, one antigen is expressed on the tumor cell and the other one is expressed on the immune effectors, like T-cell or natural killer cells. So this dual targeting mechanism offers several key advantages over conventional monoclonal antibodies because you can target at the same time the tumor antigen, downregulating the pathway of proliferation, and you can activate the immune system. So the primary mechanism through which bispecific antibodies exert their therapeutic effects are: First, T-cell redirecting. I mean, many bispecific antibodies are designed to engage tumor-associated antigens like epidermal growth factor receptor, HER2, on the cancer cell and a costimulatory molecule on the surface of T-cell. A typical target antigen on T-cell is CD3. So what does it mean? That you activate the immune system, immune cells will reach the tumor bed, and you have a dual effect. One is downregulating cell proliferation, the other one is activation of the immune system. This is really important in hematological malignancies, where we have a lot of bispecifics already approved, like acute lymphoblastic leukemia or non-Hodgkin lymphoma.  The second, in fact, is the engagement of the tumor microenvironment. So, if you engage immune effector cells like NK cells or macrophages, usually the bispecific antibodies can exploit the immune system's ability to recognize and kill the immune cells, even if there is a lack of optimal antigen presentation.  And finally, the last mechanism of action, this may have a role in the future, maybe in the early cancer setting, is overcoming immune evasion. So bispecific antibodies can overcome some of the immune evasion mechanisms that we see in cancer. For example, bispecific antibodies can target immune checkpoint receptors, like PD-L1 and CTLA-4. Actually, there is a bispecific under development in breast cancer that has a dual targeting on vascular endothelial growth factor receptor and on PD-L1. So you have a dual effect at the same time. So, what is really important, as a comment, is we need to focus first on the optimal format of the bispecific, the optimal half-life, the stability, because of course even if they are very efficient in inducing a response, they may give also a lot of toxicities. So in clinical trials already, we have several bispecifics approved. In solid tumors, very few, specifically amivantamab for non-small cell lung cancer, but we have a pipeline of almost 40 to 50 bispecifics under development in multiple solid tumors, and some of them are in the context of prospective randomized trials. Dr. Hope Rugo: So this is really a fascinating area and it's really exciting to see the expansion of the different targets for bispecific antibodies. One area that has intrigued me also is that some of the bispecifics actually will target different parts of the same receptor or the same protein, but presumably those will be used as a different strategy. It's interesting because we have seen that, for example, in targeting HER2. Dr. Giuseppe Curigliano: Oh, yes, of course. You may consider some bispecifics like margetuximab, I suppose, in which you can target specifically two different epitopes of the same antigen. This is really an example of how a bispecific can potentially be more active and downregulating, let us say, a pathway, by targeting two different domains of a specific target antigen. This is an important point.  Of course, not all the bispecifics work this way, because some of the target antigen may dimerize, and so you have a family of target antigen; an example is epidermal growth factor receptor, in which you have HER1, HER2, HER3, and HER4. So some of them can inhibit the dimerization between one target antigen and the other one, in order to exert a more antiproliferative effect. But to be honest, the new generation of them are more targeting two different antigens, one on the tumor and one on the microenvironment, because according to the clinical data, this is a more efficient way to reduce proliferation and to activate the immune system. Dr. Hope Rugo: Really interesting, and I think it brings us to the next topic, which is really where bispecific antibodies have already shown success, and that is in hematologic malignancies where we have seen very interesting efficacy and these are being used in the clinic already. But the expansion of bispecific antibodies into solid tumors faces some key challenges. It's interesting because the challenges come in different shapes and forms. Tell us about some of those challenges and strategies to optimize bispecific antibody design, delivery, patient selection, and how we are going to use these agents in the right kind of clinical trials. Dr. Giuseppe Curigliano: This is really an excellent question because despite bispecific antibodies having shown a remarkable efficacy in hematological malignancies, their application in solid tumors may have some challenges. The first one is tumor heterogeneity. In hematological malignancy, you have a clear oncogene addiction. Let us say that 90% of the cells may express the same antigen. In solid tumors, it is not the same. Tumor heterogeneity is a typical characteristic of solid tumors, and you have high heterogeneity at the genetic, molecular, and phenotypic levels. So tumor cells can differ significantly from one another, even if within the same tumor. And this heterogeneity sometimes makes it difficult to identify a single target antigen that is universally expressed in an hematological malignancy. So furthermore, sometimes the antigen expressed on a tumor cell can be also present on the normal tissue. And so you may have a cross-targeting. So let's say, if you have a bispecific against epidermal growth factor receptor, this will target the tumor but will target also the skin with a lot of toxicity. The second challenge is the tumor microenvironment. The solid tumor microenvironment is really complex and often immunosuppressive. It is characterized by the presence of immunosuppressor cells like the T regulators, myeloid derived suppressor cells, and of course the extracellular matrix. All these factors hinder immune cell infiltration and also may reduce dramatically the effectiveness of bispecific antibodies. And as you know, there is also an hypoxic condition in the tumor. The other challenge is related to the poor tumor penetration. As you know also with antibody-drug conjugate, only 1 to 3% of the drug will arrive in the tumor bed. Unlike hematological malignancies where tumor cells are dispersed in the blood and easily accessible, the solid tumors have a lot of barriers, and so it means that tumor penetration can be very low. Finally, the vascularity also of the tumor can be different across solid tumors. That is why some bispecifics have a vascular endothelial growth factor receptor or vascular endothelial growth factor as a target. Of course, what do we have to do to overcome these challenges? First, we have to select the optimal antigen. So knowing very well the biology of cancer and the tumor-associated antigens can really select a subgroup of epitopes that are specifically overexpressed in cancer cells. And so we need to design bispecifics according to the tumor type. Second, optimize the antibody format. So there are numerous bispecific antibody formats. We can consider the dual variable domain immunoglobulin, we specified this in our paper. The single chain variable fragments, so FC variable fragments, and the diabodies that can enhance both binding affinity and stability. And finally, the last point, combination therapies. Because bispecific antibodies targeting immune checkpoint, we have many targeting PD-1 or PD-L1 or CTLA-4, combined eventually with other immune checkpoint inhibitors. And so you may have more immunostimulating effect. Dr. Hope Rugo: This is a fascinating field and it is certainly going to go far in the treatment of solid tumors. You know, I think there is some competition with what we have now for antibody-drug conjugates. Do you see that bispecifics will eventually become bispecific ADCs? Are we going to combine these bispecific antibodies with ADCs, with chemotherapy? What is the best combination strategy do you think looking forward? Dr. Giuseppe Curigliano: So, yes, we have a bispecific ADC. We have actually some bispecifics that are conjugated with a payload of chemotherapy. Some others are conjugated with immunoactivation agents like IL-2. One of the most effective strategies for enhancing bispecific activity is the combination therapy. So which type of combination can we do? First, bispecific antibodies plus checkpoint inhibitors. If you combine a bispecific with an immune checkpoint, like anti-PD-1, anti-PD-L1, or anti-CTLA-4, you have more activity because you have activation of T-cells, reduction of immunosuppressive effect, and of course, the capability of this bispecific to potentiate the activity of the immune checkpoint inhibitor. So, in my opinion, in a non-small cell lung cancer with an expression of PD-L1 more than 50%, if you give pembrolizumab plus a bispecific targeting PD-L1, you can really improve both response rate and median progression-free survival.  Another combination is chemotherapy plus bispecific antibodies. Combining chemotherapy with bispecific can enhance the cytotoxic effect because chemotherapy induces immunogenic cell death, and then you boost with a bispecific in order to activate the immune system. Bispecific and CAR T-cells, until now, we believe that these are in competition, but this is not correct. Because CAR T-cells are designed to deliver an activation of the immune system with the same lymphocytes engineered of the patients, with a long-term effect. So I really do not believe that bispecifics are in competition with CAR T-cells because when you have a complete remission induced by CAR T-cell, the effect of this complete remission can last for years. The activity of a bispecific is a little bit different. So there are some studies actually combining CAR T-cells with bispecifics. For example, bispecific antibodies can direct CAR T-cells in the tumor microenvironment, improving their specificity and enhancing their therapeutic effect.  And finally, monoclonal antibody plus bispecific is another next generation activity. Because if you use bispecific antibodies in combination with existing monoclonal antibodies like anti-HER2, you can potentially increase the immune response and enhance tumor cell targeting. In hematological malignancies, this has been already demonstrated and this approach has been particularly effective. Dr. Hope Rugo: That's just so fascinating, the whole idea that we have these monoclonal antibodies and now we are going to add them to bispecifics that we could maybe attach on different toxins to try and improve this, or even give them with different approaches. I suppose giving an ADC with a bispecific would sort of be similar to that idea of giving a monoclonal antibody with the bispecific. So it is certainly intriguing. We also will need to understand the toxicity and cost overall and how we are going to use these, the duration of treatment, the assessment of biomarkers. There are just so many different aspects that still need to be explored.  And then with that idea, can you look ahead five or ten years from now, and tell us how you think bispecific antibodies will shape our next generation cancer therapies, how they will be incorporated into precision oncology, and the new combinations and approaches as we move forward that will help us tailor treatment for patients both with solid tumors and hematologic malignancies? Are we going to be giving these in early-stage disease in solid tumors? So far, the studies are primarily focusing on the metastatic setting, but obviously one of the goals when we have successful treatments is to move them into the early stage setting as quickly as possible. Dr. Giuseppe Curigliano: Let us try to look ahead five years rather than ten years, to be more realistic. So, personally I believe some bispecifics can potentially replace current approaches in specifically T-cell selected population. As we gather more data from ongoing clinical trials and we adopt a deeper understanding of the tumor immuno microenvironment, of course we may have potentially new achievement. A few days ago, we heard that bispecifics in triple negative breast cancer targeting VEGF and PD-L1 demonstrated an improvement in median progression-free survival.  So, how to improve and to impact on clinical practice both in the metastatic and in the early breast cancer setting or solid tumor setting? First, personalized antigen selection. So we need to have the ability to tailor bispecific antibody therapy to the unique tumor profile of individual patients. So the more we understand the biology of cancers, the more we will be able to better target. Second, bispecific antibodies should be combined. I can see in the future a potential trial in which you combine a bispecific anti-PD-L1 and VEGF with immune checkpoint inhibitor selected also to the level of expression of PD-L1, because integration of antibody bispecific with a range of immunotherapies, and this cannot be only immune checkpoint inhibitors, but can be CAR T-cells, oncolytic viruses, also targeted therapy, will likely be a dominant theme in the coming years. This combination will be based on the specific molecular and immuno feature of the cancer of the patient.  Then we need an enhanced delivery system. This is really important because you know now we have a next generation antibody. An example are the bicyclic. So you use FC fragment that are very short, with a low molecular weight, and this short fragment can be bispecific, so can target at the same time a target antigen and improving the immune system. And so the development of this novel delivery system, including also nanoparticles or engineered viral vectors, can enhance the penetration in the tumor bed and the bioavailability of bispecific antibodies. Importantly, we need to reduce toxicity. Until now, bispecifics are very toxic. So the more we are efficient in delivering in the tumor bed, the more we will reduce the risk of toxicity. So it will be mandatory to reduce off-target effects and to minimize toxicity.  And finally, the expansion in new indication. So I really believe you raised an excellent point. We need to design studies in the neoadjuvant setting in order to better understand with multiple biopsies which is the effect on the tumor microenvironment and the tumor itself, and to generate hypotheses for potential trials or in the neoadjuvant setting or in those patients with residual disease.  So, in my opinion, as we refine design, optimize patient selection, and explore new combination, in the future we will have more opportunity to integrate bispecifics in the standard of care. Dr. Hope Rugo: I think it is particularly helpful to hear what we are going to be looking for as we move forward to try and improve efficacy and reduce toxicity. And the ability to engineer these new antibodies and to more specifically target the right proteins and immune effectors is going to be critical, of course, moving forward, as well as individualizing therapy based on a specific tumor biology.  Hearing your insights has been great, and it really has opened up a whole area of insight into the field of bispecifics, together with your excellent contribution to the ASCO Educational Book. Thank you so much for sharing your thoughts and background, as well as what we might see in the future on this podcast today. Dr. Giuseppe Curigliano: Thank you very much for the invitation and for this excellent interview. Dr. Hope Rugo: And thanks to our listeners for joining us today. You will find a link to the Ed Book article we discussed today in the transcript of this episode. It is also, of course, on the ASCO website, as well as on PubMed. Please join us again next month on By the Book for more insightful views on the key issues and innovations that are shaping modern oncology. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Follow today's speakers:       Dr. Hope Rugo  @hope.rugo  Dr. Giuseppe Curigliano @curijoey Follow ASCO on social media:       @ASCO on X (formerly Twitter)       ASCO on Bluesky      ASCO on Facebook       ASCO on LinkedIn       Disclosures:      Dr. Hope Rugo:   Honoraria: Mylan/Viatris, Chugai Pharma  Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer  Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx  Dr. Giuseppe Curigliano: Leadership: European Society for Medical Oncology, European Society of Breast Cancer Specialists, ESMO Open, European Society for Medical Oncology Honoraria: Ellipses Pharma Consulting or Advisory Role: Roche/Genentech, Pfizer, Novartis, Lilly, Foundation Medicine, Bristol-Myers Squibb, Samsung, AstraZeneca, Daiichi-Sankyo, Boerigher, GSK, Seattle Genetics, Guardant Health, Veracyte, Celcuity, Hengrui Therapeutics, Menarini, Merck, Exact Sciences, Blueprint Medicines, Gilead Sciences Speakers' Bureau: Roche/Genentech, Novartis, Pfizer, Lilly, Foundation Medicine, Samsung, Daiichi Sankyo, Seagen, Menarini, Gilead Sciences, Exact Sciences Research Funding: Merck Travel, Accommodations, Expenses: Roche/Genentech, Pfizer, Daiichi Sankyo, AstraZeneca      

In today's episode, we had the pleasure of speaking with Anne Chiang, MD, PhD, and Stephen Liu, MD, about the FDA approval of lurbinectedin (Zepzelca) plus atezolizumab (Tecentriq) or atezolizumab and hyaluronidase-tqjs (Tecentriq Hybreza) as maintenance treatment for adult patients with extensive-stage small cell lung cancer (ES-SCLC) whose disease has not progressed after frontline induction therapy with atezolizumab or atezolizumab and hyaluronidase, carboplatin, and etoposide. Chiang is an associate professor of medicine in the Section of Medical Oncology and the associate cancer center director of Clinical Initiatives at the Yale School of Medicine in New Haven, Connecticut. Dr Liu is an associate professor of medicine at Georgetown University, as well as the director of Thoracic Oncology and head of Developmental Therapeutics at the Georgetown Lombardi Comprehensive Cancer Center in Washington, DC. In our exclusive interview, Drs Chiang and Liu discussed the significance of this approval, key efficacy and safety data from the pivotal phase 3 IMforte trial (NCT05091567), and how the addition of this regimen in the ES-SCLC treatment paradigm may affect clinical practice.

Episode 2 of our monthly GU Cast Journal Club and today we focus on two key papers from recent times - the TRANSLATE trial of transperineal vs transrectal biopsy, and Keynote-564 on the role of adjuvant pembrolizomab following nephrectomy.   After great feedback from last month's launch episode, we are delighted to welcome back our GU Cast Journal Club Editors, Dr Carlos Delgado (Melbourne, AUS), and Dr Elena Berg (Munich, GER), along with main GU Cast Hosts, Renu Eapen and  Declan Murphy Links to papers and previous podcasts below:1. Local anaesthetic transperineal biopsy versus transrectal prostate biopsy in prostate cancer detection (TRANSLATE): a multicentre, randomised, controlled trial Lancet Oncology 2025GU Cast on TRANSLATE 2. Overall Survival with Adjuvant Pembrolizumab in Renal-Cell Carcinoma NEJM 2024GU Cast on K-564 OS paper GU Cast Journal Club is supported by our Partner, MSD, through an unrestricted educational grant.Even better on our YouTube channelAbout GU Cast Journal Club:Each month, two papers are discussed, each of which are of importance to the GU Oncology community. These may be recent papers, or occasionally we will chose a classic landmark paper in GU Oncology. The objective is to draw attention to important papers in GU Oncology, and critique these in a robust manner. The key target audience is trainees working in Urology, Medical Oncology, Radiation Oncology, Nuclear Medicine, and diagnostic specialties such as Radiology and Pathology. But any of our regular audience are likely to enjoy this Journal Club series.

JCO PO authors Dr. Abhishek Tripathi and Dr. Salvador Jaime-Casas at City of Hope Comprehensive Cancer Center share insights into their article, “Comparative Genomic Characterization of Small Cell Carcinoma of the Bladder Compared With Urothelial Carcinoma and Small Cell Lung Carcinoma.”  Host Dr. Rafeh Naqash and Drs. Tripathi and Jaime-Casas discuss a novel understanding of the genomic alterations underlying SCBC, revealing actionable mutations that could serve as potential targets for improved clinical outcomes. 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 am your host, Dr. Dr. Rafeh Naqash, Podcast Editor for JCO Precision Oncology and Associate Professor at the OU Health Stephenson Cancer Center at the University of Oklahoma. Today, I am thrilled to be joined by Dr. Abhishek Tripathi, Associate Professor in the Department of Medical Oncology and Experimental Therapeutics Research at the City of Hope Comprehensive Cancer Center, as well as his mentee, Dr. Salvador Jaime-Casas, postdoctoral research fellow and first author of the JCO Precision Oncology article entitled "Comparative Genomic Characterization of Small Cell Carcinoma of the Bladder Compared with Urothelial Carcinoma and Small Cell Lung Carcinoma". At the time of this recording, our guest disclosures will be linked in the transcript. Abhishek and Salvador, welcome to our podcast and thank you for joining us today. This is a very interesting topic given that at least the landscape for neuroendocrine carcinomas, where small cell lung cancer is on one end of the spectrum, has been changing, at least on the lung cancer side, with recent approvals and some new ADCs. So, of course, understanding the genomic and transcriptomic similarities or differences between pulmonary small cell and extrapulmonary small cell is of huge interest. Could you tell us a little bit about small cell bladder cancer, current approaches to treatment of small cell bladder cancer, and then why you wanted to investigate that in this project as far as the genomic differences or similarities are concerned? Dr. Salvador Jaime-Casas: Well, first of all, thank you very much for having me. I am very excited to be here. And really what served as backbone for this research project was the notion that there is a currently evolving genomic landscape in the area of bladder cancer. We know this is a highly heterogeneous disease when it comes to molecular underpinnings and mutational profile. Specifically, we know that the most common histologic subtype is urothelial carcinoma. Small cell bladder cancer represents a histology that is found in less than 1% of all bladder cancer cases. However, it is one of the most aggressive histologies. It presents with a very poor prognosis to patients and very poor response to treatment, which is why we attempted to really elucidate what is the mutational profile behind this and provide a comparison contrast between small cell bladder cancer, small cell lung cancer, and conventional urothelial carcinoma. As your question mentioned, in terms of treatment, the conventional urothelial carcinoma and small cell bladder cancer are two distinct pathways when it comes to treatment algorithms. We know that in the current era there are newer and newer drugs being developed for conventional urothelial carcinoma. We have perioperative immunotherapy in the context of metastatic disease. We have antibody-drug conjugates such as enfortumab vedotin. But really, this amazing track record of drug development hasn't been mirrored in small cell bladder cancer. And here most of the therapy is usually extrapolated from studies from other small cell histologies like you mentioned earlier, small cell lung cancer has given some form of background in terms of what therapies are used here. Cytotoxic chemotherapy, for some patients with localized disease and small cell bladder cancer, concurrent chemotherapy and radiotherapy or perioperative cytotoxic chemotherapy have been the cornerstone of treatment for many years now. However, like I mentioned, the oncologic outcomes are very suboptimal when it comes to comparing it with other disease histologies, which is why we really wanted to describe the landscape here and provide this comparison across three different groups. For this particular study, we leveraged the Tempus dataset. So, include patients with urothelial carcinoma with small cell bladder cancer and small cell lung cancer. We included their demographic information, as well as the frequency of most common genomic alterations identified. And really, it was a very comparable Table 1. We see the demographic data across the three groups was very similar. One key thing that we identified was the female prevalence was a little bit lower in patients with small cell bladder cancer when compared to small cell lung cancer. But other than that, the age, race, ethnicity, was comparable across groups, and even the smoking history. Most of the patients in this cohort were former smokers, which we believe comes to explain that regardless of any mutational profile that we talked about in a few minutes, there are shared commonalities between these histologies and shared environmental exposures and risk factors that are going to be implicated in the disease biology for these three histologies. Dr. Rafeh Naqash: Thank you so much, Salvador, for that useful background. I would like to shift to Abhishek real quick. Abhishek, you are a practicing clinician, you have led several studies in the GU space, especially bladder. Based on what you see in the small cell lung cancer space, how drug development is shaping up, which aligns with what you are trying to evaluate in this paper as targets, how do you see some of that being implemented for small cell bladder cancer in the current era and age? Abhishek Tripathi: Thanks so much for the excellent question, Rafeh. As a GU investigator, small cell bladder cancer has always lagged behind in some regards regarding enrollment abilities for the novel clinical trials. And small cell lung cancer has paved the way and led the development of a lot of these drugs across the board. With the most recent sort of drugs targeting DLL3 already approved and several antibody-drug conjugates currently in development. That actually translates really well to how we should approach drug development in bladder cancer. What we saw in the study is that although there are overlaps and similarities between small cell lung cancer and small cell bladder cancer, there are also certain differences. So the long-term assumption that all therapies for small cell bladder cancer can be extrapolated to small cell bladder], may or may not be true, and I think it is high time that we specifically investigate these novel agents in tissue-specific small cell carcinomas. To that effect, we are excited to be participating in trials that are looking at some of the novel DLL3 targeted agents, specifically bispecific antibodies and T cell engagers so to speak, and antibody-drug conjugates that are now starting to open enrollment specifically in non-lung cancer cohorts to evaluate its efficacy. So overall, I think studies like this have the opportunity to identify more putative targets for organ-specific development of these novel agents. Dr. Rafeh Naqash: Absolutely, I could not agree more. I think tumor-agnostic therapies definitely have a place, but not all therapies work the same in different tumors with a similar histological or genomic background because there are definitely differences. So now going to the comparison that Salvador, you guys did in this project, could you help us understand what are some of the things you looked at, what were some of the commonalities and the differences, and what were some of the conceptual thoughts that come out from those results? Dr. Salvador Jaime-Casas: Of course. So, the first thing that we identified was which were the most frequent molecular alterations across these histologies. We actually provided a table showcasing how the most common mutations that we identified were TP53, TERT, RB1. However, like Dr. Tripathi mentioned, the distinction between these histologies is notable in the sense that some are more predominant in small cell-pertaining cancers such as bladder cancer and lung cancer. While some others are more common in bladder-pertaining malignancies like urothelial carcinoma and small cell bladder cancer. For instance, we saw that TP53 and RB1 were significantly more evident in small cell histologies, both small cell bladder cancer and small cell lung cancer, as opposed to conventional urothelial carcinoma, which really this mirrors what is known about these mutations and what has been published. These are markers associated with more aggressive disease with a worse prognosis and even to resistance to treatment. We also identified how TERT mutations were characteristically more prevalent in small cell bladder cancer as opposed to small cell lung cancer, as well as in urothelial carcinoma. TERT mutations were more commonly identified than in small cell lung cancer. And we give a long list of these mutations that we identified, but really what we wanted to underscore here was, A, the most common mutations across histologies; B, the most common co-occurring mutations where we saw that these are not mutually exclusive. A lot of patients had co-occurring TP53 and RB1 or RB1 and TERT or RB1 and ARID1A, really elucidating how heterogeneous this molecular landscape is across histologies. And the third one that we believe really brings down the clinical impact of this research was evidencing the idea of clinically actionable mutations. We also provided a table here showcasing how mutations like FGFR, DLL notch pathway, HER2, were evident in these histologies, and what is the current status of some clinical trials evaluating different drug designs for these mutations. Like Dr. Tripathi mentioned in the context of FGFR, approximately 6% of our cohort with small cell bladder cancer showcased mutations in FGFR3. However, up to 14% of them had mutations in any FGFR gene, which really underscores the notion that drugs like erdafitinib, which have been introduced in the market in recent years, could potentially showcase some response in the space of small cell bladder cancer. We actually provide the description of two trials, phase two, phase three trials, that are evaluating erdafitinib in the context of high-risk non-muscle invasive bladder cancer and even metastatic urothelial carcinoma. Like Dr. Tripathi mentioned as well, antibody-drug conjugates, another very interesting area of drug development targeting HER2, we included evidence on how disitamab vedotin and trastuzumab deruxtecan are currently being explored across different phase two and phase three clinical trials, both as part of basket trial designs for solid malignancies expressing HER2, but also for patients with urothelial carcinoma where there is evidence of HER2 expression. So, we believe that the landscape is shifting in the right direction in the sense that therapies are becoming much more personalized and targeted against these known molecular profiles. Dr. Rafeh Naqash: Thank you, Salvador, for summarizing some of those very interesting results and providing a very unique conceptual context to that. I would like to go to Abhishek this last portion. Of course, I am sure you guys will expand on this work and there are a lot of other interesting things that will likely come out from this work and hopefully you will publish that in JCO PO. But one of the very important things that I wanted to highlight from this podcast specifically was the science is obviously very interesting, but I feel the more important interesting aspect is giving trainees and fellows, residents, mentorship opportunities, mentoring them and giving them lead roles in projects like this, which is what Dr. Tripathi has successfully done for you in this project, Salvador. So, Abhishek, as somebody I have known for a couple of years now, more than a couple of years, as a very successful clinical translational investigator in the GU space in the early phase setting, Abhishek, really briefly, within a minute, could you tell us about your journey and what are some of the things that have worked for you as an early career investigator that you have learned from, and then your journey of mentorship, how has that been for you and what are some of the things that you take home from your mentorship role? Abhishek Tripathi: Absolutely. And as you mentioned, mentorship has been pivotal for all early career investigators for them to really succeed. So, my journey, as you know, I started off as an early career investigator at another institution, and I think I owe it to my mentors even at that time and even now who are helping me develop some of these newer translational and clinical trial ideas, creating opportunities where we could really showcase some of the interesting work that we are doing. That actually goes a long way in terms of creating independence as an established investigator. And I think the sooner we start off with mentorship prospects, I think the better it is. And paying it forward, I think I have been lucky to have mentees like Salvador who are just extremely talented, really committed, and goal-oriented. He really led the project right from the beginning in terms of initial analyses and looking up all the sort of correlative studies that we could do and the contextual data between small cell lung cancer and bladder cancer that we have delved into for the past several years. And it really showcases the ability of young mentees like Salvador to really excel given the right guidance and the support. As a mentor, it has been a really rewarding experience. It is really helpful to actually learn from some of these mentees as well as to approach the same problem from a different angle and different thought process and guide them through the study. So, it has been incredibly helpful and rewarding both being a mentee and a mentor over the past several years as I have transitioned. Dr. Rafeh Naqash: Thank you, Abhishek, for those very insightful comments on how both being a mentee and being a mentor helps shape you as an individual as well. And then you take a lot of pride in the success of your mentees. Now real quick, Salvador, could you tell us a little bit about yourself, you know, how you ended up at City of Hope under Dr. Tripathi's mentorship and what are some of the next important things that you are looking forward to doing? Dr. Salvador Jaime-Casas: So, a little bit about who I am. I did medical school in Mexico City. I was born and raised there, and towards the end of my medical training, I started to be engaged in research projects. And through one of my mentors in Mexico, I was actually introduced to the team here at City of Hope, including Dr. Tripathi. And through this, we got the opportunity to have some conversations about what I wanted to do, become a physician-researcher in the area of genitourinary oncology and hopefully my transition to residency in a few years. And that is how I came to be his mentee here at City of Hope. I think it has been a very rewarding experience, like Dr. Tripathi said, having such an incredible mentor and really being with him both in the academic setting and in the clinical setting, in patients with clinic, seeing this curiosity and all these clinical trials, all of this evidence that we have coming together to generate this insight. Dr. Rafeh Naqash: Thank you so much for both the scientific insights, as well as the journey of being a mentee for you, Salvador, and as a mentor for you, Abhishek. I really enjoyed talking to you guys about both aspects here today and hopefully we will see more of your work, Abhishek and Salvador, as far as understanding the transcriptomic heterogeneity in neuroendocrine tumors or neuroendocrine cancers of the bladder. Dr. Salvador Jaime-Casas: Thank you very much. Thank you for having us. Dr. Rafeh Naqash: Thank you for listening to JCO Precision Oncology Conversations. Do not 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. Abhishek Tripathi Disclosures Consulting or Advisory Role:  Company: Aadi biosciences, Seattle Genetics/Astellas, Exelixis, Bayer, Gilead Sciences, Pfizer, Deka biosciences Speakers' Bureau: Company: Sanofi

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Jonathon B. Cohen, MD, MS As the therapeutic landscape for follicular lymphoma continues to evolve, CAR T-cell therapy is emerging as a transformative option for select patients with relapsed or high-risk disease. But it also comes with a lot of important considerations, like knowing when to refer and how to manage common adverse events. Joining Dr. Charles Turck to explore how CAR T fits into the broader treatment algorithm for follicular lymphoma is Dr. Jonathan Cohen. Not only is he a Professor in the Department of Hematology and Medical Oncology at the Emory University School of Medicine, but he's also the Co-Director of the Lymphoma Program at the Winship Cancer Institute of Emory University in Atlanta.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Jonathon B. Cohen, MD, MS As the therapeutic landscape for follicular lymphoma continues to evolve, CAR T-cell therapy is emerging as a transformative option for select patients with relapsed or high-risk disease. But it also comes with a lot of important considerations, like knowing when to refer and how to manage common adverse events. Joining Dr. Charles Turck to explore how CAR T fits into the broader treatment algorithm for follicular lymphoma is Dr. Jonathan Cohen. Not only is he a Professor in the Department of Hematology and Medical Oncology at the Emory University School of Medicine, but he's also the Co-Director of the Lymphoma Program at the Winship Cancer Institute of Emory University in Atlanta.

In today's episode, we had the pleasure of speaking with John N. Allan, MD, and Melissa Rubianes about factors that influence treatment decision-making in chronic lymphocytic leukemia (CLL). Allan is an associate professor of clinical medicine and a member of the lymphoma faculty in the Division of Hematology and Medical Oncology, as well as a member of the CLL Research Center at Weill Cornell Medicine in New York, New York. Rubianes is a hematology/oncology physician assistant (PA) at Weill Cornell.  In our exclusive interview, Allan and Rubianes discussed best practices for oncologists and PAs when it comes to collaborating with each other to make treatment decisions for patients with CLL, disease factors and patient characteristics that affect their treatment sequencing decisions, ongoing studies and emerging therapies for CLL that they're excited to see, and more. 

In today's episode, supported by Sumitomo, we spoke with Tanya B. Dorff, MD, about the use of androgen deprivation therapy (ADT) in patients with prostate cancer. Dr Dorff is section chief of the Genitourinary Disease Program, as well as a professor in the Department of Medical Oncology & Therapeutics Research at City of Hope in Duarte, California. In our conversation, Dr Dorff discussed the role of ADT in prostate cancer management, highlighting where this class of agents fits into National Comprehensive Cancer Network guidelines and how this class has evolved with the development of LHRH antagonists and agonists. She explained how the observational OPTYX study (NCT05467176), a registry of relugolix (Orgovyx) use, aims to address safety and efficacy in combination with androgen receptor pathway inhibitors in patients with advanced prostate cancer. She also noted how early data from OPTYX presented at the 2025 ASCO Annual Meeting showed relugolix's use in localized and metastatic settings. Dorff also talked through relugolix's safety profile, particularly regarding cardiovascular risk, as well as the quality-of-life effects associated with ADT. She also addressed strategies to mitigate financial toxicity, along with the potential for future ADT-sparing treatments.

Here it is, the first of our new series called GU Cast Journal Club! A dedicated GU Cast Journal Club has been suggested by many of our listeners and viewers over the years, and we are really pleased to kick off today with the first monthly episode. And we are particularly pleased to introduce our GU Cast Journal Club Editors, Dr Carlso Delgado (Melbourne, AUS), and Dr Elena Berg (Munich, GER). Declan Murphy is anchoring today's episode while Renu is busy elsewhere. Each month, two papers will be discussed, each of which are of importance to the GU Oncology community. These may be recent papers, or occasionally we will chose a classic landmark paper in GU OncologyThe objective is to draw attention to important papers in GU Oncology, and critique these in a robust mannerThe key target audience is trainees working in Urology, Medical Oncology, Radiation Oncology, Nuclear Medicine, and diagnostic specialties such as Radiology and Pathology. But any of our regular audience are likely to enjoy this Journal Club series. For this inaugural epsiode, we have selected two very important recent papers:1. Active Surveillance for Screen-detected Low- and Intermediate-risk Prostate Cancer: Extended Follow-up up to 25 Years in the GÖTEBORG-1 Trial 2. Standard or Extended Lymphadenectomy for Muscle-Invasive Bladder Cancer GU Cast Journal Club is supported by our Partner, MSD, through an unrestricted educational grant. 

In today's episode, supported by Nuvation Bio, we spoke with Joel Neal, MD, PhD, and Christian Rolfo, MD, PhD, about the FDA approval of taletrectinib (Ibtrozi) for the treatment of patients with locally advanced or metastatic, ROS1-positive non–small cell lung cancer (NSCLC). Dr Neal is a professor of medicine in the Division of Oncology at the Stanford Cancer Institute at Stanford University in Palo Alto, California. Dr Rolfo is the director of the Division of Medical Oncology at The Ohio State University Comprehensive Cancer Center—James and a professor in the College of Medicine at The Ohio State University in Columbus. In our conversation, Drs Neal and Rolfo discussed the significance of this approval, key data from the pivotal phase 2 TRUST-I (NCT04395677) and TRUST-II (NCT04919811) trials, and taletrectinib's current role in the NSCLC treatment paradigm.

In today's episode, supported by Boehringer Ingelheim, we spoke with Ticiana Leal, MD, and Misako Nagasaka, MD, PhD, about the FDA approval of zongertinib (Hernexeos) for previously treated patients with HER2 TKD–mutant advanced non–small cell lung cancer (NSCLC). Dr Leal is an associate professor and director of the Thoracic Medical Oncology Program in the Department of Hematology and Medical Oncology at Emory University School of Medicine in Atlanta, Georgia; as well as medical director of the Clinical Trials Office and leader of the Lung Cancer Disease Team at the Winship Cancer Institute of Emory University. Dr Nagasaka is an associate professor of medicine in the Division of Hematology and Oncology at the University of California, Irvine (UCI) School of Medicine; as well as a medical oncologist at UCI Health. In our conversation, Drs Leal and Nagasaka discussed the significance of this approval, key efficacy and safety findings from the pivotal phase 1 Beamion LUNG-1 trial (NCT04886804), and where zongertinib currently fits into the NSCLC treatment paradigm.

In today's episode, we spoke with Nisha Joseph, MD, and Hans Lee, MD, about the FDA's accelerated approval of linvoseltamab-gcpt (Lynozyfic) for the treatment of adult patients with relapsed or refractory multiple myeloma who have received 4 or more prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody. Joseph is an associate professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine in Atlanta, Georgia. Lee is the director of Myeloma Research at the Sarah Cannon Research Institute in Nashville, Tennessee.  In our conversation, Drs Lee and Joseph discussed the significance of this approval, key data from the pivotal phase 1/2 LINKER-MM1 trial (NCT03761108), and where linvoseltamab fits into the relapsed/refractory myeloma treatment paradigm alongside other approved agents. 

In this episode, Raval welcomed David A. Frank, MD, PhD, FACP, who is director of the Division of Hematology and a professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. He also serves as director of the Winship Innovation Initiative and as an advisor to the Morningside Center for Innovative and Affordable Medicine within the Woodruff Health Sciences Center.

Check out this week's QuadCast as we highlight long term results from FLAME on DIL SIB in prostate cancer, how the benefits of Pluvicto are growing, the thought provoking question of surgical omission in breast cancer, and much more. Check out the website and subscribe to the newsletter! www.quadshotnews.com Founders & Lead Authors: Laura Dover & Caleb Dulaney Podcast Host: Sam Marcrom

Check out this week's QuadCast as we highlight the impact of perilesional edema on local failure risk for brain SRS, the benefits of RT in high risk prostate cancer, and much more. Check out the website and subscribe to the newsletter! www.quadshotnews.com Founders & Lead Authors: Laura Dover & Caleb Dulaney Podcast Host: Sam Marcrom

On December 5, 2025, we will kick off the IASLC ASCO 2025 North America Conference on Lung Cancer. Guest include Dr. Ramesh Rengan, the Peter Wootton Professor and Chair of Radiation Oncology at the University of Washington and Senior Vice President of the Fred Hutchinson Cancer Center and Dr. Kristen Marrone, Associate Professor of Oncology and Director of the Medical Oncology and Hematology Fellowship Program at Johns Hopkins University.

Check out this week's QuadCast as we highlight a PSMA Theranostic contender, new guidelines (and name) for GBM, current management limitations in NSCLC, and more. Check out the website and subscribe to the newsletter! www.quadshotnews.com Founders & Lead Authors: Laura Dover & Caleb Dulaney Podcast Host: Sam Marcrom

In today's episode, supported by Coherus BioSciences, we had the pleasure of speaking with Justine Bruce, MD, about the ongoing evolution of nasopharyngeal carcinoma management. Dr Bruce is a faculty member in the Division of Hematology, Medical Oncology and Palliative Care within the Department of Medicine at the University of Wisconsin, as well as the director of the VA Medical Oncology Clinical Research Program and chair of the Protocol Review and Monitoring Committee at the University of Wisconsin Carbone Cancer Center in Madison. In our exclusive interview, Dr Bruce discussed evolving treatment strategies for nasopharyngeal cancer, emphasizing the shift from chemoradiation followed by adjuvant chemotherapy to induction chemotherapy with gemcitabine and cisplatin. She also noted how toripalimab-tpzi (Loqtorzi) combined with gemcitabine and cisplatin showed improved overall survival (OS) in the first-line setting in the phase 3 JUPITER-02 trial (NCT03581786). Bruce also expressed her preference for OS as the gold standard for determining the efficacy of nasopharyngeal cancer treatments and noted the need for more US-based trials to reflect the local patient population.

Today's guest is Michael Zaiac, Head of Medical Oncology for Europe and Canada at Daiichi Sankyo. Michael joins the platform in a special episode focused on how AI is driving measurable ROI in clinical trials—particularly in patient recruitment and eligibility. Their conversation explores how life sciences teams are applying advanced analytics to accelerate enrollment, improve diversity in study populations, and reduce time to trial completion. Michael also shares where generative AI is beginning to play a role in patient-facing materials, including simplified consent forms and study summaries. Throughout the episode, Michael emphasizes the importance of early stakeholder alignment, regulatory transparency, and the discipline required to deploy AI responsibly in high-risk clinical environments. This episode is sponsored by Medable. Learn how brands work with Emerj and other Emerj Media options at emerj.com/ad1. Want to share your AI adoption story with executive peers? Click emerj.com/expert2 for more information and to be a potential future guest on the ‘AI in Business' podcast!

One of the key aspects of one's neuroendocrine cancer care is building your medical team, which typically includes a medical oncologist. In this episode, Medical Oncologist Dr. Sandy Kotiah from Mercy Medical Center in Baltimore expounds on the role of a medical oncologist. She sheds light on the first appointment, communication, and care coordination. TOP TEN QUESTIONSWhat is your role in the neuroendocrine cancer world? What is your role with your medical team?What is a medical oncologist? What training is involved? Is a medical oncologist the same thing as a hematologist oncologist? What's the difference between a medical oncologist & surgical oncologist (& radiation oncologist)?What is a NET expert and how does someone become a NET expert?When I'm looking for a NET expert, what type of doctor am I looking for? How do I know if I'm with a “NET expert”? If I call a medical institution, will I automatically get assigned to a “NET expert?” If someone tells me they are a “NET expert,” does that mean that person is a NET expert?What can I expect on my first appointment? What type of information do you try to communicate with your patients during the first appointment? Newly diagnosed patients often come to their first appointment feeling scared and overwhelmed. They wonder “how long do I have,” worry about how fast the cancer is growing, and are unsure of what to tell their family and friends. How do you address these concerns?What questions should I be asking my oncologist?When/how often should I see my medical oncologist? Who goes over my scan results with me? When does that happen/How soon after a scan should I expect results? Who communicates the tumor board discussions?How is care coordinated with other providers on my team within the same institution? How is care coordinated with other providers from different institutions (i.e. with a local oncologist and a NET expert)?What happens if someone wants a second opinion? How do you feel about second opinions?How do I navigate or work through a situation in which there are differing opinions between doctors? If I have a question, concern, or symptoms, who do I communicate with and what's the best way to communicate? What if we “run out of time” during an appointment? What if it's a question or concern I'm shy about communicating?Some people struggle with trust because of past experiences with providers who might have ignored or minimized their symptoms. What advice do you have to help build trust with my doctor? What would you say is my responsibility as a patient and your responsibility as the oncologist? If there is one thing you would like all people living with neuroendocrine cancer to know, what would it be?For more information, visit NCF.net.

Check out this week's QuadCast with many highlights from ASCO, including adding nivo to postop CRT in HNSCC, the benefits of immunotherapy in resected MMRd colon cancer, how SRS beat HA-WBRT, and more. Check out the website and subscribe to the newsletter! www.quadshotnews.com Founders & Lead Authors: Laura Dover & Caleb Dulaney Podcast Host: Sam Marcrom

Featuring perspectives from Dr Prithviraj Bose and Dr Andrew T Kuykendall, including the following topics: Systemic Mastocytosis — Dr Bose (0:00) Myelofibrosis — Dr Kuykendall (24:46) CME information and select publications

Clinical investigators discuss available data guiding the management of systemic mastocytosis and myelofibrosis.  CME information and select publications here.

Featuring perspectives from Dr Thomas A Abrams and Dr Ahmed Omar Kaseb, including the following topics: Current Treatment for Advanced Hepatocellular Carcinoma (HCC) — Dr Abrams (0:00) Promising Novel Approaches to HCC Management — Dr Kaseb (33:46) CME information and select publications

Featuring perspectives from Dr Natalie S Callander and Dr Thomas Martin, including the following topics: Introduction (0:00) Current and Emerging Therapeutic Approaches for Multiple Myeloma — Dr Callander (4:42) CAR T-Cell Therapy, Bispecific Antibodies and Antibody-Drug Conjugates — Dr Martin (31:16) CME information and select publications

Clinical investigators discuss available data guiding the management of multiple myeloma.  CME information and select publications here.

Featuring perspectives from Dr Yelena Y Janjigian and Dr Samuel J Klempner, MD, including the following topics: Role of Immune Checkpoint Inhibitors in the Management of Gastroesophageal Cancers — Dr Janjigian (0:00) Available and Emerging Targeted Therapeutic Approaches for Gastroesophageal Cancers — Dr Klempner(28:38) CME information and select publications

On this Mother's dray, we honor the heart of every mother — the love she gives, the sacrifices she makes, and the quiet strength she carries every single day. But today, we also pause to ask: how can mothers take care of themselves? How can faith and medicine guide them to nurture not just others, but their own beautiful, essential selves? Whether you are a mother, lost a mother, hope to be one, or are simply someone who has been touched by the love of a mother, this episode is for you. Together, let's explore what it means to mother others — and to mother ourselves — through the lens of both faith and wellness.Please join my two special guests on the podcast:Dr. Shabana Dewani  is board certified in Medical Oncology, Hematology, and Internal Medicine—and a joy to listen to!  You'll be able to hear her passion for how takes care of herself and advocates for other mothers. Pastor Jennifer Jackson offers faith perspective and self care for women. She provides us her learnings as she went through her own breast cancer diagnosis.  She strives to help women through life, whether it's a book, her own radio show, or by mentoring them.  You'll be uplifted by our discussion with Jennifer she talks about what faith says about women taking care of themselves.Learn More About Jennifer Jackson here.InstagramFacebookIf you want to buy my book, click the link below.Their Legacy, Their Light She Carries: A Breast Surgeon's Mission to Serve and Inspire HopeStay Connected with Dr. Deepa Halaharvi:TikTok: @breastdoctorInstagram: @drdhalaharviTBCP Instagram: @thebreastcancerpodcastWebsite: https://drdeepahalaharvi.com/YouTube: https://www.youtube.com/@deepahalaharvi5917Instagram: @thebreastcancerpodcast

Are you a physician overwhelmed by late-night charting? Dr. Mary Leung, board-certified in internal medicine, medical oncology, and hematology — and now a certified life coach — knows your struggle firsthand.Dr. Mary completed her medical education at the University at Buffalo School of Medicine. She went on to complete her residency in Internal Medicine and her fellowship in Hematology and Medical Oncology at the Zucker School of Medicine at Hofstra/Northwell. Her solid clinical background, combined with her experience as a certified life coach, gives her a unique and compassionate perspective on physician burnout and well-being.In this empowering livestream, discover how Dr. Mary went from burnout and after-hours charting to confidently finishing her clinical day on time. Learn the exact tools and mindset shifts that transformed her routine and helped her rediscover joy in medicine.✅ Why charting was draining her energy✅ How coaching transformed her time and mindset✅ How she helps physicians regain control, clarity, and time✅ Steps to build a meaningful, sustainable medical careerDr. Mary founded Shining With Gratitude MD to guide physicians through their unique journeys. Her mission: help doctors feel better, live fuller lives, and fall in love with medicine again.Connect with Dr. MaryLinkedIn Mary Leung, MDFacebook Mary LeungWebsite https://www.shiningwithgratitudemd.com

The premise behind the Carnivore Diet is to eat to our biological design: exposing ourselves to the beneficial and essential nutrients, and removing the harmful exposures.  However there are more essential and beneficial exposures beyond just meat, and there are harmful exposures besides plant toxins.  This episode takes a closer look beyond the best ditary exposures to what are some of the best overall exposures for your health as well.  Enjoy! Dr. Petra Davelaar is a naturopathic doctor specializing in Deutenomic medicine—a field that explores the role of deuterium (a heavy isotope of hydrogen) in human health. Her work focuses on how deuterium levels affect cellular processes, particularly mitochondrial function, and how reducing deuterium accumulation may support disease prevention and recovery. ​ Born and raised in the Netherlands, Dr. Davelaar moved to New York in her 20s. She earned her Doctor of Naturopathic Medicine degree from Bastyr University in California in 2016. After practicing in Santa Monica for several years, she now offers consultations via telemedicine. Since January 2021, her credentials have been recognized in Hungary and most other European countries. ​ Dr. Davelaar is also certified in functional medicine and nutrition. She has served as a peer reviewer for scientific journals such as Scientific Reports and Medical Oncology. ​ In addition to her clinical work, Dr. Davelaar has contributed to public education through lectures and podcasts, discussing topics like deuterium depletion, over-hydration, and their implications for health and disease. ​ For more information about her work or to schedule a consultation, you can visit her official website at drpetrad.com