Podcasts about metastases

TWiV discusses the latest worrisome Executive Order on oversight of federal grantmaking, RFK Jr winds down mRNA viral vaccine development, Lenacapavir, a drug for AIDS prevention and treatment, and how respiratory virus infections awaken dormant metastatic breast cancer cells in lungs. Hosts: Vincent Racaniello, Alan Dove, Rich Condit and Brianne Barker Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Support science education at MicrobeTV Oversight of Federal grantmaking (Whitehouse.gov) Grantmaking gets a Christofascist (Rasmussen Retorts) HHS winds down mRNA vaccine development (HHS) Lives saved by COVID vaccines (JAMA) Lenacapavir review (Bicochem Pharm) UNAIDS urges Gilead to lower price of lenacapavir (UNAIDS) Gilead and price gouging (Wikipedia) Respiratory virus infections awaken metastatic breast cancer (Nature) Letters read on TWiV 1243 Timestamps by Jolene Ramsey. Thanks! Weekly Picks Brianne – Xkcd: Geologic Periods Rich – Old Man's War by John Scalzi Alan – The Broken Earth trilogy by N. K. Jemisin Vincent – Cacio e pepe: Good Food pasta recipe sparks fury in Italy Listener Pick Linda – DNA captured in air could identify life forms Intro music is by Ronald Jenkees Send your virology questions and comments to twiv@microbe.tv Content in this podcast should not be construed as medical advice.

BUFFALO, NY - June 11, 2025 – A new #research paper was #published in Volume 16 of Oncotarget on May 29, 2025, titled “Durable complete response in leptomeningeal disease of EGFR mutated non-small cell lung cancer to amivantamab, an EGFR-MET receptor bispecific antibody, after progressing on osimertinib.” A team led by first author Jinah Kim, from the University of Vermont Medical Center, and corresponding author Young Kwang Chae, from the Feinberg School of Medicine, reports a clinical case in which a patient with advanced non-small cell lung cancer (NSCLC) carrying rare EGFR mutations responded remarkably to amivantamab after other treatments had failed. The patient experienced a complete resolution of brain and spinal fluid metastases, suggesting that amivantamab may be a viable option for patients with uncommon genetic profiles and limited therapy options. Lung cancer remains one of the leading causes of cancer-related deaths worldwide. Patients with NSCLC who have rare mutations in the EGFR gene often face limited treatment options and poor outcomes, especially when the disease spreads to the brain or spinal fluid. This case involved a 67-year-old man diagnosed with NSCLC who had two rare EGFR mutations—G719A and A289V. After disease progression on osimertinib and other therapies, the patient began amivantamab monotherapy. Within six weeks, his lung tumor shrank by over 30 percent. By six months, imaging confirmed the disappearance of brain metastases and leptomeningeal disease, a serious condition affecting the membranes of the brain and spinal cord. Blood tests showed no detectable cancer-related mutations, and the patient, previously wheelchair-bound, regained the ability to walk and perform daily activities. This response has been sustained for more than 19 months. “Treatment produced a durable response over 19 months, including a 32.2% reduction in tumor size at six weeks, and complete resolution of brain metastases and LMD by six months.” Amivantamab is a bispecific antibody that targets EGFR and MET, two key drivers of tumor growth. While it is approved in combination regimens for common EGFR mutations, its effectiveness as a single agent in rare mutations or in treating brain metastases remains largely unproven. This case challenges the assumption that large antibody drugs cannot cross the blood-brain barrier and suggests that amivantamab may have potential in managing central nervous system involvement. Further research is needed to clarify how the drug achieves these effects and to explore its broader use in patients with rare EGFR mutations and limited treatment options. This case highlights three key findings: amivantamab may be effective against rare EGFR mutations, can be used as monotherapy, and may overcome the challenges of the blood-brain barrier. Although based on a single patient, the results provide encouraging evidence to support further investigation of amivantamab in treating difficult-to-manage forms of NSCLC. DOI - https://doi.org/10.18632/oncotarget.28730 Correspondence to - Young Kwang Chae - young.chae@northwestern.edu Video short - https://www.youtube.com/watch?v=RJX3rmtH7h8 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, amivantamab, monotherapy, rare EGFR mutation, NSCLC, leptomeningeal disease To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

Host Dr. Davide Soldato and guest Dr. Harriet Kluger discuss the JCO article "Phase II Trial of Pembrolizumab in Combination With Bevacizumab for Untreated Melanoma Brain Metastases." Transcript The guest on this podcast episode has no disclosures to declare. 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 author Dr. Harriet Kluger. Dr. Kluger is a professor of medicine at Yale School of Medicine, Director of the Yale SPORE in Skin Cancer, and an internationally recognized expert in immuno-oncology for melanoma and renal cell carcinoma. She leads early-phase and translational trials that pair novel immunotherapies with predictive biomarkers to personalized care. Today, Dr. Kluger and I will be discussing the article titled "Phase 2 Trial of Pembrolizumab in Combination with Bevacizumab for Untreated Melanoma Brain Metastases." In this study, Dr. Kluger and colleagues evaluated four cycles of pembrolizumab plus the anti-VEGF antibody bevacizumab followed by pembrolizumab maintenance in patients with asymptomatic non-hemorrhagic melanoma brain metastases that had not previously received PD-1 therapy. Thank you for speaking with us, Dr. Kluger. Dr. Harriet Kluger Thank you for inviting me. The pleasure is really all mine. Dr. Davide Soldato So to kick off our podcast, I just wanted to ask if you could outline a little bit the biological and clinical rationale that led you to test this type of combination for patients with untreated brain metastases from metastatic melanoma. Dr. Harriet Kluger Back in approximately 2012, patients who had untreated brain metastases were excluded from all clinical trials. So by untreated, I mean brain metastases that had not received local therapy such as surgery or radiation. The reason for it was primarily because there was this fear that big molecules wouldn't penetrate brain lesions because they can't pass the blood-brain barrier. Turns out that the blood-brain barrier within a tumor is somewhat leaky and drugs sometimes can get in there. When PD-1 inhibitors were first identified as the next blockbuster class of drugs, we decided to conduct a phase 2 clinical trial of pembrolizumab monotherapy in patients with untreated brain metastases. We actually did it also in lung cancer, and we could talk about that later on. Responses were seen. The responses in the brain and the body were similar. They were concordant in melanoma patients. Now, at approximately that time, also another study was done by the Australian group by Dr. Georgina Long, where they did a randomized trial where patients who didn't require immediate steroid therapy received either nivolumab alone or nivolumab with ipilimumab, and the combination arm was substantially superior. Subsequently, also, Bristol Myers Squibb also conducted a large phase 2 multicenter trial of ipilimumab and nivolumab in patients with untreated brain metastases. And there, once again, they saw that the responses in the brain were similar to the responses in the body. Now, somewhere along the line there, we completed our anti-PD-1 monotherapy trial. And when we looked at our data, we still didn't have the data on ipilimumab and nivolumab. And our question was, “Well, how can we do better?” Just as we're always trying to do better. We saw two really big problems. One was that patients had a lot of perilesional edema. And the other one was that we were struggling with radiation necrosis in lesions that were previously Gamma Knifed. The instance of radiation necrosis was in excess of 30%. So the rationale behind this study was that if we added bevacizumab, maybe we could treat those patients who had some edema, not requiring steroids, but potentially get them on study, get that PD-1 inhibitor going, and also prevent subsequent radiation necrosis. And that was the main rationale behind the study. We had also done some preclinical work in mouse models of melanoma brain metastases and in an in vitro blood-brain barrier model where we showed that bevacizumab, or anti-VEGF, really tightens up those leaky basement membranes and therefore would be very likely to decrease the edema. Dr. Davide Soldato Thank you very much for putting in context the combination. So this was a phase 2 trial, and you included patients who had at least one lesion, and you wanted lesions that were behind 5 and 20 millimeters. Patients could be included also if the brain metastasis was higher in dimension than 20 millimeters, but it had to be treated, and it was then excluded from the evaluation of the primary objective of the trial. So regarding, a little bit, these characteristics, do you think that this is very similar to what we see in clinical practice? And what does this mean in terms of applicability of these results in clinical practice? Dr. Harriet Kluger So that's an excellent question. The brain metastasis clinical research field has somewhat been struggling with this issue of inclusion/exclusion criteria. When we started this, we showed pretty clearly that 5 to 10 millimeter lesions, which are below the RECIST criteria for inclusion, are measurable if you use MRIs with slices that are 1 to 2 millimeters. Most institutions in the United States do use these high-resolution MRIs. I don't know how applicable that is on a worldwide scale, but we certainly lowered the threshold for inclusion so that patients who have a smattering of small brain metastases would be eligible. Now, patients with single large brain metastases, the reason that we excluded those from the trial was because we were afraid that if a patient didn't respond to the systemic therapy that we were going to give them, they could really then develop severe neurological symptoms. So, for patient safety, we used 20 millimeters as the upper level for inclusion. Some of the other trials that I mentioned earlier also excluded patients with very large lesions. Now, in practice, one certainly can do Gamma Knife therapy to the large lesions and leave the smaller ones untreated. So I think it actually is very applicable to clinical practice. Dr. Davide Soldato Thank you very much for that insight, because I think that sometimes criteria for clinical trials, they have to be very restrictive. But then we know that in clinical practice, the applicability of these results is probably broader. So, going a little bit further in the results of the study, I just wanted a little bit of comment from you regarding what you saw in terms of intracranial response rate and duration of response among patients who obtained a response from the combination treatment. Dr. Harriet Kluger So we were actually surprised. When we first designed this study, as I said earlier, we weren't trying to beat out ipilimumab and nivolumab. We were really just trying to exclude those patients who wouldn't have otherwise been eligible for ipilimumab and nivolumab because of edema or possibly even previous radiation necrosis. So it was designed to differentiate between a response rate of 34%, and I believe the lower bound was somewhere in the 20s, because that's what we'd seen in the previous pembrolizumab study. What we saw in the first 20 patients that we enrolled was actually a response rate that far exceeded that. And so we enrolled another cohort to verify that result because we were concerned about premature publishing of a result that we might have achieved just by chance. The two cohorts were very similar in terms of the response rates. And certainly this still needs to be verified in a second study with additional institutions. We did include the Moffitt Cancer Center, and the response rate with Moffitt Cancer Center was very similar to the Yale Cancer Center response rate. Now, your other question was about duration of response. So the other thing that we started asking ourselves was whether this high response rate was really because the administration of the anti-VEGF will decrease the gadolinium enhancement and therefore we might actually just be seeing prettier scans but not tumor shrinkage. And the way to differentiate those two is by looking at the duration of the response. Median progression-free survival was 2.2 years. That's pretty long. The upper bound on the 95% confidence interval was not reached. I can't tell you that the duration is as good as the duration would be when you give ipilimumab. Perhaps it is less good. This was a fairly sick population of patients, and it included some who might not have been able to receive ipilimumab and nivolumab. So it provides an alternative. I do believe that we need to do a randomized trial where we compare it to ipilimumab and nivolumab, which is the current standard of care in this patient population. We do need to interpret these results with caution. I also want to point out regarding the progression-free survival that we only gave four doses of anti-VEGF. So one would think that even though anti-VEGF has a long half-life of three or four weeks, two years later, you no longer have anti-VEGF effect, presumably. So it does something when it's administered fairly early on in the course of the treatment. Dr. Davide Soldato So, in terms of clinical applicability, do you see this combination of pembrolizumab and bevacizumab - and of course, as we mentioned, this was a phase 2 trial. The number of patients included was not very high, but still you saw some very promising results when compared with the combination of ipilimumab and nivolumab. So do you see this combination as something that should be given particularly to those patients who might not be able to receive ipilimumab and nivolumab? So, for example, patients who are very symptomatic from the start or require a high dose of steroids, or also to provide a quicker response in terms of patients who have neurological symptoms, or do you think that someday it could be potentially used for all patients? Dr. Harriet Kluger The third part of your question, whether it can be used someday for all patients: I think we need to be very careful when we interpret these results. The study was substantially smaller than the ipilimumab/nivolumab trial that was conducted by Bristol Myers Squibb. Also going to point out that was a different population of patients. Those were all frontline patients. Here we had a mix of patients who'd had previous anti-CTLA-4 and frontline patients. So I don't think that we can replace ipilimumab and nivolumab with these results. But certainly the steroid-sparing aspect of it is something that we really need to take into consideration. A lot of patients have lesions in locations where edema can be dangerous, and some of them have a hard time coming off the steroids. So this is certainly a good approach for those folks. Dr. Davide Soldato And coming back to something that you mentioned in the very introduction, when you said that there were two main problems, which was one, the problem of the edema, and the second one, the problem of the radionecrosis. In your trial, there was a fair percentage of patients who received some type of local treatment before the systemic one. So the combination of pembrolizumab and bevacizumab. And most of the patients received radiosurgery. So I just wanted a brief comment regarding the incidence of radionecrosis in the trial and whether that specific component of the combination with bevacizumab was reduced. And how do you think that this fares in terms of what we see in clinical practice in terms of radionecrosis? Dr. Harriet Kluger I'm not sure that we really reduced the incidence of radiation necrosis. We saw radiation necrosis here. We saw less of it than in the trial of pembrolizumab monotherapy, but these were also different patients, different time. We saw more than we thought that we were going to see. It was 27%, I believe, which is fairly high still. We only gave the four doses of bevacizumab. Maybe to really prevent radiation necrosis, you have to continue to give the bevacizumab. That, too, needs to be tested. The reason that we gave the four doses of bevacizumab was simply because of the cost of the bevacizumab at the time. Dr. Davide Soldato Thank you very much for that comment on radionecrosis. And I really think that potentially this is a strategy, so continuing the bevacizumab, that really makes a lot of sense, especially considering that the tolerability of the regimen was really very, very good, and you didn't see any significant or serious adverse events related to bevacizumab. So just wondering if you could comment a little bit on the toxicities, whether you had anything unexpected. Dr. Harriet Kluger There was one patient who had a microperforation of a diverticulum, which was probably related to the bevacizumab. It was conservatively managed, and the patient did fine and actually remains alive now, many years later. We had one patient who had dehiscence of a previous wound. So there is some. We did not see any substantial hypertension, proteinuria, but we only gave the four doses. So it is possible that if you give it for longer, we would see some side effects. But still, relative to ipilimumab, it's very, very well tolerated. Dr. Davide Soldato Yeah, exactly. I think that the safety profile is really different when we compare the combination of ipilimumab/nivolumab with the pembrolizumab/bevacizumab. And as you said, this was a very small trial and probably we need additional results. But still, these results, in terms of tolerability and safety, I think they are very interesting. So one additional question that I think warrants a little bit of comment on your part is actually related to the presence of patients with BRAF mutation and, in general, to what you think would be the best course of treatment for these patients who present with the upfront brain metastases. So this, it's actually not completely related to the study, but I think that since patients with BRAF mutation were included, I think that this warrants a little bit of discussion on your part. Dr. Harriet Kluger So we really believe that long-term disease control, particularly in brain metastases, doesn't happen when you give BRAF/MEK inhibitors. You sometimes get long-term control if you've got oligometastatic disease in extracranial sites and if they've previously been treated with a lot of immune checkpoint inhibitors, which wasn't the case over here. So a patient who presents early in the course of the disease, regardless of their BRAF status, I do believe that between our studies and all the studies that have been done on immunotherapy earlier in the course of disease, we should withhold BRAF/MEK inhibitors unless they have overwhelming disease and we need immediate disease control, and then we switch them very quickly to immunotherapy. Can I also say something about the toxicity question from the bevacizumab? I have one more comment to make. I think it's important. We were very careful not to include patients who had overt hemorrhage from brain metastases. So melanoma brain metastases relative to other tumor types tend to bleed, and that was an exclusion criteria. We didn't see any bleeding that was attributable to the bevacizumab, but we don't know for sure that, if this is widely used, that that might not be a problem that's observed. So I would advise folks to use extreme caution and perhaps not use it outside of the setting of a clinical trial in patients with overt hemorrhage in the melanoma brain metastases. Dr. Davide Soldato Thank you very much. I think that one aspect that is really interesting in the trial is actually related to the fact that you collected a series of biomarkers, both circulating ones, but also some that were collected actually from the tissue. So just wondering if you could explain a little bit which type of biomarkers you evaluated and whether you saw any significant results that could suggest higher or lower efficacy of the combination. Dr. Harriet Kluger Thank you for that. So yes, the biomarker studies are fairly exploratory, and I want to emphasize that we don't have anything that's remotely useful in clinical practice at this juncture. But we did see an association between vessel density in the tumors and improved response to this regimen. So possibly those lesions that are more vascular are more fed by or driven by VEGF, and that could be the reason that there was improved response. We also saw that when there was less of an increase in circulating angiopoietin-2 levels, patients were more likely to respond. Whether or not that pans out in larger cohorts of patients remains to be determined. Dr. Davide Soldato Still, do you envision validation of these biomarkers in a potentially additional trial that will evaluate, again, the combination? Because I think that the signals were quite interesting, and they really make sense from a biological point of view, considering the mechanism of action of bevacizumab. So I think that, yeah, you're right, they are exploratory. But still, I think that there is very strong biological rationale. So really I wanted to congratulate you on including that specific part and on reporting it. And so the question is, really, do you envision validation of these biomarkers in larger cohorts? Dr. Harriet Kluger I would hope to see that, just as I'd like to see validation of the clinical results as well. The circulating biomarkers are very easy to do. It's a simple ELISA test. And the vessel density on the tumor is essentially CD34 staining and units per area of tumor. Also very simple to do. So I'd love to see that happen. Dr. Davide Soldato Do you think that considering the quality of the MRI that we are using right now, it would be possible to completely bypass even the evaluation on the tissue? Like, are we going in a direction where we can, at a certain point, say the amount of vessels that we see in these metastases is higher versus lower just based on MRI results? Dr. Harriet Kluger You gave me an outstanding idea for a follow-up study. I don't know whether you can measure the intensity of gadolinium as a surrogate, but certainly something worth asking our neuroradiology colleagues. Excellent idea. Thank you. Dr. Davide Soldato You're welcome. So just moving a step further, we spoke a lot about the validation of these results and the combination. And just wanted your idea on what do you think it would be more interesting to do: if designing a clinical trial that really compares pembrolizumab/bevacizumab with ipilimumab and nivolumab or going directly for the triplet. So we know that there has been some type of exploration of triplet combination in metastatic melanoma. So just your clinical impression: What would you do as an investigator? Dr. Harriet Kluger So it's under some discussion, actually. It's very difficult to compare drugs from different companies in an investigator-initiated trial. Perhaps our European colleagues can do that trial for us. In the United States, it's much harder, but it can be done through the cooperative groups, and we are actually having some discussions about that. I don't have the answer for you. It would be lovely to have a trial that compared the three drugs to ipi/nivo and to pembrolizumab/bevacizumab. So a three-arm trial. But remember, these are frontline melanoma patients. There aren't that many of them anymore like there used to be. So accrual will be hard, and we have to be practical. Dr. Davide Soldato Yeah, you're right. And in the discussion of the manuscript, you actually mentioned some other trials that are ongoing, especially one that is investigating the combination of pembro and lenvatinib, another one that is investigating the combination of nivolumab and relatlimab. So just wondering, do you think that the molecule in terms of VEGF inhibition, so bevacizumab versus lenvatinib, can really make a difference or is going to be just a mechanism of action? Of course, we don't have the results from this trial but just wondering if you could give us a general comment or your opinion on the topic. Dr. Harriet Kluger So that's a really great question. The trial of pembrolizumab and lenvatinib was our answer to the fact that bevacizumab is not manufactured by the same company as pembrolizumab, and we're trying to give a practical answer to our next study that might enable us to take this approach further. But it does turn out from our preclinical studies that bevacizumab and VEGF receptor inhibition aren't actually the same thing in terms of the effects on the blood-brain barrier or the perilesional tumor microenvironment in the brain. And these studies were done in mice and in in vitro models. Very different effects. The lenvatinib has stronger effect on the tumors themselves, the tumor cells themselves, than the bevacizumab, which has no effect whatsoever. But the lenvatinib doesn't appear to tighten up that blood-brain barrier. Dr. Davide Soldato Thank you. I think that's very interesting, and I think it's going to be interesting to see also results of these trials to actually improve and give more options to our patients in terms of different mechanism of action, different side effects. Because in the end, one thing that we discussed is that some combination may be useful in some specific clinical situation while others cannot be applicable, like, for example, an all immunotherapy-based combination. Just one final comment, because I think that we focused a lot on the intracranial response and progression-free survival. You briefly mentioned this but just wanted to reinforce the concept. Did you see any differences in terms of intracranial versus extracranial response for those patients who also had extracranial disease with the combination of pembro and bevacizumab? Dr. Harriet Kluger So the responses were almost always concordant. There were a couple of cases that might have had a body response and not an intracranial response and vice-versa, but the vast majority had concordant response or progression. We do believe that it's a biological phenomenon. The type of tumor that tends to go to the brain is going to be the type of tumor that will respond to whatever the regimen is that we're giving. In the previous trial also, we saw concordance of responses in the body and the brain. Dr. Davide Soldato Thank you very much. Just to highlight that really the combination is worth pursuing considering that there was not so much discordant responses, and the results, even in a phase 2 trial, were very, very promising. So thank you again, Dr. Kluger, for joining us today and giving us a little bit of insight into this very interesting trial. Dr. Harriet Kluger Thank you for having me. Dr. Davide Soldato So we appreciate you sharing more on your JCO article titled "Phase 2 Trial of Pembrolizumab in Combination with Bevacizumab for Untreated Melanoma Brain Metastases," which gave us the opportunity to discuss current treatment landscape in metastatic melanoma and future direction in research for melanoma brain metastasis. 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/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.

Drs Camidge and Lin discuss Dr Lin's work with brain metastases, her role in developing targeted therapies for breast cancer, the importance of systemic therapy for managing brain metastases, and the significance of mentoring the next generation of oncologist.

In this episode of SurgOnc Today, Dr. Julie Hallet, chair of the HPB disease site working group, and Dr. Callisia Clarke, member of the SSO board of directors, are joined by Dr. Jessica Maxwell and Dr. Alexandra Gangi to explore the evolving field of surgery for neuroendocrine tumors liver metastases. They discuss patient selection, pre-operative optimization, and unique surgical techniques to optimize perioperative and oncologic outcomes.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ZPG865. CME/NCPD/CPE/AAPA/IPCE credit will be available until March 2, 2026.Fine-Tuning the Selection and Sequencing of HER2-Targeting Therapies in HER2-Positive MBC With and Without CNS Metastases: Expert Guidance on How to Individualize Therapy Based on Latest Evidence, Disease Features, Treatment Characteristics, and Patient Needs and Preferences In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and GRASP. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Pfizer.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ZPG865. CME/NCPD/CPE/AAPA/IPCE credit will be available until March 2, 2026.Fine-Tuning the Selection and Sequencing of HER2-Targeting Therapies in HER2-Positive MBC With and Without CNS Metastases: Expert Guidance on How to Individualize Therapy Based on Latest Evidence, Disease Features, Treatment Characteristics, and Patient Needs and Preferences In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and GRASP. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Pfizer.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ZPG865. CME/NCPD/CPE/AAPA/IPCE credit will be available until March 2, 2026.Fine-Tuning the Selection and Sequencing of HER2-Targeting Therapies in HER2-Positive MBC With and Without CNS Metastases: Expert Guidance on How to Individualize Therapy Based on Latest Evidence, Disease Features, Treatment Characteristics, and Patient Needs and Preferences In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and GRASP. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Pfizer.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ZPG865. CME/NCPD/CPE/AAPA/IPCE credit will be available until March 2, 2026.Fine-Tuning the Selection and Sequencing of HER2-Targeting Therapies in HER2-Positive MBC With and Without CNS Metastases: Expert Guidance on How to Individualize Therapy Based on Latest Evidence, Disease Features, Treatment Characteristics, and Patient Needs and Preferences In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and GRASP. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Pfizer.Disclosure information is available at the beginning of the video presentation.

CME credits: 1.00 Valid until: 06-02-2026 Claim your CME credit at https://reachmd.com/programs/cme/systemic-management-of-brain-metastases-in-her2-bc-emerging-strategies-and-treatment-approaches/29949/ The development and availability of HER2-directed therapies has dramatically improved outcomes for patients with metastatic breast cancer (MBC). Moreover, emerging data indicate that these therapies also improve outcomes for those with brain metastasis. In this educational series, expert faculty differentiate the available HER2-directed therapies for MBC, assess their efficacy in disease with brain metastasis, and review treatment selection and sequencing considerations for these agents. Please stay tuned for additional content to this program available for credit. The maximum amount of credits available for the entire activity is 1.00.

CME credits: 1.00 Valid until: 06-02-2026 Claim your CME credit at https://reachmd.com/programs/cme/optimizing-treatment-selection-for-her2-breast-cancer-patients-with-brain-metastases/29950/ The development and availability of HER2-directed therapies has dramatically improved outcomes for patients with metastatic breast cancer (MBC). Moreover, emerging data indicate that these therapies also improve outcomes for those with brain metastasis. In this educational series, expert faculty differentiate the available HER2-directed therapies for MBC, assess their efficacy in disease with brain metastasis, and review treatment selection and sequencing considerations for these agents. Please stay tuned for additional content to this program available for credit. The maximum amount of credits available for the entire activity is 1.00.

In this episode of the Radiology Podcast, Dr. Lauren Kim speaks with Dr. Lama Dawi about a groundbreaking study comparing liquid biopsy and CT imaging in assessing tumor burden. They explore the strengths, limitations, and future of liquid biopsy in cancer diagnostics and precision medicine. Can it replace CT scans? Liquid Biopsy versus CT: Comparison of Tumor Burden Quantification in 1065 Patients with Metastases. Dawi et al.Radiology 2024; 313(2):e232674. 

Interview with Michael A. Postow, MD, author of Intracranial Outcomes of Ipilimumab and Nivolumab in Melanoma Brain Metastases After Progression on Anti–PD-1 Therapy. Hosted by Vivek Subbiah, MD. Related Content: Intracranial Outcomes of Ipilimumab and Nivolumab in Melanoma Brain Metastases After Progression on Anti–PD-1 Therapy

Interview with Michael A. Postow, MD, author of Intracranial Outcomes of Ipilimumab and Nivolumab in Melanoma Brain Metastases After Progression on Anti–PD-1 Therapy. Hosted by Vivek Subbiah, MD. Related Content: Intracranial Outcomes of Ipilimumab and Nivolumab in Melanoma Brain Metastases After Progression on Anti–PD-1 Therapy

Host: Jacob Sands, MD Guest: Aaron Lisberg, MD Unfortunately, brain metastases are very common in patients with non-small cell lung cancer (NSCLC). That's why the phase 3 TROPION-Lung01 trial examined the efficacy and safety of datopotamab deruxtecan (Dato-DXd) for advanced non-squamous NSCLC with brain metastases. Joining Dr. Jacob Sands to share the results presented at the 2024 ESMO Congress is thoracic medical oncologist Dr. Aaron Lisberg.

The incidence of brain metastases is higher in patients with non-small cell lung cancer (NSCLC) than in patients with most other cancers, and the development of brain metastases is associated with poor prognosis. The objective of the podcast is to provide information about current and future treatments for brain metastases that develop in patients with EGFR-mutated NSCLC. The panel discusses surveillance and management of patients with brain metastases, different types of currently used treatments, and recent data on the intracranial efficacy of antibody–drug conjugates (ADCs). The panel also discusses current and future studies of ADCs in patients with EGFR-mutated NSCLC with brain metastases. This podcast discussion, among four oncologists (two thoracic oncologists, one radiation oncologist, and one neurologist/neuro-oncologist), is for healthcare professionals (HCPs) at community practices and research institutions.   This podcast is published open access in Oncology and Therapy and is fully citeable. You can access the original published podcast article through the Oncology and Therapy website and by using this link: https://link.springer.com/article/10.1007/s40487-024-00315-1. All conflicts of interest can be found online.    Open Access This podcast is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The material in this podcast is included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.   This podcast is intended for medical professionals.

This guideline was created as an educational tool to guide qualified physicians through a series of diagnostic and treatment decisions to improve the quality and efficiency of care for adult patients with Brain Metastases treated with Immunotherapy. J. Bradley Elder, MD Jeffrey J. Olson, MD D. Ryan Ormond, MD, Phd

In this inaugural episode of the Surgical Oncology Insight series of SurgOnc Today®, Dr. Shishir Maithel, Editor of Surgical Oncology Insight, SSO's open-access journal, discusses with Dr. Brett Ecker the results of a systematic review and meta-analysis characterizing the incidence of cfDNA-positivity after resection of colorectal cancer liver metastases  with quantification of its sensitivity and specificity for postoperative recurrence, as reported in his article, "The Prognostic Role of Post-operative cfDNA after Resection of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis."

In this podcast, we bring you the latest insights into managing brain metastases, with expert commentary from Minesh Mehta, MD,... The post Latest updates in managing brain metastases appeared first on VJOncology.

Dr Rotow discusses data that demonstrated the central nervous system activity of datopotamab deruxtecan and osimertinib in patients with NSCLC.

With new advances in the treatment of brain cancer, patients have more options than ever. This week, Faith talks with Dr. Kathryn Beal, a radiation oncologist at NewYork-Presbyterian and Weill Cornell Medicine, to explore how breakthroughs in immunotherapy and stereotactic radiosurgery can successfully treat metastatic cancer in the brain. In recognition of Glioblastoma Awareness Day, Dr. Beal also explains treatment options for gliomas, and her hope for the future for patients with brain tumors and brain metastases.

Description: Host Dr. Narjust Florez and two esteemed international clinicians discuss the unique characteristics of CNS metastases in patients with non-small cell lung cancer and small cell lung cancer. Guest: Dr. Sarah Goldberg is an Associate Professor of Medicine in the section of Medical Oncology at the Yale School of Medicine. She is the Division Chief of Thoracic Oncology, the Research Director for the Center for Thoracic Cancers, and the Associate Program Director for the Medical Oncology-Hematology Fellowship Program at Yale Guest: Dr. Ernest Nadal is a medical oncologist and the director of Thoracic Tumors Section at the Catalan Institute of Oncology, an Associate Professor at the University of Barcelona, a vital member of the Spanish Lung Cancer Group and an expert in clinical trial development and interest in response and use of immune checkpoint inhibitors for the management of CNS metastases.

In this episode of SurgOnc Today, Alexander Parikh, MD, MPH, from the University of Texas – San Antonio and Chair of the SSO HPB disease site working group, and Laleh G. Melstrom, MD, MSCI, from City of Hope National Medical Center, are joined by Timothy Newhook, MD, from the University of Texas MD Anderson Cancer Center and Andreas Kaiser, MD, from the City of Hope. We will be discussing the management of synchronous rectal cancer with liver metastases.

Rick Greene, MD, discusses with Jean-Nicolas Vauthey, MD, a comparison of different surgical approaches to synchronous liver metastases from rectal cancer and their analysis of both clinicopathological and biological tumor factors associated with completion of the reverse approach. Professor Vauthey is the senior author of, “Hepatectomy Before Primary Tumor Resection as Preferred Approach for Synchronous Liver Metastases from Rectal Cancer.” Dr. Vauthey is Professor of Surgery and Chief of the Hepato-Pancreato-Biliary Section, and the Dallas/Fort Worth Living Legend Chair of Cancer Research in the Department of Surgical Oncology at The University of Texas MD Anderson Cancer Center in Houston, TX.

CME credits: 1.00 Valid until: 01-03-2025 Claim your CME credit at https://reachmd.com/programs/cme/case-treatment-selection-for-ros1-rearranged-nsclc-patient-with-brain-metastases/18162/ This program aims to raise awareness of approved and emerging targeted therapies and practice guidelines for ROS1+ NSCLC. It is critical to create a greater understanding of the limitations existing agents have with acquired resistance mutations and intracranial penetration and the potential advantage new and emerging agents offer to resolve and evade these challenges.

When and how often do NETs spread to the bones or brain? How are they found? What is the treatment? Dr. Robert Ramirez of Vanderbilt University addresses concerns surrounding bone metastases (or “mets”) as well as rare brain metastases.MEET DR. ROBERT RAMIREZ, DO, FACP Dr. Robert Ramirez is a medical oncologist specializing in the treatment of thoracic and neuroendocrine malignancies and an Associate Professor of Medicine at Vanderbilt University Medical Center in Nashville, TN.  He earned his medical degree from the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine. He completed an internal medicine residency at Cooper University Hospital in Camden, New Jersey. He then completed a hematology and medical oncology fellowship at the University of Tennessee Health Sciences Center in Memphis, Tennessee and served as chief fellow. He is a Fellow of the American College of Physicians, and a member of American Society of Clinical Oncology, the International Association for the Study of Lung Cancer (IASLC), and the North American Neuroendocrine Tumor Society (NANETS).  He serves on the Board of Directors for NANETS as well as the Scientific Review and Research Committee.His clinical and research interests include neuroendocrine tumors (NETs) and lung cancer.  He has a specific interest in NETs of the lung ranging from diffuse idiopathic pulmonary neuroendocrine tumor cell hyperplasia (DIPNECH) and carcinoid tumors to small cell lung cancer and other high-grade neuroendocrine carcinomas. He is active in clinical trial design including investigator-initiated trials. He enjoys teaching residents and fellows and has multiple publications and given many lectures for the scientific community on the topics of NETs and lung cancers.TOP TEN QUESTIONSBone mets:1. When and how often do NETs spread to the bones? 2. Where in the bones are tumors? What does it mean when NETs spread to the bones? How does this compare to other cancers?3. How are bone spots found and monitored? Should they be biopsied?4. What is the treatment for bone mets? Should I have radiation? Would radiation limit my ability to get PRRT?5. Should I be on bone strengthening medication? Am I at higher risk for fractures (or breaking my bones) if I have NETs in the bones?6. Do bone mets respond to PRRT?7. Does having bone mets put me at a higher risk of MDS?Brain mets:8. When and how often do NETs spread to the brain? Do all types of NETs have the potential to spread to the brain?9.    How are brain mets found and monitored? When should I suspect this?10.  How are brain mets treated? What does having brain mets mean for my life?*Bonus: What final words of hope do you have for the neuroendocrine cancer community?For more information, visit LACNETS.org.

What do you call NETs in the liver? How often do NETs spread? What causes NETs to spread? How do you determine if surgery is an option? Dr. Xavier Keutgen from University of Chicago brings clarity to NET tumors found in the liver and describes how surgery fits in with other treatments for metastatic NETs.ABOUT DR. XAVIER KEUTGENXavier M. Keutgen MD is a board-certified, double-fellowship trained surgeon who specializes in the treatment of gastro-entero-pancreatic neuroendocrine tumors and neoplasms of the thyroid-, parathyroid- and adrenal glands. A native from Belgium, Dr. Keutgen graduated magna cum laude from the University of Heidelberg Medical School in Germany and completed a general surgery residency and surgical oncology research fellowship at New York Presbyterian Hospital-Weill Cornell Medical Center.  He then completed a hepato-pancreato-biliary fellowship at the University Hospital of Zurich in Switzerland as well as an endocrine oncology and surgery fellowship at the National Cancer Institute, National Institutes of Health (NIH) in Bethesda, Maryland. Dr. Keutgen currently serves as the director of the Neuroendocrine Tumor Program, director of the Endocrine Research Program and co-director of the Von Hippel-Lindau Clinical Care Program at the University of Chicago Medicine.Throughout his career Dr. Keutgen has developed a particular interest in clinical, translational and basic science research. His laboratory specializes in investigating the role of radiation therapy and DNA damage repair in pancreatic, lung and small bowel neuroendocrine tumors, discovering new actionable molecular targets for neuroendocrine tumors, and elucidating new mechanisms of drug delivery for endocrine malignancies.TOP TEN QUESTIONS What is liver NETs? How often do NETs spread? Is it expected that NETs will eventually spread?If the primary tumor was already removed, do you now call this liver NET or do you still refer to it by the primary site of origin – and why? How is this different from liver cancer?What causes NETs to spread? Is there anything that is done to cause NET tumors to spread? Is there anything that can be done to keep them from spreading?How do you determine if surgery is an option? What is involved in evaluating metastases? What scans or labs are needed?How do you decide what the “tumor burden” is?How do you weigh the grade or ki67?  How do you weigh tumor size? Is there a cut-off for tumor size or the number of tumors that is too much to operate?How does one decide between surgery versus other options? How often can surgery or other treatments be done? How safe is liver surgery?How do you approach surgery for someone with liver tumors who also has tumors in the tail versus the head of the pancreas?When someone has had a Whipple surgery and later is found to have tumors in the liver, what are the options?What advances in the field are you most excited about? For more information, visit LACNETS.org.

Rick Greene, MD, discusses with Sean Cleary, MD, cytoreductive hepatectomy for neuroendocrine tumor liver metastases; specifically, perioperative outcomes and operative trends, rates and duration of symptomatic relief, and long-term survival and predictors of prognosis. Dr. Cleary is the senior author of, “Neuroendocrine Tumor Liver Metastases: Long-Term Follow-up Evaluation of More Than 500 Patients.” Dr. Cleary is the Bernard and Ryna Langer Chair of the Division of General Surgery in the Department of Surgery at the University of Toronto, Toronto, Canada.

As the Radical Thoughts Podcast is no longer active, I am making these old bonus episodes from Patreon publicly available so that listeners don't have to pay for an inactive podcast. - Patrick n this Patron-only bonus episode, Patrick interviews philosopher and psychoanalyst Adrian Johnston on the work of Slavoj Žižek, Lacanian psychoanalysis, theories of materialism, and more. This episode follows our discussion of the work The Metastases of Enjoyment, so you may want to listen to that episode first. NOTES: -Johnston's article on Lacan in the Stanford Encylopedia of Philosophy  -Less Than Nothing by Žižek -Self and Emotional Life: Philosophy, Psychoanalysis, and Neuroscience by Adrian Johnston and Catherine Malabou

This episode of SurgOnc Today®, features guest faculty, Astrid Botty Van Den Bruele, MD, and Meghan Flanagan, MD, MPH. In a contemporary group of patients diagnosed with contralateral axillary metastases (CAM), those selected for treatment with presumed curative intent experienced improved OS when compared to stage IV (M1) patients. The current literature, as well as some forthcoming data, adds additional support for re-evaluating the stage IV designation, in favor of N3, and consideration of curative intent treatment in this disease entity.

Dr. Iyad Alnahhas interviews Drs. Priya Kumthekar and Jeffrey Raizer about their recent manuscript entitled: A phase I/II study of intrathecal trastuzumab in human epidermal growth factor receptor 2-positive (HER2- positive) cancer with leptomeningeal metastases: Safety, efficacy, and cerebrospinal fluid pharmacokinetics", published online in Neuro-Oncology in March 2023.

Neurosurgeon Dr. Nam Tran from Moffitt Cancer Center talks with us about RF ablation for painful spinal metastases, including patient selection and the importance of a multidisciplinary approach. --- CHECK OUT OUR SPONSOR Medtronic OsteoCool https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/tumor-management/osteocool-ablation-system-rf.html --- SHOW NOTES In this episode, neurosurgeon Dr. Nam Tran and our host Dr. Michael Barraza discuss minimally invasive procedures to treat both primary spine tumors and spine metastases. Dr. Tran describes the flexibility that kyphoplasty and spinal ablation can grant patients who are not suitable candidates for open surgical decompression. These minimally invasive procedures can reduce hospital stays from 4-5 days to just one night. Dr. Tran views ablation not only from a palliative pain reduction perspective, but also from an oncologic perspective that aims to reduce tumor burden. Dr. Tran says the ideal candidate for ablation is a patient who has isolated disease to the anterior column of the spine. With larger lesions, Dr. Tran relies on his neurosurgical background to take an aggressive approach in treating the entire vertebra. The doctors also discuss research studies that have made ablation more widely accepted and available (all articles are linked below). --- RESOURCES OPuS One Study: https://pubmed.ncbi.nlm.nih.gov/33129427/ CAFE Study: https://www.clinicaltrials.gov/ct2/show/study/NCT00211237

Interview with Sean P. Pitroda, MD, author of Integrated Clinical-Molecular Classification of Colorectal Liver Metastases: A Biomarker Analysis of the Phase 3 New EPOC Randomized Clinical Trial. Hosted by Jack West, MD. Related Content: Integrated Clinical-Molecular Classification of Colorectal Liver Metastases

Interview with Sean P. Pitroda, MD, author of Integrated Clinical-Molecular Classification of Colorectal Liver Metastases: A Biomarker Analysis of the Phase 3 New EPOC Randomized Clinical Trial. Hosted by Jack West, MD. Related Content: Integrated Clinical-Molecular Classification of Colorectal Liver Metastases

August 2023 Journal Club Podcast Title: Neoadjuvant Arterial Embolization of Spine Metastases Associated With Improved Local Control in Patients Receiving Surgical Decompression and Stereotactic Body Radiotherapy To read journal article: https://journals.lww.com/neurosurgery/Fulltext/2023/08000/Neoadjuvant_Arterial_Embolization_of_Spine.10.aspx Author: Brad Elder Guest faculty: Ziya Gokaslan Moderator: Haydn Hoffman Co-chair: Rafael Vega

Dr. Steven Yevich from MD Anderson Cancer Center talks with us about his approach to Treatment and Management of Painful Extra-spinal Bony Metastases. --- CHECK OUT OUR SPONSOR Medtronic OsteoCool https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/tumor-management/osteocool-ablation-system-rf.html --- SHOW NOTES In this episode, Dr. Steve Yevich joins Dr. Michael Barraza to discuss treatment of extraspinal painful bony metastases. Dr. Yevich tells us about his training in interventional oncology at Gustave Roussy Cancer Campus in Paris, and we discuss how he adjusted to identify the individual needs of the hospital when he came back to the US. We explain how to go into a case with either curative or palliative intent. Dr. Yevich shares when he would do soft tissue ablation around nerves and the location of the metastases he commonly treats. We emphasize the anatomic considerations to determine if ablation for the extraspinal bony metastases is feasible. We discuss some of the advanced techniques Dr. Yevich learned in Paris and the two types of cases that may need pre-ablation embolization. We discuss advancements in technologies and devices that have allowed for more creative solutions in IR.

Arun D. Singh, MD, Director of Ophthalmic Oncology at Cleveland Clinic Cole Eye Institute, joins the Cancer Advances podcast to discuss metastases to the eye. Listen as Dr. Singh talks about the common types of cancer that metastasize to the eye, symptoms, treatment options, and the importance of looking out for metastases in patients.

Interventional Radiologist Jason Levy and Radiation Oncologist Amir Lavaf discuss the benefits of a Multidisciplinary Approach in the Treatment of Spinal and Bone Metastases. --- SHOW NOTES In this episode, Dr. Jason Levy and Dr. Amir Lavaf join Dr. Michael Barraza to discuss their multidisciplinary approach to treating spinal metastases. We examine the collaborative efforts between IR and radiation oncologists, and we break down the indications for treating spinal metastases. We discuss pain control and local control rates, and how doctors are working to improve them. Dr. Levy and Dr. Lavaf tell us why they are able to get better survival numbers when they approach the primary and metastatic disease at the same time. We explain how to work with tumor boards and different groups of doctors to make spinal metastases treatment easier. We discuss how to reduce risk of delayed skeletal events and radiation failure after spinal metastases treatment. We go over some of the challenges of working with the tumor board, and why it is important to develop relationships with medical oncologists and the importance of continuing systemic therapies. --- RESOURCES BackTable Podcast Episode 68: RF Ablation Therapy for Bone Metastases https://www.backtable.com/shows/vi/podcasts/68/rf-ablation-therapy-for-bone-metastases

Rick Greene, MD, discusses with Dr. Giammauro Berardi, MD, PhD, FEBS, the outcomes of a large cohort of patients undergoing upfront surgery for resectable colorectal liver metastases (CRLM) to analyze the predictability and probability of early treatment failure using clinicopathological characteristics. Dr. Berardi is author of, “A Model to Predict Treatment Failure in Patients Undergoing Upfront Surgery for Resectable Colorectal Liver Metastases.” Dr. Berardi is attending at the Department of HPB Surgery and Liver Transplantation of the San Camillo Forlanini Hospital, Rome, Italy, and previous to that was a Surgical Oncology clinical fellow at Memorial Sloan-Kettering Cancer Center, New York NY.

Dr. Christian Capitini is an associate professor and the Jean R. Finley Professor of Pediatric Hematology and Oncology. He serves as co-leader of the Developmental Therapeutics Program at the University of Wisconsin Carbone Cancer Center and director of clinical innovation at the Forward BIO Institute. He has received many awards for his clinical and research contributions, including the Department of Pediatrics Gerard B. Odell Research Award, the Outstanding New Member Science Award from the Society for Pediatric Research (SPR), and the Janet Rowley Award from the Jonas Center Cellular Therapy Symposium at the University of Chicago. Nationally, Dr. Capitini is an active member of the Society for Immunotherapy of Cancer (SITC) and serves as at-large director. Additionally, he serves on the executive board for the Pediatric Real World chimeric antigen receptor (CAR) T Consortium. Dr. Capitini leads an NIH-supported laboratory focusing on development of cell-based immunotherapies, including natural killer (NK) cells and CAR T cells, for the treatment of pediatric solid tumors. The Capitini Lab also develops alternatively activated macrophages for complications of bone marrow transplant, including graft-versus-host-disease (GVHD) and acute radiation syndrome. Dr. Capitini was one of the site principal investigators (PI) for the first multicenter CD19 CAR T cell trial, which led to the FDA approval of tisagenlecleucel-T (Kymriah) for relapsed/refractory B cell leukemia. Currently, he is site PI for a Kymriah trial related to the upfront treatment of high-risk B cell leukemia and for a multicenter GD2 CAR T cell trial for neuroblastoma and osteosarcoma through the Pediatric NCI-Cancer Immunotherapy Trials Network (CITN). He is also a sponsor and PI for a University of Wisconsin clinical trial expanding gamma delta T cells in vivo using zoledronate after alpha beta T cell depleted stem cell transplant. --- What We Do at MIB Agents: PROGRAMS: End-of-Life MISSIONS Gamer Agents Agent Writers Prayer Agents Healing Hearts - Bereaved Parent and Sibling Support Ambassador Agents - Peer Support Warrior Mail Young Adult Survivorship Support Group EDUCATION for physicians, researchers and families: OsteoBites, weekly webinar & podcast with thought leaders and innovators in Osteosarcoma MIB Book: Osteosarcoma: From our Families to Yours RESEARCH: Annual MIB FACTOR Research Conference Funding multiple $100,000 and $50,000 grants annually for OS research MIB Testing & Research Directory The Osteosarcoma Project partner with Broad Institute of MIT and Harvard ... Kids are still dying with 40+ year old treatments. Help us MakeItBetter. https://www.mibagents.org​ Help support MIB Agents, Donate here https://give-usa.keela.co/embed/YAipuSaWxHPJP7RCJ SUBSCRIBE for all the Osteosarcoma Intel

Dr. Iyad Alnahhas interviews Drs. Sherise Ferguson and Michael Davies about their recent manuscript entitled: "Changes in Outcomes and Factors Associated with Survival in Melanoma Patients with Brain Metastases", published online in Neuro-Oncology in December 2022.   Read Paper

On episode 11 of A Chat with Uma, inspired by my upcoming 4-year cancerversary and all that comes up this time of year - I share my full story + experience of living with cancer since I was 22. I talk you through the 6 months of misdiagnosis that led up to my diagnosis the day after my birthday, and I take you through the tumultuous journey of treatment that was shaped by further negligence, misdiagnosis, and mistreatment. I share the consequences of my delayed treatment on my prognosis, and I explain the reality of living with cancer rather than being in remission. I speak at length about the unique struggles of living with cancer as an AYA (adolescent + young adult patient), and I draw awareness to the experience of survivorship beyond treatment that is often completely overlooked by those in an AYA's life. I close with reflections about my experience, and a call to action + empowerment about sharing our true experiences in community with others - and allowing ourselves the chance to be truly seen + supported. Topics Covered + Timestamps: (00:00:00): Introduction to the episode, why l'm doing this episode, my upcoming 4-year cancerversary, dedication of this episode (00:09:44): Aspiring Scientists Coalition Presentation with Dr. Ben Rein THIS Thursday April 13, 9am PDT / 12pm EDT ⁠⁠Sign up for free HERE (00:14:00): Breaking Convention Presentation April 20-22 | University of Exeter ⁠Register to attend HERE⁠ (in person or virtual) (00:17:05): Digital CancerCon Presentation April 16-30, virtual platform Register HERE for free (00:19:58): Diagnosis & surgery Events leading up to my diagnosis 6 months of misdiagnosis Being diagnosed the day after my birthday The role of my young age Going through cancer surgery Consequences and effects (00:42:56): Negligence, radiation, metastasis Medical negligence after surgery Transitioning my care Highest risk of recurrence Radiation Discovery of distant spots of metastasis (01:01:20): What my cancer looks like now Current level of monitoring "Cancer suppressed" vs. in remission The role of my young age (01:07:31): The AYA cancer experience What AYA is: adolescent + young adult patients The worsened outcomes + prognoses for AYAs AYA awareness and self-advocacy (01:14:42): The reality of facing your mortality Isolation, fear, scanxiety Worsened mental health outcomes Toxic positivity and gratitude How to adequately support AYAs (01:19:27): Closing out the episode, integrating and allowing all parts of you to exist Connect with me! My website⁠: ⁠⁠⁠umarchatterjee.com⁠⁠⁠ ⁠Instagram:⁠ ⁠⁠⁠@UmaRChatterjee⁠⁠⁠ Twitter:⁠ ⁠⁠⁠@UmaRChatterjee⁠⁠⁠ TikTok:⁠ ⁠⁠⁠@UmaRChatterjee⁠⁠⁠ Email: ⁠⁠⁠hello@umarchatterjee.com⁠ --- Send in a voice message: https://podcasters.spotify.com/pod/show/umarchatterjee/message

"Nail changes in pemphigus and bullous pemphigoid: A single-center study in China." Cao, Shan, et al. Frontiers in Medicine 9 (2022)."Metastases to the nail unit and distal phalanx: a systematic review.” Curtis, Kaya L., and Shari R. Lipner. Archives of Dermatological Research (2022): 1-12.

Welcome to our 4th episode for our Spine Citation classics series. The goal of this episode is to go over the highest cited articles in the last 15-20 years on metastatic disease to the spine ! This is spearheaded by Dr. Sohum Patel, Jose Chacon , and Dr. Jay Fitts. Enjoy! Subscribe:

This episode is sponsored by BTG Speciality Pharmaceuticals. BTG provides rescue medicines typically used in emergency rooms and intensive care units to treat patients for whom there are limited treatment options. They are dedicated to delivering quality medicines that make a real difference to patients and their families through the development, manufacture, and commercialization of pharmaceutical products. Their current portfolio of antidotes counteracts certain snake venoms and the toxicity associated with some heart and cancer medications. --- Dr. Canter is a Surgical Oncologist with clinical expertise in the multidisciplinary management of sarcomas. He also runs a translational research laboratory which focuses on the therapeutic and mechanistic effects of combining natural killer (NK) cell immunotherapy with other treatment modalities to overcome NK dysfunction in the tumor microenvironment of solid tumors, including sarcomas in both humans and dogs. He serves as the co-leader of UC Davis Comprehensive Cancer Center's Comparative Oncology Program, and his laboratory is one of a select group of labs internationally which is studying canine NK cells, including first-in-dog studies of canine immunotherapy and adoptive transfer of NK cells in dogs with osteosarcoma. Dr. Rebhun is a an Associate Professor in the Department of Surgical and Radiological Sciences at the Center for Companion Animal Health at the UC Davis School of Veterinary Medicine. His research focus is in the field of comparative and translational oncology, with specific interests in metastasis and novel therapeutics. --- What We Do at MIB Agents: PROGRAMS: ✨ End-of-Life MISSIONS ✨ Gamer Agents ✨ Agent Writers ✨ Prayer Agents ✨ Healing Hearts - Bereaved Parent Support ✨ Ambassador Agents - Peer Support ✨ Warrior Mail ✨ Young Adult Survivorship Support Group ✨ EDUCATION for physicians, researchers and families: ✨ OsteoBites, weekly webinar & podcast with thought leaders and innovators in Osteosarcoma ✨ MIB Book: Osteosarcoma: From our Families to Yours ✨ RESEARCH: Annual MIB FACTOR Research Conference ✨ Funding $100,000 annually for OS research ✨ MIB Testing & Research Directory ✨ The Osteosarcoma Project partner with Broad Institute of MIT and Harvard ... Kids are still dying with 40+ year old treatments. Help us MakeItBetter.

This episode is sponsored by BTG Speciality Pharmaceuticals. BTG provides rescue medicines typically used in emergency rooms and intensive care units to treat patients for whom there are limited treatment options. They are dedicated to delivering quality medicines that make a real difference to patients and their families through the development, manufacture, and commercialization of pharmaceutical products. Their current portfolio of antidotes counteracts certain snake venoms and the toxicity associated with some heart and cancer medications. --- Dr. Weiss is a Founding Member of the Musculoskeletal Oncology Research Initiative (MORI), Pittsburgh Cure Sarcoma (PCS), the Pittsburgh Sarcoma Research Collaborative (PSaRC), and the Pittsburgh Center for Bone and Mineral Research (PCBMR). He is a peer reviewer for multiple journals including the Journal of the American Academy of Orthopaedic Surgeons, BioMed Central Cancer, Sarcoma, Cancer Research, International Journal of Cancer, and others. He is a former member of the NIH's Center for Scientific Review Early Career Reviewer program. He has served on multiple National Cancer Institute Study Sections. He is a member of the Musculoskeletal Tumor Society (MSTS) for which he serves as Chair of the Research Committee and the Connective Tissue Oncology Society (CTOS), for which he has served on the Board of Directors. --- What We Do at MIB Agents: PROGRAMS: ✨ End-of-Life MISSIONS ✨ Gamer Agents ✨ Agent Writers ✨ Prayer Agents ✨ Healing Hearts - Bereaved Parent Support ✨ Ambassador Agents - Peer Support ✨ Warrior Mail ✨ Young Adult Survivorship Support Group ✨ EDUCATION for physicians, researchers and families: ✨ OsteoBites, weekly webinar & podcast with thought leaders and innovators in Osteosarcoma ✨ MIB Book: Osteosarcoma: From our Families to Yours ✨ RESEARCH: Annual MIB FACTOR Research Conference ✨ Funding $100,000 annually for OS research ✨ MIB Testing & Research Directory ✨ The Osteosarcoma Project partner with Broad Institute of MIT and Harvard ... Kids are still dying with 40+ year old treatments. Help us MakeItBetter.

Practical Radiation Oncology deputy editor James B. Yu, MD, Columbia University Irvine Center hosts a conversation on ASTRO clinical practice guideline on radiation therapy for Brain Metastases. Eric Chang MD of the Keck School of Medicine of USC and Veronica Chiang, MD, of Yale University School of Medicine discuss the recommendations in the four key areas: what are the indications for radiosurgery alone for brain metastases, what should be done before or after surgical resection of brain metastases, when and how should we do whole brain radiation, and what are the risks of radionecrosis. Two of the guideline authors, Jona A. Hattangadi‐Gluth, MD of the University of California, San Diego and Vinai Gondi, MD of Northwestern Medicine Cancer Center and Proton Center discuss the development process of the guideline and the evidence for the recommendations.

An interview with Dr. Naren Ramakrishna from Orlando Health Cancer Institute in Orlando, FL, and Dr. Carey Anders from Duke University in Durham, NC, co-chairs on "Management of Advanced Human Epidermal Growth Factor Receptor 2 Positive Breast Cancer and Brain Metastases: ASCO Guideline Update." This guideline reviews evidence in both the local therapy management and systemic therapy management for patients with HER2-positive breast cancer and brain metastasis, and provides updated recommendations for these patients. Read the full guideline at www.asco.org/breast-cancer-guidelines.   TRANSCRIPT Brittany Harvey: Hello and welcome to the ASCO Guidelines Podcast series brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all the shows including this one at asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Naren Ramakrishna from Orlando Health Cancer Institute in Orlando, Florida. And Dr. Carey Anders from Duke University in Durham, North Carolina, co-chairs on 'Management of Advanced Human Epidermal Growth Factor Receptor 2 Positive Breast Cancer and Brain Metastases: ASCO Guideline Update'. Thank you for being here. Dr. Ramakrishna and Dr. Anders. Dr. Carey Anders: Thank you. Dr. Naren Ramakrishna: Thank you. Brittany Harvey: First, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The full conflict of interest information for this guideline panel is available online with the publication of the guideline in the Journal of Clinical Oncology. Dr. Ramakrishna, do you have any relevant disclosures that are directly related to this guideline topic? Dr. Naren Ramakrishna: No. Brittany Harvey: And Dr. Anders, do you have any relevant disclosures that are directly related to this guideline topic? Dr. Carey Anders: I do. I would just like to disclose that I receive research funding, compensated consulting roles, and royalties from several of our industry partners who are developing brain permeable compounds. Brittany Harvey: Thank you. Let's talk about the content of this guideline. So, Dr. Anders, what prompted an update to this guideline? And what is the scope of this guideline update? Dr. Carey Anders: Thank you for that question, Brittany. Our previous guideline in the management of HER2-positive breast cancer brain metastasis was published in 2018. And since that time, we've seen significant progress in both the local therapy management and systemic therapy management for our patients with HER2-positive breast cancer and brain metastasis. I think collectively, this body of work really prompted the panel to think through the changes that we could make to improve the care of our patients taking these updates into account. I'd love to hear Dr. Ramakrishna's take on the rationale for the update as he was also involved in the 2018 guideline. Dr. Naren Ramakrishna: Thank you, Carey. Well, it's really an exciting time right now for breast cancer brain metastasis treatment. And the recent data that Dr. Anders referred to has really opened up a whole new era in terms of therapeutic possibilities for breast cancer brain metastasis patients. In the past, we've relied on traditional methods of treatment like whole-brain radiotherapy, surgery, and stereotactic radiosurgery as mainstays of treatment. But this exciting data that Dr. Anders referred to, has resulted in the possibility of avoiding certain of the local therapy options in select patients, which has the potential to increase patient survival and quality of life, and is a major advancement. Brittany Harvey: Excellent. It's great to hear about those advancements. So, then next, I'd like to start by reviewing the guideline recommendations for our listeners. Dr. Ramakrishna, what are the key recommendations for local therapy for patients with HER2-positive breast cancer and brain metastases? Dr. Naren Ramakrishna: Since the 2018 updated guidelines, we've continued with our stratification of patients by prognosis by the number of metastases, size of metastases, and also whether they are symptomatic or asymptomatic. Overall, the changes include the offering of systemic therapy for patients after multidisciplinary review for asymptomatic metastases, particularly those less than two centimeters in size. In select cases, one might also offer it for patients with metastases larger than that. The other major change that we see in this update is an increasing reliance on stereotactic radiosurgery rather than whole-brain treatment as a local therapy option, both in the post-operative setting and for single or multiple metastases, for which surgery is not recommended. Finally, we see a significant change in the application of whole brain radiation, where whole-brain radiation is recommended typically for extensive disease, either with multiple, very large metastases, or many, many small metastases. We recommend whole brain treatment to always be administered with a neuroprotectant, and where possible, with what's called hippocampal sparing, which is thought to reduce the neurocognitive negative effects of whole-brain radiation treatment. Brittany Harvey: Understood, I appreciate those recommendations for local therapy and that overview that you provided. So then Dr. Anders, in addition to those recommendations, what are the key recommendations for systemic therapy for these patients? Dr. Carey Andres: Sure, Brittany, happy to review. I think some of the general principles from the 2018 guidelines remain in place. So, for instance, our patients who have progressive disease in the brain, are eligible for local therapy and have controlled extracranial disease, we still recommend continuing the current HER2-directed therapy along with the same algorithm for the treatment of patients with HER2-positive metastatic breast cancer. There are some interesting and exciting changes to the guidelines with the advent of several of the promising systemic therapies that Dr. Ramakrishna outlines such that we do have the option of leading with systemic therapy for our patients with small asymptomatic lesions in the brain predominantly based on the HER2CLIMB clinical trial which established tucatinib, capecitabine and trastuzumab in this setting. So, in concert with our local therapist, we have the consideration for moving to the HER2CLIMB regimen in the setting of active asymptomatic brain metastasis in concert with our local therapist. So, that's one key change from the 2018 guidelines. Another is the introduction of the compound trastuzumab deruxtecan, an antibody-drug conjugate, which has been shown in second line in the setting of metastatic HER2-positive breast cancer to be superior to our traditional T-DM1 therapy in this setting. In the study, the Destiny-Breast03 study that illustrated the superiority of trastuzumab deruxtecan patients with stable brain metastasis were included and illustrated in this compound, illustrated significant benefit for patients with stable brain metastasis. So, in addition to the HER2CLIMB regimen in the setting of stable brain metastasis, we also have the option of trastuzumab deruxtecan in this setting. And that was an update in our 2022 guidelines. So, we essentially have more systemic therapy tools in our toolkit to consider in concert with local therapy. And I just want to emphasize the importance of communication between the systemic therapy team and the local therapy teams, particularly when we're making the decision to move forward with the systemic therapy in the setting of progressive or stable brain metastasis. Brittany Harvey: Thank you. Yes, that multidisciplinary care is key, and I appreciate your reviewing those updates. So then, in addition to those what is recommended regarding screening for the development of brain metastases for patients with HER2-positive breast cancer? Dr. Carey Andres: So, this is a very active conversation. And in fact, I had this very conversation with two patients in the clinic just yesterday. So, should we be screening our patients with advanced HER2-positive breast cancer with brain MRIs in the absence of symptoms? I think the bottom line is we just don't have the data yet. I think we will have the data and in fact, there are ongoing prospective studies trying to determine whether or not screening brain MRIs in the absence of symptoms in this setting will improve our patient survival, and also improve our patients' quality of life. Until we have that data because we do have these new tools in the toolkit for systemic therapy treatment, the panel loosens the guidelines a bit to say that it's not that we no longer recommend screening in the asymptomatic state, but there's not enough data for or against. And I think this really will help the physician and patients as they're making decisions about their screening and restaging studies in a personalized manner. In addition to the lack of data, we also strongly recommend that clinicians and patients have a very low threshold to obtain a brain MRI in the presence of symptoms and this is really important with regards to communication about symptoms as subtle as they may be. I'd love to hear Dr. Ramakrishna's take on this challenging space where we clearly need more data. Dr. Naren Ramakrishna: Yes, Carey, I completely agree that it's quite challenging and the practice patterns are quite diverse throughout the country. It's also a source of a great deal of apprehension and anxiety for patients who automatically typically would assume that more frequent screening is better, especially when they do develop brain metastasis if that's to occur. So, we do look forward to better data for guidance. And it certainly is an area that should undergo multidisciplinary reviewing recommendations for any particular patient. Brittany Harvey: Understood, thank you both for reviewing the evidence as it states now and we'll look forward to that emerging data for perhaps a future guideline update. So then, Dr. Ramakrishna, what in your view is the importance of this guideline update and what does it mean for clinicians? Dr. Naren Ramakrishna: Well, this is a practice-changing update. I mean, I don't think that's an overstatement. Because for the first time, upfront therapy is going to include the possibility of systemic therapy. And this also means that there has to be multidisciplinary and multimodality discussions regarding local versus systemic therapy for a large proportion of HER2-positive breast cancer brain metastasis patients. So, practice patterns are going to shift as a result of the incorporation of systemic therapy into the treatment paradigm. And finally, the other very important, practice-changing local therapy change is that the use of whole-brain treatment will be reduced relative to stereotactic radiosurgery, but in some cases, also as a result of the use of systemic therapy, and when it is employed, it must be utilized with a neuroprotectant and/or hippocampal sparing. Brittany Harvey: Great and then finally, how will these guideline recommendations affect patients with HER2-positive metastatic breast cancer and brain metastases? Dr. Carey Andres: So, I would just echo Dr. Ramakrishna's comments about the advances that we've seen and the importance of multidisciplinary care. I think from a systemic therapy perspective, we have the wonderful problem of having multiple agents to consider in this space. And as we've seen, really an explosion of HER2-directed therapies that are now approved and available to patients. One of our challenges has been how to sequence these therapies. And so, we were hopeful that these guidelines will help clinicians and patients determine when to pick individual regimens that best fit the patient's scenario, whether or not their brain metastases are stable at that decision tree, or whether or not they're progressive at that decision tree. I would also point the listeners to the updated guidelines in the management of patients with HER2-positive metastatic breast cancer, as these guidelines will certainly complement the decision-making and systemic therapy, incorporating the presence or absence of brain metastasis. Brittany Harvey: Great, and yes, thank you for highlighting that companion guideline. Both are available at asco.org/breast-cancer-guidelines and in the Journal of Clinical Oncology. So, I want to thank you both so much for your work on these guidelines and for taking the time to speak with me today, Dr. Anders and Dr. Ramakrishna. Dr. Naren Ramakrishna: Thank you very much, Brittany. Dr. Carey Andres: Thank you! Thanks for the opportunity. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines Podcast series. To read the full guideline go to www.asco.org/breast-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines App available in iTunes or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   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.

This is a new stop in our ongoing series Road to a Cure. From the start, our goal for this series was not only to educate and give hope to every listener  but also to ensure that  each of these special interviews feels like an intimate conversation with our smartest friend who also happens to be an oncologist researcher. Co-hosts Victoria Goldberg and Dr. Paula Jayne sit down with neuro-oncologist Dr. Priya Kumthekar to talk about leptomeningeal metastases: what they are, how are they treated, and what research is upcoming, including a discussion on ANGled, the new Phase 3 trial for MBC patients newly diagnosed with leptomeningeal metastases.  We end this episode on a hopeful note with  a little Dash of Joy  from our Creator and Senior Producer Lisa Laudico.More info is available on our website:   www.ourmbclife.orgGot something to share?  Feedback? Email:   ourmbclife@sharecancersupport.orgSend us a voice recording via email or through speakpipe on our website.  Follow us on Facebook, Instagram, and Twitter @ourmbclife