Podcasts about relapsed

Relapsed/refractory follicular lymphoma (R/R FL) is challenging to treat, requiring thoughtful clinical decision-making during treatment selection and sequencing. In this episode, CANCER BUZZ speaks with Benjamin Heyman, MD, hematologist and clinical associate professor at City of Hope, about the importance of individualized care, shared decision-making, clinical trial referrals, and multidisciplinary collaboration. CANCER BUZZ also speaks with Laurie Adami, patient advocate with R/R FL, about her real-world experience with multiple lines of therapy, clinical trials, and patient advocacy.     "There are lots of options available, which is really great for patients, so you get to have a good conversation with patients about what they value." - Benjamin Heyman, MD   "The medications you receive in clinical trials may not be the standard of care today, but it may be the standard of care 5 years from now." - Benjamin Heyman, MD   "Patient advocacy organizations have patients that can talk to you. They know what you're talking about. They're on the road ahead of you." - Laurie Adami   Guest:                    Benjamin Heyman, MD Hematologist Clinical Associate Professor City of Hope San Diego, CA   Laurie Adami R/R FL Patient Advocate Los Angeles, LA Received care at UCLA Lymphoma Program   Additional Reading/Sources ACCC Follicular Lymphoma Effective Practice Guide: Multidisciplinary Approaches to Treating Patients With R/R FL Putting Guidance Into Practice: Real-World Approaches to Relapsed/Refractory Folicular Lymphoma ACCC's Community Oncology Research Institute

In this week's episode, Blood editor Dr. Laura Michaelis interviews authors Drs. Terri Parker and Peter Lenting on their latest papers published in Blood Journal. Dr. Lenting discusses his work on introducing a new therapeutic approach to von Willebrand disease with the development of a novel bispecific antibody (KB-V13A12) that links endogenous mouse VWF to albumin, extending VWF half-life twofold with cessation of provoked bleeding. Dr Parker shares the results of a 43-patient phase 2 study that evaluates the single agent isatuximab, a CD38 monoclonal antibody, in patients with relapsed/refractory AL amyloidosis. With a hematological response rate of 77%, organ response rates between 50 and 57%, and an excellent safety profile, the current study lays the foundation for future use of isatuximab across treatment settings and combination strategies.Featured ArticlesIsatuximab for Relapsed and/or Refractory AL Amyloidosis: Results of a Prospective Phase 2 Trial (SWOG S1702)A bispecific nanobody for the treatment of von Willebrand disease type 1

Featuring perspectives from Dr Matthew Lunning and Dr Sonali M Smith, including the following topics:  Which Driver and Which Race: CAR-T and Bispecific Antibodies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma and Follicular Lymphoma — Dr Lunning (0:00) Available and Emerging Novel Therapies for Diffuse Large B-Cell Lymphoma and Follicular Lymphoma — Dr Smith (32:37) CE information and select publications

T. Hack has been holding onto junk for way too long...until he found a use to justify it!

Prof Meletios-Athanasios (Thanos) C Dimopoulos from Alexandra Hospital in Athens, Greece, Dr Hans Lee from Sarah Cannon Research Institute in Nashville, Tennessee, Dr Joseph Mikhael from City of Hope Cancer Center in Phoenix, Arizona, and Dr Noopur Raje from Massachusetts General Hospital in Boston discuss recent updates on available and novel treatment strategies for relapsed/refractory multiple myeloma.  CE information and select publications here.

Featuring perspectives from Prof Meletios-Athanasios (Thanos) C Dimopoulos, Dr Hans Lee, and Dr Noopur Raje, moderated by Dr Joseph Mikhael, including the following topics:  Introduction (0:00) Chimeric Antigen Receptor (CAR) T-Cell Therapy for Relapsed/Refractory (R/R) Multiple Myeloma (MM) — Dr Raje (3:17) Integrating Bispecific Antibodies into the Management of R/R MM — Dr Lee (20:38) Potential Role of Antibody-Drug Conjugates and Cereblon E3 Ligase Modulators in Therapy for MM — Prof Dimopoulos (40:37) CE information and select publications

Osteosarcoma Webinar Series: Amy Armstrong, MD, a pediatric oncologist at Siteman Kids, joins us on OsteoBites to discuss an open-label, cohort-sequential dose-escalation and dose-confirmation Phase 1/2 clinical trial to evaluate the safety and efficacy of domatinostat in combination with sirolimus in adolescents and adults with relapsed, refractory sarcoma and osteosarcoma. She will review background, patient selection, treatment plan and study calendar for this clinical trial.Dr. Amy Armstrong is a pediatric oncologist who directs the Solid Tumor Program at Siteman Kids, affiliated with St. Louis Children's Hospital, as well as co-directs the Adolescent and Young Adult Sarcoma Program in collaboration with Siteman Kids and Siteman Cancer Center. She is an Associate Professor of Pediatrics at Washington University in St. Louis and has research interests in Neurofibromatosis Type 1-related plexiform neurofibromas, renal tumors, and sarcomas found most commonly in the adolescent and young adult population. Dr. Armstrong serves as site Principal Investigator for the Children's Oncology Group, Neurofibromatosis Clinical Trials Consortium and National Pediatric Cancer Foundation and is invested in conducting and developing clinical trials to serve a diverse range of solid tumors in both the upfront and relapsed setting.

This week, we continue talking about relapsed/refractory follicular lymphoma, this time focusing on cellular therapy options, namely bispecific agents and CAR T therapy. If you have not done so, we highly recommend listening to part 3 of our follicular lymphoma series. You may also recall that we discussed these agents in our DLBCL series. Be sure to review our show notes from those episode for some awesome graphics and chart. Episode contents:- What are "CAR T" and "bispecific antibodies"?- What are the approved agents?- Selection of one therapy over another- Side effect profiles**** Get paid to participate in market research surveys: https://affiliatepanel.members-only.online/FOC_24?utm_campaign=FOC&utm_source=email&utm_medium=email** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

This week, we shift our focus to talking about relapsed/refractory follicular lymphoma. In this episode, we will specifically discuss treatment options other than cellular therapy, which will be an upcoming episode. If you have not done so, we highly recommend listening to part 1 and part 2 of this follicular lymphoma series so that you can better follow this week's conversation!Episode contents:- What is the role of rituximab maintenance therapy? - What does surveillance after therapy look like? - What are options for treatment of patients who have relapsed follicular lymphoma? **** Get paid to participate in market research surveys: https://affiliatepanel.members-only.online/FOC_24?utm_campaign=FOC&utm_source=email&utm_medium=email** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

Featuring perspectives from Dr Natalie S Callander and Dr Sagar Lonial, including the following topics:  Introduction (0:00) A Farmer with Myeloma; Is Myeloma the New Chronic Myeloid Leukemia? (2:06) Clinical Trials (12:34) Chimeric Antigen Receptor Therapy (16:11) Bispecific Antibodies (21:38) Antibody-Drug Conjugates; a Patient on Belantamab Mafodotin for 3 Years (30:45) Treatment Options for Relapsed Disease (40:46) Neuropathy (44:43) Alternative Therapies (48:36) 164 Questions (53:20) CME information and select publications

Dr Natalie S Callander and Dr Sagar Lonial provide clinical perspectives on the treatment and disease-management course for patients with relapsed/refractory multiple myeloma. CME information and select publications here.

CME credits: 1.00 Valid until: 21-08-2026 Claim your CME credit at https://reachmd.com/programs/cme/case-application-unlocking-relapsedrefractory-myeloma-with-celmods/36574/ Despite recent therapeutic advances, most patients with multiple myeloma continue to face the challenge of an incurable disease and undergo cycles of remission and relapse, with the eventual development of resistance to existing therapies. This highlights the persistent need for more effective and durable treatment strategies. CELMoDs are a class of drugs that enhance T cell potency, promote combinational synergy with other antimyeloma agents, and rejuvenate exhausted T cells to improve antimyeloma effects even in T cell-exhausted settings. Dive into this series of activities to discover the potential role of these novel agents across lines of therapy and how they contribute to improved adherence and survival outcomes.

CME credits: 1.00 Valid until: 21-08-2026 Claim your CME credit at https://reachmd.com/programs/cme/case-application-unlocking-relapsedrefractory-myeloma-with-celmods/36574/ Despite recent therapeutic advances, most patients with multiple myeloma continue to face the challenge of an incurable disease and undergo cycles of remission and relapse, with the eventual development of resistance to existing therapies. This highlights the persistent need for more effective and durable treatment strategies. CELMoDs are a class of drugs that enhance T cell potency, promote combinational synergy with other antimyeloma agents, and rejuvenate exhausted T cells to improve antimyeloma effects even in T cell-exhausted settings. Dive into this series of activities to discover the potential role of these novel agents across lines of therapy and how they contribute to improved adherence and survival outcomes.

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. 

Featuring perspectives from Dr Natalie S Callander and Dr Sagar Lonial, including the following topics:  Introduction: Multiple Myeloma — 2005 to 2025 (0:00) Questions from the Beginning (7:53) Choosing Options (13:54) Clinical Trials (18:03) Neuropathy (23:55) Chimeric Antigen Receptor (CAR) T-Cell Therapy (28:40) Bispecific Antibodies (35:18) Antibody-Drug Conjugates (43:08) Interacting with the Oncology Team (51:47) Other Questions (57:30) Educational and presenter information

For this patient-focused webinar, medical oncologist Dr Neil Love is joined by Dr Natalie S Callander from the University of Wisconsin Carbone Cancer Center in Madison and Dr Sagar Lonial from the Winship Cancer Institute of Emory University in Atlanta, Georgia, to discuss the patient experience associated with the diagnosis and treatment of relapsed/refractory multiple myeloma. Educational and faculty information here.

They were doing so well... so why did they relapse? In this episode, we pull back the curtain on one of the most painful and confusing moments in addiction recovery—relapse. It's not about weakness. It's not about willpower. And it's definitely not because they "don't want it bad enough." We break down the five real reasons why people relapse, even when everything on the outside seems to be going right. If you've been blindsided by a setback—or you're terrified one is coming—this episode will give you clarity, hope, and a practical path forward. Whether you're the one in recovery or the one standing beside them, this conversation will shift the way you see relapse—and what you do next. This Episode also available on YouTube: https://youtu.be/JBHa-8bGCrI More Living Proof: https://yourlivingproof.com Free MasterClass: https://yourlivingproof.com/podcast Follow Us On Instagram : https://www.instagram.com/yourlivingproof/

In this episode of the Oncology Brothers podcast, Drs. Rahul and Rohit Gosain dive into the complexities of relapsed refractory Acute Myeloid Leukemia (AML) with FLT3 mutations. Joined by leukemia specialists Dr. Uma Borate from the Ohio State University and Dr. Naval Daver from the MD Anderson Cancer Center, the discussion focused on real-life cases and the current standard of care for patients with FLT3-positive AML. Key topics included: •⁠  ⁠The importance of retesting for FLT3 mutations at the time of relapse •⁠  ⁠Treatment paradigms for fit vs. unfit patients •⁠  ⁠The role of Gilteritinib and combination therapies in relapsed settings •⁠  ⁠Management of side effects, including cytopenias and differentiation syndrome •⁠  ⁠Insights into the use of hypomethylating agents and the potential of oral therapies Whether you're a healthcare professional or someone interested in the latest advancements in cancer care, this episode provides valuable insights into the management of challenging AML cases. Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to subscribe for more discussions on the latest in oncology!

In this episode, we discuss the management of follicular lymphoma with Dr. Gilles Salles from Memorial Sloan Kettering Cancer Center. Here are the articles we discussed: 1. Relevance of Bone Marrow Biopsy in Follicular Lymphoma: https://pubmed.ncbi.nlm.nih.gov/35787017/2. TROG 99.03 (RCT of Systemic Therapy after Involved-Field Radiotherapy in Patients with Early-Stage Follicular Lymphoma): https://pubmed.ncbi.nlm.nih.gov/29975623/3. Long-term follow-up results of RCT comparing early rituximab monotherapy versus watchful waiting for advanced stage, asymptomatic, low tumor burden follicular lymphoma: https://pubmed.ncbi.nlm.nih.gov/40306831/4. RELEVANCE RCT: Lenalidomide plus Rituximab (R2) Versus Rituximab-Chemotherapy Followed by Rituximab Maintenance in Untreated Advanced Follicular Lymphoma: https://ascopubs.org/doi/10.1200/JCO.22.008435. GALLIUM RCT: Obinutuzumab Versus Rituximab Immunochemotherapy in Previously Untreated iNHL. https://pubmed.ncbi.nlm.nih.gov/37404773/https://pubmed.ncbi.nlm.nih.gov/28976863/6. Long-term follow-up of mosunetuzumab in relapsed/refractory FL: https://pubmed.ncbi.nlm.nih.gov/39447094/7. Epcoritamab in relapsed/refractory FL: https://pubmed.ncbi.nlm.nih.gov/38889737/8. Phase 3 inMIND RCT: Tafasitamab plus Lenalidomide and Rituximab for Relapsed or Refractory Follicular Lymphoma: https://ashpublications.org/blood/article/144/Supplement%202/LBA-1/5343199. Long term follow-up results from the Phase 3 PRIMA trial of rituximab maintenance in Follicular Lymphoma: https://ascopubs.org/doi/10.1200/JCO.19.01073

Send us a textMelissa Gissy is a mother of four, a survivor of human trafficking, addiction, and trauma, and a woman in long-term recovery. After a string of DUIs, a Xanax dependency, and postpartum depression, Melissa relapsed the day after treatment—and drove home to end her life. In the basement, she saw a figure. Heard a voice. And everything changed. Today, she's a published author and advocate for recovery without shame, using her voice to remind others: you have a purpose.=============Key Learning Points

Welcome to this episode of The Oncology Brothers! Drs. Rahul and Rohit Gosain dived into the complexities of relapsed refractory diffuse large B-cell lymphoma (DLBCL) with their new series focused on challenging real-life cases. In this episode, we are joined by esteemed guests Dr. Carla Casulo from Wilmot Cancer Center and Dr. Tara Graff from Mission Cancer and Blood Center. Together, we explored the current standard of care, including R-CHOP and the role of bi-specific antibodies like epcoritamab and glofitimab. Key topics covered included: • When to use bi-specific antibodies and how to manage side effects • The importance of MRD monitoring in treatment decisions • Insights on patient management in community oncology settings • The evolving landscape of treatment options for DLBCL, including CAR-T therapy and clinical trials We also discuss practical considerations for community oncologists, including the management of cytokine release syndrome (CRS) and the role of immunoglobulin therapy in patients with low IgG levels. Whether you're a healthcare professional or someone interested in the latest advancements in oncology, this episode is packed with valuable insights and expert opinions. YouTube: https://youtu.be/05ieIyAIx_8 Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to like, subscribe, and share your thoughts in the comments! Let us know if there are specific scenarios you'd like us to cover in future episodes.

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/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/FVK865. CME/MOC/AAPA/IPCE credit will be available until June 30, 2026.4x4 in Multiple Myeloma: Maintaining Momentum for Delivering Innovative Care in Newly Diagnosed and Relapsed Disease In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and HealthTree Foundation for Multiple Myeloma. 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 independent medical education grants from Bristol Myers Squibb, GSK, Johnson & Johnson, and Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/FVK865. CME/MOC/AAPA/IPCE credit will be available until June 30, 2026.4x4 in Multiple Myeloma: Maintaining Momentum for Delivering Innovative Care in Newly Diagnosed and Relapsed Disease In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and HealthTree Foundation for Multiple Myeloma. 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 independent medical education grants from Bristol Myers Squibb, GSK, Johnson & Johnson, and Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

it is what it is....Conviértete en un seguidor de este podcast: https://www.spreaker.com/podcast/el-show-de-julio-y-el-marciano--3287774/support.

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/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/FVK865. CME/MOC/AAPA/IPCE credit will be available until June 30, 2026.4x4 in Multiple Myeloma: Maintaining Momentum for Delivering Innovative Care in Newly Diagnosed and Relapsed Disease In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and HealthTree Foundation for Multiple Myeloma. 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 independent medical education grants from Bristol Myers Squibb, GSK, Johnson & Johnson, and Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/FVK865. CME/MOC/AAPA/IPCE credit will be available until June 30, 2026.4x4 in Multiple Myeloma: Maintaining Momentum for Delivering Innovative Care in Newly Diagnosed and Relapsed Disease In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and HealthTree Foundation for Multiple Myeloma. 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 independent medical education grants from Bristol Myers Squibb, GSK, Johnson & Johnson, and Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/FVK865. CME/MOC/AAPA/IPCE credit will be available until June 30, 2026.4x4 in Multiple Myeloma: Maintaining Momentum for Delivering Innovative Care in Newly Diagnosed and Relapsed Disease In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and HealthTree Foundation for Multiple Myeloma. 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 independent medical education grants from Bristol Myers Squibb, GSK, Johnson & Johnson, and Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/FVK865. CME/MOC/AAPA/IPCE credit will be available until June 30, 2026.4x4 in Multiple Myeloma: Maintaining Momentum for Delivering Innovative Care in Newly Diagnosed and Relapsed Disease In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and HealthTree Foundation for Multiple Myeloma. 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 independent medical education grants from Bristol Myers Squibb, GSK, Johnson & Johnson, and Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

Kelly Faulk, MD, a pediatric oncologist at Children's Hospital Colorado Center for Cancer and Blood Disorders, joins us on OsteoBites to review the open phase 1/1b clinical trial evaluating the combination of losartan and sunitinib in the treatment of pediatric and adult patients with relapsed or refractory osteosarcoma (NCT03900793), including preclinical rationale from canine clinical trials and the trial's design, eligibility, and status.Dr. Kelly Faulk is a pediatric oncologist at Children's Hospital Colorado Center for Cancer and Blood Disorders, where her clinical and research focus is the development of early-phase clinical trials to investigate promising new agents for high-risk pediatric cancers. She is on the Experimental Therapeutics Program (ETP) team and serves as the leader of the High-Risk Leukemia/Lymphoma Program. She has developed and leads several early-phase clinical trials and serves as site principal investigator for numerous others. She completed her medical training at the University of Colorado School of Medicine, did her pediatric residency and pediatric hematology/oncology/bone marrow transplant fellowship at Children's Hospital Colorado, and also completed an additional fellowship in Experimental Therapeutics at Children's Hospital Colorado. She met her wonderful husband Wade in medical school, and they have 3 great kids who keep them busy.

In this JCO Article Insights episode, host Michael Hughes summarizes "Co-Occurrence of Cytogenetic Abnormalities and High-Risk Disease in Newly Diagnosed and Relapsed/Refractory Multiple Myeloma" by Kaiser et al, published February 18, 2025, followed by an interview with JCO Associate Editor Suzanne Lentzsch. Transcript Michael Hughes: Welcome to this episode of JCO Article Insights. This is Michael Hughes, JCO's editorial fellow. Today I have the privilege and pleasure of interviewing Dr. Suzanne Lentzsch on the “Co-Occurrence of Cytogenetic Abnormalities and High-Risk Disease in Newly Diagnosed and Relapsed/Refractory Multiple Myeloma” by Dr. Kaiser and colleagues. At the time of this recording, our guest has disclosures that will be linked in the transcript. The urge to identify patients with aggressive disease, which is the first step in any effort to provide personalized medical care, is intuitive to physicians today. Multiple myeloma patients have experienced heterogeneous outcomes since we first started characterizing the disease. Some patients live for decades after treatment. Some, irrespective of treatment administered, exhibit rapidly relapsing disease. We term this ‘high-risk myeloma'. The Durie-Salmon Risk Stratification System, introduced in 1975, was the first formal effort to identify those patients with aggressive, high-risk myeloma. However, the introduction of novel approaches in therapeutic agents—autologous stem cell transplantation with melphalan conditioning, proteasome inhibitors like bortezomib, or immunomodulatory drugs like lenalidomide—rendered the Durie-Salmon system a less precise predictor of outcomes. The International Staging System in 2005, predicated upon the burden of disease as measured by beta-2 microglobulin and serum albumin, was the second attempt at identifying high-risk myeloma. It was eventually supplanted by the Revised International Staging System (RISS) in 2015, which incorporated novel clinical and cytogenetic markers and remains the primary way physicians think about the risk of progression or relapse in multiple myeloma. Much attention has been focused on the canonically high-risk cytogenetic abnormalities in myeloma, typically identified by fluorescence in situ hybridization: translocation t(4;14), translocation t(14;16), translocation t(14;20), and deletion of 17p. Much attention also has been focused on the fact that intermediate-risk disease, as defined by the RISS, has been shown to be a heterogeneous subgroup in terms of survival outcomes. The RISS underwent revision in 2022 to account for such heterogeneity and has become the R2-ISS, published here in the Journal of Clinical Oncology first in 2022. Translocations t(14;16) and t(14;20) were removed, and gain or amplification of 1q was added. Such revisions to core parts of a modern risk-stratification system reflect the fact that myeloma right now is in flux, both in treatment paradigms and risk-stratification systems. The field in recent years has undergone numerous remarkable changes, from the advent of anti-CD38 agents to the introduction of cellular and bispecific therapies, to the very technology we use to investigate genetic lesions. The major issue is that we're seeing numerous trials using different criteria for the definition of high-risk multiple myeloma. This is a burgeoning problem and speaks very much now to a critical need for an effort to consolidate all these criteria on at least cytogenetic lesions as we move into an era of response-adapted treatment strategies. The excellent article by Kaiser and colleagues, published in the February 2024 edition of the JCO, does just that in a far-ranging meta-analysis of data from 24 prospective therapeutic trials. All 24 trials were phase II or III randomized controlled trials for newly diagnosed and relapsed/refractory multiple myeloma. The paper takes a federated analysis approach: participants provided summaries and performed prespecified uniform analyses. The high-risk cytogenetic abnormalities examined were translocation t(4;14), gain or amplification of 1q, deletion of 17p, and translocation t(14;16), if included in the original trials. All of these were collected into zero, single, or double-hit categories, not unlike the system currently present in diffuse large B-cell lymphomas. The outcomes studied were progression-free survival and overall survival, with these analyses adhering to modified ITT principles. The authors also performed prespecified subgroup analyses in the following: transplant-eligible newly diagnosed myeloma, transplant non-ineligible newly diagnosed myeloma, and relapsed/refractory myeloma. They, in addition, described heterogeneity by the I2 statistic, which, if above 50%, denotes substantial heterogeneity by the Cochrane Review Handbook, and otherwise performed sensitivity analyses and assessed bias to confirm the robustness of their results. In terms of those results, looking at the data collected, there was an appropriate spread of anti-CD38-containing and non-containing trials. 7,724 patients were evaluable of a total 13,926 enrolled in those 24 trials: 4,106 from nine trials in transplant-eligible myeloma, 1,816 from seven trials in transplant non-ineligible myeloma, and 1,802 from eight trials in relapsed/refractory disease. ISS stage for all patients was relatively evenly spread: stage I, 34.5%; stage II, 37%; stage III, 24%. In terms of high-risk cytogenetic lesions, double-hit disease was present in 13.8% of patients, and single-hit disease was present in 37.4%. In terms of outcomes, Kaiser and colleagues found a consistent separation in survival outcomes when the cohort was stratified by the number of high-risk cytogenetic lesions present. For PFS, the hazard ratio was for double-hit 2.28, for single-hit 1.51, without significant heterogeneity. For overall survival, the hazard ratio was for double-hit disease 2.94, single-hit disease 1.69, without significant heterogeneity except in patients with double-hit disease at 56.5%. By clinical subgroups, hazard ratios remained pretty consistent with the overall cohort analysis. In transplant-eligible newly diagnosed myeloma, the hazard ratio for progression is 2.53, overall survival 4.17. For transplant non-ineligible, 1.97 progression, 2.31 mortality. Relapsed/refractory disease progression 2.05, overall mortality 2.21, without significant heterogeneity. Of trials which started recruitment since 2015, that is to say, since daratumumab was FDA approved and thus since an anti-CD38 agent was incorporated into these regimens, analysis revealed the same results, with double-hit myeloma still experiencing worse survival by far of the three categories analyzed. Risk of bias overall was low by advanced statistical analysis. In terms of subgroup analysis, double-hit results for transplant-eligible newly diagnosed myeloma may have been skewed by smaller study effects, where the upper bound of the estimated hazard ratio for mortality reached into the 15 to 20 range. In conclusion, from a massive amount of data comes a very elegant way to think about the role certain cytogenetic abnormalities play in multiple myeloma. A simple number of lesions - zero, one, or at least two - can risk-stratify. This is a powerful new prognostic biomarker candidate and, somewhat soberingly, also may confirm, or at least suggests, that anti-CD38 agents are unable to overcome the deleterious impact of certain biologic characteristics of myeloma. Where do we go from here? This certainly needs further a priori prospective validation. This did not include cellular therapies. The very scale at which this risk-stratification system operates, agnostic to specific genetic lesion, let alone point mutations, lends itself also to further exploration. And to discuss this piece further, we welcome the one and only Dr. Suzanne Lentzsch to the episode. Dr. Lentzsch serves as an associate editor for JCO and is a world-renowned leader at the bleeding edge of plasma cell dyscrasia research. Dr. Lentzsch, there are several new investigations which suggest that translocation t(4;14), for example, is itself a heterogeneous collection of patients. There are other studies which suggest that point mutations in oncogenes like TP53, which were not assessed in Kaiser et al., carry substantial detrimental impact. Is this classification system - no-hit, single-hit, double-hit - too broad a look at tumor genetics? And how do you think we will end up incorporating ever more detailed investigations into the genetics of multiple myeloma moving forward? Dr. Suzanne Lentzsch: Michael, first of all, excellent presentation of that very important trial. Great summary. And of course, it's a pleasure to be here with JCO and with you to discuss that manuscript. Let me go back a little bit to high-risk multiple myeloma. I think over the last years, we had a lot of information on what is high-risk multiple myeloma, and I just want to mention a couple of things, that we separate not only cytogenetically high-risk multiple myeloma, we also have functional high-risk multiple myeloma, with an early relapse after transplant, within 12 months, or two years after start of treatment for the non transplant patients, which is difficult to assess because you cannot decide whether this is a high-risk patient before you start treatment. You only know that in retrospective. Other forms of high-risk: extramedullary disease, circulating tumor cells/plasma cell dyscrasia, patients who never achieve MRD positivity, extramedullary multiple myeloma, or even age and frailty is a high risk for our patients. Then we have gene expression and gene sequencing. So there is so much information currently to really assess what is high-risk multiple myeloma, that is very difficult to find common ground and establish something for future clinical trials. So what Dr. Kaiser did was really to develop a very elegant system with information we should all have. He used four factors: translocation t(14;16), t(4;14), gain or amplification of 1q, and deletion of 17p. Of course, this is not the entire, I would say, information we have on high risk, but I think it's a good standard. It's a very elegant system to really classify a standard single-hit, double-hit, high-risk multiple myeloma, which can be used for all physicians who treat multiple myeloma, and especially, it might also work in resource-scarce settings. So, ultimately, I think that system is an easy-to-use baseline for our patients and provides the best information we can get, especially with a baseline, in order to compare clinical trials or to compare any data in the future. Michael Hughes: Thank you, Dr. Lentzsch. To the point that you made about this isn't the full story. There does, as you said, exist this persistent group of functional high-risk multiple myeloma where we see standard-risk cytogenetics, but these patients ultimately either exhibit primary refractory disease or very early relapse despite aggressive, standard aggressive treatment. How do you see risk-stratification systems incorporating other novel biomarkers for such patients? Is it truly all genetic? Or is next-generation sequencing, gene expression profiling, is that the answer? Or is there still a role for characterizing tumor burden? Dr. Suzanne Lentzsch: Excellent question, Michael, and I wish I would have the glass ball to answer that question. I see some problems with the current approach we have. First of all, to do the cytogenetics, you need good material. You only detect and identify what you have. If the bone marrow is of low quality, you have mainly peripheral blood in your bone marrow biopsy, you might not really fully have a representation of all cytogenetic changes in your bone marrow. So I think with a low-quality sample, that you might miss one or the other really cytogenetic high risk. So, having said this, I think circulating tumor cells, that might be something we will look into in the future, because circulating tumor cells are readily available, can be assessed without doing a bone marrow biopsy. And what is even more exciting, in addition to the circulating tumor cells or plasma cells, using them is next-generation sequencing. I think at the moment, we are more in a collection phase where we really try to correlate sequencing with our cytogenetics and especially to establish next-generation sequencing in all of our patients. But I think after that collection phase, maybe in the future, collecting peripheral blood and doing sequencing on peripheral blood samples might be the way to go. In addition, I don't want to forget the imaging. We started with a skeletal survey, and we know that you probably need to lose 30% of the bone before you see a lesion at all. So having imaging, such as diffusion-weighted imaging, whole-body MRI, is also, together with sequencing of the tumor cells, a step into the right direction. Michael Hughes: Thank you, Dr. Lentzsch. Bringing this back to the article at hand, how has Kaiser et al. changed the way we discuss myeloma with patients in the exam room? Dr. Suzanne Lentzsch: I think we have more data on hand. So far, we talked about standard risk and high risk, but I think right now, with a very simple system, we can go into the room and we can tell the patient, "Listen, you don't have any of those cytogenetic abnormalities. I think you have a standard risk. We might give you a simple maintenance treatment with Revlimid." But we might also go into the room and say, "I'm really concerned. You have so-called double-hit multiple myeloma. You have high-risk and at least two of those abnormal cytogenetics which we discussed, and I think you need a more intense maintenance treatment, for instance, double maintenance." I think we know that a high-risk multiple myeloma can be brought into a remission, but the problem that we have is to keep those patients into a remission. So, I think a more intense treatment, for instance, with a double maintenance, or with consolidation after transplant, and a longer and more intense treatment is justified in patients who have that truly high-risk multiple myeloma described here. Michael Hughes: Dr. Lentzsch, thank you so much for your time and your wisdom. Dr. Suzanne Lentzsch: My pleasure. Thank you for having me. Michael Hughes: Listeners, thank you for listening to JCO Article Insights. Please come back for more interviews and article summaries, and be sure to leave us a rating and review so others can find our show. For more podcasts and episodes from ASCO, please visit 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.

Featuring a slide presentation from Dr Matthew Matasar and related discussion from Dr Carla Casulo, Dr Matasar and Dr Laurie H Sehn, including the following topics: EZH2 Inhibitors for Follicular Lymphoma (FL) (0:00) Bruton Tyrosine Kinase Inhibitors for FL (5:43) Anti-CD19 Antibodies for FL (9:40) Other Novel Agents Under Clinical Development for FL (18:50) Case: A woman in her early 80s with multiple comorbidities and relapsed FL (23:06) Case: A man in his early 40s with high-risk progressive FL that did not achieve deep remission with prior therapy (27:07) Case: A woman in her early 70s with rheumatoid arthritis and relapsed FL (33:46) CME information and select publications

Dr Carla Casulo from Wilmot Cancer Institute in Rochester, New York, Dr Matthew Matasar from Rutgers Cancer Institute of New Jersey in New Brunswick and Dr Laurie H Sehn from BC Cancer Centre for Lymphoid Cancer in Vancouver discuss recent updates on available and novel treatment strategies for relapsed/refractory follicular lymphoma. CME information and select publications here.

Family Reconnect Waitlist: https://www.realrecoverytalk.com/frc In this episode, we sit down with Brian, who shares his powerful journey through nearly four years of sobriety. Brian opens up about the brutal depths his addiction took him, and what it finally took for him to get clean. But his story takes a turn — even after spending a full year in treatment, he relapsed almost immediately upon leaving. Why? That's what we dig into. Brian reflects on his lack of willingness during that time and the truth he wasn't ready to face. Joining us is Nicole, who was Brian's therapist during his original treatment stay back in 2017. She offers insight into what might have been missing, the patterns she saw, and why sometimes relapse is part of the journey — not the end of it. This is a real, honest look at what recovery really takes, and why simply being in treatment isn't enough if you're not willing to do the inner work. Treatment Prep Guide: https://www.realrecoverytalk.com/treatmentprep SoberLink: https://www.soberlink.com/partners-family-and-friends/rrt Join our Big Book Study! https://www.realrecoverytalk.com/bigbookstudy Join our FREE FB Support group!: https://www.facebook.com/groups/realrecoverytalk Download our free guides!: https://www.realrecoverytalk.com/guides Tom IG: https://www.instagram.com/realrecoverytalktom/ Ben IG: https://www.instagram.com/realrecoverytalkben/ RRT IG: https://www.instagram.com/realrecoverytalkpodcast/

Featuring a slide presentation from Dr Matthew Matasar and related discussion from Dr Carla Casulo, Dr Matasar and Dr Laurie H Sehn, including the following topics: Overview of Chimeric Antigen Receptor (CAR) T-Cell Therapies for Relapsed/Refractory Follicular Lymphoma (FL) (0:00) Case: A man in his late 60s with relapsed FL who received axicabtagene ciloleucel (axi-cel) but experienced cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome and chronic cytopenia (3:50) Published Clinical Data Involving Axi-cel (10:24) Case: A man in his mid 60s with multiple comorbidities and progressive FL who received tisagenlecleucel (tis-cel) (15:34) Published Clinical Data Involving Tis-cel (19:47) Case: A woman in her late 40s with multiple comorbidities and refractory FL who received lisocabtagene maraleucel (liso-cel) after prior mosunetuzumab (22:43) Published Clinical Data Involving Liso-cel (26:05) Incidence and Management of Toxicities Associated with CAR T-Cell Therapy (27:48) Sequencing Considerations and Ongoing Trials Involving CAR T-Cell Therapy (30:35) Practical Considerations and Referrals for CAR T-Cell Therapy Administration (31:59) CME information and select publications

Dr Carla Casulo from Wilmot Cancer Institute in Rochester, New York, Dr Matthew Matasar from Rutgers Cancer Institute of New Jersey in New Brunswick and Dr Laurie H Sehn from BC Cancer Centre for Lymphoid Cancer in Vancouver discuss recent updates on available and novel treatment strategies for relapsed/refractory follicular lymphoma. CME information and select publications here.

Featuring a slide presentation from Dr Matthew Matasar and related discussion from Dr Carla Casulo, Dr Matasar and Dr Laurie H Sehn, including the following topics: Overview of Bispecific Antibodies for the Treatment of Relapsed/Refractory (R/R) Follicular Lymphoma (FL) (0:00) Clinical Data Available with Mosunetuzumab for R/R FL (1:54) Clinical Data Available with Epcoritamab for R/R FL (4:54) Clinical Data Available with Odronextamab for R/R FL (6:53) Clinical Considerations in Selecting Among Available Bispecific Antibodies for R/R FL (8:34) Practical Considerations in the Administration of Bispecific Antibodies (15:21) The Role of Vaccinations in the Prevention of Infections for Patients Receiving Bispecific Antibodies (18:34) Ongoing Clinical Trials Evaluating Bispecific Antibodies for FL (21:34) Case: A man in his late 60s with refractory FL who received mosunetuzumab monotherapy (24:24) Case: A woman in her late 50s with relapsed FL who received third-line epcoritamab monotherapy (30:14) Case: A man in his late 80s with a long-standing history of FL who received odronextamab in combination with a second novel bispecific antibody (33:48) CME information and select publications

Dr Carla Casulo from Wilmot Cancer Institute in Rochester, New York, Dr Matthew Matasar from Rutgers Cancer Institute of New Jersey in New Brunswick and Dr Laurie H Sehn from BC Cancer Centre for Lymphoid Cancer in Vancouver discuss recent updates on available and novel treatment strategies for relapsed/refractory follicular lymphoma. CME information and select publications here.

In this week's episode we'll learn about the role of autologous transplant for relapsed myeloma. In an updated analysis of the GMMG ReLApsE trial, salvage autologous transplant offered no survival benefit compared to control chemotherapy. These findings may have clinical implications in an era of alternative, and highly effective, treatment options. After that: Response to DDAVP, or desmopressin, in bleeding disorders. This study is the first large scale meta-analysis to assess the response rate to DDAVP in bleeding disorders. Authors provide new insights into determinants of response, which vary according to the disease type. Finally, turning to diffuse large B cell lymphoma. Germinal center B cells depend on the activity of DOT1 and EZH2 to maintain their pro-proliferative identity. New research shows that combined treatment with DOT1L and EZH2 inhibitors has synergistic activity in vitro.Featured Articles:Salvage autologous transplant in relapsed multiple myeloma: long-term follow-up of the phase 3 GMMG ReLApsE trialDDAVP response and its determinants in bleeding disorders: a systematic review and meta-analysisTargeting DOT1L and EZH2 synergizes in breaking the germinal center identity of diffuse large B-cell lymphoma

In this week's episode we'll learn about the role of interleukin-1 signaling in the bone marrow microenvironment in the development of myelodysplastic syndromes, the immune checkpoint regulator VISTA as a potential target for preventing graft-vs-host disease, and epcoritamab plus gemcitabine and oxaliplatin in transplant-ineligible relapsed/refractory diffuse large B-cell lymphoma.Featured Articles:IL-1R1 and IL-18 signals regulate mesenchymal stromal cells in an aged murine model of myelodysplastic syndromesTargeting cell-surface VISTA expression on allospecific naïve T cells promotes toleranceEpcoritamab plus GemOx in transplant-ineligible relapsed/refractory DLBCL: results from the EPCORE NHL-2 trial

If you've relapsed recently or had a drink after a solid streak of sobriety, I want you to take a deep breath and hear this: ✨ You are not broken.✨ You have not failed.✨ And you are absolutely not alone. Whether it's a one-time slip or a full-on spiral, relapse doesn't mean you've failed. It's feedback. And it's fixable. If you're feeling stuck in guilt, shame, or that voice in your head telling you, “You blew it,” this episode is your safe space to breathe, regroup, and move forward.

I Relapsed for a Woman: Lust, Cocaine, and the Lie of ControlA raw confession: what led to the slip, what it revealed about ego, love, and addiction — and how you claw your way back with style and power.→ The allure of chaos. The myth of control. The addict's ego dressed in desire.If you're done with fluff and ready to hear something real — you're in the right place.

Prof Martin Hutchings from Copenhagen University Hospital in Denmark, Dr Manali Kamdar from the University of Colorado Cancer Center, Dr Matthew Lunning from the University of Nebraska Medical Center and Prof Gilles Salles from Memorial Sloan Kettering Cancer Center in New York summarize currently available data guiding treatment decision-making for patients with relapsed/refractory diffuse large B-cell lymphoma and present cases from their practices.CME information and select publications here.

Featuring slide presentations and related discussion from Prof Martin Hutchings, Dr Manali Kamdar, Dr Matthew Lunning and Prof Gilles Salles, including the following topics: Evolving Role of Chimeric Antigen Receptor (CAR) T-Cell Therapy in Diffuse Large B-Cell Lymphoma (DLBCL) — Dr Kamdar (0:00) Case: A 61-year-old man with Stage IV non-GCB DLBCL receives R-CHOP but experiences disease progression 8 months later (30:39) Case: A 68-year-old man with double-hit DLBCL who experiences disease progression on chemotherapy and second-line CAR T-cell therapy receives glofitamab (39:22) Incorporation of Bispecific Antibody Therapy into DLBCL Management — Prof Hutchings (45:25) Case: A 42-year-old man with progressive DLBCL refractory to 2 lines of therapy receives glofitamab with a durable response (1:07:30) Case: An 81-year-old woman with multiregimen-refractory DLBCL experiences a prolonged response to epcoritamab (1:14:25) Case: A 69-year-old man with follicular lymphoma transformed to DLBCL and refractory to 3 lines of treatment receives glofitamab (1:21:48) Selection and Sequencing of Other Available Therapies for Relapsed/Refractory (R/R) DLBCL — Prof Salles (1:24:37) Case: An 82-year-old woman with follicular lymphoma transformed to DLBCL receives tafasitamab/lenalidomide (1:42:05) Case: A 69-year-old man with urinary bladder carcinoma and recurrent GCB DLBCL receives loncastuximab tesirine (1:46:26) Promising Investigational Approaches for Patients with R/R DLBCL — Dr Lunning (2:00:37) Case: An 80-year-old woman with multiregimen-refractory GCB DLBCL seeks treatment requiring minimal clinic visits and receives loncastuximab tesirine (2:15:59) Case: A 54-year-old man with primary refractory non-GCB DLBCL receives CAR T-cell therapy, and follow-up imaging on day 29 demonstrates a Deauville score of 4 (2:25:22) CME information and select publications

Prof Martin Hutchings from Copenhagen University Hospital in Denmark, Dr Manali Kamdar from the University of Colorado Cancer Center, Dr Matthew Lunning from the University of Nebraska Medical Center and Prof Gilles Salles from Memorial Sloan Kettering Cancer Center in New York summarize currently available data guiding treatment decision-making for patients with relapsed/refractory diffuse large B-cell lymphoma and present cases from their practices.CME information and select publications here.

This week, we talk all about disseminated testicular cancer, highlighting our current treatment modalities and why we do what we do. We also cover refractory disease. This episode builds on our prior discussions in Parts 1 and 2, so be sure to check these out if you haven't already!Episode contents:- A history lesson about how we developed our current risk stratification model - Our current treatment paradigms and regimens for disseminated seminoma and non-seminoma - To resect or not to resect? - How we approach relapsed/refractory disease ****Get paid to participate in market research surveys: https://affiliatepanel.members-only.online/FOC_24?utm_campaign=FOC&utm_source=email&utm_medium=email** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

Why Most Addiction Treatments Fail (And How to Fix It!) Many people enter treatment believing that the methods alone will save them, but the truth is the most important factor is often overlooked. In this episode, we dive deep into why most addiction treatments fall short—hint it's not because they lack effectiveness. We'll uncover the key ingredient that makes all the difference: motivation. Learn how shifting the focus to motivation first can create a foundation for lasting recovery and meaningful skill development. Tune in now for game-changing insights that could transform your understanding of addiction treatment and help you better support yourself or a loved one on the recovery journey. Don't miss this chance to shift your perspective on what truly drives successful change!

This week, we round out our AML series with a detailed discussion about the approach to management of relapsed and refractory disease. This has been a VERY long road going through all management of AML. We hope that you have continued to build on our discussions week-to-week. An exciting treatment paradigm that is ever-evolving! Episode contents: - How do we define primary induction failure in AML? - What are options for treatment of refractory disease? What is the mechanism of action of these treatment options? - What are options for relapsed disease? - What targeted therapies are available for relapsed AML? ****This episode is sponsored by our global research partners! Get paid to participate in market research surveys: https://affiliatepanel.members-only.online/FOC_24?utm_campaign=FOC&utm_source=email&utm_medium=email** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast