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In this episode of Skincare Confidential, Dr. Patti Farris and Dr. Ellen Gendler discuss the resurgence of topical estrogen in skincare. In this engaging conversation, Ellen Gendler shares her years of experience and knowledge surrounding the use of topical estrogen creams. They explore the complexities of intrinsic aging, the clinical signs of estrogen deficient skin and the role of topical estrogen for preventing skin aging. They also discuss some of the concerns surrounding the use of topical estrogen and the potential role for selective estrogen receptor modulators or SERMs. Takeaways Topical estrogens have gained popularity for their potential skin benefits.Estrogen deficiency leads to various skin issues as we age.Topical estrogen can be beneficial when used correctly and in moderation.Concerns about systemic absorption of topical estrogens are prevalent.Case reports should be interpreted cautiously in the context of topical estrogen use.Different types of estrogens have varying effects on the skin.Studies show that topical estrogens can improve skin thickness and elasticity.Topical estrogens are not a substitute for other effective skincare treatments. Topical estrogen is more about prevention than reversal.Visible changes in skin care treatments are often immediate, unlike estrogen.The effectiveness of topical estrogen varies between sun-protected and photodamaged skin.Retinoids remain the gold standard in skin care for aging.Melasma exacerbation is a concern with topical estrogen, but evidence is limited.SERM compounds show promise but require more research.Combination approaches in skin care yield better results than relying on a single product.Online health products are proliferating, but caution is necessary.The importance of vetting sources for topical treatments cannot be overstated.Clinical judgment is essential in evaluating the effectiveness of skin care treatments. Disclaimer: This podcast is not intended to provide diagnosis, treatment, or medical advice. Content provided in this podcast is for educational purposes only. Please consult with a physician regarding any health-related diagnosis or treatment.See omnystudio.com/listener for privacy information.
High test or low test, which is best? Luke and John explore examples and case studies that include various factors that could affect either side of the decision for high or low test. Thanks for watching! Want to learn how we create world-class athletes or become one yourself? Check out the links below at J3U. J3U Coaching https://j3university.com/j3u-coaching/ J3 University https://j3university.com Applied Hypertrophy Optimization https://j3university.com/funnel/aho/applied-hypertrophy/ The Female Module https://j3university.com/funnel/female-module/female-module/ Timestamps: Intro 00:00 Cycle Design 06:25 Managing Estradiol 12:10 AI & SERMS 16:03 Managing Water 22:15
Timestamps1:29 - What is estrogen & its various forms?3:15 - Why does estrogen matter & what does it do?4:45 - Common signs of low estrogen5:49 - When would it make sense to use aromatize inhibitors to manage estrogen? Common doses used to manage estrogen & how SERMS differ from aromitaze inhibitors and how they work 12:04 - Estrogen peak lag time behind testosterone, how estrogen levels are affected by body fat levels, signs of high estrogen and when to use SERMS and aromatize inhibitors to manage estrogen 16:25 - Should you treat the values on lab work or the individual symptoms of estrogen being high or low for the athlete? The value of finding the athlete's highest tolerable dose of estrogen for maximizing progress & can that change over time?23:23 - Managing estrogen with masteron and primobolan, how they affect estrogen, when would you choose masteron or primo as a secondary anabolic?32:29 - Strategies to increase estrogen ASAP if you're feeling low estrogen symptoms & benefits of higher estrogen to enhanced athletes39:01 - Could enhanced athletes benefit from higher doses of Creatine due to up regulation of Creatine synthase?Team Evil GSP - https://teamevilgsp.com/Hire Mircea - https://teamevilgsp.com/team/mircea-balaj/Membersite - https://members.teamevilgsp.com/Mircea's Instagram - https://www.instagram.com/mirceabjr/Apply For Coaching - https://bit.ly/3QpfduxGet My FREE Programs - https://bit.ly/4fF4wPcMy Instagram - https://bit.ly/3Uy2zfbMacroFactor Diet Tracking App (Use code PEELER for a 2-Week FREE Trial!) - https://bit.ly/49Vz2ADLeviathan Nutrition (Code: ADAM10) - https://leviathan-nutrition.com/Built Bar (code PEELER for 10% off) - https://builtbar.com/
Breast Cancer is complex, as are the treatment options that clinicians and patients must traverse. Stage III breast cancer has up to a 57% chance of recurring up to 20 years after diagnosis. Josh and Michael look at one of the practice-changing papers that tried to address how to manage high-risk patients. This study is called Soft and Text. It asked if adding ovarian suppression to aromatase inhibitors was better than ovarian suppression with selective estrogen receptor modulators (SERMs) to reduce the risk of recurrence in premenopausal women.Studies discussed in the episode:SOFT and TEXTFor more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer, Gilead Pharmaceuticals and Merck Pharmaceuticals. Our partners have no editorial rights or early previews, and they have access to the episode at the same time you do. Hosted on Acast. See acast.com/privacy for more information.
In this episode, we review the high-yield topic of Selective Estrogen Receptor Modulators (SERMs) from the Gynecology section at Medbullets.com Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
Today, we had the pleasure of having Melanie Sisk on the show to demystify the complex world of emerging endocrine therapies, often referred to as the "alphabet soup" of treatments. Melanie provided clarity on the different classes of drugs and how they interact with tumors, particularly focusing on those that target estrogen receptors.We discussed:SERMs (Selective Estrogen Receptor Modulators): These drugs, like tamoxifen, block the growth of cancer cells by competing with estrogen receptors.SERDs (Selective Estrogen Receptor Down Regulators/Degraders): Drugs like Fluvestrant work by degrading estrogen receptors.SERANs (Complete Estrogen Receptor Antagonists): These block both pathways of estrogen, offering a complete blockade.PROTACs: A newer class that targets specific proteins, such as the estrogen receptor, to inhibit cancer growth.+++++++++++++++++++++Attend a free virtual SurvivingBreastCancer.org event:https://www.survivingbreastcancer.org/eventsFollow us on InstagramLaura and Will: https://www.instagram.com/laura_and_will/SurvivingBreastCancer.org: https://www.survivingbreastcancer.org/Breast Cancer Conversations: https://www.instagram.com/breastcancerconversations/About SurvivingBreastCancer.org: SurvivingBreastCancer.org, Inc. (SBC) is a federally recognized 501(c)(3) non-profit virtual platform headquartered in Boston with a national and global reach. Through education, community, and resources, SurvivingBreastCancer.org supports women and men going through breast cancer. We provide a sanctuary of strength, compassion, and empowerment, where those diagnosed with cancer unite to share their stories, learn invaluable coping strategies to manage wellness and mental health, and find solace in the unbreakable bond that fuels hope, resilience, and the courage to conquer adversity.Support the show
Welcome back to another episode of Breast Cancer Conversations, where we continue to share valuable insights from the San Antonio Breast Cancer Symposium. As a breast cancer survivor and the founder of survivingbreastcancer.org, I'm thrilled to bring you key takeaways from one of the world's largest breast cancer conferences.In this episode, we focus on what to do when CDK4-6 inhibitors, such as Ibrance, Kisqali, and Verzenio, stop working. Our guest, Amy Bremer, highlights the importance of getting a biopsy to check for mutations, which can be done through a liquid biopsy or a tissue biopsy. This step is crucial for determining the next course of action.We delve into the various treatment options available based on specific mutations. For instance, if your cancer has a PIK3CA mutation, a combination of PIQRAY and Faslodex might be recommended. Other drugs like Trucap, Orserdo, and LSS strontosome are also discussed as potential options for different mutations.For those without mutations, there are still choices available, such as Affinitor plus Faslodex, or considering a switch to a different CDK4-6 inhibitor. We also discuss the possibility of continuing treatment beyond progression or, in cases of aggressive progression, looking into chemotherapy or antibody drug conjugates (ADCs).Stay tuned for our next episode, "on SERDs, SERMs, CERANs, and PROTACs" and remember to subscribe to Breast Cancer Conversations. Please note that our podcast shares personal experiences and is not a substitute for professional medical advice. If you have specific topics in mind or want to be a guest, feel free to reach out to me.Thank you for listening, and let's continue to empower each other through community, education, and resources.00:02:44 - Topic: CDK4-6 Inhibitor Efficacy00:03:31 - Options After Endocrine Therapy and CDK4-6 Inhibitors00:04:35 - Treatment Options Based on Specific Mutations00:05:40 - Options Without Identified Mutations00:06:43 - Inherited Mutations and Treatment Choices00:07:09 - Expert Opinions on Treatment Complexity00:08:44 - Importance of Clinical Trials+++++++++++++++++++++Attend a free virtual SurvivingBreastCancer.org event:https://www.survivingbreastcancer.org/eventsFollow us on InstagramLaura and Will: https://www.instagram.com/laura_and_will/SurvivingBreastCancer.org: https://www.survivingbreastcancer.org/Breast Cancer Conversations: https://www.instagram.com/breastcancerconversations/About SurvivingBreastCancer.org: SurvivingBreastCancer.org, Inc. (SBC) is a federally recognized 501(c)(3) non-profit virtual platform headquartered in Boston with a national and global reach. Through education, community, and resources, SurvivingBreastCancer.org supports women and men going through breast cancer. We provide a sanctuary of strength, compassion, and empowerment, where those diagnosed with cancer unite to share their stories, learn invaluable coping strategies to manage wellness and mental health, and find solace in the unbreakable bond that fuels hope, resilience, and the courage to conquer adversity.Support the show
Drs. Hope Rugo and Nancy Davidson discuss the next generation of endocrine therapy in hormone receptor-positive breast cancer – SERDs, SERMs, CERANs, and PROTACs – and challenges relating to the optimal sequence of therapeutic options. TRANSCRIPT Dr. Hope Rugo: Hello, I'm Dr. Hope Rugo, your guest host of the ASCO Daily News Podcast today. I'm a professor of medicine and director of breast oncology and clinical trials education at the University of California San Francisco's Comprehensive Cancer Center. Hormone receptor-positive (HR+) breast cancer is the most common subset of this disease and breast cancer is the most common cancer diagnosed in women worldwide. Endocrine therapy (ET) is the cornerstone of management in hormone receptor-positive breast cancer and may involve suppressing estrogen production with aromatase inhibitors in the cancer cell itself, or directly blocking the estrogen receptor pathway through selective estrogen receptor modulators, such as tamoxifen, or the injectable selective estrogen receptor degrader, fulvestrant. However, despite the availability of these therapies, the largest unmet need lies in treatment of HR-positive HER-negative disease lies after progression on endocrine therapy. On today's episode, we'll be discussing the emerging generation of endocrine therapies in breast cancer, some of which were designed to overcome common mechanisms of endocrine resistance, and the challenges relating to the optimal sequence of therapeutic options. Today, I'm delighted to welcome the world-renowned breast cancer researcher, Dr. Nancy Davidson, to the podcast. She's a professor and the executive vice president for clinical affairs at the Fred Hutchinson Cancer Center and professor of medicine at the University of Washington as well as past president of ASCO and AACR. You'll find our full disclosures in the transcript of this episode and disclosures of all guests on the podcast can be found in our transcripts at asco.org/DNpod. Nancy, it's great to have you on the podcast today. Thanks so much for being here. Dr. Nancy Davidson: Thank you so much, Hope, for the opportunity. Dr. Hope Rugo: You've done incredible work in the area of treating HR+ disease, but also in understanding some of the agents and pathways that are most important to our understanding of how we treat and really think about developing new drugs for HR+ breast cancer. The first generation of anti-estrogen drugs really included selective estrogen receptor modulators, but now we have a new generation of these anti-estrogen drugs. And there's also orally administered selective estrogen receptor degraders, so-called SERDs, that we hope someday will be an alternative with already one approved for the injectable SERD, fulvestrant. But there's a whole additional class of drugs, complete estrogen receptor antagonists, referred to as CERANs, and proteolysis targeting chimerics, PROTACs. These agents are all at various stages of development in both early and metastatic settings and really represent, I think, a confusing array of different treatments that are being studied, some of which of course are approved. Nancy, it would be great if you could tell us some about these exciting new agents, starting with our approved drugs and moving on to the agents that we're studying in clinical trials. Dr. Nancy Davidson: Hope, this is a terrific example of how basic science has really begun to inform clinical practice. For us as breast cancer practitioners, it was really easy for a long time because we only had tamoxifen. And then things like the aromatase inhibitors as a means of decreasing the estrogen ligand came into practice, as did fulvestrant, as you mentioned, a selective estrogen receptor degrader. Thanks though to a lot of understanding about estrogen receptor biology, and specifically, the discovery about a decade ago of estrogen receptor mutations, something that we didn't think exist ed for a long time, but which we now know exists in maybe a third to a half of breast cancers after exposure to aromatase inhibitors, that's led to really an explosion, this alphabet soup of possibilities that you talked about. SERMs, selective estrogen receptor modulators, tamoxifen is the classic one—something that acts as an agonist and as an antagonist, depending on the tissue. The SERDs, the selective estrogen receptor degraders, lead to estrogen receptor destruction. Fulvestrant is the classic example of this right now. But we're very excited that a second one has been FDA approved. That's elacestrant that was approved earlier this year, and it has specifically been developed to try to target those estrogen receptor mutant breast cancers because those are the ones that are particularly resistant. So that's the first of this new generation of SERDs that's coming on the market, has come on the market. As you say, a key advantage there is that it's oral, unlike fulvestrant, which requires 2 monthly injections and is very, very inconvenient and uncomfortable for patients. Other SERDs are coming along. I think another one that is well along in clinical development is giredestrant, which is in the same family and being tested in clinical trials of the classic varieties. It's been tested in a window trial, looking at its ability to down-regulate Ki67. It's being tested against standard of care in first-line metastatic breast cancer. And there are some studies that are going to begin looking at it in the adjuvant setting as well. There are other members of this particular family, but I think that elacestrant is the one that we have at our fingertips right now, and giredestrant is one that's certainly coming along in clinical trials, and we should look forward to those results. For those who are interested in the giredestrant, the trials in question right now that are going on are persevERA, which is in stage 4 breast cancer, and lidERA, which is in the adjuvant setting. Now that's one new category, or it's an old category with a new twist. A second is these agents that are called complete estrogen receptor antagonists, CERANs, as you talked about them. The key here is that what they do is, the estrogen receptor has a couple of domains, and in particular, it has 2 different activation domains, AFT1 and AFT2. And these CERANs are complete estrogen receptor antagonists, so they block both of those domains. And the hope would be that they might end up being more effective than the other agents that we have available to us right now. So those are also in clinical trial at the present time, and we're waiting to see whether or not there's going be any value in that particular area that's going to able to go forward for us. Another area that I think we want to talk about is the PROTACs, as you mentioned. These are proteolysis targeting chimeric entities. So, this is a kind of a complicated situation where you have a kind of bivalent situation where you have something that binds both to the estrogen receptor and then also to E3 ubiquinase. So, it leads to degradation again of the agents; that's another area for us to be watching. And then finally the SERCAs. So those are the selective estrogen receptor covalent antagonists, and what they do is they bind very specifically to a cysteine 530 that exists in the estrogen receptor but not in other steroid receptors. So that's where the selective part of this comes along. Now these are all in various stages of clinical investigation. Some of them are pretty early at this point, but I think the ones that are well established are elacestrant, giredestrant is coming along as we just talked about. Camizestrant is also coming along through the SERENA series of trials, and imlunestrant is also coming on through the EMBER series of trials. Hope, I would also be remiss if I didn't go back to an old drug that's a new drug, and that's lasofoxifene, which is also in the SERM family. Those who have been in our field for a while will remember that lasofoxifene was actually originally kind of tested in the prevention setting, where it seemed to have some activity. It came back into our interest because it has really strong activity against estrogen receptor mutant breast cancer models in the laboratory. And as a consequence of that, it's coming back into the clinic through a series of trials that are called the ELAINE trials, where we're looking to see whether or not it might also be better than fulvestrant. It too is an oral agent, so that's a real plus for us, and the first set of ELAINE trials would suggest that there's some nice activity without a lot of toxicity. So, lots going on in this field. You know, I think for all of these things, obviously, we're also working very hard to think about the toxicities. All of these, as I recall, are oral agents. So that gets rid of 1 huge toxicity, which is you don't have the need for some sort of injection. But they all do have some side effects. Frequently, [the toxicities] are like GI side effects or fatigue. In a couple of cases, there might be some concern about cardiac arrhythmias, but I think GI turns out to be one of the most important things that we have seen in some of these trials. Generally, it's very well tolerated, though. I think another important question, which I'm sure is in your head and is in mine, is that how are we going to integrate these into what we already have? And so, I think a lot of the work right now is looking at patients who have already received an aromatase inhibitor plus a CDK4/6 inhibitor and are now going on to one of these new agents. But you might wonder, if they turn out to be effective and well-tolerated, whether they too should be perhaps combined with CDK4/6 inhibitors in place of the aromatase inhibitors or the fulvestrant that we use now. So, I think that we can imagine that those clinical trials are either in progress in some cases or will be coming on as we try to think about how to integrate these new approaches into our existing standard of care, which is already quite complicated, right? We've gone far from tamoxifen, which was good for everybody, to now a really complex algorithm about how we think about hormone therapy, both in early breast cancer and in metastatic breast cancer. Dr. Hope Rugo: Well, that was a fabulous discussion about the new agents and our existing agents and both the exciting aspects, as well as the challenges. One question that comes up, I think a lot, and this is of course a huge question in many ways, but for ER-positive metastatic breast cancer, where these drugs are first being tested, maybe we'll talk about that first. There's one trial at SERENA-6, looking at camizestrant in patients who have developed evidence of an ESR1 mutation in circulating tumor DNA, who are on first-line therapy with an AI and a CDK4/6 inhibitor. What do you think about that study and where do you think that progress might go? Of course, that's based on data from another trial, which wasn't definitive, but suggested, had sort of a suggestion, you know, without studying the sequencing in detail that maybe you would have improved progression-free survival with that approach. Dr. Nancy Davidson: Yeah, by which you mean the idea of monitoring pre-ESR1 mutations and circulating DNA and then making therapy changes based on that? Is that what you're talking about? Dr. Hope Rugo: The PADA-1 trial, yes, and that led to this huge SERENA-6 trial, which of course is now accruing. Dr. Nancy Davidson: So, you know, we would love that, right? I think that obviously breast cancer for many years has been interested in trying to have circulating markers that we could use to help to guide our therapy in a more meaningful way than we have in the past. And I think that the trial that you've talked about is certainly one that's trying to make that see whether that's a possibility for us based on information like the PADA trial. I'm hopeful it's going to work out. I would say, let's see what that looks like, whether it's going to be useful or not. It seems to me in some cases, some of these trials have not been quite what we hoped for, but I don't think we necessarily had the molecular techniques or the sensitivity, nor did we necessarily have other things to move to because, you know, those two approaches require both a really good test, but also the ability to use the test to define a new therapy that's going to lead to improved patient outcomes. And I think that these are ingredients that we now have available to us at our fingertips more than we did, say, a decade or 2 decades ago. Exciting approach. Dr. Hope Rugo: I do think there's a lot of challenges inherent in this process, monitoring blood on a regular basis and following up and then randomizing based on results. But I think [SERENA-6] is an incredibly important trial, as you have mentioned, to try and think about moving past using circulating tumor cells, which didn't work, to just change blindly to the next therapy, but more have a rational reason to change to a drug that may be more effective before the disease itself progresses. And just for our listeners, the unique aspect of trials like this in SERENA-6 is that you change therapy before you have evidence of disease progression, but only this molecular evidence of a mutation that is associated with resistance to the therapy you're on. So, it's a really important question. We'll see what happens, as you mentioned, sometimes we're not clever enough to really get around the fact that there are multiple mutations driving resistance in this setting, so we'll see how straightforward this is. The question also comes up, and I think that's a question with many of these trials now, is they're randomizing patients after a progression on an AI and CDK4/6 inhibitor to receive the novel endocrine therapy or fulvestrant. One of, I think, the concerns of treating oncologists is that then you're sort of eliminating the possibility of a targeted agent in that setting. And of course, we have new targeted agents we're studying as well, AKT inhibitors and new inhibitors of the PI3 kinase pathway. So, the newer trials are now combining, as you mentioned. There's a lot of concerns about drug-drug interactions here and how you might really combine them. And then there are triplet studies looking at CDK4/6 inhibitors, oral SERDs primarily, and pi3-kinase and CDK4/6 inhibitors. What's your thought on these and will they really help to move the needle forward? Dr. Nancy Davidson: I think that's a really interesting question, Hope, is whether or not we're going to find that combination therapies from the get-go are the way to go, or whether we're going to end up having to use maybe more serial therapies. Because not only is it a question about whether or not you can tackle all of these different resistance mechanisms simultaneously, but I think the other question is, as you say, are there negative drug-drug interactions, and are there toxicities that are intolerable? Although these are targeted in all cases and they're relatively benign in terms of side effects from the breast cancer perspective, they're not devoid of toxicity. And so, I think that's going to be another issue for us – whether they're well tolerated during the time that patients are taking them. I guess the other thing I always think about, Hope, is that it's hard to know about value of cancer care, but you know, we are talking about agents that are not inexpensive. You know, when you think about the financial toxicity, in addition to the side effect toxicity that you and I just talked about, trying to think about what that value is going to look like is going to be very important for us. Also, as somebody who worked for a long time in the lab and in the clinic, you know, there are an infinite number of combinations that you and I could think about that are rational. And so, the question is, how are we going to pick the ones that are the most rational, if you will, the ones that seem to be the most promising, and take them forward into clinical trials? Because patients are our most precious resource. And so, we want to make sure that we are bringing forward only those things that really seem to have a very strong foundation and the opportunity to improve outcomes over time. Tough, tough question for us to try to think about, as you've talked about. The other thing is that, you know, these trials are not only for postmenopausal women, who are the majority of patients, but we also want to target them to premenopausal women. So, in those women, we're also looking at using an LHRH agonist on top of this, right, because many of these things are really at least so far designed for the postmenopausal state. So stay tuned. Lots of work going on. I think one of the interesting things will be making the leap from using these in metastatic disease at time of progression to taking them forward into the early breast cancer space. And several of the agents are now beginning to do that because of very strong preclinical and clinical data to date. Dr. Hope Rugo: So, we have new agents that we're studying in the metastatic setting, and we've seen a trend to move fairly rapidly from phase 1B trials directly into phase 3 trials, because as you pointed out so clearly, there are a number of drugs in this setting, and we don't really know not only which agent is better, but even what class of agents is better. So, as we move more quickly from phase 1B to phase 3, the question comes up about how we're going to study these agents optimally in the early-stage setting. They, I think we all thought that maybe changing based on ctDNA evidence of a mutation might be an approach, but that's complicated. A big question for you is whether or not you think that's ready for prime time as it's being marketed as such. And then the second question is really, are we better changing our whole approach upfront in high-risk disease or should we wait until after patients are exposed to their endocrine therapy and then switch as we go along; the EMBER-4 trial is looking at that switching approach? Dr. Nancy Davidson: Yeah, I think that this is obviously the billion-dollar question for many companies and for many of us as investigators. I don't know that I have a crystal ball into what the best approach might be. We know that already some of these have been abandoned. For example, amcenestrant. So, I don't even have to learn how to say it because it has been abandoned. It did go to phase 3, as you pointed out, in the advanced setting, looking at it with palbo vs letrozole plus palbo, and it didn't really show a whole lot that the company wanted to pursue. So, I think that sometimes these things are going to be abandoned based on the metastatic setting, which is a large trial, and that's a trial where obviously it might be a little easier to the circulating markers, as you talked about, than maybe in the early-stage breast cancer setting. I think that probably these early-stage trials are going to end up being big; they're going to have be clean. I'm guessing that most companies and most investigators will want to target them towards high-risk individuals, as you talked about, for 2 reasons. One is that ethically, I think we feel more comfortable with that. These are individuals where standard therapies are maybe not serving them as well as we would like and where we have information to think that we can at least have equipoise about a new approach. And the second is that from a trial design point of view, the event rate is likely to be higher, and therefore you might get answers earlier and with a smaller clinical trial. So that's where I suspect we're going to go. But it's a challenging question, and I think that many investigators and many companies are really trying to struggle with that right now because we do have so many options. And we're not quite sure how to, first, develop these new drugs, but then really importantly, put them in the context of our existing drugs. And as you say, we're also simultaneously trying to develop superior molecular or circulating markers to guide us. So, there's so many variables that are going on right now in this field that, from my point of view, itmakes it really exciting, but it also makes it pretty complicated, both for investigators and for pharma as we try to think about how to position these going forward. But what a great problem to have, Hope, because remember when you and I started in breast cancer, pretty much all you needed to know was tamoxifen. And I think you and I also probably started at the tail end of the time when we were using androgens and progestins and agents that now have basically completely fallen out of favor. Dr. Hope Rugo: Estrogen Dr. Nancy Davidson: Estrogen, yeah, and your side effect profiles were not as good. So, it's a good problem to have. It's a nice situation when science can inform our clinical investigation, our clinical practice. Dr. Hope Rugo: Yes, I think it'll be fascinating to see where we end up at the end, but of course, the complexities of this include the fact that sometimes just the clinical trial design leads to a less than positive result because of the way the trial itself has been designed, which I think is the nice part about moving these earlier into treatment of high-risk disease, but also brings up the question of all sorts of areas we're not really a place to discuss today, like how the statistical design is made, et cetera, that can sometimes result in poor evaluation of excellent agents. One of the questions that comes up, and you brought this up earlier, which I think is really important, is that we are in the era of combining our endocrine agents with targeted agents, and, oral agents, in a fascinating way, really bring up drug-drug interactions in a way that the injectable fulvestrant hasn't, and aromatase inhibitors were kind of quiet on the impacting metabolism, unlike tamoxifen. But we are seeing some drug-drug interactions and certainly the discussions about using these agents may include the question about whether or not you're having more diarrhea or nausea or fatigue or one drug causes photopsia, flashing lights, things like that. Keratitis is becoming a new toxicity to follow. How are we going to figure out how to sequence these drugs and are they only going to work better all of them as a class in patients with ESR1 mutations in their tumors? Dr. Nancy Davidson: I think we don't know the answer to the second question yet. That's something that really needs to be sorted out. Even if they do, that's still a really important subset of patients, assuming that we continue to start with the aromatase inhibitors, right? That's where those things really seem to emerge right now. I don't know how we're going to figure those things out. I guess that I'm hoping that maybe a couple of agents in these classes will become kind of the lead agents. And so, we'll be able to do this work with a handful of things as opposed to a whole array of things. But we'll see. I think that even within classes, obviously, these agents are going be slightly different, probably. And so it may be that one member of a class may be slightly better from a, maybe not from an efficacy point of view, but from a toxicity point of view. And we'll just have to see how it goes. I don't think I have any magic answers about that. Dr. Hope Rugo: Yes, it'll be interesting to see whether or not the agents work in sequence too. You know, could you use a PROTAC after an oral SERD, for example, or a CERAN? That'll be fascinating to see. Dr. Nancy Davidson: I'm hoping that preclinical modeling may help with that a little bit, though of course we all know that there are plenty of things that do well in preclinical models, GEMS and rodent models and PDXs, and sometimes those things translate nicely into clinical practice, but sometimes they don't. Dr. Hope Rugo: You mentioned, Nancy, that when we started out, that it was a fairly simple decision about what endocrine therapies, and we ran out very quickly. We're seeing some of those old classes come up with new agents. And you mentioned lasofoxifene, the oral SERM that seems to have some benefits and works in the later-line setting and also can be combined with a CDK4/6 inhibitor; [and also] has data with abemaciclib. There's also a new androgen receptor agonist, enobosarm, that's being tested as well. Do you think that these older mechanisms have a future as well? Dr. Nancy Davidson: I do. I think that because we'll be able to understand the biology better than we did in the past. A lot of our hormone therapy was pretty empiric several decades ago. But I think with better understanding of mechanisms and better understanding of what the patterns of resistance might be for a particular tumor, that we might be able to think about those things. You're right that there's a whole parallel universe right now in androgen receptor targeted therapies that we're not talking about today, both in perhaps in hormone-responsive breast cancers, but also in triple-negative breast cancers in a certain subset. And so that's an area where we probably need to be watching what our prostate cancer colleagues are doing as they develop these agents and thinking about where they might mechanistically make sense to apply in the breast cancer field. It won't be the first time that we've received insights from them because remember, prostate cancer people knew about androgen receptor mutations a really long time before we figured out that they existed in estrogen receptor as well. So, there's a nice cross talk, I think, between the prostate cancer field and the breast cancer field in that regard. Dr. Hope Rugo: That's an excellent point. And we learn a lot from our colleagues studying other malignancies, and prostate cancer has been a big area there for us and hopefully will help us with studying these agents because there's different toxicity profiles, of course, as well. And then you mentioned the approval of elacestrant, the first oral SERD to have regulatory approval, and it's approved in patients who have ESR1 mutations in their tumors. We're also studying it in the ELEVATE trial in combination with all of the different targeted agents, the CDK4/6 inhibitors, mTOR inhibitor, everolimus, and the PI3 kinase inhibitor, alpelisib, to really try and understand how these can be optimally combined. Would you check for ESR1 mutations at diagnosis of metastatic disease, or would you do this more after progression or start of progression of disease on an aromatase inhibitor? Dr. Nancy Davidson: I tend to be a conservative, Hope, and so unless there's a clinical trial that might be able to be considered, I would tend to check it only after progression on the aromatase inhibitor. But I think some people are earlier adopters, and I suppose it's possible that they might want to know from the get-go. Having said that, I do think elacestrant has an approval after aromatase inhibitor, as I recall. So, presumably the patient would have to have that exposure before you would be able to act on the ESR1 mutation by administering the oral SERD. This is also a new area that may well change with time, right? You know, as we develop different agents, as the agents have different requirements or different indications, and as we perhaps have better tests, it may be things that we don't do routinely now will become very routine in the future. And perhaps in series like you talked about in a serial fashion. Dr. Hope Rugo: Absolutely. I think that's a really important comment about how we're going to think about treating hormone receptor positive disease and potentially, you know, we have new chemo options, of course, not part of our talk discussion today and antibody drug conjugates. So, the future is certainly challenging in terms of understanding this appropriate sequencing. We need data, but it's exciting to have these options. As you pointed out, this is this is a great problem to have, you know, too many drugs with efficacy to try and understand how to use these in the most appropriate way. And as you also pointed out, the use in young women is particularly important. Whether or not you need to suppress the ovaries with all of these new agents is going to be important to understand as well as a next step. I don't know if you have specific thoughts on that area as well. I mean, that may reduce toxicity for younger women. Dr. Nancy Davidson: I guess our approach right now has been to suppress them, but I agree with you; you wonder if you look at some of the mechanisms of action, whether that's really a requirement biologically and medically, or whether it's something that's kind of a leftover from the approval process. You know, that for the drug approval, these women were suppressed. I think we need to work that out because that's another area where certainly women could have ovaries removed. That's pretty straightforward, although it requires a surgical procedure. But otherwise use of LHRH agonists continues to be injections, right? And so, if we're trying to minimize convenience or maximize convenience and minimize toxicity for women with any stage of breast cancer, anything we can do, it seems to me to eliminate an injection is going to be a good thing. So important for us to be able to work that out as well, even though numerically it's a smaller number of women, it's obviously a very important number. population of women. Dr. Hope Rugo: Last question for you. One question that comes up and sent to me and panels all the time is, if you have done your next generation sequencing and you see an ESR1 mutation and a P13CA mutation, what do you prioritize in terms of your choice of treatment, because we have the choice of either using elacestrant or a fulvestrant in combination with an agent targeting the PI3 kinase pathway? Dr. Nancy Davidson: I don't know that there's a right answer to that medically right now. So, when I talk about it with patients, I suggest to them that it's probably not one or the other. It's kind of the question of which one to use first. So, we talk a little bit about side effect profiles. We talk a little bit about patient preference and neither of these drugs is devoid of problems, but sometimes patients have pretty strong feelings about which set of side effects seems the least unattractive to them or the possibility of having those side effects. And I know that if one isn't well tolerated, you can swap over to the other. Dr. Hope Rugo: Absolutely. I think that's a very important way to think about next therapies in our era of not really knowing what's right. And this idea of shared decision-making is so incredibly important. Nancy, thank you so much for sharing your insights and knowledge with us today. I could talk to you for hours about this. Dr. Nancy Davidson: Hope, thank you so much for the opportunity. It is an exciting area and I really enjoyed talking with you about what we know and the many things that we don't yet know, but we're working on. Dr. Hope Rugo: Indeed, it's certainly an exciting time. Thank you to our listeners for joining us today. And thanks to the ASCO Daily News Podcast for highlighting this important area. You'll find a link to all of the studies discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Thanks so much. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers: Dr. Hope Rugo @hoperugo Dr. Nancy Davidson Follow ASCO on social media: @ASCO on Twitter ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Hope Rugo: Consulting or Advisory Role: Napo Pharmaceuticals, Puma Biotechnology, Mylan, Eisai, Daiichi Sankyo Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Genentech, Merck, Daiichi Sankyo, Sermonix Pharmaceuticals, AstraZeneca, Gilead Sciences, Astellas Pharma, Talho Oncology, Veru, GlaxoSmithKline, Hoffmann-LaRoche AG/Genentech, Inc Travel, Accommodations, Expenses: Merck, AstraZeneca Dr. Nancy Davidson: No Relationships to Disclose
Phytoestrogens... What are they? How do they work? Are they helpful or harmful? Honestly, these questions are more complicated to answer than they seem, even though researchers have been diving into this topic for decades. In the end, the basics are that phytoestrogens are plant-derived compounds that act similarly to estrogens in our bodies. But they're milder acting than our natural estrogens so on the one hand they can reduce the effect of estrogen in our bodies when they bind to receptors (so can be helpful in excess estrogen conditions for example) but they can also encourage a mild estrogenic activity when we are in an estrogen deficient state (like say, perimenopause or post-menopause).That said, not all phytoestrogens are equal, and actually there's even some new research showing that the makeup of our gut microbiome may have some effect on whether or not phytoestrogenic compounds have any benefit in our bodies. They're even being researched in estrogen-dependent cancer situations to act potentially as SERMs (or selective estrogen receptor modulator) type compounds. But all the current research aside, what benefits might they have in your body?And what kinds of plants are even included in this category?Listen in to learn:what phytoestrogens arehow phytoestrogens workwhat makes these plant compounds a bit complicatedhow phytoestrogens help to modulate estrogen levelshow phytoestrogens can reduce menopausal symptomsthe latest on phytoestrogens and cancerwhen you might want to avoid taking phytoestrogensa few phytoestrogenic herbs and simple ways to work with them Resources:FREE GUIDE: 10 essential herbs for your hormonal healthToday's shownotes: Get all the nerdy references here!Episode 18: Herbal uterine tonicsEpisode 30: 5 pillars of hormonal health the herbal wayEpisode 37: Easing into menopause with Dana LaVoieEpisode 58: How does your gut health relate to your hormones?If you loved this episode, share it with a friend, or take a screenshot and share on social media and tag me @herbalwombwisdom. And if you love this podcast, leave a rating & write a review! It's really helpful to get the show to more amazing humans like you. ❤️DISCLAIMER: This podcast is for educational purposes only, I am not providing any medical advice, I am not a medical practitioner, I'm an herbalist and in the US, there is no path to licensure for herbalists, so my role is as an herbal educator. Please do your own research and consult your healthcare provider for any personal heal
Go online to PeerView.com/YNC860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Endocrine therapy, typically with an aromatase inhibitor or fulvestrant plus a CDK4/6 inhibitor, is a mainstay for the management of HR+/HER2- metastatic breast cancer, but many questions still remain about the nuances of optimal use of these and other agents in first- and later-line settings. Furthermore, a number of investigational therapies are showing great promise in HR+/HER2- advanced disease, including novel ER-targeting agents such as oral SERDs, SERMs, SERCAs, PROTACs, and others, as well as antibody–drug conjugates such as those targeting TROP2. It is essential to learn how to best integrate these options into the current treatment arsenal. CDK4/6 inhibition with adjuvant abemaciclib has also changed the standard of care for high-risk patients with earlier-stage disease, but challenges remain, such as determining which patients benefit from this approach, and how to ensure that patients stay on therapy to reduce their risk of recurrence. This PeerView educational activity, based on a recent live symposium and produced in collaboration with GRASP and Living Beyond Breast Cancer to highlight patient perspectives, pairs compelling analyses of key evidence with practically oriented discussions focused on the evolving role of various standard, new, and emerging treatment options for HR+/HER2- advanced and early breast cancer. Leading experts show how to navigate the increasing complexity of treatment in the metastatic setting, as well as the recent expansion of new therapies into early-stage disease, and discuss implications for multidisciplinary care and patient-centric best practices. Upon completion of this activity, participants should be better able to: Describe the rationale for, mechanisms of action of, and latest efficacy and safety data supporting the use of standard, new, and emerging treatment options for patients with HR+/HER2- advanced and early breast cancer, and their evolving roles in clinical practice; Develop personalized treatment plans for patients with HR+/HER2- advanced and early breast cancer that take into account all the relevant tumor-, patient-, and treatment-related factors, and include appropriately selected standard, new, or emerging treatment options in the context of clinical practice or clinical trials; Integrate a team-based, collaborative, and coordinated approach to care to educate patients with HR+/HER2- advanced and early breast cancer about new and emerging treatment options for which they may be eligible and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Go online to PeerView.com/YNC860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Endocrine therapy, typically with an aromatase inhibitor or fulvestrant plus a CDK4/6 inhibitor, is a mainstay for the management of HR+/HER2- metastatic breast cancer, but many questions still remain about the nuances of optimal use of these and other agents in first- and later-line settings. Furthermore, a number of investigational therapies are showing great promise in HR+/HER2- advanced disease, including novel ER-targeting agents such as oral SERDs, SERMs, SERCAs, PROTACs, and others, as well as antibody–drug conjugates such as those targeting TROP2. It is essential to learn how to best integrate these options into the current treatment arsenal. CDK4/6 inhibition with adjuvant abemaciclib has also changed the standard of care for high-risk patients with earlier-stage disease, but challenges remain, such as determining which patients benefit from this approach, and how to ensure that patients stay on therapy to reduce their risk of recurrence. This PeerView educational activity, based on a recent live symposium and produced in collaboration with GRASP and Living Beyond Breast Cancer to highlight patient perspectives, pairs compelling analyses of key evidence with practically oriented discussions focused on the evolving role of various standard, new, and emerging treatment options for HR+/HER2- advanced and early breast cancer. Leading experts show how to navigate the increasing complexity of treatment in the metastatic setting, as well as the recent expansion of new therapies into early-stage disease, and discuss implications for multidisciplinary care and patient-centric best practices. Upon completion of this activity, participants should be better able to: Describe the rationale for, mechanisms of action of, and latest efficacy and safety data supporting the use of standard, new, and emerging treatment options for patients with HR+/HER2- advanced and early breast cancer, and their evolving roles in clinical practice; Develop personalized treatment plans for patients with HR+/HER2- advanced and early breast cancer that take into account all the relevant tumor-, patient-, and treatment-related factors, and include appropriately selected standard, new, or emerging treatment options in the context of clinical practice or clinical trials; Integrate a team-based, collaborative, and coordinated approach to care to educate patients with HR+/HER2- advanced and early breast cancer about new and emerging treatment options for which they may be eligible and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Go online to PeerView.com/YNC860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Endocrine therapy, typically with an aromatase inhibitor or fulvestrant plus a CDK4/6 inhibitor, is a mainstay for the management of HR+/HER2- metastatic breast cancer, but many questions still remain about the nuances of optimal use of these and other agents in first- and later-line settings. Furthermore, a number of investigational therapies are showing great promise in HR+/HER2- advanced disease, including novel ER-targeting agents such as oral SERDs, SERMs, SERCAs, PROTACs, and others, as well as antibody–drug conjugates such as those targeting TROP2. It is essential to learn how to best integrate these options into the current treatment arsenal. CDK4/6 inhibition with adjuvant abemaciclib has also changed the standard of care for high-risk patients with earlier-stage disease, but challenges remain, such as determining which patients benefit from this approach, and how to ensure that patients stay on therapy to reduce their risk of recurrence. This PeerView educational activity, based on a recent live symposium and produced in collaboration with GRASP and Living Beyond Breast Cancer to highlight patient perspectives, pairs compelling analyses of key evidence with practically oriented discussions focused on the evolving role of various standard, new, and emerging treatment options for HR+/HER2- advanced and early breast cancer. Leading experts show how to navigate the increasing complexity of treatment in the metastatic setting, as well as the recent expansion of new therapies into early-stage disease, and discuss implications for multidisciplinary care and patient-centric best practices. Upon completion of this activity, participants should be better able to: Describe the rationale for, mechanisms of action of, and latest efficacy and safety data supporting the use of standard, new, and emerging treatment options for patients with HR+/HER2- advanced and early breast cancer, and their evolving roles in clinical practice; Develop personalized treatment plans for patients with HR+/HER2- advanced and early breast cancer that take into account all the relevant tumor-, patient-, and treatment-related factors, and include appropriately selected standard, new, or emerging treatment options in the context of clinical practice or clinical trials; Integrate a team-based, collaborative, and coordinated approach to care to educate patients with HR+/HER2- advanced and early breast cancer about new and emerging treatment options for which they may be eligible and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Go online to PeerView.com/YNC860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Endocrine therapy, typically with an aromatase inhibitor or fulvestrant plus a CDK4/6 inhibitor, is a mainstay for the management of HR+/HER2- metastatic breast cancer, but many questions still remain about the nuances of optimal use of these and other agents in first- and later-line settings. Furthermore, a number of investigational therapies are showing great promise in HR+/HER2- advanced disease, including novel ER-targeting agents such as oral SERDs, SERMs, SERCAs, PROTACs, and others, as well as antibody–drug conjugates such as those targeting TROP2. It is essential to learn how to best integrate these options into the current treatment arsenal. CDK4/6 inhibition with adjuvant abemaciclib has also changed the standard of care for high-risk patients with earlier-stage disease, but challenges remain, such as determining which patients benefit from this approach, and how to ensure that patients stay on therapy to reduce their risk of recurrence. This PeerView educational activity, based on a recent live symposium and produced in collaboration with GRASP and Living Beyond Breast Cancer to highlight patient perspectives, pairs compelling analyses of key evidence with practically oriented discussions focused on the evolving role of various standard, new, and emerging treatment options for HR+/HER2- advanced and early breast cancer. Leading experts show how to navigate the increasing complexity of treatment in the metastatic setting, as well as the recent expansion of new therapies into early-stage disease, and discuss implications for multidisciplinary care and patient-centric best practices. Upon completion of this activity, participants should be better able to: Describe the rationale for, mechanisms of action of, and latest efficacy and safety data supporting the use of standard, new, and emerging treatment options for patients with HR+/HER2- advanced and early breast cancer, and their evolving roles in clinical practice; Develop personalized treatment plans for patients with HR+/HER2- advanced and early breast cancer that take into account all the relevant tumor-, patient-, and treatment-related factors, and include appropriately selected standard, new, or emerging treatment options in the context of clinical practice or clinical trials; Integrate a team-based, collaborative, and coordinated approach to care to educate patients with HR+/HER2- advanced and early breast cancer about new and emerging treatment options for which they may be eligible and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Go online to PeerView.com/YNC860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Endocrine therapy, typically with an aromatase inhibitor or fulvestrant plus a CDK4/6 inhibitor, is a mainstay for the management of HR+/HER2- metastatic breast cancer, but many questions still remain about the nuances of optimal use of these and other agents in first- and later-line settings. Furthermore, a number of investigational therapies are showing great promise in HR+/HER2- advanced disease, including novel ER-targeting agents such as oral SERDs, SERMs, SERCAs, PROTACs, and others, as well as antibody–drug conjugates such as those targeting TROP2. It is essential to learn how to best integrate these options into the current treatment arsenal. CDK4/6 inhibition with adjuvant abemaciclib has also changed the standard of care for high-risk patients with earlier-stage disease, but challenges remain, such as determining which patients benefit from this approach, and how to ensure that patients stay on therapy to reduce their risk of recurrence. This PeerView educational activity, based on a recent live symposium and produced in collaboration with GRASP and Living Beyond Breast Cancer to highlight patient perspectives, pairs compelling analyses of key evidence with practically oriented discussions focused on the evolving role of various standard, new, and emerging treatment options for HR+/HER2- advanced and early breast cancer. Leading experts show how to navigate the increasing complexity of treatment in the metastatic setting, as well as the recent expansion of new therapies into early-stage disease, and discuss implications for multidisciplinary care and patient-centric best practices. Upon completion of this activity, participants should be better able to: Describe the rationale for, mechanisms of action of, and latest efficacy and safety data supporting the use of standard, new, and emerging treatment options for patients with HR+/HER2- advanced and early breast cancer, and their evolving roles in clinical practice; Develop personalized treatment plans for patients with HR+/HER2- advanced and early breast cancer that take into account all the relevant tumor-, patient-, and treatment-related factors, and include appropriately selected standard, new, or emerging treatment options in the context of clinical practice or clinical trials; Integrate a team-based, collaborative, and coordinated approach to care to educate patients with HR+/HER2- advanced and early breast cancer about new and emerging treatment options for which they may be eligible and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Go online to PeerView.com/YNC860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Endocrine therapy, typically with an aromatase inhibitor or fulvestrant plus a CDK4/6 inhibitor, is a mainstay for the management of HR+/HER2- metastatic breast cancer, but many questions still remain about the nuances of optimal use of these and other agents in first- and later-line settings. Furthermore, a number of investigational therapies are showing great promise in HR+/HER2- advanced disease, including novel ER-targeting agents such as oral SERDs, SERMs, SERCAs, PROTACs, and others, as well as antibody–drug conjugates such as those targeting TROP2. It is essential to learn how to best integrate these options into the current treatment arsenal. CDK4/6 inhibition with adjuvant abemaciclib has also changed the standard of care for high-risk patients with earlier-stage disease, but challenges remain, such as determining which patients benefit from this approach, and how to ensure that patients stay on therapy to reduce their risk of recurrence. This PeerView educational activity, based on a recent live symposium and produced in collaboration with GRASP and Living Beyond Breast Cancer to highlight patient perspectives, pairs compelling analyses of key evidence with practically oriented discussions focused on the evolving role of various standard, new, and emerging treatment options for HR+/HER2- advanced and early breast cancer. Leading experts show how to navigate the increasing complexity of treatment in the metastatic setting, as well as the recent expansion of new therapies into early-stage disease, and discuss implications for multidisciplinary care and patient-centric best practices. Upon completion of this activity, participants should be better able to: Describe the rationale for, mechanisms of action of, and latest efficacy and safety data supporting the use of standard, new, and emerging treatment options for patients with HR+/HER2- advanced and early breast cancer, and their evolving roles in clinical practice; Develop personalized treatment plans for patients with HR+/HER2- advanced and early breast cancer that take into account all the relevant tumor-, patient-, and treatment-related factors, and include appropriately selected standard, new, or emerging treatment options in the context of clinical practice or clinical trials; Integrate a team-based, collaborative, and coordinated approach to care to educate patients with HR+/HER2- advanced and early breast cancer about new and emerging treatment options for which they may be eligible and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Jolene chats with Luca (xe/xyr) about SERMs, fags and dykes, failing at gender, the gender dysphoria bible, the button test, and more. The intro and outro music is by Lynn July. You can listen to more of her music at: https://tinytachyon.bandcamp.com/ Follow the pod on twitter: https://twitter.com/WhenAGuyHas Check out our website: https://whenaguyhas.neocities.org/ (IN PROGRESS) The RSS Feed: https://anchor.fm/s/9877d600/pod Donate to our Kofi, if you're so inclined: https://ko-fi.com/whenaguyhas
Go online to PeerView.com/DFJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Breast cancer is a heterogeneous disease comprising different subtypes, with estrogen receptor positive (ER+) being the most common subtype. Endocrine therapy (ET) is the primary treatment in ER+ breast cancer, which includes different strategies that directly or indirectly modify estrogen production. CDK4 and 6 inhibition as well as PI3K inhibition have improved outcomes in these patients, but most still develop endocrine resistance. ESR1 gene mutations, somatic alterations, microenvironmental factors, and epigenetic changes have all been implicated as underlying mechanisms promoting resistance. Novel ER-targeting agents such as oral selective estrogen receptor degraders (SERDs) are showing therapeutic promise in the face of ET resistance. In addition, other agents are being evaluated in ER+ disease, including selective estrogen receptor modifiers (SERMs), SERM/SERD hybrids, selective estrogen receptor covalent antagonists (SERCAs), proteolysis targeting chimeras (PROTACs), and others.This PeerView educational activity, based on a recent live symposium, highlights and analyzes the latest evidence and advances in the treatment of ER+/HER2- breast cancer, focusing on the expanding evidence base supporting the use of novel ER-targeted agents such as oral SERDs as a new standard of care in pretreated ER+/HER2- breast cancer. Practical guidance is also provided on how to apply the latest evidence to practice, optimize the use of these agents, and individualize treatment plans that take into account key data, patient- and tumor-related factors, and the specific needs and preferences of each patient. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including novel oral SERDs and other ER-targeting therapies, and their evolving role in clinical practice; Develop individualized treatment plans for patients with previously treated ER+/HER2- breast cancer that take into account the latest treatment options and all the relevant treatment-, tumor-, and patient-related factors; Integrate a team-based, collaborative, coordinated, and patient-centered approach to select appropriate candidates for SERDs and other new therapies for ER+/HER2- breast cancer, provide essential patient education, and ensure optimal delivery of therapy
Go online to PeerView.com/DFJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Breast cancer is a heterogeneous disease comprising different subtypes, with estrogen receptor positive (ER+) being the most common subtype. Endocrine therapy (ET) is the primary treatment in ER+ breast cancer, which includes different strategies that directly or indirectly modify estrogen production. CDK4 and 6 inhibition as well as PI3K inhibition have improved outcomes in these patients, but most still develop endocrine resistance. ESR1 gene mutations, somatic alterations, microenvironmental factors, and epigenetic changes have all been implicated as underlying mechanisms promoting resistance. Novel ER-targeting agents such as oral selective estrogen receptor degraders (SERDs) are showing therapeutic promise in the face of ET resistance. In addition, other agents are being evaluated in ER+ disease, including selective estrogen receptor modifiers (SERMs), SERM/SERD hybrids, selective estrogen receptor covalent antagonists (SERCAs), proteolysis targeting chimeras (PROTACs), and others.This PeerView educational activity, based on a recent live symposium, highlights and analyzes the latest evidence and advances in the treatment of ER+/HER2- breast cancer, focusing on the expanding evidence base supporting the use of novel ER-targeted agents such as oral SERDs as a new standard of care in pretreated ER+/HER2- breast cancer. Practical guidance is also provided on how to apply the latest evidence to practice, optimize the use of these agents, and individualize treatment plans that take into account key data, patient- and tumor-related factors, and the specific needs and preferences of each patient. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including novel oral SERDs and other ER-targeting therapies, and their evolving role in clinical practice; Develop individualized treatment plans for patients with previously treated ER+/HER2- breast cancer that take into account the latest treatment options and all the relevant treatment-, tumor-, and patient-related factors; Integrate a team-based, collaborative, coordinated, and patient-centered approach to select appropriate candidates for SERDs and other new therapies for ER+/HER2- breast cancer, provide essential patient education, and ensure optimal delivery of therapy
Go online to PeerView.com/DFJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Breast cancer is a heterogeneous disease comprising different subtypes, with estrogen receptor positive (ER+) being the most common subtype. Endocrine therapy (ET) is the primary treatment in ER+ breast cancer, which includes different strategies that directly or indirectly modify estrogen production. CDK4 and 6 inhibition as well as PI3K inhibition have improved outcomes in these patients, but most still develop endocrine resistance. ESR1 gene mutations, somatic alterations, microenvironmental factors, and epigenetic changes have all been implicated as underlying mechanisms promoting resistance. Novel ER-targeting agents such as oral selective estrogen receptor degraders (SERDs) are showing therapeutic promise in the face of ET resistance. In addition, other agents are being evaluated in ER+ disease, including selective estrogen receptor modifiers (SERMs), SERM/SERD hybrids, selective estrogen receptor covalent antagonists (SERCAs), proteolysis targeting chimeras (PROTACs), and others.This PeerView educational activity, based on a recent live symposium, highlights and analyzes the latest evidence and advances in the treatment of ER+/HER2- breast cancer, focusing on the expanding evidence base supporting the use of novel ER-targeted agents such as oral SERDs as a new standard of care in pretreated ER+/HER2- breast cancer. Practical guidance is also provided on how to apply the latest evidence to practice, optimize the use of these agents, and individualize treatment plans that take into account key data, patient- and tumor-related factors, and the specific needs and preferences of each patient. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including novel oral SERDs and other ER-targeting therapies, and their evolving role in clinical practice; Develop individualized treatment plans for patients with previously treated ER+/HER2- breast cancer that take into account the latest treatment options and all the relevant treatment-, tumor-, and patient-related factors; Integrate a team-based, collaborative, coordinated, and patient-centered approach to select appropriate candidates for SERDs and other new therapies for ER+/HER2- breast cancer, provide essential patient education, and ensure optimal delivery of therapy
Go online to PeerView.com/DFJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Breast cancer is a heterogeneous disease comprising different subtypes, with estrogen receptor positive (ER+) being the most common subtype. Endocrine therapy (ET) is the primary treatment in ER+ breast cancer, which includes different strategies that directly or indirectly modify estrogen production. CDK4 and 6 inhibition as well as PI3K inhibition have improved outcomes in these patients, but most still develop endocrine resistance. ESR1 gene mutations, somatic alterations, microenvironmental factors, and epigenetic changes have all been implicated as underlying mechanisms promoting resistance. Novel ER-targeting agents such as oral selective estrogen receptor degraders (SERDs) are showing therapeutic promise in the face of ET resistance. In addition, other agents are being evaluated in ER+ disease, including selective estrogen receptor modifiers (SERMs), SERM/SERD hybrids, selective estrogen receptor covalent antagonists (SERCAs), proteolysis targeting chimeras (PROTACs), and others.This PeerView educational activity, based on a recent live symposium, highlights and analyzes the latest evidence and advances in the treatment of ER+/HER2- breast cancer, focusing on the expanding evidence base supporting the use of novel ER-targeted agents such as oral SERDs as a new standard of care in pretreated ER+/HER2- breast cancer. Practical guidance is also provided on how to apply the latest evidence to practice, optimize the use of these agents, and individualize treatment plans that take into account key data, patient- and tumor-related factors, and the specific needs and preferences of each patient. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including novel oral SERDs and other ER-targeting therapies, and their evolving role in clinical practice; Develop individualized treatment plans for patients with previously treated ER+/HER2- breast cancer that take into account the latest treatment options and all the relevant treatment-, tumor-, and patient-related factors; Integrate a team-based, collaborative, coordinated, and patient-centered approach to select appropriate candidates for SERDs and other new therapies for ER+/HER2- breast cancer, provide essential patient education, and ensure optimal delivery of therapy
Go online to PeerView.com/DFJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Breast cancer is a heterogeneous disease comprising different subtypes, with estrogen receptor positive (ER+) being the most common subtype. Endocrine therapy (ET) is the primary treatment in ER+ breast cancer, which includes different strategies that directly or indirectly modify estrogen production. CDK4 and 6 inhibition as well as PI3K inhibition have improved outcomes in these patients, but most still develop endocrine resistance. ESR1 gene mutations, somatic alterations, microenvironmental factors, and epigenetic changes have all been implicated as underlying mechanisms promoting resistance. Novel ER-targeting agents such as oral selective estrogen receptor degraders (SERDs) are showing therapeutic promise in the face of ET resistance. In addition, other agents are being evaluated in ER+ disease, including selective estrogen receptor modifiers (SERMs), SERM/SERD hybrids, selective estrogen receptor covalent antagonists (SERCAs), proteolysis targeting chimeras (PROTACs), and others.This PeerView educational activity, based on a recent live symposium, highlights and analyzes the latest evidence and advances in the treatment of ER+/HER2- breast cancer, focusing on the expanding evidence base supporting the use of novel ER-targeted agents such as oral SERDs as a new standard of care in pretreated ER+/HER2- breast cancer. Practical guidance is also provided on how to apply the latest evidence to practice, optimize the use of these agents, and individualize treatment plans that take into account key data, patient- and tumor-related factors, and the specific needs and preferences of each patient. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including novel oral SERDs and other ER-targeting therapies, and their evolving role in clinical practice; Develop individualized treatment plans for patients with previously treated ER+/HER2- breast cancer that take into account the latest treatment options and all the relevant treatment-, tumor-, and patient-related factors; Integrate a team-based, collaborative, coordinated, and patient-centered approach to select appropriate candidates for SERDs and other new therapies for ER+/HER2- breast cancer, provide essential patient education, and ensure optimal delivery of therapy
Go online to PeerView.com/DFJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Breast cancer is a heterogeneous disease comprising different subtypes, with estrogen receptor positive (ER+) being the most common subtype. Endocrine therapy (ET) is the primary treatment in ER+ breast cancer, which includes different strategies that directly or indirectly modify estrogen production. CDK4 and 6 inhibition as well as PI3K inhibition have improved outcomes in these patients, but most still develop endocrine resistance. ESR1 gene mutations, somatic alterations, microenvironmental factors, and epigenetic changes have all been implicated as underlying mechanisms promoting resistance. Novel ER-targeting agents such as oral selective estrogen receptor degraders (SERDs) are showing therapeutic promise in the face of ET resistance. In addition, other agents are being evaluated in ER+ disease, including selective estrogen receptor modifiers (SERMs), SERM/SERD hybrids, selective estrogen receptor covalent antagonists (SERCAs), proteolysis targeting chimeras (PROTACs), and others.This PeerView educational activity, based on a recent live symposium, highlights and analyzes the latest evidence and advances in the treatment of ER+/HER2- breast cancer, focusing on the expanding evidence base supporting the use of novel ER-targeted agents such as oral SERDs as a new standard of care in pretreated ER+/HER2- breast cancer. Practical guidance is also provided on how to apply the latest evidence to practice, optimize the use of these agents, and individualize treatment plans that take into account key data, patient- and tumor-related factors, and the specific needs and preferences of each patient. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including novel oral SERDs and other ER-targeting therapies, and their evolving role in clinical practice; Develop individualized treatment plans for patients with previously treated ER+/HER2- breast cancer that take into account the latest treatment options and all the relevant treatment-, tumor-, and patient-related factors; Integrate a team-based, collaborative, coordinated, and patient-centered approach to select appropriate candidates for SERDs and other new therapies for ER+/HER2- breast cancer, provide essential patient education, and ensure optimal delivery of therapy
Better Edge : A Northwestern Medicine podcast for physicians
While testosterone replacement therapy (TRT) has become more popular and has been proven to be an effective treatment for male hypogonadism, it raises several safety concerns. In this episode of the Better Edge podcast, Joshua A. Halpern, MD, assistant professor of Urology at Northwestern Medicine, discusses alternative therapies to TRT, including selective estrogen receptor modulators (SERMs), human chorionic gonadotropin (hCG) and aromatase inhibitors. These therapies can be used to promote the endogenous production of testosterone. Dr. Halpern recently presented a plenary on this topic at the 2022 American Urological Association Annual Meeting.
Go online to PeerView.com/KVE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. CDK4 and 6 inhibitors and endocrine therapy have significantly improved outcomes in ER+/HER2- advanced breast cancer, and recently, the first CDK4 and 6 inhibitor was approved in combination with endocrine therapy in the adjuvant setting for patients with HR+/HER2-, node-positive, early breast cancer at high risk of recurrence and a Ki-67 score of ≥20%. However, pretreated ER+/HER2- breast cancer remains a challenging area with limited treatment options. A number of novel ER-targeting therapies are being investigated in this setting and are showing great promise, including oral selective estrogen receptor degraders (SERDs), selective estrogen receptor modifiers (SERMs), SERD/SERM hybrids, selective estrogen receptor covalent antagonists (SERCAs), and proteolysis-targeting chimeras (PROTACs). This activity, based on a PeerView Live Seminars & Practicum educational web broadcast held in conjunction with the 2022 ASCO Annual Meeting, provides the multidisciplinary breast cancer care team with the latest research and evidence on current and emerging targeted and endocrine therapy options and the implications of these therapeutic advances for practice to ensure that more patients benefit and have improved outcomes. The patient perspective is highlighted as well, and advice for overcoming persistent disparities in breast cancer clinical care are shared. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including CDK4 and 6 inhibitors, SERDs, and SERCAs, and their evolving role in clinical practice; Develop personalized treatment plans for patients with ER+/HER2- breast cancer that take into account recent approvals and safety and efficacy findings from emerging therapies in the context of clinical practice or clinical trials, particularly in areas of high unmet need; and Integrate a team-based, collaborative, and coordinated approach to care, educate patients about new and emerging treatment options for which they may be eligible, and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Go online to PeerView.com/KVE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. CDK4 and 6 inhibitors and endocrine therapy have significantly improved outcomes in ER+/HER2- advanced breast cancer, and recently, the first CDK4 and 6 inhibitor was approved in combination with endocrine therapy in the adjuvant setting for patients with HR+/HER2-, node-positive, early breast cancer at high risk of recurrence and a Ki-67 score of ≥20%. However, pretreated ER+/HER2- breast cancer remains a challenging area with limited treatment options. A number of novel ER-targeting therapies are being investigated in this setting and are showing great promise, including oral selective estrogen receptor degraders (SERDs), selective estrogen receptor modifiers (SERMs), SERD/SERM hybrids, selective estrogen receptor covalent antagonists (SERCAs), and proteolysis-targeting chimeras (PROTACs). This activity, based on a PeerView Live Seminars & Practicum educational web broadcast held in conjunction with the 2022 ASCO Annual Meeting, provides the multidisciplinary breast cancer care team with the latest research and evidence on current and emerging targeted and endocrine therapy options and the implications of these therapeutic advances for practice to ensure that more patients benefit and have improved outcomes. The patient perspective is highlighted as well, and advice for overcoming persistent disparities in breast cancer clinical care are shared. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including CDK4 and 6 inhibitors, SERDs, and SERCAs, and their evolving role in clinical practice; Develop personalized treatment plans for patients with ER+/HER2- breast cancer that take into account recent approvals and safety and efficacy findings from emerging therapies in the context of clinical practice or clinical trials, particularly in areas of high unmet need; and Integrate a team-based, collaborative, and coordinated approach to care, educate patients about new and emerging treatment options for which they may be eligible, and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Go online to PeerView.com/KVE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. CDK4 and 6 inhibitors and endocrine therapy have significantly improved outcomes in ER+/HER2- advanced breast cancer, and recently, the first CDK4 and 6 inhibitor was approved in combination with endocrine therapy in the adjuvant setting for patients with HR+/HER2-, node-positive, early breast cancer at high risk of recurrence and a Ki-67 score of ≥20%. However, pretreated ER+/HER2- breast cancer remains a challenging area with limited treatment options. A number of novel ER-targeting therapies are being investigated in this setting and are showing great promise, including oral selective estrogen receptor degraders (SERDs), selective estrogen receptor modifiers (SERMs), SERD/SERM hybrids, selective estrogen receptor covalent antagonists (SERCAs), and proteolysis-targeting chimeras (PROTACs). This activity, based on a PeerView Live Seminars & Practicum educational web broadcast held in conjunction with the 2022 ASCO Annual Meeting, provides the multidisciplinary breast cancer care team with the latest research and evidence on current and emerging targeted and endocrine therapy options and the implications of these therapeutic advances for practice to ensure that more patients benefit and have improved outcomes. The patient perspective is highlighted as well, and advice for overcoming persistent disparities in breast cancer clinical care are shared. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including CDK4 and 6 inhibitors, SERDs, and SERCAs, and their evolving role in clinical practice; Develop personalized treatment plans for patients with ER+/HER2- breast cancer that take into account recent approvals and safety and efficacy findings from emerging therapies in the context of clinical practice or clinical trials, particularly in areas of high unmet need; and Integrate a team-based, collaborative, and coordinated approach to care, educate patients about new and emerging treatment options for which they may be eligible, and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Go online to PeerView.com/KVE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. CDK4 and 6 inhibitors and endocrine therapy have significantly improved outcomes in ER+/HER2- advanced breast cancer, and recently, the first CDK4 and 6 inhibitor was approved in combination with endocrine therapy in the adjuvant setting for patients with HR+/HER2-, node-positive, early breast cancer at high risk of recurrence and a Ki-67 score of ≥20%. However, pretreated ER+/HER2- breast cancer remains a challenging area with limited treatment options. A number of novel ER-targeting therapies are being investigated in this setting and are showing great promise, including oral selective estrogen receptor degraders (SERDs), selective estrogen receptor modifiers (SERMs), SERD/SERM hybrids, selective estrogen receptor covalent antagonists (SERCAs), and proteolysis-targeting chimeras (PROTACs). This activity, based on a PeerView Live Seminars & Practicum educational web broadcast held in conjunction with the 2022 ASCO Annual Meeting, provides the multidisciplinary breast cancer care team with the latest research and evidence on current and emerging targeted and endocrine therapy options and the implications of these therapeutic advances for practice to ensure that more patients benefit and have improved outcomes. The patient perspective is highlighted as well, and advice for overcoming persistent disparities in breast cancer clinical care are shared. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including CDK4 and 6 inhibitors, SERDs, and SERCAs, and their evolving role in clinical practice; Develop personalized treatment plans for patients with ER+/HER2- breast cancer that take into account recent approvals and safety and efficacy findings from emerging therapies in the context of clinical practice or clinical trials, particularly in areas of high unmet need; and Integrate a team-based, collaborative, and coordinated approach to care, educate patients about new and emerging treatment options for which they may be eligible, and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Go online to PeerView.com/KVE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. CDK4 and 6 inhibitors and endocrine therapy have significantly improved outcomes in ER+/HER2- advanced breast cancer, and recently, the first CDK4 and 6 inhibitor was approved in combination with endocrine therapy in the adjuvant setting for patients with HR+/HER2-, node-positive, early breast cancer at high risk of recurrence and a Ki-67 score of ≥20%. However, pretreated ER+/HER2- breast cancer remains a challenging area with limited treatment options. A number of novel ER-targeting therapies are being investigated in this setting and are showing great promise, including oral selective estrogen receptor degraders (SERDs), selective estrogen receptor modifiers (SERMs), SERD/SERM hybrids, selective estrogen receptor covalent antagonists (SERCAs), and proteolysis-targeting chimeras (PROTACs). This activity, based on a PeerView Live Seminars & Practicum educational web broadcast held in conjunction with the 2022 ASCO Annual Meeting, provides the multidisciplinary breast cancer care team with the latest research and evidence on current and emerging targeted and endocrine therapy options and the implications of these therapeutic advances for practice to ensure that more patients benefit and have improved outcomes. The patient perspective is highlighted as well, and advice for overcoming persistent disparities in breast cancer clinical care are shared. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including CDK4 and 6 inhibitors, SERDs, and SERCAs, and their evolving role in clinical practice; Develop personalized treatment plans for patients with ER+/HER2- breast cancer that take into account recent approvals and safety and efficacy findings from emerging therapies in the context of clinical practice or clinical trials, particularly in areas of high unmet need; and Integrate a team-based, collaborative, and coordinated approach to care, educate patients about new and emerging treatment options for which they may be eligible, and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Go online to PeerView.com/KVE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. CDK4 and 6 inhibitors and endocrine therapy have significantly improved outcomes in ER+/HER2- advanced breast cancer, and recently, the first CDK4 and 6 inhibitor was approved in combination with endocrine therapy in the adjuvant setting for patients with HR+/HER2-, node-positive, early breast cancer at high risk of recurrence and a Ki-67 score of ≥20%. However, pretreated ER+/HER2- breast cancer remains a challenging area with limited treatment options. A number of novel ER-targeting therapies are being investigated in this setting and are showing great promise, including oral selective estrogen receptor degraders (SERDs), selective estrogen receptor modifiers (SERMs), SERD/SERM hybrids, selective estrogen receptor covalent antagonists (SERCAs), and proteolysis-targeting chimeras (PROTACs). This activity, based on a PeerView Live Seminars & Practicum educational web broadcast held in conjunction with the 2022 ASCO Annual Meeting, provides the multidisciplinary breast cancer care team with the latest research and evidence on current and emerging targeted and endocrine therapy options and the implications of these therapeutic advances for practice to ensure that more patients benefit and have improved outcomes. The patient perspective is highlighted as well, and advice for overcoming persistent disparities in breast cancer clinical care are shared. Upon completion of this activity, participants should be better able to: Describe the rationale, mechanisms of action, and latest efficacy and safety data of approved and emerging treatment options for patients with ER+/HER2- breast cancer, including CDK4 and 6 inhibitors, SERDs, and SERCAs, and their evolving role in clinical practice; Develop personalized treatment plans for patients with ER+/HER2- breast cancer that take into account recent approvals and safety and efficacy findings from emerging therapies in the context of clinical practice or clinical trials, particularly in areas of high unmet need; and Integrate a team-based, collaborative, and coordinated approach to care, educate patients about new and emerging treatment options for which they may be eligible, and engage patients in shared decision-making to ensure that their unique needs and preferences are taken into account when making treatment decisions.
Join me in todays episode where I breakdown about how AI, SERMs modulate oestrogen levels. I also go into how Primobolan and Masteron are able to help you control oestrogen and exactly how they do this. I then round up and give me opinion on stack design and my choice for helping control oestrogen levels. Follow me on instagram: @vwphysique
In this episode, we review the high-yield topic of Selective Estrogen Receptor Modulators (SERMs) from the Reproductive section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficialx Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message
In this episode, Dr. Cam interviews one of our medical advisors at Maximus, Dr. Rand McClain. Dr. McClain earned his medical degree at Western University and completed his internship at the University of Southern California's Keck School of Medicine Residency Program (U.S.C. California Hospital) and has worked with some of the best and original innovators in Sports, Rejuvenative, Regenerative (“Anti-Aging”), Cosmetic and Family Medicine. Dr. McClain has dedicated over 35 years of his personal and professional life to studying nutrition, exercise, herbs, and supplements and is also a Master of Acupuncture and Traditional Chinese Medicine. They discuss the best ways for men to optimize their testosterone and why The Maximus King Protocol is superior, especially for younger men. Chapters 00:00 Intro 01:15 Why did you become a medical advisor at Maximus? 02:45 Testosterone 101 05:30 Testing your testosterone levels 08:40 Total vs Free Testosterone 12:25 Monitoring SHGB levels 13:50 Causes for the decline in men's testosterone 18:00 avoiding xenoestrogens 19:50 Primary vs Secondary Hypogonadism 22:45 SERMs and Enclomiphene 25:50 Why Enclomiphene is the best SERM for most guys 27:30 How Enclomiphene works 31:30 Enclomiphene vs TRT 33:00 Aromatase inhibitors 35:10 Why Enclomiphene has fewer side effects than TRT 40:00 The benefits of Enclomiphene 43:00 Testosterone and mood 44:20 Important vitamins for hormonal health 46:10 Why everyone needs to supplement Vitamin D 51:00 Best lifestyle choices to increase testosterone 55:30 Proper diets for optimal health 01:00:55 why cholesterol is important 01:04:20 Other important health markers 01:06:40 The future of healthcare 01:09:00 Why Enclomiphene is a better option for younger men 01:10:10 HCG vs Enclomiphene 01:13:40 Outro
In this episode, we review the high-yield topic of Selective Estrogen Receptor Modulators (SERMs) from the Gynecology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
Go online to PeerView.com/HCA860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, experts in breast cancer discuss the latest advances in the management of patients with estrogen receptor–positive (ER+)/human epidermal growth factor receptor 2–negative (HER2-) breast cancer, including the rapidly accumulating evidence supporting the use of novel therapies such as selective estrogen receptor degraders (SERDs), selective estrogen receptor modulators (SERMs), selective estrogen receptor covalent antagonists (SERCAs), complete estrogen receptor antagonists (CERANs), and proteolysis-targeting chimeras (PROTACs), among others. In addition to analyzing the recent data from clinical trials with these ER-targeted therapies, patient case scenarios are presented to illustrate their potential role and use, and how to incorporate these novel treatments into the current management paradigm to improve outcomes in patients with ER+ breast cancer. Upon completion of this CE activity, participants will be able to: Cite the rationale for use, mechanism of action, and features of the various endocrine, targeted, and other therapy options for HR+ breast cancer, Incorporate the most recent efficacy, safety, and other key findings from clinical trials assessing different endocrine, targeted, and other emerging therapies and combinations into treatment regimens for eligible patients with HR+ breast cancer in the context of clinical practice or via clinical trial participation.
Go online to PeerView.com/HCA860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, experts in breast cancer discuss the latest advances in the management of patients with estrogen receptor–positive (ER+)/human epidermal growth factor receptor 2–negative (HER2-) breast cancer, including the rapidly accumulating evidence supporting the use of novel therapies such as selective estrogen receptor degraders (SERDs), selective estrogen receptor modulators (SERMs), selective estrogen receptor covalent antagonists (SERCAs), complete estrogen receptor antagonists (CERANs), and proteolysis-targeting chimeras (PROTACs), among others. In addition to analyzing the recent data from clinical trials with these ER-targeted therapies, patient case scenarios are presented to illustrate their potential role and use, and how to incorporate these novel treatments into the current management paradigm to improve outcomes in patients with ER+ breast cancer. Upon completion of this CE activity, participants will be able to: Cite the rationale for use, mechanism of action, and features of the various endocrine, targeted, and other therapy options for HR+ breast cancer, Incorporate the most recent efficacy, safety, and other key findings from clinical trials assessing different endocrine, targeted, and other emerging therapies and combinations into treatment regimens for eligible patients with HR+ breast cancer in the context of clinical practice or via clinical trial participation.
Go online to PeerView.com/HCA860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, experts in breast cancer discuss the latest advances in the management of patients with estrogen receptor–positive (ER+)/human epidermal growth factor receptor 2–negative (HER2-) breast cancer, including the rapidly accumulating evidence supporting the use of novel therapies such as selective estrogen receptor degraders (SERDs), selective estrogen receptor modulators (SERMs), selective estrogen receptor covalent antagonists (SERCAs), complete estrogen receptor antagonists (CERANs), and proteolysis-targeting chimeras (PROTACs), among others. In addition to analyzing the recent data from clinical trials with these ER-targeted therapies, patient case scenarios are presented to illustrate their potential role and use, and how to incorporate these novel treatments into the current management paradigm to improve outcomes in patients with ER+ breast cancer. Upon completion of this CE activity, participants will be able to: Cite the rationale for use, mechanism of action, and features of the various endocrine, targeted, and other therapy options for HR+ breast cancer, Incorporate the most recent efficacy, safety, and other key findings from clinical trials assessing different endocrine, targeted, and other emerging therapies and combinations into treatment regimens for eligible patients with HR+ breast cancer in the context of clinical practice or via clinical trial participation.
Go online to PeerView.com/HCA860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, experts in breast cancer discuss the latest advances in the management of patients with estrogen receptor–positive (ER+)/human epidermal growth factor receptor 2–negative (HER2-) breast cancer, including the rapidly accumulating evidence supporting the use of novel therapies such as selective estrogen receptor degraders (SERDs), selective estrogen receptor modulators (SERMs), selective estrogen receptor covalent antagonists (SERCAs), complete estrogen receptor antagonists (CERANs), and proteolysis-targeting chimeras (PROTACs), among others. In addition to analyzing the recent data from clinical trials with these ER-targeted therapies, patient case scenarios are presented to illustrate their potential role and use, and how to incorporate these novel treatments into the current management paradigm to improve outcomes in patients with ER+ breast cancer. Upon completion of this CE activity, participants will be able to: Cite the rationale for use, mechanism of action, and features of the various endocrine, targeted, and other therapy options for HR+ breast cancer, Incorporate the most recent efficacy, safety, and other key findings from clinical trials assessing different endocrine, targeted, and other emerging therapies and combinations into treatment regimens for eligible patients with HR+ breast cancer in the context of clinical practice or via clinical trial participation.
Go online to PeerView.com/HCA860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, experts in breast cancer discuss the latest advances in the management of patients with estrogen receptor–positive (ER+)/human epidermal growth factor receptor 2–negative (HER2-) breast cancer, including the rapidly accumulating evidence supporting the use of novel therapies such as selective estrogen receptor degraders (SERDs), selective estrogen receptor modulators (SERMs), selective estrogen receptor covalent antagonists (SERCAs), complete estrogen receptor antagonists (CERANs), and proteolysis-targeting chimeras (PROTACs), among others. In addition to analyzing the recent data from clinical trials with these ER-targeted therapies, patient case scenarios are presented to illustrate their potential role and use, and how to incorporate these novel treatments into the current management paradigm to improve outcomes in patients with ER+ breast cancer. Upon completion of this CE activity, participants will be able to: Cite the rationale for use, mechanism of action, and features of the various endocrine, targeted, and other therapy options for HR+ breast cancer, Incorporate the most recent efficacy, safety, and other key findings from clinical trials assessing different endocrine, targeted, and other emerging therapies and combinations into treatment regimens for eligible patients with HR+ breast cancer in the context of clinical practice or via clinical trial participation.
Go online to PeerView.com/HCA860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, experts in breast cancer discuss the latest advances in the management of patients with estrogen receptor–positive (ER+)/human epidermal growth factor receptor 2–negative (HER2-) breast cancer, including the rapidly accumulating evidence supporting the use of novel therapies such as selective estrogen receptor degraders (SERDs), selective estrogen receptor modulators (SERMs), selective estrogen receptor covalent antagonists (SERCAs), complete estrogen receptor antagonists (CERANs), and proteolysis-targeting chimeras (PROTACs), among others. In addition to analyzing the recent data from clinical trials with these ER-targeted therapies, patient case scenarios are presented to illustrate their potential role and use, and how to incorporate these novel treatments into the current management paradigm to improve outcomes in patients with ER+ breast cancer. Upon completion of this CE activity, participants will be able to: Cite the rationale for use, mechanism of action, and features of the various endocrine, targeted, and other therapy options for HR+ breast cancer, Incorporate the most recent efficacy, safety, and other key findings from clinical trials assessing different endocrine, targeted, and other emerging therapies and combinations into treatment regimens for eligible patients with HR+ breast cancer in the context of clinical practice or via clinical trial participation.
Mucho gusto! Soy otro tu! Viviendo una experiencia única! Soy una persona versátil.
Audiolibro Ilustrado Fundamentos del Tarot Parte Final
Non-Hormonal Medication Options for Preventing and Treating Osteoporosis No woman should ever suffer with osteoporosis or fractures. That's because, in addition to all the hormonal medication options for preventing and treating osteoporosis, there is a whole smorgasbord of non-hormonal medication options. Knowing about these medications can all the difference in your ability to avoid the pitfalls of developing osteoporosis in the first place. Watch this video to learn all about the SERMs for preventing and treating osteoporosis.
Mucho gusto! Soy otro tu! Viviendo una experiencia única! Soy una persona versátil.
Audiolibro Ilustrado Fundamentos del Tarot Parte 16
In this episode TYL and David discuss L-Carnitine & Lipo-C for weight loss and health benefits, ADD/ADHD and Adderall's effects, Caffeine's benefits and side effects to the adrenal system, Is Sleep a PED and one of the best sleep supplements on the market, Serms vs AI's for TRT, DIM & Calcium D-Glucarate for estrogen management, People who don't research, David's client gains 17 lbs with zero fat gain, how Cardarine (GW-501516) feels and studies on it and a TYL synthetic weed story. Test Your Levels Linkshttps://linktr.ee/testyourlevelsYoutubeInstagramTikTokSam Stolt's Linkshttp://bit.ly/sam-stolt-linksYoutubeInstagramTikTokTwitterDavid DeMesquita Linkshttps://taplink.cc/dynamite_dYoutubeInstagram
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