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The UROONCO RCC editorial board chief editor Dr. Carmen Mir, and associate editors Dr. Teele Kuusk and Dr. Riccardo Bertolo share highlights of the important kidney cancer developments for 2024. They summarise the results on several important trials such as FASTRACK, ZIRCON, KEYNOTE-564 and IMmotion010. They also discuss the developments on surgical aspects too.To learn more on the highlights discussed in this podcast, you can read the below Articles of the Month, listen to the podcasts or watch the videos.Stereotactic ablative body radiotherapy for primary kidney cancer (TROG 15.03 FASTRACK II): a non-randomised phase 2 trial[89Zr]Zr-girentuximab for PET–CT imaging of clear-cell renal cell carcinoma: a prospective, open-label, multicentre, phase 3 trialASCO GU24 special: Assoc. Prof. Barata discusses the results of KEYNOTE-564 and CheckMate-914ASCO GU24 special: Prof. Michael Hofman talks about a novel CA IX-targeting peptideASCO2024 special: Circulating kidney injury molecule-1 biomarker analysis in IMmotion010Present and future of robotic surgery for RCCThe treatment of locally advanced and metastatic renal cancerFor more EAU podcasts, please go to your favourite podcast app and subscribe to our podcast channel for regular updates: Apple Podcasts, Spotify, Google Podcasts.
Титан независимого видеопродакшена в России, Паша Карыхалин открыл индустрии рекламы и кино целое поколение новых режиссеров. В том числе и Женю Онегину. «Сначала понять с кем, а потом придумать что»: успех Stereotactic всегда был завязан на людях. Сейчас у студии появилось новое направление, Stereotactic Film, и цель команды развивать и популяризировать документальное кино. Говорим о том, как это отвечает на зрительский вопрос и оправдано и коммерчески.Ссылки на тех, кого мы упоминаем в этом эпизоде:StereotacticОля КорсунМитя Фисенко / Интервью, 2008Саша Худоконь / Интервью, 2010Паша КузнецовРома Кантор«Костры и звезды», Владимира Сорокина, 2016Леша СтародубовПодкаст Script Notes«Гимн чуме» коллектива Ataka51Подкаст Динеса Лапшинова с Пашей КарыхалинымПетр БарабакаЛеша Крупник«Василий», Саши Худоконя, 2013«Глаз», Максима Томаша, 2013«Экспресс» Руслана БратоваНепрошедшее времяСайт фильмаTraumazone, Адама Кертиса, 2022«2», Саши Карелиной, 2023Почта подкаста: darkplayground.podcast@gmail.comЗвуковое оформление: frailtynine This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit darkplayground.substack.com
Emile Daoud, MD, Associate Editor of JACC: Clinical Electrophysiology discusses a recently published original research paper on Stereotactic Radioablation for Septal Ventricular Tachycardias
Janani S. Reisenauer, MD; Patrick W. Eiken, MD; and Dawn Owen, MD PhD, join journal CHEST Podcast Moderator Dominique Pepper, MD, to discuss new research comparing outcomes for metastasis-directed therapies including sublobar resection, stereotactic body radiation therapy, and percutaneous ablation.
Dr. Konstantin Slavin is Professor and Chief of Section and Fellowship Director for Stereotactic and Functional Neurosurgery in the Department of Neurosurgery at the University of Illinois at Chicago (UIC). Dr. Slavin graduated from medical school in Baku, Azerbaijan in the Soviet Union and completed his neurosurgery residency in Moscow. He then completed his second neurosurgery residency at UIC and a fellowship in functional and stereotactic neurosurgery at Oregon Health Sciences University in Portland, Oregon. Dr. Slavin is current President of the World Society for Stereotactic and Functional Neurosurgery and the Past President of the American Society for Stereotactic and Functional Neurosurgery. He is also the President-Elect of the International Neuromodulation Society (INS) and past Secretary of the North American Neuromodulation Society (NANS). For many years, he serves on the Medical Advisory Board of the Facial Pain Association, the premier patient organization for those who suffer from trigeminal neuralgia and other facial pain syndromes. In addition, he is on the Board of non profit organization “Neuromodulation Foundation”, the publisher of Wikistim, and for more than a decade was an Executive Committee member of the Joint Section on Pain of the American Association of Neurological Surgeons and Congress of Neurological Surgeons. Dr. Slavin has published in many books and peer-reviewed journals and is an associate editor or editorial board member for a number of publications, including Neuromodulation, Neurosurgery, Brain Sciences, Stereotactic and Functional Neurosurgery, Acta Neurochirurgica and others; he is the current editor-in-chief of Progress in Neurological Surgery. His first book on Peripheral Nerve Stimulation was published in 2011; another book, co-edited with Sam Eljamel on Neurostimulation: Practice and Principles, came out in 2013; the third one, Stimulation of Peripheral Nervous System: The Neuromodulation Frontier was released in 2015. The most recent – and most relevant for this audience – book on Neuromodulation for Facial Pain came out in 2021.
Senior Editor Owen Stretton talks to Professor Shankar Shiva from the Peter MacCallum Cancer Centre in Melbourne about the International Society of Stereotactic Radiosurgery's new systematic review and practice guidelines for stereotactic body radiotherapy in primary renal cell carcinoma.Continue this conversation on social!Follow us today at...https://twitter.com/thelancet & https://Twitter.com/TheLancetOncolhttps://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv
The Accelerators (Drs. Matt Spraker and Simul Parikh) host the lung cancer legend, Brendon Stiles, MD. He is a Professor of Oncology, Medicine, and Thoracic Surgery at Montfiore and Albert Einstein College of Medicine.We discuss all things lung cancer: early stage, locally advanced, staging, quality, and more.The episode is capped with Simul's Lighting Round. Good luck Brendon!We hope you enjoy this #MedEd instant classic!Here are (almost?) all the studies and materials we mentioned during the show:Brendon's "Old Slide" on patient selection and operabilityLobar or Sublobar Resection for Peripheral Stage IA Non–Small-Cell Lung Cancer (CALGB 140503)Stereotactic ablative radiotherapy with or without immunotherapy for early-stage or isolated lung parenchymal recurrent node-negative non-small-cell lung cancer (I-SABR)Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials (STARS-ROSEL)Measuring the Integration of Stereotactic Ablative Radiotherapy Plus Surgery for Early-Stage Non–Small Cell Lung Cancer (MISSILE)Stereotactic ABlative Radiotherapy Before Resection to AvoId Delay for Early-Stage LunG Cancer or OligomEts During the COVID-19 Pandemic (SABR-BRIDGE)Five-Year Survival Outcomes From the PACIFIC Trial: Durvalumab After Chemoradiotherapy in Stage III Non–Small-Cell Lung CancerPhase II Study of Accelerated High-Dose Radiation Therapy with Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer (RTOG 0239)Randomized Phase II Study of Preoperative Chemoradiotherapy ± Panitumumab Followed by Consolidation Chemotherapy in Potentially Operable Locally Advanced (Stage IIIa, N2+) Non-Small Cell Lung Cancer (RTOG 0839)Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer (CheckMate 816)Pacific-2 Press Release, AstraZenecaStudy of Durvalumab Given With Chemoradiation Therapy in Patients With Unresectable Non-small Cell Lung Cancer (MDT-BRIDGE, in progress)Society of Thoracic Surgeons quality initiativesThe Accelerators Podcast is a production of Photon Media, a division of Cold Light Legacy Company.If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.
Stereotactic Radiosurgery for Lung Cancer with guest Dr. Nadine Housri August 27, 2023 Yale Cancer Center visit: http://www.yalecancercenter.org email: canceranswers@yale.edu call: 203-785-4095
Stereotactic Radiosurgery for Lung Cancer with guest Dr. Nadine Housri August 27, 2023 Yale Cancer Center visit: http://www.yalecancercenter.org email: canceranswers@yale.edu call: 203-785-4095
In this episode of the Cancer Advances podcast, Dale Shepard, MD, PhD is joined by Shlomo Koyfman, MD, Director of Head and Neck and Skin Radiation at Cleveland Clinic to discuss the use of stereotactic body radiation therapy (SBRT) for head and neck cancer treatment. Dr. Koyfman shares insights from his experience highlighting the role of SBRT in re-irradiation cases as a primary therapy option. This informative conversation sheds light on the innovative techniques and advancements in radiation oncology that are improving outcomes for patients with head and neck cancer.
Dr. Thimappa Hegde is a distinguished neurosurgeon and is presently working as the Director of Narayana Institute of Neurosciences, Bangalore. He finished his neurosurgery residency at the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore. He continued as a faculty at the Department of Neurosurgery, NIMHANS till 2003, where he was instrumental in starting Stereotactic and Functional Neurosurgery. In 2004 he founded the Narayana Institute of Neurosciences which has now become one of the finest centers for Neurology and Neurosurgery service with an excellent training program. Hosted on Acast. See acast.com/privacy for more information.
Join us for an illuminating conversation with Drs. Joachim Krauss, Marwan Hariz, and Christian Moll, as we delve into the history of Stereotactic and Functional Neurosurgery, and the impact of serendipity in driving discovery. In the first part of the episode, we explore the fascinating history of Stereotactic Functional Neurosurgery, discussing the advances in technology and surgical techniques that have led to the current state of the field. We also touch on the challenges and ethical considerations involved in Stereotactic and Functional Neurosurgery, as outlined in Rzesnitzek et al.'s paper “Psychosurgery in the History of Stereotactic Functional Neurosurgery.” In the second part of the episode, we turn our attention to the role of serendipity in scientific discovery, inspired by Hariz et al.'s paper “Serendipity and Observations in Functional Neurosurgery: From James Parkinson's Stroke to Hamani's & Lozano's Flashbacks.” We discuss the power of chance observations and unexpected findings in advancing our understanding of the brain and improving patient outcomes. We also debate the strengths and limitations of the serendipitous approach to discovery, in contrast to more systematic methods of target discovery. Overall, our conversation with Drs. Krauss, Hariz, and Moll sheds light on the rich history and exciting future of Stereotactic and Functional Neurosurgery, and the fascinating interplay between serendipity and scientific discovery.
Deep brain stimulation (DBS) is complex brain surgery in which electrodes are placed at strategic, predetermined targets within a patient's brain. The electrodes are then connected to a battery pack which is surgically inserted under the skin of the chest, like a pacemaker.When DBS was first introduced as a treatment option for people living with Parkinson's disease more than 20 years ago, it was a game changer.In this episode of Your Complex Brain, we'll speak with Krembil Brain Institute neurosurgeon, Dr. Suneil Kalia, and neurologist, Dr. Alfonso Fasano, about the future of DBS – and how it could be used to help many more patients improve their quality of life, including those living with other neurological diseases.We'll also hear from CBC journalist Harry Forestell about his DBS journey.Featuring: Dr. Suneil Kalia – Neurosurgeon & Senior Scientist at the Krembil Brain Institute & Associate Professor in the Division of Neurosurgery, Department of Surgery, University of Toronto. As a stereotactic and functional neurosurgeon, Dr. Kalia focuses on the surgical management of movement disorders, epilepsy and pain. He holds the R.R. Tasker Chair in Stereotactic and Functional Neurosurgery.Dr. Alfonso Fasano – Neurologist & Clinician Investigator with the Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, at the Krembil Brain Institute (Toronto Western Hospital). Dr. Fasano is a Professor of Medicine, Department of Neurology, at the University of Toronto. He holds the Chair in Neuromodulation at UHN. Harry Forestell – Long-time CBC journalist who has reported on some of the biggest stories of our time, and is the current host of CBC News New Brunswick at 6. At the age of 53, Harry was diagnosed with Parkinson's disease and subsequently had DBS surgery. Harry is first and foremost a family man; he is married to Jennifer and they have two beautiful daughters.Additional resources: Krembil Brain Institute's Movement Disorders Clinic (Toronto Western Hospital)Krembil Brain Institute's DBS Surgery Information PageCBC story about Harry Forestell's DBS experience & surgeryVIDEO – Harry Forestell story ‘See the instantaneous effects of DBS for Parkinson's'CBC story about DBS featuring Drs. Kalia & FasanoThe Krembil Brain Institute, part of University Health Network, in Toronto, is home to one of the world's largest and most comprehensive teams of physicians and scientists uniquely working hand-in-hand to prevent and confront problems of the brain and spine, such as Parkinson's, Alzheimer's, epilepsy, stroke, spinal cord injury, chronic pain, brain cancer or concussion, in their lifetime. Through state-of-the-art patient care and advanced research, we are working relentlessly toward finding new treatments and cures.Do you want to know more about the Krembil Brain Institute at UHN? Visit us at: uhn.ca/krembilTo get in touch, email us at krembil@uhnresearch.ca or message us on social media:Instagram - @krembilresearchTwitter - @KBI_UHNFacebook - https://www.facebook.com/KrembilBrainInstituteThanks for listening!
Erin S. Murphy MD is an Associate Professor in the department of radiation oncology at the Cleveland Clinic. She completed residency at the Cleveland Clinic and a fellowship in pediatric radiation oncology at St. Jude Children's Research Hospital. She specializes in radiotherapy and radiosurgery for brain tumors and pediatric tumors and is passionate about using aggressive local tools while maintaining quality of life for her patients. --- What We Do at MIB Agents: PROGRAMS: ✨ End-of-Life MISSIONS ✨ Gamer Agents ✨ Agent Writers ✨ Prayer Agents ✨ Healing Hearts - Bereaved Parent Support ✨ Ambassador Agents - Peer Support ✨ Warrior Mail ✨ Young Adult Survivorship Support Group ✨ EDUCATION for physicians, researchers and families: ✨ OsteoBites, weekly webinar & podcast with thought leaders and innovators in Osteosarcoma ✨ MIB Book: Osteosarcoma: From our Families to Yours ✨ RESEARCH: Annual MIB FACTOR Research Conference ✨ Funding $100,000 annually for OS research ✨ MIB Testing & Research Directory ✨ The Osteosarcoma Project partner with Broad Institute of MIT and Harvard ... Kids are still dying with 40+ year old treatments. Help us MakeItBetter.
Today, we are happy to introduce Dr. Bob Dess, a radiation oncologist from the University of Michigan, to our listeners! Dr. Dess is joining us to discuss another type of radiation therapy called Stereotactic Body Radiation Therapy (SBRT). SBRT can be a faster and more efficient form of radiation therapy than conventional prostate cancer treatments. Dr. Dess is an Assistant Professor in the Department of Radiation Oncology at the University of Michigan. He has published extensively in peer-reviewed journals on prostate cancer. He has collaborated to create novel prognostic models to characterize prostate cancer disease aggressiveness, to analyze racial outcomes, differences, and settings in which disparities are minimized, and to advance more convenient forms of treatment, including Stereotactic Body Radiation Therapy, and characterize the long-term quality of life post-treatment. Dr. Dess's guiding principle is to deliver the right treatment to the right patient at the right time. He is interested in maximizing efficiency, minimizing burden, and understanding the long-term toxicity risks of treatment. Stay tuned to find out how SBRT compares with more conventional treatments for prostate cancer. Disclaimer: The Prostate Health Podcast is for informational purposes only. Nothing in this podcast should be construed as medical advice. By listening to the podcast, no physician-patient relationship has been formed. For more information and counseling, you must contact your personal physician or urologist with questions about your unique situation. Show highlights: Dr. Dess explains what Stereotactic Body Radiotherapy is. How SBRT compares with the longer courses of radiation. Who would be good candidates for SBRT? The benefits of choosing SBRT as a treatment for prostate cancer. Dr. Dess talks about hypofractionation, an intermediate treatment for prostate cancer that gets delivered with the same technology and image guidance as SBRT. The potential risks and side-effects of SBRT. Why Dr. Dess prefers to use MRIs along with SBRT. Links: Follow Dr. Pohlman on Twitter and Instagram - @gpohlmanmd Get your free What To Expect Guide (or find the link here, on our podcast website) Join our Facebook group Follow Dr. Pohlman on Twitter and Instagram Go to the Prostate Health Academy to sign up for our bonus video content. You can access Dr. Pohlman's free mini webinar, where he discusses his top three tips to promote men's prostate health, longevity, and quality of life here.
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.11.29.518293v1?rss=1 Authors: Paradise, V., Sabu, M., Bafia, J., Sharif, N. A., Nguyen, C., Dhanraj Mukim, R., Wang, X., Fu, J., Ndubisi, J., Maldonado, G., Strickland, M., Figueroa, H., Almeida, D. L., Hyman, B. T., Holtzman, D. M., Nuriel, T., Ramachandran, K. V. Abstract: Neuronal membrane proteasomes (NMPs) are a functionally transmembrane subset of 20S proteasomes that degrade newly synthesized proteins. To date, the molecular composition of NMPs is undefined, and moreover, whether NMPs can influence any aspect of protein aggregation with relevance to neurodegenerative disorders remains unexplored. Using a Cre-dependent conditional knock-in mouse line to endogenously tag the proteasome, we find that NMPs co-purify with ApoE. We discover that NMP membrane localization is differentially modulated by ApoE isoforms (E4 less than E2) in vitro, in vivo, and in human postmortem samples. This isoform-dependent change in NMP localization inversely correlates with the risk that ApoE isoforms pose for Alzheimers Disease. ApoE4-dependent reduction of NMP localization is strongest in brain regions selectively vulnerable to neurodegeneration. We synthesized selective NMP-specific inhibitors and discovered that NMP inhibition induces aggregation of endogenous and newly synthesized mouse and human Tau isoforms, without the need for seeding or pathogenic mutations. We posit that newly synthesized Tau is exceptionally susceptible to aggregation due to NMP dysfunction. Stereotactic injection of NMP inhibitors in vivo induces aggregation, phosphorylation, somatodendritic mislocalization and pathology of endogenous newly synthesized Tau. Finally, using ApoE-KI/hTau-KI crosses, we find that ApoE isoforms differentially shift the aggregation threshold for Tau. Overall, our data define NMPs as a pivotal proteostasis mechanism underlying the formation of endogenous Tau aggregates, which is directly regulated by the largest genetic risk factor for late-onset Alzheimers Disease. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC
December 2022 Journal Club Podcast Concurrent Administration of Immune Checkpoint Inhibitors and Stereotactic Radiosurgery is Well Tolerated in Patients with Melanoma Brain Metastases: An International Multicenter Study of 203 Patients To read the journal article: https://journals.lww.com/neurosurgery/Fulltext/2022/12000/Concurrent_Administration_of_Immune_Checkpoint.7.aspx Lead Author: Eric Lehrer Co-author: Daniel Trifiletti Guest faculty: Toral Patel Moderator: Jeffrey Traylor Committee Co-chair/Planner: Rafael Vega
Huberman Lab Podcast Notes Key Takeaways Episodic therapy via deep brain stimulation delivered at the right time and only as needed at that time may be useful in treating obesity, addiction, and OCD to interrupt circuit dysfunctionObesity is a phenotype often reflective of behavior – there's a compulsion to overeat despite the riskDevelopment of eating disorders: (1) we've become a food-focused society – we're really not meant to have constant stimulation of food; (2) there's high fructose corn syrup in almost everything – processed foods rewire our circuitry to seek more; (3) recurring stressful event or life; (4) patients are embarrassed because society frowns on themRight before people participate in binge eating, there's a moment of feeling down or negative affect that they compensate for by binge eating or “loss of control eating”Deep brain stimulation is currently being studied for use in binge eaters by provoking the craving during surgery and identifying the exact area of the nucleus accumbens where cravings occur – then delivering electrical stimulationAnorexia, bulimia, and binge eating are all distortions in relationship to food where reward and habit are disrupted beyond controlSide note discussed: use power lifting and deadlifts specifically (with impeccable form, under supervision of trainer if needed) to profoundly improve strength & posture Read the full notes @ podcastnotes.orgMy guest is Casey Halpern, M.D., Chief of Stereotactic and Functional Neurosurgery and Professor of Neurosurgery at the Perelman School of Medicine at the University of Pennsylvania. Dr. Halpern's research and clinical practice focus on using deep brain stimulation to treat compulsive and movement disorders (e.g., binge eating disorders, bulimia, obsessive-compulsive disorder (OCD) and Parkinson's disease essential tremor, dystonia). We discuss using deep brain stimulation to help patients who suffer from movement and compulsive disorders and applying this treatment to patients afflicted with binge eating. We also explore applications of this technology to other conditions such as OCD, anorexia and tremor, and the future therapeutic directions of the use of non-invasive brain stimulation approaches, including transcranial magnetic stimulation and ultrasound, for the treatment of other psychiatric illnesses and conditions. This episode will interest those curious about the biology of eating, anorexia, bulimia, compulsive thoughts and behaviors, and movement. Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman ROKA: https://www.roka.com/huberman Eight Sleep: https://www.eightsleep.com/huberman InsideTracker: https://insidetracker.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman For the full show notes, visit hubermanlab.com Timestamps (00:00:00) Dr. Casey Halpern & Disordered Eating & Brain Stimulation (00:03:18) ROKA, Eight Sleep, InsideTracker (00:07:19) Momentous Supplements (00:08:28) Neurosurgeon's View of the Brain, Neurosurgery Specialization (00:13:05) Deep Brain Stimulation & Other Unexpected Positive Effects (00:17:20) Obsessive Compulsive Disorder (OCD), Prescriptions & Cognitive Therapies (00:25:40) Brain Areas in OCD, Risk, Rewards & Addiction (00:31:11) AG1 (Athletic Greens) (00:32:27) Facial and Vocal Ticks, Stimulants, Stress & Superstition (00:39:28) Nucleus Accumbens, Reward Circuits, Eating Disorders & Obesity (00:47:18) Stimulation of Nucleus Accumbens, Continuous vs. Episodic Stimulation (00:49:49) Binge Eating Disorder & Loss of Control Eating (00:53:02) Developing Binge Eating Disorder: Predisposition, Environment, Stress (01:02:07) Electrodes in Nucleus Accumbens, Identifying “Craving Cells” (01:11:41) Effects of Stimulation, Interrupting Craving, Intermediate Stimulation (01:16:46) Anorexia, Obesity & Compulsions, Potential Treatments for Anorexia (01:23:14) Non-Invasive Brain Stimulation, Transcranial Magnetic Stimulation (01:32:27) MRI-Guided Focused Ultrasound: Tremor, Essential Tremor & Parkinson's (01:36:40) Future of Non-Invasive Brain Stimulation, Epilepsy & Depression (01:41:51) Pre-Behavioral States in Compulsion & Awareness, Mood Provocation (01:48:02) Machine Learning/Artificial Intelligence & Compulsion Predictions (01:53:05) Neurosurgeon Hands, Resistance Training & Deadlifts (01:59:00) “Neurosurgeon Calm,” Quality Time & Prioritization, Neurosurgeon Training (02:09:53) Daily Habits: Sleep, Exercise, Mediation (02:11:59) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Neural Network Newsletter, Instagram, Twitter, Facebook, LinkedIn Title Card Photo Credit: Mike Blabac Disclaimer
Huberman Lab: Read the notes at at podcastnotes.org. Don't forget to subscribe for free to our newsletter, the top 10 ideas of the week, every Monday --------- My guest is Casey Halpern, M.D., Chief of Stereotactic and Functional Neurosurgery and Professor of Neurosurgery at the Perelman School of Medicine at the University of Pennsylvania. Dr. Halpern's research and clinical practice focus on using deep brain stimulation to treat compulsive and movement disorders (e.g., binge eating disorders, bulimia, obsessive-compulsive disorder (OCD) and Parkinson's disease essential tremor, dystonia). We discuss using deep brain stimulation to help patients who suffer from movement and compulsive disorders and applying this treatment to patients afflicted with binge eating. We also explore applications of this technology to other conditions such as OCD, anorexia and tremor, and the future therapeutic directions of the use of non-invasive brain stimulation approaches, including transcranial magnetic stimulation and ultrasound, for the treatment of other psychiatric illnesses and conditions. This episode will interest those curious about the biology of eating, anorexia, bulimia, compulsive thoughts and behaviors, and movement. Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman ROKA: https://www.roka.com/huberman Eight Sleep: https://www.eightsleep.com/huberman InsideTracker: https://insidetracker.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman For the full show notes, visit hubermanlab.com Timestamps (00:00:00) Dr. Casey Halpern & Disordered Eating & Brain Stimulation (00:03:18) ROKA, Eight Sleep, InsideTracker (00:07:19) Momentous Supplements (00:08:28) Neurosurgeon's View of the Brain, Neurosurgery Specialization (00:13:05) Deep Brain Stimulation & Other Unexpected Positive Effects (00:17:20) Obsessive Compulsive Disorder (OCD), Prescriptions & Cognitive Therapies (00:25:40) Brain Areas in OCD, Risk, Rewards & Addiction (00:31:11) AG1 (Athletic Greens) (00:32:27) Facial and Vocal Ticks, Stimulants, Stress & Superstition (00:39:28) Nucleus Accumbens, Reward Circuits, Eating Disorders & Obesity (00:47:18) Stimulation of Nucleus Accumbens, Continuous vs. Episodic Stimulation (00:49:49) Binge Eating Disorder & Loss of Control Eating (00:53:02) Developing Binge Eating Disorder: Predisposition, Environment, Stress (01:02:07) Electrodes in Nucleus Accumbens, Identifying “Craving Cells” (01:11:41) Effects of Stimulation, Interrupting Craving, Intermediate Stimulation (01:16:46) Anorexia, Obesity & Compulsions, Potential Treatments for Anorexia (01:23:14) Non-Invasive Brain Stimulation, Transcranial Magnetic Stimulation (01:32:27) MRI-Guided Focused Ultrasound: Tremor, Essential Tremor & Parkinson's (01:36:40) Future of Non-Invasive Brain Stimulation, Epilepsy & Depression (01:41:51) Pre-Behavioral States in Compulsion & Awareness, Mood Provocation (01:48:02) Machine Learning/Artificial Intelligence & Compulsion Predictions (01:53:05) Neurosurgeon Hands, Resistance Training & Deadlifts (01:59:00) “Neurosurgeon Calm,” Quality Time & Prioritization, Neurosurgeon Training (02:09:53) Daily Habits: Sleep, Exercise, Mediation (02:11:59) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Neural Network Newsletter, Instagram, Twitter, Facebook, LinkedIn Title Card Photo Credit: Mike Blabac Disclaimer
My guest is Casey Halpern, M.D., Chief of Stereotactic and Functional Neurosurgery and Professor of Neurosurgery at the Perelman School of Medicine at the University of Pennsylvania. Dr. Halpern's research and clinical practice focus on using deep brain stimulation to treat compulsive and movement disorders (e.g., binge eating disorders, bulimia, obsessive-compulsive disorder (OCD) and Parkinson's disease essential tremor, dystonia). We discuss using deep brain stimulation to help patients who suffer from movement and compulsive disorders and applying this treatment to patients afflicted with binge eating. We also explore applications of this technology to other conditions such as OCD, anorexia and tremor, and the future therapeutic directions of the use of non-invasive brain stimulation approaches, including transcranial magnetic stimulation and ultrasound, for the treatment of other psychiatric illnesses and conditions. This episode will interest those curious about the biology of eating, anorexia, bulimia, compulsive thoughts and behaviors, and movement. Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman ROKA: https://www.roka.com/huberman Eight Sleep: https://www.eightsleep.com/huberman InsideTracker: https://insidetracker.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman For the full show notes, visit hubermanlab.com Timestamps (00:00:00) Dr. Casey Halpern & Disordered Eating & Brain Stimulation (00:03:18) ROKA, Eight Sleep, InsideTracker (00:07:19) Momentous Supplements (00:08:28) Neurosurgeon's View of the Brain, Neurosurgery Specialization (00:13:05) Deep Brain Stimulation & Other Unexpected Positive Effects (00:17:20) Obsessive Compulsive Disorder (OCD), Prescriptions & Cognitive Therapies (00:25:40) Brain Areas in OCD, Risk, Rewards & Addiction (00:31:11) AG1 (Athletic Greens) (00:32:27) Facial and Vocal Ticks, Stimulants, Stress & Superstition (00:39:28) Nucleus Accumbens, Reward Circuits, Eating Disorders & Obesity (00:47:18) Stimulation of Nucleus Accumbens, Continuous vs. Episodic Stimulation (00:49:49) Binge Eating Disorder & Loss of Control Eating (00:53:02) Developing Binge Eating Disorder: Predisposition, Environment, Stress (01:02:07) Electrodes in Nucleus Accumbens, Identifying “Craving Cells” (01:11:41) Effects of Stimulation, Interrupting Craving, Intermediate Stimulation (01:16:46) Anorexia, Obesity & Compulsions, Potential Treatments for Anorexia (01:23:14) Non-Invasive Brain Stimulation, Transcranial Magnetic Stimulation (01:32:27) MRI-Guided Focused Ultrasound: Tremor, Essential Tremor & Parkinson's (01:36:40) Future of Non-Invasive Brain Stimulation, Epilepsy & Depression (01:41:51) Pre-Behavioral States in Compulsion & Awareness, Mood Provocation (01:48:02) Machine Learning/Artificial Intelligence & Compulsion Predictions (01:53:05) Neurosurgeon Hands, Resistance Training & Deadlifts (01:59:00) “Neurosurgeon Calm,” Quality Time & Prioritization, Neurosurgeon Training (02:09:53) Daily Habits: Sleep, Exercise, Mediation (02:11:59) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Neural Network Newsletter, Instagram, Twitter, Facebook, LinkedIn Title Card Photo Credit: Mike Blabac Disclaimer
It was my great pleasure to talk with Veerle Visser-Vandewalle, who is the Head of the Department of Stereotactic and Functional Neurosurgery at University Hospital of Cologne. As a unique setup, she chairs the stereotactic department with access to their own operating theaters in which they have carried out a wide variety of surgeries, including DBS for Parkinson's, Tremor, Dystonia, OCD, Alzheimer's Disease and Pain; as well as spinal chord stimulation and even brachytherapy as one of the few centers in Germany. At age 34, Veerle published the first neuropsychiatric DBS case in the Lancet, 1999, operating on a 42-year old man with Gilles de la Tourette's Syndrome and self-injurious behavior. It was a good year for DBS: Soon after Veerle, Bart Nuttin published the first case series of OCD-DBS (also in the Lancet) and in the same year, Joachim Krauss published the first three Dystonia DBS cases (also in the Lancet). We discuss how DBS for Tourette's has evolved since the first case and what are next steps to come. Currently, Veerle focuses on fornix-DBS in Alzheimer's Disease, taking part as a key center in the ADvance II trial and was able to report some interesting insights. Finally, we talk about the crisis of access to DBS in diseases with low numbers, such as OCD (based on her recent Nature Medicine commentary), her being a knight of Leopold the II and the book she wrote for her son's 18th birthday, “Plato & Cola or the secret of your brain”, that unfortunately, so far, he didn't read (we are sure that one day, he will!)
How do we think about treatment of lung cancer? Recap on staging (see Episode 025) * Pro-tip: Highly recommend that you “forget” about the actual staging and focus more on the individual T, N, and M status * Tumor size:**T1a
Guest host Dr. Nathan Pennell, of the Cleveland Clinic Taussig Cancer Institute, and Dr. Vamsi Velcheti, of the NYU Langone Perlmutter Cancer Center, discuss the ATLANTIS trial and other novel therapies in advanced SCLC, NSCLC, and malignant pleural mesothelioma featured at the 2022 ASCO Annual Meeting Poster Sessions. Transcript Dr. Nathan Pennell: Hello, I'm Dr. Nathan Pennell, your guest host for the ASCO Daily News Podcast, today. I'm the co-director of the Cleveland Clinic Lung Cancer Program and vice-chair of Clinical Research for the Taussig Cancer Institute. My guest today is my friend Dr. Vamsidhar Velcheti, an associate professor and medical director of thoracic oncology at the Perlmutter Cancer Center at NYU Langone Health. We'll be discussing key posters on lung cancer that will be featured at the 2022 ASCO Annual Meeting. Although the oral sessions tend to get the most press, we want to make sure you don't miss out on some high-impact abstracts that are presented in the poster session. Our full disclosures are available in the show notes and disclosures of all guests on the podcast can be found on our transcripts at asco.orgpodcasts. Vamsi, it's great to speak with you today. Dr. Vamsidhar Velcheti: Thank you, Nate. It's a pleasure to discuss these 5 outstanding abstracts. Dr. Nathan Pennell: Why don't we start with Abstract 9021, “Genomic correlates of acquired resistance to PD-(L)1 blockade in patients with advanced non—small cell lung cancer (NSCLC).” Vamsi, what were your key takeaways from this study? Dr. Vamsidhar Velcheti: This is an important study in my opinion. This was a very large study of 1,700 patients from Dana Farber and the investigators looked at 45 specimens and matched pre- and post- immunotherapy treated patients. And they looked at the data mechanisms of resistance that were identified in 25 out of the 45 patients, that is 55% of the patients. 5 patients had acquired STK11 mutations. One patient had a KEAP1 alteration. There were several patients who had like KEAP1 SMARCA4 mutations. And interestingly, there were also some patients who developed KRAS-G12C mutation as well on the post-treatment specimens. So, this is an interesting abstract. We typically don't do biopsies on patients progressing on immunotherapy. At this point, we don't have a standard clinical indication to do so. However, identifying these new novel mechanisms of genomic mechanisms of resistance is actually very important, because a lot of new therapy medications are being developed to target, for example, KEAP1, and could be approached to target microglobulin mutations. So, it's very important to kind of understand the mechanisms of resistance. Dr. Nathan Pennell: Yeah, I completely agree. I mean, most of the benefits in second line in the refractory setting with targeted treatments came about through studies like this where there was broad sequencing of resistance and trying to understand and I think we're still kind of in the infancy of understanding resistance to immunotherapy, but it's a good start. Abstract 9019 was another interesting study in non—small cell lung cancer. That was “A phase II study of AK112 (PD-1/VEGF bispecific) in combination with chemotherapy in patients with advanced non—small cell lung cancer.” Can you tell us a little bit about that study? Dr. Vamsidhar Velcheti: Yeah, this is a multicenter phase-2 trial. This is an interesting agent. It's a PD-1/VEGF bispecific antibody developed by Akeso Bio. This is a single-arm study, and they did the study in 3 different cohorts. One of the cohorts was patients with advanced non—small cell lung cancer who had wild-type EGFR/ALK, and they were treatment-naive. There was another cohort of patients where they enrolled patients with EGFR mutation who developed resistance to EGFR tyrosine kinase inhibitors (TKIs) and essentially progressed on osimertinib. And there was another cohort where patients were enrolled who were PD-1 refractory, they had prior PD-1or PD-1 chemo combination, and they had progressions. So, they enrolled a total of 133 patients, it was a decent-sized study, but a very early efficacy finding study. In the cohort-1 which is the cohort that is enrolled with untreated patients with advanced non—small cell lung cancer. They had like 20 partial responses out of 26 patients that were evaluable and enrolled in the cohort, and there were 6 patients who had stable disease. So, overall, the response rate was 76.9% and 100% disease control rate. So, this is a very small cohort and small data set. So, we have to interpret this with caution. But suddenly, a very interesting signal here for this VEGF/PD-1 bispecific antibody. Dr. Nathan Pennell: The 40% response rate in the immunotherapy (IO) and chemo refractory patients, I thought was fairly interesting, although, as you said, very small numbers in these cohorts will have to be reproduced in larger trials. Dr. Vamsidhar Velcheti: Right. I think there was a lot of excitement early on the IMpower150, right? With the combination of bevacizumab with chemo-theralizumab. There seems to be some signal in terms of the addition of a VEGF inhibitor to immunotherapy. And we've seen that consistently in renal cells and other tumor types. So, I think this is a really intriguing signal. I think this definitely warrants further exploration. So, the other interesting thing was cohort-2 where they enrolled patients who had progressed on EGFR TKIs. So, in that cohort, they had like 19 evaluable patients and 13 patients had a partial response and 5 had stable disease. So, a very respectable response rate of 68.4% and 94.7 disease control rate. So, again, very small numbers, but a nice signal here for the efficacy of the drug. There was another cohort, which is the cohort-3 where they enrolled patients who progressed on PD-1 therapy, and they enrolled a total of 20 patients with 8 patients having a partial response, following progression on PD-1 therapy. Dr. Nathan Pennell: Yeah, I look forward to seeing further follow-up on this. It definitely sounds interesting. Moving on to Abstract 8541. This was “Durvalumab (durva) after chemoradiotherapy (CRT) in unresectable, stage III, EGFR mutation-positive (EGFRm) NSCLC: A post hoc subgroup analysis from PACIFIC,' which of course was the study that led to the broad use of durvalumab, the anti-PD-L1 antibody after chemoradiotherapy for unresectable stage III non-small cell, but this was the post hoc subgroup analysis of the EGFR mutation-positive group. And this is a subgroup we've really been curious about whether there was a role for consolidation, immunotherapy, or not. And so, what are your thoughts on the study? Dr. Vamsidhar Velcheti: I agree with you, Nate, that this is actually some data that I was really, really looking forward to. Before we actually talk about the abstract. What do you do for those patients? If you have an EGFR mutation patient who has stage IIIB, what do you do right now? Dr. Nathan Pennell: It's a great question. I have a discussion with them about the potential pluses and minuses of doing consolidation durvalumab. But I actually don't always use durvalumab in this setting, because of concerns about if you're using durvalumab and they recur, perhaps there is a problem with toxicity with using osimertinib. Honestly, I go back and forth about what the right thing is to do in this subgroup. Dr. Vamsidhar Velcheti: No, I think that's the right context. I think that's a good setup to kind of discuss the data from the trial. I'm really excited about this. And I'm glad that we have this data to look at. So, as you pointed out, the Pacific trial, its U.S. Food and Drug Administration (FDA) approval for durvalumab in the consolidation setting for patients with stage III after chemoradiation. This has now been the standard of care for like a few years now. The problem with the study is that patients with EGFR/ALK were allowed to enroll in the study. Typically, for most IO trials, we generally tend to see patients with EGFR/ALK being excluded. So, this trial was an exception. In this study, they actually presented a post-hoc exploratory analysis of efficacy and safety of patients who did consolidation with durvalumab, but there was a total of 35 patients of the 713 patients that were randomized in the trial. And out of the 35 patients with EGFR mutation, 24 received durvalumab and 11 received a placebo. So, of course, you're going to interpret this data with a little bit of caution. This is a full stock analysis, not pre-planned in small numbers. In this dataset, essentially, the median progression-free survival (PFS) was not different among patients treated with durvalumab or placebo, and the median survival was also not statistically significant. Overall, there was not much benefit from adding durvalumab in this setting in patients who have EGFR mutation-positive stage III lung cancer. Dr. Nathan Pennell: I think that tends to track along with what we who have been treating patients with EGFR mutations for years, and knowing the disappointing response rates, certainly in the advanced stage with immunotherapy, I think we were concerned that in this consolidation phase that it would also potentially be a relatively marginal benefit. I agree with you that 35 patients are too small to make any definitive conclusions, but it certainly isn't supportive of a large benefit. Dr. Vamsidhar Velcheti: But I think I'm excited about the LAUREL study that's ongoing, hopefully, that'll give us a little bit more definitive answers as to what we should be doing for patients with EGFR mutation-positive disease. Suddenly this is a piece of information that's helpful for treating physicians to make some decisions on clinical management for these patients. Dr. Nathan Pennell: I agree. Now moving beyond the non—small cell. Let's talk about “Final survival outcomes and immune biomarker analysis of a randomized, open-label, phase I/II study combining oncolytic adenovirus ONCOS-102 with pemetrexed/cisplatin (P/C) in patients with unresectable malignant pleural mesothelioma (MPM).” That's Abstract 8561. What were your takeaways here? Dr. Vamsidhar Velcheti: Yeah, it's always good to see some new therapeutic options for patients with mesothelioma. This is somewhat of an orphan disease and we haven't seen a lot of advances. Granted, we have some new therapeutic options with immunotherapy now, like, there is now a standard of care in the frontline setting. So, this particular approach with ONCOS-102 is an oncolytic adenovirus expressing GM-CSF. And this is intended to stimulate the local and systemic immune response and remodulate the tumor microenvironment. This was a small phase 1 study where they had a CFT run-in of 6 patients and a total of 25 patients were randomly assigned to receive ONCOS-102 intratumorally with ultrasound guidance or CT guidance and they injected this oncolytic virus into the tumor directly. They were also getting treatment with platinum pemetrexed which is the standard of care in the frontline setting. The control here was 6 cycles of platinum pemetrexed. So, they enrolled both the treatment-naive patients in the frontline setting and they also enrolled patients who will progress on a platinum doublet. I should note that none of these patients were treated with immunotherapy. I think that's something that we'll kind of get back to and we'll discuss. Overall, from a safety standpoint, there were some expected toxicities like pyrexia and nausea which is seen in the experimental group. It's just kind of to be expected with an oncolytic virus. Overall, the 30-month survival rates were 34.3% and 18.2% in the control arm, and the median overall survival (OS) was 19.3 months and 18.3 in the controller. So, for patients who were treated with the frontline chemotherapy, the survival rate was better with 30 months survival, it was 33.3 [months]. And in the experimental group, it was 0%. So, overall, they also looked at tumor-infiltrating lymphocytes, they had CD4 around CD8 and granzyme B expressing CDA T-cells, and they had favorable PK from increased immune cell infiltration. So, this is very promising data but of course in a small study, and also in a population that hasn't had immunotherapy patients who are getting platinum doublet. In terms of safety, I think it looks promising. We need to see larger studies, especially with immunotherapy combinations. Dr. Nathan Pennell: Yeah, I was impressed with the increased tumor infiltration of CD4 and CDA-positive T-cells, and the survival in the first line looked fairly impressive, although again, a very small subgroup of patients. But as you said, a standard of care these days is definitely going to involve immunotherapy. And so, I look forward to seeing combination trials in the future with this drug. Shifting from mesothelioma over to small cell lung cancer, Abstract 8570 is “Stereotactic radiosurgery (SRS) versus whole brain radiation therapy (WBRT) in patients with small cell lung cancer (SCLC) and intracranial metastatic disease (IMD): A systematic review and meta-analysis.” Do you think that this would influence how we approach patients with brain metastases in the small cell? Dr. Vamsidhar Velcheti: There are some in the community who kind of advocate for SRS in small cells if they have limited CNS disease. Certainly, I'm not one of them, but I think this is an interesting study in that light like we have never had any proper randomized trial. And we probably won't have randomized trials in that setting. So, at the end of the day, I think we all kind of customize our treatment approaches based on our patients and how much disease burden they have. But having said that, the authors here have done a pretty large systemic analysis, and they looked at 3,700+ trials, they looked at random effects meta-analysis pooled hazard ratios for overall survival in patients who received SRS in the whole brain with or without SRS boost. What they found was that overall survival following SRS was not inferior to whole brain RT. What do we really make out of this data? I think, given the heterogeneity, we have to see how the analysis was done and the kind of studies that went into the analysis. But however, I think the bigger question is, is there a population that we need to maybe—perhaps like, if somebody has an isolated brain met, you could potentially consider SRS with a whole brain RT for better local control. So, the authors actually look at pooled data to look at local control versus intracranial distant control. So, this is a really interesting approach that asks the question, if patients had SRS and whole brain radiation, would it actually offer adequate intracranial distant control meaning like, do they develop new lesions? So, it does look fairly decent. But again, it all depends on what kind of studies went into the analysis. And I don't think we should read too much into it. But at the same time, it kind of raises the question: is there a population of patients with small cell where it may be potentially appropriate to give SRS? So, that's what I do in my day-to-day clinical practice. Sometimes there are situations where you kind of do the thing that we don't usually always do like in the small cell, we always think about whole brain radiation as something that we always have to offer, but I want to hear your perspectives too. Dr. Nathan Pennell: No, I was always taught that you never did anything with whole brain radiation in the small cell even with a solitary metastasis. For a study like this, it's certainly interesting. You wonder how much selection bias there was towards people with fewer brain metastases and perhaps being in better health or better response to systemic disease that were referred for SRS, compared to whole brain radiation. Part of the issue is the morbidity associated with whole brain radiation is significantly more than with SRS. And now that we are starting to, for the first time, see some patients with small cell [lung cancer] that are living substantially longer with immunotherapy, it might be worth exploring which patients might benefit from having that lower morbidity from whole brain radiation. But I agree with you that I'm not sure that we know who those patients are. Dr. Vamsidhar Velcheti: Yeah, I think this is a difficult question to answer through a meta-analysis in my opinion. But having said that, your thought in terms of proving systemic therapies, then we kind of revisit the paradigm of offering SRS to some patients may be, especially with new BiTE T-cell engager studies that are ongoing, and hopefully, if you see some positive results, that might change what we do, but it's an important clinical question. Dr. Nathan Pennell: And finally, in Abstract 8524, we have an interesting analysis of patients with relapsed small cell lung cancer, who received single-agent Lurbinectedin in the phase-3 Atlantis trial. What do you think about this poster, and why should this be on our radar? Dr. Vamsidhar Velcheti: Yeah, I think this has been an interesting approval, of course, lurbinectedin FDA approved, as you know, like in June of 2020, based on data from a trial that uses 3.2 milligrams per meter square dosing every 21 days in second line setting post-chemotherapy. What happened after that was there was a trial with the combination with doxorubicin in the second line setting comparative arm in that phase 3 trial topotecan or CAV. In that trial, it was a negative trial, the primary endpoint was not met. The primary endpoint was overall survival, and it was a negative trial. And there were subgroup analyses done in the trial. The study that is presented now is actually a post-hoc analysis looking at patients who received treatment with this combination with doxorubicin that is like a lurbinectedin with doxorubicin, who had like a total of 10 cycles of the combination, and they switched to lurbinectedin monotherapy. So, there were a total of 50 patients in that trial. They looked at the responses and the durability of responses in that population. It's a highly select population that made it to 10 cycles and they had stable disease or better and they switched to lurbinectedin monotherapy. So, the highlight of the abstract is the median overall survival was 20.7 months. Of course, for small cell, that's really impressive. But I think we've got to be really careful in interpreting this data. This is like a small subgroup of highly selected patients who actually benefited from the trial. My question for you, Nate, is do you use lurbinectedin in the second line setting frequently or are you still treating them with topotecan? Dr. Nathan Pannell: We still often use topotecan. I think lurbinectedin certainly seems to be an active drug, and it has some favorable schedule of administration pretty well tolerated from a tolerability standpoint, but from an efficacy standpoint, I still haven't really seen much that makes it stand out as significantly better than older options like topotecan or irinotecan. That being said, it is intriguing that there is a subgroup of people who seem to have prolonged disease control with this. The problem, of course, is if you already select the people who make it 10 cycles without progression, then you're already picking the group of people who are doing extremely well. So, it's not surprising that they would continue to do extremely well. Nonetheless, it's a sizable subgroup of people that seem to benefit and it would really be nice if there was, for example, a biomarker that might tell us which patients would truly benefit from this drug compared to our other options. Dr. Vamsidhar Velcheti: Yeah, exactly. True. Right, I mean, like all of us have patients who have done exceedingly well on topotecan and I had a patient on paclitaxel for years. So, it's really important to kind of keep that in mind when we look at these sub-proof post hoc analyses. Dr. Nathan Pennell: Well, thanks Vamsi for sharing these important advances in lung cancer that will be featured at the 2022 ASCO Annual Meeting. Dr. Vamsidhar Velcheti: Thank you, Nate. Dr. Nathan Pennell: And thank you to our listeners for joining us today. If you're enjoying the content on the ASCO Daily News podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Disclosures: Dr. Nathan Pennell: Consulting or Advisory Role: AstraZeneca, Lilly, Cota Healthcare, Merck, Bristol-Myers Squibb, Genentech, Amgen, G1 Therapeutics, Pfizer, Boehringer Ingelheim, Viosera, Xencor, Mirati Therapeutics, Janssen Oncology, Sanofi/Regeneron Research Funding (Inst): Genentech, AstraZeneca, Merck, Loxo, Altor BioScience, Spectrum Pharmaceuticals, Bristol-Myers Squibb, Jounce Therapeutics, Mirati Therapeutics, Heat Biologics, WindMIL, Sanofi Dr. Vamsidhar Velcheti: Honoraria: ITeos Therapeutics Consulting or Advisory Role: Bristol-Myers Squibb, Merck, Foundation Medicine , AstraZeneca/MedImmune, Novartis, Lilly, EMD Serono, GSK, Amgen Research Funding (Institution): Genentech, Trovagene, Eisai, OncoPlex Diagnostics, Alkermes, NantOmics, Genoptix, Altor BioScience, Merck, Bristol-Myers Squibb, Atreca, Heat Biologics, Leap Therapeutics, RSIP Vision, GlaxoSmithKline 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.
Care of the Patient Undergoing Robotic-Assisted Brain Biopsy With Stereotactic Navigation by AORNJournal
Emergencies happen in hematology and oncology. This is a fact. But how do we manage these emergencies? Look no further. In this episode, we talk all about our second oncologic emergency: new brain mets. Brain mets:Strongly consider steroids, particularly with the presence of vasogenic edema associated with brain mets Stereotactic radiosurgery (SRS): use of high dose radiation delivered in a single treatment (“fraction”) that is delivered focally to the area of disease seen on imaging (typically MRI); great option for brain mets; can be performed by radiation oncology What to do to expedite Rad Onc planning: Thin-cut MRIStart patient on steroids Interpreting MRI imaging: T1 post-contrast sequence: to look for brain massT2 sequence: looking for vasogenic edema surrounding brain massMidline shift is an issue more so when it is acute; this is very different than slow changes over timeWho to operate on? Functional status prior to surgery; not in an area that can cause other harm; no other good alternative treatment optionsWhat to tell your NSGY colleague during a consult: A quick neuro exam (consciousness, strength, sensation, focal neurologic issues)Brief cancer historyUnderlying organ dysfunction Antiplatelet/anticoagulants A HUGE thank you to our special guests:Ryan Miller, MD, MS: PGY5 in Radiation Oncology at Thomas Jefferson University Hospital, Philadelphia, PAJoshua Lowenstein, MD, MBA: Neurosurgery Attending, REX Neurosurgery and Spine Specialists, Raleigh, NC Please visit our website (TheFellowOnCall.com) for more information Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast
Welcome to the Thoracic Oncology Group of Australasia Podcast series. Today Rachel Roberts-Thomson, Medical Oncologist from Queen Elizabeth Hospital in Adelaide, discusses Improving Outcomes in EGFR-Mutated Non-Small-Cell Lung Cancer . Rachel is joined byVenessa Chin from St. Vincent's Hospital in Sydney & Angeline Low who has her own personal experience with EGFR lung cancer .EGFR mutations are identified in approximately 15% of NSCLC patients. Efficacious, PBS-reimbursed first line treatments are available, but resistance to treatment and progression remains a concern. In this podcast, options for treatment post-progression are discussed, including accessible treatment and sequencing options and the role of patient preferences and clinical trials.In collaboration/partnership/supported with/by Roche.Disclaimer: The opinions, beliefs and viewpoints expressed by the various authors and participants contained in this message do not necessarily reflect the opinions, beliefs and viewpoints of TOGA or official policies of TOGA. Dosage & administration of any treatments mentioned during TOGA medical education may differ between Regions. Please refer to your local prescribing information for further details. Note: SRS is Stereotactic radiosurgery
In this VETgirl online veterinary continuing education podcast, we discuss the use of sterotactic body radiation therapy for the treatment of heart base tumors in dogs. The two most common anatomic locations for cardiac neoplasia include the right atrium/auricle, and the heart base. Tumors at the heart base are most commonly chemodectomas, otherwise known as aortic body tumors, which are neuroendocrine tumors arising from the wall of the ascending aorta. Brachycephalic breeds are overrepresented in dogs with heart base tumors (HBTs). In many dogs, the identification of HBTs is incidental. Clinical signs in dogs with HBTs are generally associated with complications of local tumor invasion, including pericardial effusion, cardiac arrhythmias, obstruction of cardiac chambers or vasculature, and right sided congestive heart failure. HBTs are rarely confirmed via antemortem histopathology due to the risk of complications associated with biopsy and the relatively reliable predictive nature of tumor type based on ultrasonographic location. Treatment options for dogs with HBTs have remained relatively limited due to inability to safely perform surgical resection and limited response to traditional chemotherapeutics. Data evaluating response of HBTs to radiation therapy has been limited to date. So, Kruckman-Gatesy et al wanted to evaluate this in a study entitled "A retrospective analysis of stereotactic body radiation therapy for canine heart base tumors: 26 cases."
Care of the Patient Undergoing Robotic-Assisted Brain Biopsy With Stereotactic Navigation by AORNJournal
Care of the Patient Undergoing Robotic-Assisted Brain Biopsy With Stereotactic Navigation: by AORNJournal
By listening to this fascinating conversation you will gain a greater understanding of the relationship between the brain, the body, our consciousness, and our spirit.This week, on The Conscious Consultant Hour, Sam welcomes behavioral neuroscientist, Dr. Rowshanak Hashemiyoon.Dr. Rowshanak Hashemiyoon is a neuroscientist, speaker, and author. She is also the founder of Access to the Path, a company that provides transformational and scientific consulting services for individuals, businesses, and media. As a highly trained scientific researcher, she combines the power of quantitative scientific knowledge with qualitative conceptual intelligence to help people and businesses become more purposeful, effective, and prosperous. Before launching Access to the Path, she was the founder and chief of the Human Brain and Behavior Laboratory in the Department of Stereotactic and Functional Neurosurgery at the University Hospital of Cologne. Dr. Hashemiyoon's work as a computational, clinical, and behavioral neuroscientist has spanned studies of the physical senses, social neuroscience, and the pathophysiology underlying neuropsychiatric disorders. With a deep passion for and understanding of the human condition, Dr. Hashemiyoon now reaches out to serve more than just the scientific and medical community. She uses her unique skill set to help people power through the noise of a complex, rapidly changing world with innovative, usable strategies that support mental well-being and optimize performance. Her mission is to promote the ethical growth and success of businesses and help individuals elevate to the greatest version of themselves. Sam and Dr. Hashemiyoon will be discussing all about the relationship between the brain, consciousness, and higher states of being.https://accesstothepath.com/ Tune in for this enlightening conversation at TalkRadio.nyc or watch the Facebook Livestream by Clicking Here. Segment 1The Conscious Consultant, hosted by Sam Liebowitz, is a fantastic episode this week with guest, Dr. Rowshanak Hashemiyoon. Sam opens up this show talking about integrity, and how once we learn how to be sympathetic with ourselves, we can learn how to be sympathetic and empower others; this is all information that can be found in Sam's new book, Everyday Awakening. Dr. Hashemiyoon has a deep appreciation for spiritual rituals as well as a deep understanding for hard, real science. She begins talking about how she was born this way, and how her love for science began. Segment 2Dr. Hashemiyoon begins this segment by explaining what the “default mode network,” which is a system in the brain that is functioning when you are in a task mode state. She then begins explaining the difference between bad stress and good stress; a certain amount of stress is actually okay for the body and can be productive, but if you have too much stress then that is when it becomes negative. Stress does not have to always be viewed in a negative light, which is very enlightening for all to know; each person has a different set point where stress can be defined as bad rather than useful. A good thing to practice is mindfulness meditation so that you can become aware of your own personal levels; there is also a study that shows that mindfulness meditation can increase your tolerance to certain things such as pain. Segment 3Host, Sam Liebowitz, and Dr. Hashemiyoon begins segment 3 by talking about the great resignation; this is about how people have decided how to fit work into their lives, rather than fitting their lives into work. This is important because people were starting to want to leave their place of work. They began to transition into the talk about how there are so many remote jobs due to the pandemic, and how this is giving people the chance to engage with themselves. There is also such a drive today to be an entrepreneur, and the number of personal businesses have skyrocketed. Segment 4Sam begins segment 4 by asking Dr. Rowshanak Hashemiyoon what she does besides her day-to-day office job, and she referred to herself as a “functional, integrated scientist.” She talks about how one of her biggest skills is taking really big, complicated ideas and turning them into bite size ideas so that she can share with others. Both, Sam and Dr. Hashemiyoon, talk about how important breaks are for those who are working; if you are overworking yourself then productivity rate drops significantly which is obviously not the goal. Dr. Hasemiyoon talks about how she has many different programs where she shares this information with others as well as companies so that she can help benefit these companies and people. You can stay in touch with Dr. Rowshanak Hashemiyoon on her website, twitter, or clubhouse, and she hopefully will be back for another episode with host, Sam Liebowitz, soon on the Conscious Consultant! Support this podcast at — https://redcircle.com/the-conscious-consultant-hour8505/donations
Chad Tang discusses his recent Lancet oncology paper.
Listen to neuroscientist Dr. Rowshanak Hashemiyoon explain to Heather some of the real reasons why people feel so stressed and overwhelmed today. She explains why the cultural splitting off of science, spirit and magic has been detrimental to individual and collective wellbeing, why the benchmarks for mental health are all changing and how self care changes your brain function. She also addresses how our beliefs get formed, and why trust is so important where you both live and work. In this episode, Heather and Rowshanak discuss: Why the fractionation of information in our environments today is impacting mental health How we get programmed and how our beliefs get formed The impact of your first social circle Differences in the brains between men and women at the critical neurodevelopmental period at puberty Why we outgrow people Why work impacts your health so much Importance of practicing physical, emotional and spiritual hygiene Why it's important to connect more with the wisdom of the elders Why benchmarks for mental health are all changing to look more at the biopsychosocial and spiritual perspective than a mental-only perspective The wisdom of tribal elders Why the DSM-V is being heavily scrutinized The pitfalls of looking at mental health issues without looking at biological contributors The importance of being happy at work because you spend so much time connected to work Why employers need to support employees in new ways, focusing on their physical, mental and spiritual health Why many self-care practices result in improved executive function, creating a thicker cerebral cortex, thicker hippocampus, and/or increases in GABA Why you don't want to get inflammation, the “kiss of death” Dr. Rowshanak Hashemiyoon is a behavioral neuroscientist and the founder of Access to the Path. As a highly trained scientific researcher, she combines the power of modern science with emotional and spiritual intelligence to generate compelling and innovative strategies that help people and businesses become more purposeful, effective, and prosperous. Her mission is to promote the ethical growth and success of businesses and help individuals elevate to the greatest version of themselves. Her passion has always been understanding and improving the human condition. Before launching Access to the Path, she was the founder and chief of the Human Brain and Behavior Laboratory in the Department of Stereotactic and Functional Neurosurgery at the University Hospital of Cologne. Dr. Hashemiyoon is a trained computational, clinical, and behavioral neuroscientist with a PhD in physiology and biophysics. Her work has spanned studies of the physical senses, social neuroscience, and the pathophysiology underlying neuropsychiatric disorders. After spending decades studying the interplay of the brain; behavior; and environment, she realized it was time to serve more than just the scientific and medical community; thus was born Access to the Path. Heather Grzych is the author of The Ayurvedic Guide to Fertility and the host of the Wisdom of the Body podcast. A board-certified Ayurvedic practitioner, she teaches the Regenerative Fertility Method to support future generations worldwide. Heather is on the board of directors for the National Ayurvedic Medical Association (NAMA) and has consulted with doctors, governments, and insurance companies. She offers virtual consultations and programs worldwide. www.heathergrzych.com Connect with Heather: Instagram.com/heathergrzych Facebook.com/grzychheather Book an Ayurvedic consultation or connection call with Heather to explore the Regenerative Fertility Method: https://www.heathergrzych.com/book-online Join the Wisdom of the Body club on Clubhouse: https://www.joinclubhouse.com/club/wisdom-of-the-body This podcast is for educational and entertainment purposes only.
Gene Barnett, MD, MBA, neurosurgeon and Director of the Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center joins the Cancer Advances podcast to discuss the standard of care for brain metastases. Listen as Dr. Barnett discusses how the traditional surgical approaches for treating patients with brain metastases have evolved and how we are using stereotactic radiosurgery to deliver superior outcomes.
Please join me for a very special episode of The Locher Room in honor of Rare Disease Day which takes place on the last day of February each year (February 28). Airdate: February, 25, 2021Today you will meet two very brave young survivors of Hydrocephalus along with their parents to learn more about this rare lifelong condition that affects over one million Americans from newborn to seniors. 15 year-old Cole Illions is a 13-time brain surgery survivor who will be here with his parents Michael and Kim Illions to share their story and talk about the Pediatric Hydrocephalus Foundation started in Cole's honor. Joining them from Michigan will be four year-old Clara Shanks and her mother Heather and rounding out this panel will be Dr. Amit Ayer whose clinical focus is Neruosurgery, Epilepsy and Stereotactic and Functional Neurosurgery at Stanford University. Dr. Ayer will be here to share insight to help us all learn more about this disease affecting children and seniors alike around the world. As the name implies, Hydrocephalus is a condition in which the primary characteristic is excessive accumulation of fluid in the brain. Although Hydrocephalus was once known as “water on the brain,” the “water” is actually cerebrospinal fluid (CSF) — a clear fluid that surrounds the brain and spinal cord. The excessive accumulation of CSF results in an abnormal widening of spaces in the brain called ventricles. This widening creates potentially harmful pressure on the tissues of the brain.Hydrocephalus is a rare condition that is only treatable through brain surgery and is the number one reason for pediatric brain surgery. Please consider making a donation today to help raise money for funding research projects, to help find a cure and to help find better treatment options for Hydrocephalus. The only treatment right now is brain surgery and the medical device used, which is called a shunt and has the highest failure rate of any medical device. Hydrocephalus is the number one reason for pediatric brain surgery in our country and an average of 40,000 shunt operations are performed each year. The lack of advancements in treatment for Hydrocephalus have left many diagnosed with hydrocephalus unable to lead full and productive lives.
After getting a second opinion, abnormalities were discovered in both breasts. The next result was a mammogram guided stereotactic biopsy would be conducted on the right breast to examine the area on microcalcifications and a core need biopsy would be conducted on the left side to examine the lump tissue. Explanation of both procedures, pain involved and recovery are discussed. Support the show
Bakotunes flashback live from the Vans Warped Tour in Fresno, CA. 2006. Interview with Stereotactic lead vocalist, Kyle Whitaker (Bakersfield, CA). Info: mattomunoz@gmail.com
Prof Keyoumars Ashkan is Professor of Neurosurgery at King's College Hospital in London. He has a special interest in functional neurosurgery, image guided surgery, and surgery for brain and spinal tumours. He holds many senior roles including President of the British Society for Stereotactic and Functional Neurosurgery and Lead for Genomics England Programme for brain tumours. He was also voted as a clinician of the year by the Brain Tumour Charity in 2018. In this episode we ask him about: His career Neurosurgery (3:47) Research (24:19) His advice to medical students and young doctors Article Prof Ashkan mentioned about why he picked neurosurgery - BMJ article "Nothing is Impossible" - https://www.bmj.com/content/333/7561/s46 For comments, collaboration or feedback, contact us via email or Twitter. Email: medspirepodcast@gmail.com Twitter: @medspirepodcast
A conversation with Dr. Joseph Neimat
Interview with David R. Raleigh, MD, PhD, and William C. Chen, MD, authors of Efficacy and Safety of Stereotactic Radiosurgery for Brainstem Metastases: A Systematic Review and Meta-analysis
Interview with David R. Raleigh, MD, PhD, and William C. Chen, MD, authors of Efficacy and Safety of Stereotactic Radiosurgery for Brainstem Metastases: A Systematic Review and Meta-analysis
Single-fraction SBRT is safe and effective in treating early stage, medically inoperable NSCLC, according to a ten-year retrospective study of 229 patients, the largest single-institution report to date. Gregory Videtic, MD, radiation oncologist at Cleveland Clinic Cancer Center, joins the Cancer Advances podcast to discuss the findings that were presented at the American Society for Radiation Oncology (ASTRO) annual meeting.
Full article: https://www.ajronline.org/doi/10.2214/AJR.20.24117 Percutaneous interventions are the mainstay for patients with non-operative HCC. This podcast by Ben Kipper, MD examines a paper comparing outcomes between thermal ablation and stereotactic body radiation therapy following transarterial chemoembolization and how those outcomes might affect clinical treatment plans going forward.
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.05.06.078584v1?rss=1 Authors: Ho, H., Fowle, A., Coetzee, M., Greger, I. H., Watson, J. F. Abstract: Investigating brain function requires tools and techniques to visualise, modify and manipulate neuronal tissue. One powerful and popular method is intracerebral injection of customised viruses, allowing expression of exogenous transgenes. This technique is a standard procedure for adult mice, and is used by laboratories worldwide. Use of neonatal animals in scientific research allows investigation of developing tissues, and enables long-term study of cell populations. However, procedures on neonatal mice are more challenging, due to the lack of reliable methods and apparatus for anaesthesia of these animals. Here, we report an inhalation-based protocol for anaesthesia of neonatal (P0-2) mice, and present a custom 3D-printed apparatus for maintenance of anaesthesia during surgical procedures. This approach significantly enhances animal welfare and facilitates wider and simpler use of neonatal rodents in scientific research. Our optimised method of anaesthesia enables a rapid method of stereotactic injection in neonatal mice for transduction of brain tissue. We demonstrate this procedure for targeted labelling of specific brain regions, and in vivo modification of tissue prior to organotypic culture. This anaesthetic approach can be readily employed by any laboratory, and will enable safer use of neonatal rodents across a diverse spectrum of scientific disciplines. Copy rights belong to original authors. Visit the link for more info
Предыстория от Паши Карыхалина / Stereotactic by Big Picture Festival
In April of 1990, Kirsty Salisbury (the host of the Let’s Talk Near Death Podcast) experienced a sudden brain illness which took her straight to the operating theatre for emergency brain surgery. It was during this surgery that her Near Death Experience took place, and she experienced some very different dimensions to the ones we experience here on earth. She woke to a completely new life, and her interest into NDE’s has consistently grown ever since. __________ To gain exclusive members-only benefits, such as access to our VIP members-only Facebook page and bonus content from some of our amazing guests, become a Let's Talk Near Death premium subscriber over on Patreon: https://www.patreon.com/kirstysalisbury
Professor Mark Callaway (the RCR’s medical director, professional practice for clinical radiology) talks to Dr Katharine Aitken on the role of stereotactic ablative radiotherapy (SABR) for colorectal cancer. Dr Katharine Aitken is a consultant clinical oncologist based at The Royal Marsden Hospital.
Commentary by Dr. Valentin Fuster
Featuring: Joseph H. Schwab, MD, Ilya Laufer, MD, Daniel M. Sciubba, MD Disclosures: Laufer, Ilya: Consulting: BrainLab (A), DePuy Synthes (B), Globus (B), Medtronic (C), SpineWave (B). Schwab, Joseph H.: Scientific Advisory Board: Chordoma Foundation (None); Speaking and/or Teaching Arrangements: AO Spine (Travel Expense Reimbursement, Outside 12-Month Requirement), Stryker Spine (B, Outside 12-Month Requirement). Sciubba, Daniel M.: Consulting: Baxter (B), DePuy Synthes (B), Globus (B), Medtronic (C), NuVasive (B), Stryker (C). Key: A: $100-$1,000; B: $1001-$10,000; C: $10,001-$25,000; D: $25,001-$50,000; E: $50,001-$100,000; F: $100,001- $500,000; G: $500,001-$1M; H: $1,000,001- $2.5M; I: $2.5M+
JNS March 27, 2015—click here to listen. Plaque morphology (the PLAC Scale) on CT angiography: predicting long-term anatomical success of primary carotid stenting. A successful case of multiple stereotactic radiosurgeries for ipsilateral recurrent trigeminal neuralgia. Stereotactic radiosurgery for intracranial hemangioblastomas: a retrospective international outcome study. Combined rigid and flexible endoscopy for tumors in the posterior […]