Podcasts about TACE

There are now multiple phase 3 studies on combination transarterial chemoembolization (TACE) and immunotherapy showing a significant benefit over TACE alone. How do these findings change the hepatocellular carcinoma (HCC) treatment algorithm? In this multidisciplinary episode of the BackTable Podcast, Dr. Richard Finn (Medical Oncologist at UCLA) and Dr. Julius Chapiro (Interventional Radiologist at Yale University) join host Dr. Chris Beck to discuss immunotherapy, TACE, emerging trends in HCC treatment, and the future of the field.---This podcast is supported by an educational grant from Guerbet.---SYNPOSISThe doctors highlight the importance of high quality clinical data and the pivotal studies shaping current best practices. They explore the role of the different players on the multidisciplinary team and compare the oncologic and radiologic perspectives. Additionally, they discuss the synergy between TACE and immunotherapy, the criteria for selecting appropriate treatments, and the ongoing need for research and collaboration.---TIMESTAMPS00:00 - Introduction 03:35 - HCC from an Oncologic Perspective 05:33 - Radiological Perspective on Liver Cancer06:50 - Referral Patterns and Organizing a Multidisciplinary Approach18:01 - Explaining TACE and Variations in the Procedure27:27 - Choosing the Right Procedure for HCC36:13 - Making a Decision on Medical Treatment Candidacy 42:23 - Importance of Data Driven HCC Treatment, Practical Insights, and Studies to Know55:30 - Planning an Approach for a TACE Procedure01:02:26 - Final Thoughts and Future Prospects in Liver Cancer Treatment---RESOURCESBarcelona Staging System:https://www.ncbi.nlm.nih.gov/books/NBK569796/table/Ch3-t0001/TRACE Trial:https://pubs.rsna.org/doi/full/10.1148/radiol.211806PREMIERE Trial:https://www.gastrojournal.org/article/S0016-5085(16)34971-X/fulltextEMERALD-1 Trial:https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432LEAP O12 Study:https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02575-3/abstract

El Dr. Diego Felip Ballén, oncólogo médico del Instituto Nacional de Cancerología en Bogotá, Colombia, junto con el Dr. Ismael Ghamen Cañete, oncólogo médico del Hospital Universitario La Paz en Madrid, España, presentaron recientemente en Barranquilla, Colombia, durante el congreso de CLOC, los últimos avances presentados durante el año pasado en estudios con tumores gastrointestinales.Durante la conversación, los expertos abordaron las opciones terapéuticas disponibles para pacientes con cáncer colorrectal metastásico con inestabilidad de microsatélites (MSI) o mutación en BRAF. También discutieron las estrategias de tratamiento en pacientes con hepatocarcinoma previamente manejados con quimioembolización transarterial (TACE), y finalmente, hablaron sobre las actualizaciones más recientes en el abordaje del carcinoma del canal anal.Cobertura apoyada por el Curso Latinoamericano de Oncología Clínica (CLOC). Fecha de grabación: 07 de marzo de 2025              Todos los comentarios emitidos por los participantes son a título personal y no reflejan la opinión de ScienceLink u otros. Se deberá revisar las indicaciones aprobadas en el país para cada uno de los tratamientos y medicamentos comentados. Las opiniones vertidas en este programa son responsabilidad de los participantes o entrevistados, ScienceLink las ha incluido con fines educativos. Este material está dirigido a profesionales de la salud exclusivamente. 

#notizie #podcast #politica #rassegnastampa

Urmăriți un material șocant în care sunt dezvăluite masacrele ce se petrec împotriva creștinilor în Africa și modul în care presa internațională reușește să ignore aceste violențe de necrezut. Să luăm aminte!Vizionare plăcută!Pentru Pomelnice și Donații accesați: https://www.chilieathonita.ro/pomelnice-si-donatii/Pentru mai multe articole (texte, traduceri, podcasturi) vedeți https://www.chilieathonita.ro/

The process of liver transplantation involves many complexities, and each patient's path to transplant is unique. To offer insider perspectives on this process, Dr. Zachary Berman sits down with transplant and hepatobiliary surgeon Dr. John Seal, as well as transplant hepatologists Dr. Heather Patton and Dr. Steve Young. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125740 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The panel begins by discussing the multidisciplinary pre-transplant evaluation process, which assesses factors such as liver function, comorbidities, surgical risk, and the availability of psychosocial support. Once a patient is listed for transplant, they enter a system that prioritizes those with the highest Model for End-Stage Liver Disease (MELD) score. During the waiting period, several comorbidities should be carefully monitored. Dr. Seal explores the impact of portal vein hypertension and portal vein thrombosis, explaining how these conditions may necessitate intraoperative thrombectomy or bypass. Dr. Patton and Dr. Young focus on considerations for using anticoagulation in patients with a high baseline bleeding risk and selecting the appropriate anticoagulant for patients listed for transplant. For patients with hepatocellular carcinoma (HCC), eligibility for MELD exception points may depend on factors such as time spent on the waiting list, adherence to the Milan criteria, and the presence of extrahepatic complications of liver disease. The panel also discusses bridging therapies to transplant, including Y90 and TACE. In the peri-transplant phase, they highlight innovations such as living donor transplants, liver perfusion pumps, and the use of hepatitis C- and HIV-positive organs. Finally, the discussion turns to post-transplant considerations, including surgical complications, organ rejection, immunosuppression, predictors of HCC recurrence, and long-term surveillance. --- TIMESTAMPS 00:00 - Introduction 01:16 - Current Landscape of Liver Transplantation 03:22 - Transplant Evaluation Process 09:48 - Timeline from Listing to Transplantion 11:16 - Treating Portal Vein Thrombosis and Hypertension 18:44 - MELD Exception Points 22:05 - Bridging Therapies 25:34 - Peri-Transplant Considerations 30:53 - Post-Transplant Period 37:39 - Repeat Transplantation --- RESOURCES Model for end-stage liver disease (MELD) and allocation of donor livers (Wiesner et al, 2003): https://www.gastrojournal.org/article/S0016-5085%2803%2950022-1/fulltext Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis- Milan Criteria (Mazzaferro et al, 1996): https://pubmed.ncbi.nlm.nih.gov/8594428/ Validation of the prognostic power of the RETREAT score for hepatocellular carcinoma recurrence using the UNOS database (Mehta et al, 2019): https://pmc.ncbi.nlm.nih.gov/articles/PMC6445634/ CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

Hostem středečního pořadu Na place s moderátorem Pavlem Nečasem byl fotbalový trenér Martin Svědík. Jak vzpomíná na úspěšné období, které prožil se Slováckem? „Vyhrát finále poháru proti Spartě bylo něco, jako kdybychom vyhráli titul. Za pět let jsem si tam s klukama z týmu vytvořil krásné vztahy,“ vzpomíná na skvělé časy v menším českém klubu. Co všechno zažil v pozici trenéra, respektive asistenta v reprezentace U20 a U21? Poslechněte si celý rozhovor.Všechny díly podcastu Na place můžete pohodlně poslouchat v mobilní aplikaci mujRozhlas pro Android a iOS nebo na webu mujRozhlas.cz.

Featuring perspectives from Dr Anthony El-Khoueiry, Dr Richard S Finn, Dr Aiwu Ruth He and Dr Stacey Stein, moderated by Dr Stephen “Fred” Divers, including the following topics: Adjuvant Systemic Therapy for Early-Stage Hepatocellular Carcinoma (HCC) — Dr El-Khoueiry Introduction (0:00) Faculty Presentation (3:08) IMbrave050: Adjuvant systemic treatment for high-risk resected HCC — Robin K (Katie) Kelley, MD and Thomas A Abrams, MD (13:43) Neoadjuvant systemic therapy for patients with borderline resectable HCC — Dr Abrams (20:15) Case: A man in his early 70s with locally advanced HCC and tumor thrombus that extends into the right atrium — Ghassan Abou-Alfa, MD, MBA (24:34) Recent Developments in the Management of Intermediate-Stage HCC — Dr Finn  Faculty Presentation (31:18) EMERALD-1 and LEAP-012 trials of TACE with immunotherapy — Drs Abrams and Kelley (42:15) Systemic treatment for patients with Child-Pugh B cirrhosis and HCC — Dr Kelley (48:29) Use of immunotherapy for patients with autoimmune disorders: A man in his early 30s with active colitis and metastatic HCC receives first-line lenvatinib — Drs Abrams and Abou-Alfa (53:05) Current First-Line Therapy for Advanced HCC — Dr He Faculty Presentation (1:00:39) Selection of first-line treatment regimen for advanced HCC — Drs Abrams, Kelley and Abou-Alfa (1:12:00) Role of single-agent immunotherapy in the treatment of advanced HCC — Dr Kelley (1:18:22) Management of HCC in patients with discordant tumor markers or mixed tumor histology — Dr Abrams (1:23:03) Promising Investigational Front-Line Strategies for Advanced HCC; Selection and Sequencing of Therapy for Relapsed/Refractory HCC — Dr Stein  Faculty Presentation (1:29:42) Choice of tyrosine kinase inhibitor as second-line systemic treatment for HCC; prevention, monitoring and mitigation of lenvatinib-associated side effects — Dr Kelley (1:42:59) Case: A man in his early 70s with metastatic HCC that has rapidly progressed on atezolizumab/bevacizumab — Dr Abou-Alfa (1:49:27) Supportive care measures to manage ascites in patients with HCC — Dr Abrams (1:55:20) CME information and select publications

Check out this week's QuadCast as we highlight the role of staging brain MRI in metastatic breast cancer, the link between acute and late toxicity in prostate cancer treatment, the benefits of liver SBRT over TACE, and more. Check out the website and subscribe to the newsletter! www.quadshotnews.com Founders & Lead Authors: Laura Dover & Caleb Dulaney Podcast Host: Sam Marcrom

In the past five years, the use of immunotherapeutic agents for advanced cancers has emerged as a promising alternative to tyrosine kinase inhibitors and chemotherapy, making it an exciting time to be practicing oncology. In this episode, Dr. Tyler Sandow interviews oncology experts about the landscape of advanced hepatocellular carcinoma (HCC) and the current state of immunotherapy treatments. He is joined by medical oncologists Dr. Jonathan Mizrah, Dr. Lingling Du, and Dr. Adam Burgoyne, as well as interventional oncologist Dr. Zachary Berman. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125737 --- This podcast is supported by an educational grant from: AstraZeneca https://www.astrazeneca.com/our-therapy-areas/oncology.html With additional support from: Boston Scientific https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology.html --- SYNPOSIS Drs. Burgoyne and Mizrahi provide a primer on immunotherapy and explain how they communicate the principles of this treatment to their patients. Dr. Du discusses the Imbrave clinical trial and how recent studies have shown improved overall survival when immunotherapeutic agents are used, especially when multiple agents targeting various pathways are employed. When choosing between different regimens, the doctors consider factors such as the patient's underlying liver function, symptom burden, and prior treatments. Importantly, the doctors also discuss contraindications to immunotherapy, including a history of organ transplant, autoimmune disease, and poor performance status—all of which put patients at high risk for deterioration with this treatment. The treatment of patients with poor liver function remains controversial, as underlying cirrhosis may prevent the recovery of liver function. Dr. Berman outlines recent clinical trials studying the effects of transarterial chemoembolization (TACE) combined with immunotherapy. Finally, the doctors discuss the future of HCC treatment and the benefits of continued innovation in both interventional and medical oncology. --- TIMESTAMPS 00:00 - Introduction to Immunotherapy 04:32 - Notable Clinical Trials 13:39 - HCC Etiology and Immunotherapy Outcomes 18:43 - Contraindications for Immunotherapy 23:05 - Adverse Effects from Treatment 25:14 - Combination Therapy 36:22 - Considerations for Immunotherapy Dosing 40:26 - The Future of HCC Treatment --- RESOURCES Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma, IMbrave150 Trial (Finn et al, 2020): https://pubmed.ncbi.nlm.nih.gov/32402160/ Tremelimumab plus Durvalumab in Unresectable Hepatocellular Carcinoma, HIMALAYA Trial (Abou-Alfa et al, 2022): https://evidence.nejm.org/doi/full/10.1056/EVIDoa2100070 Nivolumab versus sorafenib in advanced hepatocellular carcinoma (CheckMate 459): a randomised, multicentre, open-label, phase 3 trial (Yau, 2022): https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00604-5/abstract Nivolumab (NIVO) plus ipilimumab (IPI) vs lenvatinib (LEN) or sorafenib (SOR) as first-line treatment for unresectable hepatocellular carcinoma (uHCC): First results from CheckMate 9DW (Galle, 2024): https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA4008 Randomized Phase 3 LEAP-012 Study: Transarterial Chemoembolization With or Without Lenvatinib Plus Pembrolizumab for Intermediate-Stage Hepatocellular Carcinoma Not Amenable to Curative Treatment (Llovet, 2022): https://pubmed.ncbi.nlm.nih.gov/35119481/ Find this episode on BackTable.com for more resources.

In this final episode of the four-part series on hepatocellular carcinoma (HCC), hosted by the Oncology Brothers, Drs Rohit and Rahul Gosain, the discussion focuses on the evolving role of immunotherapy (IO) in intermediate HCC. The episode explores multimodal approaches that combine IO and IO-based therapies with loco-regional treatments and highlights the essential role of a multidisciplinary care team. Drs Nina Sanford (radiation oncologist), Mark Yarchoan (medical oncologist), and Ed Kim (interventional radiologist) join the Oncology Brothers to share their insights on: • Current treatment options for intermediate HCC, addressing its heterogeneity and standard treatment pathways • Latest clinical trial data (EMERALD-1, LEAP-012) on combining IO with loco-regional therapies, and the clinical implications • The importance of effective collaboration within the multidisciplinary team for delivering optimal patient care • Combining IO with loco-regional therapy and future perspectives in the field Clinical takeaways • IO and IO-based treatments are moving earlier in the treatment paradigm for patients with intermediate HCC. Earlier integration of these therapies aims to achieve improved systemic control, allowing loco-regional therapy to target oligoprogression, residual lesions or reduce tumour burden • Emerging data supports combining systemic and loco-regional therapies for patients with intermediate HCC. EMERALD-1 and LEAP-012 show promising PFS data using IO-based combination regimens like durvalumab + bevacizumab or pembrolizumab + lenvatinib alongside TACE. Long-term OS data are awaited • Effective communication and coordinated care among specialists, such as medical oncologists, radiation oncologists, hepatologists, and interventional radiologists, are essential to developing optimal treatment strategies for patients with intermediate HCC Follow us on social media: •⁠ ⁠X/Twitter: https://twitter.com/oncbrothers •⁠ ⁠Instagram: https://www.instagram.com/oncbrothers •⁠ YouTube: https://www.youtube.com/channel/UCjfxKlVho5xWH5ltufj4F4A/ Subscribe to our channel for more insights on oncology treatments and patient care!

Ep. 680 - Fofana e Reijnders con la lingua di fuori: dal mercato tutto tace. Eppure uno ci sarebbe...

Shirin Mu Zagaya Duniya na wannan mako tare da Nura Ado Sulaiman kamar ko yaushe ya yi duba kan muhimman labaran da suka faru a makon da ya gabata, ciki kuwa har da batun yaddama'aikatar tsaron Najeriya ta bakin hafsan hafsoshin sojin ƙasar Janar Christopher Musa ta sanar da cewa cikin watanni 6 na ƙarshen wannan shekara adadin ƴan ta'adda dubu 129 da 417 tare da iyalansu ne suka ajje makamai bayan miƙa wuya ga mahukuntan ƙasar, lamarin da ke matsayin gagarumar nasara a ƙoƙarin da Najeriya ke yi na kawo ƙarshen barazanar ta'addancin da ya yi mata katutu. 

Il commento di politica è di @FrancescoBechis e riguarda le elezioni in Veneto e il terzo mandato di De Luca, quindi ci spostiamo in Medioriente con l'analisi di @LorenzoVita e il ferimento di 4 soldati italiani, andiamo in America con il commento di @AnnaGuaita che ci spiega il silenzio di Donald Trump sull'Ucraina in fiamme, per lo spettacolo torna Momenti di Gloria con @GloriaSatta che ci parla di Leo Gassmann, nipote e figlio d'arte e del suo prossimo film,

ABOUT THIS EPISODEIn this 2-part series, Dr. Osman Ahmed from the University of Chicago covers liver-directed therapies for neuroendocrine neoplasms (NENs or neuroendocrine cancer). In this second episode, he details the embolization techniques, including bland embolization (TAE), chemoembolization (TACE), and radioembolization (TARE, SIRT, y90). He discusses decision-making, sequencing, and follow-up after these procedures.TOP TEN QUESTIONS ABOUT LIVER-DIRECTED THERAPY PART 2:1. What do patients need to know about bland embolization (TAE)? a. What are the possible side effects? b. How do the size of beads play a role? c. When is this recommended? d. Do you always do both sides of the liver? If so, what is the timing and why? e. What is the recovery like? What is post-embolization syndrome?2. What do patients need to know about chemoembolization (TACE)?a. What drug is used & does this go through the whole body? b. What is the recovery like? What are the possible side effects?3. What do patients need to know about radioembolization (TARE, SIRT, y90)? a. In the era of PRRT, is there a concern with using y90 or radioembolization? How is the approach and technique used with radioembolization different than how it was done in the past? Is there a total lifetime limit of radiation?b. What is the recovery like? What are the possible side effects?4. Is there a limit to how much LDT one can do? Can they be repeated?5. How does one decide between the various types of liver-directed therapies?6. Is there a sequencing to treatments?7. Are there certain treatments that make you ineligible for other treatments? [PRRT, chemo, y90 etc] 8. If someone has had surgery such as a Whipple or surgery or procedures involving the bile duct, such as a stent in the bile duct or surgical removal of part of the bile duct, how does this weigh into the decision-making process for LDT?9. How do you determine if the treatment “worked?” What is the follow-up like? What scan might you do and in what timing?10. What do you see as the future of liver-directed therapy in neuroendocrine cancer treatment? MEET DR. OSMAN AHMEDOsman Ahmed, MD, is an expert vascular and interventional radiologist who diagnoses and treats a wide range of conditions. Using image-guided technology and small, sophisticated instruments, Dr. Ahmed performs minimally invasive procedures for acute and chronic deep vein thrombosis, benign prostatic hyperplasia, peripheral vascular disease, liver/bone/lung/kidney cancer, spinal fractures, uterine fibroids and more. He also implants inferior vena cava (IVC) filters, which prevent a blood clot from traveling around the body or creating a blockage.In addition to his clinical expertise, Dr. Ahmed researches novel treatment options that improve outcomes for patients. His research on liver cancer, IVC filters and venous diseases has been published in several high-impact, peer-reviewed journals, including the Journal of Vascular and Interventional Radiology, Radiology, Chest, Journal of American College of Radiology, and Journal of Surgical Oncology.Dr. Ahmed also believes in the importance of educating medical students, residents, fellowships and peers in order to enhance health care across the world. He has been invited to speak at a number of symposiums, practicums and national/international meetings about the newest advancements in interventional radiology.For more information, visit https://www.lacnets.org/lacnets-podcastFor more information, visit LACNETS.org.

This recording features audio versions of October 2024 Journal of Vascular and Interventional Radiology (JVIR) abstracts:Outcomes Analysis of Yttrium-90 Radioembolization for Tumors Other Than Metastatic Colorectal Cancer from the Radiation-Emitting SIR-Spheres in Nonresectable (RESiN) Registry ReadOpen access: Using Voxel-Based Dosimetry to Evaluate Sphere Concentration and Tumor Dose in Hepatocellular Carcinoma Treated with Yttrium-90 Radiation Segmentectomy with Glass Microspheres ReadClinical Effectiveness of Drug-Eluting Microsphere Transcatheter Arterial Chemoembolization Combined with First-Line Chemotherapy as the Initial Treatment for Patients with Unresectable Intrahepatic Cholangiocarcinoma ReadComparison of Small-Sized (70–150 μm) and Intermediate-Sized (100–300 μm) Drug-Eluting Embolics for Transarterial Chemoembolization of Small Hepatocellular Carcinomas (≤3 cm) ReadOpen access: Technical Feasibility and Outcome of Cryoablation of Aneurysmal Bone Cysts in Pediatric Patients ReadPrimary Limb-Based Patency for Chronic Limb-Threatening Ischemia Treated with Endovascular Therapy Based on the Global Limb Anatomic Staging System ReadOpen access: Initial Outcomes of Embolization for Type II Endoleak: Comparison of n-Butyl Cyanoacrylate–Ethiodized Oil Mixture with n-Butyl Cyanoacrylate– Ethiodized Oil–Ethanol Mixture ReadTrack Sealing in CT-Guided Lung Biopsy Using Gelatin Sponge Slurry versus Saline in Reducing Postbiopsy Pneumothorax: A Prospective Randomized Study ReadJVIR and SIR thank all those who helped record this episode:Host:Manbir Singh Sandhu, University of California Riverside School of MedicineAudio editor:Hannah Curtis, Loma Linda University School of MedicineAbstract readers:Maximillion Hayama, Duke University School of MedicineLana Kamel, University of Minnesota Medical SchoolJessalyn Yam, University of Illinois College of Medicine at ChicagoSiddak Dhaliwal, University of Missouri School of MedicineJason Hoang, The Ohio State University College of MedicineAkumbir Singh Grewal, St. George University School of MedicineMillennie Chen, University of California Riverside School of MedicineDaniel Roh, Loma Linda University School of Medicine Support the showSupport the show

#notizie #podcast #politica #rassegnastampa

Les cétacés sont des mammifères marins qui utilisent les sons dans leurs activités vitales et leurs interactions sociales. Les dauphins produisent des clics et des sifflements tandis que les baleines émettent des vocalisations harmoniques. À partir de l'écoute d'enregistrements originaux, Olivier Adam, professeur en bioacoustique à l'Institut Jean Le Rond d'Alem- bert (Sorbonne Université/CNRS1), détaillera leur générateur vocal et les caractéristiques de ces sons. À quoi ils servent ? Sont-ils structurés ? Si on parle de chants, peut-on parler de langage ? Est-ce que les activités humaines ont un impact et si oui, comment se manifeste-t-il ?

Massimo Giannini, editorialista e opinionista di Repubblica, racconta dal lunedì al venerdì il suo punto di vista sullo scenario politico e sulle notizie di attualità, italiane e internazionali. “Circo Massimo - Lo spettacolo della politica“ lo puoi ascoltare sull’app di One Podcast, sull’app di Repubblica, e su tutte le principali piattaforme.See omnystudio.com/listener for privacy information.

Join us in this exciting episode of the Oncology Brothers podcast as we dive into the highlights from ESMO 2024, focusing on gastrointestinal malignancies. Hosts Drs. Rohit and Rahul Gosain are joined by Dr. Kristen Ciombor, a GI medical oncologist from Vanderbilt University, to discuss four key studies that have significant implications for clinical practice. In this episode, we covered: •⁠ ⁠LEAP-012 Study: An update on HCC treatment with Lenvatinib and Pembrolizumab combined with TACE, exploring the promising progression-free survival (PFS) data and the need for mature overall survival (OS) results. •⁠ ⁠Keynote-811: The current standard of care for HER2-positive gastroesophageal junction and gastric adenocarcinoma, highlighting improved OS with Pembrolizumab, chemotherapy, and Trastuzumab. •⁠ ⁠POD1UM-303 Trial: A groundbreaking study in metastatic anal cancer that shows significant OS improvement with the addition of the PD-1 inhibitor Retifanlimab to chemotherapy. •⁠ ⁠NICHE-2 Study: A remarkable update on MSI-high patients, showcasing a 100% three-year disease-free survival rate with neoadjuvant immunotherapy. Tune in for an insightful discussion that will keep you updated on the latest advancements in GI oncology! Don't forget to like, subscribe, and hit the notification bell for more conference highlights and oncology discussions. #OncologyBrothers #ESMO24 #GIMalignancies #CancerResearch #Podcast Subscribe for more updates and insights from the Oncology Brothers! Website: http://www.oncbrothers.com/ Twitter: https://twitter.com/oncbrothers Contact us at info@oncbrothers.com  

Manovra: Salvini dice "paghino i banchieri" e Meloni tace! - Proteste pro Palestina… contro la cyber security!

The RISE-UP project is a transformative initiative to revolutionize rehabilitation services for underserved populations, focusing on racial and ethnic minorities. Dr. Mari Guillermo and Dr. Mark Tucker, Project Directors at San Diego State University's Interwork Institute, highlight how this project seeks to drive systemic change through state agency partnerships and tools like QA Advisor Plus. RISE-UP strives to reshape vocational rehabilitation and improve employment outcomes nationwide by fostering equity, inclusion, and access.   Listen Here   Full Transcript:   {Music} Mark: QA Advisor Plus, a tool that agencies can use to check their RSA 911 data for errors and to help facilitate or expedite analysis of their own data.   Mari: How do we close this gap? Where are people not being served, what populations specifically are not being served? And the emphasis is on systems change because we can't improve these outcomes without really looking at what needs to change within that system.   Mark: So we hope that when you see information about the survey coming out, that you take a few minutes to fill it out and can provide us with information both about what they see as needs related to serving underserved populations. But also, we're asking folks to identify any promising practices that they're aware of with respect to providing effective services to underserved populations.   Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute, Dr. Mari Guillermo and Dr. Mark Tucker, are co-project directors with San Diego State University Interwork Institute. And they are joining me in the studio today. So how are things going in San Diego, Mari?   Mari: Uh, well, it's warming up. It's going to be in the 90s by tomorrow, but it's also the start of the semester at San Diego State University. We're in our second week, so things are still trying to settle down, but it's been quite a good busy two weeks for sure.   Carol: Oh, good for you. Well, I was in San Diego back in June and I'm going, okay, why isn't it warm here now? It was warmer in Minnesota than it was in San Diego. It was so crazy with that kind of, I don't know, marine layer or whatever hangs out. Yeah. How about you, Mark? How are things going for you?   Mark: Going well, yeah, That marine layer in June we that's like a typical thing June Gloom we call it. And then we pay the price in September. September is usually warm for us, but we'll get back to our normal San Diego weather in October.   Carol: Nice. I do love your fair city though. It is really awesome. Well, I thought, and I'm so glad I could get you two because I've been trying to snag you. I think I've been talking to you since last December, but now is finally the sweet spot. I thought it was super timely that we talk about the project given you're at the end of year one. October is also National Disability Employment Awareness Month, and I really think the project that you guys are embarking on could have a significant impact on the employment arena for underserved populations. As a little side note, we're super happy as part of the George Washington University team to be a partner on this project. So I want to give our listeners just a little bit of background. Over a year ago, RSA competed a discretionary grant, and the grant was specifically related to section 21 of the Rehab Act, as amended by WIOA, which requires RSA to reserve 1% of the funds appropriated each year for programs under titles three, title six, and seven to provide grant, contract or cooperative agreement awards to minority entities and Indian tribes to carry out activities under the Rehab Act. Secondly, minority entities and Indian tribes to conduct research training to or a related activity to improve services provided under the act, especially services provided to individuals from minority backgrounds. Or thirdly, state or public or private non-profit agencies or organizations to provide outreach and technical assistance to minority entities and American Indian tribes to promote their participation in activities under the Rehab Act. I learned a whole bunch. I know for our listeners, you're getting a whole history lesson, but I thought this was cool. And so under this priority, the department provides funding for a cooperative agreement for a minority entity or an Indian tribe to provide training and TA to a minimum range of 5 to 15 state VR agencies over a five year period of performance, so they are equipped to serve as role models for diversity, equity, inclusion and accessibility in the workforce system by implementing policies, Practices and service delivery approaches designed to contribute to increasing competitive, integrated employment outcomes for individuals with disabilities from underserved populations. And the other cool part is that you also need to contribute via our research and really good practices that promote access, and this will be really of great benefit across the whole country. So I'm super excited. Let's dig in. So, Mari, typically our listeners like to know a little bit about our guests, your backgrounds. So can you tell a little bit about yourself and your background?   Mari: Yeah, I'm originally from Hawaii, born and raised in Honolulu, Hawaii. I moved to San Diego in the late 80s to as a graduate student in the rehabilitation program at San Diego State University. So since moving to San Diego, I haven't moved very far from San Diego State University and our rehab counseling program. I'm currently faculty in our graduate program, but I've been with the Interwork Institute since its beginning, when it was started by doctors Fred McFarlane and Doctor Ian Champion, and just worked with some incredible number of leaders in our rehabilitation field. And upon graduating from the master's program, I started working with Doctor Bobby Atkins. And for those of you who few of you who are not familiar with Doctor Atkins, she is a leader. When we look at all diversity initiatives and in fact, when we look at section 21, that was started with her groundbreaking research looking at the involvement and participation of African Americans in vocational rehabilitation. But I worked with Doctor Atkins upon graduating from the program in the capacity building projects funded by this same pool of money. And Doctor Atkins was the national director for the Rehabilitation Cultural Diversity Initiative, which then morphed over into the Rehabilitation Capacity Building Project. So I worked with her from the 90s. All the way up to like 2015 I think is when the project ended. So a lot of the work that we are doing in Rise Up really builds on the foundational work that we did with Doctor Atkins back in the 1990s. So it's an incredible honor.   Carol: I think that is very cool. You've come full circle. Oh my gosh, I love that. I had no idea. And for our listeners too, I just want to say a word about Doctor Fred McFarlane. Fred had passed away this summer. Fred has been a good friend to many, and many of our listeners have benefited from Fred's work with the NRLI and the Leadership Institute. Fred was the founding person developing that and really did such an amazing job touching so many VR professionals over his career. And his legacy definitely lives on. So I just I needed to say that because Fred is definitely missed. So, Marc, how about you? Why don't you tell us a little bit about your background.   Mark: Sure, I've got a Master of Science in rehabilitation counseling, and I'm a certified rehabilitation counselor. And in fact, you know, when I was applying to the graduate program in rehabilitation counseling, Fred interviewed me. Uh, that was a few years back. But that...   Carol: Yeah, 1 or 2.   Mark: Yeah, but he was there right at the start for me. And then kind of in the profession, I got my start in community based non-profit agencies and then from there joined the Rehabilitation Continuing Education program for region nine at Interwork and SDSU in the early 2000. And when I was there, was involved in all kinds of different technical assistance, training and research projects, while also kind of teaching in an adjunct capacity in the Rehabilitation counseling graduate program at SDSU. And then eventually the Rehabilitation Continuing Education programs transitioned into the Technical Assistance and Continuing Education centers. So I continued doing that same type of work with what were called the TACE centers, and then in 2014, joined the Rehabilitation Counseling Program faculty at SDSU full time. So that's sort of where I spend a lot of my time. But I still continue working with, you know, Interwork. The two are just so intricately joined. It's really difficult to be part of one without being part of the other. So I continue doing work at Interwork. One of the recent projects that Mari and I were both involved in a few years back was the California version of the Promise Projects. It was a 5 or 6 years of work with transition age youth who were recipients of Supplemental Security Income. Presently, I'm the coordinator of the Rehabilitation Counseling program at SDSU, and do that while maintaining connections to a variety of projects at Interwork.   Carol: Yeah, you're always wearing about 40 hats. I always think of you, Mark, as being the data guy though, too, because you love the data. I mean, everybody likes data, sort of but you love the data. I mean, you've done some really amazing things with our national data.   Mark: Thank you. I enjoy that. I appreciate being able to bring that to a lot of the projects that I'm involved in. Yeah, you're right. I think I find it fun maybe at times where other people are like, oh, we'll leave that to somebody else.   Carol: Yeah, absolutely. Oh my gosh. So why don't you guys tell us a little bit about your project? I know it's called Rise Up. Maybe you can tell our group like what's that stand for? Everybody's got their fun acronyms and what you're trying to accomplish.   Mari: The name really captures the overall vision for this project, and we have to give a shout out to Doctor Chaz Compton because after several failed acronyms, as we were writing the proposal, it was Chaz who came up with the name. And RISEUP stands for Rehabilitation Improvements in Services and Employment for Underserved Populations. And so that really captures what we're aiming to do, improving the services and in the process of improving services, improving the outcomes for underserved populations, in competitive integrated employment, in careers, in academic achievements and accomplishments now underserved populations. There's many ways we can look at that, but RSA has defined it for us and it concentrates on race and ethnicity. So it encompasses individuals who are black, Latino, indigenous, Native American persons, Asian Americans, Pacific Islanders, and other persons of color. And so that is the specific focus for this grant and the population that we hope to impact ultimately with the work that we do with the state agencies. An important component of the project is the partnerships that we aim to build with ten state agencies. And that partnership is really important because while we think about this work is okay, we'll do training and technical assistance and all these different topics and how it intersects with these different populations based on evidence based practices and promising practices. But we can only do so much with training and technical assistance. We really have to look at, okay, how does this then translate into the work that goes on in the agency and not just in the agency? How does that look at the different levels within the agency? How a director would translate the training will look different than how a counselor or a technician would translate. We hope that it complements each other, but everyone has a different role in this process. And that's the other part of the project, is that we want to really look at the whole agency and all the different levels, and being able to provide that support to them where they need it. And really looking at how do we close this gap? Where are people not being served, what populations specifically are not being served within a state or a section of the state? And the emphasis is on systems change, because we can't improve these outcomes without really looking at what needs to change within that system. And there's different components that we're going to be incorporating into the project in our partnerships with the state agencies to look at what are the strengths and weaknesses within your agencies and what are the opportunities and gaps. And while there are big challenges that we all are aware of, there's also some great things going on and we want to highlight that, and we believe we'll be able to find that also within each of the state agencies.   Carol: I like a couple of things about what you just said. Well, I like it all, but a couple things stick out to me because holistically, we've seen it as we do TA and as people put in new initiatives in place. If you really get the whole agency going in the same direction, it is the rise or fall of that project for sure, because maybe the director is all in, but the mid-level managers and the counselors are like, I don't even understand what's going on. You're asking us to do this other thing? I don't get it. It seems weird. It's extra. I don't want to. I'm not going to. And then it doesn't happen. And so you really have to get everybody in sync. So I think you're smart to look at the whole organization and how everybody interprets the information and the training and how it actually gets implemented, because it isn't the director implementing it. It's the boots on the ground folks, it's your counselor. You need your line folks engaged and involved and giving you feedback and understanding what's happening. So that I think that is brilliant. Secondly, the data I think it's been interesting and I think Mark, it's some of the work that you've done over the last couple of years that I've known you as well, that as people start to get better about looking at their data, I think folks were looking really high level, not getting into the real intricacies and seeing the maybe the disparities that are happening in employment as you start looking at different races and ethnicities and who's getting what kind of work and what those outcomes are. And then we've seen states be completely shocked, like we didn't know we have a huge problem in this area. So I think getting at the data is super important. So I know, Mark, you and I had spoken to and you talked about this special wrinkle, and we're not using wrinkle in a bad way. It was in a good way. But you have a contractor called Encorpe and they're bringing something special to the project. Tell us a little bit about that.   Mark: Sure, and this relates a bit more to the data aspects of the project that we were just talking about. So Encorpe is a partner on the project. It's an organization that's headed by a couple of individuals with considerable experience with the public VR program, and they offer a tool that's known as QA Advisor Plus. So this is a tool that agencies can use to check their RSA 911 data for errors and to kind of help facilitate or expedite analysis of their own data. So users of the tool can run custom queries on their data. They can do things like track changes from quarter to quarter in things like population served on a variety of measures that might include things like applications or eligibility plan services, competitive integrated employment outcomes. Those are the kinds of things that are of interest, particularly to us as part of the Rise Up project and built into this project is that Rise Up will pay for one year of QA advisor Plus for participating agencies if they elect to use it. So agencies aren't required to use QA Advisor Plus if they don't want to. We have other strategies for helping and assisting with data analysis if they elect not to use it, but that's there as an offer. Rise Up will cover one year of the cost of that service. And I think one of the things that we're trying to get at is that through the project is to kind of help facilitate kind of long term attention and ongoing attention to things like population served and differences in services and outcomes, and to use that for more data informed planning, in our case, particularly around underserved populations. But agencies can certainly pretty easily extend that out to other groups of interest or other aspects of the rehabilitation process. That may not be maybe the central focus of what Rise Up is doing. And one of the things I sort of want to underscore here is that the project is intentionally designed to make considerable use of data that the state agencies are already gathering and reporting to RSA anyway. So if agencies are interested maybe in participating in Rise Up, but they're like, oh, I don't want there to be like an additional heavy burden on my data folks or my direct service folks. Our intention is that things will be fairly light with respect to those kinds of demands, because we'll take advantage of existing data that's already being gathered, and then we'll either use QA Advisor Plus or some of our own staff to assist with the analyses.   Carol: That's the beauty of this project really, I love that because it isn't like you're going, okay, state, we're knocking on your door to like, come and do this thing. And then you need to add like ten positions to pay attention to this. And I think it's great because I got a chance to look at that QA Advisor Plus. I saw the Encorpe guys at, CSAVR and they were like, hey, do you want to see a little demo of this? I was like, oh my gosh, I know as being a small blind agency director, we had one data person who's doing a million things, and so we were very surfacey. We got a little bit of stuff, but it was really hard. You have one person there doing a million things, and so that tool, I liked how it kind of rose up little things. It had that cool feature and it would just flag something for you to go like, hey, what's going on in this particular area? That would have been so lovely because I know a lot of our programs are small, so you might just have a half a position or one position that's working in this area. They don't have a whole team that's got all this really developed deep skill set in there. I just think having that added resource is amazing and could really take that level of sort of your data analytics to a whole different place than what you've been able to do so far and not, you know, not disparaging anybody's current skill level at it. It's just that people don't have time because there's so many demands. So when you can add like a feature to help with analyzing that data, it really is a great gift. So who are your agencies that are currently participating in the project?   Mari: So we've had initial conversations with a number of agencies, and certainly there were a number of agencies who had written letters of commitment when we wrote the grant, and that was really important. I don't want to mention the states yet until we have agreements in place out of respect for the agencies, our goal is to have by the end of year two, our goal is to have six agreements in place and by the end of year three, another four. So that will be a total of ten. But we've already started to have that conversation and people are at different starting points, right? And trying to map out how will this make sense and be of value to your agency and mapping that out in an individualized agreement with each of the states? So maybe we'll be invited for a second visit a year down the road, and I can at least give you a few more names more specific than what I'm giving you now, Carol.   Carol: No,  that's totally fine. Absolutely. I wasn't sure if, you know, like, are you needing some people? Because sometimes our listeners are like, hey, I want to be part of that project. I want to be in.   Mari: No, absolutely. And we're more than happy to talk to agencies throughout this whole process, because really the intent is we targeted ten agencies because we want to make sure that with the resources that we have available to us, that we use that in a way to really make that impact, to really try to get to that systems change because again, change doesn't happen overnight and it doesn't happen on a zero budget, right? But the hope is the lessons that are learned from the ten agencies in this work will be relevant to the rest of the country.   Carol: That's what I've loved about all of these different discretionary grants that RSA has put out, because I've been talking to people for the last year, and there is such cool things being done and demonstrated that now they're sharing out, you know, with other people and just that wonderful plethora of ideas. It makes it super fun. And everybody gets really excited planting the seeds of a different way of looking at things and doing things. So you are at the end of year one, and I love it when I talk to all our grantees that have gotten these grants, like, what have been your challenges this year?   Mark: I would say some of the challenges that we've encountered are things that it's not like they're not doable. It's just that they're the time and process demands are, you know, things have sort of taken longer, I guess I've started to come to kind of expect it. But still, when you're anxious to kind of get going and get rolling, these things sort of surface as challenges or frustrations. And so some of them are, I think, very predictable things like fleshing out the project staff, developing and executing subcontracts. I think Mari, she's nodding her head often. It's a little bit more complicated or involved than you think it might be. We've been working on things like establishing the technical infrastructure for the project, information management, information sharing systems, and we have a website that's in development that will ultimately use to share information coming out of this project, with many more than just the ten state agencies that we work intensively with. So there will be kind of dissemination of project learning far beyond those ten. We've been comprehensively surveying the literature related to underserved populations in VR, and it's not really just a challenge. It's just kind of a time consuming thing that we're kind of working our way through. We are going to be implementing a national survey of state VR staff around both challenges and opportunities related to serving underserved populations and the instrument development process is always a little time consuming, and you get a lot of feedback and you make revisions and there's several feedback and revision stages. So that's something that will be surfacing in the near future. That's just it's taken time, but we'll get there. Or going through things like the human subjects institutional review process, just to make sure that everybody's, you know, treated well and treated ethically. So those are all, you know, just things that have moved along or are moving along and we're squaring them away. But for those of us who are like, would like to just get going, all of that process stuff at the beginning is a little bit of a challenge. One thing that I think the team is wrestling with a little bit, and this is something that I think were a challenge that we will contend with going forward, and I've got confidence that we'll be able to address it, but it's just going to require some thought is that, you know, as Mari indicated earlier, the underserved populations of interest are defined by race and ethnicity. And we know already from looking at our data over a long period of time that our clients, like everybody else, often are multiracial, and they check a whole bunch of boxes So we're not going to necessarily be able to look at clients who are folks don't fall neatly into very convenient categories, right. So I think we're going to have to be very sensitive to that dynamic in the process and probably develop multiple ways of looking at race and ethnicity, so that we don't kind of miss any really important lessons that are coming out of this project.   Carol: Absolutely. And regarding that national survey, is there something our listeners can do to be of help in that or something they should be looking out for?   Mark: We're still in the process of piloting it like we want to get it right before it goes out, but we will be working with one of our project partners, which is CSAVR, to disseminate this national survey. It'll be an electronic survey, and it's really designed to go to VR staff at all levels. Like we talked about earlier, involvement of folks, feedback from folks at all levels in VR system really important. So VR staff at all levels, folks like SRC members will be disseminating it through CSAVR. And we would encourage everybody to, you know, I know we survey ourselves all the time in society here in the US. But this one is important. And to me and I think to the overall intent of the project. And so we hope that when you see information about the survey coming out, that you take a few minutes to fill it out and complete it. It will be anonymous. It won't be linked back to you. So we hope people will respond candidly and provide us with information both about what they see as needs related to serving underserved populations. But also, we're asking folks to identify any promising practices that they're aware of with respect to providing effective services to underserved populations. I think both of those types of information can be really helpful to us in terms of planning out the future of this project, designing effective training, effective technical assistance efforts. So we see it as one way of kind of triangulating that information. We will look to triangulate it with other forms of information, but really critical to kind of building some of the key infrastructure to the project.   Carol: Good.   Mark: Yeah.   Carol: And we definitely can be a help to in passing out the word when the survey comes out. I know Chaz, he'll be like, Carol, can you get that out in our email groups too? We have lots of different ways. We communicate out. We have different COPs. We've got lots of mailing lists and such, so we can help kind of promote the word to get at the different groups of folks. So you get kind of a wide range of participation. So I know, Mark, you've alluded to a few things that really you've learned so far this year. One, because always year one's a learning year because people don't fall neatly in boxes. Are there any other kind of learnings you've had from year one so far, or Mari, too. either of you?   Mark: Yeah, I'm going to defer to Mari on this one.   Mari: We've learned a lot. And when you say, what have you learned so far? It's almost what has been confirmed. The whole reason why this funding opportunity is available because there's a gap there, right? And so what the conversations that we've had with agencies is just confirmed that there's a lot of work that we need to do and that we need to do better. But every agency is at a different starting point. Who they consider underserved will vary from state to state, or even from city to city within the same state. Right And where those gaps and inequities occur will also vary. For some states, it's just getting the outreach to communities to that door exists in their area, to certain populations dropping out before they even reach the point of developing an EIP, and other agencies are seeing where the EIP is developed. Things start to roll out and then for different reasons that we want to dig into, we lose people, you know, in certain populations compared to the overall populations being served. And so one of the things we are learning is that we really need to direct the training and technical assistance to where each agency wants to start, but also helping them and working together using that data that Marc talked about to confirm or not confirm whether these actual inequities at different points in the process are occurring. And then of course, the environment and the climate that agencies operate under impacts what they're tackling, something that we've heard repeatedly. And I'm sure, Carol, you've heard often, is the staffing challenges that our state agencies are experiencing upwards to 40% of unfilled positions, and that will certainly impact the work and the progress and the impact when we start to work with the agencies. Some agencies are further along in the process where they've really looked at the data from their comprehensive statewide needs assessment and saw a hole there and actually started to develop a goal to address that. And so they've already have that beginning understanding and now are at the stage of, okay, what do we do with this information? What kind of training and technical assistance can we provide our staff, and how can you help with this. And getting us to move the needle, at least move the needle forward, right? And I know we're going to get a lot of new information or confirming knowledge from the national survey, but also using that national survey to start the conversation with each of the individual agencies. You know, how does this national data look for you? Is it true or how different it is? And so I think we've learned a lot, and there's a lot more that we're going to unravel in this process.   Carol: I love it. The CSNAs, you know, I think states for a long time did it as a check the box. We have to do the thing. We're going to contract to somebody to do the thing. Here's the thing. It's 300 pages. All right. We put it on the shelf. It's in the electronic folder. But I have noticed this over the years we've been doing the QM work. People are really taking the CSNA and actually paying attention to it and starting to put all the dots together, linking that as the basis for then what flows into the state plan flows into goals and priorities and really connecting and spending more time. The thing I've been very hopeful of is spending time with direct staff so that they understand the whole process, because staff will hear about this stuff, but they don't really understand it or what is that about? And now people are linking like, here's why we're doing all of this. We're actually finding out what's the situation in our state, and we're taking this and we're putting together goals and priorities within our state plan based on this data, this information. So it all links together, because I think people feel like everybody's just doing these random activities, but they actually all come together.   Mari: Yeah.   Carol: So that I have seen as a change, definitely in the five plus years I've been doing TA work now, I've seen a big swing and I've loved it, because now people are digging down in the organization and including not just your executive leadership and middle managers. They're including the line staff and having them have an understanding of what's going on so that they can understand their contributions to this overall big picture. So I love that.   Mari: Yeah, and we learned that from the Cal Promise Project We had this whole large, comprehensive database and our team were able to put together, I guess, reports of here's what the data is looking like, here's how your region is being impacted, and the transition specialists, the people who are meeting with the families and with the students, like we've never seen this before. We're always feeding data to our supervisor. Our boss is always asking for data, and so we give it to them. But we never know what happens to it. And now it makes sense. This is how my work is impacting people.   Carol: Absolutely. It's mind blowing to the staff because when you go out, you're talking and you're like, okay. They're like, well, why is Congress doing all this crazy stuff with our money or whatever is going on? I always tell them, I go, the only way your story can be told because they don't know all your anecdotal, really neat. You got Joe, a job like this is awesome and it's a great career and you know, all this great things are happening. They don't know any of that. They only know by the data you put in the system. And when you put data in the system, that isn't very good. That's the picture, the story that your agency is telling. This is the only way for other people to make decisions. You just see this. Aha. Like people are like, oh well this stuff actually does matter. And it is being used for something and then they can figure it out. And I love it when you get down in regional levels because then they go like and they'll know what's going on. Sometimes up here the management's like, oh they're trying to figure out what's happening in that region. Talk to the staff. They see boots on the ground, what's going on. So the data confirms what's been happening in that area. And then the whole agency having that conversation, it's really exciting and super empowering and energizing. I feel like for their customers and what's going to happen for their people, I love that. The other thing I was going to say, Mari too, is we've been seeing a slight improvement in staffing levels. Now it seems like things for some reason, because we work with a load of states and we talk a lot about this particular issue, the staffing levels, it's been leveling off with that whole people leaving, leaving, leaving, leaving, leaving. And now I've had a couple agencies in the last year where they were sitting at 25, 30% now. They're at 5% and 8% turnover. Like there have been significant changes because of all of the things they put into play to not only get staff, but to keep them, to retain them. So we've been trying to do some efforts on our end and we can't say it's all us, you know, but people have been putting a lot of strategy into this, and it's really fun to see on this other side, this more encouraging landscape for the staff out there.   Mari: Wow, that's great to hear.   Carol: Yeah. So I'm hopeful for you guys as you're carrying this out. So now what are your plans for year two as you go into year two? What are you guys hoping to accomplish this year?   Mark: I think it'll be a busy year for us. I think one of the major efforts, you know, we've already kind of alluded to a little bit, which is get the national survey out there to get that information back, have our team kind of start analyzing the results. We'll use that data. As I said before, we'll triangulate that with other information sources that we have our team working on. You mentioned comprehensive statewide needs assessments and state plans. Our team is doing an analysis of that specifically through the lens of underserved populations to see what can be gleaned from those statewide reports. And they're triangulating that also with kind of other forms of published literature around underserved populations. So there's a lot of kind of building that kind of database of information will be focused on executing agreements with the first of the agencies that are going to be involved with kind of the intensive phases of Rise Up, while at the same time kind of establishing the groundwork for agencies that we will add to the Rise Up group, you know, to as we work towards our goal of getting to up to ten state agencies. And then I think as we work with each of the agencies, kind of to begin to identify the populations that they want to focus on for, you know, kind of sustained efforts to enhance getting folks in the door, getting them into plan, getting them services. The outcomes will also begin to kind of roll out. You know, one aspect of Rise Up will be training. Some of it will be technical assistance. That will be kind of systems change focused efforts. We'll begin to roll out initial training. Some of those will focus on topics like cultural humility And then we'll be using the literature search, the national survey, consultation with the agencies that we're working with to lend direction to the development of additional trainings that will be kind of targeted towards all levels of the organization. And then within the agencies that we begin to work with, we'll also begin kind of identifying the targeted and specific areas of need for technical assistance that will be unique to each of the agencies. So I see those as kind of the major tasks that will be kind of getting into in the beginning of year two and then kind of sustaining through the next year.   Carol: That is super exciting. I'm really excited about this. I would love to talk to you guys too, again at the end of like next year to see where things are at. Now, I understand you to, I believe, or somebody coming to CSAVR and people may want to chat with you. Is there a way folks could reach out to you if they are interested in talking to you about the project?   Mark: Sure.   Mari: Yeah   Mark: Yeah, so we will be at CSVAR, our project coordinator, Letty Vavasour will be there. Mari will be there. I will be there. So we're certainly kind of approachable there. As we mentioned before, CSAVR is a project partner of ours, and we mentioned encore. I think they're going to be there as well at CSAVR. And one other partner we haven't mentioned, but we should give them some credit, is a major partner with us is the George Washington Center for Rehabilitation Counseling, Research and Education. They're also a project partner with us and will be instrumental in kind of our efforts. So CSAVR is one place where folks can connect with us. Our team is working on a website, so we should have that up kind of in the near future. That's another way to get a hold of us. Email is always a good way to get a hold of us. I'm easy to get a hold of by email at MTucker at SDSU.edu and Mari is MGuillermo@SDSU.edu. So those are kind of really easy ways to get Ahold of us. And then of course Interwork Institute and the VRTAC-QM, we're sort of housed right there and involved in a number of those projects going on there so folks can track us down through Interwork or the QM.   Carol: Excellent. And, Mari, would you mind, Mari, would you spell out your email address? Just in case, because like me, it's like, how is that spelled?   Mari: And for those of you who know Spanish, my last name is Guillermo, which is William in Spanish, but it's m g as in George. U I L L E R M as in Mari o at SDSU.edu.   Carol: Excellent. Thank you. I really appreciate you taking the time. I'm super excited. And I wish our listeners could see like, the excitement on both of your faces about this project because it makes me like, super happy. I mean, the project couldn't be in better hands. You guys always do really good work out of Interwork, and I'm really excited to see what comes. So let's definitely chat again down the road.   Mark: That would be great.   Carol: Thanks for joining me.   Mari: Absolutely. Thank you Carol.   {Music}   Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!

Massimo Giannini, editorialista e opinionista di Repubblica, racconta dal lunedì al venerdì il suo punto di vista sullo scenario politico e sulle notizie di attualità, italiane e internazionali. “Circo Massimo - Lo spettacolo della politica“ lo puoi ascoltare sull’app di One Podcast, sull’app di Repubblica, e su tutte le principali piattaforme.See omnystudio.com/listener for privacy information.

En esta cápsula de ESMO 2024 EXPRESS, la Dra. Teresa Macarulla, oncóloga médica y especialista en tumores gastrointestinales adscrita al Hospital Vall d'Hebron en Barcelona, España, nos comenta brevemente las novedades presentadas durante el congreso que, a su parecer, son las más representativas en cáncer digestivo. Estudio PANDA: El estudio PANDA, en pacientes con cáncer de páncreas con enfermedad borderline, evaluó la eficacia de la quimioterapia perioperatoria más radioterapia. Los resultados mostraron que la radioterapia no ofrece beneficios adicionales a la quimioterapia en este grupo de pacientes, por lo que se recomienda descartar la radioterapia en estos casos. Estudio IMbrave050: Este estudio en hepatocarcinoma evaluó la combinación de atezolizumab y bevacizumab en comparación con seguimiento activo tras resección o ablación. Los resultados presentados en ESMO 2024 muestran que no hay diferencias significativas en la supervivencia libre de recaída entre los dos grupos, lo que sugiere que, hasta la fecha, no se justifica el uso de tratamiento adyuvante en estos pacientes. Estudio NIP-012: El estudio NIP-012, que fue presentado en la sesión presidencial de ESMO, comparó la quimioembolización transarterial (TACE, por sus siglas en inglés) sola versus TACE más pembrolizumab y lenvatinib en hepatocarcinoma en estadio intermedio. Los resultados indicaron una mejora en la supervivencia libre de progresión con la combinación de TACE, pembrolizumab y lenvatinib, pero sin impacto significativo en la supervivencia global. Es necesario un mayor seguimiento para determinar si estos datos modificarán la práctica clínica​. Estudio TOPGEAR: En pacientes con cáncer gástrico localizado, el estudio TOPGEAR investigó la radioterapia perioperatoria más quimioterapia. Los resultados mostraron que la radioterapia no mejora la supervivencia libre de recaída ni la supervivencia global en comparación con la quimioterapia sola. Por lo tanto, se descarta la radioterapia en este contexto​. Estudio KEYNOTE-811: Este estudio evaluó la combinación de quimioterapia, trastuzumab y pembrolizumab en cáncer gástrico HER2 positivo en comparación con quimioterapia más trastuzumab. Los datos recientes confirman que la supervivencia es significativamente mejor en el grupo que recibió pembrolizumab, consolidando este régimen como tratamiento estándar para pacientes con expresión de PD-L1 superior al 1%. Estudio NICHE-2 y NICHE-3: El estudio NICHE-2 mostró resultados impresionantes en pacientes con cáncer de colon MSI tratados con neoadyuvancia de ipilimumab y nivolumab. El estudio NICHE-3 evaluó la combinación de nivolumab más relatlimab, obteniendo una tasa de respuesta patológica completa superior al 90%, lo que lo posiciona como una estrategia prometedora para este grupo de pacientes. Fecha de grabación: 15 de septiembre de 2024

Una storia di fascinazione e, forse, d'amore viene raccontata in "Chi dice chi tace" di Chiara Valerio (Sellerio). Siamo Scauri (provincia di Latina) all'inizio degli anni '90. La vita del paese viene turbata dalla morte di Vittoria, una sessantenne che si era trasferita là vent'anni prima insieme a una donna più giovane. Alcuni avevano pensato fossero madre e figlia, in realtà le due donne erano compagne. Eppure, contrariamente a quanto si potrebbe pensare, questo non era stato oggetto di pettegolezzo o, peggio, di discriminazione. Tutti erano rimasti affascinati da Vittoria, questa donna di poche parole che arrivava da Roma, "distante ma curiosa" viene definita nel romanzo "accogliente ma riservata". A essere turbata per la morte di Vittoria è soprattutto Lea, la voce narrante, che vuole vederci chiaro sulle cause del decesso (Vittoria è annegata nella vasca da bagno). Inizia così un'indagine nel passato di Vittoria rendendosi conto che non la conosceva affatto, ma porta avanti soprattutto un'indagine su sè stessa e sul desiderio.

Please visit answersincme.com/SWS860 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, an expert in liver cancer discusses emerging transarterial chemoembolization (TACE) plus immunotherapy–based combinations in intermediate-stage hepatocellular carcinoma (iHCC). Upon completion of this activity, participants should be better able to: Identify the limitations of currently available therapeutic approaches for patients with locoregional therapy–eligible, unresectable hepatocellular carcinoma (HCC); Describe the clinical significance of combination therapies that involve transarterial chemoembolization (TACE) and immunotherapy for patients with intermediate HCC (iHCC); and Review clinical strategies to integrate TACE plus immunotherapy–based combination regimens into the treatment paradigm for patients with iHCC, based on the preliminary data.

Massimo Giannini, editorialista e opinionista di Repubblica, racconta dal lunedì al venerdì il suo punto di vista sullo scenario politico e sulle notizie di attualità, italiane e internazionali. “Circo Massimo - Lo spettacolo della politica“ lo puoi ascoltare sull’app di One Podcast, sull’app di Repubblica, e su tutte le principali piattaforme.See omnystudio.com/listener for privacy information.

Una storia di fascinazione e, forse, d'amore viene raccontata in "Chi dice chi tace" di Chiara Valerio (Sellerio). Siamo Scauri (provincia di Latina) all'inizio degli anni '90. La vita del paese viene turbata dalla morte di Vittoria, una sessantenne che si era trasferita là vent'anni prima insieme a una donna più giovane. Alcuni avevano pensato fossero madre e figlia, in realtà le due donne erano compagne. Eppure, contrariamente a quanto si potrebbe pensare, questo non era stato oggetto di pettegolezzo o, peggio, di discriminazione. Tutti erano rimasti affascinati da Vittoria, questa donna di poche parole che arrivava da Roma, "distante ma curiosa" viene definita nel romanzo "accogliente ma riservata". A essere turbata per la morte di Vittoria è soprattutto Lea, la voce narrante, che vuole vederci chiaro sulle cause del decesso (Vittoria è annegata nella vasca da bagno). Inizia così un'indagine nel passato di Vittoria rendendosi conto che non la conosceva affatto, ma porta avanti soprattutto un'indagine su sé stessa e sul desiderio. Nella seconda parte parliamo di "Il dolore non esiste", titolo del nuovo romanzo di Ilaria Bernardini (Mondadori), ma anche una delle frasi che suo padre ripeteva spesso insieme all'espressione "i figli non si scelgono, amarsi solo perché siamo imparentati non ha senso". Il padre di Ilaria, Achille, è un uomo difficile da inquadrare. È un anaffettivo che per anni si rifiuta di parlare con la figlia e non le risponde neanche ai messaggi. E così la figlia Ilaria, pur sapendo sapendo di fargli cosa poco gradita, decide di scrivere di lui quasi per conoscerlo, forse nel tentativo disperato di poter avere un dialogo virtuale con lui. Un romanzo in cui l'autrice si pone domande sul suo rapporto con il padre, ma anche sul suo ruolo di madre.

Un paesino affacciato sul mare, una donna misteriosa che nessuno ha mai capito fino in fondo e una avvocatessa che decide di saperne di più sulla sua strana morte. Nel suo nuovo libro “Chi dice e chi tace” Chiara Valerio ci porta nell'Italia di provincia degli ‘90.

After the 2024 Gastrointestinal Cancers Symposium, Jun Gong, MD, and Daneng Li, MD, sat down to discuss the most relevant trial data to have come from the conference. They convened for a live X Space hosted by CancerNetwork®. During the discussion, they covered different trials across the gastrointestinal space, which included those evaluating different disease states from hepatocellular carcinoma (HCC) to colorectal cancer (CRC), and those assessing circulating tumor DNA (ctDNA) dynamics. Gong, a hematologic oncologist focusing on gastrointestinal and genitourinary cancers at Cedars-Sinai Medical Center, and Li, an associate professor in the Department of Medical Oncology and Therapeutics Research at City of Hope, each gave their perspective on the clinical trial data and discussed if they had implemented any of these study treatments into clinical practice.  The studies they covered included:  1.        Phase 3 NETTER-2 Trial (NCT03972488)1: - Investigated lutetium Lu 177 dotatate (Lutathera) plus octreotide vs octreotide alone for advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs). - Lutetium Lu 177 significantly improved progression-free survival (PFS) and overall response rate (ORR) compared with octreotide alone. - The agent may be considered for patients with high-grade GEP-NETs who desire significant tumor shrinkage. 2.        Phase 3 EMERALD-1 Trial (NCT03778957)2: - Studied transarterial chemoembolization (TACE) plus durvalumab (Imfinzi) with or without bevacizumab (Avastin) for unresectable HCC. - Durvalumab/bevacizumab plus TACE improved PFS compared with placebo plus TACE. - TACE may be preferred over transarterial radioembolization (TARE) due to faster patient recovery. 3.        Phase 3 CheckMate-8HW Trial3: - Evaluated nivolumab (Opdivo) plus ipilimumab (Yervoy) vs chemotherapy for first-line treatment of microsatellite instability-high/mismatch repair deficient metastatic CRC. - Nivolumab/ipilimumab demonstrated superior PFS compared with chemotherapy. - Chemotherapy may no longer be the standard first-line treatment for this patient population. 4.        BESPOKE Study (NCT04264702)4: - Assessed the impact of minimal residual disease (MRD) detected by ctDNA on disease recurrence in patients with stage II and III CRC receiving adjuvant chemotherapy. - MRD positivity was associated with worse disease-free survival (DFS). - ctDNA clearance at 12 weeks indicated improved DFS.  5.        GALAXY Trial5: - ctDNA is a promising biomarker that can be used to predict recurrence in patients with CRC. - Patients with ctDNA-positive disease had a worse DFS than patients with ctDNA-negative disease. - This suggests that ctDNA may be useful for making treatment decisions, but more research is needed before it can be used in clinical practice. 6.        Phase 3 FRESCO-2 Trial (NCT04322539)6: - Fruquintinib (Fruzaqla) improved the quality of life in patients with metastatic CRC when combined with best supportive care and significantly improved quality-adjusted time without symptoms of disease or toxicity compared with placebo and best supportive care. - The study showed positive effects on PFS, response rate, disease control, and duration of response with the fruquintinib combination. - The findings from this trial supported the FDA approval of fruquintinib for metastatic CRC in November 2023.7 References 1.        Singh S, Halperin D, Myrehaug S, et al. [177Lu]Lu-DOTA-TATE in newly diagnosed patients with advanced grade 2 and grade 3, well-differentiated gastroenteropancreatic neuroendocrine tumors: primary analysis of the phase 3 randomized NETTER-2 study. J Clin Oncol. 2024(suppl 3):LBA588. doi:10.1200/JCO.2024.42.3_suppl.LBA588 2.        Lencioni R, Kudo M, Erinjeri J, et al. EMERALD-1: a phase 3, randomized, placebo-controlled study of transarterial chemoembolization combined with durvalumab with or without bevacizumab in participants with unresectable hepatocellular carcinoma eligible for embolization. J Clin Oncol. 2024;42(suppl 3):LBA432. doi.10.1200/JCO.2024.42.3_suppl.LBA432 3.        Andre T, Elez E, Van Cutsem E, et al. Nivolumab (NIVO) plus ipilimumab (IPI) vs chemotherapy (chemo) as first-line (1L) treatment for microsatellite instability-high/mismatch repair-deficient (MSI-H/dMMR) metastatic colorectal cancer (mCRC): First results of the CheckMate 8HW study. J Clin Oncol. 2024;42(suppl_3):LBA768. doi.10.1200/JCO.2024.42.3_suppl.LBA768 4.        Kasi P, Aushev V, Ensor J, et al. Circulating tumor DNA (ctDNA) for informing adjuvant chemotherapy (ACT) in stage II/III colorectal cancer (CRC): interim analysis of BESPOKE CRC study. J Clin Oncol. 2024;42 (suppl _3):9. doi:10.1200/JCO.2024.42.3_suppl.9 5.        Yukami H, Nakamura Y, Mishima S, et al. Circulating tumor DNA (ctDNA) dynamics in patients with colorectal cancer (CRC) with molecular residual disease: Updated analysis from GALAXY study in the CIRCULATE-JAPAN. J Clin Oncol. 2024;42(suppl_3):6. doi:10.1200/JCO.2024.42.3_suppl.6 6.        Stintzing S, Tabernero J, Satoh T, et al. Quality-adjusted time without symptoms of disease or toxicity (Q-TWiST) analysis of fruquintinib + best supportive care (BSC) compared with placebo + BSC in metastatic colorectal cancer (mCRC): results from the FRESCO-2 trial. J Clin Oncol. 2024;42(suppl 3):116. doi:10.1200/JCO.2024.42.3_suppl.116 7.        FDA approves fruquintinib in refractory metastatic colorectal cancer. FDA. News release. November 8, 2023. Accessed February 7, 2024. https://shorturl.at/isJW2

Drs. Shaalan Beg and Rachna Shroff discuss key abstracts on GI cancers that were featured at the 2024 ASCO Gastrointestinal Cancers Symposium, including SKYSCRAPER-08, EMERALD-1, and NEST-1 in esophageal squamous cell carcinoma, hepatocellular carcinoma, and colorectal cancer, respectively. TRANSCRIPT Dr. Shaalan Beg: Hello, and welcome to the ASCO Daily News Podcast. I'm Dr. Shaalan Beg, your guest host of the podcast today. I'm an adjunct associate professor at UT Southwestern's Simmons Comprehensive Cancer Center and vice president of oncology at Science 37. Today, we'll be discussing key abstracts and other exciting highlights from the 2024 ASCO Gastrointestinal Cancers Symposium. Joining me to discuss some key takeaways from the meeting is the chair of this year's Symposium, Dr. Rachna Shroff. Dr. Shroff is the division chief of Hematology Oncology and chief of GI Medical Oncology at the University of Arizona Cancer Center. She also serves as the associate dean for clinical and translational research at the University of Arizona College of Medicine – Tucson. Our full disclosures are available in the transcript of this episode, and disclosures related to all episodes of the podcast are available at asco.org/DNpod.  Dr. Shroff, welcome back to the ASCO Daily News Podcast, and congratulations on a great Symposium. The scientific advances and innovative, multidisciplinary approaches that were featured throughout the meeting were really inspiring and reflect the incredible strides we're making in GI cancer research. Dr. Rachna Shroff: Thank you so much for having me back. I am delighted to be here.  Dr. Shaalan Beg: Dr. Shroff, the theme of this year's symposium was "Taking Personalized Care to the Next Level." I'd love to hear your reflections on the sessions that you found most exciting and really resonated with the attendees.  Dr. Rachna Shroff: Yes, thank you. We were really excited about this theme because we really felt that “Taking Personalized Care to the Next Level” translated to thinking through personalized approaches to patient care, not just in the traditional ways that we think of with precision oncology and genomics driving our care, but also how we can think through multidisciplinary approaches and an individualized care plan. Thinking through how artificial intelligence and novel clinical trial designs can and should be implemented to meet the needs of our individual patients. And so we really highlighted that in what was a somewhat new reboot of a session called “Intersections,” which were every day and were really more cross-tumor; they were tumor agnostic but were thematic focused. As I mentioned, those themes were really based on feedback that we had from prior attendees, as well as from the program committee's feeling on what are really the questions that we are dealing with and that are burning in the clinic today and that includes the emerging role of artificial intelligence and machine learning and how we integrate that into our clinical care, approaches to oligometastatic disease, and it's not really just something that we think of in colorectal cancer but haven't fully used that paradigm to really apply it to other GI malignancies. And then the art and science of clinical trial design where, again, traditional randomized phase 3 trials might not be the best and most innovative and most expedient way of bringing novel therapeutics to our patients. And so, I thought that all of those sessions were really highlighting different important topics that we deal with day to day. Additionally, we had a really fantastic keynote lecture from Dr. Kimmie Ng of the Dana-Farber Cancer Institute. She is a world-renowned expert in the early-onset colorectal cancer space, and the timing of her keynote was perfect with the new cancer statistics that came out literally days before GI ASCO that demonstrated this just dramatic rise in early onset GI malignancies as a whole, not just colorectal. And she spoke really in a comprehensive manner not just on clinical approaches, screening approaches, and how to find these patients at an earlier stage, but also kind of gave us a call to action, if you will, in terms of public health initiatives, as well as like I said, clinical care and really thinking outside of the box for how to reach these patients.  And then, of course, we always have what I think is one of my favorite aspects of the meeting, which are the networking opportunities that include the Trainee and Early Career Networking Luncheon, the Women's Networking Reception, and the Meet the Experts Luncheon where, especially as junior career investigators, you have an opportunity to meet what we think of as the “big names” in GI cancer. Dr. Shaalan Beg: Absolutely, I remember my first couple of GI ASCO meetings and those were probably the most memorable sessions that I attended as junior faculty as well.   So let's take a deeper dive into some key abstracts from the meeting. I'd like to begin with Abstract 245. This is the SKYSCRAPER-08 study. It's first-line tiragolumab and atezolizumab with chemotherapy in an Asian patient population with esophageal squamous cell carcinoma. What are your key takeaways from this study?  Dr. Rachna Shroff: Yeah. This was an exciting study in my opinion in the sense that thinking through how we can build on immunotherapy backbones is obviously a pressing question across the GI cancer space. So this was a phase 3 randomized, double-blinded, placebo-controlled trial that looked specifically at patients with esophageal squamous cell carcinomas. And the study was enrolled fully with an Asian population. It looked at taking the traditional chemotherapy backbone and adding to it an anti-PD-L1 with atezolizumab and an anti-TIGIT with tiragolumab. Again, that proof of principle of using anti-TIGIT and PD-L1 has been looked at across a lot of different GI cancer spaces and we know that the esophageal squamous cell cancers tend to be very immunotherapy responsive. So this was a really important question.  This involved a number of patients, a little over 460 patients, who were randomized one-to-one to receive the tiragolumab with atezolizumab with the standard paclitaxel and cisplatin, that's used for esophageal squamous versus chemotherapy alone with placebo. And the primary endpoint was independent review of progression-free survival, and overall survival. And so, out of the 461 patients randomized, there was at the primary analysis, a median improvement in progression free survival, from 5.4 months in the control arm to 6.2 months with a tira-paclitaxel plus chemo arm with a hazard ratio of 0.56, highly statistically significant. Similarly the median overall survival was also improved from 11.1 months to 15.7 months again with a hazard ratio of 0.7 and some of the other key efficacy endpoints were also improved with the addition of the anti-TIGIT PD-L1 approach. And importantly, there was not really safety signals that jumped out at us.  And so, to me, what this means is that, in our patients with esophageal squamous cell carcinoma, we really should be thinking about chemotherapy with immunotherapy as a backbone and how we can build on it. And, you know, I would imagine that it's hard to argue with both the PFS and OS endpoint that adding anti-TIGIT won't necessarily be kind of the new approach to these patients. And importantly, I'll point out that it seems to be a benefit across the subgroups, including PD-1 status, which is always our big question here. I think the only thing to keep in mind is this was an all-Asian population and whether or not that kind of immune profile of the immune responsiveness is different in those patients, but regardless, a positive phase 3 trial. Dr. Shaalan Beg: It's really exciting to see immune checkpoint inhibitors or immunotherapy beyond PD-1 targeted, CTLA-4 targeted treatments making their way into GI Cancers.  Dr. Rachna Shroff: Absolutely. Dr. Shaalan Beg: Sticking with the immunotherapy theme, let's focus on hepatocellular carcinoma. So LBA432, the EMERALD-1 study of transarterial chemoembolization combined with durva with or without bevacizumab looked at people with unresectable hepatocellular carcinoma eligible for embolization. So really a highly anticipated study, I'm wondering what your thoughts are and whether it'll be practice-changing for this field.  Dr. Rachna Shroff: I was excited to see the press release when it showed that the study was positive, and I think it's because now that we're using immunotherapy in the advanced HCC space, our obvious question is, can we integrate it into multimodality approaches? There are a lot of smaller studies looking at neoadjuvant IO approaches, and in this intermediate stage, unresectable hepatocellular carcinoma patients. We wanted to know if there was a utility to liver directed therapy with immunotherapy.  So, this was a large study. It was a global study looking at unresectable HCC with preserved Child-Pugh function. But it was Child-Pugh A and up to B7, importantly. And there were 616 patients randomized in a 1:1:1 fashion, with the control arm being just TACE alone. But then, there was also an opportunity for durvalumab with TACE, as well as durvalumab plus bevacizumab with TACE. The patients would receive durvalumab during their TACE treatments and could receive up to four TACE treatments and then subsequently were either continued on durvalumab alone, durvalumab plus bevacizumab, or the placebo. The primary endpoint was progression-free survival, powered specifically to look at TACE versus durvalumab plus TACE. In this study, the primary endpoint was met with a significant improvement in PFS. Median PFS was 15 months versus 8.2 months, with a hazard ratio of 0.77. Most prespecified subgroups demonstrated this benefit.  Importantly, there was a secondary endpoint looking at durvalumab plus TACE versus TACE alone, and that actually did not show a statistically significant improvement in median PFS from 8.2 months in the control arm to 10.0 months. The overall response rates were slightly higher with the durvalumab plus bevacizumab approach at 43.6%. And importantly in these patients, who oftentimes have a higher burden of disease in the liver, median time to progression is a really important and clinically meaningful endpoint. That was 22 months with the durvalumab plus bevacizumab and TACE versus 10 months for TACE alone. I would just point out that the overall concern we always have with bevacizumab is the increased risk of bleeding and the treatment-related adverse event profile. Overall, there were no safety signals that emerged from this, with nothing that really, especially in that bleeding risk category, jumped out at us. Of course, we haven't seen the overall survival data yet because we have not seen enough follow-up to really see that number.  I do think that this is potentially practice-changing, and I think it just demonstrates that there's probably some synergy between anti-VEGF with anti-PD-1, and then the liver-directed treatments. The obvious question for us in the United States is that the vast majority of people are moving away from TACE and towards more radioembolization and what can we extrapolate from this? Does this really tell us much if people are using more of a Y90-based approach? I think those are a lot of the burning questions that most of us have.  Dr. Shaalan Beg: Yeah, and it's a very interesting direction that the HCC space is taking because we heard in previous meetings, the role of PD-1 inhibition as adjuvant therapy after resection. Now, we have data for local-regionally advanced disease over local-regional treatments. And of course, you already mentioned the data for more advanced disease. So it sounds like immunotherapy may be impacting the management of anyone diagnosed with hepatocellular carcinoma.  Let's talk about the MONET trial, Abstract 249, which compared thoracoscopic esophagectomy and open esophagectomy for thoracic esophageal cancer. Do you think this is a study which may influence the treatment of patients with thoracic esophageal cancer? Dr. Rachna Shroff: So, this was, again, I think, a really important question. It was a randomized, controlled phase 3 trial comparing a more minimally invasive approach with TE — thoracoscopic esophagectomy — versus an open approach. This had patients with clinical stage 1-3, excluding T4 thoracic esophageal squamous cell carcinomas. They were randomized 1:1 to the open versus the TE approach, with a primary endpoint of overall survival and an important secondary endpoint of relapse-free survival. 300 patients were randomized, and at the second planned interim analysis, the median follow-up was a little over two and a half years. The 3-year overall survival was 82% in the TE group versus 70.9% in the open group. The DSMC of this trial actually recommended early termination based on the non-inferiority, which is what they were specifically looking at. There was a very statistically significant one-sided p-value for non-inferiority.  Importantly, the 3-year recurrence-free survival was also markedly better in the TE group versus the open group, with no real notable differences in R0 resection, or a large percentage of patients who needed to be converted from a TE to an open approach, and really not any significant difference in overall postoperative morbidity. I think this just supports the concept that minimally invasive approaches for our patients with GI malignancies can and should be considered. Again, esophageal squamous because they tend to be seen a lot more in Asia, this study was conducted in Japan, but I think that being said, a lot of our surgeons in Europe and in the U.S. are also very amenable to minimally invasive approaches. And I think this just supports the fact that an open approach is not necessary. So, I would think again, that this is something that is implementable and I think will affect the field.  Dr. Shaalan Beg: Moving on to metastatic cholangiocarcinoma, there have been many FGFR inhibitors that have shown activity and promise and are approved for the management of cholangiocarcinoma with FGFR alteration. But at this ASCO GI, we heard the results of the safety and efficacy of an FGFR1, 2, and 3 inhibitor, tinengotinib, as monotherapy for advanced metastatic cholangiocarcinoma (Abstract 434). How do you see this fitting into the broad picture? Dr. Rachna Shroff: Yeah, so this was highly anticipated data, primarily because at this point, the FGFR space in cholangiocarcinoma is quite crowded. And so a lot of us were getting sick of the "me-too" drugs. What is really unique about tinengotinib is that, not only is it a selective multikinase inhibitor, but it also, in preclinical models as well as in early phase one trials, demonstrated potent inhibition of patients with FGFR2 fusions and rearrangements who had acquired resistance mutations. So, as we better understand the first generation of FGFR inhibitors and note the resistance mechanisms, these drugs are now being developed to try to circumvent or overcome those.  This study looked at 4 different cohorts: 1 cohort with FGFR2 fusion patients who had primary progression who never responded to FGFR inhibitors, a second cohort with FGFR2 fusion patients who had progression after primary response, so those with acquired resistance, and then there was non-fusion FGFR alterations because we do know that a number of cholangiocarcinoma patients have other FGFR alterations that are not fusions, and then those with FGFR wild-type. The primary endpoint was objective response rate, with a total of 48 patients enrolled across the four cohorts. And so the 40 patients who were evaluable in the group that had primary resistance, which was the first cohort, there was a response rate was 9.1% and that was partial response, and 31% had tumor reduction with tinengotinib. And similarly in those with acquired resistance, 37.5%, 3 out of 8 patients had a partial response and tumor reductions were noted with an overall disease control rate between those patients with FGFR2 fusions of 94.7%, between those with primary and secondary resistance.  In the patients who had FGFR alterations, there was 3 out of 9 patients with a partial response and again, tumor reductions were notable across the board and the disease control rate was 88.9%. The FGFR wild-type group, not surprisingly, did not see any partial responses, but interestingly, 75% of these patients had at least disease control, and the median progression-free survival was 5.26 months, again, kind of most notably impressive in the 2 cohorts that included FGFR2 fusions. The toxicity profiles are what we come to expect for FGFR inhibitors and we've gotten better at managing those and mitigating some of those so there was really nothing to jump out there. So there is now an ongoing randomized phase III trial specifically looking at tinengotinib versus physician's choice in patients with FGFR2-altered cholangiocarcinoma after having received prior FGFR inhibitors. So that's where I think it's in is for those of us who know that there are multiple drugs in the space, our big question is can we sequence through that? Can we offer multiple FGFR inhibitors in these patients? And I think we are all eagerly anticipating this data as well as the subsequent data to really justify the use of these novel second generation FGFR inhibitors.  Dr. Shaalan Beg: It's been fantastic to see the evolution of these compounds in precision medicine, or precision oncology at its finest, in terms of understanding mechanisms of resistance and treating refractory disease.   Let's focus on colorectal cancer. I'll tell you, there has been a lot of discussion, Dr. Shroff, on social media, on insurance companies sometimes rejecting one biologic or the other based on tumor sidedness. We have talked about tumor sidedness predicting response on this podcast based on data from previous studies. But this year in GI ASCO, Abstract 207 explored the role of tumor genomics and tumor sidedness and they said that it's tumor genomics, that tumor genomics better explains the differences on outcomes, and it explains it better than sidedness. What does this mean to the field? Because a lot of professional organizations have guidelines that are asking people to now incorporate sidedness. So how does that change based on these results? Dr. Rachna Shroff: I really commend these authors on leveraging real-world data, and I think we're getting better and better at recognizing that real world data actually informs our clinical decision making, possibly better than sometimes some of these studies that lead to the guidelines and algorithms that we develop. So this is a perfect example of a little bit cart before horse in trying to understand the way that sidedness and genomics may interplay.   So this was a study that basically leveraged both the Foundation Medicine and Flatiron Health clinical genomic database and looked at patients with microsatellite stable metastatic colorectal cancer. There were a total of 3,845 patients included in a kind of two-thirds one-third split between left sided and right-sided colorectal cancer. And they found the typical genomic alterations that historically have been thought of more with left-sided colorectal cancer like APC and then more of the RAS BRAF alterations in the right-sided patients. But I think what they really thought and what I think was remarkable is they really looked at the patients and how they received chemotherapy with anti-EGFR or bevacizumab therapies, and they did a multivariate analysis to really see what is driving outcomes. And like you mentioned, what they found was patients in the RAS pathway, those classified as having alterations in the RAS pathway, had less favorable outcomes, while those with APC altered group had more favorable outcomes. And that was regardless of treatment received and sidedness.  And so when they did an analysis of what was called a “likelihood ratio test,” they found that when genomics was added to the sidedness evaluation, there was an improvement in outcome prediction, but not when sidedness was added to genomics. Like you said, it kind of demonstrates, at least in this mining of real-world data from Flatiron that tumor genomics is probably a better driver and a more important driver in determining outcomes than sidedness.  I totally agree with you. I would push for us to really kind of bring a little bit of noise to this and to make insurance companies and other companies that are looking at this to think through this a little bit more and make sure that we're putting all of the data together in a comprehensive passion before making the treatment plans and determinations. Dr. Shaalan Beg: The last abstract I'd like to ask you about is Abstract 117, the NEST-1 trial. This study looked at neoadjuvant botensilimab and balstilimab for resectable mismatch repair proficient and deficient colorectal cancer, both MSS and MSI. What are your key takeaways from this study?  Dr. Rachna Shroff: This is another study that is demonstrating that there may potentially be a role for immunotherapy in microsatellite stable patients. I will make the caveat that this was a single-arm study that really was looking at feasibility safety, with efficacy as a secondary endpoint. The combination of bot-bal in the neoadjuvant space for colorectal cancer patients, they received one dose of boten and two fixed doses of bal two weeks apart and then were taken to surgery. They limited the number of patients and out of the 12 patients that were enrolled, they limited the number of mismatch repair deficient patients. So to your point, they allowed both, but they wanted to make sure it was not just MSI-high patients. What they basically found is that it was safe and did not delay surgery or increase risks of adverse events. But importantly, there was significant regression of tumor noted. And some interesting spatial biology analyses demonstrated potentially novel mechanisms of action, especially in the MSS population, and that ctDNA reductions correlated with pathologic response. There were a lot of different things that they were looking at, basically suggesting that bot-bal is safe and can be used in both mismatch repair–deficient and proficient patients with colorectal cancer. And now importantly, they've added some additional cohorts and expanding the study. As I mentioned, this is right now just 12 patients, but does definitely have a provocative result.  Dr. Shaalan Beg: Thanks so much, Dr. Shroff.  Finally, the role of cell-free DNA (cfDNA) in GI cancers has been an exciting and important development in our field. There's tremendous data that emerged at the GI meeting, and we have decided to do a separate ASCO Daily News Podcast dedicated to ctDNA. So listeners, please look out for our coverage of key studies on ctDNA in GI cancers very soon here on the ASCO Daily News Podcast.  Many thanks, Dr. Shroff, for sharing your insights with us today and for your great work in building a robust GI meeting this year. Thank you very much. Dr. Rachna Shroff: Thank you so much. Dr. Shaalan Beg: And thank you to all our listeners for your time today. You'll find links to the abstracts discussed on 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. Disclaimer: The purpose of this podcast is to educate and inform. It is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Our guests on this podcast express their own opinions, experiences, and conclusions. These statements do not necessarily reflect the views of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an endorsement by ASCO.   Find out more about today's speakers: Dr. Shaalan Beg @ShaalanBeg Dr. Rachna Shroff @rachnatshroff   Follow ASCO on social media:  @ASCO on Twitter  ASCO on Facebook  ASCO on LinkedIn    Disclosures: Dr. Shaalan Beg: Employment: Science 37 Consulting or Advisory Role: Ipsen, Array BioPharma, AstraZeneca/MedImmune, Cancer Commons, Legend Biotech, Foundation Medicine Research Funding (Inst.): Bristol-Myers Squibb, AstraZeneca/MedImmune, Merck Serono, Five Prime Therapeutics, MedImmune, Genentech, Immunesensor, Tolero Pharmaceuticals   Dr. Rachna Shroff: Consulting or Advisory Role: Exelixis, Merck, QED Therapeutics, Incyte, Astra Zeneca, Taiho Pharmaceutical, Boehringer Ingelheim, SERVIER, Genentech, Basilea Research Funding: Pieris Pharmaceuticals, Taiho Pharmaceutical, Merck, Exelixis, QED Therapeutics, Rafael Pharmaceuticals, Bristol-Myers Squibb, Bayer, Immunovaccine, Seagen, Novocure, Nucana, Loxo/Lilly, Faeth Therapeutics

 “What you teach patients about that the side effects may be somewhat different, because it's more of a regional treatment with less systemic toxicities, so it's teaching patients about the drugs, the side effects, and the actual procedure itself,” Lisa Hartkopf-Smith, MS, RN, AOCN®, CHPN, advanced practice nurse at OhioHealth Center in Columbus and ProMedica Cancer Institute in Toledo, OH, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about the oncology nurse's role in intra-arterial chemotherapy administration. This episode is part of a series about chemotherapy administration, which we'll include a link to in the episode notes. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD), which may be applied to the nursing practice, oncology nursing practice, or treatment ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by February 2, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge about the nurse's role in intra-arterial chemotherapy administration. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast: Episode 252: Intraperitoneal Administration: The Oncology Nurse's Role Episode 285: Transarterial Chemoembolization: The Oncology Nurse's Role Additional episodes about chemotherapy administration Clinical Journal of Oncology Nursing article: Evaluation of a Chemotherapy and Medication Education Process for Patients Starting Cancer Treatment ONS Huddle Card: Chemotherapy ONS Courses: ONS Fundamentals of Chemotherapy and Immunotherapy Administration ONS/ONCC Chemotherapy Immunotherapy Administration Certificate™ ONS books:  Access Device Guidelines: Recommendations for Nursing Practice and Education (fourth edition) Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.   To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.   Highlights From Today's Episode  “Intra-arterial chemotherapy has actually been in existence over 70-plus years. It's been around for a long time. There are case reports in the literature as early as 1950 of intra-arterial chemotherapy, one specifically being giving nitrogen mustard, of all things, interactively through a catheter for the treatment of Hodgkin lymphoma.” TS 1:43  “Retinoblastoma is a common indication at this point in time for intra-arterial chemotherapy and has very good success rates. Intra-arterial chemotherapy is also used in liver cancers, whether it's an unresectable liver metastasis from adenocarcinoma of the colon or it's unresectable intrahepatic cholangiocarcinoma, as an another example where it's used. And it can also be used in hepatocellular or HCC carcinoma.” TS 6:36  “Some of the things, like pretreatment, things that the nurse has to look for in any of those are labs and particularly clotting times. You know, to make sure that a PT and an INR and a platelet count was drawn because this patient is going to have a catheter in their artery and frequently will have heparin, so we need to make sure you know what that is.” TS 8:22  “When you're pulling your drug information, your patient drug information sheets, it may not be appropriate to give the Adriamycin® teaching sheet from OncoLink or ChemoCare or ONS because that's generally the side effects of systemic treatment. Whereas if it's going to be given intra-arterially, they are probably not going to have hair loss and mouth sores, and their blood counts may not be affected.” TS 10:36  “In some cases, the nurse may be actually administering the medication, and in other cases they're not going to be actually administering it. So, if you have the situation where that intra-arterial procedure is done, like within the operating room or interventional radiology, then typically the radiologist or another physician will be administering it, but the RN may be in the room. It's often not a chemotherapy-qualified RN, it's often interventional radiology RN, so this is really a group effort between oncology nurses and those interventional radiology nurses and operating room nurses.” TS 12:03  “But in that case, as far as administration, again, it will probably be the physician, but where the nurse can play the role is with all those steps of verification. So, the dual verification process for chemotherapy needs to not just apply when you're giving it ID and an infusion center or inpatient. But it needs to happen in those off sites like interventional radiology in the operating room. So, the nurse in this suite can work and be part of that dual verification process, you know, comparing the orders with the drug and the patient identifiers. The nurse in that type of situation, in interventional radiology or operating room, can help ensure that safe handling occurs because those employees and physicians may not be as familiar with it. So, making sure that you have the PPE gowns the gloves goggles in the correct ways to dispose of it in those suites.” TS 12:43  “With time, just as it would with a venous port, that catheter can move out of place. So, even with the implanted pumps I was mentioning before, those catheters can move, and so we don't routinely check placement of the tip. What can happen is if the tip moves into another place, the patient will have those high doses of chemotherapy going systemic and will experience more side effects.” TS 19:22  “Some part of the adverse reactions could be related to the catheter or the pump itself, and then some of the adverse reactions are related to the drug itself.” TS 20:06  “So, other things that can happen with catheters and pumps, whether they're temporary or permanent, is always the risk for hemorrhage because it's in an artery. So, if something breaks or some tubing becomes disconnected, then the patient could hemorrhage. So, it's important that everything is always lured locked, connections taped, and that is being checked frequently to make sure that everything is tight and secure so that there's not that risk for hemorrhage from a catheter, an IV tubing, or needle becoming disconnected.” TS 21:11  “I honestly think this entire topic is something that's not discussed much, and I wish people knew more about it. I also wish people knew more about one of the areas of this topic—hepatic chemoembolizations, also called TACE [trans-arterial chemoembolization]. There are a lot of patients out there that are getting this in different locations, different hospitals, parts of the country, but because we typically are working in infusion centers are impatient areas, we are often not that knowledgeable about it because it happens somewhere else in interventional radiology or the OR. But our patients are affected by it, and we need to know more about it.” TS 26:55 

It's been a busy few weeks here at CURE® and in the oncology space as a whole, as the last two weekends had back-to-back meetings: the American Society of Clinical Oncology's Gastrointestinal Cancers Symposium, and then their Genitourinary Cancers Symposium.  Here are some highlights from the conference, but as always, you can find all of our coverage at curetoday.com.  Gastrointestinal Cancers Symposium  Imfinzi, Avastin, TACE May ‘Set a New Standard of Care' in Liver Cancer For patients with liver cancer whose disease is not eligible to be removed via surgery, adding Imfinzi and Avastin to transarterial chemoembolization — also known as TACE — tended to lengthen the time patients lived before their disease got worse, according to findings from the EMRALD-1 trial. These improvements in progression-free survival over TACE alone could lead to a new standard of care for this patient population, according to the lead study author, Dr. Riccardo Lencioni.  More specifically, patients who received Imfinzi and Avastin plus TACE lived for a median of 15 months before death or disease worsening, compared to 8.2 months for patients who received TACE alone. This correlates to a 23% reduction in the risk of disease progression or death, and benefits were seen across different patient subgroups.  Notably, the researchers on EMRALD-1 are still monitoring how the addition of the two drugs impacts overall survival. Once those data become more clear, it is possible that the drug manufacturers could submit this regimen to the FDA for approval, thereby officially shaking up the standard of care of TACE, which has remained the main treatment in this setting for about two decades.  Cancer in Bloodstream May Predict CRC Outcomes Circulating tumor DNA — also known as ctDNA — was another hot topic at the Gastrointestinal Cancers Symposium. So ctDNA measures little fragments of cancer that are found in the bloodstream after cancer treatment.  Now, findings from the BESPOKE trial highlight the fact that ctDNA may offer insight into the recurrence risk in patients with stage 2/3 colorectal cancer who underwent surgery and then chemotherapy. The researchers used ctDNA to help determine minimal residual disease, or MRD, status. Essentially, patients with disease still detected in the blood stream were MRD positive, while those without detectable cancer were MRD negative. Findings showed that those with MRD negativity tended to live longer without experiencing relapse or death compared to patients with MRD positivity.  Genitourinary Cancers Symposium Survival Benefits with Keytruda and Padcev in Advanced Urothelial Cancer Back in December, the Food and Drug Administration approved Padcev plus Keytruda for patients with previously treated locally advanced or metastatic bladder cancer. The approval was based on primary findings from the EV-302 trial. Now, updated findings from that trial are showing that the drug duo continues to outperform chemotherapy when it comes to progression-free survival — that's the time patients live before their disease gets worse — as well as overall survival, which is the time patients live before death of any cause.  Notably, these survival benefits were seen across patient subgroups, such as those with visceral metastases and lymph node-only disease. According to the lead study author, Dr. Michiel S. Van Der Heijden, this could result in a new standard of care in patients with locally advanced or metastatic urothelial carcinoma.  Many Patients Miss Out on Testing to Guide Prostate Cancer Treatment On the prostate cancer front, a study found that many people with metastatic castration-resistant prostate cancer are not undergoing germline or somatic testing. Now this is really important because back in 2020, two PARP inhibitors were approved in this setting. These are targeted drugs approved for patients whose cancers have certain characteristics, which can be determined by these types of tests.  Rates of germline and somatic testing have increased since the FDA approvals, but according to the study — which looked at real-world evidence of patients being treated in community cancer and urology centers — about 40% of patients did not undergo standard-of-care testing.  Study author, Dr. Neal Shore, said that this indicates the need for improved education on the importance of germline and somatic testing.  For more news on cancer updates, research and education, don't forget to subscribe to CURE®'s newsletters here. 

Jak často se stává, že odvolací soud zmírní původní trest vězení za dlouhodobé znásilňování na podmínku? Mohlo by Maďarsko přijít v Evropské unii o svá hlasovací práva? A proč se Jiří Suchý rozhodl připsat Jitce Molavcové mužskou roli ve hře Poslední štace, která má dnes po více než půl století obnovenou premiéru v divadle Semafor?

This recording features audio versions of December 2023 Journal of Vascular and Interventional Radiology (JVIR) abstracts:Sclerotherapy of Venous Malformations Using Polidocanol: Effectiveness, Safety, and Predictors of Outcomes and Adverse Events ReadComparison of the Safety of Transjugular and Percutaneous Liver Biopsies ReadEffect of Previous Transarterial Chemoembolization on Survival and Toxicity after Yttrium-90 Transarterial Radioembolization of Hepatocellular Carcinoma in the Radiation-Emitting SIR-Spheres in Nonresectable Liver Tumor Registry ReadHepatic Hypertrophy in Normal and Cirrhotic Livers Following Portal Vein Embolization: Comparative Assessment of 2 Different Embolic Regimens in a Large Animal Model ReadGenicular Artery Embolization for Treatment of Knee Osteoarthritis: Interim Analysis of a Prospective Pilot Trial Including Effect on Serum Osteoarthritis-Associated Biomarkers ReadQuantifying Change in Perfusion after Genicular Artery Embolization with Parametric Analysis of Intraprocedural Digital Subtraction Angiograms Read JVIR and SIR thank all those who helped record this episode:Host:Rommell Noche, Frank H. Netter MD School of Medicine at Quinnipiac University, ConnecticutAudio editor:Manbir Sandhu, University of California Riverside School of MedicineAbstract readers:Melissa Millett, St. George's University, GrenadaAlena Khalil, MA, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, FloridaChristopher Loiselle, MS, Lincoln Memorial University-DeBusk College of Osteopathic Medicine, TennesseeJonathan Dzielski, Kansas City University, MissouriAndrew Brandser, Frank H. Netter MD School of Medicine at Quinnipiac University, ConnecticutTaji Kommineni, MD, JD, LLM, American University of Antigua©  Society of Interventional RadiologySupport the show

“I think oftentimes people think this is just a radiology procedure that is rather benign. That's really the role of the oncology nurse, just to be [an educator], support, emotional support, and a coach,” Lisa Parks, MS, APRN-CNP, ANP-BC, nurse practitioner in hepatobiliary surgery at The James Cancer Hospital and Solove Research Institute at The Ohio State University Comprehensive Cancer Center in Columbus, Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about what oncology nurses should know about transarterial chemoembolization administration and their role surrounding that procedure. This episode is part of a series about non-IV chemotherapy administration; the others are linked below.  You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD), which may be applied to the oncology nursing practice or treatment ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by November 10, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation.  Learning outcome: The learner will report an increase in knowledge related to transarterial chemoembolization.   Episode Notes  Complete this evaluation for free NCPDComplete this evaluation for free NCPD.  Oncology Nursing Podcast episodes about non-IV chemotherapy administration:  Episode 271: Intraventricular and Intrathecal Administration: The Oncology Nurse's Role  Episode 265: Intravesical Administration: The Oncology Nurse's Role  Episode 252: Intraperitoneal Administration: The Oncology Nurse's Role  Oncology Nursing Forum articles:  Symptom Distress in Patients With Hepatocellular Carcinoma Toward the End of Life  Living With Hepatocellular Carcinoma Near the End of Life: Family Caregivers' Perspectives  ONS Chapters  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  Highlights From Today's Episode  “So, TACE was commonly used to treat liver metastatic cancers, primarily metastatic colon cancer, until research showed that some of these cancers were not responding to TACE. Therefore, it is no longer really used in metastatic colon cancer. TACE is used in hepatocellular cancer. It also was used more than 10 years ago to treat metastatic neuroendocrine cancers. But recent research has showed that neuroendocrine cancers respond to this embolization without the use of chemotherapy. By eliminating chemotherapy, we also eliminate the potential for side effects.” TS 3:29  “TACE, or TAE, is usually completed more than once in the course of a patient's treatment. Depending on the tumor burden of the liver, the procedure can be segmentally completed on a liver lobe, or you can do the procedure on the right lobe and then follow-up treatment in about six weeks in the left lobe.” TS 5:45  “This is something that isn't even really taught in medical school. So it's really important to understand that even though this is a postprocedural side effect, there are certain things that you have to be aware of. So, the most common side effect that you will see is right upper-quadrant pain, and this is very common. And if the left side of the liver has received the therapy, this pain can radiate to the epigastric area and the patient will describe it as chest pain. And when you have the patient point to that area where he's having pain, it's often epigastric and it's just a referred pain, it's not cardiac pain, typically. You can get a EKG and troponin, but those are almost always negative and it's just really part of this embolization syndrome.” TS 14:30  “As far as what the oncology nurse needs to really be aware of pre-TACE or pre-TAE, I just want to emphasize the importance of patient education. The patient and their family need to understand again, it's not a surgery, it's a radiology procedure, and that the patient is going to have abdominal pain and nausea and vomiting that will last for several weeks and that is why they are not kept in the hospital for three weeks until these symptoms dissipate. Oftentimes these symptoms will be present until they get reimaged at the medical oncologist and then it's time for them to come back and maybe get another phase of their procedure that they are supposed to have as part of their treatment plan.” TS 17:44  “I do want to let you know, though, that patients that have a significant spike of their transaminases over 1,000, those patients are of great concern of going into liver failure. So, the nurses need to let the patient know that they will be monitored and kept in the hospital until we start to see a downtrend in those transaminases before they will be discharged.” TS 19:48  “As an oncology nurse and medical oncology, [it's] education, education, education. Also being able to triage these patients on the phone, talking them through how to keep themselves hydrated. . . . So I just think it's really a coaching job of the oncology nurse. A lot of reassurance, a lot of suggestions on how to get through this very uncomfortable difficult procedure.” TS 21:16  “I want it to be clear that if you're doing local regional therapy, TACE or TAE, this is considered a palliative procedure. You are not going to get a cure with this treatment. In this situation, neuroendocrine carcinoma, it's already metastatic if you're treating the liver. And with hepatocellular, again, it's still palliative because you're not doing a surgical resection on this patient. And every TACE experience for every patient, I've had patients that've and I've had six of these procedures, every experience they get is different.” TS 28:11  “When the patient comes back to our floor after having the treatment, it's just very important for those nurses to know the ‘abnormal normal,' to know that some of the things that they're seeing, the hypertension, the severe pain, the severe nausea, is actually normal and the provider will work with them to try to come up with a regimen that will make the patient as comfortable as possible.” TS 33:22

Anche dal Corriere della Sera arriva la richiesta di avere più Vigili nelle vie della città. Ma l'Amministrazione tace e l'unica risposta che noi abbiamo avuto è stata quella, offesissima, della categoria: siamo agenti di polizia locale, perbacco!

Ennesimo femminicidio a RomaSeguimi su YouTube: https://www.youtube.com/channel/UClkB_8jqDS7SWoltMjIu-3Q/Supporta il progetto qui: https://www.paypal.com/paypalme/pierjcSupport this podcast at — https://redcircle.com/storia/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

On this episode of Oncology Unscripted, patient advocates Julie Johnson and Katie Coleman and radiation oncologist Dr. Matt Spraker continue The Insider's Guide to Radiation Therapy! This four episode series will cover radiation 101, stereotactic body radiation therapy (SBRT), and proton therapy!In this episode, we discuss SBRT, alternatively called stereotactic ablative body radiotherapy (SABR). We also discuss a related treatment, stereotactic radiosurgery (SRS).Here are some links to things we discussed during the show:Rare Cancer Research FoundationPattern.orgCount Me InJAMA Oncology SBRT/SABR patient pageCyberKnife information from the manufacturer (Accuray)GammaKnife information from the manufacturer (Eleckta)The patient-led Remove the Mask CampaignHere are some clinical and scientific publications mentioned during this show:Original Timmerman study of SBRT for early stage lung cancerDiscovery of the SBRT "No Fly Zone" in the chestInternational Radiosurgery Consortium of the Kidney (IROCK) meta-analysis of SBRT for primary kidney cancer (renal cell carcinoma).Here are some resources that may be of interest, but were not discussed in this episode:An excellent video on Stereotactic Radiosurgery (SRS) versus Whole Brain Radiotherapy (WBRT) for brain metastases from our friends at PRIMRRTOG 1112 Trial: Benefit of adding SBRT to Sorafenib in locally advanced liver cancer (hepatocellular carcinoma). (conference abstract only)TRENDY Trial: Suggests that SBRT is superior to trans-arterial chemoembolization (TACE) for early liver cancer (haptocellular carcinoma).MD Anderson Cancer Center Phase II Trial: Suggests that SBRT may be used to defer systemic therapy in patients with oligometastatic kidney cancer (renal cell carcinoma) Oncology Unscripted is a Photon Media production. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.Additional content from Katie Coleman can be found at her website, https://www.katiekickscancer.com/. This show and our opinions are meant for general informational purposes and are not medical advice. We encourage you to reach out to your doctors to discuss your individual case. 

This recording features audio versions of September 2023 Journal of Vascular and Interventional Radiology (JVIR) abstracts:An Interim Analysis of the First 102 Patients Treated in the Prospective Vertebral Augmentation Sacroplasty Fracture Registry  ReadEffectiveness and Safety of Intra-arterial Imipenem/Cilastatin Sodium Infusion for Patients with Hand Osteoarthritis–Related Interphalangeal Joint Pain  ReadMiddle Meningeal Artery Embolization with Liquid Embolic Agents for Chronic Subdural Hematoma: A Systematic Review and Meta-analysis  ReadDouble-Barrel Nitinol Stent Placement for Iliocaval Reconstruction: The Effect of Deployment Sequence and Direction on Final Configuration  ReadRadioembolization with Yttrium-90 Glass Microspheres as a First-Line Treatment for Unresectable Intrahepatic Cholangiocarcinoma—A Prospective Feasibility Study  ReadRobot-Assisted Transarterial Chemoembolization of Hepatocellular Carcinoma Using a Coaxial Microcatheter Driving Controller-Responder Robot System: Clinical Pilot Study  ReadA 5-Year Update on the IR Residency Match: 2022 National Survey Results of Program Directors and Matched Applicants Compared with 2017   ReadJVIR and SIR thank all those who helped record this episode:Host:Rommell Noche, Frank H. Netter MD School of Medicine at Quinnipiac University, ConnecticutAudio editor:Manbir Sandhu, University of California Riverside School of MedicineAbstract readers:Emily Barr, MBA, Burrell College of Osteopathic Medicine at New Mexico State UniversityJoy Achuonjei, MS, MBA, Zucker School of Medicine at Hofstra/Northwell, New YorkJoan Hwang, A.T. Still University School of Osteopathic Medicine, ArizonaChristopher Loiselle, MS, Lincoln Memorial University-DeBusk College of Osteopathic Medicine, TennesseeBenjamin Ellison, Medical University of South CarolinaJack Ficke, Frank H. Netter MD School of Medicine at Quinnipiac University, ConnecticutAnne-Marie Nwajei, MS, Chicago Medical School at Rosalind Franklin University of Medicine and Science, Illinois ©  Society of Interventional RadiologySupport the show

It's radiology read to you! Andrew reads our TACE article to interventional radiologist Heather Moriarty while she throws in clinical gems along the way. Frank drifts once again into talking about neuroradiology.  Radiopaedia's TACE article ► https://radiopaedia.org/articles/transcatheter-arterial-chemoembolisation Vorasidenib for low-grade glioma ► https://www.nejm.org/doi/full/10.1056/NEJMoa2304194 Radiopaedia 2023 Virtual Conference ► https://radiopaedia.org/courses/radiopaedia-2023-virtual-conference Become a supporter ► https://radiopaedia.org/supporters Get an All-Access Pass ► https://radiopaedia.org/courses/all-access-course-pass Andrew's Twitter ► https://twitter.com/drandrewdixon Frank's Twitter ► https://twitter.com/frankgaillard Ideas and Feedback ► podcast@radiopaedia.org   The Reading Room is a radiology podcast intended primarily for radiologists, radiology registrars and residents. 

Zuppa di Porro. Solo Berlusconi: oggi, per me, non c’è altro.

Accelerators co-host Dr. Matt Spraker hosts Radiation Oncologists Drs. Krish Jethwa, Neil Newman, and Jeff Ryckman for part 2 of our discussion on radiotherapy for liver tumors. We kick off with Neil reviewing his Twitter thread comparing TACE and SBRT for liver tumors. We discuss the data supporting SBRT as superior therapy, especially in patients who have recurrence after TACE. We further share some talking points for your tumor board. Then discuss one of our faves, a randomized trial of sorafenib with or without SBRT (NRG/RTOG 1112). This leads to more discussion about how to approach large/unresectable liver tumors in your tumor board and possible future studies for these patients. Here are some things we discussed in the episode:Barcelona Liver StagingSapir et al., Stereotactic Body Radiation Therapy as an Alternative to Transarterial Chemoembolization for Hepatocellular CarcinomaComito et al., SBRT versus TACE/TAE for recurrence after TACEAkarapatima et al., TACE versus BSC for HCCXiang et al., TACE versus BSC for HCCLlovet et al., TACE/TAE versus BSC for HCC TRENDY trial., TACE versus SBRT for HCCBush et al., proton radiotherapy versus TACE for HCCVerbus et al., SBRT versus TACE as bridging therapy in HCC Hong et al., phase II trial of proton radiotherapy for unresectable cholangiocarcinomaRTOG 1112 survival curvesPodcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.The Accelerators Podcast is a Photon Media production. 

Accelerators co-host Dr. Matt Spraker hosts Radiation Oncologists Drs. Krish Jethwa, Neil Newman, and Jeff Ryckman for romp through the exciting world of radiotherapy for liver tumors! In the first of this two part episode, we Krish, Neil, and Jeff explore how liver tumors are treated in practice. We learn that Jeff can tell your Child-Pugh score by looking at your finger nails and other tips that can help with patient selection. Then we have a fantastic data-driven discussion on treatment planning. We also cover motion management and delivery. Toward the end, we approach the topic that inspired this episode, comparing SBRT with catheter-based therapies. Like Krish, we all want to know: will Neil "let it fly" on why SBRT should be the therapy of choice? Tune in next week to find out.Here are some things that were discussed doing the show:Dr. Newman's epic Twitter thread on TACE versus SBRT for HCCThe liver has a body - a Cook's tour by Adrien RubenDr. Zaorsky's Liver Anatomy Explained Using Your Right FistBujold et al., phase I and II studies of SBRT for HCCRitter et al., Application of Critical Volume-Dose Constraints for SBRT in NRG TrialsDawson et al., Individualized image guided iso-NTCP based liver cancer SBRTDawson et al., Partial Irradiation of the LiverPodcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.The Accelerators Podcast is a Photon Media production. 

From a basic science perspective, a number of questions remain unanswered regarding deep veins. Venous disease is a cause of morbidity and mortality for patients of all ages, though the past several years have shown marked progress in research and approval of techniques and devices used for the treatment of venous disease. Major areas of research potential include the inflammatory pathway from acute deep venous thrombosis (DVT) to chronic fibrosis, and venous wall biomechanics and flow dynamics in the normal and disease states.In the audio version of "The venous revolution: Where we are and where we're going"  (IR Quarterly supplement: New Horizons in Interventional Radiology), authors  David S. Shin, MD, Frederic Bertino, MD, Ramsey A. Al-Hakim, MD, Ronald Winokur, MD, FSIR, Kush Desai, MD, FSIR, and Jeffrey Forris Beecham Chick, MD, MPH, discuss new and emerging research in superficial venous disease, inferior vena cava filters, thrombectomy and venous reconstruction, and venous stent reconstruction.Related articles:Read the text article Other articles in the "New Horizons in Interventional Radiology" supplement of IR Quarterly, covering genicular artery embolization, TACE and immunotherapy for immediate-stage HCC, and bariatric embolization.  "Predicting the Safety and Effectiveness of Inferior Vena Cava Filters (PRESERVE): Outcomes at 12 months" ReadContact us with your ideas and questions, or read more about about interventional radiology in IR Quarterly magazine or SIR's Patient Center.(c) Society of Interventional Radiology.Support the show

Rashes always makes us, none dermatologist worry and maybe a bit anxious. Which rashes are worrisome? and what should we look for as the red flags of pediatric rashes. I discuss this and more With Dr. Tace Rico our Pediatric Dermatologist.  

Full article: https://www.ajronline.org/doi/10.2214/AJR.22.28385 Locoregional therapies for hepatocellular carcinoma perform differently when compared by rates of complete pathologic necrosis of lesions. Juliet Alla, MD discusses a new AJR study that demonstrates improved rates of complete pathologic necrosis for patients with HCC who underwent thermal ablation and TARE therapies, when compared to those who received TACE. Special guest Dr. Zachary Berman, an interventional radiologist who specializes in locoregional therapies for hepatocellular carcinoma, joins to discuss the implications for clinical practice.

In this crossover episode between BackTable VI and BackTable Innovation, Dr. Chris Beck interviews Dr. Riad Salem (Chief of Interventional Radiology at Northwestern University) and Peter Pattison (President of Interventional Oncology at Boston Scientific) about how TheraSpheres for Y90 radioembolization became a mainstay in the IR toolkit for HCC and where the technology is heading next. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PvWJlD --- SHOW NOTES To begin, Peter outlines how the original concept of TheraSpheres began at the University of Missouri, as a collaboration between Drs. Delbert Day and Gary Ehrhardt, who combined their ceramic and nuclear chemistry expertises to create radioactive glass beads and published a paper in 1987. After animal and human testing, the product was licensed to the company Nordion, where Peter worked. The product was given a humanitarian device exemption (HDE) from the FDA, which allowed TheraSpheres to be used for investigational purposes. In the late 1990s, Dr. Salem was in his early interventional oncology career and heard about TheraSpheres. He recognized the enormous potential that this technology had to ensure known amounts of radioactive doses were delivered to the tumor and minimize adverse effects. In fact, he noticed that his Y90 patients had less pain, post-embolization syndrome, and hospitalization than his transarterial chemoembolization (TACE) patients. In the mid 2000s, he collected and submitted data to various conferences and journals, but he was met with criticism from the IR world, which was more comfortable with TACE, since it was the current standard of care. In 2011, Nordion decided to run a clinical trial, EPOCH, which eventually showed that the addition of TARE to systemic therapy for colorectal metastases to the liver led to longer progression free survival. Dr. Riad has focused his efforts on training more IRs on the methodology of Y90, since this was an important step to increasing adoption and minimizing missteps with the new technology. He believes that the advent of Y90 has resulted in better angiography, since IRs are more cognizant of off-target embolization. Dr. Salem also petitioned at the US Nuclear Regulatory Committee to allow IRs to become the authorized users for Y90 injection and advocated to add TARE to the National Comprehensive Cancer Network guidelines for liver cancer. Both of these developments allowed TARE to become more widely adopted. Finally, Peter discusses the competition that TheraSpheres has faced from TACE and SIRSpheres (resin-based radioembolization). He shares exciting new developments that have occurred since acquisition by Boston Scientific. These include exploration for the extra-hepatic use of TheraSpheres in glioblastoma and prostate cancer. --- RESOURCES BackTable Ep. 223- Portal Vein Recan #ReCanDoIt with Dr. Riad Salem: https://www.backtable.com/shows/vi/podcasts/223/portal-vein-recan-recandoit Therapeutic Use of 90Y Microspheres: https://pubmed.ncbi.nlm.nih.gov/3667306/ A phase I dose escalation trial of yttrium-90 microspheres in the treatment of primary hepatocellular carcinoma: https://pubmed.ncbi.nlm.nih.gov/1327493/ Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up: https://pubmed.ncbi.nlm.nih.gov/7931662/ Humanitarian Device Exemption: https://www.fda.gov/medical-devices/premarket-submissions-selecting-and-preparing-correct-submission/humanitarian-device-exemption EPOCH Trial: https://ascopubs.org/doi/full/10.1200/JCO.21.01839 Radioembolization with 90Yttrium Microspheres: A State-of-the-Art Brachytherapy Treatment for Primary and Secondary Liver Malignancies: https://www.jvir.org/article/S1051-0443(07)60901-4/fulltext

La pace tra il leader di Forza Italia e la presidente del Consiglio in pectore (dopo le polemiche per l'elezione del presidente del Senato e per i posti nel governo) è durata poche ore. E così la temperatura della coalizione che esprimerà il prossimo governo è tornata a salire. In tutto questo, colpisce il basso profilo scelto dal segretario della Lega. Tommaso Labate e Cesare Zapperi spiegano che cosa sta succedendo.Per altri approfondimenti:- Cosa ha detto Berlusconi su Putin e ministri e cosa vuol dire che ha picconato l'accordo con Giorgia Meloni https://bit.ly/3Sd4wZZ- Meloni su Berlusconi: “Perché queste uscite? Per rendermi la vita difficile” https://bit.ly/3Tw6E04- Lega-FdI, la contesa sul ministero dell'Agricoltura e la carta segreta di Meloni https://bit.ly/3TghzeI