Podcasts about taofeek owonikoko

Drs. Vamsi Velcheti, Taofeek Owonikoko, and Janakiraman Subramanian discuss their experiences navigating the cancer drug shortage in the United States, the impact on patients and clinical trial enrollment, lessons learned, and proactive strategies to mitigate future crises. TRANSCRIPT  Dr. Vamsi Velcheti: Hello, I'm Dr. Vamsi Velcheti, your guest host for the ASCO Daily News Podcast today. I'm a professor of medicine and director of thoracic oncology at the Perlmutter Cancer Center at NYU Langone. On today's episode, we'll be discussing the impact of the shortage of cancer chemotherapy drugs across the United States. This has been affecting several thousands of patients with adult and pediatric cancers and hampering enrollment in clinical trials. Among the shortages are very commonly used drugs like cisplatin, carboplatin, methotrexate, and fludarabine. Some of these shortages have persisted since the time of the pandemic in 2020.   So today, to discuss this really troubling scenario, I have two outstanding colleagues, Dr. Janakiraman Subramanian, the director of thoracic oncology at Inova Schar Cancer Institute in Virginia, and Dr. Taofeek Owonikoko, a professor of medicine and the chief of the Division of Hematology and Oncology at the University of Pittsburgh Hillman Cancer Center in Pittsburgh.   Our full disclosures are available in the transcript of this episode, and disclosures relating to all episodes of the podcast are available at asco.org/DNpod.  So, a recent survey by the NCCN found that 90% of the nation's largest cancer centers have experienced a shortage in carboplatin, and 70% of the centers have reported a shortage in cisplatin. These are platinum-based chemotherapies we use frequently in patients with cancer, and these are often curative intent treatments for several cancers, and these are used in several tumor types, both solid tumors and hematologic malignancies. So, the scale of the problem is immense.   Dr. Owonikoko, I'd like to hear your take on this situation and how are you dealing with this at the UPMC Cancer Center.  Dr. Taofeek Owonikoko: Yeah, thank you, Dr. Velcheti, and happy to be part of this panel. As you rightly surmised, the chemotherapy drug shortage is what we've all experienced across the length and breadth of the United States. Our cancer center here in Pittsburgh is not an exception. We've had to be proactive as well as think outside the box to be able to manage the challenge. Just like every other cancer center across the country, maybe to varying degrees, we've had to look at patients in need of chemotherapy with these standard-of-care agents such as cisplatin or carboplatin, and to some degree docetaxel, during this past episode of drug shortage that we all went through. And while we did not have to, fortunately, cancel any patient treatment, we all went through it with bated breath; not sure of where the next batch of chemotherapy drugs will come through, but I would say in the past couple of weeks, we've actually seen some improvement in drug availability.   But before then, we've had to have contingency plans where, on a weekly basis, we review our patient list and the drug regimens that they're going to need, and must make sure that we have enough drug on hand for those patients. And in situations where we thought we might not have enough drug; we also had a plan to use alternative regimens. We were proactive in having guiding principles that are consistent with ASCO's recommendations in terms of quality care delivery for cancer patients. So, I'm sure that this is more or less the same approach adopted by other leading cancer centers across the country.   Dr. Vamsi Velcheti: Thank you, Dr. Owonikoko. And Dr. Subramanian, you're in a community setting, a large cancer center that serves a lot of patients in the state of Virginia. So, what is the scale of the problem at your institution and how are you handling it?   Dr. Janakiraman Subramanian: First of all, Dr. Velcheti, thanks for having me here on this panel. And as you rightly said, this is a significant problem, and it is across the country like Dr. Owonikoko said. And as medical oncologists, we are not always thinking of drug shortages. Our focus is on taking care of our patients. So, this is one more issue that we need to keep in mind now as we manage our patients with cancer. When this shortage started, the biggest problem, as you know, was when we became aware of this was primarily in cisplatin and we had some of our patients who were getting curative treatment and we had to make a decision - can they get cisplatin or can they get carboplatin. And one of the things we did was to have an ethics committee that will review each patient that is being planned to receive cisplatin-based chemotherapy and come to a decision on how best we can support them.   The template for some of this was based upon some of the triage mechanisms we used during COVID, as well as the ASCO guideline document for managing this chemotherapy shortage, which was one of the blueprints we used. And they have reviewed all cases, all patients that are being planned for cisplatin or carboplatin for that matter, and we come to a decision based on that. And we also have another committee that constantly monitors drug availability on a weekly basis and tries to forecast where the next problem would be as we take care of our patients.   And particularly as a lung cancer doctor, we've had situations where we had to use carboplatin instead of cisplatin and even we also have carboplatin shortage. And so, the committee usually approves two cycles at a time, but thankfully so far we have not had a situation where we could not offer our patients the chemotherapy treatment. But we are very carefully monitoring the situation, hoping that this will improve.   The other aspect of the shortage has been in 5FU. A lot of our GI colleagues; I treat esophageal cancer patients as well, where we've had to forego the bolus 5FU and have a 10% reduction on all 5FU infusions. And we've been using some of that dose reduction to ensure that we can have 5FU available for all our patients. And that's how we've been trying to manage this shortage situation here at Inova Schar.   Dr. Vamsi Velcheti: Dr. Subramanian and Dr. Owonikoko, we are oncologists, we are treating patients, and the toughest part really is telling a patient that we don't have access to certain drugs and we have to switch treatments to perhaps another treatment regimen that may be suboptimal. And it's always a very anxiety-provoking discussion, and especially for patients with metastatic cancer, they're already under a lot of stress and it's a really difficult conversation. How do you handle that, Dr. Owonikoko?  Dr. Taofeek Owonikoko: That's a conversation we all hope we don't have to have. And fortunately, with this current crisis, I've actually not had such misfortune of having to inform a patient that we don't have drugs to treat them or that we have to switch to something inferior. But conceptually, it's possible that could have happened and that would have been very difficult. But the one thing that we did, though, as part of our mitigation strategy was actually to inform the patient ahead of time because the way we handled this was to look at our inventory on a week-by-week basis. And if there are patients where we felt maybe they will be coming in towards the end of the week and we may not have enough drugs for them, to let them know the possibility exists that we might have to switch them to something different. While we did not have to do that for any patient, yes, there are patients that we had to give that heads up to, to say, “We're having this shortage. We're doing everything we can to make sure it's available. But just in case it's not available…” I think what is most important for most patients is to be aware of that decision ahead of time, to be able to process it, and to be transparent.   The other challenge that we face was, if you have to choose between patients, what should be your guiding principles as to who gets the drug and who doesn't get it? I think it's very easy for all of us to say, “Oh, if it's curative intent, we do it. If it's not curative intent, we don't do it.” It's a little more complicated than that because if we put the equity hat on, curative intent doesn't actually mean that that life is more valuable than somebody who cannot be cured. And this is where really, I think having people with expertise in ethics of care delivery and disaster management will be very important for us to proactively anticipate that, should this become a recurrent problem in the future that we actually have a well-vetted approach, just like we did during COVID where you have to ration resources that we have those people with expertise to help us as oncologists because not all of us, at least personally I can speak for myself, that is not my area of expertise and comfort.  Dr. Vamsi Velcheti: Excellent points. Dr. Subramanian, anything to add?  Dr. Janakiraman Subramanian: Oh, absolutely. I echo what Dr. Owonikoko said. These are conversations that we would like to hopefully never have with our patients. But this is a crisis that we are facing now. And personally, I can tell you two situations where we ran into this problem. But overall, though, we never had to stop a treatment or cancel a treatment for our patient. In the first situation, we had a young man with a rare germ cell tumor in the hospital for whom cisplatin was key. He was already in the ICU and sometimes the treatment start dates are not perfect, unlike what we do in the outpatient setting, depending on how well he's doing or the treatment start dates might move by a day or so. So we basically had to hold a certain dose of cisplatin for him.   This brings the next question, which is how do we decide who gets cisplatin versus who can go for an alternative option? And I think Dr. Owonikoko made a great point where, just because it is a curative disease does not mean their life is more valuable. This is where I think trying to make that decision at an individual level, as an individual treating physician can be extremely hard. And that's why at our institution we have this ethics committee where we have oncologists, pharmacists, and ethicists that review these chemotherapy orders, particularly for cisplatin, and try to use some guiding principles that we learned from COVID as well as ASCO's guidance to decide how we assign our resources. That's one option, one way we have done it.    And then in another situation that was faced by one of my GI oncology colleagues was a patient that was originally planned to go on a clinical trial where the chemotherapy backbone was FOLFOX and because we had the 5FU shortage, we could not offer that patient clinical trial enrollment. And that was a tough conversation where they had to tell them that they could not go on a clinical trial that they were looking forward to. And this then brings the next question, which is by foregoing the bolus 5FU and by the 10% reduction in the infusional 5FU, are we providing them inferior treatment? And it's a conversation that's had at a very individual level. I don't envy my colleague who had to have that conversation. It's a challenge and we try to do our best to communicate to our patients that we are trying to provide care without trying to compromise the effectiveness of treatment for them.  Dr. Vamsi Velcheti: Thank you so much both of you. And we had the same issues here at NYU in New York City as well. It appears, you know, the degree of shortage and the drugs that are in shortage has been somewhat different at different locations across the United States. But the theme has been that we are having to ration treatments for our patients. And of course, there are some tumor types where there's really no adequate substitution, for example, GU cancers. I mean, you can't really not give them cisplatin. A lot of these are situations which have curative intent and young patients. So, it's really troubling.   And I think one of the things that really came out of this is there's been a lot of push from professional societies that actually ASCO has been spearheading and some intense discussions with CMS and legislators to kind of provide more long-term fix for these things. And I think all of us have to be more engaged in those discussions with our professional societies like ASCO to kind of help promote awareness. So if you kind of think about it, these drugs are not that expensive. These are generic drugs that we've all been using for such a long time. And the fact that we can't provide these drugs for various reasons is kind of really concerning. We spend so much money on research and more expensive drugs and not being able to manufacture these drugs within the country and kind of having to rely on complex supply chains is troubling, and I hope the situation improves very soon.    So, I know both of you are at large cancer centers that enroll patients on clinical trials. Of course, these drugs, especially carboplatin, for lung cancer, especially, are like core treatments that are used in managing cancer patients with lung cancer. So how is this affecting your clinical trial accrual? Are you prioritizing patients on clinical trials for these drugs? Have you had to make any decisions to hold clinical trial accrual for certain trials? Kind of curious to hear.  Dr. Taofeek Owonikoko: Yeah, so I can maybe weigh in a little bit on that in terms of what we've had to do for patients receiving treatment as standard of care versus those going on clinical trials. As we all recognize that when a patient goes on a clinical trial, even if they are going to receive a standard-of-care regimen as part of that trial, it still has to be administered in line with the protocol. So, during the extreme period of shortage anxiety, we actually had consideration for perhaps not putting patients on trial if we're not sure that they will be able to continue to receive the protocol-mandated treatment, whether it's a control intervention or the experimental intervention.   The good thing to come out of this is at least here at UPMC, we actually did not have any instance where we had to deny a patient clinical trial participation. But there were anxious periods when we already had patients enrolled and they were scheduled to receive a platinum-containing regimen and we were not sure whether or not we were going to have adequate supply of the drug for them while on trial. I think this really raises an important consideration going forward as we come out of this current shortage. I don't by any stretch of the imagination assume that this is going to be the last one we experience, but I think the lessons learned here, we have to also carry that forward both in the design of the trial as well as in the regulatory environment surrounding clinical trial conduct, to say, should another incidence of drug shortage are to happen, how do we actually operationalize that with respect to patients on trial, whether starting or already on trial?   I think it's much more challenging when the patient is already on the trial, they've already started. It's less challenging if you just have to make a decision about somebody starting newly on the trial. But equally important is that by not allowing new patients to go on trial is denying something that potentially could be of benefit to them, albeit it is still a trial, it's not an established treatment option yet.  Dr. Janakiraman Subramanian : I completely agree with Dr. Owonikoko. Those were very key points and issues that we face as well. In terms of my patients with lung cancer, we haven't had a problem in getting them on clinical trials. Even though we have had carboplatin shortage patients who are already on treatment, they were able to get the carboplatin. For new patients, we were still able to provide them carboplatin as well. The biggest problem for clinical trials has been primarily with my GI colleagues who have to use 5FU. And there, as I said before, we are unable to give bolus 5FU and there is a 10% reduction of the infusional 5FU. So, we can't have any of these patients go on clinical trials.    And as a result, anything that has to do with 5FU has come to a screeching halt in terms of clinical trials for our patients. And I think I echo the point of Dr. Owonikoko that by no means this is the last drug shortage we're going to be dealing with and we are here today discussing this, also because this shortage has not ended. It's been ongoing. It's one of the longest drug shortages in my memory as a medical oncologist, and that's concerning. We still see that there is some improvement, but we haven't gotten past it yet.     And therefore, as we develop clinical trials and we need to have methods to address drug shortages and how we manage patient enrollment as well as how do we manage existing patients who are already on a clinical trial and, if possible, what might be their options in that situation. We may not have all the answers, but it is definitely an issue that we need to think about in the future as we develop and implement newer clinical trials for our patients.  Dr. Vamsi Velcheti: I completely agree and great points, both of you. And we've had the same issues with clinical trials at NYU Langone as well due to the shortage. It's been a challenge, and I think this is a problem that's so complex because of supply chain issues and the way the drugs are priced and incentives for manufacturing these drugs in the United States are not lucrative enough to actually onshore a lot of the production of these drugs.   I think at the end of the day, I think we have to come up with some creative, innovative, reimbursement structures for these generic chemotherapy drugs. I think this would require a very complex economic solution that perhaps ASCO and other organizations should kind of really foster an environment of innovation to kind of help facilitate onshoring some of the manufacturing of these key drugs within the United States. I think ASCO is already trying to do that, trying to collaborate with all the stakeholders to kind of address this problem is very critical, and I think all of us have to be engaged in some of the advocacy efforts that are ongoing to kind of address these drug shortages. And this is not a short-term problem.  So, Dr. Owonikoko and Dr. Subramanian, any final thoughts before we wrap up the podcast today?  Dr. Janakiraman Subramanian: So, Vamsi, you mentioned the whole complex supply chain and the fact that we rely primarily on overseas manufacturers to get these drugs that are off-patent but still a key backbone of our cancer treatment. I think those are all key issues that policymakers and leaders in the field have to keep in mind. As an institution at Inova, one of the key mechanisms that have helped us to sort of stay ahead of the shortage was to have this inventory management team that monitors the inventory out there. And in fact, the inventory management team does have access to what the inventory is in some of their main suppliers in terms of the drugs. And they also have an idea of how many patients are going through treatment, what is the weekly usage of a specific drug like carboplatin. And they try to forecast what is coming down the road and try to prepare for it.   And as we try to look for solutions, maybe a forecasting mechanism in a larger scale like either spearheaded by ASCO or by policymakers level that can, for the overall country, try to see where some of the inventory is for some of these critical drugs and try to prepare for it ahead of time, rather than wait till we hit the shortage and then try to find alternative suppliers to get the drug, which obviously doesn't happen quick enough. It takes months or even longer to catch up and get the inventory back to the level where we can comfortably take care of our patients.  I think that is something we should be advocating for that as well as the professional societies should take a handle on that and see if they can support something like that as well as letting the institutions know ahead of time what's coming might be very helpful.  Dr. Vamsi Velcheti: Yeah, very good point, Janakiraman, and I think that's a key takeaway here. I think we have to learn from other industries and try to– I mean this is not unique to healthcare by any means. I mean these chronic shortages due to supply chain issues, inventory management, there might be some learnings from other industries here that we probably should also focus on inventory management and improve supply chain logistics.   Dr. Owonikoko, any closing thoughts?   Dr. Taofeek Owonikoko: Yeah, I agree as well with all the points made by Dr. Subramanian and yourself. This is a chronic problem that requires a long-term strategy. I think it's both an economic problem as well as a regulatory problem. As we all know, part of the reason why we went through this current crisis is the regulatory decision by the FDA regarding safety of one of the manufacturers. So being proactive in terms of how these audits are conducted and giving people lead time I think will help avoid similar situations in the future.    It's an economic problem. There's a reason why a lot of the big pharma companies are not producing these drugs. And if the cost of production is such that the amount of money you get paid is enough to cover your price, I think there is an economic issue there to be addressed. That is unfortunately not within the scope of what any one of us can do individually, but as advocates in terms of the structure of incentivizing new drug versus old drug, some of these newer drugs are quite expensive, but oftentimes they are used along with standard drugs that are not as expensive. So, where do we strike that balance where we do not stifle innovation but at the same time, we don't create a perverse incentive system where everybody just wants to come up with the newest, most expensive drug and nobody is interested in really producing the backbone chemotherapy and other agents that will make those new drugs work well.   So, I think we have to pay attention. We have to advocate for our patients through our different institutions and organizations, and I hope that society as a whole that we've learned a lot of lessons from this crisis and that will help us craft some long-term strategies.   Dr. Vamsi Velcheti: Thank you both Dr. Owonikoko and Dr. Subramanian for your time today to speak with me and our listeners and for sharing your insights with us on the ASCO Daily News podcast.   Dr. Taofeek Owonikoko: Thank you.   Dr. Janakiraman Subramanian: Thank you.  Dr. Vamsi Velcheti: And thank you to our listeners for your time today. If you value the insights that you hear on ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcast. Thank you so much.  Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  ASCO Resources Related to Drug Shortages are available here.     Follow today's speakers:    Dr. Vamsidhar Velcheti    @VamsiVelcheti    Dr. Janakiraman Subramanian  @RamSubraMD  Dr. Taofeek Owonikoko  @teekayowo    Follow ASCO on social media:     @ASCO on X (formerly Twitter)    ASCO on Facebook    ASCO on LinkedIn      Disclosures:     Dr. Vamsidhar Velcheti:     Honoraria: ITeos Therapeutics    Consulting or Advisory Role: Bristol-Myers Squibb, Merck, Foundation Medicine, AstraZeneca/MedImmune, Novartis, Lilly, EMD Serono, GSK, Amgen, Elevation Oncology, Taiho Oncology, Merus    Research Funding (Inst.): Genentech, Trovagene, Eisai, OncoPlex Diagnostics, Alkermes, NantOmics, Genoptix, Altor BioScience, Merck, Bristol-Myers Squibb, Atreca, Heat Biologics, Leap Therapeutics, RSIP Vision, GlaxoSmithKline      Dr. Janakiraman Subramanian:  Consulting or Advisory Role: AstraZeneca, Boehringer Ingelheim, Pfizer, Novartis, Daichi, G1 Therapeutics, Jazz Pharmaceuticals, Janssen Oncology, Lilly, Blueprint Medicines, Axcess, BeiGene, Cardinal Health, Takeda, OncoCyte  Speakers' Bureau: AstraZeneca, Boehringer Ingelheim, G1 Therapeutics, Jazz Pharmaceuticals, Janssen Oncology  Research Funding (Inst.): G1 Therapeutics, Tesaro/GSK, Novartis, Genentech, Novocure, Merck   Dr. Taofeek Owonikoko:  Stocks and Other Ownership Interests: Cambium Oncology, GenCart, Coherus Biosciences  Consulting or Advisory Role: Novartis, Celgene, Abbvie, Eisai, GI Therapeutics, Takeda, Bristol-Myers Squibb, MedImmune, BerGenBio, Lilly, Amgen, AstraZeneca, PharmaMar, Boehringer Ingelheim, EMD Serono, Xcovery, Bayer, Merck, Jazz Pharmaceuticals, Zentalis, Wells Fargo, Ipsen, Roche/Genentech, Janssen, Exelixis, BeiGene, Triptych Health Partners, Daichi, Coherus Biosciences  Speakers Bureau: Abbvie  Research Funding (Inst.): Novartis, Astellas Pharma, Bayer, Regeneron, AstraZenece/MedImmune, Abbvie, G1Therapeutics, Bristol-Myers Squibb, United Therapeutics, Amgen, Loxo/Lilly, Fujifilm, Pfizer, Aeglea Biotherapeutics, Incyte, Merck, Oncorus, Ispen, GlaxoSmithKline, Calithera Biosciences, Eisai, WindMIL, Turning Point Therapeutics, Roche/Genentech, Mersana, Meryx, Boehringer Ingelheim  Patents, Royalties, Other Intellectual Property (Inst.):   Overcoming Acquired Resistance to Chemotherapy Treatments Through Suppression of STAT3  Selective Chemotherapy Treatments and Diagnostic Methods Related Thereto  DR4 Modulation and Its Implications in EGFR-Target Cancer Therapy Ref: 18089 PROV (CSP) United States Patent Application No. 62/670,210 June 26, 2018 (Co-Inventor)  Soluble FAS ligand as a biomarker of recurrence in thyroid cancer; provisional patent 61/727,519 (Inventor)  Other Relationship: Roche/Genentech, EMD Serono, Novartis  Uncompensated Relationships: Reflexion Medical           

Dr. Taofeek Owonikoko is a Professor and Vice Chair for Faculty Development in the Department of Hematology and Medical Oncology at Emory University, Atlanta. He is also a Georgia Research Alliance Distinguished Cancer Scientist. Owonikoko received his medical degree from the Obafemi Awolowo University, Ile-Ife Nigeria in 1991 and a doctoral degree in Anatomic Pathology from the Heinrich Heine University, Dusseldorf, Germany in 2000.  He has been on faculty at Emory University since 2008 and has focused on lung cancer, thyroid cancer as well as early phase drug development.

In this episode, Dr. Taofeek Owonikoko, lung cancer specialist at the Winship Cancer Institute at Emory University and chair of the 2021 ASCO Annual Meeting Education Program, discusses the diverse ways that cancer care equity will be featured during #ASCO21.   Transcript ASCO Daily News: Welcome to the ASCO Daily News podcast. I'm Geraldine Carroll, a reporter for the ASCO Daily News. My guest today is Dr. Taofeek Owonikoko, a lung cancer specialist at the Winship Cancer Institute at Emory University. Dr. Owonikoko serves as the chair of the education program of the 2021 ASCO Annual Meeting. And he's here to tell us about the diverse sessions that will be featured this year. Dr. Owonikoko reports no conflicts of interest relating to our discussion today. His full disclosures and those relating to old episodes of the podcast are available at asco.org/podcast. Dr. Owonikoko, it's great to have you on the podcast today. Dr. Taofeek Owonikoko: Thank you. Glad to be here. ASCO Daily News: Health equity is the major theme of this year's Annual Meeting. And as you know, ASCO's President, Dr. Lori Pierce, has been focusing on patient care equity during her term. Can you tell us about how the concept of cancer care equity has been incorporated into the education program this year? Dr. Taofeek Owonikoko: Thank you very much. I actually want to use this opportunity for us to thank all the ASCO volunteers, who spent countless hours putting together a very educational program for the Annual Meeting. It's very difficult for me to come out and say [that] this is the best session to go to. I think all of the sessions are very important and educational. The challenges that we've faced with COVID-19 that is making this a virtual meeting, actually, I think is an opportunity for people to be able to participate in all these sessions. Having said that, there are some sessions that we intentionally placed within the Education Program based on how important we felt these topics were to our patients, to their caregivers, family members, and also to ASCO members. We want sessions that focus on various aspects of health equity from individual patient interaction with their providers, to patient experience within the larger context of how health care systems are built, and how we deliver care. Some of the sessions that I really encourage members to listen to and participate in will be--there is a session that is going to bring diverse viewpoints from across the world, not just in the U.S. We want to see how oncologists practice in a limited resource setting, how they go about taking care of patients, and how they are able to use the challenges that they face as a stepping stone to bring the best care forward for that patient. So we have this session where we're going to have a speaker from Uganda in Africa. We have another speaker from Pakistan representing the Asian viewpoint. We are going to have a speaker who will speak to delivering care to the inner city population here in the U.S. And that session will also have a speaker that will discuss how we take care of our patients within the Native American community here in the U.S. So you're going to see these diverse viewpoints that we feel will shed light on the important point that Dr. Pierce has been trying to make with the presidential theme, that we need to focus on every patient, everywhere in terms of equitable care delivery. ASCO Daily News: Intersectionality in cancer care is a topic that has been getting more attention over the past year. How will this issue be addressed during the Education Program? Dr. Taofeek Owonikoko: We've talked about determinants of health outcomes for patients. How we look at all of these issues in isolation, whether it's gender, sexual orientation, race or ethnic background, rural versus urban, big city versus small towns, and different regions of the world. There's actually now this emerging consensus that a lot of these factors actually do not stand alone. There is an intersection of where someone lives and what type of access they have to health care--where someone lives and what type of care providers, someone's gender, and their socioeconomic status influencing the outcomes of care that they get. So this session on intersectionality, I think will really bring this to the forefront of our discussion about how to address health inequities--that we don't want to focus on one issue at a time. All these issues are important and they are interrelated. I think this type of session will help all of us to understand that there's a lot going on that determines the outcome for patients, especially for patients with cancer. One additional session I want to highlight, which is also very important to the presidential theme is the session on viruses and cancer. While there is this pandemic with the COVID-19 virus that we are very aware of, what we also did not want to lose sight of is the fact that viruses are etiology for cancer. This has been a topic that we've been struggling with for decades. And now that everyone is paying attention to the COVID-19 virus and development of a vaccine to prevent the infection or make the severity less for those who eventually get infected, I think we also need to bring that focus back to what viruses have done as etiology for different types of cancer--from either neck cancer to cervical cancer to liver cancer. And bringing this session together which speaks to how viral infection could be a key driver of the geographical differences in incidence of cancer around the world, I think will be very important for ASCO members and the general audience attending the meeting. ASCO Daily News: Absolutely, well you spoke about the pandemic and of course today health care inequality is more relevant than ever. As you say, the pandemic has disproportionately affected people of color, so clearly changes must occur if the oncology field if it is to make strides in improving outcomes for patients of color, increasing representation in clinical trials, for example, improving access to precision medicine and more. So what do you hope that people will take away from this meeting, that will stay with them in the months and years ahead? Dr. Taofeek Owonikoko: Yeah, I'm very hopeful that at the end of the Annual Meeting, with all the offerings we have in terms of educational sessions and topical issues that we want to address and some of them very provocative, we will learn that we have to be honest and open. Some of these issues are not easy to discuss, but we have to confront them if we are going to get past that, and not just brush them aside but actually have genuine discussion and be open about what the challenges are. I think that, when we look at the impact of cancer care delivery and the disparate outcomes that we see across different minority communities, including people of color, this doesn't just start from where you're delivering care, it also has to do with how we actually develop treatments that are given to patients. And nothing brings that to the surface [more] than what we've observed in terms of participation of people of color in cancer clinical trials. I know that this is a vaccine issue it's not something that I just started today, but we have to then become more systematic as to how we address it. If we are going to develop drugs that are going to be applicable to all populations, we have to be intentional in making sure that we have equitable and fair representation of all people, and that the treatment would be applicable too, so that we can start learning right from the beginning of the earliest stages of drug development. Whether there are unique differences in the way these drugs work, whether there are cultural influences that would determine whether or not the way we want to administer the drug is going to have any impact. And I want to use this to highlight one session that we have put together that's going to talk about minority patient enrollment in clinical trials. This session is not about the problem. We all recognize what the problem is. This is actually a session that is meant to show potential solutions, where we invited experienced investigators in this area to talk about gaps in how we conduct clinical trials, and what can be done to improve that process. They will talk about communications and blind-spots that we as oncologists and investigators may not even be aware of when we talk about clinical trials and we want someone to participate--what are the things that we can do to make sure that we convey the information about this study in a culturally appropriate manner, so that our own attitude of presenting the trial does not alienate and discourage participation from people of color and other minority groups? And then, there will be a talk about a real world experience of a large trial where key factors led to success in recruiting people of color on a large randomized phase III trial of prostate cancer that will be shown and shared with the audience. And people can take this back home to their individual practices and countries to see whether or not some of these strategies will also be applicable to them to help get around this problem of poor enrollment of minority patients in cancer clinical trials. ASCO Daily News: Thank you, Dr. Owonikoko, for highlighting some of these important issues on minority enrollment in cancer clinical trials, intersectionality, and cancer care, the management of DNA virus associated cancers, and the always popular ASCO voices session, which this year will use the power of the narrative to advocate for equity in cancer care. Dr. Owonikoko, thank you again for taking the time to speak with me today. Dr. Taofeek Owonikoko: Thank you. ASCO Daily News: And thank you to our listeners for joining us as well. If you're enjoying the content on the podcast, please take a moment to rate, and review us wherever you get your podcasts.   Disclosures: Dr. Taofeek Owonikoko Stock and Other Ownership Interests: Cambium Oncology Consulting or Advisory Role: Novartis, Celgene, Abbvie, Eisai, G1 Therapeutics, Takeda, Bristol-Myers Squibb, MedImmune, BerGenBio, Lilly, Amgen, AstraZeneca, PharmaMar, Boehringer Ingelheim, EMD Serono, Xcovery, Bayer, Merck, Jazz Pharmaceuticals, Zentalis, Wells Fargo, Ipsen, Eisai, Roche/Genentech, Janssen Speakers' Bureau: Abbvie Research Funding (Institution): Novartis, Astellas Pharma, Bayer, Regeneron, AstraZeneca/MedImmune, Abbvie, G1 Therapeutics, Bristol-Myers Squibb, Corvus Pharmaceuticals, United Therapeutics, Amgen, Loxo/Lilly, Fujifilm, Pfizer, Aeglea Biotherapeutics, Incyte, Merck, Oncorus, Ipsen, GlaxoSmithKline, Calithera Biosciences, Eisai, WindMIL, Turning Point Therapeutics, Roche/Genentech, Mersana, Meryx, Boehringer Ingelheim Patents, Royalties, Other Intellectual Property (Institution): OVERCOMING ACQUIRED RESISTANCE TO CHEMOTHERAPY TREATMENTS THROUGH SUPPRESSION OF STAT3, SELECTIVE CHEMOTHERAPY TREATMENTS AND DIAGNOSTIC METHODS RELATED THERETO, DR4 Modulation and its Implications in EGFR-Target Cancer Therapy Ref:18089 PROV (CSP) United States Patent Application No. 62/670,210 June 26, 2018 (Co-Inventor), Soluble FAS ligand as a biomarker of recurrence in thyroid cancer; provisional patent 61/727,519 (Inventor) Other Relationship: Roche/Genentech, EMD Serono Uncompensated Relationships: Reflexion Medical Disclaimer: The purpose of this podcast, is to educate and to inform. This is not a substitute for professional medical care, and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

Host: Jacob Sands, MD Guest: Taofeek K. Owonikoko, MD, PhD, MSCR After years without new approvals, advancements in small cell lung cancer are at the forefront of oncology. But what do these therapeutic developments mean for the field? Dr. Taofeek Owonikoko, professor and vice-chair for faculty development in the Department of Hematology and Medical Oncology at Emory University School of Medicine, joins Dr. Jacob Sands to talk about long-awaited developments in small cell lung cancer.

Host: Jacob Sands, MD Guest: Taofeek K. Owonikoko, MD, PhD, MSCR After years without new approvals, advancements in small cell lung cancer are at the forefront of oncology. But what do these therapeutic developments mean for the field? Dr. Taofeek Owonikoko, professor and vice-chair for faculty development in the Department of Hematology and Medical Oncology at Emory University School of Medicine, joins Dr. Jacob Sands to talk about long-awaited developments in small cell lung cancer.

Dr. Taofeek Owonikoko of Winship Cancer Institute at Emory University speaks with Dr. Jack West about his decision to retrain in oncology, the draw he felt to thoracic oncology and small cell lung cancer, & a few cultural challenges he felt along the way.

Host Jack West speaks with Dr. Taofeek Owonikoko of Emory University, who traces his childhood & medical training in Nigeria as a pathologist, followed by a move to Düsseldorf, Germany before settling in the US & re-training in oncology.

Janet Daily-Freeman moderates a question & answer session with Drs. Leora Horn and Taofeek Owonikoko on issues of acquired resistance to targeted therapies for ALK+ and ROS1 patients.

Janet Daily-Freeman moderates a question & answer session with Drs. Leora Horn and Taofeek Owonikoko on issues of acquired resistance to targeted therapies for ALK+ and ROS1 patients.

Janet Daily-Freeman moderates a question & answer session with Drs. Leora Horn and Taofeek Owonikoko on issues of acquired resistance to targeted therapies for ALK+ and ROS1 patients.

Dr. West moderates a question & answer session with Drs. Karen Reckamp and Taofeek Owonikoko on issues of acquired resistance to targeted therapies for patients with advanced NSCLC that harbors a driver mutation.

Dr. West moderates a question & answer session with Drs. Karen Reckamp and Taofeek Owonikoko on issues of acquired resistance to targeted therapies for patients with advanced NSCLC that harbors a driver mutation.

Dr. West moderates a question & answer session with Drs. Karen Reckamp and Taofeek Owonikoko on issues of acquired resistance to targeted therapies for patients with advanced NSCLC that harbors a driver mutation.

Dr. Taofeek Owonikoko reviews why we often see brain metastases develop as a first or only site of progression in patients with NSCLC and a driver mutation.

Dr. Taofeek Owonikoko reviews why we often see brain metastases develop as a first or only site of progression in patients with NSCLC and a driver mutation.

Dr. Taofeek Owonikoko reviews why we often see brain metastases develop as a first or only site of progression in patients with NSCLC and a driver mutation.

Does it make sense to do molecular testing on early stage lung cancer patients? Dr. Taofeek Owonikoko of Emory University School of Medicine and the Winship Cancer Institute thinks it does in some settings. February 2014

Does it make sense to do molecular testing on early stage lung cancer patients? Dr. Taofeek Owonikoko of Emory University School of Medicine and the Winship Cancer Institute thinks it does in some settings. February 2014

Does it make sense to do molecular testing on early stage lung cancer patients? Dr. Taofeek Owonikoko of Emory University School of Medicine and the Winship Cancer Institute thinks it does in some settings. February 2014

Research into small cell lung cancer may soon pay off in new treatments. Dr. Taofeek Owonikoko of Emory University School of Medicine and the Winship Cancer Institute discusses new approaches that hold great promise. February 2014

Research into small cell lung cancer may soon pay off in new treatments. Dr. Taofeek Owonikoko of Emory University School of Medicine and the Winship Cancer Institute discusses new approaches that hold great promise. February 2014

Research into small cell lung cancer may soon pay off in new treatments. Dr. Taofeek Owonikoko of Emory University School of Medicine and the Winship Cancer Institute discusses new approaches that hold great promise. February 2014