Podcasts about tkis

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Best podcasts about tkis

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Latest podcast episodes about tkis

The Fellow on Call
Episode 035: Lung Cancer Series, Pt. 12: NSCLC Capstone with Dr. Jack West (Con't)

The Fellow on Call

Play Episode Listen Later Oct 26, 2022


We strongly recommend you listen to our previous episodes metastatic lung cancer (Episodes 0032 and 0033) to better be able to follow along with this conversation. Key trials mentioned in this episode include:CHECKMATE 227KEYNOTE 024Q:Do you send molecular testing (PDL1 and NGS) on the biopsy, peripheral blood or both?* Yield is highest from the tissue sample* Peripheral blood (circulating DNA) samples are dependent on the burden of disease and so often the yield is lower ** One of the benefits is that it can be sent quickly and having a fast turn-around; Tissue samples are dependent on being able to schedule a biopsy* Dr. West says he definitely sends this on a non-smoker with non-squamous lung cancer, as they are more likely to have molecular targets* Dr. West has not personally adopted the idea of sending peripheral and tissue samples for NGS testing for everyoneQ: Do you ever use Ipi/Nivo in patients with PDL1

CURE Talks Cancer
S5 Ep6: Patient With Lung Cancer ‘Stays One Step Ahead' of His Rare Mutation

CURE Talks Cancer

Play Episode Listen Later Oct 20, 2022 26:27


Jeffery Battles, a 53-year-old with stage 4 lung cancer, says that he feels lucky for having a rare genetic mutation. The father of three from Connie Lake, Pennsylvania, wasn't expecting lung cancer to become part of his life. Even when he started experiencing chest pains in February 2021, Battles originally dismissed the pains as lingering symptoms from an earlier case of COVID-19. Once he finally saw his doctor, he was diagnosed with non-small cell lung cancer, the most common type of lung cancer. He then immediately underwent genetic testing, which revealed that Battles had an EGFR exon 20 insertion mutation — information his doctors used to modify his cancer treatment.  EGFR exon 20 insertion mutation is a mutation in the cells that increases the growth of the epidermal growth factor receptor (EGFR), a protein on cells that helps cancer cells grow. Of note, cancers with an EGFR exon 20 insertion mutation doesn't respond to tyrosine kinase inhibitors (TKIs), the typical treatment for EGFR-positive lung cancer. In today's episode of “Cancer Horizons,” Battles describes how he feels fortunate to know the status of his mutation, and how it helped him be proactive with his cancer treatment, finding support from his family and online communities.

The Fellow on Call
Episode 033: Lung Cancer Series, Pt. 10: Metastatic NSCLC with driver mutations

The Fellow on Call

Play Episode Listen Later Oct 12, 2022


Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. This week, we continue our discussion on metastatic non-small cell lung cancer, focusing on NSCLC with driver mutations. * The approach to treatment of a patient with widespread metastatic NSCLC (mNSCLC) is very different than a patient without distant disease, which highlights why we do what we do:- Important to complete staging (discussed in prior episodes) to determine the extent of disease- Important to check molecular testing (looking for mutations in the cancer cells) and IHC for tumor proportion score (TPS) helps determine treatment options - If your molecular testing is identified in a driver mutation gene, there are targeted options for this! *Driver mutations are predictive of response to an oral therapy and a LACK of response to immune therapy (particularly in EGFR and ALK mutated patients) * EGFR Mutation:- Pay attention to the types of mutation in EGFR (not all are the same):-- Exon 19 deletion -- Exon 19 L858R-- Exon 21 T790M-- Exon 20 Insertion (Osimertinib [see below] cannot be used for this mutation)- Osimertinib is first-line standard of care for patients with EGFR-- Used to be a second-line agent. Many patients with EGFR mutations receiving earlier generation TKIs would develop resistance and when these tumors were sequenced, they would have Exon 21 T790M mutations. Osimertinib was effective even with this mutation and had superior overall survival data compared to chemotherapy (AURA3 Trial)--Now it is used in first-line setting for patients with EGFR mutation based on the FLAURA trial --- In this study, patients received osimertinib as first line vs. older generation EGFR-targeting TKIs (erlotinib or gefitib) and Osimertinib had better outcomes: ---- Showed that the median OS was 38.6 months with Osi vs. 31.8 months; also improved brain penetration! ---- Also effective in patients with metastatic disease to the brain: ----- Only 6% of patients had CNS progression with Osi vs. 15% with others- What if a patient is on Osi and later develops new brain mets?-- If there is progression within just the brain (and good control in other sites of the body) you can refer patient to Radiation Oncology for SRS-- Remember, based on discussion with Dr. Osmundson in our RadOnc lectures (Episode 028), it is important to HOLD Osimertinib if patient is going to get radiation to minimize the side effects- What is patient had progression of disease in several sites throughout the body?-- Management is less straightforward. -- In many of these cases, you can consider:--- Consolidative radiation - If small amounts of disease--- Changing therapy - If there has been widespread progression; likely would change to chemotherapy (without IO, since lower predictive response to IO with EGFR mutation)---- No clear guidelines if you should continue the TKI---- Remember that IO + TKIs can cause increased risk of side effects, such as pneumonitis and hepatitis. DO NOT DO THIS!* ALK Mutation:- There are many options for ALK mutations-- The first generation drug is crizotinib--- Lots of side effects —> “It is crazy to start with crizotinib”--- Studies for later generation TKIs were compared to crizotinib -- Many people today will use third generation ALK-inhibitor alectinib (Important trials: ALEX Trial and J-ALEX Trial)--- With alectinib, PFS 34.8 months, RR 83%, less CNS progression (12% vs 45%)--- 5 year OS rate 62.5%- What to do with disease progression while on ALK inhibitor?-- In ALK, you can actually switch to another ALK inhibitor and many will respond well--- Of course, with each change, you may expect not as great of a response * Lots of other mutations!- TFOC recommends just looking these up!-- Link to NCCN Guidelines on NSCLC; Page 41 has full list!- Another way to think about this, when do we NOT do TKIs as first line: -- KRAS G12C-- EGFR Exon 20 Insertion-- HER2- How do you counsel a patient when considering/starting a TKI? -- Patients with highest chance of having a targeted mutation are younger non-smokers with adenocarcinoma-- Set expectations: great outcomes overall, but still not a cure. -- Remembering the drugs: All TKIs usually end in “-nib” -- In general, the way we recommend remembering this: “Fatigue, GI, Derm (skin/nail changes)”; rarely pneumonitis References:* AURA3 Trial - https://www.nejm.org/doi/full/10.1056/NEJMoa1612674Established osimertinib was better than chemo for patients with EGFR mutation and acquired Exon 21 T790M resistance mutation* FLAURA Trial - https://www.nejm.org/doi/full/10.1056/nejmoa1713137 Established osimertinib as first-line agent for patients with EGFR mutation * ALEX Trial - https://www.nejm.org/doi/full/10.1056/nejmoa1704795Helped establish alectinib as superior for ALK mutations compared to crizotinib * J-ALEX Trial - https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30565-2/fulltextHelped establish alectinib as superior for ALK mutations compared to crizotinib * NCCN Guidelines on NSCLC - https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1450 Please visit our website (TheFellowOnCall.com) for more information Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google PodcastLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!

OncLive® On Air
S7 Ep34: Shepard Discusses Symptoms, Management, and Future Directions in Desmoid Tumors

OncLive® On Air

Play Episode Listen Later Sep 29, 2022 20:18


Dr Shepard discusses the unpredictable course of desmoid tumors, the use of TKIs for these tumors, and findings from 2 trials presented at the 2022 ESMO Congress that may represent new treatment options for patients with desmoid tumors.

OncoPharm
Biliary Tract Cancer & Pemigatinib (unrelated) Updates

OncoPharm

Play Episode Listen Later Sep 9, 2022 15:56


Updates on billiary track cancer - a role for durvalumab? And pemigatinib - an approval in r/r myeloid/lymphoid neoplasms. Plus, an oral suspension of ibrutinib is approved and more evidence ICI combination should be given early in BRAF-mutated metastatic melanoma (rather than waiting until disease progression on TKIs)

The Fellow on Call
Episode 028: Lung Cancer Series, Pt. 6: Radiation Oncology in the Treatment of Lung Cancer

The Fellow on Call

Play Episode Listen Later Sep 7, 2022


Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. An important component of treatment in lung cancer (and many other cancers) is the use of radiation. This week, we continue our discussion about the fundamentals of Radiation Oncology with our guest, Dr. Evan Osmundson. *We hear the terms “hypo-fractioned” and “hyper-fractionated” radiation. What do those mean?- Fractionation, that is breaking up the total dose of radiation into smaller ones, has allowed patients to tolerate the radiation better. The repeat exposure allows the healthy tissue to repair, whereas the tumor is not able to heal as well- Standard fractionation involves keeping the maximum dose per session at 1.8-2Gy/fraction. - Hyper-fractionation is when a patient gets multiple doses per day, each less than 2Gy. This is important in small cell lung cancer, where the standard dose of radiation is 1.5Gy twice daily- Hypo-fractionation os when larger doses are given in each session, typically larger than 2.5-3Gy, often 4-5Gy per fraction. This is analogous to SBRT. *With regards to SBRT, how do you determine the number of sessions? - Typically 3-5 sessions, and this is based on data run through their computer algorithm that allows the dose to be tumoricidal. - More sessions (more likely 5 sessions) if central tumor (

PeerView Internal Medicine CME/CNE/CPE Video Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Internal Medicine CME/CNE/CPE Video Podcast

Play Episode Listen Later Aug 25, 2022 65:17


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

PeerView Gastroenterology CME/CNE/CPE Audio Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Gastroenterology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Aug 25, 2022 64:59


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

PeerView Gastroenterology CME/CNE/CPE Video Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Gastroenterology CME/CNE/CPE Video Podcast

Play Episode Listen Later Aug 25, 2022 65:17


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

PeerView Heart, Lung & Blood CME/CNE/CPE Audio Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Heart, Lung & Blood CME/CNE/CPE Audio Podcast

Play Episode Listen Later Aug 25, 2022 64:59


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast

Play Episode Listen Later Aug 25, 2022 65:17


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

PeerView Internal Medicine CME/CNE/CPE Audio Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Internal Medicine CME/CNE/CPE Audio Podcast

Play Episode Listen Later Aug 25, 2022 64:59


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

PeerView Kidney & Genitourinary Diseases CME/CNE/CPE Video Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Kidney & Genitourinary Diseases CME/CNE/CPE Video Podcast

Play Episode Listen Later Aug 25, 2022 65:17


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

PeerView Kidney & Genitourinary Diseases CME/CNE/CPE Audio Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Kidney & Genitourinary Diseases CME/CNE/CPE Audio Podcast

Play Episode Listen Later Aug 25, 2022 64:59


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

PeerView Neuroscience & Psychiatry CME/CNE/CPE Audio Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Neuroscience & Psychiatry CME/CNE/CPE Audio Podcast

Play Episode Listen Later Aug 25, 2022 64:59


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

PeerView Neuroscience & Psychiatry CME/CNE/CPE Video Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Neuroscience & Psychiatry CME/CNE/CPE Video Podcast

Play Episode Listen Later Aug 25, 2022 65:17


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

PeerView Oncology & Hematology CME/CNE/CPE Audio Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Oncology & Hematology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Aug 25, 2022 64:59


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

PeerView Oncology & Hematology CME/CNE/CPE Video Podcast
Alexander Drilon, MD - Uncovering Gene Fusions and Other Key Genomic Alterations in Lung, Thyroid, Colon, Breast, and Other Solid Tumors to Enable All Patients to Gain the Full Benefits of Targeted Treatment

PeerView Oncology & Hematology CME/CNE/CPE Video Podcast

Play Episode Listen Later Aug 25, 2022 65:17


Go online to PeerView.com/PUE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Gene fusions and other key alterations (NTRK, RET, and others) represent actionable targets in a substantial proportion of patients with solid tumors. Appropriate biomarker testing is crucial to identify all alterations that are treatable with current or investigational targeted therapies. Multikinase tyrosine kinase inhibitors (TKIs) have been used to treat such alterations, but they have limited efficacy. Therefore, next-generation TKIs with greater selectivity have been developed and approved for tumor-agnostic indications (such as NTRK alterations) and for specific tumor types (such as RET alterations in lung and thyroid cancers). These newer therapies have demonstrated impressive efficacy with favorable safety profiles, and their use can significantly improve patient outcomes and quality of life. The tumor-agnostic indications are anticipated to expand further, and novel options are also emerging for patients who have developed resistance to standard RET- and TRK-targeted therapies. In this PeerView educational offering, experts on gene fusion-positive solid tumors provide a cutting-edge update on the role and relevance of gene fusions and other key alterations in solid tumors. These KOLs offer guidance on how to best identify patients with gene alterations and discuss accumulating clinical evidence for the best use of targeted therapies, while also providing practical guidance for optimizing multidisciplinary and interprofessional strategies for biomarker testing and use of targeted therapy across solid tumors harboring NTRK and RET fusions and other actionable alterations. Upon completion of this activity, participants should be better able to: Describe the role of NTRK, RET, ALK, and other key genomic alterations in the oncogenesis of solid tumors, the importance of appropriate biomarker testing to identify patients with these alterations, and clinical evidence supporting the use of matched targeted therapies to optimize patient outcomes; Collaborate with the broader cancer care team to identify patients for biomarker testing, select appropriate tests to capture all relevant genomic alterations, including gene fusions, and interpret testing results to guide treatment selection; Apply the latest evidence and guidelines to individualize targeted therapy for patients with cancers harboring NTRK, RET, ALK, and other targetable genomic alterations; and Educate patients about the role of biomarker testing, risks and benefits of targeted therapies, and importance of selecting optimal therapy based on biomarker testing results and patient needs, values, and preferences.

CCO Oncology Podcast
Experts Discuss Challenges in Advanced Hepatocellular Carcinoma Management

CCO Oncology Podcast

Play Episode Listen Later Aug 22, 2022 26:12


In this podcast episode from Clinical Care Options (CCO), Heinz-Josef Klumpen, MD, PhD, and Chris Verslype, MD, PhD, discuss challenges in selecting and sequencing therapy for patients with advanced hepatocellular carcinoma. Topics include:Factors to consider before selecting frontline immunotherapyRole of TKIs in the frontlineImpact of Child-Pugh status on the efficacy of immunotherapy/VEGF inhibitor combination therapyReal-world evidence on frontline immunotherapy/VEGF combination therapyFactors to consider when selecting second-line therapy including the role of TKIs and planning for multiple lines of therapyPresenters:Heinz-Josef Klumpen, MD, PhDStaff Specialist, Medical OncologistDepartment of Medical OncologyAmsterdam UMCAmsterdam, The NetherlandsChris Verslype, MD, PhDProfessorClinical Digestive OncologyKULeuvenHead of ClinicHepatologyDigestive OncologyU.Z. LeuvenLeuven, Belgium

OBR Peer-Spectives
Kidney Cancer at a Crossroads: What New Trial Results Could Mean for Patients

OBR Peer-Spectives

Play Episode Listen Later Aug 19, 2022 13:19


Michael B. Atkins, MD, and Robert Figlin, MD, discuss results from the EVEREST clinical trial as well as new data on TKIs, immunotherapy, and HIF-2 inhibitors. They also discuss adjuvant therapy and how depth of response differs between immunotherapy and TKIs, and look ahead to what the future holds.

Oncotarget
Press Release: Kinase Activity in RCC, Renal Tissue and in Response to TKI

Oncotarget

Play Episode Listen Later Aug 17, 2022 4:12


A new research paper was published in Oncotarget on August 4, 2022, entitled, “Kinase activity profiling in renal cell carcinoma, benign renal tissue and in response to four different tyrosine kinase inhibitors.” Kinase activity is frequently altered in renal cell carcinoma (RCC), and tyrosine kinase inhibitors (TKIs) are part of the standard treatment strategy in patients with metastatic disease. However, there are still no established biomarkers to predict clinical benefits of a specific TKI. “Despite a number of new treatment options improving RCC patients' disease control rates and survival, the lack of useful biomarkers remains a major clinical concern.” In the current study, researchers Andliena Tahiri, Katarina Puco, Faris Naji, Vessela N. Kristensen, Glenny Cecilie Alfsen, Lorant Farkas, Frode S. Nilsen, Stig Müller, Jan Oldenburg, and Jürgen Geisler, from University of Oslo, Oslo University Hospital, Akershus University Hospital, and Pamgene International BV, performed protein tyrosine kinase (PTK) profiling using PamChip® technology. “The aim of this study was to identify differences in PTK activity between normal and malignant kidney tissue obtained from the same patient, and to investigate the inhibitory effects of TKIs frequently used in the clinics: sunitinib, pazopanib, cabozantinib and tivozanib.” The results showed that 36 kinase substrates differ (FDR < 0.05) between normal and cancer kidney tissue, where members of the Src family kinases and the phosphoinositide-3-kinase (PI3K) pathway exhibit high activity in renal cancer. Furthermore, ex vivo treatment of clear cell RCC with TKIs revealed that pathways such as Rap1, Ras and PI3K pathways were strongly inhibited, whereas the neurotrophin pathway had increased activity upon TKI addition. Their assay showed that tivozanib and cabozantinib exhibited greater inhibitory effects on PTK activity compared to sunitinib and pazopanib, implying they might be better suitable as TKIs for selected RCC patients. “The results of our study contribute to better understanding of the changes in kinase activity in RCC tumor cells involved in fundamental oncogenic cellular processes and the ex vivo effect of TKIs. We found tivozanib and cabozantinib to be more potent TKIs in RCC samples than sunitinib or pazopanib. The next step will be to correlate the efficacy and toxicity in individual patients with their respective kinase activity of normal and malignant kidney tissue.” DOI: https://doi.org/10.18632/oncotarget.28257 Correspondence to: Jürgen Geisler – Email: juergen.geisler@medisin.uio.no Keywords: kidney cancer, kinase activity, tyrosine kinase inhibitors, renal cell carcinoma, tyrosine kinase About Oncotarget: Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. To learn more about Oncotarget, visit Oncotarget.com and connect with us on social media: Twitter – https://twitter.com/Oncotarget Facebook – https://www.facebook.com/Oncotarget YouTube – www.youtube.com/c/OncotargetYouTube Instagram – https://www.instagram.com/oncotargetjrnl/ LinkedIn – https://www.linkedin.com/company/oncotarget/ Pinterest – https://www.pinterest.com/oncotarget/ LabTube – https://www.labtube.tv/channel/MTY5OA SoundCloud – https://soundcloud.com/oncotarget For media inquiries, please contact: media@impactjournals.com.

Research To Practice | Oncology Videos
Chronic Myeloid Leukemia | Meet The Professor: Optimizing the Management of Chronic Myeloid Leukemia — Part 2

Research To Practice | Oncology Videos

Play Episode Listen Later Aug 4, 2022 60:52


Featuring perspectives from Dr Daniel DeAngelo, including the following topics: Introduction: Perspectives on chronic myeloid leukemia (CML) (0:00) Asciminib — ASC4FIRST study (8:33) Case: A woman in her early 60s with a PMH of Stage IA hormone receptor-positive breast cancer on adjuvant tamoxifen with newly diagnosed CML — Michael R Grunwald, MD (22:38) Case: A man in his mid 40s with low-risk CML who achieves MR4 on imatinib but loses molecular response 3 months after discontinuing therapy — Shams Bufalino, MD (27:23) Case: A man in his early 40s with CML on dasatinib who does not achieve treatment milestone (MR3) at 18 months but does at 24 months — Dr Grunwald (33:19) Case: A man in his early 80s with CML who initially receives imatinib followed by nilotinib develops CHF and has a BCR-ABL of 0.8% (IS) — Namrata I Peswani, MD (37:33) Case: A woman in her late 20s with CML that is resistant to multiple TKIs and therapy compliance concerns — Minesh Dinubhai Patel, MD (40:44) Case: A woman in her early 40s who initially receives dasatinib for chronic-phase CML with a good response but then develops lymphoid blast crisis — Dr Grunwald (52:17) Case: A woman in her mid 70s with CML who achieves MMR on nilotinib but then develops peripheral arterial occlusion after 9 years on therapy — Dr Grunwald (58:10) CME information and select publications

PeerView Oncology & Hematology CME/CNE/CPE Audio Podcast
Luke Maese, DO - Applying Therapeutic Innovations Against ALL: From Updated Evidence to Everyday Practice

PeerView Oncology & Hematology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Jul 22, 2022 25:36


Go online to PeerView.com/DGJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you up to date on recent evidence on acute lymphoblastic leukemia (ALL) emerging from major scientific congresses? In this activity, an ALL specialist explores recent evidence presented at the 2022 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) annual meetings on developments in various treatment modalities for ALL. Watch this video to hear about the latest evidence and practical applications in asparaginase use in chemotherapy protocols, including important dosing and safety data on recombinant Erwinia; get updated on longer-term outcomes with CAR-T therapy in adult and pediatric patients and hear practical considerations when using CAR-T options; and learn about emerging chemo-sparing TKI plus bispecific combinations in Ph-positive ALL. Upon completion of this activity, participants should be better able to: Summarize new evidence on multi-faceted strategies for ALL management based on modern chemotherapy protocols, antibody-based approaches, cellular therapy, and TKIs; Cite evidence supporting the use of novel asparaginase compounds for ALL in the context of asparaginase toxicity/hypersensitivity, including in pediatric, AYA, and adult populations; and Apply new science to the team-based management of ALL, including when managing asparaginase hypersensitivity or toxicity, developing TKI-based protocols in Ph-positive disease, or when utilizing novel immunotherapy-based approaches in patient care.

PeerView Oncology & Hematology CME/CNE/CPE Video Podcast
Luke Maese, DO - Applying Therapeutic Innovations Against ALL: From Updated Evidence to Everyday Practice

PeerView Oncology & Hematology CME/CNE/CPE Video Podcast

Play Episode Listen Later Jul 22, 2022 25:38


Go online to PeerView.com/DGJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you up to date on recent evidence on acute lymphoblastic leukemia (ALL) emerging from major scientific congresses? In this activity, an ALL specialist explores recent evidence presented at the 2022 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) annual meetings on developments in various treatment modalities for ALL. Watch this video to hear about the latest evidence and practical applications in asparaginase use in chemotherapy protocols, including important dosing and safety data on recombinant Erwinia; get updated on longer-term outcomes with CAR-T therapy in adult and pediatric patients and hear practical considerations when using CAR-T options; and learn about emerging chemo-sparing TKI plus bispecific combinations in Ph-positive ALL. Upon completion of this activity, participants should be better able to: Summarize new evidence on multi-faceted strategies for ALL management based on modern chemotherapy protocols, antibody-based approaches, cellular therapy, and TKIs; Cite evidence supporting the use of novel asparaginase compounds for ALL in the context of asparaginase toxicity/hypersensitivity, including in pediatric, AYA, and adult populations; and Apply new science to the team-based management of ALL, including when managing asparaginase hypersensitivity or toxicity, developing TKI-based protocols in Ph-positive disease, or when utilizing novel immunotherapy-based approaches in patient care.

PeerView Internal Medicine CME/CNE/CPE Video Podcast
Luke Maese, DO - Applying Therapeutic Innovations Against ALL: From Updated Evidence to Everyday Practice

PeerView Internal Medicine CME/CNE/CPE Video Podcast

Play Episode Listen Later Jul 22, 2022 25:38


Go online to PeerView.com/DGJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you up to date on recent evidence on acute lymphoblastic leukemia (ALL) emerging from major scientific congresses? In this activity, an ALL specialist explores recent evidence presented at the 2022 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) annual meetings on developments in various treatment modalities for ALL. Watch this video to hear about the latest evidence and practical applications in asparaginase use in chemotherapy protocols, including important dosing and safety data on recombinant Erwinia; get updated on longer-term outcomes with CAR-T therapy in adult and pediatric patients and hear practical considerations when using CAR-T options; and learn about emerging chemo-sparing TKI plus bispecific combinations in Ph-positive ALL. Upon completion of this activity, participants should be better able to: Summarize new evidence on multi-faceted strategies for ALL management based on modern chemotherapy protocols, antibody-based approaches, cellular therapy, and TKIs; Cite evidence supporting the use of novel asparaginase compounds for ALL in the context of asparaginase toxicity/hypersensitivity, including in pediatric, AYA, and adult populations; and Apply new science to the team-based management of ALL, including when managing asparaginase hypersensitivity or toxicity, developing TKI-based protocols in Ph-positive disease, or when utilizing novel immunotherapy-based approaches in patient care.

PeerView Internal Medicine CME/CNE/CPE Audio Podcast
Luke Maese, DO - Applying Therapeutic Innovations Against ALL: From Updated Evidence to Everyday Practice

PeerView Internal Medicine CME/CNE/CPE Audio Podcast

Play Episode Listen Later Jul 22, 2022 25:36


Go online to PeerView.com/DGJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you up to date on recent evidence on acute lymphoblastic leukemia (ALL) emerging from major scientific congresses? In this activity, an ALL specialist explores recent evidence presented at the 2022 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) annual meetings on developments in various treatment modalities for ALL. Watch this video to hear about the latest evidence and practical applications in asparaginase use in chemotherapy protocols, including important dosing and safety data on recombinant Erwinia; get updated on longer-term outcomes with CAR-T therapy in adult and pediatric patients and hear practical considerations when using CAR-T options; and learn about emerging chemo-sparing TKI plus bispecific combinations in Ph-positive ALL. Upon completion of this activity, participants should be better able to: Summarize new evidence on multi-faceted strategies for ALL management based on modern chemotherapy protocols, antibody-based approaches, cellular therapy, and TKIs; Cite evidence supporting the use of novel asparaginase compounds for ALL in the context of asparaginase toxicity/hypersensitivity, including in pediatric, AYA, and adult populations; and Apply new science to the team-based management of ALL, including when managing asparaginase hypersensitivity or toxicity, developing TKI-based protocols in Ph-positive disease, or when utilizing novel immunotherapy-based approaches in patient care.

PeerView Immunology & Transplantation CME/CNE/CPE Audio Podcast
Luke Maese, DO - Applying Therapeutic Innovations Against ALL: From Updated Evidence to Everyday Practice

PeerView Immunology & Transplantation CME/CNE/CPE Audio Podcast

Play Episode Listen Later Jul 22, 2022 25:36


Go online to PeerView.com/DGJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you up to date on recent evidence on acute lymphoblastic leukemia (ALL) emerging from major scientific congresses? In this activity, an ALL specialist explores recent evidence presented at the 2022 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) annual meetings on developments in various treatment modalities for ALL. Watch this video to hear about the latest evidence and practical applications in asparaginase use in chemotherapy protocols, including important dosing and safety data on recombinant Erwinia; get updated on longer-term outcomes with CAR-T therapy in adult and pediatric patients and hear practical considerations when using CAR-T options; and learn about emerging chemo-sparing TKI plus bispecific combinations in Ph-positive ALL. Upon completion of this activity, participants should be better able to: Summarize new evidence on multi-faceted strategies for ALL management based on modern chemotherapy protocols, antibody-based approaches, cellular therapy, and TKIs; Cite evidence supporting the use of novel asparaginase compounds for ALL in the context of asparaginase toxicity/hypersensitivity, including in pediatric, AYA, and adult populations; and Apply new science to the team-based management of ALL, including when managing asparaginase hypersensitivity or toxicity, developing TKI-based protocols in Ph-positive disease, or when utilizing novel immunotherapy-based approaches in patient care.

PeerView Heart, Lung & Blood CME/CNE/CPE Audio Podcast
Luke Maese, DO - Applying Therapeutic Innovations Against ALL: From Updated Evidence to Everyday Practice

PeerView Heart, Lung & Blood CME/CNE/CPE Audio Podcast

Play Episode Listen Later Jul 22, 2022 25:36


Go online to PeerView.com/DGJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you up to date on recent evidence on acute lymphoblastic leukemia (ALL) emerging from major scientific congresses? In this activity, an ALL specialist explores recent evidence presented at the 2022 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) annual meetings on developments in various treatment modalities for ALL. Watch this video to hear about the latest evidence and practical applications in asparaginase use in chemotherapy protocols, including important dosing and safety data on recombinant Erwinia; get updated on longer-term outcomes with CAR-T therapy in adult and pediatric patients and hear practical considerations when using CAR-T options; and learn about emerging chemo-sparing TKI plus bispecific combinations in Ph-positive ALL. Upon completion of this activity, participants should be better able to: Summarize new evidence on multi-faceted strategies for ALL management based on modern chemotherapy protocols, antibody-based approaches, cellular therapy, and TKIs; Cite evidence supporting the use of novel asparaginase compounds for ALL in the context of asparaginase toxicity/hypersensitivity, including in pediatric, AYA, and adult populations; and Apply new science to the team-based management of ALL, including when managing asparaginase hypersensitivity or toxicity, developing TKI-based protocols in Ph-positive disease, or when utilizing novel immunotherapy-based approaches in patient care.

PeerView Family Medicine & General Practice CME/CNE/CPE Audio Podcast
Luke Maese, DO - Applying Therapeutic Innovations Against ALL: From Updated Evidence to Everyday Practice

PeerView Family Medicine & General Practice CME/CNE/CPE Audio Podcast

Play Episode Listen Later Jul 22, 2022 25:36


Go online to PeerView.com/DGJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you up to date on recent evidence on acute lymphoblastic leukemia (ALL) emerging from major scientific congresses? In this activity, an ALL specialist explores recent evidence presented at the 2022 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) annual meetings on developments in various treatment modalities for ALL. Watch this video to hear about the latest evidence and practical applications in asparaginase use in chemotherapy protocols, including important dosing and safety data on recombinant Erwinia; get updated on longer-term outcomes with CAR-T therapy in adult and pediatric patients and hear practical considerations when using CAR-T options; and learn about emerging chemo-sparing TKI plus bispecific combinations in Ph-positive ALL. Upon completion of this activity, participants should be better able to: Summarize new evidence on multi-faceted strategies for ALL management based on modern chemotherapy protocols, antibody-based approaches, cellular therapy, and TKIs; Cite evidence supporting the use of novel asparaginase compounds for ALL in the context of asparaginase toxicity/hypersensitivity, including in pediatric, AYA, and adult populations; and Apply new science to the team-based management of ALL, including when managing asparaginase hypersensitivity or toxicity, developing TKI-based protocols in Ph-positive disease, or when utilizing novel immunotherapy-based approaches in patient care.

PeerView Clinical Pharmacology CME/CNE/CPE Video
Luke Maese, DO - Applying Therapeutic Innovations Against ALL: From Updated Evidence to Everyday Practice

PeerView Clinical Pharmacology CME/CNE/CPE Video

Play Episode Listen Later Jul 22, 2022 25:38


Go online to PeerView.com/DGJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you up to date on recent evidence on acute lymphoblastic leukemia (ALL) emerging from major scientific congresses? In this activity, an ALL specialist explores recent evidence presented at the 2022 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) annual meetings on developments in various treatment modalities for ALL. Watch this video to hear about the latest evidence and practical applications in asparaginase use in chemotherapy protocols, including important dosing and safety data on recombinant Erwinia; get updated on longer-term outcomes with CAR-T therapy in adult and pediatric patients and hear practical considerations when using CAR-T options; and learn about emerging chemo-sparing TKI plus bispecific combinations in Ph-positive ALL. Upon completion of this activity, participants should be better able to: Summarize new evidence on multi-faceted strategies for ALL management based on modern chemotherapy protocols, antibody-based approaches, cellular therapy, and TKIs; Cite evidence supporting the use of novel asparaginase compounds for ALL in the context of asparaginase toxicity/hypersensitivity, including in pediatric, AYA, and adult populations; and Apply new science to the team-based management of ALL, including when managing asparaginase hypersensitivity or toxicity, developing TKI-based protocols in Ph-positive disease, or when utilizing novel immunotherapy-based approaches in patient care.

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast
Luke Maese, DO - Applying Therapeutic Innovations Against ALL: From Updated Evidence to Everyday Practice

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast

Play Episode Listen Later Jul 22, 2022 25:38


Go online to PeerView.com/DGJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you up to date on recent evidence on acute lymphoblastic leukemia (ALL) emerging from major scientific congresses? In this activity, an ALL specialist explores recent evidence presented at the 2022 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) annual meetings on developments in various treatment modalities for ALL. Watch this video to hear about the latest evidence and practical applications in asparaginase use in chemotherapy protocols, including important dosing and safety data on recombinant Erwinia; get updated on longer-term outcomes with CAR-T therapy in adult and pediatric patients and hear practical considerations when using CAR-T options; and learn about emerging chemo-sparing TKI plus bispecific combinations in Ph-positive ALL. Upon completion of this activity, participants should be better able to: Summarize new evidence on multi-faceted strategies for ALL management based on modern chemotherapy protocols, antibody-based approaches, cellular therapy, and TKIs; Cite evidence supporting the use of novel asparaginase compounds for ALL in the context of asparaginase toxicity/hypersensitivity, including in pediatric, AYA, and adult populations; and Apply new science to the team-based management of ALL, including when managing asparaginase hypersensitivity or toxicity, developing TKI-based protocols in Ph-positive disease, or when utilizing novel immunotherapy-based approaches in patient care.

PeerView Family Medicine & General Practice CME/CNE/CPE Video Podcast
Luke Maese, DO - Applying Therapeutic Innovations Against ALL: From Updated Evidence to Everyday Practice

PeerView Family Medicine & General Practice CME/CNE/CPE Video Podcast

Play Episode Listen Later Jul 22, 2022 25:38


Go online to PeerView.com/DGJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you up to date on recent evidence on acute lymphoblastic leukemia (ALL) emerging from major scientific congresses? In this activity, an ALL specialist explores recent evidence presented at the 2022 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) annual meetings on developments in various treatment modalities for ALL. Watch this video to hear about the latest evidence and practical applications in asparaginase use in chemotherapy protocols, including important dosing and safety data on recombinant Erwinia; get updated on longer-term outcomes with CAR-T therapy in adult and pediatric patients and hear practical considerations when using CAR-T options; and learn about emerging chemo-sparing TKI plus bispecific combinations in Ph-positive ALL. Upon completion of this activity, participants should be better able to: Summarize new evidence on multi-faceted strategies for ALL management based on modern chemotherapy protocols, antibody-based approaches, cellular therapy, and TKIs; Cite evidence supporting the use of novel asparaginase compounds for ALL in the context of asparaginase toxicity/hypersensitivity, including in pediatric, AYA, and adult populations; and Apply new science to the team-based management of ALL, including when managing asparaginase hypersensitivity or toxicity, developing TKI-based protocols in Ph-positive disease, or when utilizing novel immunotherapy-based approaches in patient care.

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast
Luke Maese, DO - Applying Therapeutic Innovations Against ALL: From Updated Evidence to Everyday Practice

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Jul 22, 2022 25:36


Go online to PeerView.com/DGJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you up to date on recent evidence on acute lymphoblastic leukemia (ALL) emerging from major scientific congresses? In this activity, an ALL specialist explores recent evidence presented at the 2022 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) annual meetings on developments in various treatment modalities for ALL. Watch this video to hear about the latest evidence and practical applications in asparaginase use in chemotherapy protocols, including important dosing and safety data on recombinant Erwinia; get updated on longer-term outcomes with CAR-T therapy in adult and pediatric patients and hear practical considerations when using CAR-T options; and learn about emerging chemo-sparing TKI plus bispecific combinations in Ph-positive ALL. Upon completion of this activity, participants should be better able to: Summarize new evidence on multi-faceted strategies for ALL management based on modern chemotherapy protocols, antibody-based approaches, cellular therapy, and TKIs; Cite evidence supporting the use of novel asparaginase compounds for ALL in the context of asparaginase toxicity/hypersensitivity, including in pediatric, AYA, and adult populations; and Apply new science to the team-based management of ALL, including when managing asparaginase hypersensitivity or toxicity, developing TKI-based protocols in Ph-positive disease, or when utilizing novel immunotherapy-based approaches in patient care.

PeerView Oncology & Hematology CME/CNE/CPE Audio Podcast
Nancy P. Moldawer, RN, MSN - Aligning Nursing Care Strategies With Evolving Patient Needs in RCC: Interprofessional Insights on Optimizing Outcomes With Novel Targeted and Immune-Based Therapies

PeerView Oncology & Hematology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Jun 16, 2022 98:00


Go online to PeerView.com/ASX860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Do you know the best strategies for integrating novel therapeutic approaches into the care of your patients with renal cell carcinoma (RCC)? With the rapid expansion of effective treatments, oncology nurses have more opportunities than ever before to provide support and guidance that favorably influences outcomes for their patients with advanced kidney cancer. However, research has shown that many patients are not receiving individualized, evidence-based, and guideline-concordant treatment and those patients who are receiving new therapies are not receiving appropriate nurse-led care. Join PeerView for an interprofessional case-based activity featuring two nurse professionals and an oncologist to get insight on bringing treatment advances, including immune checkpoint inhibitors and combination strategies, into clinical practice. The expert panel will provide learners with a strong understanding of how current therapeutic regimens fit within the current management paradigm. Participants will also be offered tools to help them master practical aspects tied to effective use of therapies and tips on how to create optimized interprofessional care that empowers patients to participate in shared decision-making, provide multidisciplinary AE management, and support clinical trial enrollment for eligible patients. Upon completion of this activity, participants should be better able to: Appraise recent data on therapeutic advances and updated practice standards, including the use of immune checkpoint inhibitors, TKIs, and combination approaches utilizing these agents, in the management of RCC across the disease spectrum, Update nursing care plans to incorporate practical and team-based strategies to promptly identify, mitigate, and manage AEs associated with novel systemic therapy options for RCC, Develop a team-based education plan focused on novel systemic therapy options for patients with RCC that includes pertinent information on therapeutic expectations, safety considerations, sequential treatments, and clinical trial opportunities.

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast
Nancy P. Moldawer, RN, MSN - Aligning Nursing Care Strategies With Evolving Patient Needs in RCC: Interprofessional Insights on Optimizing Outcomes With Novel Targeted and Immune-Based Therapies

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Jun 16, 2022 98:00


Go online to PeerView.com/ASX860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Do you know the best strategies for integrating novel therapeutic approaches into the care of your patients with renal cell carcinoma (RCC)? With the rapid expansion of effective treatments, oncology nurses have more opportunities than ever before to provide support and guidance that favorably influences outcomes for their patients with advanced kidney cancer. However, research has shown that many patients are not receiving individualized, evidence-based, and guideline-concordant treatment and those patients who are receiving new therapies are not receiving appropriate nurse-led care. Join PeerView for an interprofessional case-based activity featuring two nurse professionals and an oncologist to get insight on bringing treatment advances, including immune checkpoint inhibitors and combination strategies, into clinical practice. The expert panel will provide learners with a strong understanding of how current therapeutic regimens fit within the current management paradigm. Participants will also be offered tools to help them master practical aspects tied to effective use of therapies and tips on how to create optimized interprofessional care that empowers patients to participate in shared decision-making, provide multidisciplinary AE management, and support clinical trial enrollment for eligible patients. Upon completion of this activity, participants should be better able to: Appraise recent data on therapeutic advances and updated practice standards, including the use of immune checkpoint inhibitors, TKIs, and combination approaches utilizing these agents, in the management of RCC across the disease spectrum, Update nursing care plans to incorporate practical and team-based strategies to promptly identify, mitigate, and manage AEs associated with novel systemic therapy options for RCC, Develop a team-based education plan focused on novel systemic therapy options for patients with RCC that includes pertinent information on therapeutic expectations, safety considerations, sequential treatments, and clinical trial opportunities.

PeerView Clinical Pharmacology CME/CNE/CPE Video
Nancy P. Moldawer, RN, MSN - Aligning Nursing Care Strategies With Evolving Patient Needs in RCC: Interprofessional Insights on Optimizing Outcomes With Novel Targeted and Immune-Based Therapies

PeerView Clinical Pharmacology CME/CNE/CPE Video

Play Episode Listen Later Jun 16, 2022 98:27


Go online to PeerView.com/ASX860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Do you know the best strategies for integrating novel therapeutic approaches into the care of your patients with renal cell carcinoma (RCC)? With the rapid expansion of effective treatments, oncology nurses have more opportunities than ever before to provide support and guidance that favorably influences outcomes for their patients with advanced kidney cancer. However, research has shown that many patients are not receiving individualized, evidence-based, and guideline-concordant treatment and those patients who are receiving new therapies are not receiving appropriate nurse-led care. Join PeerView for an interprofessional case-based activity featuring two nurse professionals and an oncologist to get insight on bringing treatment advances, including immune checkpoint inhibitors and combination strategies, into clinical practice. The expert panel will provide learners with a strong understanding of how current therapeutic regimens fit within the current management paradigm. Participants will also be offered tools to help them master practical aspects tied to effective use of therapies and tips on how to create optimized interprofessional care that empowers patients to participate in shared decision-making, provide multidisciplinary AE management, and support clinical trial enrollment for eligible patients. Upon completion of this activity, participants should be better able to: Appraise recent data on therapeutic advances and updated practice standards, including the use of immune checkpoint inhibitors, TKIs, and combination approaches utilizing these agents, in the management of RCC across the disease spectrum, Update nursing care plans to incorporate practical and team-based strategies to promptly identify, mitigate, and manage AEs associated with novel systemic therapy options for RCC, Develop a team-based education plan focused on novel systemic therapy options for patients with RCC that includes pertinent information on therapeutic expectations, safety considerations, sequential treatments, and clinical trial opportunities.

PeerView Kidney & Genitourinary Diseases CME/CNE/CPE Audio Podcast
Nancy P. Moldawer, RN, MSN - Aligning Nursing Care Strategies With Evolving Patient Needs in RCC: Interprofessional Insights on Optimizing Outcomes With Novel Targeted and Immune-Based Therapies

PeerView Kidney & Genitourinary Diseases CME/CNE/CPE Audio Podcast

Play Episode Listen Later Jun 16, 2022 98:00


Go online to PeerView.com/ASX860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Do you know the best strategies for integrating novel therapeutic approaches into the care of your patients with renal cell carcinoma (RCC)? With the rapid expansion of effective treatments, oncology nurses have more opportunities than ever before to provide support and guidance that favorably influences outcomes for their patients with advanced kidney cancer. However, research has shown that many patients are not receiving individualized, evidence-based, and guideline-concordant treatment and those patients who are receiving new therapies are not receiving appropriate nurse-led care. Join PeerView for an interprofessional case-based activity featuring two nurse professionals and an oncologist to get insight on bringing treatment advances, including immune checkpoint inhibitors and combination strategies, into clinical practice. The expert panel will provide learners with a strong understanding of how current therapeutic regimens fit within the current management paradigm. Participants will also be offered tools to help them master practical aspects tied to effective use of therapies and tips on how to create optimized interprofessional care that empowers patients to participate in shared decision-making, provide multidisciplinary AE management, and support clinical trial enrollment for eligible patients. Upon completion of this activity, participants should be better able to: Appraise recent data on therapeutic advances and updated practice standards, including the use of immune checkpoint inhibitors, TKIs, and combination approaches utilizing these agents, in the management of RCC across the disease spectrum, Update nursing care plans to incorporate practical and team-based strategies to promptly identify, mitigate, and manage AEs associated with novel systemic therapy options for RCC, Develop a team-based education plan focused on novel systemic therapy options for patients with RCC that includes pertinent information on therapeutic expectations, safety considerations, sequential treatments, and clinical trial opportunities.

PeerView Oncology & Hematology CME/CNE/CPE Video Podcast
Nancy P. Moldawer, RN, MSN - Aligning Nursing Care Strategies With Evolving Patient Needs in RCC: Interprofessional Insights on Optimizing Outcomes With Novel Targeted and Immune-Based Therapies

PeerView Oncology & Hematology CME/CNE/CPE Video Podcast

Play Episode Listen Later Jun 16, 2022 98:27


Go online to PeerView.com/ASX860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Do you know the best strategies for integrating novel therapeutic approaches into the care of your patients with renal cell carcinoma (RCC)? With the rapid expansion of effective treatments, oncology nurses have more opportunities than ever before to provide support and guidance that favorably influences outcomes for their patients with advanced kidney cancer. However, research has shown that many patients are not receiving individualized, evidence-based, and guideline-concordant treatment and those patients who are receiving new therapies are not receiving appropriate nurse-led care. Join PeerView for an interprofessional case-based activity featuring two nurse professionals and an oncologist to get insight on bringing treatment advances, including immune checkpoint inhibitors and combination strategies, into clinical practice. The expert panel will provide learners with a strong understanding of how current therapeutic regimens fit within the current management paradigm. Participants will also be offered tools to help them master practical aspects tied to effective use of therapies and tips on how to create optimized interprofessional care that empowers patients to participate in shared decision-making, provide multidisciplinary AE management, and support clinical trial enrollment for eligible patients. Upon completion of this activity, participants should be better able to: Appraise recent data on therapeutic advances and updated practice standards, including the use of immune checkpoint inhibitors, TKIs, and combination approaches utilizing these agents, in the management of RCC across the disease spectrum, Update nursing care plans to incorporate practical and team-based strategies to promptly identify, mitigate, and manage AEs associated with novel systemic therapy options for RCC, Develop a team-based education plan focused on novel systemic therapy options for patients with RCC that includes pertinent information on therapeutic expectations, safety considerations, sequential treatments, and clinical trial opportunities.

PeerView Kidney & Genitourinary Diseases CME/CNE/CPE Video Podcast
Nancy P. Moldawer, RN, MSN - Aligning Nursing Care Strategies With Evolving Patient Needs in RCC: Interprofessional Insights on Optimizing Outcomes With Novel Targeted and Immune-Based Therapies

PeerView Kidney & Genitourinary Diseases CME/CNE/CPE Video Podcast

Play Episode Listen Later Jun 16, 2022 98:27


Go online to PeerView.com/ASX860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Do you know the best strategies for integrating novel therapeutic approaches into the care of your patients with renal cell carcinoma (RCC)? With the rapid expansion of effective treatments, oncology nurses have more opportunities than ever before to provide support and guidance that favorably influences outcomes for their patients with advanced kidney cancer. However, research has shown that many patients are not receiving individualized, evidence-based, and guideline-concordant treatment and those patients who are receiving new therapies are not receiving appropriate nurse-led care. Join PeerView for an interprofessional case-based activity featuring two nurse professionals and an oncologist to get insight on bringing treatment advances, including immune checkpoint inhibitors and combination strategies, into clinical practice. The expert panel will provide learners with a strong understanding of how current therapeutic regimens fit within the current management paradigm. Participants will also be offered tools to help them master practical aspects tied to effective use of therapies and tips on how to create optimized interprofessional care that empowers patients to participate in shared decision-making, provide multidisciplinary AE management, and support clinical trial enrollment for eligible patients. Upon completion of this activity, participants should be better able to: Appraise recent data on therapeutic advances and updated practice standards, including the use of immune checkpoint inhibitors, TKIs, and combination approaches utilizing these agents, in the management of RCC across the disease spectrum, Update nursing care plans to incorporate practical and team-based strategies to promptly identify, mitigate, and manage AEs associated with novel systemic therapy options for RCC, Develop a team-based education plan focused on novel systemic therapy options for patients with RCC that includes pertinent information on therapeutic expectations, safety considerations, sequential treatments, and clinical trial opportunities.

The Bio Report
Battling Resistance in Tumors with “Pan-Variant” Kinase Inhibitors

The Bio Report

Play Episode Listen Later Jun 2, 2022 30:17


The emergence of tyrosine kinase inhibitors represented a major advance in the fight against cancer, but the ability of tumors to mutate and develop resistance to these therapies remains a challenge. Theseus Pharmaceuticals is developing what it calls “pan-variant” kinase inhibitors in the hopes of outsmarting tumors by anticipating the range of kinases that may drive their spread and growth as they change. We spoke to Tim Clackson, president and CEO of Theseus Pharmaceuticals, about its structural-based approach to drug development, how it determines the appropriate targets for its pan-variant kinase inhibitors, and why it believes its next-generation TKIs can overcome the challenge of drug resistance.

ASCO Daily News
ASCO22: Key Advances in Hematologic Malignancies

ASCO Daily News

Play Episode Listen Later May 27, 2022 17:49


Dr. John Sweetenham, of the UT Southwestern's Harold C. Simmons Comprehensive Cancer Center, and Dr. Marc Braunstein, of NYU Langone Health, discuss key data from the CAPTIVATE and GRIFFIN trials and other compelling studies in hematologic malignancies featured at the 2022 ASCO Annual Meeting.  Dr. John Sweetenham: Hello. I'm John Sweetenham, the associate director for Clinical Affairs at UT Southwestern Harold C. Simmons Comprehensive Cancer Center and host of the ASCO Daily News podcast.  For my guest today, I'm pleased to introduce Dr. Marc Braunstein, a hematologist, and oncologist at NYU Perlmutter Cancer Center. We'll be discussing key posters on advances in hematologic malignancies that will be featured at the 2022 ASCO Annual Meeting.  Our full disclosures are available in the show notes and disclosures of all guests on the podcast can be found on our transcripts at asco.org/podcasts.  Marc, it's great to have you on the podcast today.  Dr. Marc Braunstein: Thank you, John. It's a pleasure to be here.  Dr. John Sweetenham: So, Marc, there are going to be some very interesting abstracts with some provocative results presented at the ASCO Annual Meeting this year. I know we've selected a number of these to speak about today, beginning with Abstract 8027 on the subject of multiple myeloma. And this I think is a long-term follow-up study for long-term survivors of multiple myeloma more than 12 years out now. Can you comment on this and let us know what you believe the key takehomes from this study are?  Dr. Marc Braunstein: Sure. Absolutely, John. So, this was a prospective registry that has been in place since 2009, and it's composed of various practice settings, but primarily community practices where most patients get their myeloma care. And what they did was they looked at about 1,400 patients with newly diagnosed multiple myeloma across 250 sites in the U.S. between 2009 and 2011 who were included in the registry. The participants also filled out the quality-of-life surveys, and they compared a group of long-term survivors who had more than 8 years of follow-up to patients who were not long-term survivors below that 8-year threshold.  So, about 20% were in the long-term survival group and 80% in the non-long term survival group. And they basically characterized those 2 groups. What they found was that the individuals who did have long-term survival were generally younger—median age of 62 versus 68, and had better performance status, were more likely to receive stem cell transplants, about 66 versus 60%.  And therefore, the implication of this is that patients who fit those criteria may have a better prognosis in addition to the other cytogenetics and other factors we use as prognostic indicators. And what was also interesting was that the 8-year overall survival of the overall group was about 36%.  So, we still have room to go in terms of bringing new therapies to extend survival in this condition. And only 20% of the total population were long-term survivors at that 8-year threshold. So, those were the general findings of the abstract.  Dr. John Sweetenham: Do you think it gives us new information on patient selection for more intensive therapies upfront?  Dr. Marc Braunstein: Well, I think it certainly tells us which patients are more likely to have longer-term survival. I think we know in multiple myeloma that it's essential to really use the patient's presenting features, their disease features, their comorbidities, and their degree of fitness or frailty to guide how intensive a therapy or regimen we can devise for that individual patient. But I think it certainly says that if you have a patient who is on the younger side of the spectrum, who is eligible for stem cell transplant, who has a better performance status, those are the patients that are more likely to have the long-term survival. It doesn't necessarily say that if you're not in that category, you won't have long-term survival, but on average, those were the patients who fared better in the long term.  Dr. John Sweetenham: Okay. So, staying for a little while on the subject of multiple myeloma, Abstract 8037 is really addressing a very different question. It's the application of circulating tumor DNA analysis and its association with relapse in patients with refractory myeloma. Would you comment a little on this and maybe let us know what you think the significance of this will be for the future?  Dr. Marc Braunstein: Sure. My colleagues in the solid tumor space are using circulating tumor DNA regularly and in the myeloma field, we're a little bit jealous of them.  So, it's helpful to have a study like this that's looking at circulating peripheral blood markers, in this case circulating tumor DNA, to help guide various prognostic or predictive indices that will help us guide therapeutic decisions.  So, this was a study where they looked at patients who were enrolled in a phase 2 study of a free-drug regimen of carfilzomib-thalidomide-dexamethasone the MM17 study, and they took 50 transplant eligible multiple myeloma patients who were refractory to their first line of therapy, and they collected bone marrow samples and peripheral blood at 3 time points at the third cycle of treatment and at the end of the study or at the point of refractoriness to that regimen.  They collected about 187 samples in total. They used a sequencing technique to determine the variance of 22 gene signatures known to be mutated in multiple myeloma. And what they found was a particular gene signature that was associated with shorter progression-free and overall survival in that phase 2 study. And those genes included known oncogenic drivers, including BRAF genes, ATM, and P53.  What was particularly interesting among the circulating tumor DNA mutations was that they were found in about 88% of patients at the start of the study. So, what that tells us is, number 1, circulating tumor DNA offers a wealth of information that can be highly valuable in multiple myeloma, which is a disease where we typically rely on the bone marrow to assess the status of the plasma cells and status of the mutation profile.  And number 2, that many of these mutations may be present earlier on in a disease that we know evolves in a clonal way that leads to disease progression. So, I think there's still a lot of information we have to learn about the utility of circulating tumor DNA in myeloma, but this study certainly shows that there's a lot to be explored in terms of the mutational profile and peripheral blood in myeloma.  Dr. John Sweetenham: A couple of questions that arise for me out of this study. First of all, do you think this is going to have any implications for future study design and patient selection?  Dr. Marc Braunstein: Definitely. I think the whole field in multiple myeloma is progressing quickly in terms of how we assess response, how we use minimal residual disease, and moving more towards using novel markers in peripheral blood, including mass spectrometry, and now perhaps circulating tumor DNA to look at surrogate markers for survival.  And so, what this abstract is showing is that we could potentially use circulating tumor DNA both as prognostic markers, potentially as disease response markers, and prognostic markers to guide which patients may be more likely to have shorter survival. So, I think this has a lot of implications for how we design future studies.  Dr. John Sweetenham: Yeah. And the second question, do you think this is the beginning of the end of bone marrow analysis in multiple myeloma?  Dr. Marc Braunstein: So, I can tell you if it is, patients I think will be very happy and so will clinicians because we really want to know at the core what the degree of residual disease is in a patient. And right now, the only way to do that is through a bone marrow biopsy.  And so, I think that this is the beginning of the use of peripheral blood studies with higher resolution to allow us to gain more information on patients that hopefully will allow us to obviate the need for more invasive testing like bone marrow biopsies.  Dr. John Sweetenham: Yeah, absolutely. Thanks. Just changing gears now, moving on to Abstract 7050. This is an abstract that addresses what I think we'd all agree is becoming an increasingly important question in the management of chronic myeloid leukemia (CML), and that is number 1, is it safe to discontinue therapy in responding patients? And number 2, when is it safe to discontinue that therapy?  Dr. Marc Braunstein: So, this is an abstract that is looking primarily at CML. You know that we're making a lot of progress when we can begin to talk about discontinuation and de-escalation of therapy.  And so, in the field of CML, the use of tyrosine kinase inhibitors (TKIs) and the targeting of the BCR-ABL mutation has brought about tremendous progress in patients in the chronic phase.  So, there have been several retrospective studies that have looked at the role of discontinuing one of the TKIs. Most of the studies have focused on imatinib since that was the first one that was discovered, but they've looked at others in the class as well.  What struck me the most is that there's a remarkable consistency between these studies. So, when you discontinue one of these TKIs, the percentage of patients who remain in remission is somewhere between 40 to 50%. And what this abstract looked at was a single institution retrospective assessment of 284 patients with CML, between 1999 and 2017, who were treated with a TKI for their CML and then subsequently discontinued the therapy.  Now, what's worth noting in the various studies that have looked at discontinuation therapy is that patients who were taken off of the TKI generally were in a good molecular remission, MR 4 or 4.5, for at least 2 or 3 years. And in this study, about 70% of patients had electively discontinued and 24% of patients stopped due to adverse events.  So, it wasn't necessarily guided by their response to treatment at the time of discontinuation. What they found actually was fairly consistent with the literature that at a median follow-up of 36 months after TKI discontinuation, about 19% lost their molecular remission and 88% had achieved a molecular remission after resuming therapy. And that is consistent with the literature that fortunately, even if a patient loses their molecular remission off of the TKI therapy, the majority of patients will go back into molecular remission when you re-challenge them.  Dr. John Sweetenham: Important data, indeed. And you know, on something of a similar theme, the next abstract that we're going to look at is the Abstract 7519. In this case, in chronic lymphocytic leukemia (CLL), and certainly, those of us who remember when ibrutinib was initially introduced into the second-line treatment of CLL, didn't really know whether discontinuation or fixed duration treatment with agents like this was going to be something that we could pursue or whether treatment with these drugs was going to be indefinite. This abstract certainly addresses that specific question, and again, I'm interested in your insights into this.  Dr. Marc Braunstein: Sure. So, this is an abstract looking at CLL, where we've really begun to move away from chemotherapy, and we have a variety of targeted oral therapies that target the underlying pathology of this leukemia.  And so, as you mentioned, ibrutinib is approved both in the relapsed and more recently in the frontline setting, wherein the RESONATE-2 study that was published in the New England Journal of Medicine in 2015, there was actually an overall survival benefit of ibrutinib even in higher-risk patients.  So, the CAPTIVATE study is an ongoing phase 2 study that is looking at whether we can improve the efficacy of single-agent ibrutinib in the first-line setting when combined with venetoclax.  Ibrutinib targets protein tyrosine kinase and venetoclax targets Bcl-2, and that combination is hypothesized to further weaken the resistance of CLL and lead to better outcomes.  So, this was a multicenter phase 2 study. And in this abstract, they looked at the 3-year follow-up of patients who were actually able to discontinue therapy on this regimen. So, just as a bit of background, ibrutinib is typically continued until progression, and venetoclax as it's been studied in the first-line setting with obinutuzumab is given for about 12 months.  So, in this study, at 3-year follow-up, they looked at the patients in the cohort who were off therapy and looked at the percentage of patients who maintained a complete remission at 3 years. And that complete remission rate was about 57%.  The majority of patients, greater than 95% of patients, were alive at 3 years even in the high-risk cohort. So, I think the implications of the study is that upfront or oral targeted therapies when you combine ibrutinib and venetoclax really produce tremendous responses that are durable, and it's found even in the high-risk patients who are expected not to do quite as well at 3 years.  Dr. John Sweetenham: Yeah, I agree. I think it's very reassuring actually to see these durable responses with this fixed duration regimen. And to conclude, Abstract 8011 was an abstract which addressed treatment in the first-line setting for multiple myeloma. And again, I wonder if you could comment on this study.  Dr. Marc Braunstein: Sure! So, this is a study looking at the GRIFFIN regimen, which was a phase 2 randomized study of daratumumab (DARA), plus lenalidomide, bortezomib, and dexamethasone.  So, DARA RVd versus RVd alone. In that study, the primary endpoint was stringent, complete remission, and it has been previously presented and published that the stringent complete remission (CR) rate was significantly improved, 42% versus 32%, when you include daratumumab upfront.  In this abstract, they looked at the sustained rate of minimal residual disease negativity, which is basically the deepest possible remission you can achieve in upfront therapy and in myeloma.  What they found was that, again, when you looked at the quadruplet regimen versus the triplet regimen, the rates of minimum residual disease (MRD) negativity were just improved with the quad regimen.  So, at a median follow-up of 38.6 months, there were about 54 versus 20% of patients who were MRD negative at 12 months amongst the patients who had achieved a CR, and 59 versus 17% MRD negative among the patients who achieved a stringent CR favoring the daratumumab arm.  So, I think this abstract shows the benefit of including a monoclonal antibody upfront in newly diagnosed patients with myeloma combined with stem cell transplant and maintenance, allowing for sustained MRD negativity.  Dr. John Sweetenham: Do you think this represents a new standard of care?  Dr. Marc Braunstein: I do. At our institution, we've adopted this regimen for most newly diagnosed transplant-eligible patients. I think the data clearly show an improved depth of response and MRD negativity rates, and I think that there are a number of ongoing studies looking at the role of monoclonal antibodies in the maintenance phase as well.  I'm especially excited this year, at ASCO Annual Meeting there's a plenary session involving myeloma looking at patients who received RVd upfront and then went for transplant. But I think we can improve on that regimen by including monoclonal antibodies and immunotherapies upfront, and I do think it represents a new era of immunotherapies in multiple myeloma.  Dr. John Sweetenham: Well, thanks, Marc. I mean, to your last point, it sounds as if there is a lot, including these abstracts, to look forward to at the upcoming ASCO meeting. So, we really appreciate you sharing your insights into these abstracts with us today.  Dr. Marc Braunstein: Sure. My pleasure. Thank you for having me, John.  Dr. John Sweetenham: And thank you to our listeners for joining us today. You'll find links to the abstract discussed today 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.      Disclosures:  Dr. John Sweetenham:  Consulting or Advisory Role: EMA Wellness  Dr. Marc Braunstein:  Consulting or Advisory Role: Celgene, Janssen, AstraZeneca, Amgen, Takeda, Verastem, Celgene, Janssen, Karyopharm Therapeutics, Epizyme, Morphosys, Takeda, Pfizer  Research Funding (Inst): Janssen, Celgene/BMS  Travel, Accommodations, Expenses: Takeda  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 Daily News
ASCO22: Novel Therapies in Lung Cancer

ASCO Daily News

Play Episode Listen Later May 26, 2022 20:03


Guest host Dr. Nathan Pennell, of the Cleveland Clinic Taussig Cancer Institute, and Dr. Vamsi Velcheti, of the NYU Langone Perlmutter Cancer Center, discuss the ATLANTIS trial and other novel therapies in advanced SCLC, NSCLC, and malignant pleural mesothelioma featured at the 2022 ASCO Annual Meeting Poster Sessions.  Transcript   Dr. Nathan Pennell: Hello, I'm Dr. Nathan Pennell, your guest host for the ASCO Daily News Podcast, today. I'm the co-director of the Cleveland Clinic Lung Cancer Program and vice-chair of Clinical Research for the Taussig Cancer Institute.  My guest today is my friend Dr. Vamsidhar Velcheti, an associate professor and medical director of thoracic oncology at the Perlmutter Cancer Center at NYU Langone Health.  We'll be discussing key posters on lung cancer that will be featured at the 2022 ASCO Annual Meeting. Although the oral sessions tend to get the most press, we want to make sure you don't miss out on some high-impact abstracts that are presented in the poster session.  Our full disclosures are available in the show notes and disclosures of all guests on the podcast can be found on our transcripts at asco.orgpodcasts.  Vamsi, it's great to speak with you today.  Dr. Vamsidhar Velcheti: Thank you, Nate. It's a pleasure to discuss these 5 outstanding abstracts.  Dr. Nathan Pennell: Why don't we start with Abstract 9021, “Genomic correlates of acquired resistance to PD-(L)1 blockade in patients with advanced non—small cell lung cancer (NSCLC).” Vamsi, what were your key takeaways from this study?  Dr. Vamsidhar Velcheti: This is an important study in my opinion. This was a very large study of 1,700 patients from Dana Farber and the investigators looked at 45 specimens and matched pre- and post- immunotherapy treated patients. And they looked at the data mechanisms of resistance that were identified in 25 out of the 45 patients, that is 55% of the patients.  5 patients had acquired STK11 mutations. One patient had a KEAP1 alteration. There were several patients who had like KEAP1 SMARCA4 mutations. And interestingly, there were also some patients who developed KRAS-G12C mutation as well on the post-treatment specimens.  So, this is an interesting abstract. We typically don't do biopsies on patients progressing on immunotherapy. At this point, we don't have a standard clinical indication to do so. However, identifying these new novel mechanisms of genomic mechanisms of resistance is actually very important, because a lot of new therapy medications are being developed to target, for example, KEAP1, and could be approached to target microglobulin mutations. So, it's very important to kind of understand the mechanisms of resistance.  Dr. Nathan Pennell: Yeah, I completely agree. I mean, most of the benefits in second line in the refractory setting with targeted treatments came about through studies like this where there was broad sequencing of resistance and trying to understand and I think we're still kind of in the infancy of understanding resistance to immunotherapy, but it's a good start.  Abstract 9019 was another interesting study in non—small cell lung cancer. That was “A phase II study of AK112 (PD-1/VEGF bispecific) in combination with chemotherapy in patients with advanced non—small cell lung cancer.” Can you tell us a little bit about that study?  Dr. Vamsidhar Velcheti: Yeah, this is a multicenter phase-2 trial. This is an interesting agent. It's a PD-1/VEGF bispecific antibody developed by Akeso Bio. This is a single-arm study, and they did the study in 3 different cohorts.  One of the cohorts was patients with advanced non—small cell lung cancer who had wild-type EGFR/ALK, and they were treatment-naive. There was another cohort of patients where they enrolled patients with EGFR mutation who developed resistance to EGFR tyrosine kinase inhibitors (TKIs) and essentially progressed on osimertinib. And there was another cohort where patients were enrolled who were PD-1 refractory, they had prior PD-1or PD-1 chemo combination, and they had progressions. So, they enrolled a total of 133 patients, it was a decent-sized study, but a very early efficacy finding study.  In the cohort-1 which is the cohort that is enrolled with untreated patients with advanced non—small cell lung cancer. They had like 20 partial responses out of 26 patients that were evaluable and enrolled in the cohort, and there were 6 patients who had stable disease.  So, overall, the response rate was 76.9% and 100% disease control rate. So, this is a very small cohort and small data set. So, we have to interpret this with caution. But suddenly, a very interesting signal here for this VEGF/PD-1 bispecific antibody.  Dr. Nathan Pennell: The 40% response rate in the immunotherapy (IO) and chemo refractory patients, I thought was fairly interesting, although, as you said, very small numbers in these cohorts will have to be reproduced in larger trials.  Dr. Vamsidhar Velcheti: Right. I think there was a lot of excitement early on the IMpower150, right? With the combination of bevacizumab with chemo-theralizumab.  There seems to be some signal in terms of the addition of a VEGF inhibitor to immunotherapy. And we've seen that consistently in renal cells and other tumor types. So, I think this is a really intriguing signal. I think this definitely warrants further exploration.  So, the other interesting thing was cohort-2 where they enrolled patients who had progressed on EGFR TKIs. So, in that cohort, they had like 19 evaluable patients and 13 patients had a partial response and 5 had stable disease. So, a very respectable response rate of 68.4% and 94.7 disease control rate. So, again, very small numbers, but a nice signal here for the efficacy of the drug.  There was another cohort, which is the cohort-3 where they enrolled patients who progressed on PD-1 therapy, and they enrolled a total of 20 patients with 8 patients having a partial response, following progression on PD-1 therapy.  Dr. Nathan Pennell: Yeah, I look forward to seeing further follow-up on this. It definitely sounds interesting. Moving on to Abstract 8541. This was “Durvalumab (durva) after chemoradiotherapy (CRT) in unresectable, stage III, EGFR mutation-positive (EGFRm) NSCLC: A post hoc subgroup analysis from PACIFIC,' which of course was the study that led to the broad use of durvalumab, the anti-PD-L1 antibody after chemoradiotherapy for unresectable stage III non-small cell, but this was the post hoc subgroup analysis of the EGFR mutation-positive group. And this is a subgroup we've really been curious about whether there was a role for consolidation, immunotherapy, or not. And so, what are your thoughts on the study?  Dr. Vamsidhar Velcheti: I agree with you, Nate, that this is actually some data that I was really, really looking forward to. Before we actually talk about the abstract. What do you do for those patients? If you have an EGFR mutation patient who has stage IIIB, what do you do right now?  Dr. Nathan Pennell: It's a great question. I have a discussion with them about the potential pluses and minuses of doing consolidation durvalumab. But I actually don't always use durvalumab in this setting, because of concerns about if you're using durvalumab and they recur, perhaps there is a problem with toxicity with using osimertinib. Honestly, I go back and forth about what the right thing is to do in this subgroup.  Dr. Vamsidhar Velcheti: No, I think that's the right context. I think that's a good setup to kind of discuss the data from the trial. I'm really excited about this. And I'm glad that we have this data to look at.  So, as you pointed out, the Pacific trial, its U.S. Food and Drug Administration (FDA) approval for durvalumab in the consolidation setting for patients with stage III after chemoradiation. This has now been the standard of care for like a few years now. The problem with the study is that patients with EGFR/ALK were allowed to enroll in the study.  Typically, for most IO trials, we generally tend to see patients with EGFR/ALK being excluded. So, this trial was an exception. In this study, they actually presented a post-hoc exploratory analysis of efficacy and safety of patients who did consolidation with durvalumab, but there was a total of 35 patients of the 713 patients that were randomized in the trial. And out of the 35 patients with EGFR mutation, 24 received durvalumab and 11 received a placebo.  So, of course, you're going to interpret this data with a little bit of caution. This is a full stock analysis, not pre-planned in small numbers. In this dataset, essentially, the median progression-free survival (PFS) was not different among patients treated with durvalumab or placebo, and the median survival was also not statistically significant. Overall, there was not much benefit from adding durvalumab in this setting in patients who have EGFR mutation-positive stage III lung cancer.  Dr. Nathan Pennell: I think that tends to track along with what we who have been treating patients with EGFR mutations for years, and knowing the disappointing response rates, certainly in the advanced stage with immunotherapy, I think we were concerned that in this consolidation phase that it would also potentially be a relatively marginal benefit. I agree with you that 35 patients are too small to make any definitive conclusions, but it certainly isn't supportive of a large benefit.  Dr. Vamsidhar Velcheti: But I think I'm excited about the LAUREL study that's ongoing, hopefully, that'll give us a little bit more definitive answers as to what we should be doing for patients with EGFR mutation-positive disease. Suddenly this is a piece of information that's helpful for treating physicians to make some decisions on clinical management for these patients.  Dr. Nathan Pennell: I agree. Now moving beyond the non—small cell. Let's talk about “Final survival outcomes and immune biomarker analysis of a randomized, open-label, phase I/II study combining oncolytic adenovirus ONCOS-102 with pemetrexed/cisplatin (P/C) in patients with unresectable malignant pleural mesothelioma (MPM).” That's Abstract 8561. What were your takeaways here?  Dr. Vamsidhar Velcheti: Yeah, it's always good to see some new therapeutic options for patients with mesothelioma. This is somewhat of an orphan disease and we haven't seen a lot of advances. Granted, we have some new therapeutic options with immunotherapy now, like, there is now a standard of care in the frontline setting.  So, this particular approach with ONCOS-102 is an oncolytic adenovirus expressing GM-CSF. And this is intended to stimulate the local and systemic immune response and remodulate the tumor microenvironment.  This was a small phase 1 study where they had a CFT run-in of 6 patients and a total of 25 patients were randomly assigned to receive ONCOS-102 intratumorally with ultrasound guidance or CT guidance and they injected this oncolytic virus into the tumor directly.  They were also getting treatment with platinum pemetrexed which is the standard of care in the frontline setting. The control here was 6 cycles of platinum pemetrexed. So, they enrolled both the treatment-naive patients in the frontline setting and they also enrolled patients who will progress on a platinum doublet.  I should note that none of these patients were treated with immunotherapy. I think that's something that we'll kind of get back to and we'll discuss. Overall, from a safety standpoint, there were some expected toxicities like pyrexia and nausea which is seen in the experimental group. It's just kind of to be expected with an oncolytic virus. Overall, the 30-month survival rates were 34.3% and 18.2% in the control arm, and the median overall survival (OS) was 19.3 months and 18.3 in the controller.  So, for patients who were treated with the frontline chemotherapy, the survival rate was better with 30 months survival, it was 33.3 [months]. And in the experimental group, it was 0%.  So, overall, they also looked at tumor-infiltrating lymphocytes, they had CD4 around CD8 and granzyme B expressing CDA T-cells, and they had favorable PK from increased immune cell infiltration. So, this is very promising data but of course in a small study, and also in a population that hasn't had immunotherapy patients who are getting platinum doublet. In terms of safety, I think it looks promising. We need to see larger studies, especially with immunotherapy combinations.  Dr. Nathan Pennell: Yeah, I was impressed with the increased tumor infiltration of CD4 and CDA-positive T-cells, and the survival in the first line looked fairly impressive, although again, a very small subgroup of patients. But as you said, a standard of care these days is definitely going to involve immunotherapy. And so, I look forward to seeing combination trials in the future with this drug.  Shifting from mesothelioma over to small cell lung cancer, Abstract 8570 is “Stereotactic radiosurgery (SRS) versus whole brain radiation therapy (WBRT) in patients with small cell lung cancer (SCLC) and intracranial metastatic disease (IMD): A systematic review and meta-analysis.” Do you think that this would influence how we approach patients with brain metastases in the small cell?  Dr. Vamsidhar Velcheti: There are some in the community who kind of advocate for SRS in small cells if they have limited CNS disease. Certainly, I'm not one of them, but I think this is an interesting study in that light like we have never had any proper randomized trial. And we probably won't have randomized trials in that setting. So, at the end of the day, I think we all kind of customize our treatment approaches based on our patients and how much disease burden they have.  But having said that, the authors here have done a pretty large systemic analysis, and they looked at 3,700+ trials, they looked at random effects meta-analysis pooled hazard ratios for overall survival in patients who received SRS in the whole brain with or without SRS boost.  What they found was that overall survival following SRS was not inferior to whole brain RT. What do we really make out of this data? I think, given the heterogeneity, we have to see how the analysis was done and the kind of studies that went into the analysis. But however, I think the bigger question is, is there a population that we need to maybe—perhaps like, if somebody has an isolated brain met, you could potentially consider SRS with a whole brain RT for better local control.  So, the authors actually look at pooled data to look at local control versus intracranial distant control. So, this is a really interesting approach that asks the question, if patients had SRS and whole brain radiation, would it actually offer adequate intracranial distant control meaning like, do they develop new lesions?  So, it does look fairly decent. But again, it all depends on what kind of studies went into the analysis. And I don't think we should read too much into it. But at the same time, it kind of raises the question: is there a population of patients with small cell where it may be potentially appropriate to give SRS?  So, that's what I do in my day-to-day clinical practice. Sometimes there are situations where you kind of do the thing that we don't usually always do like in the small cell, we always think about whole brain radiation as something that we always have to offer, but I want to hear your perspectives too.  Dr. Nathan Pennell: No, I was always taught that you never did anything with whole brain radiation in the small cell even with a solitary metastasis. For a study like this, it's certainly interesting. You wonder how much selection bias there was towards people with fewer brain metastases and perhaps being in better health or better response to systemic disease that were referred for SRS, compared to whole brain radiation.  Part of the issue is the morbidity associated with whole brain radiation is significantly more than with SRS. And now that we are starting to, for the first time, see some patients with small cell [lung cancer] that are living substantially longer with immunotherapy, it might be worth exploring which patients might benefit from having that lower morbidity from whole brain radiation. But I agree with you that I'm not sure that we know who those patients are.  Dr. Vamsidhar Velcheti: Yeah, I think this is a difficult question to answer through a meta-analysis in my opinion. But having said that, your thought in terms of proving systemic therapies, then we kind of revisit the paradigm of offering SRS to some patients may be, especially with new BiTE T-cell engager studies that are ongoing, and hopefully, if you see some positive results, that might change what we do, but it's an important clinical question.  Dr. Nathan Pennell: And finally, in Abstract 8524, we have an interesting analysis of patients with relapsed small cell lung cancer, who received single-agent Lurbinectedin in the phase-3 Atlantis trial. What do you think about this poster, and why should this be on our radar?  Dr. Vamsidhar Velcheti: Yeah, I think this has been an interesting approval, of course, lurbinectedin FDA approved, as you know, like in June of 2020, based on data from a trial that uses 3.2 milligrams per meter square dosing every 21 days in second line setting post-chemotherapy.  What happened after that was there was a trial with the combination with doxorubicin in the second line setting comparative arm in that phase 3 trial topotecan or CAV.  In that trial, it was a negative trial, the primary endpoint was not met. The primary endpoint was overall survival, and it was a negative trial. And there were subgroup analyses done in the trial. The study that is presented now is actually a post-hoc analysis looking at patients who received treatment with this combination with doxorubicin that is like a lurbinectedin with doxorubicin, who had like a total of 10 cycles of the combination, and they switched to lurbinectedin monotherapy.  So, there were a total of 50 patients in that trial. They looked at the responses and the durability of responses in that population. It's a highly select population that made it to 10 cycles and they had stable disease or better and they switched to lurbinectedin monotherapy.  So, the highlight of the abstract is the median overall survival was 20.7 months. Of course, for small cell, that's really impressive. But I think we've got to be really careful in interpreting this data. This is like a small subgroup of highly selected patients who actually benefited from the trial. My question for you, Nate, is do you use lurbinectedin in the second line setting frequently or are you still treating them with topotecan?  Dr. Nathan Pannell: We still often use topotecan. I think lurbinectedin certainly seems to be an active drug, and it has some favorable schedule of administration pretty well tolerated from a tolerability standpoint, but from an efficacy standpoint, I still haven't really seen much that makes it stand out as significantly better than older options like topotecan or irinotecan.  That being said, it is intriguing that there is a subgroup of people who seem to have prolonged disease control with this. The problem, of course, is if you already select the people who make it 10 cycles without progression, then you're already picking the group of people who are doing extremely well. So, it's not surprising that they would continue to do extremely well.  Nonetheless, it's a sizable subgroup of people that seem to benefit and it would really be nice if there was, for example, a biomarker that might tell us which patients would truly benefit from this drug compared to our other options.  Dr. Vamsidhar Velcheti: Yeah, exactly. True. Right, I mean, like all of us have patients who have done exceedingly well on topotecan and I had a patient on paclitaxel for years. So, it's really important to kind of keep that in mind when we look at these sub-proof post hoc analyses.  Dr. Nathan Pennell: Well, thanks Vamsi for sharing these important advances in lung cancer that will be featured at the 2022 ASCO Annual Meeting.  Dr. Vamsidhar Velcheti: Thank you, Nate.  Dr. Nathan Pennell: And thank you to our listeners for joining us today. If you're enjoying the content on the ASCO Daily News podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts.    Disclosures:  Dr. Nathan Pennell:   Consulting or Advisory Role: AstraZeneca, Lilly, Cota Healthcare, Merck, Bristol-Myers Squibb, Genentech, Amgen, G1 Therapeutics, Pfizer, Boehringer Ingelheim, Viosera, Xencor, Mirati Therapeutics, Janssen Oncology, Sanofi/Regeneron  Research Funding (Inst): Genentech, AstraZeneca, Merck, Loxo, Altor BioScience, Spectrum Pharmaceuticals, Bristol-Myers Squibb, Jounce Therapeutics, Mirati Therapeutics, Heat Biologics, WindMIL, Sanofi  Dr. Vamsidhar Velcheti:  Honoraria: ITeos Therapeutics  Consulting or Advisory Role: Bristol-Myers Squibb, Merck, Foundation Medicine , AstraZeneca/MedImmune, Novartis, Lilly, EMD Serono, GSK, Amgen  Research Funding (Institution): Genentech, Trovagene, Eisai, OncoPlex Diagnostics, Alkermes, NantOmics, Genoptix, Altor BioScience, Merck, Bristol-Myers Squibb, Atreca, Heat Biologics, Leap Therapeutics, RSIP Vision, GlaxoSmithKline  Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.  Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   

Keeping Current
The Molecular Tumor Board: Best Practices for Managing Primary and Acquired EGFR TKI Resistance

Keeping Current

Play Episode Listen Later May 24, 2022 45:12


Do you know that primary resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) occurs in approximately 20% to 30% of patients with EGFR-mutated non-small cell lung cancer (NSCLC), and acquired resistance is inevitable? Credit available for this activity expires: 5/23/2023 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/974097?src=mkm_podcast_addon_974097

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast
Sumanta Kumar Pal, MD, FASCO - Navigating Evolving Standards of Care in Renal Cell Carcinoma: Expert Insights on Selecting and Sequencing Targeted and Immunotherapy Options and a Look at Emerging Strategies

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Apr 22, 2022 88:28


Go online to PeerView.com/TRX860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you ready to bring the new standard of care for advanced renal cell carcinoma (RCC) into your clinical practice? Join PeerView and KCCure to learn what the latest research on multi-targeted TKIs, immune checkpoint inhibitors, and combination strategies (dual checkpoint blockade and immune checkpoint inhibitor/TKI combinations) means for your patients with advanced disease. Our panel of experts will discuss how highly efficacious therapeutic strategies are changing outcomes in earlier lines of treatment and the potential for approved agents to be used in new settings. With illustrative patient cases guiding the discussion, this engaging activity will provide participants with the information they need to navigate important clinical decisions, including how to sequence available therapies; which systemic therapies to use in patients with metastatic, locally advanced, or high-risk localized disease; what steps should be taken to manage AEs associated with newer treatment strategies; and which patients could benefit from clinical trial enrollment. Don't miss this opportunity to learn more about providing guideline-recommended individualized care for your patients with RCC. Upon completion of this CE activity, participants will be able to: Incorporate novel therapeutic approaches, latest clinical evidence, expert recommendations, and patient-, disease-, and treatment-specific factors in the development of contemporary, personalized management plans for patients with RCC, Recommend clinical trials evaluating novel agents and/or combination approaches as standard treatment options for eligible patients with RCC across the disease spectrum, Apply evidence-based strategies and best practices to diagnose, mitigate, and manage AEs related to novel systemic therapies, including combination regimens, for patients with RCC.