Podcasts about Weill Cornell Medicine

Listener feedback, transcatheter tricuspid valve replacement, a new metabolic disease called CKM, the ARISE-FLUIDS Trial, the BIHCA trial, and temporal trends in ICD therapies are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback LOSE-AF Trial https://jamanetwork.com/journals/jama/fullarticle/2849335 ARREST-AF Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2840225 POP-AF Trial https://doi.org/10.1093/eurheartj/ehaf689 PRAGUE-25 Trial https://www.jacc.org/doi/10.1016/j.jacc.2025.04.042 II Transcatheter Tricuspid Valve Replacement TRISCEND Cost Study https://doi.org/10.1016/j.shj.2026.101049 TRISCEND II Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2401918 III More Disease Creation – the CKM Syndrome ACC/AHA Release First-Ever Guideline for CKM Syndrome https://www.medscape.com/viewarticle/acc-aha-release-first-ever-guideline-ckm-syndrome-2026a1000jbs CKM Guideline in Circulation https://www.ahajournals.org/doi/10.1161/CIR.0000000000001447 IV Two Trials That Teach Important EBM Lessons ARISE-FLUIDS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2516225 Dr Josh Farkas Post on X https://x.com/PulmCrit/status/2065064796270022845?s=20   V  Bicarbonate for Inpatient Cardiac Arrest –The BIHCA trial BIHCA Trial https://jamanetwork.com/journals/jama/fullarticle/2850405 VI The Decline of VT in Heart Failure Trends and Outcomes in ICD Recipients: 15-Year Analysis https://doi.org/10.1093/europace/euag110 Declining Risk of Sudden Death in HF https://www.nejm.org/doi/full/10.1056/NEJMoa1609758 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Chemical cardioversion in the ED, HF monitoring, weight loss in AF, and surgical LAA excision are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Chemical Cardioversion of AF in the ED: The FLECA-ED Trial FLECA-ED Rationale paper https://pmc.ncbi.nlm.nih.gov/articles/PMC10299428/ FLECA-ED ESC Slides https://esc365.escardio.org/presentation/321209 Review on Flecainide Use Despite CAST https://doi.org/10.1016/j.hrthm.2025.08.034 RACE 7 ACWAS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1900353 II Heart Failure Monitoring – The ALLEVIATE-HF Trial ALLEVIATE-HF Trial https://doi.org/10.1016/j.jacc.2026.03.075 CHAMPION Trial https://doi.org/10.1016/S0140-6736(11)60101-3 GUIDE HF Trial https://doi.org/10.1016/S0140-6736(21)01754-2 ALLEVIATE-HF Editorial: Alerts Are Not Treatment https://doi.org/10.1016/j.jacc.2026.04.014 Steve Stiles Medscape report on CHAMPION https://www.medscape.com/viewarticle/755189 III A Negative Weight Loss Study in AF LOSE-AF Trial https://jamanetwork.com/journals/jama/fullarticle/2849335 IV Surgical LAA Excision OPINION Trial https://doi.org/10.1093/eurheartj/ehaf674 LAAOS 3 trial https://www.nejm.org/doi/full/10.1056/NEJMoa2101897 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Tick bites and concerns about Lyme disease are increasing, especially during warmer months. In this episode of Health Matters, host Courtney Allison speaks with Dr. Laura Kirkman and Dr. Karen Acker of NewYork-Presbyterian, Weill Cornell Medicine, and NewYork-Presbyterian Komansky Children's Hospital of Children's Hospital of New York about what people should know about ticks and Lyme disease. Dr. Kirkman explains the types of ticks found in the U.S., where they live, and how they attach to the body. She emphasizes that not every tick bite leads to Lyme disease—it depends on the tick species, whether it carries the bacteria, and how long it remains attached. Dr. Acker explains how Lyme disease is transmitted and outlines the stages of infection, including early symptoms such as the characteristic bullseye rash, fever, and fatigue, as well as less common complications involving the nervous system, heart, or joints. The conversation also covers how Lyme disease is diagnosed and treated, including when testing is necessary and when a preventive dose of antibiotics may be recommended after a tick bite. Finally, the doctors share practical strategies to prevent tick bites—from tick checks and proper clothing to repellents and safe tick removal—and discuss emerging concerns like lone star ticks and alpha-gal syndrome. Their key message: with awareness and simple precautions, you can significantly reduce your risk.   Chapters 00:00 – Understanding Ticks and Their Risks Overview of tick species, where they live, and how they interact with humans 04:30 – What Is Lyme Disease? How Lyme disease is transmitted, early symptoms, and stages of infection 08:45 – Diagnosis, Treatment, and Tick Removal When to test for Lyme disease, antibiotic options, and how to safely remove a tick 12:00 – Preventing Tick Bites and Emerging Concerns Prevention strategies, protecting kids and pets, and lone star tick risks   Key Topics Covered Tick species in the U.S. Where ticks live and how they attach Lyme disease transmission Early symptoms of Lyme disease Bullseye rash and warning signs Diagnosis and antibody testing Antibiotic treatment and prevention Proper tick removal techniques Tick bite prevention strategies Lone star tick and alpha-gal syndrome Takeaway Message A tick bite does not automatically mean Lyme disease. By checking for ticks regularly, removing them promptly, and using simple prevention strategies, you can significantly reduce your risk. When caught early, Lyme disease is highly treatable—making awareness and prevention your best tools for staying safe outdoors.   Doctor Bios Dr. Laura Kirkman is a physician-scientist whose research focuses on the molecular pathogenesis of infection with bloodborne parasitic diseases: malaria and babesiosis. Dr. Kirkman received her M.D. from the Albert Einstein College of Medicine with distinction in research where she benefitted from support from a Howard Hughes Medical Student research award. She completed her clinical training in internal medicine at Yale-New Haven Hospital and her infectious disease fellowship at the NewYork-Presbyterian/Weill Cornell Medical Center. She is an associate professor of medicine and microbiology and immunology at Weill Cornell Medicine.   Dr. Karen Acker is a pediatric hospital epidemiologist at NewYork-Presbyterian Komansky Children's Hospital of Children's Hospital of New York, and an assistant professor in clinical pediatrics at Weill Cornell Medicine. She received her medical degree from SUNY Downstate Medical Center followed by a residency in pediatrics at NewYork-Presbyterian/Weill Cornell Medical Center. After completing her fellowship in pediatric infectious diseases at NewYork-Presbyterian/Columbia University Irving Medical Center in 2018, she joined the pediatric infectious disease division at Weill Cornell Medicine, and has served as a hospital epidemiologist since 2019. Her clinical and research interests include the epidemiology of infectious outbreaks and healthcare-associated infections, diagnostic stewardship, Staphylococcus aureus infections, respiratory viral infections in children, and factors influencing vaccine uptake in children. Dr. Acker is board-certified in pediatrics and board-certified for pediatric infectious diseases.

A life-long treatment for high LDL, a VESALIUS subanalysis, tirzepatide beats semaglutide again, arrhythmia burden in cardiac amyloidosis, and a lipid guideline rebuttal are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Permanent Lipid Lowering therapy Verve 102 Therapy for FH https://www.nejm.org/doi/full/10.1056/NEJMoa2601283 II Vesalius Substudy on PCSK9i Use in Patients With Previous PCI VESALIUS Subgroup Analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.080616 VESALIUS Study - NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2514428 III Tirzepatide looking to be best again SURPASS-EARLY Trial https://www.acpjournals.org/doi/10.7326/ANNALS-25-05602 SURMOUNT-5 Trial https://www.nejm.org/doi/abs/10.1056/NEJMoa2416394 IV Arrhythmias in Cardiac Amyloidosis Loop Recorders Reveal Arrhythmias in Cardiac Amyloidosis https://www.medscape.com/viewarticle/loop-recorders-reveal-arrhythmias-cardiac-amyloidosis-2026a1000gq9 EXCALIBUR Study https://www.jacc.org/doi/10.1016/j.jacc.2026.04.030 V Lipid Guidelines ·       In Defense of the 2026 Dyslipidemia Guideline https://www.medscape.com/viewarticle/defense-2026-dyslipidemia-guideline-2026a1000hd0 Lipid Guidelines: Four Major Concerns https://www.medscape.com/viewarticle/lipid-guidelines-four-major-concerns-2026a1000fim You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

What if the persistent pelvic pain, the performance issues in the bedroom, or that nagging brain fog isn't just a physical "glitch," but a physical manifestation of an underlying mental struggle? Most men are trained to wear a mask in the clinic, but the body always keeps the score. When a man avoids reality, his physiology pays the price.Today, we're peeling back that mask with Dr. Daniel Margolis. Dr. Margolis is an Associate Professor of Radiology at Weill Cornell Medicine in New York City and a world-renowned diagnostic radiologist. A graduate of UC Berkeley and USC, he completed advanced fellowships at Stanford and UCLA, specializing in using MRI to detect and characterize prostate cancer. With over 90 publications to his name, Dr. Margolis serves on the ACR PI-RADS Committee and Co-Chairs the Society of Abdominal Radiology Prostate Cancer Panel. He isn't just someone who looks at screens; he's the "driver" of the most advanced imaging "cars" in the world. If you've been worried about Gadolinium brain deposits or simply want to know if you can skip the needle during your next scan, this is the masterclass you've been waiting for.In this episode, you'll learn:The Biparametric Breakthrough: Why most men can now skip MRI contrast without missing significant cancer.1.5T vs. 3T: Why a "stronger" magnet isn't always better, especially if you have a hip replacement.The Biopsy-Free Future: How AI and blood tests are converging to eventually eliminate the needle.Expert Vetting: How to tell if your radiologist is a "pro" or just a "tech" by looking for ACR certification.Chapters00:00 – Intro & Why MRI Matters in Prostate Cancer02:45 – How Many MRIs Does a Radiologist Read a Day?06:20 – Will AI Replace Radiologists?11:20 – The PRIME Trial: Can We Skip MRI Contrast Dye?14:15 – 1.5 Tesla vs 3 Tesla MRI: Does It Matter?22:45 – How to Know if You're Getting a Good Prostate MRI24:00 – Multiparametric vs Biparametric MRI Explained35:00 – PRIME Trial Results: Did Contrast Actually Matter?38:15 – Is Gadolinium Contrast Safe?44:20 – Why the PRIME Trial Worked: Quality Control Matters48:00 – Who Still Needs Contrast on Their MRI?56:00 – Will Prostate Biopsies Disappear?59:00 – How AI is Changing Prostate MRI___________________________________

Jonathan Avery, M.D., is the Vice Chair for Addiction Psychiatry, the Stephen P. Tobin and Dr. Arnold M. Cooper Professor in Consultation-Liaison Psychiatry, and the Program Director for the Addiction Psychiatry Fellowship at Weill Cornell Medicine and New York-Presbyterian Hospital.  He is also the medical director for the NBA/NBPA's Anti-Drug Program. Today on the show we discuss: why today's weed is far more potent and risky than the marijuana many people grew up hearing about, how high-THC products can impact anxiety, depression, sleep, psychosis, withdrawal, and cannabinoid hyperemesis syndrome, why cannabis addiction is often dismissed and misunderstood, how social media is rewiring kids' brains through dopamine-driven attention loops, why porn, OnlyFans, AI girlfriends, and loneliness are becoming a major crisis for young men, and how sports betting has become one of the fastest-growing behavioral addictions because of constant access through phones and much more. ⚠ WELLNESS DISCLAIMER ⚠ Please be advised; the topics related to health and mental health in my content are for informational, discussion, and entertainment purposes only. The content is not intended to be a substitute for professional advice, diagnosis, or treatment. Always seek the advice of your health or mental health professional or other qualified health provider with any questions you may have regarding your current condition. Never disregard professional advice or delay in seeking it because of something you have heard from your favorite creator, on social media, or shared within content you've consumed. If you are in crisis or you think you may have an emergency, call your doctor or 911 immediately. If you do not have a health professional who is able to assist you, use these resources to find help: Emergency Medical Services—911 If the situation is potentially life-threatening, get immediate emergency assistance by calling 911, available 24 hours a day. National Suicide Prevention Lifeline, 1-800-273-TALK (8255) or https://suicidepreventionlifeline.org.  SAMHSA addiction and mental health treatment Referral Helpline, 1-877-SAMHSA7 (1-877-726-4727) and https://www.samhsa.gov Learn more about your ad choices. Visit megaphone.fm/adchoices

Three more digoxin trials, yet another GLP-1 drug on the horizon, vagal nerve stimulation, trial inside baseball, and more on lipid guidelines are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I More About Low-dose Digoxin in HF — The DECISION Trial(s) DECISION Trial https://www.nature.com/articles/s41591-026-04406-6 Digitalis Glycosides in HF — JAMA Meta-Analysis https://jamanetwork.com/journals/jama/fullarticle/2848972 DIGIT-HF Trial https://www.nejm.org/doi/10.1056/NEJMoa2415471 RADIANCE Trial (1993) https://www.nejm.org/doi/full/10.1056/NEJM199307013290101 DECISION Withdrawal Study https://doi.org/10.1093/eurheartj/ehag385 Digoxin Discontinuation vs Continuation in Chronic HF https://doi.org/10.1016/j.amjcard.2007.02.099 II Yet another GLP-1 Drug Announced this Week Lillly News Release on Retatrutide https://investor.lilly.com/news-releases/news-release-details/lillys-triple-agonist-retatrutide-delivered-powerful-weight-loss III A Big Story in HF Science – Vagal Nerve Stimulation in HFrEF ANTHEM HFrEF trial https://doi.org/10.1016/j.jacc.2026.03.040 Editorials An Unfinished ANTHEM https://doi.org/10.1016/j.jacc.2026.04.033 When Trials Stop Prematurely https://doi.org/10.1016/j.jacc.2026.03.039 IV Lipid Guideline News Lipid Guidelines: Four Major Concerns https://www.medscape.com/viewarticle/lipid-guidelines-four-major-concerns-2026a1000fim Editorial: Time to Move Beyond the Statin Nocebo Effect  https://www.jacc.org/doi/10.1016/j.jacc.2026.04.002 Correspondence: SAMSON N-of-1 Trial of Statin, Placebo, or No Treatment https://www.nejm.org/doi/full/10.1056/NEJMc2031173 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Another positive digoxin trial, another classic coronary physiology study from Imperial College London (ORBITA-FIRE), news in hypertrophic cardiomyopathy, and TAVR done in the wrong patients are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Digoxin in Rheumatic Heart Disease Dig-RHD Trial https://jamanetwork.com/journals/jama/fullarticle/2848973 Safety and Efficacy of Digoxin: Meta-Analysis https://www.bmj.com/content/351/bmj.h4451.long DIGIT-HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2415471 DIG Trial https://www.nejm.org/doi/full/10.1056/NEJM199702203360801 RADIANCE Trial https://www.nejm.org/doi/full/10.1056/NEJM199307013290101 II The Physiologic Threshold for Angina ORBITA-FIRE Trial https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.125.078738 III Prediction in Hypertrophic Cardiomyopathy Predictors of Long-Term Outcomes in HCM https://jamanetwork.com/journals/jama/fullarticle/2848800#250998713 IV TAVR Trends in Young Patients Temporal Trends in AVR for Aortic Stenosis in Patients < 65 https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.126.016826 Wall Street Journal article https://www.wsj.com/health/healthcare/heart-valve-tavr-surgery-aorta-1e0eda70 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Listener feedback from the DanGer Shock investigators, complete vs staged revascularization, polygenic risk scores, and quality improvement failure in an RCT are the topics John Mandrola, MD, discusses in this week's podcast.   This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback DanGer Shock Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2312572 CHIP-BCIS 3 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2515704 II Immediate Complete vs Staged Revascularization in STEMI Meta-analysis: Timing of Complete Revasc in Patients with STEMI and Multivessel Disease https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.126.016601 COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775 FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149 iMODERN Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2512918 III Polygenic Risk Scores for Prediction Polygenic Risk Report in US-Based Hospitals for 8 CV Conditions  https://www.jacc.org/doi/10.1016/j.jacc.2026.03.035 IV Practice Improvement Policies Undergo the Proper Test – Randomization Quality Improvement on Hospitalizations and Health Outcomes for People with CHD https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.125.012904 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Welcome to the Oncology Brothers podcast! In this episode, we dived deep into the treatment algorithm for metastatic non-small cell lung cancer (NSCLC) without actionable driver mutations in frontline settings. Listen us on: Spotify: https://open.spotify.com/show/31BXhY9FM4gPWG10WgE11o Apple Podcast: https://podcasts.apple.com/us/podcast/oncology-brothers-practice-changing-cancer-discussions/id1653340966 Follow us on social media: ⁠X/Twitter: https://twitter.com/oncbrothers ⁠Instagram: https://www.instagram.com/oncbrothers Website: https://oncbrothers.com/ We discussed the latest updates in lung cancer treatment, including the recent approval of Teliso-V for C-MET overexpressing disease and Zongertinib for HER2 positive cases. We explored the nuances of choosing between single-agent and dual checkpoint inhibitors, the role of PD-L1 scores, and the impact of molecular testing on treatment decisions. Special guest Dr. Christine Garcia, a thoracic medical oncologist and fellowship program director at Weill Cornell Medicine, shared her insights on the importance of biomarker testing, the implications of STK11 and KEAP1 mutations, and the evolving landscape of KRAS inhibitors. Key topics covered in this episode: The significance of NGS testing and PD-L1 scores in treatment decisions The role of chemotherapy in high PD-L1 patients Insights on dual checkpoint inhibitors based on recent clinical trials The latest options for KRAS G12C mutations and C-MET overexpression Practical considerations for managing treatment-related side effects Tune in for an informative discussion that bridges the gap between academic research and community practice in oncology. Don't forget to subscribe for more episodes on treatment algorithms and the latest in cancer care! #MetastaticNSCLC, #Immunotherapy, #KRASG12C, #BiomarkerTesting, #OncologyBrothers

Three years after her small cell lung cancer diagnosis, patient advocate Wendy Brooks sits down with Dr. Ashish Saxena, medical oncologist at Weill Cornell Medicine, to talk about the rapid changes transforming SCLC care. From immunotherapy and bispecific T-cell engagers to emerging targeted therapies, this episode unpacks what every patient should know about today's treatment landscape. You'll learn why clinical trials are NOT a last resort, why you should ask about them at your very first appointment, and how to advocate for yourself through side effects and treatment decisions. Dr. Saxena also explains the evolving role of biomarker testing in small cell lung cancer and shares why he's more hopeful than ever about patient outcomes. Whether you're newly diagnosed, a long-term survivor, or a caregiver, this conversation delivers honest answers and real hope. Guests: Dr. Ashish Saxena, Medical Oncologist, Weill Cornell Medicine Wendy Brooks, Patient Co-Host, Living with Small Cell Lung Cancer Show Notes: https://lcfamerica.org/wp-content/uploads/2026/05/LCFA-SCLC-Clinical-Trials-Long-Term-Outlook-Show-Notes.pdf  Transcript: https://lcfamerica.org/wp-content/uploads/2026/05/LCFA-HWA-SCLC-Clinical-Trials-Transcript.pdf  Video: https://youtu.be/RCwJvdcOS-4  For more information, visit lcfamerica.org.

Time to quadruple therapy, the disappointing AVANT GUARD trial, PFA risks, the TREAT-PVC trial, and NSTEMI care in the frail elderly are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Time to Quadruple Therapy in HFrEF Time to Quadruple Therapy After Diagnosis of HFrEF https://jamanetwork.com/journals/jamacardiology/fullarticle/2846899 II AVANT GUARD PFA Bests Meds as First-Line Treatment for Persistent AF in Randomized Trial https://www.medscape.com/viewarticle/pulsed-field-ablation-bests-meds-first-line-treatment-2026a1000dsm Pulsed Field Ablation of AF Disappoints in Setup for Success: AVANT GUARD https://www.medscape.com/viewarticle/pulsed-field-ablation-af-disappoints-setup-success-avant-2026a1000ddt AVANT GUARD Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600929 Persistent AF: Meta-analysis of Invasive Strategies 10.1016/j.ijcard.2018.11.127 External Link III Speaking of Scary News on PFA – The TIFFANY Study Abstract - The TIFFANY Study https://www.heartrhythmjournal.com/article/S1547-5271(26)01747-9/fulltext Delayed Myocardial Ischemia and Malignant Arrhythmias After PFA https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.125.077983 Alberto Alfie Comment https://x.com/ALFIEEP1/status/2050029151315189774?s=20 IV TREAT PVC Trial TREAT-PVC Trial https://doi.org/10.1016/j.jacep.2026.01.011 TREAT-AF Study 2020 https://doi.org/10.1016/j.jacep.2019.11.008 V NSTEMI In Frail Older Patients SENIOR-RITA Trial https://www.nejm.org/doi/10.1056/NEJMoa2407791 Subanalysis of Senior RITA Trial https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847995 Timing of Invasive Strategy in Patients With Non-ST-Elevation Acute Coronary Syndrome -- Meta-analysis https://doi.org/10.1016/S0140-6736(17)31490-3 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

This episode recorded live at the Becker's 16th Annual Meeting features Keith Elgart, Chief Executive Officer, Concierge Choice Physicians and Timothy P. Seibert, MPH Chief Administrative Officer & Executive Director — Primary Care Initiative, Weill Cornell Medicine. They discuss how hybrid concierge programs can improve physician satisfaction, enhance patient experience, and create sustainable revenue streams while maintaining equitable access to care.This episode is sponsored by Concierge Choice Physicians.

PCSK9 inhibitors in high-risk diabetes without ASCVD, the CAAN-AF trial, conduction system pacing vs biventricular pacing, PFA and stroke, and therapeutic fashion infects expert consensus are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I VESALIUS-CV  VESALIUS-CV Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2514428 JAMA Substudy https://jamanetwork.com/journals/jama/fullarticle/2847162 II How Best to Maximize CRT Benefit in Patients with AF CAAN-AF Trial https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag206/8654625?searchresult=1 Role of AV Node Ablation: Meta-analysis of Observational Studies https://www.jacc.org/doi/10.1016/j.jacc.2011.10.891 III Stroke Rates in PFA vs Thermal Ablation Comparative Safety of RF versus PFA for AF in a High-Volume US Medical Center https://esc365.escardio.org/Ehra-congress/sessions/18281 IV Five New CSP Studies Presented and Published HeartSync-LBBP Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2845803 PhysioSync-HF Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2845802 LEFT-BUNDLE-CRT Trial https://doi.org/10.1093/eurheartj/ehag225 Long-Term Follow-up of His-Alternative I Trial https://www.jacc.org/doi/10.1016/j.jacep.2026.02.016 LECART Trial https://esc365.escardio.org/Ehra-congress/sessions/17140 V New EP Training Document Published Advanced Training Statement on Clinical Cardiac Electrophysiology  https://www.jacc.org/doi/10.1016/j.jacc.2026.01.074 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Show Notes Inflammation is one of the body's most important defense mechanisms—but when it doesn't shut off, it can quietly contribute to serious health problems. In this episode of Health Matters, host Courtney Allison speaks with Dr. Charis Meng, a rheumatologist at NewYork‑Presbyterian and Weill Cornell Medicine, about how inflammation works and why chronic inflammation can put the body at risk. Dr. Meng explains the difference between short‑term, helpful inflammation and long‑term inflammation that lingers for months or years, affecting everything from joints to the heart, brain, and immune system. The conversation explores autoimmune conditions like rheumatoid arthritis, what causes inflammation, and how lifestyle factors such as diet, sleep, stress, and physical activity can impact inflammation. Dr. Meng also discusses treatment options ranging from targeted immune therapies to lifestyle changes, acupuncture, and emerging research on GLP‑1 medications. This episode offers clear, science‑based guidance to help listeners understand inflammation—and what they can do to help keep it in check. Chapters 00:00 – What Is Inflammation, and When Is It Helpful? How inflammation works as the body's natural defense system 03:45 – Acute vs. Chronic Inflammation Why inflammation sometimes doesn't shut off—and how it can cause harm 07:30 – Inflammation and Disease Risk Autoimmune conditions, heart disease, diabetes, and cancer 09:45 – How to Reduce Chronic Inflammation Medical treatments, diet, exercise, sleep, and emerging research   Key Topics Covered Inflammation and the immune system Acute vs. chronic inflammation Autoimmune diseases and rheumatoid arthritis Heart disease, diabetes, and cancer risk Anti‑inflammatory lifestyle habits Mediterranean diet and inflammation Exercise, sleep, and immune balance Acupuncture and integrative care GLP‑1 medications and inflammation research   Takeaway Message Inflammation is the body's natural healing response, but when it becomes chronic and doesn't turn off, it can contribute to serious conditions like heart disease, diabetes, and cancer. While some chronic inflammation is driven by autoimmune disease or factors beyond our control, healthy habits like diet, exercise, and sleep can still help support the body and reduce long-term health risks.   Doctor Bio Dr. Charis Meng is an assistant attending rheumatologist at NewYork-Presbyterian/Weill Cornell Medical Center and an assistant professor of clinical medicine at Weill Cornell Medicine, who is also certified in acupuncture. Her practice is in general rheumatology, and her special interests are in treating older patients with chronic pain, low back pain and inflammatory arthritis.

SPIRIT-HF, another spironolactone trial in HFpEF; the ESSENCE imaging study of the drug olezarsen; the SirPAD trial in peripheral artery disease; and ultrasound-guided femoral venous access are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I ACC: SPIRIT-HF Trial FINEARTS-HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2407107 TOPCAT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1313731 TOPCAT Americas Trial https://www.ahajournals.org/doi/10.1161/circulationaha.114.013255 II A New Class of Lipid Lowering Drug Has a Dubious Debut At ACC ESSENCE-TIMI 73b Imaging Study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.080012 ESSENCE-TIMI 73b Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2507227 IMPROVE IT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1410489 III Drug-Coated Balloons Looked Quite Good in PAD interventions Sirolimus-Coated Balloon Reduces Amputation Risk in Peripheral Artery Disease https://www.medscape.com/viewarticle/sirolimus-coated-balloon-reduces-amputation-risk-peripheral-2026a1000a83 SirPAD trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600360 IV Another Vascular Story from the European Heart Rhythm Association ULYSSES Trial https://doi.org/10.1093/eurheartj/ehag291 ULTRA-FAST Trial https://doi.org/10.1093/europace/eux175 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

In this episode of the Neurocritical Care Society Podcast Masterclass series, hosts Stephan Mayer, MD, FCCM, FNCS, and Jon Rosenberg, MD, are joined by Hooman Kamel, MD, MS, professor of neurology at Weill Cornell Medicine, to discuss how clinical trials take shape in practice. Dr. Kamel reflects on his path into research, the importance of strong mentorship and what it takes to grow from early-stage projects to large multicenter trials. Their conversation explores practical aspects of trial design in neurocritical care, including building robust data sets, leveraging EMR-based tools, designing pragmatic studies and fostering collaboration across institutions. They also discuss the Arcadia trial and the broader mindset required to stay engaged in research, even when results do not go as expected. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

Three imaging-guided PCI trials (two with surprising results), LDL targets, an oral PCSK9 inhibitor, and another beta-blocker withdrawal trial are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I IVUS-Guided PCI OPTIMAL Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600440 IVUS-CHIP Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2601521 ILUMIEN IV Trial https://www.nejm.org/doi/10.1056/NEJMoa2305861 DKCRUSH VIII Trial https://doi.org/10.1016/j.jacc.2026.01.081 II Ez-PAVE Trial — Low vs Very Low LDL-targets Does Ez-PAVE Support 'Lower Is Better' for LDL-C? https://www.medscape.com/viewarticle/does-ez-pave-support-lower-better-ldl-c-2026a1000akx Ez-PAVE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600283 2026 ACC/AHA Lipid Guidelines https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423 III CORALreef AddOn CORALreef AddOn Trial https://www.jacc.org/doi/abs/10.1016/j.jacc.2026.03.036 This Week in Caardiology 2-6-26 https://www.medscape.com/viewarticle/1003240 CORALreef Lipids Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2511002 IV Another Post-MI Beta-blocker Withdrawal Study: SMART-DECISION SMART-DECISION Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2601005 ABYSS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2404204 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

John Mandrola offers an ACC recap of 5 big trials—Hi-PEITHO, PROTAVI, ORBITA-CTO, CHIPS-BCIS3 and CHAMPION AF This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Catheter Based Fibrinolysis of Pulmonary Embolism –Hi PEITHO Fibrinolysis Treatment Validated in Large Trial for Acute Intermediate-Risk PE https://www.medscape.com/viewarticle/fibrinolysis-treatment-validated-large-trial-acute-2026a10009im Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolism (HI PEITHO) https://www.nejm.org/doi/full/10.1056/NEJMoa2516567 National Early Warning Score (NEWS) https://www.england.nhs.uk/ourwork/clinical-policy/sepsis/nationalearlywarningscore/ II PRO-TAVI trial Deferral of percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation (PRO-TAVI) 10.1016/S0140-6736(26)00308-9 External Link PCI in Patients Undergoing Transcatheter Aortic-Valve Implantation (Notion 3) https://www.nejm.org/doi/full/10.1056/NEJMoa2401513 III ORBITA CTO Sham vs PCI for Angina Relief Tightly Blinded Trial Confirms PCI Reduces Angina in Obstructive Occlusion https://www.medscape.com/viewarticle/tightly-blinded-trial-confirms-pci-reduces-angina-2026a10009ob A Randomized, Placebo-Controlled Trial of Chronic Total Occlusion Percutaneous Coronary Intervention in Stable Angina - ORBITA-CTO https://www.jacc.org/doi/10.1016/j.jacc.2026.03.027 ORBITA 1 10.1016/S0140-6736(17)32714-9 External Link ORBITA 2 https://www.nejm.org/doi/full/10.1056/NEJMoa2310610 DECISION CTO https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.031313 EuroCTO https://doi.org/10.1093/eurheartj/ehy220   IV CHIPS BCIS3 Impella Supported High-Risk PCI Adoption Before Evidence: CHIP-BCIS3 Humbles Impella https://www.medscape.com/viewarticle/adoption-before-evidence-chip-bcis3-humbles-impella-2026a10009jh Left Ventricular Unloading in High-Risk PCI (CHIP BCIS3) https://www.nejm.org/doi/full/10.1056/NEJMoa2515704 Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock (DanGer Shock) https://www.nejm.org/doi/full/10.1056/NEJMoa2312572 V CHAMPION AF – Watchman vs DOAC in Patients With AF CHAMPION-AF Trial Finds LAAC an Alternative for NOAC in Lower-Risk Patients https://www.medscape.com/viewarticle/champion-af-trial-finds-laac-alternative-noac-lower-risk-2026a10009ij Six Reasons Why CHAMPION-AF Should Not Change Practice https://www.medscape.com/viewarticle/six-reasons-why-champion-af-should-not-change-practice-2026a10009i7 Left Atrial Appendage Closure or Anticoagulation for Atrial Fibrillation (CHAMPION AF) https://www.nejm.org/doi/full/10.1056/NEJMoa2517213 Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation (CLOSURE AF) https://www.nejm.org/doi/full/10.1056/NEJMoa2513310 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Clinical trials can feel intimidating, but they are one of the most important ways new lung cancer treatments become available to patients. In this episode of Hope With Answers: Living With Lung Cancer, patient advocate Wendy Brooks sits down with Dr. Ashish Saxena, thoracic medical oncologist at Weill Cornell Medicine, to break down what clinical trials really are and why they matter. Together, they discuss when patients should ask about clinical trials, what to expect when participating, and common misconceptions — including the fear of being a “guinea pig.” Dr. Saxena explains how clinical trials are carefully designed, closely monitored, and often provide access to promising new therapies earlier in the treatment journey. You'll learn: What clinical trials are and how they work Why timing matters and why you should ask early What patients actually receive in a clinical trial How clinical trials are improving outcomes in lung cancer What questions to ask your doctor Whether you're newly diagnosed or exploring your options, this conversation offers clear, practical insight to help you better understand clinical trials and your role in the decision-making process. Show Notes: https://lcfamerica.org/wp-content/uploads/2026/04/LCFA-HWA-Clinical-Trials-Show-Notes-2026Spring.pdf  Transcript: https://lcfamerica.org/wp-content/uploads/2026/04/LCFA-HWA-Clinical-Trials-Transcript-2026Spring.pdf  Watch Video: https://youtu.be/kBfh8EAGey8  To learn more about clinical trials and download the free toolkit, visit https://lcfamerica.org/trials.

Lawrence Casalino is a professor of population health sciences at Weill Cornell Medicine. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. L.P. Casalino. Physicians, Corporatization, and the Unmeasured Quality of Care. N Engl J Med 2026;394:1249-1251.

Early aortic valve replacement in aortic stenosis, left atrial appendage occlusion in JAMA Cardiology, and a big preview of the upcoming American College of Cardiology meeting are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Early AVR RECOVERY Trial at 10 Years https://www.nejm.org/doi/full/10.1056/NEJMoa2511920 II Major Bleeding with Amulet and Watchman in JAMA Cardiology Amulet IDE Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2847047 5-year Results From Amulet IDE  https://www.jacc.org/doi/10.1016/j.jacc.2024.10.101 III ACC Preview Mandrola's Top 4 Trials from ACC 2026: Details Matter https://www.medscape.com/viewarticle/mandrolas-top-4-trials-acc-2026-details-matter-2026a10008ti CHIB-BCIS3 Trial https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.123.013367 Champion-AF Protocol https://doi.org/10.1016/j.ahj.2023.05.022 ORBITA-CTO Protocol Paper https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1172763/full SPIRIT-HF Clinical Trials.gov  https://clinicaltrials.gov/study/NCT04727073 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

"A side effect patients might experience is lymphedema. This is an increased buildup of lymphatic fluid in the tissues, either in the breast or in the arm and hand of the affected side. It's quite problematic for women. They might feel self-conscious. It might feel uncomfortable that the arm feels like it's throbbing or heavy. Clothing may not fit quite right. So we're always on the lookout for lymphedema," Maria Fenton-Kerimian, APRN, AOCNP®, nurse practitioner at Weill Cornell Medicine in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation site-specific side effects in breast cancer. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by March 27, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to side effects experienced with radiation therapy to the breast. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 368: Best Practices for Challenging Patient Conversations in Metastatic Breast Cancer Episode 354: Breast Cancer Survivorship Considerations for Nurses Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices Episode 298: Radiation Oncology: Nursing's Essential Roles Episode 194: Sex Is a Component of Patient-Centered Care ONS Voice articles: Could High-Dose Radiation Be the Missing Link in Breast Cancer Immunotherapy? Exercise Program Improves Quality of Life in Patients With Breast Cancer—and Keeps Them Moving Daily Frank Conversations Enhance Sexual and Reproductive Health Support During Cancer How to Handle Even the Worst Radiation Therapy Side Effects Clinical Journal of Oncology Nursing articles: Instruments to Evaluate Self-Management of Radiation Dermatitis in Patients With Breast Cancer The Effects of a Clinical Care Model on Quality Process Outcomes in Radiation Oncology Oncology Nursing Forum articles: Feasibility of Breast Radiation Therapy Video Education Combined With Standard Radiation Therapy Education for Patients With Breast Cancer ONS Guidelines™ for Cancer Treatment–Related Radiodermatitis ONS books:  Guide to Breast Care for Oncology Nurses Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS/ONCC® courses:  Radiation Oncology Conference Recordings Bundle™ Radiation Therapy Certificate™ ONS Huddle Cards: Altered Body Image Late Effects of Cancer Treatment Radiation Sexuality ONS Guidelines™: Cancer Treatment–Related Lymphedema Cancer Treatment–Related Radiodermatitis ONS Learning Libraries: Breast Cancer Radiation American Society for Radiation Oncology (ASTRO) National Comprehensive Cancer Network home page To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "The goals of radiation to the breast are typically broken out into three different rationales. Either adjuvant treatment, where the tumor is removed surgically from the breast first and then radiation is delivered to lower the likelihood of return of the cancer. And then the second way it's given is with a curative intent. That may be for tumors that couldn't be fully resected, and the hope is to eradicate the tumor that is still present in the tissue. Lastly, it can be given in a palliative fashion where you're not expecting to completely cure the person of the cancer, but you hope to shrink the tumor enough to relieve symptoms." TS 1:46 "We really try to focus on patients managing fatigue by ensuring that they're having an appropriate, balanced diet with proper macro and micronutrients and that they're having adequate protein intake. We encourage patients to get adequate sleep. There is a culture of people pushing themselves and working into late hours of the night, and this would be quite difficult if you're experiencing radiation-induced fatigue. If someone is familiar and does regular exercise, we highly encourage them to continue that. If someone has not done much exercise and has slipped into a little bit of deconditioning or they're older or more frail, we might refer them for physical therapy or strength training to rebuild some of that stamina and energy." TS 7:56 "One of the key products to use for prevention of radiation dermatitis are silicone patches, and there are many on the market that are worn during the course of radiation or when the skin reaction begins. And they could stay on for several days during treatment, even if you're gently showering around the area. There are many homeopathic creams made from calendula flower, aloe vera, or some kind of combination of these types of products. The real issue with these products is that many of them aren't covered by insurance, so patients have to buy them out of pocket, over the counter. For some of our patients who are more financially challenged, it may be a problem. So I think [it's important] to be familiar with many different products so that patients have access to something that will minimize their skin reaction." TS 14:48 "After 90 days, it may be more common to see some of the cosmetic changes that can happen in the soft tissue of the breast. One of them is radiation fibrosis, which can be like a diffused scar tissue in the breast. It can sometimes cause hardening, retraction, or asymmetry. Sometimes it can cause a tight feeling where people can't stretch their arm to the full extent. We also know that there can be slower healing if surgery is done. For people that have tissue expanders or still want to have corrective plastic surgery, we really encourage them to wait at least six months or longer before approaching any of those plastic surgery procedures." TS 19:55 "Sexual health is such a big topic, but I think that nurses in radiation oncology are in a very good position to discuss that because we see patients for repeated period of time. So, there's maybe a quicker intimacy or familiarity that happens with the nurses in radiation. Personally, I always bring it up at a follow-up visit, which we do about a month after radiation ends. And it's kind of because the dust is settling and people are getting back to their lives." TS 23:53

What does your gut really do—and how can you keep it healthy? In this episode of Health Matters, host Courtney Allison sits down with Dr. Haley Zylberberg, a gastroenterologist at NewYork‑Presbyterian and Weill Cornell Medicine, to find out the basics of gut health, from digestion and the microbiome to fiber, fermented foods, and the gut‑brain connection. Dr. Zylberberg explains how fiber supports digestion, why everyone's “normal” gut function looks different, and how stress and mental health can directly affect the digestive system. She also shares signs of a healthy gut, red flags that shouldn't be ignored, and why colorectal cancer screening is so important—especially as younger adults are being diagnosed more often. Whether you're curious about probiotics, wondering how much fiber you really need, or looking to better understand your body, this episode offers practical, science‑backed guidance to help support lifelong gut health. Chapters: 00:00 – The Basics of Gut Health and the Microbiome What the gut is, how digestion works, and why the microbiome plays a critical role in overall health. 06:30 – Fiber, Food, and Supporting Your Gut How fiber supports digestion, how much you need each day, common misconceptions, and tips for increasing fiber safely. 11:30 – The Gut‑Brain Connection How stress affects digestion, why the gut and brain communicate so closely, and what that means for digestive symptoms. 15:10 – Red Flags and Colorectal Cancer Screening Warning signs of an unhealthy gut, when to see a doctor, and why colorectal cancer screening is essential and preventive. Key Topics Covered   ·  Gut anatomy and digestion ·  The gut microbiome and “good” bacteria ·  Fiber benefits and daily fiber intake ·  Fermented foods and probiotics ·  Gas, bloating, constipation, and diarrhea ·  The gut‑brain connection and stress ·  Red flag digestive symptoms ·  Colorectal cancer prevention and screening guidelines Takeaway Message Your gut plays a central role in your overall health, and small, consistent habits—like eating enough fiber, managing stress, and knowing what's normal for your body—can make a big difference. Paying attention to changes and staying up to date with recommended screenings can help catch problems early and even prevent serious disease. Expert Guest Dr. Haley Zylberberg's clinical focus is general gastroenterology, with a specialization in celiac disease. She has a sustained interest in patient-outcomes research using large databases and has authored numerous peer-reviewed articles on celiac disease diagnosis and its clinical manifestations.  Dr. Zylberberg earned her B.A. in neuroscience and behavior from Columbia University and her medical degree at Hofstra-Northwell School of Medicine, where she graduated with a distinction in research. She completed internal medicine residency at The Mount Sinai Hospital, followed by a gastroenterology fellowship at NewYork-Presbyterian/Columbia University Irving Medical Center, where she served as chief fellow. During her fellowship, Dr. Zylberberg undertook advanced training in research methods, culminating in a master's degree in patient-oriented research from Columbia's Mailman School of Public Health.

Listener feedback, the huge CLOSURE-AF trial of LAAC vs best medical therapy, previews of CHAMPION AF, and the controversial ACC/AHA lipid treatment guidelines are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback COBRRA Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2510703 Closure AF published in NEJM CLOSURE-AF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2513310 CHAMPION AF Rationale - Watchman FLX vs DOACs in Patients With AF https://pubmed.ncbi.nlm.nih.gov/37279840/ LIPID Guidelines ACC/AHA Joint Committee Guideline on Management of Dyslipidemia https://www.jacc.org/doi/10.1016/j.jacc.2025.11.016 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Welcome to the Oncology Brothers podcast! In this episode, we discussed the current treatment landscape for prostate cancer, featuring special guest Dr. Scott Tagawa, a GU Medical Oncologist from Weill Cornell Medicine. Listen us on: Spotify: https://open.spotify.com/show/31BXhY9FM4gPWG10WgE11o Follow us on social media: X/Twitter: https://twitter.com/oncbrothers Instagram: https://www.instagram.com/oncbrothers Website: https://oncbrothers.com/ Join us as we explored: The current standard of care for localized prostate cancer, including active surveillance, surgery, and radiation. The significance of ADT and abiraterone in high-risk disease, supported by the STAMPEDE trial. The role of PSMA PET/CT in staging and how it impacts treatment decisions. Treatment options for castration-sensitive and castration-resistant prostate cancer, including the use of ARPi and chemotherapy. The importance of germline and somatic testing, especially with the recent approval of Niraparib for BRCA2-positive disease. Insights on managing side effects and the nuances of patient-centered care in oncology. Whether you're a healthcare professional or someone interested in the latest advancements in cancer treatment, this episode is packed with valuable information to help you stay informed. Don't forget to like, subscribe, and hit the notification bell for more episodes from the Oncology Brothers! #ProstateCancer, #ADT, #PSMA, #PARPinhibitor, #OncologyBrothers

Beta-blocker in non-obstructive hypertrophic cardiomyopathy, a head-to-head apixaban vs rivaroxaban RCT, diltiazem vs metoprolol combined with DOAC, and the accuracy of smart watches for AF are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback EMPATICC trial https://academic.oup.com/eurheartj/article/47/9/1034/8242490 II Beta-blocker in Non-obstructive HCM BB vs Calcium Channel Blocker in Non-obstructive HCM https://doi.org/10.1016/j.jacc.2025.11.028 RCT of Metoprolol in Patients With Obstructive HCM https://doi.org/10.1016/j.jacc.2021.07.065 III Apixaban vs Rivaroxaban for Bleeding Risk COBRRA Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2510703 AMPLIFY Trial (Apixaban) https://www.nejm.org/doi/10.1056/NEJMoa1302507 EINSTEIN Trial (Rivaroxaban) https://www.nejm.org/doi/full/10.1056/NEJMoa1007903 IV Diltiazem vs Metoprolol When Combined with DOAC Risk for Bleeding in AF Patients Using Apixaban or Rivaroxaban With Diltiazem https://www.acpjournals.org/doi/10.7326/ANNALS-25-01408 V Actual Clinical Use of Smart Watches CIRCA-DOSE Original Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.042622 Wearable Smartwatches for AF Detection After Ablation https://doi.org/10.1093/europace/euaf280 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Listener feedback, urgent AF ablation, AF ablation as a stroke-reducing therapy, implantable loop recorder accuracy, and HF management in the setting of serious disease are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Urgent AF ablations Urgent vs Elective AF Ablation in the US  https://www.jacc.org/doi/10.1016/j.jacep.2025.12.030 II AF Ablation Is Not Likely a Good Therapy for Stroke Reduction STABLED Trial https://jamanetwork.com/journals/jamaneurology/fullarticle/2845745 Catheter Ablation for AF Associated With Lower Incidence of Stroke https://doi.org/10.1093/eurheartj/ehw087 III Loop Recorders ILR Accuracy - Multicenter, Multidevice Comparison https://doi.org/10.1016/j.jacep.2025.12.039 IV Heart Failure Therapy when there is Cancer EMPATICC Trial https://doi.org/10.1093/eurheartj/ehaf705 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

A superb note on CPR and DNR orders, patients' vs doctors' preferences for statins, more on GLP-1s, another LAAC story, and some closing cautionary notes on PFA are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback Addressing Inadequate Documentation of Unilateral DNR https://jamanetwork.com/journals/jama/fullarticle/2829203 Video: Can We Talk About CPR? https://www.youtube.com/watch?v=yTCRfY3ETvI Personal Reminiscences of CPR's Origin https://www.ajconline.org/article/S0002-9149(03)00977-9/pdf II Public Preferences for Statin Therapy Measuring Public Preferences for Statin Therapy https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2844660 III GLP-1 RA News ACHIEVE Trial https://doi.org/10.1016/S0140-6736(26)00202-3 IV New Trial in GLP-1 for Patients with AF Seminal-AF Trial https://clinicaltrials.gov/study/NCT06499857 V Relationship between Spontaneous Echo Contrast and LAAC Outcomes OCEAN-LAAC Trial https://doi.org/10.1016/j.jacep.2025.09.028 News Release on Upcoming LAAOS-4 trial  https://www.phri.ca/watchman/ Reading the "Smoke" -- Editorial on OCEAN-LAAC https://www.jacc.org/doi/10.1016/j.jacep.2025.10.029 VI Concluding Remarks on My Talk at Western AF Delayed Myocardial Ischemia and Malignant Arrhythmias After PFA https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077983 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

Dr. Lakshmi Rajdev and Dr. Manish Shah join the podcast to discuss the updated guideline on immunotherapy and targeted therapy in unresectable locally advanced, advanced, or metastatic gastroesophageal cancer. They share first-line and subsequent-line recommendations for both gastroesophageal adenocarcinoma and esophageal squamous cell carcinoma based on actionable biomarkers including PD-L1 expression, MMR and/or MSI, CLDN18.2 expression, and HER2 status. They note the importance of the algorithms and tables in the guidelines that provide visual illustrations and quick reference guides of the evidence-based recommendations. They also comment on ongoing and recently presented trials that may impact future guidelines in this space. Read the full guideline, "Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline Update" at www.asco.org/gastrointestinal-cancer-guidelines" TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/gastrointestinal-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology,  https://ascopubs.org/doi/10.1200/JCO-25-02958      Timestamps ·       00:00 – 02:15 Introduction and Overview ·       02:16 - 08:20 First-line treatment for patients with pMMR/MSS, HER2-negative gastroesophageal adenocarcinoma ·       08:21 –10:29 First-line treatment for patients with pMMR/MSS, HER2-positive gastroesophageal adenocarcinoma ·       10:30 – 14:39 First-line treatment for patients with dMMR/MSI-H, gastroesophageal adenocarcinoma ·       14:40 – 18:03 First-line treatment for ESCC ·       18:04 – 22:04 Second- and third-line therapy for gastroesophageal adenocarcinoma and ESCC ·       22:05 – 24:38 Importance of guideline ·       24:39 – 27:45 Outstanding questions and future research   Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts.   My name is Brittany Harvey, and today I am interviewing Dr. Lakshmi Rajdev from the Icahn School of Medicine at Mount Sinai and Dr. Manish Shah from Weill Cornell Medicine, co-chairs on "Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline Update." Thank you for being here today, Dr. Rajdev and Dr. Shah. Dr. Lakshmi Rajdev: Thank you. Dr. Manish Shah: Thank you for having us. It is wonderful. Brittany Harvey: And then just before we discuss this guideline, I would like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Rajdev and Dr. Shah, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then to dive into what we are here today to talk about, Dr. Shah, I would like to start first with what prompted the update to this guideline, which was previously published in 2023, and what is the scope of this updated guideline? Dr. Manish Shah: Yes, terrific. So even in the last few years, the pace of drug development in gastroesophageal cancers has just been astounding. So, what prompted this guideline is actually the practice-changing results for a new biomarker, CLDN18.2 hat was based on the GLOW and SPOTLIGHT studies, as well as a practice-changing study in HER2-positive disease where we added pembrolizumab to trastuzumab and chemotherapy for tumors that are HER2-positive and PD-L1 CPS 1 or greater. And then there were also new studies and new approvals in esophageal squamous cell cancer that you will hear about as well. So there were several studies, overall more than 5,000 patients were reported on, and that led to several new therapies, new indications, and it really necessitated this guideline. Brittany Harvey: Excellent. It is great to hear about all of these exciting updates in this space. So then to next review the key recommendations of this guideline by clinical question that the expert panel addressed. So, Dr. Rajdev, what is the recommended first-line treatment for patients with proficient mismatch repair, microsatellite stable, HER2-negative gastroesophageal adenocarcinoma? Dr. Lakshmi Rajdev: Thank you for that question. So historically, we have sort of used fluoropyrimidine and platinum doublets, which yielded a survival of about one year. More recently, immunotherapy and targeted therapy options have improved outcomes in patients with advanced esophageal and gastric adenocarcinoma, as well as squamous cell carcinoma. Patients with gastric and GE junction adenocarcinoma have a high rate of actionable alterations, so it is imperative that physicians test the following biomarkers upfront so that it can help guide therapy. The markers recommended by the ASCO panel are HER2, MMR or MSI, CLDN18.2, and PD-L1. And also, it was recommended to use NGS if feasible in this patient population. HER2, as we know, is expressed in about 15% to 25% of patients; PD-L1 expression occurs in about 80% of patients; MSI-high, deficient MMR is present in about 5% to 8% of patients; and CLDN18.2 expression is present in about 40% of patients. There is, of course, biomarker overlap. About 13% to 22% of CLDN18.2 patients are also PD-L1 positive. For patients with pMMR or microsatellite stable HER2-negative disease with PD-L1 expression greater than 1 and absence of CLDN18.2, the panel recommended a first-line therapy with fluoropyrimidine and platinum-based therapy in combination with immunotherapy. These recommendations stem from large phase 3 trials, and the agents approved in the United States are pembrolizumab, nivolumab, and tislelizumab. It has been shown that immunotherapy benefit is greater in patients with higher PD-L1 expression, and it is not possible to comment on the individual PD-L1 cutoff scores and sort of identify the optimal PD-L1 cutoff score that sort of balances benefits and harms. But what is recommended is that immunotherapy-based treatments can be offered in patients with a CPS score of greater than 1. With regard to the choice of immunotherapy agents, that is pembrolizumab, nivolumab, or tislelizumab, these agents are considered to have similar efficacy, and the selection of an agent could be based on dosing schedule, cost considerations, toxicity, and the method of administration. Typically, clinicians should avoid withholding the start of chemotherapy while awaiting biomarker testing, depending on the clinical scenario. Now, for patients with pMMR microsatellite stable disease that is HER2-negative with PD-L1 expression less than 1 and positive CLDN18.2 expression, zolbetuximab-based treatments or in combination with chemotherapy is recommended, and this is based on two global phase III randomized controlled trials, the GLOW and the SPOTLIGHT. And across both studies, the hazard ratio for the overall survival was 0.78, and similarly, there was also an improvement in progression-free survival favoring the zolbetuximab group compared to the chemotherapy group alone. An important note is that nausea, vomiting is commonly associated with zolbetuximab-based treatments, and the panel recommended prophylactic antiemetics, adjusting zolbetuximab infusion rates, pausing infusion temporarily, using non-prophylactic antiemetics, and hydration intravenously prior to discontinuation of zolbetuximab-based chemotherapy. So effective handling of the GI-related symptoms with zolbetuximab is recommended prior to discontinuation of therapy. Now, for patients with pMMR microsatellite stable HER2-negative gastric, GE junction adenocarcinoma with PD-L1 expression greater than 1 and CLDN18.2 positivity, the ones with the dual expression with CLDN18.2 as well as PD-L1 chemotherapy, the choice of therapy can be based on the degree of PD-L1 expression, the toxicity profile, the burden of symptoms, and the anticipated improvement in symptoms associated with response to treatment, the patient comorbidities, the prior medical and treatment history. So this decision needs to be made on a case-by-case basis, and these are some of the factors that we suggested that could potentially influence the choice of therapy. For patients with pMMR microsatellite stable disease that is HER2-negative and a PD-L1 expression less than 1 and an absence of CLDN18.2 expression, first-line therapy with fluoropyrimidine and platinum-based chemotherapy is recommended. So you can see we have segmented out patients based on PD-L1 expression, pMMR and microsatellite stable disease expression, and also based on CLDN expression. Brittany Harvey: Absolutely. And that first point you noted, I think is really important, that biomarker testing is really critical for treatment decision-making in this space. So then the next subgroup of patients that the panel looked at, Dr. Shah, what first-line therapy is recommended for patients with proficient mismatch repair, microsatellite stable, HER2-positive gastroesophageal adenocarcinoma? Dr. Manish Shah: So this was an update from a few years ago. So we have known for 15 years now that if you are HER2-positive, you should get trastuzumab plus chemotherapy. That was based on the ToGA trial. And the update now is based on a trial called KEYNOTE-811, where it examined the addition of pembrolizumab to trastuzumab and chemotherapy versus trastuzumab and chemotherapy, and there was a progression-free and overall survival benefit. And again, here, the biomarkers are important. If your CPS PD-L1 is less than 1, we would not recommend Pembrolizumab in that setting, so you would still get trastuzumab and chemotherapy. But if it is 1 or greater, the PD-L1 CPS score, then we do recommend pembrolizumab unless there is a contraindication to immunotherapy. The take-home message really is from the onset of diagnosis, please check your biomarkers. And I will just, it is worth repeating, it is important to check your PD-L1 status, HER2 status, mismatch repair status, and CLDN18.2 status. And then the optimal therapy, and it is outlined in the publication, is really biomarker-driven. We know that if we are able to hit the target that is overexpressed, we are going to have a better outcome. And Dr. Rajdev did mention where there is overlap, there can be a lack of data, and that is where we are with both PD-L1 positive and CLDN positive. Here we do have data in HER2-positive cases where if you are both HER2-positive and PD-L1 positive, you would combine trastuzumab and pembrolizumab for the best outcomes. Brittany Harvey: Understood. I really appreciate you detailing what is most important for each individual biomarker combination that patients may have. So then following that, Dr. Rajdev, what does the expert panel recommend for first-line treatment for patients with esophageal squamous cell carcinoma that is not amenable to definitive chemoradiation? Dr. Lakshmi Rajdev: There are three phase III randomized clinical trials that have influenced practice in patients with esophageal squamous cell carcinoma examining the benefit of immunotherapy in this patient population. The RATIONALE-306 was a randomized trial of tislelizumab plus chemotherapy with platinum and fluoropyrimidine or paclitaxel versus placebo with chemotherapy. And then you have the KEYNOTE-590, which compared pembrolizumab plus chemotherapy versus chemotherapy alone. And then you have CheckMate-648, which included comparisons of nivolumab plus chemotherapy versus nivolumab plus ipilimumab or chemotherapy. And the primary endpoints for these studies were overall survival, and they did look at subgroups with PD-L1 expression. They used TPS score greater than 1% in CheckMate-648 and PD-L1 CPS greater than 10 in KEYNOTE-590. The bottom line is that the overall hazard ratio for overall survival across this patient population was 0.72. So clearly, there is benefit in patients that express PD-L1 CPS greater than 1 for benefit for the addition of immunotherapy. Now, the benefit again in patients with a PD-L1 expression less than 1 remains limited, and so the panel has made a recommendation for using immunotherapy in combination with platinum-based chemotherapy in patients with a PD-L1 greater than 1. Again, we know that it is hard to make recommendations on what PD-L1 cutoffs are recommended in this patient population, meaning that should it be limited to patients with a PD-L1 of 1 to 4 or greater than 10? I think that the general consensus that has been gleaned from the data is that the higher the PD-L1 expression, the greater the benefit. I do want to comment on another option that is available in patients with squamous cell carcinoma compared to adenocarcinoma, and that is the combination of nivolumab and ipilimumab. Now, in CheckMate-648, nivolumab with ipilimumab was also recommended as a treatment option in patients that have a PD-L1 score of greater than 1. There was a survival benefit demonstrated with this combination compared to chemotherapy alone. And an important observation in this study is that, although there was a slightly increased rate in early death, but there was really no significant difference in PFS and OS compared to chemotherapy alone. Importantly, the treatment appeared to be pretty well tolerated by the study population. There was a notable difference in the objective response rate, which was 35% in the nivolumab plus ipilimumab group compared to patients receiving nivolumab and chemotherapy, where it was 53%. So superiority is, so the importance of chemotherapy in patients with esophageal squamous cell carcinoma is to be noted. However, there is no difference in overall survival and progression-free survival when using the combination of nivolumab and ipilimumab, and thus it affords a chemotherapy-free option for this patient population with esophageal squamous cell carcinoma and a CPS with a score of greater than 1. Brittany Harvey: Understood. I appreciate you reviewing the evidence underpinning those recommendations as well. So then the next patient population that the guideline panel addressed, what first-line therapy is recommended for patients with deficient mismatch repair, microsatellite instability-high, gastroesophageal adenocarcinoma or esophageal squamous cell carcinoma? Dr. Lakshmi Rajdev: The rate of MSI-high expression is about 3% to 7% across different studies. Now, the KEYNOTE-158 was a tumor-agnostic study in patients with non-colorectal cancers, and again, the problem with the MSI-high population, given that it is so rare, the numbers in the individual studies are fairly small. But consistent outcomes do emerge, indicating high response to immunotherapy. So in KEYNOTE-158, a response rate of about 46% was noted. The number of patients was small, it was about 24. In CheckMate-649, which is a study of chemotherapy plus or minus nivolumab in patients with advanced gastric adenocarcinoma, there was again a very small number of patients, and patients that were MSI-high or deficient MMR did experience substantial benefits with the addition of immunotherapy, with hazard ratios in the order of about 0.38. In KEYNOTE-062, again, it was a very small number of patients, again about 6% or so, and similar to CheckMate-649, a substantial benefit was noted in combination with chemotherapy, but also there were benefits noted with pembrolizumab alone. The RATIONALE-305 again was a study of tislelizumab in combination with chemotherapy and similarly showed benefits to the combination of chemotherapy plus immunotherapy in this patient population. I think that we are all aware of the dramatic benefits of immunotherapy in this particular subset of patients, deficient MMR MSI-high, and also we have seen in CheckMate-649 they did have a subset of patients that received nivolumab and ipilimumab. And in this patient population, they noted unstratified hazard ratio of 0.28. So I think that the overall consensus is that immunotherapy is a very important treatment modality in patients with deficient MMR MSI-high disease, given that a lot of the trials in gastroesophageal adenocarcinoma have utilized chemotherapy-based options, that is certainly a recommendation of the panel to use chemotherapy in combination with immunotherapy. However, on a case-by-case basis, the panel recommended immunotherapy alone as well, and given the high response rates noted in trials across different diseases as well as noted in this disease as well. Brittany Harvey: Certainly. And I appreciate you both for reviewing these first-line recommendations. So moving to later lines of therapy, Dr. Rajdev, what recommendations did the expert panel make for second or third-line therapy for gastroesophageal adenocarcinoma and esophageal squamous cell carcinoma? Dr. Lakshmi Rajdev: So, I think that the RAINBOW trial that investigated the utility of the addition of ramucirumab as second-line therapy has been around since 2014, and those results have led to the addition of ramucirumab to taxane-based therapy in the second-line setting. Based on the utilization of oxaliplatin and platinum-based therapy in the front-line setting, there may be patients that have an underlying neuropathy, and so we wanted to really include treatment options for this patient population so that an agent that is less neurotoxic could also be recommended in combination with ramucirumab. The RAMIRIS trial is one such trial where ramucirumab was combined with FOLFIRI, and it demonstrated benefit in combination with ramucirumab. So we have listed that as a potential treatment option for patients in the second-line setting who may have an underlying neuropathy or even for whatever reason that based on the toxicity profile, that needs to be the preferred option by a physician, that recommendation is new from the older guidelines that we have. With regard to the utility of PD-1 inhibitors, there really has been no benefit noted in the second-line setting with regard to overall survival or progression-free survival, so no recommendation is made for that option. I think an important study that has been recently presented is the DESTINY-Gastric04 trial, which really has been practice-changing and has led to the recommendation for trastuzumab deruxtecan in patients that have HER2-positive metastatic gastric or GE junction adenocarcinoma. Now, this is a phase III trial in patients who retained HER2-positive disease after progressing on front-line trastuzumab-based treatments, and the comparator for this trial was trastuzumab deruxtecan versus ramucirumab plus paclitaxel. There was significant improvement and progression-free survival in patients that received trastuzumab deruxtecan. The patients that were excluded from the trial are patients that have pulmonary problems, interstitial lung disease; that is one of the toxicities of this particular agent, and close monitoring and prompt initiation of therapy such as glucocorticoid treatment in patients who develop this toxicity was also highlighted by the panel. So to summarize, the new guidelines highlight the possibility of FOLFIRI plus ramucirumab as a second-line option and then trastuzumab deruxtecan as a later-line option in patients that still retain HER2 expression. And that is very important because the trial did retest patients whether they expressed HER2. As we know, in a substantial number of patients, there is downregulation of HER2, and there is emerging data that the benefit for subsequent HER2-directed therapies is best noted in patients that still retain HER2 expression. Brittany Harvey: Great. So as our listeners have heard, there are many recommendations and new treatment options for advanced gastroesophageal cancer. Dr. Shah, earlier you highlighted the importance of biomarker testing, but I would like to hear in your view, what is the importance of this guideline and how will it impact both clinicians and patients with gastroesophageal carcinoma? Dr. Manish Shah: So as we have discussed throughout this podcast, the treatment for gastroesophageal cancer, both adenocarcinoma and squamous cell cancer, is increasingly complex, increasingly biomarker-driven. And I think the value of the guideline is to place all of that into context. So it provides the data for why certain biomarkers are important, what therapies should be indicated. Not only that, but if you are able to review the guideline, it provides the details of each of these studies and summarizes them in a meta-analysis fashion to sort of give you the context, because sometimes the individual studies can be maybe a little bit discordant or confusing and the guideline attempts to harmonize all that. And then also, I think the tables are very, very interesting because they give you actual numbers in terms of how many patients over a thousand would this benefit or how many patients over a thousand would this cause harm in terms of nausea, vomiting, or other things like that. So it gives you context for helping clinicians and patients weigh the potential benefits of the novel treatment strategies against the potential adverse events. And then finally, the guideline does also provide an algorithm that you are able to follow based on the biomarkers, and those are in figures 4 and 5. So I think overall, it is a very comprehensive guideline. It intends to make more manageable a very complex subject, and you know, I really encourage our listeners to review it after listening to the podcast. Dr. Lakshmi Rajdev: If I can add to that, I think that what is also really good about the guidelines is there are quick summaries. So if someone is busy in the clinic, of course, there is the opportunity to review the data supporting the guidelines in great depth in the manuscript, but what is also really good is that there are good summaries. In the event that you are very busy, you can easily identify what the recommendations should be for that particular patient based on these summaries. Brittany Harvey: Absolutely. Listeners are encouraged to review the full guideline, including those tables and figures that may be more helpful when they are looking for something quick to look at in the clinic as well. So, as you both mentioned, there have been a number of recent practice-changing trials in this area. So I imagine there is still a lot of ongoing research as well. So Dr. Shah, what are the outstanding questions regarding treatment options for patients with locally advanced unresectable, advanced, or metastatic gastroesophageal carcinoma? Dr. Manish Shah: I think we touched upon it a little bit. The guidelines are based on the data available, and they are primarily examining one novel therapy with chemotherapy in a specific biomarker population. But as you know, the biomarkers are not either/or; you are not either CLDN18.2 positive or PD-L1 positive. A portion of patients could have dual biomarkers, and you know, I think that we are generating data on how to manage those patients. At the recent GI Symposium in January this year, the ILUSTRO trial was presented by Dr. Shitara, which looked at combining zolbetuximab and chemotherapy with immunotherapy for dual-positive biomarkers, and that is leading to a phase III study that has begun to enroll. So unanswered questions are: how do we manage dual-positive biomarkers? The other thing that was mentioned is that the current data for mismatch repair deficiency involve chemotherapy plus immunotherapy. Only squamous cell cancer is there a study with a positive non-chemotherapy kind of backbone, that is CheckMate-648 that Dr. Rajdev mentioned. As we move forward, it will be good to get data on non-chemotherapy options in certain biomarker-positive populations. And then finally, another update, which is likely to be practice-changing, is the HERIZON-GEA-01 study that looked at zanidatamab, which is another biparatopic antibody that targets HER2, and that is likely to change practice. And as that data gets published, we may look to even do a rapid update for the current immunotherapy and targeted therapy guideline that is just being published. Dr. Lakshmi Rajdev: So, if I can add to that, there are numerous ADCs that look very interesting. There are bispecific antibodies; in fact, the zanidatamab is a bispecific antibody showing improved activity in patients with HER2-positive disease. So I think there are studies from Asia looking at CLDN CAR T-based therapies. So, I think that there are a lot of novel agents and a lot of excitement in the field. We know that the bemarituzumab study, unfortunately, the FGFR2 inhibitor failed to demonstrate any benefit, but I think that there are other agents that are being explored, so there are newer targets, newer agents, ADCs, bispecifics that could potentially change the field in the future. Brittany Harvey: Yes, we will look forward to the data to address these unanswered questions and new agents and inform future guideline updates. So, I would like to thank you both for all of your work to review the evidence here and update this important guideline, and for your time today, Dr. Rajdev and Dr. Shah. Dr. Lakshmi Rajdev: Thank you. Dr. Manish Shah: Thank you. Brittany Harvey: And finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/gastrointestinal-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you have heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. 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.

This episode is a conversation with Dr. Jonathan Avery about why addiction has so much stigma and how that has stopped patients and families from getting real help.Most people still view addiction through a lens of shame and judgment, yet experts like Dr. Jonathan Avery are transforming how we understand and support those struggling. Dr. Avery is Vice Chair for Addiction Psychiatry and Professor of Clinical Psychiatry at Weill Cornell Medicine, known for pioneering efforts to reduce stigma and elevate evidence-based care. His work has transformed lives and inspired a new approach to addiction globally.He also founded the SAFE Program (Support, Advocacy, and Family Education) to provide evidence-based support to families affected by addiction. Dr. Kibby sits down with Dr. Avery to talk about how his personal experience with family addiction led him to develop groundbreaking programs and research to dismantle stigma, empower families, and open new pathways to recovery. In this episode, we break down:How addiction affects the brain and why stigma persists despite medical advancesThe innovative SAFE program supporting families affected by addictionDr. Avery's insights on challenging societal judgment and fostering compassionThe role of advocacy, policy, and personal understanding in changing the narrative around substance useHis upcoming book "Thriving with Addiction" and what it reveals about resilience and hope Whether you're supporting a loved one or seeking deep understanding, this episode is essential listening. This is your chance to hear from one of the most influential voices in addiction psychiatry who shares insights that could change the way you see and support those affected by addiction. Resources:Thriving with Addiction book and podcast with Dr. Jonathan Avery

How much can what you eat really influence your heart health — and how quickly can you improve your blood pressure or cholesterol through diet? In this episode of Health Matters, host Courtney Allison sits down with cardiologist Dr. Sean Mendez of NewYork-Presbyterian Brooklyn Methodist Hospital to break down the real connection between food and cardiovascular wellbeing. They explore what your health numbers mean — from blood pressure ranges to LDL cholesterol, triglycerides, HDL, and the emerging marker ApoB — and how these values signal current or future risk. Dr. Mendez explains how dietary shifts can lower LDL cholesterol by 3 to 15 percent and reduce blood pressure by several points, even without medication. He also discusses salt sensitivity, the impact of saturated fats and processed foods, and why soluble fiber, healthy fats, and whole foods can play a powerful role in improving cholesterol. The conversation dives into the DASH diet and the Mediterranean diet, outlining how each works, what they emphasize, and the evidence behind their ability to reduce blood pressure and overall cardiovascular risk. Dr. Mendez offers practical tips for getting started and key lifestyle factors that are essential for heart health.  Whether you're hoping to lower your numbers, prevent future heart issues, or simply make more informed choices at the grocery store, this episode provides clear, accessible guidance on building a heart‑healthy way of eating. Chapters: 01:13 – What Do Heart Health Numbers Mean? 04:33 – How Quickly Diet Changes Improve Labs 10:59 – How to Start Changing Eating Habits Key Topics Covered What cholesterol, blood pressure, triglycerides, HDL, LDL, and ApoB measure How these numbers relate to cardiovascular disease risk Healthy ranges for blood pressure and cholesterol How diet can lower LDL cholesterol and blood pressure How quickly lab results change after modifying eating habits The role of salt sensitivity and saturated fats in heart health Foods that help lower LDL, including soluble fiber and healthy fats The DASH diet: its structure, purpose, and evidence for lowering blood pressure The Mediterranean diet: core foods, flexibility, and cardiovascular benefits Differences between DASH and Mediterranean diets Practical starting points for improving eating habits Benefits of tracking food intake and identifying patterns Easy, heart‑healthy food and snack swaps Why lifestyle factors like sleep, stress, exercise, and limiting alcohol matter Common misconceptions about eating for heart health Why heart‑healthy eating is beneficial at every age Takeaway Message Small, consistent changes to your diet and lifestyle can meaningfully improve your heart health — at any age. Understanding your numbers (like LDL, blood pressure, and ApoB) empowers you to make targeted choices, and evidence‑based eating patterns such as the DASH or Mediterranean diet can lower risk over time. Even if medications are part of your care, diet, sleep, exercise, and stress management remain essential tools for protecting your heart. Expert Guest Dr. Sean Mendez is a non-invasive cardiologist at New York Presbyterian Brooklyn-Methodist Hospital and an assistant professor of clinical medicine at Weill Cornell Medicine. His clinical interests include preventive cardiology, valvular heart disease, and cardiovascular imaging, including echocardiography, stress testing, and vascular imaging. In addition to seeing patients in his outpatient clinic, he provides inpatient care in the cardiac care unit, cardiac telemetry unit, and consultative cardiology service. Dr. Mendez is passionate about providing his patients with the highest-quality, comprehensive cardiovascular care. He addresses all aspects of health to prevent the development and progression of cardiovascular disease. Dr. Mendez, a native of Buffalo, New York, graduated magna cum laude from the University of Alabama with a bachelor's degree in both biology and mathematics. He attended medical school at the University at Buffalo, where he was inducted into the prestigious Alpha Omega Alpha Medical Society. Dr. Mendez then completed his residency in internal medicine at Massachusetts General Hospital/Harvard Medical School.  He then completed his fellowship in cardiology at the Mount Sinai Hospital, where he was chief fellow. For more health and wellness news, visit NewYork-Presbyterian's Health Matters website. 

Dr. Bishal Gyawali and Dr. Tessa Cigler share the new, comprehensive, evidence-based update of the ASCO guideline on the use of hematopoietic colony-stimulating factors in patients with cancer. They discuss recommendations on primary prophylaxis, secondary prophylaxis, and treatment of febrile neutropenia along with stem cell mobilization, efficacy, safety, duration, dosing, and administration of CSFs – including biosimilars. They highlight where it is appropriate to use a CSF, and importantly, when not to use a CSF. They touch on the significance of individual patient considerations and cost implications, and future work to refine the risk factors for the development of complications of febrile neutropenia. Read the full guideline, "White Blood Cell Growth Factors: ASCO Guideline Update" at www.asco.org/supportive-care-guidelines TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/supportive-care-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology,  https://ascopubs.org/doi/10.1200/JCO-25-02938     Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Bishal Gyawali from Queen's University in Kingston, Ontario, Canada, and Dr. Tessa Cigler from Weill Cornell Medicine in New York, New York, co-chairs on "White Blood Cell Growth Factors: ASCO Guideline Update." Thank you for being here today, Dr. Gyawali and Dr. Cigler. Dr. Bishal Gyawali: Thank you very much for having me. It's a pleasure. Dr. Tessa Cigler: Hi there. Nice to be here as well. Brittany Harvey: Great. And then before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Cigler and Dr. Gyawali, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then I'd like to dive into the guideline that we're here today to talk about. So first, what prompted an update to this guideline on the use of hematopoietic colony-stimulating factors in patients with cancer, and what is the scope of this updated guideline? Dr. Bishal Gyawali: The last version of the guidelines from ASCO on this topic was back in 2015, so it has been more than a decade since ASCO had a guideline on the use of G-CSF in patients with cancer receiving treatment. So it was due for an update because there has been a lot more evidence based on not necessarily new drugs, but evidence for proper timing of these agents and the duration of these agents, as well as there have been a lot of new biosimilars, and there are questions about are these biosimilars equivalent or how do we choose among these different options. One is that content of the evidence that has evolved over time in the last decade, but also I think the last time we had these guidelines, the ASCO guidelines were not incorporated to have those evidence GRADE tables. So the quality of the ASCO guidelines itself has evolved over the years, so we wanted to have a new version of the guideline that includes not only the new evidence, but also contains those evidence GRADE tables that will help to quantify the benefits. And so I think it was high time, and even more than that, the newer ASCO guidelines for any guideline, they also include considerations of cost, access, equity, and all these factors that were not included in the previous version of the guideline. So I think it's only natural that with time the guideline should also evolve. Dr. Tessa Cigler: I agree completely, and just as a framework, as we all know, neutropenia and its complications, including febrile neutropenia and infections, are still an important toxicity of many myelosuppressive chemotherapies. And these neutropenic complications do require prompt evaluation and treatment and often hospitalization, and we know that hematopoietic colony-stimulating factors, which I'm going to refer to as growth factors, can reduce the duration and severity of neutropenia and the risk of febrile neutropenia, so it remains an important topic in the practice of clinical oncology. Brittany Harvey: Absolutely. It's an important topic for both clinicians and for patients who are receiving treatment for their cancer. And as you said, there was a substantial amount of literature to review here and updating everything to be in line with the GRADE evidence rating system, so there was a lot of work that you both put into this. So then next, I'd like to review the key recommendations of this guideline by clinical question. So first, what factors did the expert panel identify that should influence the decision to administer primary prophylaxis of febrile neutropenia with a CSF? Dr. Bishal Gyawali: Yeah, so I think that constitutes one of the most important recommendations in our guidelines about primary prophylaxis with G-CSF. And this is important because not only it's about when to use it, it's also about when not to use it, as in the ASCO "Choosing Wisely" campaign has also made some recommendations about this. So our guideline recommendations are also aligned with that. So first of all, we recommend that primary prophylaxis with G-CSF is recommended when the risk of febrile neutropenia because of the chemotherapy regimen is equal to or more than 20% unless an alternative chemotherapy regimen with comparable efficacy and safety that does not need G-CSF is available. And the quality of evidence to make this recommendation is high, so we give a strong strength of recommendation for this. Having said that, even for patients where the risk of febrile neutropenia is not necessarily 20%, it's a little lower, but because of other patient-related factors, the patient is at a higher risk of complications from febrile neutropenia, such as age, comorbidities, and other factors, in such case primary prophylaxis with G-CSF should be offered. And we also make a recommendation that if G-CSF is not affordable or available, then antibiotic prophylaxis can also be offered, but the evidence quality for this is low, and the strength of recommendation is very conditional. A couple of things to highlight here would be that, I think Dr. Cigler can attest to that, we ran into lots of problems about finding the data for the evidence base to say what are the patient-related factors that actually make them at a higher risk of febrile neutropenia, you know, like how did that 20% benchmark come about? Why 20%? Or when we say even if it's less than 20%, if based on other comorbidities, if the risk is higher, we tried to dig into that evidence. For example, we're talking about our "Box 1" in the guideline, what is the evidence for each item we have included under that "Box 1"? And we tried to do a lot of search to find the evidence for that, and some of them do have strong evidence, and that will tie into our future research ideas as well. And some of them actually don't have such solid evidence too, so that was one of the reasons why we ran into lots of problems about how do we quantify whether someone is at a high risk of febrile neutropenia and where that 20% benchmark comes from. Dr. Tessa Cigler: And definitely, because there's not very clear data, our guidelines definitely leave room for physician discretion in all these situations. Brittany Harvey: Absolutely. I find that in a lot of these guidelines the key point is that there's a lot of shared decision-making with patients after talking through what risk factors they may have and what is best for them in their individual clinical scenario. So then moving on to secondary prophylaxis, what factors did the expert panel identify that should influence the decision to administer secondary prophylaxis of febrile neutropenia with a CSF? Dr. Tessa Cigler: So for patients who've already experienced a neutropenic complication from a previous cycle of chemotherapy, the question is which patients should then receive prophylactic G-CSF for subsequent cycles of chemotherapy. And without a lot of evidence again to guide us, the panel really felt strongly that secondary prophylaxis should be used when a treatment delay or when a reduced dose of chemotherapy would be thought to compromise cure rates or survival outcomes. We do note that in many situations, certainly a dose reduction or a delay would be a very reasonable alternative or an additional strategy to G-CSF administration. Dr. Bishal Gyawali: Yeah, I think it's more like if there is going to be compromise in outcomes without using G-CSF, as in if we can't maintain the dose intensity and that's going to lead to inferior outcomes, then we should. But if we can reduce the dose intensity and treatment frequency and still have the same outcomes, then I guess in simple words, we're just trying to say use it when it's absolutely needed, or you can also look into other alternatives that might not need G-CSF but you could maintain the same outcomes. Brittany Harvey: Understood. It's helpful to review those options for clinicians and showing that there's not just one way to address potential neutropenic complications for later cycles of chemotherapy. So then following those recommendations for prophylaxis, what does the expert panel recommend regarding CSFs for the treatment of febrile neutropenia? Dr. Bishal Gyawali: This is an important question because this ties strongly with the "Choosing Wisely" campaign. In other words, primary and secondary prophylaxis we talked about when CSF should be used; here we make a sort of negative recommendation in that we say when CSF should not be used, because this is where we see most overuse or overtreatment with G-CSF. So first, we say that we should not be using a CSF routinely simply because a patient has neutropenia. If they are afebrile but they only have neutropenia, we recommend against using CSF just to boost neutrophil counts; that's not a meaningful metric. Then the second recommendation we make is CSF should not be routinely used as an adjunctive treatment with antibiotic therapy for patients with fever and neutropenia. So the first one was neutropenia, no fever, don't use it. The second one is okay, there is neutropenia and fever, but the treatment for that is use of antibiotic therapy, and so in such situations routinely we should not be using G-CSF just to boost the neutrophil count. And that is tied on to the third recommendation where if the patient has fever and neutropenia but is also at a very high risk for infection-related complications or who have other prognostic factors that we think will lead to poor outcomes for the patient, then in such situations, a CSF can be used as an adjunctive treatment. But we talk about the data in the manuscript, but the data show that the most that this will do is reduce the days of hospitalization by a couple of days. It actually does not have any data that it's going to improve the mortality rates. So as of now, we use the word "may be offered," it's not "should be offered," it's "may be offered" if there are other factors that we think will make the patient at the very poor risk of mortality outcomes, and the evidence quality here therefore is low and our strength of recommendation is conditional. And we also have a box that lists those items that we think might be associated with poor prognosis for the patients, but again the data for those, are they really hard evidence? No. And that is also tied with our future research recommendation that we should study more about these factors that might lead to these poor outcomes. Dr. Tessa Cigler: And again, allowing for discretion of the treating physician. Brittany Harvey: Absolutely. It's just as important to know when not to use CSFs routinely, and those risk factor boxes that you mentioned are available in the full manuscript along with the full list of recommendations, and our listeners can refer to that; a link will be in the show notes of the episode . Dr. Tessa Cigler: Just so you know, the panel, we really discussed those criteria a lot and agonized over them and gave you our best recommendations. Brittany Harvey: Definitely, and it sounds like there was varying degrees of evidence to support a lot of those risk factors, and so it's really important that the evidence supports those, but also there was expert consensus of the panel in reviewing each of those factors individually to come up with recommendations that can be applicable for all clinicians. Dr. Bishal Gyawali: If I may add, we're proud of our panel because I think our panel is quite inclusive of people representing different specialties within cancer care, as in we had radiation oncologist, we had infectious disease expert, pharmacists, and most importantly, we also had patient partners. Brittany Harvey: Absolutely. Having a multidisciplinary panel is really important for each and every guideline. So then, this is probably relevant now, but addressing a few more specific sections addressed in the guideline, what is the role of CSFs as adjuncts to progenitor cell transplantation? Dr. Tessa Sigler: Great question, and so, as solid tumor oncologists, Dr. Gyawali and I really leaned heavily on our hematology experts within the panel. The panel decided that a CSF should be used alone after chemotherapy or in combination with a CXCR4 inhibitor to mobilize peripheral blood progenitor cells. Clearly the choice of mobilization strategy depends on the type of cancer and the type of transplantation. The panel noted that a CSF should be routinely administered after autologous stem cell transplantation to reduce the risk of severe neutropenia, and that a CSF may be administered after allogeneic stem cell transplant to reduce the duration of severe neutropenia. Again, this last recommendation has not a lot of evidence to support it, and so we kind of tempered our language that it may be administered or can be considered based on clinical judgment of the physician and the clinical status of the patient. Brittany Harvey: And that really highlights the need for a multidisciplinary panel, because as you are solid tumor oncologists, you need the hematologists to make recommendations for all sorts of patients and make sure that these guidelines are comprehensive.   So then moving on to another smaller subset population, for patients receiving concomitant chemotherapy and radiation therapy, are CSFs recommended? Dr. Bishal Gyawali: I think there is very little evidence for patients who are receiving radiation therapy alone, so there is no evidence to suggest the use of CSF in patients with radiation therapy alone. The bigger question is in patients who are receiving both chemo and radiation together, chemoradiotherapy. In those patients, up until now, the classical recommendation has been to avoid G-CSF use. I think in our updated guidelines we discuss a couple newer trials that are trying to address this issue, but in the totality of evidence, we still stick with the same recommendation as before, which is CSFs are not recommended in patients receiving concomitant chemotherapy and radiation therapy, especially those involving the mediastinum because the biggest evidence of harm is for these patients. Dr. Tessa Cigler: I agree completely. Brittany Harvey: Definitely. It's important to recognize when that balance of benefits and harms leans more towards harms, and so that this should not be recommended for those patients. So there are several different CSFs that are recommended in the guideline, including biosimilars. So do the recommended CSFs differ in efficacy or safety? Dr. Tessa Cigler: So as supported by evidence, and the panel all agreed, that the various forms of CSFs, including the biosimilars, really have the same evidence for efficacy and for safety, and that the choice of agent really should depend on cost, availability, accessibility, patient convenience, and sometimes disease subtypes and treatment regimens. But, in essence, these can be used interchangeably without concern for efficacy or toxicity differences. Dr. Bishal Gyawali: I completely agree. I think in terms of efficacy outcomes, I don't think there is anything to choose between these agents. The choice between these agents would largely depend on different patient and treatment-related factors: cost, availability, affordability, feasibility. We even discuss things like where does the patient live, as in how frequently the patient can commit to the cancer center, and we also discussed things like even for the daily shots of filgrastim, patients can be taught and they can get it by themselves at home. So we discussed all these factors, but in a nutshell, the choice within these agents primarily depends not on efficacy factors, but simply based on all these other factors that are equally important but which can lead to informed decision-making about what is best for a given patient. But we mention it explicitly that the biosimilars, there is nothing to choose between them, especially the biosimilars; it's about price competition and what you can get at an affordable rate. Brittany Harvey: Understood. It's great to have many different options for patients so that there's something that can work for them based off access, cost, and all these factors that you listed. As you mentioned, it may be easier for some patients to get their treatment at home rather than in clinic, and so having different options and reviewing those with patients is very important. Dr. Bishal Gyawali: As we are having this conversation, I'm thinking that we might be a very unique guideline in that I don't think in many other settings you have this many options that you are asking about, you know, choices between equally good options and making decisions based on cost. I don't think there are any other areas in oncology where we have the privilege of making these decisions based on cost and convenience and all these factors, as well as we might be one of those guidelines where we have, as discussed before, so many recommendations about when not to do things and trying to promote judicial use of treatments. Dr. Tessa Cigler: As you might imagine, our panel discussions were very lively. Dr. Bishal Gyawali: Yes. But Dr. Cigler, do you recall any other guideline where there is so much discussion about when not to use things and how we have so many biosimilar options and we can choose the one that's most appropriate? I don't recall any other. Dr. Tessa Cigler: I agree with you. Brittany Harvey: It's certainly a unique guideline in that regard. So we'll move into the last clinical question that the expert panel addressed. But what does the expert panel recommend for the initiation, duration, dosing, and administration of CSFs? Dr. Bishal Gyawali: Yeah, I think there has been some new data in this regard that were not available in the previous guideline. For example, we have new trials testing a shorter duration of filgrastim injections compared to the standard of care. So we have some data, we call this 'de-escalation of treatment'. So we have more data supporting de-escalation of treatment. We have some data for lower dose of pegfilgrastim, we have data for lower duration of filgrastim, we have also some new data about timing of treatment, as in there has been some newer data presented about the relationship of timing of the drug and the frequency of adverse events from G-CSF such as bone pain. There is also the question about, for patients who don't live near the cancer center, can they get their pegfilgrastim shot on the day of chemo while they are in the cancer center? So all these questions that are very pragmatic and important questions, but were not answered before, we're glad that we had more evidence to talk about all these factors and give a more solid recommendation to our users of the guideline. Brittany Harvey: Definitely. And listeners can review the full list of dosing and administration recommendations in Table 2 in the guideline, and that will be linked in the show notes of the episode. So then I really want to thank you both for reviewing all of these recommendations. There's certainly a large amount of clinical questions and recommendations that you went through. I'd like to next ask, in your view, what is the importance of this updated guideline and how will it impact both clinicians and patients? Dr. Bishal Gyawali: I think the importance of this updated guideline is that, as mentioned before, we talk about newer data that have come up with regards to not just the most important two questions as in when to use it as primary prophylaxis and when to use it as secondary prophylaxis and when to use it as treatment, but also with regards to the duration and timing and dosing and multiple options and how these all factors as well as patient-related factors should be combined to make an informed decision, the most appropriate decision for the patient. And as mentioned before, we have the GRADE tables that were not in the previous version of this guideline. So I think even those users that are familiar with the 2015 guideline, I think they will find very novel content in this new updated guideline, and they will find it useful for their practice. I would encourage the readers to not only read the headlines of the box recommendations, but also read the full text of these guidelines because we have worked really hard to incorporate the latest evidence and also interpret them contextually. The discussion regarding de-escalation, patient considerations, cost implications; usually, people just skip these portions when they read a guideline. But I think these are also one of the most important paragraphs in our guideline, so they have been written with very careful thought, and I think reading the whole guideline is very much worth your time. Dr. Tessa Cigler: As you can imagine, I agree completely, having just spent several months thinking about these guidelines and all their nuances. Brittany Harvey: Certainly, this guideline is definitely a very comprehensive update, and that nuance in the manuscript is really important for clinicians to understand and read through and understand when it's appropriate to make certain decisions. So then to wrap us up, I'd like to ask, what are the outstanding questions and active research areas regarding the use of white blood cell growth factors in patients with cancer? Dr. Tessa Cigler: As you all know from clinical practice and that we've said several times already in this podcast is that the risk factors for the development of complications of febrile neutropenia are still not clearly worked out. And one of the things that is, I think, really needed in clinical practice is the development of predictive algorithms or biomarkers to really allow us to understand who might be more at risk and to allow for the clinician to be able to tailor the use of G-CSF as needed. Brittany Harvey: Yes, and so we'll look forward to future updates in this space to inform new recommendations and an updated guideline in the future. So I want to thank you both so much for your work to develop this comprehensive guideline. It was certainly a lot of effort, and thank you for your time today, Dr. Gyawali and Dr. Cigler. Dr. Tessa Cigler: Oh, my pleasure. It's nice to be here and to speak with you all. Dr. Bishal Gyawali: Yeah, it was great to speak with both of you but also through you to the audience, and we had a great time. Thank you. Brittany Harvey: And then finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/supportive-care-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. 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.

EVOLUT Low Risk data, a provocative meta-analysis, DNR orders, targeted hypothermia, good news in HFpEF evidence, and GLP-1s as AF drugs are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I EVOLUT Low Risk 6-year Results and a 5-year Meta-Analysis of TAVR vs SAVR 6-Year Outcomes of TAVR vs SAVR https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5063 EVOLUT Low Risk Trial at 2 years https://www.nejm.org/doi/full/10.1056/NEJMoa1816885 EVOLUT Low Risk Trial at 3 years https://www.jacc.org/doi/10.1016/j.jacc.2023.02.017 EVOLUT Low Risk Trial at 4 years https://www.jacc.org/doi/10.1016/j.jacc.2023.09.813 Nonproportional Hazards for Time-to-Event Outcomes in Clinical Trials https://www.jacc.org/doi/10.1016/j.jacc.2019.08.1034 TAVR vs SAVR 5-Year Outcomes - Systematic Review https://heart.bmj.com/content/early/2026/02/11/heartjnl-2025-327092 TAVR vs SAVR Updated Meta-Analysis of RCTs https://www.jacc.org/doi/10.1016/j.jacc.2024.12.031 UK TAVI Trial https://jamanetwork.com/journals/jama/fullarticle/2792251 Dr David Cohen on X https://x.com/djc795/status/2023556582030852172?s=46&t=zXMCUoVjSsdyemzWlzeBjA II DNR in the Hospital Inadequate Documentation of Unilateral DNR Orders https://jamanetwork.com/journals/jama/fullarticle/2829203 GeriPal Blog Unilateral DNR Orders https://geripal.org/unilateral-dnr-gina-piscitello-erin-demartino-will-parker/ III Yet another failure of Targeted Hypothermia 2-Year Follow-Up of TTM2 Trial https://jamanetwork.com/journals/jamaneurology/fullarticle/2845193 TTM2 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2100591 IV Good news in HFpEF Evidence ALT-FLOW II Trial https://doi.org/10.1093/ejhf/xuaf016 V GLP-1 as AF drugs Semaglutide as Adjunctive Therapy in Obesity-Related PAF https://doi.org/10.1093/europace/euag018 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Your brain isn't breaking. It's rewiring in ways no one explained, and for many women, menopause is the moment everything suddenly feels unfamiliar.Brain fog, sleep disruption, anxiety, memory lapses, and feeling unlike yourself can be deeply unsettling, especially when no one has given you a framework for what's happening. In this conversation, we explore the science behind midlife brain changes and why menopause is a neurological transition, not a personal failure.Dr. Lisa Mosconi is an associate professor of Neuroscience in Neurology and Radiology at Weill Cornell Medicine and director of the Alzheimer's Prevention Program and the Women's Brain Initiative. She is a world-renowned neuroscientist and the New York Times bestselling author of The Menopause Brain.In this episode, you'll discover • Why Alzheimer's risk begins in midlife, not old age • What estrogen actually does in the brain and why its shift matters • The hidden reason brain fog and mood changes show up during menopause • How the brain adapts and rebuilds after hormonal change • What science currently says about hormone therapy and brain healthMenopause can feel confusing and isolating, but understanding what your brain is doing can replace fear with clarity. Listen to learn how to navigate this transition with more confidence, compassion, and agency.You can find Lisa at: Website | Instagram | Episode TranscriptNext week, we're sharing a really meaningful conversation with psychiatrist and mental health educator Dr. Tracey Marks about what anxiety really is, why it feels so physical, and how understanding your brain can help you feel steadier and more at ease.Check out our offerings & partners: Join My New Writing Project: Awake at the WheelVisit Our Sponsor Page For Great Resources & Discount Codes Hosted on Acast. See acast.com/privacy for more information.

Ticagrelor vs prasugrel, a new LAAC device, pulsed field ablation AF results, lifestyle intervention in AF, the term "provider" vs "doctor," and coffee are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I TUXEDO-2 Trial TUXEDO-2 Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2844869 ISAR-REACT 5 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1908973 II VERITAS Study of Dual-Seal LAAO VERITAS Study https://doi.org/10.1016/j.jacep.2026.01.021 III PFA vs RF over 4 years Advent-LTO study https://www.nature.com/articles/s41591-026-04246-4 ADVENT Study https://www.nejm.org/doi/full/10.1056/NEJMoa2307291 SPHERE PER-AF Study https://www.nature.com/articles/s41591-024-03022-6 SINGLE SHOT CHAMPION Study https://www.nejm.org/doi/full/10.1056/NEJMoa2502280 BEAT PAROX-AF Trial https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaf1115/8436829 IV What's in a Name — Use of the Term "Provider" Physicians Are Not Providers: The Ethical Significance of Names https://www.acpjournals.org/doi/10.7326/ANNALS-25-03852 V Coffee and Dementia Risk Coffee/Tea Intake and Dementia Risk https://jamanetwork.com/journals/jama/fullarticle/2844764 Mandrola Commentary: Enough With the Coffee Research and Other Distractions https://www.medscape.com/viewarticle/883709 VI Lifestyle interventions Post AF ablation Improving Outcomes of AF by Lifestyle Interventions https://academic.oup.com/eurheartj/article/47/6/669/8243674 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Anxiety often feels like it comes out of nowhere in midlife—especially during perimenopause and after menopause. You're doing “all the right things,” yet your nervous system feels constantly on edge. Racing thoughts. Poor sleep. A sense that something isn't right… but you can't quite name it.In this episode of Asking for a Friend, I'm joined by Dr. Lori Davis, licensed psychologist, clinical instructor at Weill Cornell Medicine, and author of the upcoming workbook This Is Your Anxiety on Menopause. Together, we unpack why anxiety often intensifies in midlife—and what women can actually do about it.Dr. Davis shares both the science and the lived experience behind anxiety, explaining how hormonal shifts, nervous system changes, sleep disruption, perfectionism, and decades of “pushing through” collide in this season of life. We also talk about why anxiety may feel different now than it did earlier in life—and why you are not broken.In this conversation, we cover:Why anxiety often spikes during perimenopause and menopauseWhether menopause causes anxiety or unmasks an existing vulnerabilityThe role of hormones, cortisol, sleep, and the nervous systemWhy worry loops and nighttime anxiety are so commonEvidence-based tools to calm anxiety (including breathing, exposure, and cognitive strategies)When therapy or medication may be helpful—and when lifestyle alone isn't enoughHow to stop fighting anxiety and start working with your nervous systemThis episode is grounding, practical, and deeply validating for women navigating midlife changes. If you've ever thought, “Why am I suddenly anxious when nothing is technically wrong?”—this conversation will help you connect the dots.

Problems with the PREVENT score, a breakthrough in lipid-lowering therapy, a surprising benefit in stroke care, and more thoughts on statins and preventive care of heart disease are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I PREVENT Score PREVENT Equations in Young Adults https://doi.org/10.1016/j.jacc.2025.12.019 Hospital Readmission Reduction Program for HF https://pmc.ncbi.nlm.nih.gov/articles/PMC7664458/ II A New Breakthrough in LDL-C Management With an Oral PCSK9 Inhibitor https://www.medscape.com/viewarticle/time-overcome-pcsk9i-inertia-new-data-future-options-2025a1000wf8 CORALreef Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2511002 CORALreef Outcomes Trial https://clinicaltrials.gov/study/NCT06008756 III A Win for the Factor XI Inhibitor Asundexian – OCEANIC Stroke Trial https://www.medscape.com/viewarticle/first-clear-win-factor-xia-inhibitors-stroke-reduced-2026a10003t0 OCEANIC-STROKE Slide deck https://clinicaltrialresults.org/wp-content/uploads/2026/02/26-02-02_ISC_OCEANIC-STROKE-primary.pdf OCEANIC-AF Study Stopped Early https://www.bayer.com/media/en-us/oceanic-af-study-stopped-early-due-to-lack-of-efficacy/ IV Statin Side Effects Assessment of AEs Attributed to Statins -- Meta-analysis https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01578-8/fulltext N-of-1 Trial to Assess AEs of Statins https://www.nejm.org/doi/full/10.1056/NEJMc2031173 When to Start a Statin Is a Decision About Preference -- Editorial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.029808 V Heart Disease Statistics CV Statistics in the US, 2026 https://www.jacc.org/doi/10.1016/j.jacc.2025.12.027 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Listener feedback, huge news in the rapidly expanding world of PFA AF Ablation, obesity, and a beautiful trial studying an AI-enhanced diagnostic tool in the office are the topics discussed by John Mandrola, MD, in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback Risk-Based TEE Omission in PVI 10.1016/j.hrthm.2025.04.056 External Link II PFA News BEAT PAROX-AF trial https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaf1115/8436829 Life-Threatening Delayed Myocardial Ischemia and Malignant Arrhythmias Occurring After PFA https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.125.077983 Heart Rhythm TV: Life-Threatening Delayed Myocardial Ischemia and Malignant Arrhythmias  https://www.youtube.com/watch?v=M-npoLKmRa4 MAUDE Adverse Event report https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/detail.cfm?mdrfoi__id=23733351&pc=QZI III Obesity trends US State-Level Obesity Trends 1990-2022 and Forecasted to 2035 https://jamanetwork.com/journals/jama/fullarticle/2844495 IV New Tools in the Office TRICORDER Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02156-7/fulltext You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Lisa Mosconi is a world-renowned neuroscientist and the director of the Women's Brain Initiative at Weill Cornell Medicine, where she studies how sex differences and hormonal transitions influence brain aging and Alzheimer's disease risk. In this episode, Lisa explores why Alzheimer's disease disproportionately affects women and why longer lifespan alone does not explain their nearly twofold risk compared to men. She explains why Alzheimer's disease may be best understood as a midlife disease for women, beginning decades before symptoms appear, and how menopause represents a fundamental brain event that reshapes brain energy use, structure, and immune signaling. The conversation also examines what advanced brain imaging reveals about preclinical Alzheimer's disease, estrogen receptors in the brain, and why genetic risks such as APOE4 appear to affect women differently from men. Finally, Lisa discusses the nuanced evidence around menopause hormone therapy, the legacy of the WHI, her new CARE Initiative to cut women's Alzheimer's risk in half by 2050, and practical, evidence-based strategies to support brain health through midlife—including lifestyle, sleep, metabolism, mood, and emerging therapies such as GLP-1 agonists and SERMs (selective estrogen receptor modulators). We discuss: How Lisa's personal family history and scientific background led her to focus on the intersection of women's health, brain aging, and Alzheimer's disease (AD) [2:45]; The long preclinical phase of AD and the emotional burden carried by patients before dementia becomes severe [7:15]; How AD compares to other common forms of dementia: prevalence, pathology, symptoms, diagnostic challenges, and more [10:45]; Why AD disproportionately affects women: how AD is not simply a disease of old age or longevity but a midlife disease in which women develop pathology earlier [16:15]; Menopause as a leading explanation for women's increased Alzheimer's risk, and how advanced braining imaging can detect early changes in the brain [26:15]; How a new method for imaging estrogen receptors in the brain is changing how we think about the menopause transition [35:45]; What estrogen receptor imaging can and cannot tell us about hormone therapy's potential impact on brain health [48:45]; Lisa's studies on the relationship between levels of systemic estrogen and density of estrogen receptors in the brain [58:00]; Why blood estrogen levels poorly reflect brain estrogen signaling, and how tightly regulated brain hormone dynamics complicate our understanding of menstrual-cycle and lifestyle effects [1:02:15]; The CARE Initiative: Lisa's research program looking to slash AD rates in women [1:07:45]; The dramatic difference in AD risk between men and women associated with APOE4 [1:10:45]; What the evidence suggests about menopausal hormone therapy (MHT) and AD risk, and why timing, formulation, and uterine status appear to matter [1:12:00]; How the CARE initiative plans to study MHT and AD risk, within the practical constraints of a three-year research window [1:17:30]; How to think about starting hormone therapy during perimenopause: balancing symptom relief, hormonal variability, and individualized care [1:21:00]; Investigating selective estrogen receptor modulators (SERMs) as a targeted approach to brain health during and after menopause [1:25:00]; Why estrogen became wrongly associated with cancer risk and what the evidence actually shows [1:29:30]; Why better biomarkers are central to advancing women's Alzheimer's research [1:38:30]; Modifiable risk factors for dementia, the limitations of risk models, and questionable conclusions drawn from observational data [1:44:15]; GLP-1 agonists and brain health: exploring potential neuroprotective effects of GLP-1 agonists beyond metabolic benefits [1:49:00]; The importance of lifestyle factors in reducing risk of dementia: practical strategies for women to support brain health [1:53:45]; Why long-term, consistent lifestyle habits are essential for building cognitive resilience and protecting brain health over decades [2:01:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

Listener feedback, the value of procedural volume for TAVR and MTEER, ventricular arrhythmia in older athletes, and the Goldilocks time horizon for predicting and modifying CV risk are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Procedural Volume and Outcomes for TAVI and M-TEER Operator Procedural Volumes and Outcomes for TAVR and MTEER https://jamanetwork.com/journals/jamacardiology/fullarticle/2843740 II Ventricular Arrhythmia in Older Male Endurance Athletes Myocardial Fibrosis May Raise Arrhythmia Risk in Older Male Endurance Athletes https://www.medscape.com/viewarticle/myocardial-fibrosis-may-raise-arrhythmia-risk-older-male-2026a10001y0 Timing and Relationship of VA With Exercise Patterns in Older Male Endurance Athletes https://doi.org/10.1093/eurjpc/zwag021 III Predicting Cardiac Risk and Statin Use 30-Year ASCVD Risk Among US Adults Aged 30-59 https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.125.012348 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Ruth Gotian: Networking in the Age of AI Ruth Gotian is the former Chief Learning Officer and Associate Professor of Education in Anaesthesiology at Weill Cornell Medicine. Thinkers50 has ranked her the #1 emerging management thinker in the world, and she’s a top LinkedIn voice in mentoring. She’s the author of The Success Factor and, with Andy Lopata, The Financial Times Guide to Mentoring. Most of us recognize the value of building a better network, but we also know the time and dedication it takes. In this conversation, Ruth and I explore how we can use AI tools to do some of the administrative legwork so that we can spend more time on the real relationship-building. Key Points McKinsey reports that since the pandemic, most people's networks have shrunk or stalled. Consider the 90/9/1 rule: 90% of people lurk in online communities, 9% interact somewhat regularly, 1% post and lead the conversation. Use AI to enhance, not replace, your communications. Invite AI to do the administrative legwork (i.e. brainstorming, proofreading) so you focus on the human aspects. Ask AI to analyze speaker and attendee lists in advance at conferences in the context of your goals. Consider being the person that puts together an in-person dinner or gathering at a conference. Use AI to help you prep questions and discover the best people to invite. Ask AI to help complete your LinkedIn profile. An All-Star LinkedIn profile makes it substantially more likely that you'll get surfaced to others. Resources Mentioned Networking in the Age of AI by Ruth Gotian Related Episodes How to Grow Your Professional Network, with Tom Henschel* (episode 279) How to Build a Network While Still Doing Everything Else, with Ruth Gotian* (episode 591) The Key Elements of a Powerful Personal Brand, with Goldie Chan* (episode 757) Discover More Activate your free membership for full access to the entire library of interviews since 2011, searchable by topic. To accelerate your learning, uncover more inside Coaching for Leaders Plus.

I am delighted and honored to interview Dr. Lisa Mosconi today. She is an Associate Professor of Neuroscience in neurology and radiology at Cornell Medicine and Director of the Women's BRAIN Initiative and the Alzheimer's Prevention Clinic at Weill Cornell Medicine, New York Presbyterian Hospital. She is also a globally acclaimed neuroscientist with a Ph.D. in neuroscience and nuclear medicine and the author of the New York Times bestseller The XX Brain and, more recently, The Menopause Brain. In our conversation, we discuss how women's brains change during perimenopause and menopause, looking at the significance of puberty, pregnancy, and perimenopause, as well as the lack of medical research on women and medical gaslighting. We explore the concept of bikini medicine and its misconceptions regarding women's health and hormones, alongside the crucial roles of hormones like estradiol, progesterone, and testosterone in our neuroendocrine system. Dr. Mosconi also provides insights into evolving menopausal treatments, including lifestyle interventions.  Dr. Mosconi is an esteemed figure in neuroscience and a prominent voice in women's health. I am confident you will gain valuable insights and perspectives from my discussion with her today. IN THIS EPISODE YOU WILL LEARN: How women's brains change during perimenopause and menopause How the lack of information for young girls can lead to medical gaslighting and confusion during perimenopause Dr. Mosconi explains how a simple sugar is used as a tracer to track glucose metabolism in the brain during perimenopause Why brain changes during menopause may lead to mental fatigue and brain fog How the lack of training and research on menopause in medical residency programs leads to a poor understanding among clinicians Why women need to consider their brain and metabolic health during perimenopause Why estrogen is essential after menopause The benefits of HRT for menopausal women How stress impacts hormone production Connect with Cynthia Thurlow Follow on X, Instagram & LinkedIn Check out Cynthia's website Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community (The Midlife Pause/Cynthia Thurlow)  Cynthia's Menopause Gut Book is on presale now! Cynthia's Intermittent Fasting Transformation Book The Midlife Pause supplement line Connect with Dr. Lisa Mosconi On her ⁠website⁠ ⁠Instagram⁠ The Menopause Brain

In this episode, Roger Hartl, MD, Hansen-MacDonald Professor of Neurological Surgery, Director of Neurosurgery Spine at Weill Cornell Medicine, and Neurosurgical Director of Och Spine at NewYork-Presbyterian/Weill Cornell Medical Center, shares key trends shaping spine care, including AI, biologics, minimally invasive surgery, and the importance of multidisciplinary collaboration and patient communication.

Some great listener feedback, one of the best studies of the year in atrial fibrillation and heart failure, imaging to exclude left atrial thrombus, and a truly amazing first cardiac procedure are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback On Fish Oil and AF Links between omega-3 fatty acids and AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.058596 Omega-3 and risk of AF https://doi.org/10.1016/j.pcad.2024.11.003 DHA vs EPA in reducing vulnerability to AF https://www.ahajournals.org/doi/10.1161/CIRCEP.112.971515 II Withdrawal of HF Therapy  AF rhythm control The AF is Gone, the EF Is Up. Can You Stop the HF Meds? https://www.medscape.com/viewarticle/af-gone-ef-can-you-stop-hf-meds-2024a1000h6o Effect of beta-blockers in patient with HF plus AF -- meta-analysis https://pubmed.ncbi.nlm.nih.gov/25193873/ TRED HF Trial 10.1016/S0140-6736(18)32484-X External Link WITHDRAW-AF Trial https://academic.oup.com/eurheartj/article/47/2/250/8238240 III ICE or TEE Before AF Ablation ICE vs TEE in Atrial Fibrillation Ablation https://jamanetwork.com/journals/jamacardiology/fullarticle/2839370 IV The Vector Procedure Percutaneous Aorto-Coronary Bypass Graft: the VECTOR procedure https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.125.016130 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

In this episode of Health Matters, host Courtney Allison is joined by Dr. Rekha Kumar, endocrinologist and primary care physician at NewYork-Presbyterian and Weill Cornell Medicine, to unpack the science behind aging well. They discuss biohacking, longevity, and health span, separating evidence-based strategies from social media hype and exploring what truly helps us age well.What You'll Learn in This EpisodeWhat “biohacking” really means● How biohacking ranges from simple lifestyle optimization to high-tech, experimental interventions● The difference between lifespan (how long you live) and health span (how long you live well)The Longevity Pyramid● Why the foundation of healthy aging is built on:SleepMovement and strength trainingNutritionStress managementSocial connection● How advanced tools and supplements sit at the top—and why they should never replace the basicsWearables and Tracking● How devices like smartwatches, glucose monitors, and fitness trackers can support behavior change● When tracking becomes counterproductive or stressfulPeptides and “Anti-Aging” Supplements● What's proven (e.g., metformin, GLP-1 receptor agonists)● What's still experimental or under-studied (BPC-157, sermorelin, NAD boosters)Nootropics and Cognitive Enhancers● Everyday nootropics like caffeine● The role of L-theanine for “calm focus”● Myths around perfectly timed caffeine and cortisol rhythmsNutrigenomics and Personalized Nutrition● How genes can influence responses to foods (e.g., lactose intolerance, APOE and saturated fat)● Why many direct-to-consumer genetic tests may overpromiseThe Gut Microbiome● The role of Akkermansia muciniphila in metabolic health● How medications like metformin and GLP-1s may positively shift gut bacteria● What's still unknown about probiotic supplementationGenetic and Biomarker Testing● The difference between actionable medical insights and “information overload”● Why results of unknown significance can cause unnecessary anxietyThe Big Takeaways● There are no true shortcuts to longevity● Sustainable habits beat quick fixes● Our biology is built for rhythms, not constant optimizationFeatured ExpertAbout Rekha B. Kumar, M.D., M.S.Dr. Rekha B. Kumar is an attending endocrinologist at NewYork-Presbyterian/Weill Cornell Medical Center and an associate professor of Clinical Medicine at Weill Cornell Medicine. She specializes in adult primary care and endocrinology and has academic expertise in the diagnosis and treatment of various endocrine disorders, including obesity/weight management, type 2 diabetes, polycystic ovarian syndrome (PCOS), thyroid disorders, as well as metabolic bone disease.Dr. Kumar completed her undergraduate studies at Duke University and received her masters degree in Physiology from Georgetown University. She received her M.D. from New York Medical College and completed her residency training in Internal Medicine at NewYork-Presbyterian/Weill Cornell Medical Center. Dr. Kumar obtained her clinical fellowship in the combined Diabetes, Endocrinology, and Metabolism program at the NewYork-Presbyterian/Weill Cornell Medical Center and the Memorial Sloan Kettering Cancer Center. Dr. Kumar is Board Certified in Internal Medicine, Endocrinology, Diabetes, & Metabolism, and Obesity Medicine.Coming Up NextIn the next episode of Health Matters, we'll explore brain health and the short- and long-term effects of alcohol on the brain with Dr. Hugh Cahill. Subscribe and follow Health Matters on Apple Podcasts, Spotify, or wherever you listen to stay up to date with expert-driven conversations on living well at every stage of life.About Health MattersHealth Matters is your bi-weekly dose of health and wellness information, from the leading experts. Join host Courtney Allison to get news you can use in your own life. New episodes drop each Wednesday.If you are looking for practical health tips and trustworthy information from world-class doctors and medical experts you will enjoy listening to Health Matters. Health Matters was created to share stories of science, care, and wellness that are happening every day at NewYork-Presbyterian, one of the nation's most comprehensive, integrated academic healthcare systems. In keeping with NewYork-Presbyterian's long legacy of medical breakthroughs and innovation, Health Matters features the latest news, insights, and health tips from our trusted experts; inspiring first-hand accounts from patients and caregivers; and updates on the latest research and innovations in patient care, all in collaboration with our renowned medical schools, Columbia and Weill Cornell Medicine.To learn more visit: https://healthmatters.nyp.org

The limits of knowing coronary artery disease anatomy, fish oil and AF risk, a new drug for PSVT, and maybe I was wrong about a drug for AF conversion (the RAFF4 trial). These are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Prediction of CAD is hard — even if you have anatomy CCTA in Prediction of First Coronary Events https://jamanetwork.com/journals/jama/fullarticle/2841255 II Fish Oil and AF (and as a bonus we learn again about analytic flexibility) Are Fish Oils on the Hook for AF Risk? https://www.medscape.com/viewarticle/995290 Omega-3 and Fish Oil Use With Risk of AF  https://www.ahajournals.org/doi/full/10.1161/JAHA.125.043031 Effect of Long-Term Marine Omega-3 Fatty Acids on the Risk of AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654 RESPECT-EPA Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065520 Association Between Omega-3 Fatty Acids and AF: Meta Analysis https://link.springer.com/article/10.1007/s10557-021-07204-z Fish Oil Supplements and Risk of AF https://academic.oup.com/eurjpc/article/29/14/1911/6679610 Editorial: Fish Oil Supplements and AF Risk https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057464 III A New Drug for PSVT FDA Approval https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-drug-type-abnormally-fast-heart-rhythm RAPID trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00776-6/fulltext IV AF Conversion with Vernakalant RAFF4 Trial https://www.bmj.com/content/391/bmj-2025-085632.long Editorial: Rapid Cardioversion for Acute AF https://www.bmj.com/content/391/bmj.r2264 VI A Quick Note on HFpEF Med Op-Ed: Avalanche Survival, HFpEF Skepticism, and More https://www.medscape.com/viewarticle/med-op-ed-avalanche-survival-hfpef-skepticism-and-more-2026a1000012 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

The MI paradox of risk scores, the CELEBRATE trial of a new subcutaneous glycoprotein IIb/IIIA inhibitor (with its funny endpoint), the SURPASS CVOT trial, and the bad story of andexanet alfa are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I What do risk scores mean for individuals? Or perhaps a better question: Is a first MI preventable? Limitations of Screening in Predicting First MI https://www.jacc.org/doi/10.1016/j.jacadv.2025.102361 Sudden Death Due to Cardiac Arrhythmias https://www.nejm.org/doi/abs/10.1056/NEJMra000650 UMC Amsterdam group (EHJ) https://academic.oup.com/eurheartj/article/46/38/3762/8181058 II CELEBRATE Trial CELEBRATE Trial https://evidence.nejm.org/doi/full/10.1056/EVIDoa2500268 III SURPASS CVOT Trial Published Aug 01, 2025 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1002781 SURPASS-CVOT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2505928 REWIND Trial 10.1016/S0140-6736(19)31149-3 External Link IV FDA Pulls Andexanet Alfa From the Market ANNEXA 4 https://www.nejm.org/doi/10.1056/NEJMoa1814051 ANNEXA I https://www.nejm.org/doi/full/10.1056/NEJMoa2313040 Richard Buka Tweet https://x.com/richardbuka/status/2001045834050216327?s=20 V Mandrola's Top Cardiovascular Stories of 2025 https://www.medscape.com/viewarticle/mandrolas-top-10-cardiovascular-stories-2025-2025a1000yuh You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

An elegant study in post-TAVI atrioventricular block, a PSA for my structural colleagues, revascularization in women, and a CTO PCI trial are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I AV Block After TAVR Heart Blocks During vs After TAVR Show Distinct Patterns https://www.medscape.com/viewarticle/heart-blocks-during-vs-after-tavr-show-distinct-patterns-2025a1000ypp Mechanisms Underlying Alterations in Cardiac Conduction After TAVR https://jamanetwork.com/journals/jamacardiology/fullarticle/2842748 II Related PSA Announcement to My Structural Colleagues III Revascularization Strategies in Women with Severe Chronic CAD Women With Chronic Severe CAD Fare Better With CABG vs PCI https://www.medscape.com/viewarticle/women-chronic-severe-cad-fare-better-cabg-vs-pci-2025a1000ygd PCI vs CABG in Women With Chronic CAD https://doi.org/10.1093/eurheartj/ehaf806 PCI vs CABG - Meta-Analysis of 4 RCTs https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02334-5/abstract CABG vs Drug-Eluting Stent Implantation for CAD - Meta-Analysis https://www.jacc.org/doi/10.1016/j.jcin.2016.10.008 RECHARGE trial https://therechargetrial.com/ IV A CTO PCI RCT – But don't get your hopes up Early vs Late-Staged PCI After Subintimal Tracking and Re-entry for CTO https://doi.org/10.1016/j.jacc.2025.09.1598 DECISION CTO trial https://pubmed.ncbi.nlm.nih.gov/30813758/ National Inpatient Sample Database PCI CTO Associated With Higher Mortality https://pubmed.ncbi.nlm.nih.gov/37356643/ V Mandrola's Top 10 Stories You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Less is more after PCI, the TARGET-FIRST trial, a negative blood pressure trial that is actually positive, aspirin vs OAC for bleeding, AEDs, and Factor XI is not dead yet are the topics discussed by John Mandrola, MD, on this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Less is More: TARGET-FIRST TARGET-FIRST Trial https://www.nejm.org/doi/10.1056/NEJMoa2508808 STOPDAPT-2 ACS Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2789701 II A Negative Trial That Is Actually Positive The RETREAT-FRAIL Study https://www.nejm.org/doi/full/10.1056/NEJMoa2508157 III Major Bleeding With Aspirin vs Apixaban Subanalysis of ARTESiA https://jamanetwork.com/journals/jamacardiology/fullarticle/2841075 ARTESiA Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2310234 AVERROES Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1007432 IV High Value Interventions – The AED Experts Call for AED Placement on All Commercial Aircraft https://www.medscape.com/viewarticle/experts-call-aed-placement-all-commercial-aircraft-2025a1000xzf In-Flight Sudden Cardiac Arrest and AED Use 10.1016/j.cjca.2025.10.010 External Link V Factor XI Inhibitors – OCEANIC STROKE trial Bayer Press Release on Asundexian https://www.bayer.com/en/us/news-stories/oceanic-stroke You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net