Author: atif

How to Treat Metastatic Non-Small Cell Lung Cancer w/o Targeted Mut in Front-line – Dr. Preeshagul

Post author By atif
Post date July 25, 2024

In this episode of the Oncology Brothers podcast, we delved into the treatment options for metastatic non-small cell lung cancer without actionable mutations in first-line settings. Dr. Isabel Preeshagul from Memorial Sloan Kettering Cancer Center joined us to provide valuable insights.
•⁠ ⁠PD-L1 status is essential for guiding treatment decisions in metastatic non-small cell lung cancer, influencing the choice between immunotherapy and other treatment options.
•⁠ ⁠High PD-L1 expression (greater than 50%) may indicate a better response to Pembrolizumab, while lower levels require alternative approaches, considering histology and disease characteristics.
•⁠ ⁠Comprehensive genetic testing and consideration of tumor burden are crucial for personalizing treatment strategies, combining therapies, and improving patient outcomes in advanced lung cancer.

Key points discussed include the significance of obtaining comprehensive testing, the use of immunotherapy and chemotherapy combinations based on PD-L1 status and histology, and the emergence of second-line treatment options. Dr. Preeshagul highlighted the importance of considering clinical trials for patients with specific mutations, such as KRAS G12C and HER2, and the potential for re-challenging patients with immunotherapy after progression.

Overall, the episode emphasized the evolving landscape of treatment options for non-small cell lung cancer and the need for personalized approaches based on individual patient characteristics and mutation profiles.

Journal of Lung Cancer

How to Treat Non-Small Cell Lung Cancer with Actionable Mutations with Dr. Balazs Halmos

Post author By atif
Post date July 18, 2024

In this episode of the Oncology Brothers podcast, we had the privilege of hosting Dr. Balazs Halmos, a thoracic medical oncologist from Montefiore-Einstein Comprehensive Cancer Center. The focus of our discussion was on the current landscape of metastatic non-small cell lung cancer with actionable mutations in first-line settings.

Personalized treatment based on specific mutations is essential for optimizing outcomes in metastatic NSCLC.
Patient-centered decision making involves tailoring treatment plans to individual needs and preferences.
Targeted therapies for rare mutations require staying updated with the latest research and treatment options.
Precision medicine in lung cancer focuses on identifying genetic mutations to provide personalized and effective treatments.
Identifying and targeting specific mutations through NGS testing is crucial for selecting appropriate and cutting-edge therapies.

Dr. Halmos provided valuable insights on the importance of NGS testing in identifying specific mutations in lung cancer patients. We delved into the treatment options for various actionable mutations, including EGFR, ALK, ROS1, RET rearrangements, MET exon 14 skipping mutations, and much more. The discussion highlighted the evolving treatment options available and the need for personalized medicine in optimizing patient outcomes.

The podcast emphasized the significance of selecting the right targeted therapy for patients based on their specific mutation profile and the importance of managing the potential toxicities associated with these treatments. Dr. Halmos also touched on the role of immunotherapy in certain cases and the potential for future novel agents in the field of precision medicine for lung cancer.

Overall, the episode provided a comprehensive overview of the current treatment landscape for metastatic non-small cell lung cancer with actionable mutations, showcasing the advancements and challenges in this rapidly evolving field. Tune in to our other discussions in the lung cancer series for more insights from the Oncology Brothers.

Algorithms Journal of Lung Cancer

How to Treat Small Cell Lung Cancer using Treatment Algorithm with Dr. Eric Singhi

Post author By atif
Post date July 8, 2024

In this episode of the Oncology Brothers podcast, we had the pleasure of discussing small cell lung cancer with Dr. Eric Singhi, a thoracic medical oncologist from MD Anderson Cancer Center.

Key Points:

•⁠ ⁠The Adriatic study’s impact on improving overall survival with Durvalumab in limited stage disease.
•⁠ ⁠Treatment options for extensive stage disease, including second-line therapies like Lurbinectedin and the recent approval of Tarlatamab.
•⁠ ⁠The significance of individualized treatment decisions and ongoing research in small cell lung cancer management.

The episode delved into various aspects of small cell lung cancer, starting with the management of limited stage disease. Dr. Singhi highlighted the importance of assessing surgical candidacy for patients with small primary tumors and no nodal involvement, followed by postoperative pathology review and adjuvant platinum-based therapy.

The conversation then shifted to the role of prophylactic cranial irradiation (PCI) in limited stage disease, with Dr. Singhi emphasizing the need for shared decision-making and multidisciplinary discussions with patients. The discussion also touched on the recent practice-changing data from the Adriatic study, which showed improved survival with Durvalumab in limited stage small cell lung cancer.

Moving on to extensive stage disease, the standard of care was discussed, including the use of platinum-based chemotherapy with Atezolizumab or Durvalumab. Second-line treatment options such as Lurbinectedin and the recent approval of Tarlatamab were also discussed. Dr. Singhi provided insights into the administration and monitoring of Tarlatamab, highlighting the importance of patient education and close monitoring for cytokine release syndrome. The episode concluded with a discussion on the management of patients with small cell lung cancer and driver mutations, emphasizing the need for individualized treatment approaches. Dr. Singhi also highlighted the importance of patient advocacy groups, such as the Small Cell Smashers, in providing support for patients with small cell lung cancer.

Overall, the episode provided a comprehensive overview of the current treatment landscape for small cell lung cancer, showcasing the advancements and challenges in managing this devastating disease.

2024 ASCO

GI Cancer ASCO 2024 Practice Changing Highlights – Discussion with Dr. Mark Lewis

Post author By atif
Post date June 24, 2024

In this episode of the Oncology Brothers podcast, Dr. Mark Lewis joins as a guest to discuss key studies in GI malignancies from ASCO 2024. The episode covers significant updates from the ESOPEC trial comparing concurrent chemoradiation with periopflot for upper GI adenocarcinoma.
• The ESOPEC study comparing concurrent chemoradiation versus periopflot for upper GI adenocarcinoma.
• The ARMANI trial on switch maintenance with bramicerumab plus paclitaxel.
• The TRANSMET trial exploring chemotherapy followed by liver transplantation for metastatic liver-confined colorectal cancer.
• The COLLISION trial comparing surgery versus ablation for small size colorectal liver metastatic disease.
• The COMET study looking at the use of atezolizumab with chemotherapy in first-line treatment for MSI high metastatic colorectal cancer.

The ARMANI trial on switch maintenance with bramicerumab plus paclitaxel is also discussed, along with the TRANSMET trial exploring chemotherapy followed by liver transplantation for metastatic liver-confined colorectal cancer. The Collision trial comparing surgery versus ablation for small size colorectal liver metastatic disease and the COMET study looking at atezolizumab with chemotherapy in first-line treatment for MSI high metastatic colorectal cancer are also highlighted. The importance of biomarker testing and a multidisciplinary approach in oncology treatment is emphasized throughout the discussion. Overall, the episode provides valuable insights into the latest advancements in GI oncology and the evolving treatment landscape for patients with gastrointestinal malignancies.

2024 ASCO

GU Cancer ASCO 2024 Practice Changing Highlights – Discussion with Dr. Toni Choueiri

Post author By atif
Post date June 20, 2024

In this episode of the Oncology Brothers podcast, we were joined by Dr. Toni Choueiri from Dana-Farber Cancer Institute to discuss key abstracts from ASCO 2024 in the field of Genitourinary Oncology. The discussion covered various studies and updates, including the EV302 study with Enfortumab Vedotin in combination with Pembrolizumab, which has been a new standard of care regimen for advanced urothelial carcinoma, since its last presentation at ESMO 2024, but here we discussed patient-reported outcomes from this study. The potential role of ctDNA was discussed, mainly using as a biomarker in bladder cancer, and real world data on how to treat advanced RCC was also highlighted.

EV-302: Patient reported outcomes from EV+Pembro vs. Platinum based chemo in mUC

KIM-1: Biomarker analysis in IMmotion010 in pts with RCC

Real world evidence from the IMDC: favorable vs. very favorable mRCC

PSMAfore: Health-related QoL and pain in taxane naïve pts with mCRPC

The conversation delved into the evolving paradigm in PSMA-targeted therapies for advanced prostate cancer, particularly focusing on health-related quality of life and pain outcomes. The discussion emphasized the significance of tailored therapies for favorable risk profiles in metastatic RCC, as well as the potential use of chemo with nivolumab in lymph node-only disease.

Overall, the episode provided valuable insights into the latest updates and studies from ASCO 2024 in the field of Genitourinary Oncology, showcasing the importance of patient outcomes, biomarkers, and personalized treatment approaches in improving cancer care. Tune in to our podcast for more discussions on oncology updates across different cancer types.

2024 ASCO

Breast Cancer ASCO 2024 Practice Changing Highlights – Discussion with Dr. Erika Hamilton

Post author By atif
Post date June 17, 2024

In this episode of the Oncology Brothers podcast, we were joined by Dr. Erika Hamilton from the Sarah Cannon Research Institute to discuss key abstracts presented at ASCO 2024 in the field of breast cancer. The episode covered a range of topics including updates on hormone receptor positive breast cancer, the use of CDK4/6 inhibitors in metastatic settings, and the evolving landscape of HER2-targeted therapies.

RxPONDER: AMH levels identifying premenopausal pts with HR+, HER2-, node+ to benefit from adj chemo
postMONARCH: Abema/Fulv vs. Fulv for HR+, HER2- mBC post progession on prior CDK4/6i/ET
INAVO120: inavo/Pbo+Palbo+Fulv in pts with PIK3CA-mut, HR+, HER2- mBC
DESTINY-Breast06: T-DXd vs chemo in pts with HR+, HER2-low or ultralow in mBC with prior ET
JBCRRG-M06/EMERALD: Trast + Pert + Eribulin or a Taxane as first-line chemo Rx for HER2+ mBC

Dr. Hamilton provided insights on the RxPonder study, highlighting the importance of AMH levels in determining the need for chemotherapy in postmenopausal patients. She also discussed the postMONARCH study, which examined the efficacy of adding abemaciclib after progression on CDK4/6 inhibitors in hormone receptor positive breast cancer.

The conversation then shifted to the INAVO120 trial, which focused on first-line treatment options for patients with PI3 alterations who relapsed quickly after adjuvant therapy. Dr. Hamilton emphasized the potential paradigm shift in treatment strategies for high-risk patients based on the trial results.

The discussion also touched on the evolving classification of HER2 status, particularly in light of the DESTINY-Breast06 study, which questioned the need to check HER2 status given the efficacy of trastuzumab deruxtecan in

Lastly, the Emerald trial was discussed, highlighting the comparison of eribulin with taxanes in HER2-positive metastatic breast cancer. Dr. Hamilton shared insights on the practical implications of the study and its potential impact on treatment decisions.

Overall, the episode provided valuable insights into the latest advancements in breast cancer treatment and the importance of biomarker testing in guiding personalized treatment strategies. Listeners were encouraged to stay tuned for more ASCO 2024 highlights across different cancer types.

2024 ASCO

Lung Cancer ASCO 2024 Practice Changing Highlights – Discussion with Dr. Joshua Sabari

Post author By atif
Post date June 12, 2024

In this episode of the Oncology Brothers podcast, we delved into the highlights from ASCO 2024, focusing on key studies in lung cancer. Dr. Joshua Sabari, a thoracic medical oncologist from NYU Langone Health, joined us to discuss the latest findings.

•⁠ ⁠LAURA Trial: Discussing the use of Osimertinib as a consolidation approach after chemoradiation in unresectable stage 3 non-small cell lung cancer patients with common EGFR mutation.
•⁠ ⁠MARIPOSA Study: Exploring the potential of Amivantamab and Lazertinib in common EGFR mutations.
•⁠ ⁠CROWN Study and other ALK inhibitors: Alectinib, Lorlatinib, and Brigatinib for metastatic non-small cell lung cancer.⁠
•⁠ ⁠ADRIATIC Study: Examining the use of Durvalumab after concurrent chemoradiation in limited-stage small cell lung cancer.
•⁠ ⁠PALOMA-3 Trial: Discussing subcutaneous Amivantamab vs. IV Amivantamab with Lazertinib

Overall, the episode emphasized the importance of precision medicine, the evolving landscape of treatment options in lung cancer, and the significance of multidisciplinary and patient-centered approaches in oncology practice.

Stay tuned for more highlights from ASCO 2024 across different cancer types in upcoming episodes. Thank you for listening to the Oncology Brothers podcast.

Algorithms

Multidisciplinary Treatment Approach for Rectal Cancer – Discussion with Drs. Deb Schrag & Krishan Jethwa

Post author By atif
Post date May 27, 2024

In this episode of the Oncology Brothers podcast, the hosts, Rahul and Rohit Gosain, delve into the topic of locally advanced rectal cancer, specifically focusing on the potential for omitting radiation in certain patient populations. They are joined by Dr. Deb Schrag, a medical oncologist from Memorial Sloan Kettering Cancer Center, and Dr. Krishan Jethwa, a radiation oncologist from the Mayo Clinic.
The discussion revolves around the findings of the Prospect study, which explored the possibility of avoiding radiation in select rectal cancer patients to minimize long-term side effects. The study showed that outcomes were comparable between traditional treatment methods and the selective approach, with a quality-of-life advantage for the latter.
The hosts and guests also touch upon the evolving paradigm of radiation therapy, the importance of MSI high status testing, and the considerations for omitting surgery in certain cases. They emphasize the need for a multidisciplinary approach and tailoring treatment based on individual patient characteristics.
Overall, the episode highlights the significance of personalized treatment strategies in managing locally advanced rectal cancer and the importance of staying abreast of the latest research and advancements in the field.

Journal Club

Zanubrutinib – FDA Approval, Efficacy & Safety Profile – Discussion with Dr. Shadman

Post author By atif
Post date May 23, 2024

In this episode of the Oncology Brothers podcast, we had the privilege of discussing the groundbreaking studies Sequoia and Alpine with Dr. Mazyar Shadman from Fred Hutch Cancer Center. The focus was on the approval of Zanubrutinib in CLL based on these trials.
The Sequoia trial, a study in first-line CLL, demonstrated the superiority of Zanubrutinib over bendamustine or rituximab in terms of progression-free survival. Notably, Zanubrutinib showed benefit across all molecular subtypes, making it a promising option for frontline therapy.
On the other hand, the Alpine study, conducted in relapsed or refractory settings, compared Zanubrutinib to ibrutinib. The results showed that Zanubrutinib was superior to ibrutinib for progression-free survival, even in high-risk populations. The safety profile of Zanubrutinib was also favorable, with lower rates of atrial fibrillation compared to ibrutinib.
Dr. Shadman also discussed a match-adjusted indirect trial comparison between Acalabrutinib and Zanubrutinib, highlighting the complexities of such analyses and the need for caution in interpreting results.
Furthermore, the podcast delved into the common side effects of BTK inhibitors, emphasizing the importance of monitoring and managing issues such as bleeding, infections, and cardiac toxicity.
Overall, the episode provided valuable insights into the evolving landscape of CLL treatment, showcasing the efficacy and safety of Zanubrutinib in both frontline and relapsed/refractory settings. Listeners were encouraged to stay tuned for more practice-changing data and conference highlights from the Oncology Brothers.

Algorithms Hematology

How to treat Myelofibrosis – Discussion with Dr. Naveen Pemmaraju

Post author By atif
Post date May 20, 2024

In this episode of the Oncology Brothers podcast, we discussed the complexities of myelofibrosis, a challenging blood cancer. Dr. Naveen Pemmaraju from MD Anderson Cancer Center provided valuable insights into the diagnosis, prognosis, and management of myelofibrosis. Key points discussed included the importance of bone marrow biopsy, molecular analysis, and risk stratification using various scoring systems.

The discussion highlighted that while allogeneic stem cell transplant remains the only potential cure, JAK inhibitors such as ruxolitinib, fadratinib, pacritinib, and momelotinib have shown efficacy in controlling symptoms and disease progression. It was emphasized that JAK inhibitors can benefit patients regardless of JAK2 mutation status.

Unique side effects of different JAK inhibitors were also addressed, along with strategies to manage them. Supportive care options like erythropoietin-stimulating agents and luspatercept for anemia were discussed, as well as the importance of considering individual patient factors in treatment decisions.

Overall, the episode provided a comprehensive overview of myelofibrosis treatment options and highlighted the need for a personalized approach to patient care in this complex disease.

Quick Links

Contact

Subscribe Now

Dr. Rahul