Oncology for the Inquisitive Mind

In this episode, Josh and Michael examine the rapidly developing world of early lung cancer treatment. An area that will hopefully only grow in importance, treatment for early NSCLC is becoming ever more sophisticated, with recent developments in neoadjuvant management and confirmation of the benefit of adjuvant driver-mutation inhibitior treatment. Today's articles cover two such topics: will osimertinib finally reach the pinnacle it was born to reach and be used in the neoadjuvant treatment of EGFR-mutant NSCLC? Will alectinib join its older, more successful cousin in being effective in resected ALK-mutant NSCLC? Listen on to find out, but we'll give you this one for free: if you have a patient with early NSCLC, it is becoming imperative that you test them for these mutations. Truly a fascinating time.Links to articles discussed in this episode (subscription may be required): NEOS: https://www.lungcancerjournal.info/article/S0169-5002(23)00072-7/fulltextALINA: https://www.nejm.org/doi/full/10.1056/NEJMoa2310532For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comOncology for the Inquisitive Mind is recorded with the support of education grants from Pfizer, Gilead Pharmaceuticals and Merck Pharmaceuticals. Our partners have no editorial rights or early previews, and they have access to the episode at the same time you do.Art courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

On this very special episode, Josh and Michael welcome Dr Adam Brufsky, a trailblazer in the world of breast cancer treatment and a titan in the frenetic development of breast cancer therapies since the mid-late 90s. Dr Brufsky is a Professor of Medicine at the University of Pittsburgh School of Medicine, Chief of the university's Division of Haematology and Oncology and co-director of its Comprehensive Cancer Centre. He received his MD and PhD from the University of Connecticut's School of Medicine in 1990 and has previously worked at Bringham and Women's Hospital and the Dana-Farber Cancer Institute. His areas of special interest include novel therapeutics and management strategies for breast cancer, bone-breast cancer interactions and therapeutics and molecular biology of metastatic breast cancer. He is a font of knowledge and we are so privileged to welcome Dr Brufsky onto the show.For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comOncology for the Inquisitive Mind is recorded with the support of education grants from Gilead Pharmaceuticals and Merck Pharmaceuticals. Our partners have no editorial rights, and they have access to the episode at the same time you do. Art courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

On today's blessedly brief episode, Josh and Michael give an overview of one of the greatest challenges for any practicing oncologist: the conundrum of cancer in young people. In recent decades, the number and proportion of young patients diagnosed with colorectal cancer has skyrocketed. This trend has been noted in news outlets across the world, reported in sources as disparate as the New York Times and the Australian Broadcasting Company. From the medical to the logistical and emotional, managing a young person with a cancer diagnosis is very difficult. While neither of our intrepid hosts has an answer to this very complex topic, there are a number of nuggets they drop that could help. Listen on for a thought provoking episode of Oncology for the Inquisitive Mind.Article discussed in this episode (subscription may be required): "‘More Young People Than Ever Will Get Colorectal Cancer This Year," by Knuvul Sheikh.Available from: https://www.nytimes.com/2024/03/27/well/colon-cancer-symptoms-treatment.html?unlocked_article_code=1.gE0.C_DO.__AnqnMB1F4M&smid=nytcore-ios-share&referringSource=articleShareArt courtesy of Taryn SilverAudio courtesy of:Olexy on pixabay: https://pixabay.com/users/olexy-25300778/JuliusH on pixabay: https://pixabay.com/users/juliush-3921568/The opinions discussed in this episode are those of the authors and should not be taken for medical advice. They exist to engender discussion, debate and thought.

IN BREAKING NEWS... Or not really, as we are a bit late to the party. But in honour of liposomal irinotecan's recent approval by the Federal Drugs Administration, we thought we would take another look at the NAPOLI-3 trial. The first potentially practice-changing update to the treatment of advanced pancreatic cancer arguably in more than a decade, the combination of liposomal irinotecan with 5-fluorouracil and oxaliplatin proved itself superior (spoiler alert) to the established combination of gemcitabine and nab-paclitaxel. Will this practically change practice for our patients? The answer, for Australia at least, is a resounding maybe. Listen on for all the juicy details, and the return of OftiM Newsreader "Walter Fernando-Cronkite."Links to articles discussed in this episode (subscription may be required):NAPOLI-3: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01366-1/fulltextFor more episodes, resources and blog posts, visit www.inquisitiveonc.comFind us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of Music Unlimited: https://pixabay.com/users/music_unlimited-27600023/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

It is a tale as old as time, as old as the stars, the heavens and human consciousness itself. Okay, we're exaggerating a bit, but for as long as pharmacology and capitalism have been joined at the hip, the question of "which drug is best" has been at or near the forefront of medical decision-making. With the development of standardised clinical trials and the difficulty of conducting direct head-to-head comparisons, this question has become more difficult to answer conclusively. Nowhere is this epitomised better than with the triptych of available CDK4/6 inhibitors: palbociclib, ribociclib and abemaciclib. A lot of ink and pixels have been devoted to comparing the pivotal trials of these three equally pivotal agents: PALOMA-2, MONALEESA-2 and MONARCH-3, respectively. However, Josh and Michael have brought the definitive and not-at-all rambling answer to this question. Listen on to find out!Links to studies discussed in this episode (subscription may be required):Review Article (Grinshpun et al.): https://www.nature.com/articles/s41523-023-00520-7For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

In this episode, Michael and Josh welcome a very special guest: Michael's Labrador Beans. Beans is a world-renowned expert in eating snacks, but unfortunately, had very little to offer on their topic today: the treatment of progressive or recurrent cutaneous melanoma with primary and secondary resistance to immunotherapy. So, unfortunately, the discussion was left to your regular hosts. For approximately 50% of patients, this is fortunately not a question they need to worry about, as immunotherapy and BRAF/MEK inhibitors remain effective treatments. However, that still leaves half of all patients facing an uncertain future, as treatment beyond these two agents remains uncertain. Josh and Michael examine two studies that may shine a light in this dark corner of oncology: LEAP-004, a single-arm study of lenvatinib + pembrolizumab, and an article published in the New England Journal of Medicine examining the use of tumour-infiltrating lymphocytes (TILs) as a novel weapon against immunotherapy-resistant melanoma. Links to studies discussed in this episode (subscription may be required):LEAP-004: https://ascopubs.org/doi/full/10.1200/JCO.22.00221Rohaan et al: https://www.nejm.org/doi/full/10.1056/NEJMoa2210233For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

While Josh and Michael enjoy a good rambling, meandering podcast as much as the next guy, we made a promise to keep our coverage of the ASCO GU 2024 conference short and sweet. So, as promised, here is the second - and final - episode of our miniseries. For a change of pace, one of our studies involves the adjuvant use of immunotherapy! Specifically, AMBASSADOR looks at pembrolizumab in patients with early urothelial cancer, a patient cohort that is crying out for more effective treatments for early-stage disease. Meanwhile, Josh tries to "BRCAAway" from our comfort zone by discussing the latest trial examining the use of PARP inhibitors in metastatic castration-resistant prostate cancer. Yes, we'll show ourselves out now. Links to studies discussed in this episode (subscription may be required):AMBASSADOR (courtesy of ASCO Daily news): https://ascopost.com/news/january-2024/ambassador-pembrolizumab-in-muscle-invasive-and-locally-advanced-urothelial-carcinoma/#:~:text=AMBASSADOR%20(A031501)%20is%20a%20randomized,and%20locally%20advanced%20urothelial%20carcinoma.BRCAAway (courtesy of urotoday.com): https://www.urotoday.com/conference-highlights/asco-2022/asco-2022-prostate-cancer/137781-asco-2022-brcaaway-a-randomized-phase-2-trial-of-abiraterone-olaparib-or-abiraterone-olaparib-in-patients-with-mcrpc-with-dna-repair-defects.htmlFor more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

With Josh's Grand Adventure(TM) now in the books, he and Michael return to their usual programming, examining two studies presented at the not-so-recent ASCO GU conference in San Fransisco. While the conference took place in January of this year, as the old adage goes: better late than never. In this episode, our hosts examine two studies; the CONTACT-02 study examining a combination of immunotherapy + cabozantinib in patients with metastatic castration-resistant prostate cancer, and an update from the KEYNOTE-564 that examined whether pembrolizumab had any benefit in the adjuvant treatment of renal cell cancer. Will either of these studies change practice? Fear not, for our fearless oncological explorers are on hand to guide you through the hazardous ratios and nefarious p values!Links to studies discussed in this episode via ASCO Daily News(subscription may be required):CONTACT-02: https://ascopubs.org/doi/10.1200/JCO.2024.42.4_suppl.18#:~:text=CONTACT%2D02%20is%20the%20only,Clinical%20trial%20information%3A%20NCT04446117.KEYNOTE-564: https://dailynews.ascopubs.org/do/keynote-564-adjuvant-pembrolizumab-prolongs-survival-high-risk-clear-cell-renal-cell#:~:text=KEYNOTE%2D564%20is%20the%20first,at%20higher%20risk%20for%20recurrence.For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

In this episode, Josh interviews the man who helped make this grand adventure possible, his mentor, Professor Elgene Lim of the Kinghorn Cancer Centre in Sydney. Professor Lim is a medical oncologist specialising in breast cancer research. He has previously worked at the Walter and Eliza Hall Institute, completing his PhD under the mentorship of Dr Geoffrey Lindeman and Dr Jane Visvader with research focussed on identifying culprit cells in BRCA1 mutant gene carriers. He subsequently worked with Dr Eric Winer and Dr Myles Brown at the Dana-Farber Cancer Institute and Harvard Medical School. As if this was not enough, Elgene is proud of his volunteer work with asylum seekers and his work with the Asha Kiran Hospital in Orissa, India, in a program of expertise transfer and partnership with local doctors. The Kinghorn Cancer Centre and The Beverley Alt Scholarship proudly support this mini-series.The Kinghorn Cancer Centre: https://tkcc.org.au/Dana Farber Cancer Institute: https://www.dana-farber.org/For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice. Minor edits have been made to the episode to improve sound quality and flow.