65 episodes

The ASCO Daily News Podcast features oncologists discussing the latest research and therapies in their areas of expertise.

ASCO Daily News American Society of Clinical Oncology (ASCO)

    • Science

The ASCO Daily News Podcast features oncologists discussing the latest research and therapies in their areas of expertise.

    Dr. James L. Gulley Discusses Scientific Highlights From #ImmunoOnc20

    Dr. James L. Gulley Discusses Scientific Highlights From #ImmunoOnc20

    2020 ASCO-SITC Clinical Immuno-Oncology Symposium Program Committee Chair-Elect Dr. James L. Gulley discusses learning points and practice-changing science presented during the Symposium.

    • 16 min
    Dr. Clement Adebamowo Discusses Global Barriers to Cancer Prevention and Screening

    Dr. Clement Adebamowo Discusses Global Barriers to Cancer Prevention and Screening

    ASCO Daily News: Welcome to the ASCO Daily News Podcast. Joining me today is Dr. Clement Adebamowo. He is a Professor of Epidemiology and Public Health, Associate Director in Population Science, Greenbaum Comprehensive Cancer Center at the University of Maryland School of Medicine, and he's also a research scientist at the Institute of Human Virology, Nigeria, and Center for Bioethics and Research, also in Nigeria. Additionally, he is the President of the Society of Oncology and Cancer Research of Nigeria, which is a professional society modeled after ASCO. Welcome to the podcast. Dr. Clement Adebamowo: Thank you very much. Thank you for having me. ASCO Daily News: I'm so glad you're here. Today, we are talking about global cancer health and some of the challenges people face around the world. Let's start with cancer prevention and screening. What are some of the barriers to cancer screening for people in sub-Saharan Africa? Dr. Clement Adebamowo: Thank you for asking that question. I think the barriers to cancer screening for people in sub-Saharan Africa include limited public and health care professionals' knowledge, such that population is not aware of their availability and the methods of cancer screening and health care professionals often do not have up to date information about the methods that are applicable in their particular environments. Dr. Clement Adebamowo: Secondly, there is the issue of poor funding, which prevents patients from taking advantage of screening opportunities even when they're there, and even when this screening is offered at the point of service as a free service, because the individuals who have to take advantage of the service will still have to endure some cost in order to take advantage of the service. So that poor funding certainly limits the access of people to cancer prevention services. Dr. Clement Adebamowo: And there is also the challenge of poor infrastructure, where many of the institutions in low- and middle-income countries do not have the resources that they need to implement systematic, widespread population-based screening programs that make a difference in the incidence of cancer in their environment. So those are the main reasons that I think-- those are the main barriers to cancer screening in sub-Saharan Africa. ASCO Daily News: Let's talk about cancer prevention. What are some of the opportunities and challenges in cancer types such as breast cancer and cervical cancer? Dr. Clement Adebamowo: Very good. So these two concerns in many sub-Saharan Africa constitute more than 50% of the cancer that affect women, so it's very important that we are proactive in identifying ways of preventing them. Cervical cancer in particular has many opportunities and resources, including taking advantage of interventions like the program for HIV-positive women. And because of this, organizations like the WHO think that there is the possibility that over the next few decades we may be able to eliminate eliminate cervical cancer as a public health problem in different parts of the world. Dr. Clement Adebamowo: So the technologies, many of which are very refined and studied, and new technologies are also becoming available that are adapted to the low resource environment where the incidence of cervical cancer is so very high. Dr. Clement Adebamowo: Breast cancer is a different kettle of fish, because there is no appropriate systematic screening tool for low resource environments at this time, particularly given that the [INAUDIBLE] of breast cancer in those countries tends to present in people younger than 40, 50 years of age, at which time the commonest evidence-based intervention, which is a screening mammography, is not optimal for early detection and diagnosis. In addition, it requires a lot of further infrastructure in order to actually diagnose the screen detected lesion and give optimal tr

    • 14 min
    Key Scientific Takeaways from the GI Cancers Symposium with Dr. Emily K. Bergsland

    Key Scientific Takeaways from the GI Cancers Symposium with Dr. Emily K. Bergsland

    • 20 min
    Dr. Heath Skinner Discusses Treatment Options for Head and Neck Cancer

    Dr. Heath Skinner Discusses Treatment Options for Head and Neck Cancer

    ASCO Daily News: Welcome to the ASCO Daily News podcast. I'm Lauren Davis. And joining me today is Dr. Heath Skinner, an Associate Professor at the UPMC Hillman Cancer Center specializing in the study and treatment of head and neck cancer. Dr. Skinner maintains an active translational research lab focused upon identifying novel clinically targetable biomarkers of resistance to radiation. Dr. Skinner, welcome to the podcast. Dr. Heath Skinner: Thanks so much for having me. ASCO Daily News: We're glad you're here. Today we're talking about ways to improve the patient experience when they're undergoing radiation. One of the ways we want to help patients is to reduce toxicities. So what are some ways to reduce toxicities while maintaining cure rates? Dr. Heath Skinner: So generally speaking, the side effects due to radiation are largely due to organs that don't actually have cancer cells in them receiving radiation. Unfortunately, there's no way, at least at this point, to actually make radiation appear just in the area of tumor and nowhere else nearby. Dr. Heath Skinner: However, over the course of several decades, the field has really progressed and utilizing a number of different strategies to try to minimize the amount of radiation going to areas that don't need treatment. Broadly speaking, over that amount of time, we've honed our ability to do that via a few different ways. Dr. Heath Skinner: Firstly, over the course, again, of several decades, we've actually progressed from back many decades ago we were actually planning radiation by drawing it on a piece of paper. Nowadays we actually use a combination of CAT scans as well as what we call motion management. For example, if I'm treating a tumor in the lung, what I will do is a series of CAT scans to try to visualize that tumor throughout breathing, throughout respiratory motion. Dr. Heath Skinner: And then I can utilize that advanced imaging to only treat the tumor and to try to minimize the areas of uncertainty of treatment by using that for DCT or four-dimensional CAT scan. Moreover, same thing with the lung. To try to minimize tumor motion and minimize the area of normal lung that receives treatment, I can even do breath hold treatment for example, only treating the tumor when the patient is actually holding their breath, again, trying to minimize the area of normal lung that's receiving radiation. Dr. Heath Skinner: Moreover, not only have we advanced in regards to visualizing the tumor and visualizing our treatment plan, we've actually progressed in the types of radiation that are given. Starting way back, just doing one field, one beam of radiation, then to several beams of radiation, to more recently utilizing what we call intensity modulated radiation. That's many beams of radiation or even an arc of radiation that is constantly modulated [INAUDIBLE] intensity based upon the planning that's done by the physician. Again, with the goal of trying to minimize dose of radiation going to normal tissues. Dr. Heath Skinner: And finally, every day we've gone from, again, a long time ago utilizing just x-rays to visualize that the patient was largely in the right position every day for radiation, all the way to now doing daily image guidance using a combination of CAT scans and even MRI to try to make certain that the tumor is in the exact right position every day for treatment. Now that's basically technology. Dr. Heath Skinner: Secondarily, we've tried to develop novel drugs to do one of two things, either to protect normal tissues in combination with radiation or try to make radiation work better to sensitize tumor's radiation but not sensitize normal tissues. So unfortunately, heretofore the only drug that we've really had any kind of positive clinical trial data for is a drug called [INAUDIBLE]. But unfortunately, that drug is not commonly given with radiation because o

    • 19 min
    Dr. Jeanny Aragon-Ching Highlights Key Research in Genitourinary Cancers

    Dr. Jeanny Aragon-Ching Highlights Key Research in Genitourinary Cancers

    Transcription Welcome to the ASCO Daily News podcast. I'm Lauren Davis, and joining me today is Dr. Jeanny Aragon-Ching, a medical oncologist who serves as the clinical program director of genitourinary cancers at Inova Schar Cancer Center in Fairfax, Virginia. She treats patients with genitourinary cancers. Dr. Aragon-Ching, welcome to the podcast. Dr. Jeanny Aragon-Ching: Thank you very much, Lauren, glad to be here. We're glad you're here. Today we're talking about new treatment options for patients with prostate cancer and renal cell carcinoma. There are new therapies available, but I wonder how do you decide which combination of drugs to use for a particular patient? Dr. Jeanny Aragon-Ching: Yes, Lauren, so there has been a lot of exciting challenges and changes actually in both prostate and advanced kidney cancer treatment, so let me first start off with advanced kidney cancers. There has been several recent approvals with a combination of immuno-oncology drugs-- so that's what they're called, I-O drugs-- and VEGF TKIs, which have paved the way for better treatment outcomes. But it is very crucial to pay attention to potential side effects, as we decide to choose between different treatment options. Dr. Jeanny Aragon-Ching: So for first-line metastatic kidney cancer treatment, the options have always included TKIs alone. So for instance, we've always had sunitinib and pazopanib, although cabozantinib soon joined the first-line TKI therapy, since about late December 2017. So more recently, combination I-Os using nivolumab and ipilimumab, as well as I-O plus TKI combinations, such as pembrolizumab and axitinib, or avelumab and axitinib, have been approved and are currently available commercially. Dr. Jeanny Aragon-Ching: So one way to distinguish these different regimens would be to evaluate what to call the IMDC criteria. So that stands for international Metastatic RCC Database Consortium criteria. So these are six different factors that the clinician can evaluate for each of their patients. So any time they have presence of anemia, leukocytosis, thrombocytosis, hypercalcemia, and a poor performance status, and if their time from diagnosis to systemic treatment is less than a year, they get a point for each. Dr. Jeanny Aragon-Ching: So if a patient has none of these factors, they would be considered to have favorable risk disease. And if they have one to two factors, then they are considered to have intermediate risk disease. If they have three or more of these, they're considered poor risk. And that's important because we want to be able to distinguish between these different categories of patients. Dr. Jeanny Aragon-Ching: So for instance, if we think about intermediate or a poor-risk disease patient, they benefit a lot from the combination of nivolumab and ipilimumab. And this is based on what you call the CheckMate 214 trial. And they reported the 30-month update at ASCO GU earlier this year. So the results showed 11.3% complete response rate compared to sunitinib, which only yielded 1.2% complete response rate. So if we look at the overall response rates for all the patients, 42% versus only 29% in the sunitinib arm. Dr. Jeanny Aragon-Ching: Now, on the other hand, pembrolizumab and axitinib with the KEYNOTE-426 Trial, also showed remarkable objective responses at around 59% versus only 35% for the sunitinib arm. And the complete responses was also impressive, occurring in about 5.8% in the combination arm. Dr. Jeanny Aragon-Ching: Now, if we look at the risk of death, it was 47% lower in the pembro/axitinib group compared to the sunitinib group. And the 18-month overall survival was 82% compared to 72% in the sunitinib arm. Now, there's another trial that looked at combination of avelumab and axitinib. This was called the JAVELIN Renal 101 Trial. And it also showed an impressive objective response rate of 55% in th

    • 24 min
    Dr. Megan Kruse Discusses a New Treatment for Metastatic Breast Cancer

    Dr. Megan Kruse Discusses a New Treatment for Metastatic Breast Cancer

    ASCO Daily News: Welcome to the ASCO Daily News Podcast. I'm Lauren Davis, and joining me today is Dr. Megan Cruz, a medical oncologist at the Cleveland Clinic who treats patients with breast cancer. ASCO Daily News: Today we're talking about a new therapeutic option for patients with metastatic breast cancer who carry the PIC3CA mutation. Dr. Cruz, welcome to the podcast. Dr. Megan Cruz: Good morning. Thank you for having me. ASCO Daily News: We're glad you're here. ASCO Daily News: So the PIK3CA is a commonly mutated gene in HR positive and HER2 negative advanced breast cancer. What kind of tests are used to detect this mutation? Dr. Megan Cruz: Yes, so that's correct. The PI3 kinase mutation is found in about 40% of hormone receptor positive HER2 negative advanced breast cancer cases. And this mutation can actually be detected by a variety of tests, many of which are convenient for our patients. Dr. Megan Cruz: Most commonly, we use tissue-based testing. And that can be samples of tissue that have been archived from either a patient's initial breast cancer diagnosis or a newer biopsy from a metastatic site. If neither of those places can be accessed or that tissue sample is no longer available, patients can have testing run on a blood-based sample. And this is often very helpful for patients who potentially have bone-only metastatic disease. ASCO Daily News: Are new agents are available to treat this form of cancer? Dr. Megan Cruz: Yes. So earlier this year, we had FDA approval of a new medication called alpelisib, which is used in combination with endocrine-based therapy in the form of fulvestrant in order to treat patients with the PI3 kinase mutated breast cancer. ASCO Daily News: And how effective is this treatment in terms of survival or overall survival? Dr. Megan Cruz: So this treatment was studied in the SOLAR-1 trial. And in that trial, it was found that there was a progression-free survival advantage for patients who received the combination of alpelisib and fulvestrant compared to placebo and fulvestrant. And that difference at 20 months was approximately from 11 months with alpelisib and fulvestrant from 5.7 months for the placebo fulvestrant combination. ASCO Daily News: And what do clinicians need to know about side effects? Dr. Megan Cruz: So there are some unique side effects with this medication, alpelisib, that clinicians will need to pay attention to. The most common ones are hypoglycemia and rash, which are generally pretty easily managed, but we have to be aware of them. Dr. Megan Cruz: When starting a patient on this medication, they need to have fasting blood sugar testing as well as hemoglobin A1C testing done prior to starting as a baseline. And then shortly after initiation of the medication, we recheck these labs to make sure that they're staying stable. Dr. Megan Cruz: If the blood sugar is rising, it's recommended to do more frequent monitoring and consideration of starting a medication like metformin to help control the blood sugars. In terms of the rash, that can actually be dealt with in a preventative way, where patients can be started on prophylactic antihistamine medications along with the start of alpelisib. And then if the rash does happen once they're on the medication, we often use either topical steroids or oral steroids to help control it. Dr. Megan Cruz: The last toxicity that I think that the clinicians should be aware of his diarrhea, which is one that we're more familiar with managing from other chemotherapies and targeted agents. So typically, use of our common anti-diarrheal medications will help to control that. ASCO Daily News: What do you think's on the horizon for metastatic breast cancer treatment? Dr. Megan Cruz: I think that we will continue to see medications like this that are targeted for specific mutations that we find in a patient's breast cancer. And then along wi

    • 4 min

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