Changing paradigms of haemophilia care in Europe

COR2ED Medical Education: In this podcast, Prof. Cedric Hermans and Prof. Jerzy Windyga discuss their perspectives on the changing paradigms of haemophilia care. They share their past experience and their views on the current situation in Europe, based on results from a recent survey and published in Therapeutic Advances in Hematology. The aim of this survey was to determine whether the paradigms of haemophilia care in Europe have changed with the introduction of novel treatment options. In the podcast, the two experts not only discuss the past and present of haemophilia care, but also share their visions on the future.

Prof. Hermans is the Head of the Division of Haematology at the Cliniques Universitaires of Saint-Luc in Brussels, Belgium. Prof. Windyga is the Head of the Department of Haemostasis Disorders and Internal Medicine at the Institute of Haematology and Transfusion Medicine in Warsaw, Poland. Both experts are members of HEMOSTASIS CONNECT’s European Collaborative Haemophilia Network.

Prostate Cancer Highlights from ASCO GU, ASCO and EAUN 2022

COR2ED Medical Education: In this podcast Dr Jason Alcorn and Jennifer Sutton discuss the oncology nursing highlights from ASCO GU, ASCO and EAUN 2022. 

The experts discuss:

Shared decision-making in nmCRPC: Treatment considerations to maintain quality of life

COR2ED Medical Education: Brenda Martone, a nurse practitioner at Northwestern Medicine in Chicago Illinois and Dr Alicia Morgans, Genitourinary Medical Oncologist at the Dana-Farber Cancer Institute in the United States discuss ‘Shared decision-making in nmCRPC: Treatment considerations to maintain quality of life’ in this GU CONNECT podcast.

In this podcast, the experts discuss how patients are more likely to be able to adhere to a treatment plan if they understand their choices and the implications of each treatment. 

They discuss how nmCRPC patients are relatively asymptomatic and the importance of understanding the patients’ goals of treatment and how these may differ from a physician’s perspective.

Alicia reviews the efficacy and safety data from the key trials for nmCRPC, the SPARTAN trial with apalutamide, the PROSPER trial with enzalutamide and the ARAMIS trial with darolutamide.

Brenda discusses ways to manage adverse events for the nmCRPC patients in order to keep them on treatment whilst still maintaining a good quality of life and Alicia explains how she goes about determining the right treatment for the right patient whilst considering comorbidities and drug to drug interactions.

COR2ED Medical Education: Dr. Tanya Dorff, a Medical Oncologist from the City of Hope Comprehensive Cancer Center and Dr. Neal Shore, Uro-Oncologist and Chief Medical Officer for Genesis Care and Urology and Surgical Oncology in the United States discuss ‘Timing of ARSI and taxanes for mCSPC’ in this GU CONNECT podcast.

In this podcast, the experts reflect on how the treatment landscape for mCSPC has evolved over the past 7 years resulting in treatment intensification with ADT plus docetaxel following the CHAARTED and STAMPEDE studies and then more recently the use of ADT and androgen receptor inhibitors including abiraterone (LATITUDE, STAMPEDE), apalutamide (TITAN), and enzalutamide (ARCHES, ENZAMET). 

This has further evolved with the recent reporting of the PEACE 1 and ARASENS trials which demonstrated a survival benefit with triplet therapy with abiraterone and darolutamide respectively, being used in combination with ADT and docetaxel.

The experts discuss the importance of balancing benefit against risk for their mCSPC patients but state that the triplet therapies appear to be well tolerated in both the PEACE 1 and ARASENS trials.

They provide their views, Neal as a urologist and Tanya as a medical oncologist, on the things to consider when making treatment decisions for these patients such as comorbidities, age, performance status, de novo versus recurrent disease, amongst others.

They finish by concluding that treatment intensification should be implemented as standard of care for mCSPC patients to enable patients to have as many treatments with different mechanisms of action as early as possible in their treatment journey. 

COR2ED Medical Education: In this podcast episode, Prof. Kris Kowdley, Director, Liver Institute Northwest, Washington State University, USA and Prof. Jörn Schattenberg, Director, Metabolic Liver Research, University Medical Centre Mainz, Germany provide their take-home messages on primary biliary cholangitis (PBC) data presented at the International Liver Congress 2022.

The two experts discuss how to improve PBCdiagnosis, the importance of listening to patient needs when considering PBC treatment options, considerations for treating PBC-related symptoms, differences in PBC diagnosis and treatment guidelines between Europe and the US, and what's coming next for this rare liver disease. 

COR2ED Medical Education: In this podcast, Prof. Gideon Hirschfield, Professor of Medicine, Division of Gastroenterology, University of Toronto, Canada and Prof. Ana Lleo, Professor of Internal Medicine, Humanitas University, Milan, Italy, discuss key abstracts on primary biliary cholangitis (PBC) from the International Liver Congress 2022. Their discussions focus on treatments currently available, treatment sequencing, management of adverse events, expected future therapeutic options and how to address the unmet clinical need of this rare liver disease.

COR2ED Medical Education: In this podcast, Beth Wittmer RN, Director of Care Management at Florida Cancer Specialists, USA and Prof. Hans Prenen, GI Medical Oncologist from Antwerp University Hospital, Belgium, discuss the management of dermatological side effects that patients may experience when receiving treatment with multikinase inhibitors, such as regorafenib, sunitinib, cabozantinib amongst others.  They discuss the different skin related side effects that a patient may experience such as hand foot skin reactions, rash, hair and nail changes as well as mucosal changes. The experts note that these side effects can affect a patient emotionally and impair their quality of life so the objective is to effectively treat and manage side effects and to keep patients on the treatment, whilst maintaining reasonable quality of life.  They discuss preventative measures, the importance of discussing potential side effects with the patient and when to involve a dermatologist as well as dose management strategies to enable the patient to stay on their cancer treatment.

COR2ED Medical Education: In this podcast, two haematology experts discuss their views on the use of immune tolerance induction (ITI) in haemophilia. Prof. Jan Astermark, professor of Clinical Coagulation Medicine from Sweden, and Dr. Katharina Holstein, Haematologist from Germany, talk about whether ITI is still the first choice in patients with haemophilia A with inhibitors. A recent survey on the use of ITI in Europe, conducted by the speakers and other members of the European Collaborative Haemophilia Network, forms the basis of the discussion. In March 2022 the results of the survey were published in the journal Haemophilia.

In this podcast episode the two experts discuss the results of the survey and the implications for management of haemophilia A.

COR2ED Medical Education: In this podcast episode, myeloma experts Dr. María Victoria Mateos (Haematologist at the University Hospital Salamanca, Spain) and Dr. Alexander Lesokhin (Associate Attending on the Myeloma Service at the Memorial Sloan Kettering Cancer Center, New York, NY, USA) discuss how they choose the best treatment regimen for patients with multiple myeloma and a high-risk cytogenetic profile. 

Firstly, they discuss the treatment options available for patients with high-risk cytogenetics in the US and in Europe. However, the key question is how to decide, for each individual, which treatment option is the best one. Dr. Mateos and Dr. Lesokhin discuss the factors they consider in these decisions in their clinical practice. Although the prior treatment is the most important consideration in the relapsed setting, the type of cytogenetic abnormality also plays a role. The experts specifically discuss treatment decisions in patients with extramedullary multiple myeloma: a difficult-to-treat population.

The speakers also discuss the future of myeloma treatment. How should trial design be adapted to better meet the needs of patients with a high-risk cytogenetic profile? What will be the role of CAR-T and bispecific antibodies in this population?

The experts conclude by summarising their key take-aways from the discussion.

COR2ED Medical Education: Dr Alicia Morgans, Genitourinary Medical Oncologist at the Dana-Farber Cancer Institute in the United States and Dr. Neal Shore, Uro-Oncologist and Chief Medical Officer for Genesis Care and Urology and Surgical Oncology in the United States discuss ‘Prostate Cancer Highlights from ASCO GU 2022’ in this GU CONNECT podcast.

In this podcast, the experts review data from a number of key plenary sessions from ASCO GU 2022 and discuss potential implications for clinical practice. The ARASENS trial is covered first which looked at triplet therapy in the form of ADT plus docetaxel and darolutamide in patients with metastatic castration sensitive prostate cancer (mCSPC). Discussion then moves to two trials investigating the combination of abiraterone acetate with PARP inhibitors in metastatic castration resistant prostate cancer (mCRPC) patients with and without homologous recombination repair (HRR) mutations: the PROpel trial with olaparib and the MAGNITUDE trial with rucaparib. 

Neal and Alicia also discuss a fascinating presentation by Dr. Daniel Spratt which looked at digitising histopathology slides and using Artificial Intelligence (AI) to inform on the likelihood of disease progression and whether or not patients needed androgen deprivation therapy (ADT)

Finally, Alicia discusses a number of posters which she felt made an impact, including one on PSA responses in the TITAN and SPARTAN trials and a secondary analysis from the VISION trial looking at treatment related adverse events, amongst others.