COR2ED - Oncology Medical Conversation

In this podcast, Prof. Martyn Caplin and Dr Aman Chauhan discuss the role of somatostatin analogues (SSAs) at progression and whether to continue or not. In patients with well-differentiated Grade 1/2 neuroendocrine tumours (NETs) and slowly progressive asymptomatic disease, potential strategies for continuing SSA at progression include increasing the SSA dose frequency from every four to every two weeks, increasing the monthly SSA dose, using SSA as maintenance therapy in stable patients unable to tolerate chemotherapy, and—in patients receiving peptide receptor radionuclide therapy (PRRT)—during and/or post PRRT.

They share their clinical experience and their own clinical practice, based on data from key studies including NETTER-1, CLARINET FORTE, and REMINET, as well as relevant retrospective analyses. Prof. Martyn Caplin is Professor of Gastroenterology and GI Neuroendocrinology at the Royal Free Hospital and University College London, London, UK. Dr Aman Chauhan is a Medical Oncologist and Director of NET Theranostics at the University of Kentucky Markey Cancer Center, Kentucky, USA.

In this HCC CONNECT podcast HCC Experts Prof. Matthias Pinter and Prof. Jeroen Dekervel, discuss and debate the clinical implications of new HCC Phase 3 clinical trials data presented and discussed at the ILCA and ESMO congresses. They discuss Immuno-oncology agents and their place in the upcoming updated guidance such as the proposed new ILCA Systemic Therapies Guidance algorithm. They also discuss new treatment options in first line for advanced HCC presented at ESMO including the three late breaking abstracts LEAP-002, RATIONALE-301 and tislelizumab monotherapy trials. The latter two studying first-line treatment with an anti-PD1 antibody with or without a kinase inhibitor in patients with advanced hepatocellular carcinoma. The experts evaluate and provide their insights into how to integrate these new treatments for HCC in the clinical practice.

This second GI CONNECT podcast episode, covers the highlights on gastroesophageal cancer from ESMO 2022.  Dr Sam Klempner (Massachusetts General Hospital, Boston, USA) and Dr Yelena Janjigian (Memorial Sloan Kettering Cancer Center, New York, USA) discuss a number of key posters and oral presentations from the meeting and their implications for clinical practice.

The experts start by covering a number of first line studies. First of all, they discuss a study from Dr. Janjigian’s research group which investigated regorafenib with nivolumab and FOLFOX in HER2 negative oesophagastric cancer.  They then discuss LEAP-015 which investigated first-line lenvatinib plus pembrolizumab plus chemotherapy in advanced/metastatic gastroesophageal adenocarcinoma (GEA).  Dr. Klempner then covers one of his posters from ESMO 2022 on the DisTinGuish trial which looked at DKN-01 and tislelizumab plus chemotherapy as first-line investigational therapy in GEA.  Later they discuss MOONLIGHT which investigated FOLFOX plus nivolumab and ipilimumab versus FOLFOX induction followed by nivolumab and ipilimumab in patients with previously untreated advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma.  Later in the podcast, they cover a number of second line studies, including the PRODIGE 59 - DURIGAST trial which evaluated FOLFIRI plus durvalumab and FOLFIRI plus durvalumab plus tremelimumab in second line treatment of patients with advanced gastric or GEJ adenocarcinoma.  Finally they discuss DESTINY-Gastric02 which followed on from DESTINY-Gastric01 in Asian patients and was undertaken to evaluate T-DXd in Western patients with HER2+ unresectable/metastatic gastric/GEJ cancer who progressed on or after trastuzumab-containing regimen.

In the first episode of this GI CONNECT podcast covering the lower gastrointestinal (GI) cancer highlights from ESMO 2022, Dr Jenny Seligmann, Medical Oncologist from the University of Leeds in the UK and Dr Dominik Modest, Medical Oncologist from the Charité Universitaetsmedizin, Berlin, Germany discuss a number of key oral presentations from ESMO 2022 and potential implications for clinical practice. 

They start their discussion with the  NICHE-2 which looked at neoadjuvant immune checkpoint inhibition in locally advanced MMR-deficient colon cancer. Discussion then moves to the HIPECT4 trial which explored adjuvant hyperthermic intraperitoneal chemotherapy in locally advanced colon cancer and challenges previous perceptions of HIPEC in colorectal cancer patients. The FRESCO-2 trial is reviewed which evaluated the efficacy and safety of fruquintinib in patients with refractory metastatic CRC with results potentially supporting a new option for these patients. The experts then review two trials in patients with KRASG12C mutant CRC, the KRYSTAL-1 which used adagrasib with or without cetuximab in these patients and the CodeBreaK101 study which used sotorasib in combination with panitumumab.  They discuss their opinions on the results from these studies and the implications for clinical practice.

In this podcast, Sven De Keersmaecker, RN and Assoc. Prof. Gerald Prager, MD discuss flexible dosing regimens of the oral treatments regorafenib, trifluridine / tipiracil (TAS-102) and capecitabine to optimise treatment duration and to manage adverse events in patients with metastatic colorectal cancer.  The two experts also discuss the importance of keeping patients on treatment to optimise outcomes whilst managing side effects and ensuring the best possible quality of life. Treatment strategies are discussed as well as key data from the ReDOS and REARRANGE trials. The experts also discuss the importance of the nurse and other multi-disciplinary team members in terms of adverse event management and treatment adherence.

Sven De Keersmaecker RN is Study Co-ordinator at Antwerp University Hospital in Belgium and Dr Gerald Prager is a Medical Oncologist and Associate Professor at Medical University of Vienna in Austria.

In this SARCOMA CONNECT Guidelines Podcast, two SARCOMA CONNECT Experts, Prof. Robert Maki and Prof. Silvia Stacchiotti, discuss recent updates in the ESMO and NCCN bone sarcoma guidelines. Focussing on osteosarcoma and Ewing sarcoma, but also including chordoma and Giant Cell Tumour of bone, the Experts compare and contrast the latest updates to the guidelines. They highlight the key clinical practice learning points from the guidelines, discuss the latest clinical trial data, and consider what they mean for patients.

In this podcast, liver cancer experts Prof. Amit Singal and Assoc. Prof Neil Mehta discuss recent advances in systemic and locoregional therapy for advanced and early stage hepatocellular carcinoma (HCC).  They focus on the role of immunotherapy and review data from three major congresses in 2022 (ASCO, WCGIC and ILC) together with recent publications. 

Prof. Amit Singal is Director of Liver Cancer Program at UT Southwestern Medical Center, Dallas, TX, USA and Assoc. Prof. Neil Mehta is Director of Liver Cancer Program at University of California San Francisco, USA.

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

The experts discuss:

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.

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.