COR2ED - Oncology Medical Conversation

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.

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. 

Medical Education podcast by COR2ED. Professor James Harding, HCC Connect member, provides his perspectives and insights on key abstracts and topics discussed at ASCO GI 2022 and EASL liver cancer summit 2022 in hepatocellular carcinoma. He discusses the HIMALAYA study which evaluated dual immune checkpoint blockade inhibition namely, anti-CTLA-4 antibody tremelimumab with the anti-PD-L1 antibody durvalumab in the frontline setting with patients with unresectable hepatocellular carcinoma. There were other important studies at the meeting and Prof Harding highlights the RENOBATE study and the GOING study that evaluated nivolumab in combination with regorafenib and early addition of nivolumab to regorafenib regimen, respectively.

COR2ED Medical Education: Dr Jason Alcorn, nurse consultant for Uro-Oncology & Andrology at the Mid Yorkshire Hospitals NHS Trust, United Kingdom and Dr Alicia Morgans, Genitourinary Medical Oncologist and Medical Director of the Survivorship Program at the Dana-Farber Cancer Institute in the United States, discuss 'PARP inhibitors in prostate cancer: Management of adverse events and the importance of communication with patients’ as part of the GU NURSES CONNECT podcast series covering ‘PARP inhibitors in prostate cancer’.

In this podcast, the experts discuss adverse events associated with PARP inhibitors and the management of them, in particular thrombocytopenia, gastrointestinal effects and fatigue. Jason provides some insight into how nurses support and communicate with patients, the importance of early reporting of side effects and how to manage these. Finally, the ongoing trials of PARP inhibitors in combination with other prostate cancer treatments are also considered and what these trials may mean for patients.

COR2ED Educación Médica: Pablo Peinado, coordinador de Enfermería de Investigación, y la Dra. Elena Castro, oncóloga médica, quienes trabajan en el Hospital Universitario Virgen de la Victoria de Málaga en España, discuten 'El potencial de los inhibidores de PARP en el cáncer de próstata: Lo que las enfermeras necesitan para saber'.

En este podcast, los expertos analizan los inhibidores de PARP (PARPi), cómo funcionan y los datos clave de los ensayos de registro de rucaparib y olaparib, TRITON2 y PROfound. También discuten cómo seleccionar PARPi para sus pacientes con cáncer de próstata y dónde encajan en la secuencia general del tratamiento. Pablo brinda información sobre la comunicación con los pacientes y los tipos de preguntas e inquietudes que suelen tener en relación con las pruebas genéticas y el tratamiento con PARPi. Además, también analizan los PARPi que se encuentran actualmente en la última etapa de desarrollo, como niraparib y talazoparib, así como el posible uso futuro de los PARPi en combinación con inmunoterapias o inhibidores de la vía del receptor de andrógenos.

COR2ED Medical Education: Pablo Peinado, Research Nurse Coordinator, and Dr. Elena Castro, medical oncologist, who both work at Hospital Universitario Virgen de la Victoria in Malaga in Spain, discuss ‘The potential of PARP inhibitors in prostate cancer: What nurses need to know’. 

In this podcast, the experts discuss PARP inhibitors (PARPi’s), how they work and key data from the registration trials for rucaparib and olaparib, TRITON2 and PROfound.  They also discuss how to select PARPi’s for their prostate cancer patients and where they fit in the overall treatment sequence. Pablo provides some insight into communicating with patients, and the types of questions and concerns they often have in relation to genetic testing and treatment with PARPi’s.  In addition, they also discuss the PARPi’s currently in late-stage development such as niraparib and talazoparib as well as the potential future use of PARPi’s in combination with immunotherapies or androgen receptor pathway inhibitors.

COR2ED Medical Education: Joanne Chien, Nurse Practitioner specialising in urologic cancers at Stanford Health Care in Palo Alto, California, and Dr Alexander Wyatt, Assistant Professor in genitourinary cancer genomics at the Vancouver Prostate Centre, Department of Urologic Sciences at the University of British Columbia, discuss ‘Genetic testing and PARP inhibitors in prostate cancer’ as part of the GU NURSES CONNECT podcast series covering ‘PARP inhibitors in prostate cancer’.

In this podcast, the experts discuss the gene alterations in prostate cancer and why we should consider genetic testing when thinking about treatment options such as PARP inhibitors (PARPi’s). The discussion covers why genetic testing should be performed, who should undergo testing, how to test and what this means in relation to treatment with PARP inhibitors. Dr. Alex Wyatt explains the difference between germline and somatic mutations and Joanne Chien discusses the role of the nurse during genetic counselling discussions and how this role may evolve in the future. Finally, the ongoing trials of PARP inhibitors in combination with other prostate cancer treatments are also considered and whether the outcome of these trials is likely to impact the need to perform genetic testing.

In this medical education podcast, NTRK CONNECT members Assoc. Prof. Caterina Marchiò (University of Turin, Italy) and Prof. Christian Rolfo (Center of Thoracic Oncology Tisch Cancer Institute Icahn School of Medicine at Mount Sinai, New York, USA) provide pathologist and medical oncologist perspectives about the detection and treatment of TRK fusion-positive lung cancers.

They discuss a number of techniques and strategies to identify this rare fusion in lung cancer patients, before going on to summarise the robust efficacy and safety data for both entrectinib and larotrectinib. Prof. Rolfo briefly covers second-generation therapies in clinical development and describes how liquid biopsy is emerging as a new technique not only to identify but also monitor patients. They conclude by stressing the importance of the collaboration and communication between pathologists and oncologists to test for and identify TRK fusion-positive lung cancer patients.

In this medical education podcast episode, Prof. Peter Galle and Prof. Amit Singal discuss the use of VEGFR-TKIs in the treatment of advanced or unresectable HCC and explain the immunomodulation rationale to combine it with immune checkpoint inhibitor.

Combination approach has been validated recently with the atezolizumab+bevacizumab combination being the new standard of care in 1L setting for advanced HCC patients. In the context of advanced HCC, both experts share their view about the dosing approach with VEGFR-TKI and provide insight to handle the dosing when combining with PD-1 inhibitor.

Both experts reiterate that biomarkers are urgently needed in HCC and summarize the current stratification of patients used to predict the response with VEGFR-TKI monotherapy or in immunotherapy combination. Finally, they emphasize that pre-habilitation of HCC patients is key to make the HCC patient fit for the best available treatment option.