Summary

In this episode, hosts James Larkin & Sapna Patel discuss the Women in Melanoma Conference, highlighting its role in fostering networking and collaboration among female oncologists. They reflect on the evolution of the conference, its impact on participants, and the importance of addressing women's issues in oncology. The discussion also touches on the potential for expanding the initiative beyond the U.S. and the value of creating a supportive community for women in the medical field.

James reveals a lack of stupid human tricks, Sapna reports on her skill with napkin lipstick blots, and the two fawn over word clouds in the shape of the female form (e.g. Figure 1). Moral of the story? Don't tease, and James is the bigger geek... all around

Keywords

melanoma, women in oncology, networking, collaboration, medical conference, women empowerment, survivorship, oncology research, patient care, medical community

Takeaways

The Women in Melanoma Conference was initiated to address the lack of female representation in oncology meetings.

Networking and collaboration are crucial for professional growth in oncology.

The conference has evolved to include a broader range of topics relevant to women in the medical field.

Participants have expressed feelings of camaraderie and support through the conference.

The initiative has led to successful collaborations and publications among attendees.

There is potential for expanding the Women in Melanoma initiative internationally.

The conference addresses both professional and personal challenges faced by women in oncology.

Role-playing exercises have been beneficial for participants in handling difficult conversations.

The conference serves as a platform for discussing patient-centered care and survivorship.

The success of the initiative may inspire similar programs in other medical specialties.

Sound Bites

"It's been a lovely forum."

"There's no reason this has to stay U.S."

"We captured lightning in a bottle here."

Chapters

00:00 Introduction and Icebreakers

02:53 Val Guild & the Inception of WIM

06:53 Networking and Collaboration in Oncology

10:45 Expanding the Women in Melanoma Initiative

14:26 Figure 1. Word Cloud

You wanted it, we gave it... best of ASCO ...colon...2025 :D

In this episode, hosts James and Sapna discuss the key highlights from ASCO 2025, focusing on significant abstracts related to melanoma treatment. They delve into the implications of adrenal insufficiency, the 5 year, final results of Lifileucel, and the ongoing debate between neoadjuvant and adjuvant therapies. The conversation also explores the role of IL-6 in treatment efficacy and the importance of understanding sentinel lymph node positivity. The hosts emphasize the need for innovative clinical trial designs to adapt to emerging data and improve patient outcomes.

Keywords

ASCO 2025, melanoma, neoadjuvant therapy, adrenal insufficiency, lifileucel, immunotherapy, clinical trials, IL-6, treatment outcomes, cancer research

Chapters

00:00 Introduction and Overview of ASCO 2025

03:16 DoorDash!

05:43 Key Highlights from ASCO 2025

08:29 Lifileucel and Its Impact on Treatment

10:53 Long-term Outcomes and Toxicity Considerations

15:49 Exploring Treatment Efficacy in Refractory Populations

17:41 Neoadjuvant and Adjuvant Therapies: A Comparative Analysis

21:07 Investigating GM-CSF's Role in Mitigating Toxicity

22:36 RELA 098: Insights and Implications

25:37 Understanding Sentinel Lymph Node Positivity in Melanoma

26:34 Future Directions in Neoadjuvant Therapy Research

36:18 Fact Check

38:17 Discussion on IPI GM-CSF and Adrenal Insufficiency

42:09 Impact of Adrenal Insufficiency on Patients

45:06 Future Directions in Neoadjuvant Trials

47:26 Wrap-Up and Reflections

Summary

In this episode, Sapna Patel and James Larkin engage with Monty Pal from City of Hope, discussing his unique journey into oncology, the significance of the microbiome in cancer treatment, and the impact of diet and lifestyle on patient outcomes. They explore current research, including clinical trials involving fecal microbiome transplants and the potential of specific bacteria to enhance immunotherapy effectiveness. The conversation highlights the evolving landscape of cancer treatment and the promising future of microbiome research in oncology.

Keywords

oncology, microbiome, cancer treatment, immunotherapy, diet, clinical trials, kidney cancer, melanoma, fecal microbiome transplant, City of Hope

Takeaways

Monty Pal started college at the age of 13, showcasing an unconventional path to medicine.

His journey into oncology was influenced by a pivotal decision to switch from engineering to medicine

Monty has significantly contributed to the growth of the GU oncology program at City of Hope.

The microbiome plays a crucial role in predicting patient outcomes and side effects in cancer treatment.

Dietary fiber intake has been linked to improved clinical outcomes in melanoma patients receiving immunotherapy.

Random probiotics may not be beneficial and could even be harmful to patients.

Research indicates that specific bacteria can enhance the effectiveness of immunotherapy.

The future of cancer treatment may involve turning cold tumors into hot tumors using microbiome interventions.

Titles

The Journey of Monty Pal: From Prodigy to Oncologist

Microbiome and Cancer: Turd Burglars to Treatment

Sound Bites

"I started college when I was 13."

"Fiber seems to be somewhat interesting."

Chapters

00:00 Introduction and Introduction of Monty Pal from City of Hope

01:42 Monty's Journey to Medicine

05:19 GU Oncology at City of Hope

10:28 The Microbiome: A New Frontier in Oncology

14:52 Microbiome Research and Clinical Outcomes

19:21 Lifestyle Factors and the Microbiome

23:51 Intervention Strategies: Fecal Microbiome Transplant and Beyond

24:35 South Park Episode: Turd Burglars

29:58 An Upcoming SWOG trial

32:48 Fact Check

Summary

In this episode of Melanoma Matters, hosts Sapna Patel and James Larkin discuss the Godfather 15 trial, focusing on the neutralizing GDF 15 antibody and its implications in overcoming PD-1 and anti-PD-L1 resistance in solid tumors. They explore the background of GDF-15, its role in immune suppression, and the trial's methodology, including safety and efficacy results. The conversation also touches on the future directions of GDF-15 antibody trials and the importance of understanding treatment resistance in cancer therapy.

Keywords

Melanoma, GDF-15, Godfather 15 trial, immunotherapy, cancer research, PD-1, antibody therapy, clinical trials, immune suppression, treatment resistance

Takeaways

The Godfather 15 trial focuses on neutralizing GDF-15 antibody.

GDF-15 is linked to immune suppression in tumors.

The trial is a phase 1/2 study with multiple dose levels.

Understanding treatment resistance is key in cancer research.

The importance of defining refractory cohorts in trials.

Biological proof of concept is essential in early studies.

Future trials should focus on specific patient populations.

Sound bites

"This is a phase 1/2 study"

"This is the biology we're targeting"

"I think this is obviously just a first step"

Chapters

00:00 Introduction to the Godfather 15 Trial

07:48 Understanding GDF-15 and Its Role in Cancer

11:48 Exploring the Study Design and Methodology

18:42 Results and Efficacy of the GDF-15 Antibody

25:09 Future Directions and Closing Thoughts

Summary

In this conversation, James Larkin and Sapna Patel discuss the consensus definitions for resistance to immune checkpoint inhibitors, focusing on a recent paper from the Journal of Immunotherapy of Cancer. They explore the complexities of primary and secondary resistance, the importance of defining these terms for clinical trials, and the challenges in trial design and control arms. The discussion emphasizes the need for clear definitions to improve patient outcomes and guide future research in oncology.

Keywords

immune checkpoint inhibitors, cancer treatment, resistance, clinical trials, melanoma, PD-1, adjuvant therapy, response rate, tumor sensitivity, oncology

Takeaways

Resistance to immune checkpoint inhibitors is a major challenge in melanoma treatment.

Primary resistance occurs when there is no benefit from treatment, while secondary resistance follows initial benefit.

Defining resistance is crucial for clinical trials and understanding patient populations.

The duration of drug exposure is key in determining resistance types.

Clinical trial design must consider the expectations of efficacy in control arms.

Investigators should be cautious about the definitions of patient populations in trials.

Response rates of 15-20% are considered significant for primary resistance.

Secondary resistance may show higher response rates due to residual sensitivity.

Clear definitions help in layering data for future research.

Collaboration among clinicians, industry, and regulatory bodies is essential for advancing cancer treatment.

Sound Bites

"It's probably the biggest challenge we now have in clinic."

"There's something in the middle."

"I think that's where we might need to be there."

Chapters

00:00 Introduction to Immune Checkpoint Inhibitors and Resistance

08:08 Understanding Resistance: Definitions and Scenarios

14:47 Primary vs. Secondary Resistance in Clinical Trials

22:00 Trial Design and Control Arms in Immunotherapy

30:36 Conclusions and Future Directions

33:28 outro fade long expo.mp4

Summary

In this episode of Melanoma Matters, James Larkin and Sapna Patel discuss the recent advancements in understanding and treating cancer cachexia, particularly focusing on the drug ponsegramab. They explore the implications of cachexia across different cancer types, the role of cytokine GDF-15, and the importance of nutrition and physical activity in managing cachexia. They opine on body weight and protein, as per usual.

Keywords

cancer cachexia, ponsegramab, GDF-15, treatment options, nutrition, clinical trials, melanoma, kidney cancer, pancreatic cancer, weight gain

Takeaways

Cancer cachexia is a significant issue in various cancers.

Ponsegramab shows promise in treating cachexia with meaningful weight gain.

GDF15 is a key cytokine elevated in cancer cachexia.

Historical treatments for cachexia have included progestins, but newer options are emerging.

Nutrition and physical activity are crucial in managing cachexia.

Collaboration between academia and industry is vital for drug development.

The study of Ponsegramab was conducted across multiple institutions.

Cachexia management requires a multifactorial approach.

Clinical trials must consider the contributions of all stakeholders.

Future research is needed to optimize treatment for cachexia.

Sound Bites

"This is about cancer cachexia."

"We do see the sarcopenia."

"Doctors have known about this for 2,000 years."

Chapters

00:00 Introduction to Cancer Cachexia

02:43 Understanding Cachexia in Different Cancers

06:41 The Role of GDF-15 in Cancer Cachexia

10:39 Clinical Trial Insights on Ponsegramab

18:37 Exploring Treatment Implications and Future Directions

24:36 Authorship and Collaboration in Cancer Research

32:47 Fact Check

33:36 Discussion on Cancer Cachexia and Bonsegramab

38:14 Historical Context of Treatment in Kidney Cancer

42:28 Current Guidelines and Future Directions for Cachexia Treatment

Summary

In this conversation, Sapna Patel and James Larkin discuss the recent approval of Opdivo Qvantiq, a subcutaneous formulation of nivolumab, and its implications for oncology treatment. They explore the Checkmate 6-7-T study that led to its approval, the efficacy and safety of the new formulation, and the broader regulatory landscape. The discussion also touches on patient perspectives regarding subcutaneous versus intravenous treatment, the potential for future clinical trials, and the importance of patient choice in treatment options.

Keywords

Opdivo, Qvantiq, subcutaneous formulation, oncology, Checkmate 6-7-T, nivolumab, patient experience, regulatory approval, cancer treatment, clinical trials

Takeaways

The approval of Opdivo Qvantiq represents a significant advancement in oncology.

Subcutaneous formulations offer convenience and the possibility of home treatment.

Patient acceptance of subcutaneous treatment is generally high.

The Checkmate 67T study demonstrated the efficacy of subcutaneous nivolumab.

Regulatory approval for subcutaneous formulations is becoming more streamlined.

Patients may value the social interaction of IV treatments over subcutaneous injections.

The future of clinical trials may need to incorporate both subcutaneous and IV options.

Understanding patient preferences is crucial for treatment decisions.

The role of reimbursement in treatment choice cannot be overlooked.

The transition from IV to subcutaneous treatment may impact patient care dynamics.

Titles

Revolutionizing Cancer Treatment: Opdivo Qvantiq

The Future of Subcutaneous Nivolumab

Sound Bites

"It's a no-brainer for patients."

"The FDA has taken a view there."

"This is not just a flu shot."

Chapters

00:00 Why does J have Napoleon on his wall?

05:36 Dreams of new work office furniture...or gym equipment

08:01 CheckMate 67T

19:31 Patient Perspectives on Subcutaneous vs. Intravenous Treatment

27:43 Regulatory and Approval Insights for Opdivo Qvantig

33:30 Future Directions in Clinical Trials

38:02 Fact Check

38:06 Subcutaneous Treatments in Oncology

41:01 Patient Experience and Acceptance of Subcutaneous Treatments

44:17 The Shift in Oncology Patient Interactions

47:06 Current Landscape of Subcutaneous Drugs in Oncology

In this episode of Melanoma Matters, hosts James Larkin and Sapna Patel pick up with Part 2 of 2 - a deep conversation with Claire Turnbull - about the complexities of cancer screening, overdiagnosis, and the role of genetic testing. They explore the implications of screening practices illustrated by the Gilbert Welch paradigm, the challenges faced in patient management, and the future of genetic testing in oncology. The discussion emphasizes the importance of understanding the risks and benefits associated with genetic testing.

Keywords

melanoma, cancer screening, overdiagnosis, genetic testing, patient management, healthcare, public health, cancer research, screening guidelines, cancer predisposition

Takeaways

• The conversation highlights the importance of understanding the value of cancer screening.

• Overdiagnosis is a significant concern in cancer screening practices.

• Genetic testing plays a crucial role in identifying cancer predisposition.

• Screening should be evaluated rigorously to ensure it benefits patients.

• The implications of false positives in screening can lead to unnecessary anxiety for patients.

• Healthcare providers must be responsible for interpreting test results they order.

• The need for genetic counseling is critical in managing test results and patient care.

• There is a growing concern about the overuse of broad genetic testing panels.

• Future advancements in technology may improve screening methods.

• Public health messaging must address the complexities of cancer screening and genetic testing.

Chapters

00:00 Clare Turnbull - Part 2 of 2

04:05 High penetrance, common SNPs, and in betweens

07:15 The Gilbert Welch Paradigm

12:30 Understanding Lead Time and Overdiagnosis

16:11 Randomized Trials in Screening

19:59 Consequences of Screening: Overdiagnosis and Anxiety

22:22 Debate on Screening Protocols and Their Efficacy

25:37 Need for Evidence-Based Genetic Testing

31:19 Ripple Effects of Genetic Testing on Families

34:00 Fact Check

35:47 Genetic testing for ACC?!

36:34 Clinical Genetics clinics are NOT just reading guidelines...

39:52 David Sackett: Evidence-Based Medicine

43:03 Triggering James: (S)he who orders the test reviews & interprets the test

Summary

In this episode of Melanoma Matters, hosts Sapna Patel and James Larkin welcome Clare Turnbull, a clinical geneticist in London, to discuss her journey from studying mathematics to medicine, her work in cancer genetics, and the impact of COVID-19 on healthcare. The conversation explores the role of genetic testing in melanoma, the challenges of public health in cancer treatment, and the ongoing effects of the COVID-19 pandemic on cancer care and patient outcomes.

Keywords

melanoma, genetics, COVID-19, public health, cancer treatment, screening, early detection, healthcare, epidemiology, clinical genetics

Takeaways

Clare Turnbull transitioned from mathematics to medicine in uni,

She has worked extensively in clinical genetics, focusing on cancer genetics.

COVID-19 significantly impacted healthcare delivery and cancer treatment prioritization, the effects of which will take a long time to bear out.

The importance of genetic testing in melanoma is highlighted, for young onset cases or those with a significant family history.

Public health initiatives are crucial for improving cancer outcomes.

The pandemic created a bulge in cancer mortality due to delayed diagnoses.

Screening for melanoma is essential, but the pick-up rates for genetic mutations are low - a cautionary tale.

Sound Bites

"A can-do attitude, what can I do to help?"

"There will be a bulge of mortality."

"The pick-up rate's pretty low."

Chapters

00:00 Opening theme music (My Favourite Dress...The Wedding Present)

00:48 Introduction of Guest Clare Turnbull

03:27 Clare's Journey in Clinical Genetics

05:36 Genomics England, 100K Genomes Project

06:58 Clare's extraordinary efforts during COVID

12:07 Melanoma and genetic risk(s) versus environmental risk

16:28 The Ripple Effects of Genetic Testing on Families

Summary

On mountain emergencies...Sapna's had them, James denies them...This conversation delves into the treatment options available for patients with advanced melanoma who have progressed after anti PD-1 therapy. The discussion covers various clinical studies, response rates, and the implications of combination therapy post-PD1 progression. James and Sapna conclude that while combination therapies show promise, the responses may not be as robust as those seen in frontline treatments.

Keywords

melanoma, PD-1, treatment, clinical trials, immunotherapy, BRAF, response rates, efficacy, combination therapy, patient outcomes

Takeaways

The conversation focuses on treatment options after PD-1 progression.

Clinical studies provide valuable data on post-PD-1 therapies.

Response rates for combination therapies are generally higher than monotherapy.

BRAF status is a critical factor in treatment decisions.

Randomized studies help clarify the efficacy of different treatment approaches.

Combination therapy may offer better outcomes for patients post-PD-1.

Acquired resistance remains a challenge.

Titles

Exploring Treatment Options Beyond PD-1

The Role of Clinical Trials in Melanoma Therapy

Sound Bites

"What to do post PD-1 exposure?"

"Can you get a response to IPI after PD-1?"

"The primary endpoint was PFS, not ORR... "

Chapters

00:00 Opening theme music (My Favourite Dress by The Wedding Present)

01:25 Mountain rescue quickfire

03:08 Post anti-PD1 studies - the issues

04:13 Pires da Silva retrospective study

08:53 Olson single-arm prospective study (and yes we see you Jason)

10:38 SWOG S1616 randomized ph 2 study

16:35 Conclusions

17:17 Fact Check