Oncology for the Inquisitive Mind

This episode is about IDH-mutant glioma, a cancer that often hits people in their thirties and forties who may live for decades, which makes the long-term cost of treatment matter as much as the benefit. We’re looking at two trials, almost thirty years apart. RTOG 9402 opened in 1994 and asked whether adding PCV chemotherapy to radiotherapy did better than radiotherapy alone in anaplastic oligodendroglioma. INDIGO asked whether a daily tablet, the IDH inhibitor vorasidenib, could let patients with grade 2 disease put off radiotherapy and chemotherapy altogether. One asks whether more is better. The other asks whether we can safely wait. What did they find, and what do they mean for the patient in front of you on Monday? Let’s get into it.

Studies Discussed in Today's Episode

RTOG 9402

INDIGO

For more episodes, resources and blog posts, visit www.inquisitiveonc.com

Please find us on Twitter @InquisitiveOnc!

If you want us to look at a specific trial or subject, email us at [email protected]

Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content.

Hosted on Acast. See acast.com/privacy for more information.

Cervical cancer is notoriously difficult to treat, but treatment like most cancers continue to improve. This week we discuss two pivotal immunotherapy (Keynote) trials.

KEYNOTE-826 was the first trial to show that adding immunotherapy to first-line chemotherapy helps women whose cervical cancer has come back or spread. They lived longer, and five-year results confirm the benefit lasts. KEYNOTE-A18 then moved pembrolizumab earlier, adding it to chemoradiation for newly diagnosed, high-risk disease, when the aim is cure. At three years, 82.6% of women were alive, compared with 74.8% with chemoradiation alone. Together, the two trials have made immunotherapy part of standard care across the course of this disease.

Studies Discussed in Today's Episode

KEYNOTE-826

KEYNOTE A18

For more episodes, resources and blog posts, visit www.inquisitiveonc.com

Please find us on Twitter @InquisitiveOnc!

If you want us to look at a specific trial or subject, email us at [email protected]

Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content.

Hosted on Acast. See acast.com/privacy for more information.

This week we cover endometrial cancer. It is one of the clearest examples of molecular classification changing how we treat patients. PORTEC-3 randomised women with high-risk disease to pelvic radiotherapy with or without chemotherapy. Adding chemotherapy improved survival, and the benefit held at 10 years. The molecular analysis is where it gets interesting, but you'll have to tune in to find out why! RUBY then showed those same dMMR tumours respond to something else entirely. Adding dostarlimab to carboplatin-paclitaxel in advanced or recurrent disease improved overall survival. Should one molecular result now decide whether a patient gets chemotherapy, immunotherapy or both? In this episode, we unpack both trials and what they mean for practice.

Studies Discussed in Today's Episode

PORTEC-3

RUBY

For more episodes, resources and blog posts, visit www.inquisitiveonc.com

Please find us on Twitter @InquisitiveOnc!

If you want us to look at a specific trial or subject, email us at [email protected]

Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content.

Hosted on Acast. See acast.com/privacy for more information.

Last week Josh and Michael discussed early ovarian cancer, but as is always the case many patients either do not respond completely to treatment of their early disease or present with advanced disease and thus are robbed of that chance. In these patients, getting the treatment right is a complex discussion but a vital one. In this episode, we discuss two studies in the advanced ovarian cancer space, a space that could still use more love, but has seen developments in recent years.

Studies Discussed in Today's Episode

AURELIA

ICON4

For more episodes, resources and blog posts, visit www.inquisitiveonc.com

Please find us on Twitter @InquisitiveOnc!

If you want us to look at a specific trial or subject, email us at [email protected]

Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content.

Hosted on Acast. See acast.com/privacy for more information.

Our Back to Basics odyssey nears its end, a journey just as epic as Matt Damon's (we think so, anyway). As we enter the final stretch, we discuss ovarian cancer, a cancer with significant mortality and morbidity despite advances in treatment. In this episode Josh and Michael discuss two studies in the early ovarian cancer space, a topic fraught with challenges as unique as Scylla and Charybdis.

Studies Discussed in Today's Episode

ICON7

PAOLA-1

For more episodes, resources and blog posts, visit www.inquisitiveonc.com

Please find us on Twitter @InquisitiveOnc!

If you want us to look at a specific trial or subject, email us at [email protected]

Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content.

Hosted on Acast. See acast.com/privacy for more information.

On this episode, Josh and Michael examine the treatment of advanced melanoma, the condition that blazed the trail for immunotherapy to change the face of cancer treatment. However, immunotherapy is not the ONLY treatment for melanoma, as a significant proportion of cases also harbour a BRAF mutation. So, if you have someone with such an example, what do you do? How would you sequence your treatment? This question, and a reflection on the incredible beginnings of immunotherapy is coming to you on today's episode.

Studies Discussed in Today's Episode

Checkmate 067

DreamSeq

For more episodes, resources and blog posts, visit www.inquisitiveonc.com

Please find us on Twitter @InquisitiveOnc!

If you want us to look at a specific trial or subject, email us at [email protected]

Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content.

Hosted on Acast. See acast.com/privacy for more information.

Our guest today is someone whose work touches almost every corner of oncology: from the exam room to the lab to the systems we work within.

Dr Narjust Florez, MD, FASCO, is a thoracic medical oncologist at Dana-Farber Cancer Institute and Assistant Professor of Medicine at Harvard Medical School, where she treats young patients and women with lung cancer and leads a research program spanning early diagnosis, clinical trials, and cancer health disparities. She's the Associate Director of the Cancer Care Equity Program and leads the EQUAL Study, which tackles disparities in lung cancer screening among Hispanic and East Asian patients. She's also become one of the most influential voices on physician wellness and burnout in oncology, and on building a more equitable path for women and underrepresented trainees in the field — work that's earned her recognition as the youngest Fellow ever named to the Association for Clinical Oncology, and a spot as JAMA Oncology's first Latina Associate Editor for Diversity, Equity, and Inclusion.

Please welcome Dr Narjust Florez.

For more episodes, resources and blog posts, visit www.inquisitiveonc.com

Please find us on Twitter @InquisitiveOnc!

If you want us to look at a specific trial or subject, email us at [email protected]

Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners, Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content.

Hosted on Acast. See acast.com/privacy for more information.

In this episode, Michael and Josh delve into the world of early melanoma. Some may think that melanoma has had its moment in the sun (pun slightly intended) and that other cancer treatments are passing it by. But in this instance, you can teach an old dog new tricks, an old immunotherapy dog, to be precise. In addition, one of today's studies has Michael's favourite design of any trial: see if you can figure out which one!

Studies Discussed in Today's Episode

KEYNOTE-054

NADINA

For more episodes, resources and blog posts, visit www.inquisitiveonc.com

Please find us on Twitter @InquisitiveOnc!

If you want us to look at a specific trial or subject, email us at [email protected]

Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content.

Hosted on Acast. See acast.com/privacy for more information.

If you like cemiplimab, you will like this episode. Since its introduction, cemiplimab has become the mainstay of treatment for cutaneous SCC, the most common non-melanoma skin cancer likely to attend an oncologist. Cemiplimab's scope is expanding; once reserved purely for the locally advanced or metastatic setting, evidence is emerging for its efficacy in the neoadjuvant setting. Today, Josh and Michael explore the use cases for cemiplimab in cSCC

NOTE: this episode was NOT sponsored by cemiplimab!

Studies Discussed in Today's Episode

Migden et al. (2018)

Gross et al (2023)

For more episodes, resources and blog posts, visit www.inquisitiveonc.com

Please find us on Twitter @InquisitiveOnc!

If you want us to look at a specific trial or subject, email us at [email protected]

Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content.

Hosted on Acast. See acast.com/privacy for more information.

For over a decade, sorafenib remained unchallenged as first-line therapy for hepatocellular carcinoma, based on the SHARP trial, which showed survival increasing from 7.9 to 10.7 months. This demonstrated modest efficacy in a disease notoriously resistant to systemic treatment. That drought broke in 2020, when IMbrave150 demonstrated that atezolizumab plus bevacizumab beat sorafenib outright, pushing median survival past 19 months and putting immunotherapy on the map for liver cancer. Two years later, HIMALAYA proved that a single priming dose of anti-CTLA-4 could unlock durable responses, with the STRIDE regimen nearly doubling five-year survival compared with sorafenib. Then IMbrave050 asked whether that success could move earlier, into the adjuvant setting after resection — and the early promise didn’t hold up on longer follow-up. Together, these three trials mark both immunotherapy’s arrival in liver cancer and the limits of assuming it translates cleanly across settings.

Trials Discussed on Today's Episode:

HIMALAYA Trial

IMbrave 050

IMbrave 150

For more episodes, resources and blog posts, visit www.inquisitiveonc.com

Please find us on Twitter @InquisitiveOnc!

If you want us to look at a specific trial or subject, email us at [email protected]

Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content.

Hosted on Acast. See acast.com/privacy for more information.