In last week’s issue of The Cancer Letter, Paul Goldberg, editor and publisher of The Cancer Letter, and Jacquelyn Cobb, associate editor, each had a big story: Jacquelyn wrote about the  April 30 meeting of the Oncologic Drugs Advisory Committee, and Paul wrote about Vinay Prasad’s inaccurate claims on his CV.  

In this week’s episode of The Cancer Letter Podcast, Jacquelyn and Paul talk more about these stories.

In a document dated June 23, 2023, Prasad, who is described as a social media star, inaccurately claims to have served as a “Member” of “U.S. President’s Cancer Panel” between 2016 and 2017. 

“The President's Cancer Panel is one of those interesting institutions created in the National Cancer Act of 1971, which is, and its function is to inform the president of the United States about barriers towards implementation of the National Cancer Act of 1971 and the National Cancer Program,” Paul said. “And one of the great honors in oncology is to be placed on this panel and it's had some really illustrious members. The first chair of the president's cancer panel was none other than Ben Schmidt. I mean, I'm pretty sure that Mrs. Lasker was on it. I mean, this is a big deal—it's also three members at a time, and they're actually advising the president of the United States.

“So, when you have three of them, there's not much room to hide.” 

Later in the episode, Jacquelyn and Paul talked about AstraZeneca’s new drug application for camizestrant, a next-generation oral selective estrogen receptor degrader, or SERD, in metastatic breast cancer, appearing before the FDA Oncologic Drugs Advisory Committee. 

The application, with a Breakthrough Therapy designation from FDA, an ASCO plenary, and publication in The New England Journal of Medicine under its belt, might have seemed set to sail smoothly through the FDA approval process. 

But ultimately, the application got a thumbs down from the committee.

In this disease setting, patients develop resistance to first-line treatment, and “a primary way it develops is through this one mutation called ESR1,” Jacquelyn said.  

“Basically, this mutation, we know, is a resistance mutation and it leads to progression. What we don't know is that between that mutation being acquired and the progression actually happening on scans, or radiographic progression, we don't know whether it's better for patients to continue on the aromatase inhibitor or to switch to a new drug. 

“So, that's basically the big question about this trial, about this drug and this approach, this biomarker-driven progression approach. And that's why this was such a bigger question than just the ODAC. This approach is going to be coming up in other indications. It's a technological advancement that is coming for the field, whether we're ready or not.”

Stories mentioned in this podcast include:

• Breakthrough Therapy designation, ASCO plenary, and NEJM publication notwithstanding, breast cancer drug camizestrant gets a No from ODAC

• Vinay Prasad’s CV inaccurately claims past membership on the President’s Cancer Panel

• J. Craig Venter’s work was foundational to cancer advancement of the past 25 years

• Trump changes pick for Surgeon General, nominating Nicole Saphier

A transcript of this podcast is available: https://cancerletter.com/podcastc/20260513-prasad-and-odac/

The Cancer Letter’s coverage of HHS-led overhauls of foundational scientific institutions continued last week with two unrelated stories pointing to continued disarray amongst public health leadership.

In this week’s In the Headlines, Claire Marie Porter, Sara Willa Ernst, and Jacquelyn Cobb, reporters with The Cancer Letter, talk about 1) HHS Secretary Robert F. Kennedy Jr. promising to reform the U.S. Preventive Services Task Force by replacing medical generalists with medical specialists, and 2) FDA rejected a drug for treating advanced melanoma, RP1 (vusolimogene oderparepvec)—for a second time—on April 10.

USPSTF is an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services.

“What's at stake is this group kind of quietly shapes a huge part of American healthcare,” said Claire. “Their recommendations determine what happens in your routine doctor visits, so everything from cancer screenings to preventive counseling, and under the ACA, the Affordable Care Act, they decide what insurers have to cover for free.”

Experts say Kennedy’s changes would cripple the task force’s ability to apply the principles of evidence-based medicine and undermine the scientific credibility that has made the panel a cornerstone of preventive care in the U.S.

“There are 16 members on the panel. Five are rotating out this year, I think they serve a 4-year term, and he wants to replace them with medical specialists, which is a really big shift, because since 1984, the Task Force has been intentionally built around primary care doctors and methodology experts and not disease specialists,” Claire said. “And the idea behind that is that you want people on the panel who can look at the data broadly, not folks who are deep in one lane.”

And FDA’s rejection of the melanoma drug, RP1, took the field by surprise.

“The data is really robust. So, when you look at the data and you look at some of the comments that they had in the complete response letter, a lot of people were just kind of dumbfounded,” said Sara. “I heard from one oncologist that they were flabbergasted. I talked to a patient advocate that said that there is a lot of disappointment about this rejection. This is a Melanoma Research Foundation, and at least 75 patients have reached out in the few weeks since the rejection saying, ‘Hey, I really oppose this, and I wish it went a different way.’”

The concern about FDA’s handling of the Replimune’s drug are a part of broader worries about inconsistency in the agency’s decisions (The Cancer Letter, March 13, 2026). 

At least nine other companies have reported surprising regulatory decisions from the Center for Biologics Evaluation and Research in recent months, according to The Wall Street Journal. 

Stories mentioned in this podcast include:

• By adding specialists to USPSTF, Kennedy would reshape the functioning and decisions of the influential health panel

• FDA’s second rejection of Replimune’s melanoma treatment stirs worry among oncologists, patients

• Benjamin Ebert, Amy Gladfelter, Stephen Liberles, and Pardis Sabeti are among new members of the National Academy of Sciences

A transcript of this podcast is available: https://cancerletter.com/podcastc/20260506-hhs/

The intersection of art and education is well established, but its application in oncology remains limited. 

Last week’s issue of The Cancer Letter featured two stories about the role of art in cancer outreach and education—one about a comic book designed to increase cervical cancer screening and HPV vaccination in Nigeria, the other about a film festival comprised of films directed by cancer survivors.

On this week’s episode of In the Headlines, Paul Goldberg, editor and publisher of The Cancer Letter, and Jacquelyn Cobb, associate editor, discuss their approach to reporting on art in the world of oncology.

“The cool thing about this job, which is why it's great to be a journalist here, is that you're doing a police beat, you're doing investigative, you're doing lifestyles, you're doing just pretty much everything. And that's during just any week. Oh, regulatory beat. Just name it all. It's all there,” Paul said. “And art is a big part of our lives, and a big part of how we communicate. And so, whenever somebody gives me an art story, I go nuts.”

Dr. Obi Cancer Chronicles, Vol. 1: Cervical Cancer and the HPV Vaccine,” is the first iteration of a series of comic books developed by a nonprofit called Global Oncology that is focused on equitable cancer care in resource-constrained areas. The comic book was disseminated in Nigeria, where cervical cancer is a major public health crisis, and the response has been very positive.

Nearly all of the 350,000 cervical cancer deaths in 2022—94%—occured in low- and middle-income countries. 

“This story in particular was interesting because we had been covering these recent advances in the cervical cancer screening and HPV screening space,” said Jacquelyn. “This is a preventable cancer, like 99% preventable with screening, vaccination, and follow up, and yet people are dying every hour in Nigeria.”

Cervical cancer experts insist that outreach and accessibility strategies are the most important lever to improve outcomes. In theory, cervical cancer could be almost entirely eliminated with prevention and screening efforts, thanks to a quirk of the disease’s histology: Virtually all cases are caused by high-risk human papillomavirus, for which there is both a vaccine and an effective screening test.

“What I loved about that story was, first of all, there was no way it wasn't going to get done because the art was amazing,” Paul said. “Because comic book art is always amazing. Comic book art and a comic book that is really calibrated to address, to communicate with people in Nigeria is incredible.” 

According to the book’s afterward, Dr. Obi is modeled on Olufunmilayo I. Olopade, a native of Nigeria and a leader in the global oncology space. Olopade is the Walter L. Palmer Distinguished Service Professor of Medicine and director of the Center for Clinical Cancer Genetics and Global Health at the University of Chicago. She is also a past winner of Global Oncology’s Visionary award.

“So, it was just really fun to see that also, the role model of Funmi Olopade. My God, she's awesome,” Paul said. “The really cool thing about this is that we're not bored. I hope our readers aren't bored.”

“How can you be bored with Dr. Olopade in comic form?” Jacquelyn said.

Stories mentioned in this podcast include:

• The Directors: UPMC’s Byrd and Jefferson’s Chapman speak about avoiding catastrophism and using bridge funding to keep labs open

• At AACR, Letai announces prevention and screening project for southern Appalachia, describes a future without paylines

• Problem: Misinformation and stigma prevent uptake of HPV vaccines and screening. Solution: A comic book

• Directing the narrative of your survival: How The Remission Film Festival centers survivorship stories

• Forty years after Chernobyl: Little evidence to show that radiation released from the accident increased cancers globally

A transcript of this podcast is available: https://cancerletter.com/podcastc/20260429-art/

In recent months, several directors of cancer centers, appearing on The Directors segment of The Cancer Letter Podcast, mentioned that their institutions are increasingly providing small grants—typically in the range of $50,000—to scientists to enable them to keep their labs open.

Andrew Chapman, director of the Sidney Kimmel Cancer Center at Jefferson, said he and other officials at Jefferson designed a bridge funding mechanism that applies to oncology as well as to other therapeutic areas.

John Byrd, director of UPMC Hillman Cancer Center, said bridge funding at his institution was started by Kathryn Schmitz, who served as the interim director before he started his job last November.

Chapman and Byrd appeared together on The Directors, a monthly podcast series that focuses on the problems that keep directors of cancer centers up at night.

The extent of reliance on bridge funding at NCI grantee institutions hasn’t been studied systematically, but in recent months, it has come up regularly on The Directors. As cancer centers strategize amid this time of uncertainty, many are tapping into their resources to keep their labs and federally-funded programs going—in essence becoming short-term lenders to the government and placing a bet that the money will soon begin to flow.

This may be a sound strategy if the problem is limited to temporary constriction of federal funds—and assuming that Congress will continue to provide robust funding to NIH and NCI.

A transcript of this episode is available: https://cancerletter.com/podcastc/20260424_1/

FDA has cleared the first at-home self-collection kit for HPV screening, removing significant obstacles to cervical cancer detection. 

The kit includes the only FDA-approved HPV assay to individually identify six high-risk genotypes and is the most comprehensive HPV screening tool available in the U.S. today.

“The population that ends up dying from cervical cancer, which is highly preventable, are these populations that have historically fallen through the cracks of the healthcare system,” said Claire Marie Porter, reporter with The Cancer Letter. “So, this kind of levels the playing field.”

On this week’s episode, Claire and Jacquelyn Cobb, associate editor of The Cancer Letter, talk about why approximately 12,000 cases of cervical cancer still occur every year in the U.S. when it's considered one of the most preventable of all cancers. Because 99% of cases are caused by high-risk HPV, widespread vaccination and screening could, in theory, almost entirely eliminate the disease. 

“I mean, this story is like, come on, let's cure cancer,” Jacquelyn said.

We also hear from Otis Brawley, the Bloomberg Distinguished Professor of Oncology and Epidemiology at the Johns Hopkins Kimmel Cancer Center, on the history of the Pap smear, and what has changed over the last century of cervical cancer screening. 

“The self HPV testing is a tremendous improvement, especially amongst women who don't want a Pap smear or don't want a pelvic examination,” Brawley said. “I don't need to tell you how invasive it is. And we've actually started learning that it's certain types of HPV that are more likely to regress versus others.”

Stories mentioned in this podcast include:

• Self-collection kits for HPV are among innovations adding momentum to eradication of cervical cancer

• Long-awaited results from first phase III trial of a RAS inhibitor in pancreatic cancer shows that daraxonrasib doubles median OS

• Calabresi’s “Cancer at a Crossroads” report was the first step toward historic doubling of the NIH budget

• Most Favored Nation drug pricing could put China on top

• Bridging communication and genomics: A path toward equitable cancer care

• FDA adds stereotactic breast biopsy needles to the shortage list

• CMS proposed rule would implement electronic prior authorization requirements for covered drugs in federal health plans

• At Friends meeting, data quality, modern evidence generation, and early regulatory alignment top the list of “next steps” for external control arms

The Cancer Letter’s most recent cover story featured an in-depth Q&A with Anthony G Letai, director of the National Cancer Institute. 

In this week’s episode of The Cancer Letter Podcast, Paul Goldberg, editor and publisher of The Cancer Letter, and Jacquelyn Cobb, associate editor, shared the behind-the-scenes editorial decisionmaking behind the story.

“It might almost read a little bit of a boring story,” Jacquelyn said. “It's not, but it's very repetitive, it's very in line with what he has been saying, and that is the point. That is the point—this repetition is what he's trying for and what NCI is trying for and what the national cancer enterprise arguably needs, according to Letai, at this time.”

In this episode, listeners can hear an excerpt from The Cancer Letter’s interview with Letai. The full conversation is available as a video.

One major lingering concern from the oncology community is about the status of granted money getting out of NCI and to grantees. 

“Really, I want to make it clear there are no real major speed bumps or impediments in our way to getting these grants out the door,” Letai said. “The major impediment really was the government shutdown. And I think it's a credit to the NCI staff who've been doing an excellent job, given the many changes that have come their way, to keep business as usual, keep the grant money flowing out to the extramural programs. As is typical, as is usual, roughly 75% of the entire NCI budget is going to the extramural program, and Fiscal Year 2026 is going to follow exactly that pattern.”

According to the latest numbers NCI provided to The Cancer Letter, on March 17, 22 competing grants were awarded by the institute. By April 9, 167 grants were awarded.

This amounts to about 200 competing grants awarded per month or about 50 per week, though this is just a very small sample size, as NCI did not receive many competing awards to pay until late February, an NCI institute official said. The plan is for that pace to pick up significantly.

Additionally, 1,514 non-competing awards have been paid since mid-November 2025.

“It's nice to remind people that there is an actual scientist at NCI, not a blogger like us. Not a podcaster, like us,” Paul said. “Who actually has a scientific vision, which is fantastic to have, and who is more like the past NCI directors than not. And if you've heard him say something that's vaguely reassuring, it's nice to have him repeat it because that way you know that you heard it correctly the first time.

“He's got enormous influence in his job. And part of the influence is to be essentially the unlicensed psychiatrist and chief. That’s what is needed. 

“Actually, that doesn't make him any different from any other NCI director that we've ever known. Some have been better psychiatrists than others. But all have been unlicensed.”

The new 2025-2030 Dietary Guidelines for Americans, or DGA, which inform federal nutrition policies, school meals, and public health education were announced by Health Secretary Robert F. Kennedy Jr. earlier this year. 

On this episode of The Cancer Letter Podcast, Jacquelyn Cobb, associate editor with The Cancer Letter, and Claire Marie Porter, reporter, lament a missed opportunity for cancer prevention messaging. 

While the DGA agrees with settled science in many instances, the guidelines diverge in some noticeable ways that have the oncology community and public health experts scratching their heads.

The food pyramid graphic has also been resurrected, replacing MyPlate, and flipped upside down, emphasizing red meat, full-fat dairy products, and fruits and vegetables at the top, eliminating junk food and refined sugar, and deemphasizing plant-based fiber. 

“It's an inverted pyramid where, as opposed to the previous pyramid, where protein was kind of just a food group, now protein is kind of the organizing factor of the entire pyramid,” Claire said.

Jacquelyn and Claire talked about the implications of Kennedy’s DGA for the oncology community who are contending with an upswing in early-onset cancers, particularly colorectal cancer. 

“It's interesting because on one hand, these dietary guidelines are super prescriptive, like eat more protein, embrace full fat diary, don't be afraid of animal fats like beef tallow and butter,” Claire said. “And on the other hand when it comes to alcohol, where cancer data are actually pretty consistent and pretty strong, we just get ‘drink less.’”

The new DGA increases limits on daily protein, even though Americans already consume more animal protein than any other country in the world. It also officially removed specific daily alcohol limits—previously one drink for women and two for men—revising guidance to a general recommendation to "consume less alcohol for better overall health".

“If you're going to say, ‘End the war on red meat,’... then people feel good going and eating bacon when that causes stomach cancer,” Jaqcuelyn said. “So, yeah, I guess that's my little soapbox.”

Members of the Dietary Guidelines Advisory Committee, the group that provides the evidence that informs the final DGA, say that half of their recommendations were dismissed, and Kennedy instead built the DGA on a “shadow report” devised by a group of nutritionists with very direct industry ties. 

Stories mentioned in this podcast include:

• HHS presents new protein-forward dietary guidelines, turning the food pyramid upside down

• Ukrainian oncologists press on in year four of wartime disruptions

• FDA’s guidance on MRD in MM goes beyond the ODAC vote—and that’s where it matters most

• The Cancer Letter Podcast nominated for 30th annual Webby Awards

A transcript of this podcast is available: https://cancerletter.com/podcastc/20260408-dietary-guidelines/ 

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Colorectal Cancer Awareness Month is putting a sharper edge on an uncomfortable question: if colorectal cancer is now the leading cause of cancer death in people under 50, why aren’t more people getting screened?

The incidence of early-onset cancers have been rising for years, with colorectal cancer at the forefront of that shift. Thirty years ago, colorectal cancer ranked fifth among cancer killers in younger adults and rarely topped the list of concerns for physicians treating patients in their mid-40s.

Today, the risk profile has changed—but awareness and action haven’t kept up the pace.

“Early-onset cancer in general has been on the rise, but early onset colorectal cancer obviously has been on the rise at a much higher rate than the other early-onset cancers,” said Jacqueyn Cobb, associate editor at The Cancer Letter.

On this week’s episode, Jacquelyn and Sara Willa Ernst, reporter with The Cancer Letter, discuss the still-uncertain “whys” of the upswing in early-onset colorectal cancer mortality, and why screening uptake for people aged 45-50 is so low.

“Colorectal cancer is the leading cause of cancer death and it's been rising 1.1% [on average] annually since 2005 for people under 50,” Sara said. “That's a big shift, or there's a big contrast when you compare that to other types of cancer deaths such as brain cancer, breast cancer, leukemia, lung cancer. All of those have been pretty much flat or trending downwards. To see colorectal cancer as this outlier when in general, deaths, maybe not incidence, but deaths are declining, raises a lot of question marks.”

In response to this trend, the U.S. Preventive Services Task Force changed its clinical guidelines to recommend colorectal cancer screening for people ages 45-49 in 2021 (The Cancer Letter, Oct. 30, 2020). Despite this, screening prevalence has only budged incrementally.

“It's 2026 now, maybe we finally have a little bit of a sense as to what happened after that policy change,” Sara said of USPSTF screening updates. “According to a study published in the journal of the NCI, they found that the rates of CRC screenings for people under 50 are pretty low. Only 22.5% of respondents reported any form of colorectal cancer testing.”

Those CRC testing methods could include colonoscopy, fecal occult blood test, multi-targeted stool, or DNA testing. 

The average screening rates for adults aged 50-75 years old—a cohort that has seen consistent declines in incidence and mortality since the mid-1980s—was at 72% in 2021.

Sara said that “22.5% is not nearly, I think, where most oncologists hope it would be.”

Other stories mentioned in this podcast include: 

• The Directors: Wistar’s Altieri and ChristianaCare’s Petrelli say partnership of their institutions will go on as the guard changes

• Early-onset cancer is on the rise. Here is how OSUCCC–James is adapting to the needs of younger patients

• In the era of immunotherapy, response rate alone fails to predict true patient benefit—Regulators must adapt

• Colorectal cancer is now the leading cause of cancer death in patients under 50—Why aren’t 45-year-olds getting their recommended CRC screenings?

• Michael Bishop, Nobel-winning cancer researcher, dies at 90

A transcript of this podcast is available: https://cancerletter.com/podcastc/20260401-early-onset-crc/

Leadership is changing at The Wistar Institute and the Helen F. Graham Cancer Center & Research Institute in the months to come—but the leaders of the two institutions say that this will have little if any effect on the clinical-research collaboration that they have spent the past 15 years building.

Dario C. Altieri, president and CEO of Wistar, director of the Ellen and Ronald Caplan Cancer Center, and Robert and Penny Fox Distinguished Professor, prepares to step down from his executive jobs by the end of the year. A bit more than a year ago, his Delaware counterpart—Nicholas J. Petrelli—retired from his leadership position in 2024 after 22 years as Bank of America Endowed Medical Director of the Helen F. Graham Cancer Center and Research Institute at ChristianaCare. 

Petrelli remains in his job as director of the Cawley Center for Translational Cancer Research.

On this episode of The Directors Podcast, Altieri and Petrelli spoke with The Cancer Letter’s editor and publisher Paul Goldberg about what it takes to build a resilient cancer center as the ground beneath their feet is constantly shifting. 

The partnership between Wistar and ChristianaCare’s Graham Center is equal parts Wistar, a research powerhouse that has the NCI Basic Science Center designation, and equal parts ChristianaCare’s Graham Center, a hybrid academic and community center that operated an NCI Community Oncology Research Program site.

At various points, the two institutions have been hoping that they could become an NCI-designated consortium, but during that time, the NCI requirements for consortium designation have become increasingly difficult to meet.

But Altieri and Petrelli are convinced that they have hardwired the scientific collaboration of their institutions. 

A transcript of this episode is available: https://cancerletter.com/podcastc/20260327_1/ 

Last week’s issue of The Cancer Letter was dominated by one event: the meeting of the National Cancer Advisory Board, the group of experts which advises and assists the NCI director on the activities of the National Cancer Program. 

“There are times when NCI is—as a news story—either so stable that it's dormant or so active that it's erupting all the time,” Paul Goldberg, editor and publisher of The Cancer Letter, said. “And we’re in a place where it's news outbreaks all the time.”

On this week’s episode, Paul and Sara Willa Ernst, reporter with The Cancer Letter, talk about last week's meeting of the National Cancer Advisory Board, which featured a comprehensive report from NCI Director Tony Letai, and introduced two new big ideas: a cancer vaccine “roadmap,” and an ad hoc working group to conduct site visits.

“Stability, stability, stability” was the theme of Letai’s director’s report, and it’s a promise that he can deliver on, Paul said.  

“Despite, I would say understandable uncertainty in 2025, the NCI is on a solid footing financially and programmatically,” Letai said in his directors report. “I think you are all aware that when appropriations came out, there was not a cut in the NCI budget. Rather, there was actually an increase of over $120 million to the NCI budget, which means that we can simply do more. We will execute the mission with whatever resources are provided to us.”

Also, a public-private effort, spearheaded by Letai, and led by the Foundation for the National Institutes of Health, was introduced at the NCAB meeting. With an aggressive funding goal, and a comprehensive “roadmap,” the team will develop a three-year clinical trial strategy for prioritizing which emerging cancer vaccine technologies are ready to advance—and which are not.

An ad hoc working group that will assess cancer centers as part of the designation process was also introduced and approved unanimously with one abstention at the NCAB meeting. 

“Having covered cancer centers for a really long time, I think of them as a culture, a highly collaborative culture, and the scientists all speak to each other mostly,” Paul said. “When they say to you, ‘The enemy is not the excellent cancer center down the street, the enemy is cancer,’ they mean it. They really do.”

Stories mentioned in this podcast include:

• Hoping to hit a $200M target, NCI and FNIH develop a plan for advancing cancer vaccines 

• A new working group will conduct site visits and advise NCAB and NCI director on cancer center grants

• Letai: “From this point forward, it really is much more like business as usual at the NCI.”

• Early-onset colorectal cancer demands a new research playbook

A transcript of this podcast is available: https://cancerletter.com/podcastc/20260325-ncab/