BackTable Tumor Board

Ep. 55 Updates in Colorectal Cancer Management: Insights from ASCO GI with Dr. Shruti Patel

Tue, 14 Apr 2026 07:00:00 -0000

How will the newest colorectal cancer trial results discussed at the 2026 ASCO GI Cancers Symposium in San Francisco impact patient care and therapeutic strategies? Medical oncologists Dr. Shruti Patel and Dr. Jun Gong dissect evidence from multiple practice-changing studies, translating complex data into practical recommendations.

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Timestamps

00:00 - Introduction
01:50 - BREAKWATER Trial for Metastatic CRC
11:31 - COMMIT Trial for Metastatic CRC dMMR
17:34 - STELLAR-303 Trial for Refractory CRC
26:03 - ALASCCA Trial on Adjuvant Low Dose Aspirin in CRC
31:29 - CHALLENGE Trial on Structured Exercise Programs
38:48 - ATOMIC Trial on Adjuvant Immunotherapy
44:34 - The Role of GLP-1s in CRC Prevention

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More about this episode

Dr. Patel and Dr. Gong cover key findings and takeaways from recent colorectal cancer studies, including BREAKWATER, COMMIT, STELLAR-303, ALASCCA, CHALLENGE, and ATOMIC.

BREAKWATER evaluates first-line targeted therapy combinations in BRAF V600E–mutant metastatic CRC, demonstrating improved response rates and progression-free survival with the addition of encorafenib-based regimens.

COMMIT investigates the role of immunotherapy with or without chemotherapy in dMMR metastatic CRC, helping clarify whether upfront chemotherapy adds benefit to checkpoint blockade in this population.
STELLAR-303 examines a novel therapeutic option in refractory CRC, comparing a new agent against standard therapies and showing modest survival benefit in heavily pretreated patients.

ALASCCA assesses the impact of adjuvant low-dose aspirin in biomarker-selected CRC patients, suggesting improved disease-free survival in patients with PI3K pathway alterations.

CHALLENGE evaluates structured exercise interventions in the post-treatment setting, demonstrating that increased physical activity is associated with improved disease-free survival and overall outcomes.
ATOMIC explores the addition of immunotherapy to standard adjuvant chemotherapy in resected dMMR CRC, supporting a potential shift toward incorporating checkpoint inhibitors in earlier-stage disease.

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Resources

BREAKWATER Trial Cohort 3 Study
https://ascopubs.org/doi/10.1200/JCO.2026.44.2_suppl.13

COMMIT Phase 3 Trial
https://ascopubs.org/doi/10.1200/JCO.2026.44.2_suppl.14

STELLAR-303 Phase 3 Trial
https://pubmed.ncbi.nlm.nih.gov/41130252/

Immunotherapy Efficacy in Mismatch Repair-Proficient Colorectal Cancer Patients With and Without Liver Metastases
https://ascopubs.org/doi/10.1200/JCO-25-01044

ALASCCA Trial
https://clinicaltrials.gov/study/NCT02647099?tab=study
CHALLENGE Phase 3 Trial

https://ascopubs.org/doi/10.1200/JCO.2025.43.17_suppl.LBA3510
Regular Physical Activity Can Help Manage CRC-Related Fatigue
https://dailynews.ascopubs.org/do/regular-physical-activity-can-help-manage-crc-related-fatigue

ATOMIC Phase 3 Trial
https://ascopubs.org/doi/10.1200/JCO.2025.43.17_suppl.LBA1

GLP-1 Receptor Agonist vs Aspiring for Primary Prevention of Colorectal Cancer
https://ascopubs.org/doi/10.1200/JCO.2026.44.2_suppl.18

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Ep. 54 Clinical Advances in Muscle Invasive Bladder Cancer with Dr. Tyler Stewart

Tue, 07 Apr 2026 07:00:00 -0000

Don’t miss the “curative window”! This episode takes a closer look at how evolving perioperative strategies and biomarker integration are changing bladder cancer care, with a focus on preserving opportunities for cure. Jun Gong hosts Tyler Stewart to review key bladder cancer updates from ASCO Genitourinary Cancers Symposium 2026.

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Timestamps

00:00 - Introduction
01:50 - KEYNOTE-905 Overview
07:09 - Practice-Changing Takeaways
13:28 - Bladder Preservation Trials
16:06 - ctDNA Biomarker Updates
21:16 - Using ctDNA in Clinic
28:48 - Metastatic ADC Data
33:36 - Wrap-Up

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More about this episode

The discussion begins with KEYNOTE-905/EV-303 in cisplatin-ineligible muscle-invasive bladder cancer, where perioperative enfortumab vedotin plus pembrolizumab demonstrated improvements in event-free and overall survival. This is followed by KEYNOTE-B15, which compares perioperative EVP with gemcitabine/cisplatin and identifies EVP as the first non-platinum regimen to outperform cisplatin-based therapy. Implications for clinical adoption are considered, including the potential for EVP to extend across cisplatin eligibility groups, unresolved questions regarding perioperative duration and adjuvant use, and the need to avoid premature de-escalation outside of trial settings.
The latter portion of the episode focuses on biomarker-driven decision-making. Data from RETAIN-2 highlight the prognostic value of post-neoadjuvant ctDNA positivity for systemic relapse risk, while underscoring its limitations in detecting intravesical recurrence. Complementary findings from NIAGARA suggest that urine tumor DNA may more accurately reflect local disease burden and pathologic complete response. Together, these studies frame an evolving role for circulating and urine-based biomarkers in guiding surveillance, treatment selection, and timing—central considerations in maintaining the curative window.

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Resources

KEYNOTE-B15
https://ascopubs.org/doi/10.1200/JCO.2026.44.7_suppl.LBA630

KEYNOTE-905
https://www.nejm.org/doi/abs/10.1056/NEJMoa2511674

EV-302 Clinical Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2312117

Ep. 53 Hereditary GYN Cancer Syndromes: Practical Screening & Risk Reduction Guide with Dr. Marcia Ciccone

Tue, 31 Mar 2026 07:00:00 -0000

When to test, how to prevent, and what you need to know about hereditary gynecologic cancer syndromes. Two USC gynecologic oncologists, Dr. Mona Guo and Dr. Marcia Ciccone, go in-depth in this BackTable OBGYN x Tumor Board crossover episode.

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Timestamps

00:00 - Introduction
01:37 - Why Hereditary Cancer Matters
04:51 - Family History Red Flags
09:01 - Who Should Order Genetic Testing
11:32 - Variants and Counseling Pitfalls
13:30 - Access and Remote Testing Options
19:27 - BRCA1 Positive Patient Walkthrough
24:52 - Risk-Reducing Surgeries
29:11 - Prevention and Screening Limits
32:38 - Why Ovarian Cancer Is Hard
34:04 - Combining Breast and Gyn Surgery
35:41 - Preop Ultrasound and CA-125
36:27 - BRCA Timing and HRT Nuance
42:32 - Nonhormonal Menopause Options
47:14 - Lynch Syndrome Screening Basics
54:22 - Endometrial Biopsy Debate
56:43 - Insurance and Coverage Pitfalls
59:00 - Fertility Preservation and REI
01:01:41 - Cascade Testing
01:02:45 - Conclusion

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More about this episode

Dr. Guo and Dr. Ciccone discuss how careful family history can identify patients who may benefit from genetic evaluation and highlight key red flags, including a family history of ovarian cancer, breast cancer at age 50 or younger, and metastatic prostate cancer. They explain the role of genetic counseling, including pre- and post-test discussions and how to approach variants of uncertain significance. They then cover BRCA counseling and risk-reduction strategies, including the timing of risk-reducing bilateral salpingo-oophorectomy, ongoing salpingectomy trials, and considerations for hysterectomy. Additionally, they touch on pathology protocols, breast cancer screening, and the potential protective effect of hormonal contraception.

The doctors address the limitations of ovarian cancer screening and outline patterns suggestive of Lynch syndrome, such as endometrial cancer occurring alongside gastrointestinal or urinary tract cancers. They review the Lynch workup, including tumor mismatch repair immunohistochemistry and MLH1 hypermethylation testing. Finally, they discuss practical considerations like barriers to access, Medicare coverage challenges, fertility preservation referrals, menopause management, and cascade testing in families, including the timing of testing in children.

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Resources

NCCN Guidelines: Detection, Prevention, and Risk Reduction
https://www.nccn.org/guidelines/category_2

Ep. 52 Antibody Drug Conjugates Across the HER2 Spectrum: From HER2-Positive to Ultralow Breast Cancer with Dr. Sara Nunnery

Tue, 24 Mar 2026 07:00:00 -0000

Antibody-drug conjugates (ADCs) are expanding treatment options in breast cancer, but their use requires careful attention to toxicity. In this episode of the BackTable Tumor Board Podcast, Dr. Kate Baker and Dr. Sara Nunnery review the role of ADCs in HER2-positive disease and their growing application in HER2-low and HER2-ultralow metastatic settings.

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Timestamps

00:00 - Introduction
01:46 - How ADCs Work
08:40 - ILD Risk and Monitoring
13:46 - Next-Generation HER2 ADCs
24:14 - HER2-Low and Ultralow Disease
29:56 - Sequencing After Endocrine Therapy
33:42 - Future Targets and Bispecifics
38:08 - Wrap Up

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More about this episode

The discussion outlines ADC mechanisms and recent trial-driven shifts in clinical practice, with emphasis on interstitial lung disease (ILD) risk, monitoring, and patient counseling. They address practical considerations including patient selection, sequencing after endocrine therapy, and potential maintenance approaches. Additional topics include evolving pathology reporting, considerations for earlier-stage use in high-risk patients, and the development of next-generation HER2- and HER3-targeted ADCs, as well as bispecific therapies.

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Resources

DESTINY Breast 09
https://www.nejm.org/doi/full/10.1056/NEJMoa2508668

DESTINY Breast 05
https://www.nejm.org/doi/full/10.1056/NEJMoa2514661

DESTINY Breast 06
https://www.nejm.org/doi/abs/10.1056/NEJMoa2407086

Ep. 51 Intratumoral Immunotherapy Injections for Melanoma with Dr. Jennifer McQuade and Dr. Rahul Sheth

Tue, 17 Mar 2026 07:00:00 -0000

When standard-of-care checkpoint blockade fails in metastatic melanoma, how can oncologists and interventional radiologists join forces to turn around patient outcomes? In this episode of the BackTable Podcast, medical oncologist Dr. Jennifer McQuade and interventional radiologist Dr. Rahul Sheth join host Dr. Tyler Sandow to discuss the growing evidence for intratumoral oncolytics as a therapeutic strategy for frontline immunotherapy-refractory melanoma and the interdisciplinary work that is required for successful implementation in practice.

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This podcast is supported by:
Replimune
https://www.replimune.com/

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SYNPOSIS

The physicians review how engineered viral vectors, particularly RP1, complement checkpoint blockade through direct tumor lysis and immune activation, and summarize the IGNYTE trial data supporting their use in patients with metastatic melanoma refractory to anti-PD-1 and anti-CTLA-4 agents. The discussion then shifts to practical administration, highlighting the central role of interventional radiology in delivering these therapies to visceral and deep-seated lesions under image guidance. The doctors go on to address the nuances of patient and lesion selection, injection technique, and response assessment, including the importance of recognizing pseudo-progression. They place particular emphasis on the need for multidisciplinary collaboration and stakeholder buy-in efforts on the part of IRs seeking to integrate intratumoral oncolytic injections into their scope of practice. The episode concludes with a forward-looking discussion on the potential for expansion of oncolytic platforms into other solid tumors, underscoring this field as a growing, IR-forward frontier in cancer treatment.

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TIMESTAMPS

00:00 - Introduction
02:28 - Immunotherapy Basics
06:51 - How Oncolytic Viruses Work
11:01 - IGNYTE Trials and Why IR Matters
18:14 - T-VEC vs RP1 Indications and Logistics
21:57 - Physician Communication and Multidisciplinary Treatment
23:06 - RP1 Protocol and Administration Techniques
30:28 - RP1 Safety Profile
32:46 - Follow-Up Imaging and Response Assessment
35:44 - Future Applications Beyond Melanoma
41:42 - Final Thoughts and Closing Remarks

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RESOURCES

Wong MK, et al. RP1 Combined With Nivolumab in Advance Anti-PD-1-Failed Melanoma (IGNYTE). J Clin Oncol. 2025;43(33):3589-3599.
https://doi.org/10.1200/jco-25-01346

IGNYTE-3 Trial
https://clinicaltrials.gov/study/NCT06264180

Ep. 50 Beyond the Beam: Integrating Radiopharmaceuticals into Modern Oncology Practice with Dr. Ryan Funk

Tue, 10 Mar 2026 07:00:00 -0000

Though relatively new, there is a rapidly growing interest in the field of therapeutic radiopharmaceuticals and their potential to play a significant role in cancer treatment. This episode of BackTable Tumor Board covers recent developments in radiopharmaceutical therapies with radiation oncologists Dr. Dustin Boothe and Dr. Ryan Funk, where they discuss efficacy, side effects, and better tolerability of modern radiopharmaceuticals compared to older ones.

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This podcast is supported by:

Siemens Healthineers

https://cancercare.siemens-healthineers.com/products/software/digital-oncology/aria-core-for-theranostics

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SYNPOSIS

Dr. Boothe and Dr. Funk cover the roles of radiation oncologists in treating patients and collaborating with different specialists, the challenges in starting a radiopharmaceutical program, and the importance of having an authorized user and radioactive materials license. They also delve into the promising future of radiopharmaceuticals, emphasizing potential advancements such as personalized dosimetry, new indications, and combination therapies.

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TIMESTAMPS

00:00 - Introduction
02:54 - Understanding Radiopharmaceutical Terminology
04:40 - The Evolution of Radiopharmaceuticals
07:07 - The Rise of Targeted Radiopharmaceutical Therapies
12:35 - Radiation Oncologists’ Role in Systemic Therapy
23:55 - Challenges and Strategies in Practice Development
30:33 - Starting Up a Radiopharmaceutical Practice: Challenges, Authorized Users & RAM Licensing
37:47 - Advancing Practices with Clinical Trials and Dosimetry
44:48 - Future of Radiopharmaceutical Therapy
52:39 - Final Thoughts

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RESOURCES

Siemens Healthineers: ARIA CORE for Theranostics
https://cancercare.siemens-healthineers.com/products/software/digital-oncology/aria-core-for-theranostics

PREEMPT Trial (NRG-CC014)
https://clinicaltrials.gov/study/NCT06745024#collaborators-and-investigators

Community Theranostics
https://www.communitytheranostics.com/

Ep. 49 Inflammatory Breast Cancer: Symptoms, Diagnosis, & Management with Dr. Bora Lim

Tue, 24 Feb 2026 08:00:00 -0000

Inflammatory breast cancer (IBC) is rare but highly aggressive, and often hides in plain sight. Rather than presenting as the distinct lump, IBC typically appears as redness or swelling in the breast and skin changes that can mimic mastitis or infection, leading to dangerous delays in diagnosis. In this episode of BackTable Tumor Board, breast medical oncologists Dr. Lindsay Peterson and Dr. Bora Lim break down how to recognize IBC’s typical and atypical presentations, approach diagnostic workup, and tailor treatment across subtypes.

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SYNPOSIS

Dr. Peterson and Dr. Lim explore evolving neoadjuvant strategies, emerging clinical trials, combination therapies, IBC vaccine development, and the growing role of AI and MRI pattern recognition in predicting recurrence and guiding surveillance. The discussion highlights the importance of multidisciplinary expertise and calls for broader clinician awareness–especially in primary care, dermatology, and urgent care–so that persistent “infection-like” breast changes prompt timely evaluation and treatment for IBC.

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TIMESTAMPS

0:00 - Introduction
3:26 - Typical Presentations of Inflammatory Breast Cancer (IBC)
8:30 - Atypical Presentations of IBC
11:48 - Routine Diagnostic Workup
16:06 - Treatments for Different Subtypes of IBC
19:49 - Clinical Trials
22:53 - Surveillance for Different Stages of IBC
25:59 - Current Clinical Trials for Best Treatments
29:18 - Central Nervous System Recurrence and Other Relapse Patterns in IBC
33:29 - Novel Neoadjuvant Therapy
37:27 - Centers Dedicated to Treating IBC
42:13 - Final Thoughts

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RESOURCES

Atezolizumab, Cobimetinib, and Eribulin in Treating Patients With Chemotherapy Resistant Metastatic Inflammatory Breast Cancer
https://clinicaltrials.gov/study/NCT03202316?tab=researcher#study-record-dates

Dana-Farber Cancer Institute
https://www.dana-farber.org/cancer-care/treatment/breast-oncology/programs/inflammatory-breast-cancer

MD Anderson Inflammatory Breast Cancer Clinic
https://www.mdanderson.org/patients-family/diagnosis-treatment/care-centers-clinics/breast-center/inflammatory-breast-cancer-clinic.html

Ep. 48 HER2-Positive Metastatic Breast Cancer: Treatment Insights & Protocols with Dr. Erika Hamilton

Tue, 17 Feb 2026 08:00:00 -0000

In a patient with metastatic HER2-positive breast cancer, what should guide the next decision: trial data, toxicity, or durability of response? In this episode of BackTable Tumor Board, Dr. Lindsay Peterson (Washington University) sits down with Dr. Erica Hamilton (Sarah Cannon Research Institute) to examine how next-generation HER2-directed therapies are reshaping the management of metastatic disease. As treatment options expand beyond trastuzumab-based regimens to agents such as trastuzumab deruxtecan and tucatinib, clinical decision-making increasingly hinges on sequencing strategy, interpretation of evolving trial data, and thoughtful toxicity management.

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SYNPOSIS

The discussion integrates findings from pivotal studies including DESTINY-Breast09 and PATINA, highlighting how these data influence frontline and maintenance approaches. Dr. Hamilton outlines practical considerations in balancing depth and durability of response with quality-of-life concerns, and how she approaches therapy transitions in real-world practice. The episode also explores the management of CNS involvement within the broader systemic treatment landscape and considers whether current advances meaningfully shift long-term outcomes for patients with HER2-positive metastatic breast cancer.

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TIMESTAMPS

00:00 - Introduction
01:16 - Metastatic HER2-Positive Breast Cancer
06:46 - Treatment Strategies and Patient Management
11:57 - Maintenance Therapy Options
16:28 - HER2-Positive Breast Cancer Trials
20:13 - Brain Metastases and Systemic Therapy
27:38 - Future Directions in HER2-Positive Breast Cancer

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RESOURCES

DESTINY-Breast09 Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2508668

PATINA Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2511218

HER2CLIMB Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1914609

Ep. 47 NSCLC Treatment: Bispecific Antibodies & EGFR Mutations with Dr. Wade Iams

Tue, 10 Feb 2026 08:00:00 -0000

Bispecific antibodies are emerging as an important therapeutic class in non-small cell lung cancer (NSCLC); but how do they work, where do they fit in clinical practice, and what should oncologists be thinking about next? In this episode of Back Table Tumor Board, Dr. Kate Baker and Dr. Wade Iams from Tennessee Oncology answer these questions and more.

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SYNPOSIS

Dr. Baker and Dr. Iams discuss the evolving role of bispecific antibodies in NSCLC, covering the clinical data behind amivantamab, the practical benefits of subcutaneous vs IV administration, and key considerations for managing unique bispecific-related toxicities in real-world practice. This episode also explores emerging data in NSCLC, highlighting tarlatamab and its promising results in various treatment scenarios, including potential earlier-stage applications.

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TIMESTAMPS

00:00 - Introduction
01:14 - Recent Developments in Bispecific Antibodies
03:24 - Real-World Application of MARIPOSA Trial Data
04:28 - Managing Toxicities and Side Effects
06:28 - CNS Disease and Efficacy of Combination Therapy
08:26 - Counseling Patients on Prognosis and Treatment Options
12:45 - Challenges in Rolling Out New Treatments in Rural Areas
18:21- Future Directions in Non-Small Cell Lung Cancer
20:57 - BiTE Therapies in Small Cell Lung Cancer
35:00 - Final Thoughts

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RESOURCES

MARIPOSA Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2503001

FLAURA2 Trial
http://pubmed.ncbi.nlm.nih.gov/37937763/

COPERNICUS Trial
https://clinicaltrials.gov/study/NCT06667076

DeLLphi-304 Trial
https://clinicaltrials.gov/study/NCT05740566?tab=results

Ep. 46 Pulse Electrical Field Ablation: Lung Cancer Applications & Benefits with Dr. William Moore and Dr. Daniel Sterman

Tue, 03 Feb 2026 08:00:00 -0000

Pulsed electric field (PEF) therapy is an emerging cancer treatment that utilizes short electrical pulses to disrupt tumor cell membranes, leading to cell death—all without the risk of thermal damage seen in traditional ablation. How does this novel approach compare to gold-standard treatments like stereotactic body radiation therapy (SBRT) in primary and metastatic lung cancer? Find out in this episode of the BackTable Podcast featuring NYU radiation oncologist Dr. Benjamin Cooper, radiology professor Dr. William Moore, and cardiothoracic surgery professor Dr. Daniel Sterman.

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SYNPOSIS

The doctors break down the unique mechanism of PEF and its potential immunological benefits over other ablation techniques like cryoablation and microwave ablation. They also discuss PEF’s evolving role in both primary and metastatic cancer, its integration with therapies like SBRT, procedural efficiency and safety considerations, and why multidisciplinary collaboration and clinical trials are critical to defining its future in lung cancer care.

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TIMESTAMPS

00:00 - Introduction
01:38 - Understanding Pulsed Electric Field (PEF) Ablation
05:36 - Comparing Ablation Techniques: Cryoablation vs Microwave Ablation vs PEF Ablation
10:08 - Potential Immunological Responses, Safety, and Efficacy of PEF
23:40 - The Imprint Lung Trial: Exploring Immune System Stimulation in Cancer Treatment
29:18 - Patient Case Studies and Treatment Outcomes
32:41 - Challenges in Post-Treatment Imaging
36:41 - Procedure Times and Techniques for Ablation
41:51 - Comparing Pneumothorax Rates in Different Ablative Technologies
43:56 - Future Directions and Collaborative Efforts in Cancer Treatment

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RESOURCES

PEF in Stage IV Lung Cancer
https://pubmed.ncbi.nlm.nih.gov/40409026/

IMPRINT-Lung Trial
https://www.cancer.gov/research/participate/clinical-trials-search/v?id=NCI-2018-01588

Phase 1b Study of Dazostinag plus Pembrolizumab after Hypofractionated Radiotherapy in Patients with Select Advanced Solid Tumors
https://pmc.ncbi.nlm.nih.gov/articles/PMC12754119/

FLASH Radiotherapy
https://pmc.ncbi.nlm.nih.gov/articles/PMC9591027/

Ep. 45 Urothelial Carcinoma: Understanding ctDNA & Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor

Tue, 27 Jan 2026 08:00:00 -0000

Is the era of cisplatin over, or are we simply becoming more precise about who benefits from it? As perioperative strategies in bladder cancer continue to evolve, emerging tools like circulating tumor DNA (ctDNA) are playing a bigger role in how clinicians assess recurrence risk and tailor treatment. In this episode of BackTable Tumor Board, host Alan Tan, medical oncologist at Vanderbilt-Ingram Cancer Center, is joined by bladder cancer experts Dr. Amanda Nizam and Dr. Brad McGregor to discuss recent advances in the diagnosis and treatment of urothelial carcinoma.

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SYNPOSIS

The doctors examine the evolving management of muscle-invasive bladder cancer (MIBC), including the role of neoadjuvant and adjuvant therapies, the integration of immunotherapy, and the recent approval of enfortumab vedotin plus pembrolizumab. The discussion explores the rapidly changing perioperative landscape, the prognostic utility of ctDNA, and how biomarkers such as HER2 and FGFR are influencing treatment selection across disease states. They also address bladder preservation strategies, management of treatment-related toxicities, and the importance of multidisciplinary coordination. The episode concludes with a forward-looking discussion on emerging therapies and the potential to improve cure rates in bladder cancer.

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TIMESTAMPS

00:00 - Introduction
01:44 - Overview of Bladder Cancer Treatment
04:54 - Patient Staging and Treatment Goals
10:12 - Bladder Preservation vs. Radical Cystectomy
16:39 - Emerging Trials and Future Directions
22:40 - ctDNA and Precision Medicine
33:50 - Metastatic Disease and Biomarker Strategies
42:16 - Managing Neuropathy in Metastatic Treatment
48:44 - HER2 and FGFR in Bladder Cancer
54:15 - Future Directions in Bladder Cancer Treatment

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RESOURCES

EV-302/303 Trial
https://newsroom.astellas.com/2023-12-15-PADCEV-R-enfortumab-vedotin-ejfv-with-KEYTRUDA-R-pembrolizumab-Approved-by-FDA-as-the-First-and-Only-ADC-Plus-PD-1-to-Treat-Advanced-Bladder-Cancer

NIAGARA Regimen
https://www.nejm.org/doi/full/10.1056/NEJMoa2408154

KEYNOTE-905 Study
https://www.annalsofoncology.org/article/S0923-7534(25)04894-X/fulltext

Ep. 44 ESMO Update: Advances in Upper GI Malignancies with Dr. Jun Gong

Tue, 20 Jan 2026 08:00:00 -0000

The FLOT regimen is the standard-of-care for upper gastroesophageal malignancies, but what if there were other drug combinations or perioperative strategies that could further improve outcomes? In Part II of our ESMO 2025 recap, medical oncologists Dr. Jun Gong and Dr. Jonathan Mizrahi cover emerging studies and treatments in gastroesophageal cancers.

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SYNPOSIS

The discussion provides an overview of pivotal trials, including MATTERHORN, which demonstrated improved overall survival with durvalumab plus FLOT, and FORTITUDE-10, which highlights ongoing challenges in treatment efficacy with FGFR2b inhibitors. This episode also explores the role of lenvatinib-based combinations for esophageal squamous cell carcinoma and practical considerations for integrating checkpoint inhibitors into real-world clinical practice.

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TIMESTAMPS

00:00 - Introduction
01:23 - The MATTERHORN Study
03:24 - PD-L1 Status and Clinical Implications
07:09 - FORTITUDE-101 and 102 Studies: Discrepancies and Insights on FGFR2b Inhibition
11:15 - LEAP-014 and 015 Studies: The Role of Lenvatinib
14:57 - Conclusion and Final Thoughts

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RESOURCES

Phase III MATTERHORN Study
https://dailynews.ascopubs.org/do/matterhorn-durvalumab-chemotherapy-demonstrates-superior-efs-over-standard-care

ESOPEC Phase III Trial
https://pmc.ncbi.nlm.nih.gov/articles/PMC4952147/

FORTITUDE-101 Trial
https://clinicaltrials.gov/study/NCT05052801

FORTITUDE-102 Trial
https://clinicaltrials.gov/study/NCT05111626

LEAP-014 Phase III Study
https://ascopubs.org/doi/10.1200/JCO.2022.40.4_suppl.TPS367

LEAP-015 Study
https://ascopubs.org/doi/10.1200/JCO-25-00748

Ep. 43 ESMO Update: Trial Results & New Therapies in Colorectal Cancer with Dr. Jun Gong

Tue, 13 Jan 2026 08:00:00 -0000

Get caught up on the cutting edge colorectal cancer trial data from ESMO 2025 with this 30-minute BackTable Tumor Board recap! Featuring medical oncologists Dr. Jonothan Mizrahi and Dr. Jun Gong.

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SYNPOSIS

The doctors discuss the DESTINY-CRC02 trial with focus on HER-2 positive metastatic colorectal cancer, the DYNAMIC-III and Pegasus studies regarding CTDNA-guided therapies, and the pivotal STELLAR-303 study for treatment-refractory microsatellite stable colorectal cancer. They also review the implications of NICHE-2 and FOxTROT studies on neoadjuvant chemotherapy versus immunotherapy for MSI high patients. Emphasis is placed on the real-world practice applications of these study findings, potential treatment shifts, and how these new trial results will impact future guidelines in colorectal cancer care.

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TIMESTAMPS

00:00 - Introduction
01:25 - Overview of ESMO 2025 Annual Congress
13:50 - cTDNA Monitoring in Clinical Practice
16:24 - STELLAR-303 Study: Immunotherapy in MSS Colorectal Cancer
20:40 - Neoadjuvant Immunotherapy for MSI High Colorectal Cancer
26:39 - DESTINY-CRC02 Study: Final Analysis
29:30 - Conclusion and Outro

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RESOURCES

DESTINY-CRC02 Trial
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00380-2/abstract

DYNAMIC-III Trial
https://www.nature.com/articles/s41591-025-04030-w

STELLAR-303 Trial
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02025-2/abstract

Ep. 42 Neoadjuvant Therapy in Resectable Pancreatic Cancer with Dr. Rebecca Snyder

Tue, 06 Jan 2026 08:00:00 -0000

For the small subset of pancreatic cancer patients whose cancer is detected early and remains localized, there are now opportunities to offer treatment and improve outcomes. In this episode of the BackTable Tumor Board Podcast, Ochsner medical oncologist Dr. Jonathan Mizrahi and MD Anderson surgical oncologist Dr. Rebecca Snyder discuss the contemporary management of localized pancreatic cancer.

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SYNPOSIS

Dr. Snyder and Dr. Mizrahi break down the categories of resectable, borderline resectable, and locally advanced pancreatic cancer; and explain the current treatment strategies that are tailored to each stage. The discussion highlights the role of neoadjuvant therapy, the potential benefits of radiation for certain subpopulations, and the importance of a multidisciplinary team approach for optimal patient care. The doctors also cover pivotal clinical trials, ongoing research, and future directions in the field, including targeted therapies and biomarker development, to inform best practices in treating patients with localized pancreatic cancer.

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TIMESTAMPS

00:00 - Introduction
02:24 - Defining Resectable, Borderline, and Locally Advanced Pancreatic Cancer
11:10 - Neoadjuvant Therapy for Resectable Pancreatic Cancer
17:16 - Ongoing Clinical Trials: FOLFIRINOX and Gemcitabine Nab-Paclitaxel
23:04 - The Role of Radiation in Pancreatic Cancer Treatment
26:52 - Treating Locally Advanced Pancreatic Cancer
34:49 - Future Directions and Targeted Therapies

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RESOURCES

APOLLO Randomized Phase II Study
https://clinicaltrials.gov/study/NCT04858334

PRODIGE 29-UCGI 26 (NEOPAN) Phase III Trial
https://ascopubs.org/doi/10.1200/JCO-24-02210

ALLIANCE A021806 Phase III Trial
https://doi.org/10.1245/s10434-024-15817-5

NORPACT-1 Phase II Trial
https://pubmed.ncbi.nlm.nih.gov/38237621/

Dutch Randomized Phase III PREOPANC Trial
https://pubmed.ncbi.nlm.nih.gov/32105518/

SWOG S1505 Randomized Clinical Trial
https://pubmed.ncbi.nlm.nih.gov/32740235/

ALLIANCE A021501 Phase II Randomized Clinical Trial
https://pubmed.ncbi.nlm.nih.gov/35834226/

LAP07 Randomized Clinical Trial
https://pubmed.ncbi.nlm.nih.gov/27139057/

LAP100 Phase III Trial
https://clinicaltrials.gov/study/NCT06958328

Meta-analysis on Arterial Resections in Pancreatic Cancer
https://pmc.ncbi.nlm.nih.gov/articles/PMC12070998/

PANOVA-3 Phase III Study
https://ascopubs.org/doi/10.1200/JCO-25-00746

NRG-GI011 Clinical Trial: Opening
https://www.nrgoncology.org/patients/patient-study-webpages/nrg-gi011-testing-higher-dose-rt-for-locally-advanced-pancreatic-cancer

Ep. 41 Advanced Pancreatic Cancer: Systemic Therapy Strategies with Dr. Shubham Pant

Tue, 30 Dec 2025 08:00:00 -0000

Metastatic pancreatic cancer is no longer a ‘one size fits all’ diagnosis. In this episode of the BackTable Tumor Board Podcast, medical oncologist Dr. Jon Mizrahi and Dr. Shubham Pant, a professor of GI Medical Oncology at MD Anderson Cancer Center, discuss the evolving landscape of systemic therapy for advanced pancreatic cancer.
---
SYNPOSIS
The doctors cover the current options for first- and second-line chemotherapy treatments, the significance of molecular profiling and germline testing, and the emerging potential of targeting KRAS mutations. The discussion also highlights the importance of supportive and palliative care for patients, focusing on pain management, nutritional support, and the role of pancreatic enzymes. The conversation concludes with speculation on the future of pancreatic cancer treatment and the need for improved access to clinical trials.
---
TIMESTAMPS
00:00 - Introduction
02:32 - First-Line Therapy Options
10:31 - Second-Line Therapy Options
20:18 - Challenges in Pancreatic Cancer Immunotherapy
26:47 - Supportive Care and Quality of Life
35:57 - Disparities in Pancreatic Cancer Treatment
38:58 - Conclusion and Future Directions
---
RESOURCES
Adagrasib Clinical Trial
https://www.clinicaltrials.gov/study/NCT05853575

Ep. 40 Advanced Surgical Approaches in Lung Cancer Management with Dr. Scott Atay and Dr. Scott Oh

Tue, 16 Dec 2025 08:00:00 -0000

Is the open thoracotomy becoming outdated as robotic surgery and advanced ablation techniques take center stage in lung cancer treatment? In the final discussion of the 2025 NSCLC Creator Weekend™ series, our virtual tumor board of interventional radiologists and pulmonologists from leading medical institutions discuss recent surgical and interventional advancements in the treatment of lung cancer.

---

This podcast is supported by an educational grant from Johnson & Johnson and Varian.

---

SYNPOSIS

The conversation covers the contemporary role of PET scans, endobronchial ultrasound (EBUS), mediastinal staging, and the importance of perioperative systemic therapy. The doctors explore surgical and non-surgical methods for treating lung cancer, including lymph node dissection, criteria for resection, and the advantages of minimally invasive approaches such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgeries.

A key focus of this episode is the decision-making process for treating multifocal lung cancers while preserving lung function, and the use of combined therapies like ablation and radiation. The episode concludes with a detailed case study illustrating the long-term management of a patient with multiple lung adenocarcinomas over several years, highlighting the multidisciplinary approach required in such complex scenarios.

---

TIMESTAMPS

00:00 - Introduction
10:07 - Patient Selection and Comorbid Conditions
27:29 - Surgical Margins and Resection Strategies
42:11 - Understanding Upstaging in Cancer Treatment
53:27 - Technical and Clinical Resectability
56:13 - Case Study: Managing Multifocal Lung Cancer
01:11:41 - Long-Term Outcomes and Treatment Strategies

---

RESOURCES

Tue, 18 Nov 2025 08:00:00 -0000

How do leading oncologists interpret the abundance of molecular tests, genomic data, and biomarkers to create a lung cancer patient’s treatment plan? In this episode of the 2025 NSCLC Creator Weekend™ series, our tumor board discusses the complexities of lung cancer treatment, including new systemic therapies, lung cancer staging, and the role of molecular diagnostics and liquid biopsies.

---

This podcast is supported by an educational grant from Johnson & Johnson and Varian.

---

SYNPOSIS

The panel, featuring specialists from various institutions, discusses the specifics of sequencing therapies, the impact of targeted and immunotherapies, and the nuances of treating different patient profiles, including non-smokers and those with specific genetic mutations. The conversation also touches on the integration of new staging systems, the benefits of multidisciplinary clinics, and the ongoing evolution of cancer treatment trials. The discussion aims to provide clarity on the latest advancements and future directions in managing lung cancer, emphasizing the importance of tailored treatment plans and the potential of emerging technologies.

---

TIMESTAMPS

00:00 - Introduction
05:16 - Molecular Diagnostics and Liquid Biopsy
21:43 - Targeted Therapy Options
27:29 - Managing Toxicities and Treatment Strategies
33:13 - Challenges with Immunotherapy in Special Cases
34:07 - Lung Transplantation in Cancer Patients
48:38 - Multidisciplinary Clinics and Collaboration
01:06:29 - Future Directions

---

RESOURCES

ADAURA Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2027071

Gomez NSCLC
https://pmc.ncbi.nlm.nih.gov/articles/PMC5143183/

Ep. 35 NSCLC Tumor Board Discussion: Considerations for Oligometastatic Disease with Dr. Karen Reckamp, Dr. Scott Atay, Dr. Scott Oh, Dr. Alan Lee

Fri, 14 Nov 2025 08:00:00 -0000

When cancer spreads to the brain, what is the best approach: immediate local treatment or systemic immunotherapy first? Part two of the 2025 NSCLC Creator Weekend™ series focuses on a complex case involving a 75-year-old woman with a history of breast malignancy, presenting with new dyspnea and a large mass in the left lower lobe.

---

This podcast is supported by an educational grant from Johnson & Johnson and Varian.

---

SYNPOSIS

Our mock tumor board consists of surgeons, medical oncologists, and radiation oncologists to deliberate and determine the best treatment plan. The specialists explore diagnostic and treatment options, including neoadjuvant chemoimmunotherapy, invasive mediastinal staging, and the potential for surgical resection or radiation therapy.

---

TIMESTAMPS

00:00 - Introduction
05:01 - Approach to Isolated Brain Metastasis
09:09 - Radiation Therapy Considerations
12:06 - Imaging and Follow-Up Strategies
14:39 - Resectability and Surgical Decisions
19:10 - Conclusion

---

RESOURCES

PACIFIC Clinical Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1709937

Ep. 34 Lung Cancer Tumor Boards: Multidisciplinary Approaches & Best Practices with Dr. Karen Reckamp, Dr. Scott Atay, Dr. Scott Oh, and Dr. Alan Lee

Tue, 11 Nov 2025 08:00:00 -0000

As lung cancer treatments become more complex, is a collaborative tumor board more essential than ever? We’re kicking off the 2025 NSCLC Creator Weekend™ series with an in-studio panel discussion on the multidisciplinary management of lung cancer. The panel includes experts from medical oncology, thoracic surgery, radiation oncology, and interventional pulmonology from major institutions in Los Angeles. ---
This podcast is supported by an educational grant from Johnson & Johnson and Varian.

---

SYNPOSIS

They discuss the operation of tumor boards at their respective institutions, the impact of virtual meetings, optimal strategies for mediastinal staging, the management of early-stage lung cancer, and the emerging role of ablation therapy. The conversation dives into the complexities of treating patients with recurrence or metastatic disease, highlighting the importance of collaborative decision-making in navigating these challenging scenarios. The episode emphasizes the critical role of multidisciplinary tumor boards in providing informed, patient-centered care.

---

TIMESTAMPS

00:00 - Introduction
06:59 - Role of Pulmonologists in Tumor Boards
12:08 - Importance of Tissue Diagnosis
24:52 - Lung Cancer Screening and Stigma
34:01 - Interventional Radiology and Biopsies
46:21 - Challenges with Immunotherapy and Radiation
53:44 - The Importance of Multidisciplinary Teams
54:24 - Final Thoughts

---

RESOURCES

American Lung Association 2024 Data
https://www.lung.org/getmedia/12020193-7fb3-46b8-8d78-0e5d9cd8f93c/SOLC-2024.pdf

National Lung Screening Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1102873

Checkmate 816
https://www.nejm.org/doi/full/10.1056/NEJMoa2202170

PACIFIC Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1709937

Ep. 33 Keynote-689: Implementation & Multidisciplinary Care for Immunotherapy in Head & Neck Cancer with Dr. Adam Luginbuhl, Dr. Jennifer Johnson, Dr. Mihir Patel and Dr. Siddharth Sheth

The conversation covers diagnostic dilemmas, navigating the treatment options of surgery, systemic therapy, and radiation, and the importance of a multidisciplinary approach. Through detailed case reviews, the panel highlights practical pearls, emerging clinical trials, and collaborative approaches that exemplify modern kidney cancer care.

---

TIMESTAMPS

0:00 - Introduction
02:20 - Case 1 (Incidental Renal Mass)
16:52 - Case 2 (Bilateral Renal Masses)
37:22 - Case 3 (Locally Advanced Renal Mass)
56:34 - Case 4 (Symptomatic, Metastatic Disease)
01:14:00 - Final Takeaways

S02 Ep. 22 Multidisciplinary Spine Oncology Care: Insights and Techniques with Dr. Ran Lador and Dr. Mark Amsbaugh

Tue, 16 Sep 2025 07:00:00 -0000

When it comes to spinal oncology, no single specialty holds all the answers. In this episode of the BackTable Podcast, host Dr. Alexa Levey, an interventional radiologist from Yale School of Medicine, is joined by Dr. Mark Amsbaugh, a radiation oncologist, and Dr. Ran Lador, an orthopedic spine surgeon, both from the University of Texas McGovern Medical School. The discussion explores complexities and innovations in the multidisciplinary treatment of spinal tumors.

---

This podcast is supported by:
Ferring Pharmaceuticals
---

SYNPOSIS

Dr. Amsbaugh and Dr. Lador highlight their cohesive, patient-centered approach at Memorial Hermann, integrating various specialties including surgery, radiation oncology, and interventional radiology. The episode emphasizes the importance of collaborative techniques, advances in minimally invasive surgeries, the role of stereotactic radiosurgery, and the critical nature of personalized patient care in improving outcomes for patients with spinal tumors.

---

TIMESTAMPS

00:00 - Introduction
01:20 - Multidisciplinary Approach to Spinal Tumors at Memorial Hermann
10:22 - Surgical Techniques and Timing for Radiation Treatments
12:25 - Approach to Collaborative Treatment Planning
25:45 - Connection Between Surgical and Radiation Oncology in Patient Care
31:08 - The Role of Vertebral Augmentation in Spinal Oncology
40:08 - Multimodal Pain Management Strategies
47:35 - Thoughts on Future Directions in Spinal Oncology and Conclusion

---

RESOURCES

Dr. Mark Amsbaugh, MD
https://med.uth.edu/neurosciences/dr-mark-j-amsbaugh-md/

Dr. Ran Lador, MD
https://med.uth.edu/ortho/2022/11/02/ran-lador-md/

Dr. Alexa Levey, MD
https://medicine.yale.edu/profile/alexa-levey/

S02 Ep. 21 Prostate Tumor Board: Risk Stratification & Treatment Strategies with Dr. Neeraj Agarwal and Dr. Tyler Seibert

Tue, 19 Aug 2025 07:00:00 -0000

Could ongoing trials redefine the management of oligometastatic and advanced prostate cancer? In this installment of BackTable Tumor Board, leading prostate cancer experts Dr. Neeraj Agarwal, a medical oncologist from the University of Utah, and Dr. Tyler Seibert, a radiation oncologist from UC San Diego, join host Dr. Parth Modi to share their insights on the latest clinical trials and persistent challenges in managing prostate cancer.

---

This podcast is supported by:
Ferring Pharmaceuticals

---

SYNPOSIS

The multidisciplinary discussion addresses clinical decision-making in active surveillance versus early intervention, the role of PSMA PET imaging in detection and treatment planning, and evolving strategies for metastatic and castration-resistant disease. They also evaluate the therapeutic potential of alpha emitters and radioligand therapies, consider the evidence behind treatment intensification and de-intensification, and explore how these approaches can be individualized to optimize patient outcomes.

---

TIMESTAMPS

0:00 - Introduction
1:48 - Active Surveillance in Low-Risk Prostate Cancer
7:08 - Molecular Testing and Risk Stratification
8:28 - Radiation Therapy Approaches
20:16 - PSA Recurrence and PSMA PET Scans
32:40 - The Role of ADT
37:15 - PSMA PET Scans
40:58 - Genetic Testing in High-Risk and Metastatic Prostate Cancer
46:54 - Treatment Intensification vs. De-Intensification Trials
55:59 - Castration-Resistant Prostate Cancer

S02 Ep. 20 BCG Shortage: Salvaging Bladder Cancer Care When Standard Care Is Scarce with Dr. Amy Luckenbaugh

Tue, 22 Jul 2025 07:00:00 -0000

How do you effectively treat your bladder cancer population with an insufficient supply of BCG? Dr. Amy Luckenbaugh, a urologic oncologist at Vanderbilt University Medical Center, joins host Dr. Ruchika Talwar to highlight challenges and solutions to managing bladder cancer amidst ongoing BCG shortages.

---

This podcast is supported by an educational grant from UroGen Pharma. UGN-102 was approved by the FDA on June 12, 2025.

---

SYNPOSIS

Dr. Luckenbaugh and Dr. Talwar delve into the history and significance of BCG in bladder cancer treatment, exploring the reasons behind the shortages and discussing various coping strategies, including split dosing and alternative intravesical therapies like gemcitabine, docetaxel, and the new mitomycin hydrogel. The conversation also covers emerging treatments for high-risk patients, the role of radical cystectomy, and the importance of standardization and innovation in dealing with medication shortages. Dr. Luckenbaugh highlights the importance of patient quality of life, cost considerations, and the need for resilient pharmaceutical supply chains.

---

TIMESTAMPS

00:00 - Introduction
01:56 - History and Importance of BCG in Bladder Cancer
03:21 - Challenges and Shortages of BCG
06:36 - Managing BCG Shortages in Clinical Practice
12:33 - New Alternatives and Treatments for Bladder Cancer
23:28 - The Role of Cystectomy in Bladder Cancer Treatment
26:12 - Future Directions and Final Thoughts

---

RESOURCES

BCG Shortage AUA Recommendations:
https://www.auanet.org/about-us/bcg-shortage-info

Reduced-dose bacillus Calmette-Guérin (BCG) in an era of BCG shortage: real-world experience from a tertiary cancer centre:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11951178/

Bladder Cancer Advocacy Network (BCAN):
https://bcan.org/

Primary Chemoablation of Recurrent Low-Grade Intermediate-Risk Nonmuscle-Invasive Bladder Cancer With UGN-102: A Single-Arm, Open-Label, Phase 3 Trial (ENVISION)
https://pubmed.ncbi.nlm.nih.gov/39446087/b

FDA Approves Intravesical Mitomycin in Non–Muscle-Invasive Bladder Cancer:
https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-mitomycin-intravesical-solution-recurrent-low-grade-intermediate-risk-non-muscle

TAR-200 - SunRISe-3 Study:
https://www.jnjmedicalconnect.com/products/tar-200/medical-content/tar-200-sunrise-3-study

Tue, 27 May 2025 07:04:00 -0000

With so many treatment modalities for upper tract urothelial carcinoma, how does new evidence inform optimal care? In this episode of BackTable Tumor Board, urologic oncologist Dr. Nirmish Singla (Johns Hopkins), medical oncologist Dr. Jeannie Hoffman-Censits (Johns Hopkins), and urologic oncologist Dr. Bogdana Schmidt discuss treatment and diagnosis of upper tract urothelial carcinoma (UTUC).

---

This podcast is supported by:

⁠⁠Ferring Pharmaceuticals⁠

---

SYNPOSIS

The discussion covers real-world UTUC cases, highlighting diagnostic challenges, treatment options, and evidence-based management strategies. They address scenarios ranging from localized to advanced UTUC, the role of systemic therapies, perioperative treatments, and the potential for novel approaches with immune checkpoint inhibitors. The episode underscores the evolving landscape of UTUC treatment and the importance of clinical trials and emerging biomarkers in improving patient outcomes.

---

TIMESTAMPS

00:00 - Introduction
02:49 - Case Study 1: 66-Year-Old Male with UTUC
11:19 - Case Study 2: 73-Year-Old Male with High-Grade Urothelial Carcinoma
28:11 - Intravesical Chemotherapy Protocols
30:44 - Case Study 3: 57-Year-Old Male with Recurrent Urothelial Cancer
41:25 Clinical Trials and Emerging Treatments
45:40 Case Study: 55-Year-Old Female with Bulky Lymphadenopathy
56:45 Concluding Remarks and Future Directions

---

RESOURCES

Society of Urologic Oncology
https://suonet.org/home.aspx

S02 Ep. 15 Integrative Oncology in Urologic Cancer Care with Dr. Viraj Master

Tue, 27 May 2025 07:03:00 -0000

What if the key to better cancer outcomes lies not just in surgery or chemotherapy, but also in mindfulness, movement, and diet? In this episode of the BackTable Tumor Board, host Dr. Aditya Bagrodia interviews urologic oncologist Dr. Viraj Master, Professor of Urology at Emory University, about his role in developing the integrative oncology and survivorship service line at Winship Cancer Institute.

---

This podcast is supported by:

⁠⁠Ferring Pharmaceuticals⁠

---

SYNPOSIS

They discuss the evidence-based use of complementary therapies alongside conventional cancer treatments, touching on various integrative methods including diet, exercise, mindfulness, acupuncture, yoga, and supplements. Dr. Master emphasizes the importance of physicians being open to these practices and understanding their potential benefits for improving patient outcomes and quality of life, even in highly acute cases like muscle-invasive bladder cancer. The conversation covers the importance of honesty and understanding across patient journeys–from initial diagnosis to survivorship–highlighting the value of holistic approaches in cancer care.

---

TIMESTAMPS

00:00 - Integrative Oncology: Definitions and Basics
06:28 - Exercise and Its Impact on Cancer Treatment
08:12 - Physician Perspectives on Complementary Medicine
20:58 - Acupuncture and Acupressure in Cancer Care
25:28 - Practical Implementation of Integrative Approaches
31:30 - Supplements and Immuno Nutrition
36:25 - Cannabis, CBD, and Ayurveda in Cancer Care
44:39 - Conclusion and Final Thoughts

---

RESOURCES

Society of Urologic Oncology
https://suonet.org/home.aspx

S02 Ep. 14 Multidisciplinary Approaches to Pediatric Urologic Cancer Care with Dr. David Rodeberg and Dr. Patrick Hensley

Tue, 27 May 2025 07:02:00 -0000

How can pediatric and adult urologists team up to tackle complex cancer cases? In this episode of the BackTable Tumor Board, host Dr. Amanda Buchanan, Division Chief of Pediatric Urology at the University of Kentucky, is joined by her colleagues Dr. Patrick Hensley, an adult urologic oncologist, and Dave Rodeberg, Division Chief of Pediatric Surgery. Their discussion centers around the importance of professional collaboration in urologic oncology care in order to improve patient outcomes.

---

This podcast is supported by:

⁠⁠Ferring Pharmaceuticals⁠

---

SYNPOSIS

The urologists discuss topics such as the experiences and benefits of interdisciplinary collaboration in complex cases and the role of pediatric urologists in treating adolescent and young adult patients. They also provide insights into the Children's Oncology Group (COG) studies and their intersections with adult oncology research. The episode concludes with practical advice for other institutions aiming to improve collaborative efforts between pediatric and adult urology departments.

---

TIMESTAMPS

00:00 - Importance of Collaboration in Urologic Oncology
05:38 - Challenges in Multidisciplinary Collaboration
08:30 - Pediatric Urologists’ Role in Testicular Cancer
11:05 - Clinical Trials and Research Collaborations
14:21 - Navigating COG and Adult Oncology Groups
19:03 - Collaborative Approach to Kidney Tumors
29:31 - Resident Education and Collaboration
35:22 - Final Thoughts

---

RESOURCES

Society of Urologic Oncology:
https://suonet.org/home.aspx

Children’s Oncology Group
https://www.childrensoncologygroup.org/

S02 Ep. 13 Multidisciplinary Approaches to Renal Cancer Care with Dr. Louis Hinshaw and Dr. Jason Abel

Tue, 27 May 2025 07:01:00 -0000

How can urologists and radiologists work together to improve kidney cancer treatment? In this episode, BackTable Tumor Board brings together Dr. Jason Abel (Professor of Urology and Radiology at the University of Wisconsin), Dr. Louis Hinshaw (Section Chief of Abdominal Imaging Intervention at the University of Wisconsin), and Dr. Ruchika Talwar (Assistant Professor of Urologic Oncology at Vanderbilt) for a multidisciplinary conversation regarding the treatment of renal tumors.

---

This podcast is supported by:

⁠⁠Ferring Pharmaceuticals⁠

---

SYNPOSIS

Their discussion covers the history and benefits of collaboration between urology and interventional radiology (IR), advances in image-guided procedural technologies, and the importance of teamwork in improving patient outcomes. The episode also considers the encouraging, but limited data in IR treatments such as microwave ablation and discusses the lasting role for surgery. Finally, Dr. Abel and Dr. Hinshaw share their experiences in establishing a successful interdisciplinary kidney cancer program. Ultimately, they conclude that the future of renal tumor treatment lies not in silos, but in collaboration.

---

TIMESTAMPS

00:00 - Multidisciplinary Collaboration in Renal Tumor Treatment
05:59 - Advancements in Ablation Techniques: From Cryoablation to Microwave
10:13 - Ablation vs. Surgery: Patient Selection and Clinical Decision Making
14:00 - Technical Considerations and Complications in Ablation Procedures
24:19 - Patient Experience and Recovery Post-Ablation
36:17 - Importance of Teamwork in Modern Medicine

---

RESOURCES

Society of Urologic Oncology
https://suonet.org/home.aspx

S02 Ep. 12 Tumor Board: Multidisciplinary Management of Testicular Germ Cell Tumors with Dr. Nabil Adra and Dr. Richard Matulewicz

Tue, 27 May 2025 07:00:00 -0000

What does it take to deliver truly personalized, multidisciplinary care in testicular cancer? Get an inside look in this episode of BackTable Tumor Board, where renowned testicular cancer experts Dr. Nabil Adra and Dr. Richard Matulewicz join host Dr. Aditya Bagrodia for a virtual tumor board session on the nuanced management of germ cell tumors.

---

This podcast is supported by:

⁠Ferring Pharmaceuticals

---

SYNPOSIS

The expert panel uses specific patient cases to review their decision-making processes on the use of surgery, chemotherapy, and radiation. They highlight the importance of a multidisciplinary approach, particularly for advanced disease and challenging surgical scenarios. The episode reviews patient-specific factors, standard treatment protocols, post-treatment surveillance, and the latest research. This episode also highlights the benefits of personalized cancer care.

---

TIMESTAMPS

00:00 - Case Presentation: 23-Year-Old Male with Testicular Mass
09:53 - Surveillance vs. Adjuvant Therapy Debate
13:53 - Recurrence, Comprehensive Staging, and Next Steps
23:09 - Case Study: 44-Year-Old with Mixed Non-Seminoma Germ Cell Tumor
27:47 - Surveillance and Surgery Recommendations
28:11 - Case Study: 17-Year-Old with Developmental Delay and Cancer
30:10 - Chemotherapy, Surgical Timing, and Prognosis
44:58 - Case Study: 21-Year-Old with Scrotal Swelling
47:12 - Surgical Considerations and Multidisciplinary Approach

---

RESOURCES

Society of Urologic Oncology
https://suonet.org/home.aspx

S01 Ep. 11 Immunotherapy and TACE in HCC Treatment with Dr. Julius Chapiro and Dr. Richard Finn

Tue, 29 Apr 2025 06:00:00 -0000

There are now multiple phase 3 studies on combination transarterial chemoembolization (TACE) and immunotherapy showing a significant benefit over TACE alone. How do these findings change the hepatocellular carcinoma (HCC) treatment algorithm? In this multidisciplinary episode of the BackTable Podcast, Dr. Richard Finn (Medical Oncologist at UCLA) and Dr. Julius Chapiro (Interventional Radiologist at Yale University) join host Dr. Chris Beck to discuss immunotherapy, TACE, emerging trends in HCC treatment, and the future of the field.
---
This podcast is supported by an educational grant from Guerbet.
---
SYNPOSIS
The doctors highlight the importance of high quality clinical data and the pivotal studies shaping current best practices. They explore the role of the different players on the multidisciplinary team and compare the oncologic and radiologic perspectives. Additionally, they discuss the synergy between TACE and immunotherapy, the criteria for selecting appropriate treatments, and the ongoing need for research and collaboration.
---
TIMESTAMPS
00:00 - Introduction
03:35 - HCC from an Oncologic Perspective
05:33 - Radiological Perspective on Liver Cancer
06:50 - Referral Patterns and Organizing a Multidisciplinary Approach
18:01 - Explaining TACE and Variations in the Procedure
27:27 - Choosing the Right Procedure for HCC
36:13 - Making a Decision on Medical Treatment Candidacy
42:23 - Importance of Data Driven HCC Treatment, Practical Insights, and Studies to Know
55:30 - Planning an Approach for a TACE Procedure
01:02:26 - Final Thoughts and Future Prospects in Liver Cancer Treatment
---
RESOURCES
Barcelona Staging System:
https://www.ncbi.nlm.nih.gov/books/NBK569796/table/Ch3-t0001/
TRACE Trial:
https://pubs.rsna.org/doi/full/10.1148/radiol.211806
PREMIERE Trial:
https://www.gastrojournal.org/article/S0016-5085(16)34971-X/fulltext
EMERALD-1 Trial:
https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432
LEAP O12 Study:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02575-3/abstract

S01 Ep. 10 Collaborative Oncology: Surgeon’s Perspective and Role in Locoregional Therapy with Dr. Robert Martin

Tue, 11 Mar 2025 06:00:00 -0000

Medical, surgical, radiation, and interventional oncology all play vital roles in delivering care to patients battling liver cancer. How do we optimize outcomes when so many specialties have something to offer the same patient? The answer is collaborative oncology. Dr. Robert Martin (Director of Surgical Oncology, University of Louisville) and pioneer in liver-directed therapies, joins host Dr. Sabeen Dhand to discuss a collaborative approach to oncology and recent advances in locoregional therapy.

---

This podcast is supported by:

RADPAD® Radiation Protection

https://www.radpad.com/

---

SYNPOSIS

Dr. Martin discusses the importance of a growth mindset in advancing medical techniques and fostering collaborations between specialists. He then shares insights into minimally invasive procedures, such as microwave ablation and irreversible electroporation (IRE). The doctors also touch on the evolution of liver cancer treatments, emphasizing the significance of clinical trials on the horizon. To conclude, Dr. Martin encourages young professionals in surgery and interventional radiology to stay open-minded, be life-long learners, and find synergistic ways to integrate new technologies into patient care.

---

TIMESTAMPS

00:00 - Introduction

02:31 - Dr. Martin’s Background and Career Path

06:18 - Evolution of Liver Directed Therapies

10:12 - Collaboration Between Specialties

18:34 - Clinical Trials and Emerging Therapies

36:08 - Advice for Young Professionals

39:15 - Conclusion

---

RESOURCES

Radioembolization Oncology Trial Utilizing Transarterial Eye90 (ROUTE 90) for the Treatment of HCC:

https://clinicaltrials.gov/study/NCT05953337?term=NCT05953337&rank=1

Intratumoral Injection of IP-001 Following Thermal Ablation in Patients With CRC, NSCLC, and STS (INJECTABL-1):

https://clinicaltrials.gov/study/NCT05688280

Immunophotonics, CIRSE, and Next Research Announce Innovative Phase 2/3 Clinical Trial: INJECTABL-3:

https://immunophotonics.com/news/immunophotonics-cirse-and-next-research-announce-innovative-phase-2-3-clinical-trial-injectabl-3/

S01 Ep. 9 Principles to Practice: An HCC Tumor Board

Fri, 17 Jan 2025 07:20:00 -0000

Do you ever wish you could be a fly on the wall at a tumor board meeting? In this episode of BackTable, we’re excited to give you an insider’s view of the real case discussions that take place during hepatocellular carcinoma (HCC) tumor boards. Host Dr. Zach Berman sits down with a multidisciplinary team, including Drs. Adam Burgoyne (medical oncologist), Heather Patton (hepatologist), Siddharth Padia (interventional radiologist), and Gabriel Schnickel (transplant and hepatobiliary surgeon).

Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125743

---

This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.

---

SYNPOSIS

The team walks through a range of diverse HCC cases, reviewing patient histories, imaging, and treatment options. They cover eight cases in total, each featuring patients with varying treatment histories, comorbidities, liver function, and lesion characteristics. For the full educational experience, we recommend watching the video format on our YouTube channel.

---

TIMESTAMPS

00:00 - Introduction

00:47 - Case 1: Small Lesion in a Young Patient

05:01 - Case 2: Moderate Sized Lesion in an Older Patient

11:10 - Case 3: Multifocal HCC with Dominant Lesion

21:09 - Case 4: Dominant Lesion with Portal Hypertension

32:08 - Case 5: Ruptured Solitary Lesion

34:34 - Case 6: Rupture with Multifocal Lesions

44:08 - Case 7: Portal Vein Invasion

52:12 - Case 8: Metastatic HCC After Transplant

---

RESOURCES

CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

S01 Ep. 8 Getting Started in Interventional Oncology: Tips for Starting Your Career

Fri, 17 Jan 2025 07:10:00 -0000

Are you seeking to build your reputation and patient base within interventional oncology? In this episode, host Dr. Zachary Berman interviews Dr. Siddarth Padia, Dr. Tyler Sandow, Dr. Kavi Krishnasamy, and Dr. Kevin Burns about their journeys into interventional oncology (IO) and their experiences providing care in different practice settings.

Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125742

---

This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.

---

SYNPOSIS

The doctors begin by discussing how they became interested in interventional oncology, with most of them recognizing opportunities to address unmet needs in the field. Each guest shares insights on the timelines and challenges involved in starting their IO practices, which vary significantly today. For instance, telehealth clinics are particularly viable in private practice IO, thanks to conferencing software and virtual translators. Hybrid care models, which combine in-person and remote consultations, can help overcome patient-level barriers such as time and transportation. The panel also emphasizes how increased clinic availability can significantly drive growth in procedural volume. Finally, they offer advice for starting an IO practice, including the importance of having clinic support staff, building strong relationships with referring physicians, and staying up to date with new technologies.

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TIMESTAMPS

00:00 - Introduction

05:38 - Balancing Career Interests and Expectations

07:10 - Building an Interventional Oncology Practice

13:42 - Gaining Trust from Referring Physicians

17:33 - Importance of Open Communication

19:19 - Comparing Clinic Settings

26:01 - Essential Components of a Clinic

33:28 - Narrowing Your Interventional Practice

40:09 - Introducing New Technology

---

RESOURCES

CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

S01 Ep. 7 Surgery for HCC: What’s Its Role Today?

Fri, 17 Jan 2025 07:00:00 -0000

Is surgery truly the "cure" for hepatocellular carcinoma (HCC), and when is it a viable option? In this episode, Dr. Sabeen Dhand leads a roundtable discussion with interventional radiologist Dr. Siddharth Padia and transplant/hepatobiliary surgeons Dr. John Seal and Dr. Gabriel Schnickel, delving into the complexities of surgical treatments for HCC and the evolving landscape of liver resection and transplantation.

Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125741

---

This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.

---

SYNPOSIS

The doctors begin by discussing how they manage patient expectations regarding both palliative and curative treatments, highlighting the risk of recurrent HCC as a new lesion. They then outline key factors that influence their recommendations for liver transplant versus resection, such as the extent of underlying liver disease, the function of the future liver remnant, body habitus, overall health, and organ availability. The surgeons also review various surgical approaches to liver resection and recent advancements in liver transplantation, including living donor transplants and the ability to refer patients for downstaging procedures.

Dr. Padia explains the original role of Y90 as a bridging treatment to downstage tumors and promote hypertrophy in the non-diseased liver segments, preparing the organ for surgical resection. However, Y90 treatment can also lead to the formation of adhesions, which may complicate future surgeries. Finally, the doctors discuss strategies to improve care coordination between community physicians and transplant centers to optimize patient outcomes.

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TIMESTAMPS

00:00 - Curative vs. Palliative Treatment

04:03 - Choosing Between Transplantation and Resection

05:47 - Liver Resection Types

07:27 - Bridging Role of Y90

12:14 - Evolving Landscape of Liver Transplantation

20:59 - Patient Counseling in Minimally Invasive Procedures

28:40 - Considerations for Surgery After Y90

33:32 - Coordination Between Specialists

40:08 - Immunotherapy as a Bridge to Transplant

---

RESOURCES

CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

S01 Ep. 6 Transplantation for HCC: Who, When, and How?

Fri, 17 Jan 2025 06:50:00 -0000

The process of liver transplantation involves many complexities, and each patient's path to transplant is unique. To offer insider perspectives on this process, Dr. Zachary Berman sits down with transplant and hepatobiliary surgeon Dr. John Seal, as well as transplant hepatologists Dr. Heather Patton and Dr. Steve Young.

Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125740

---

This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.

---

SYNPOSIS

The panel begins by discussing the multidisciplinary pre-transplant evaluation process, which assesses factors such as liver function, comorbidities, surgical risk, and the availability of psychosocial support. Once a patient is listed for transplant, they enter a system that prioritizes those with the highest Model for End-Stage Liver Disease (MELD) score. During the waiting period, several comorbidities should be carefully monitored. Dr. Seal explores the impact of portal vein hypertension and portal vein thrombosis, explaining how these conditions may necessitate intraoperative thrombectomy or bypass. Dr. Patton and Dr. Young focus on considerations for using anticoagulation in patients with a high baseline bleeding risk and selecting the appropriate anticoagulant for patients listed for transplant.

For patients with hepatocellular carcinoma (HCC), eligibility for MELD exception points may depend on factors such as time spent on the waiting list, adherence to the Milan criteria, and the presence of extrahepatic complications of liver disease. The panel also discusses bridging therapies to transplant, including Y90 and TACE. In the peri-transplant phase, they highlight innovations such as living donor transplants, liver perfusion pumps, and the use of hepatitis C- and HIV-positive organs. Finally, the discussion turns to post-transplant considerations, including surgical complications, organ rejection, immunosuppression, predictors of HCC recurrence, and long-term surveillance.

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TIMESTAMPS

00:00 - Introduction

01:16 - Current Landscape of Liver Transplantation

03:22 - Transplant Evaluation Process

09:48 - Timeline from Listing to Transplantion

11:16 - Treating Portal Vein Thrombosis and Hypertension

18:44 - MELD Exception Points

22:05 - Bridging Therapies

25:34 - Peri-Transplant Considerations

30:53 - Post-Transplant Period

37:39 - Repeat Transplantation

---

RESOURCES

Model for end-stage liver disease (MELD) and allocation of donor livers (Wiesner et al, 2003):

https://www.gastrojournal.org/article/S0016-5085%2803%2950022-1/fulltext

Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis- Milan Criteria (Mazzaferro et al, 1996):

https://pubmed.ncbi.nlm.nih.gov/8594428/

Validation of the prognostic power of the RETREAT score for hepatocellular carcinoma recurrence using the UNOS database (Mehta et al, 2019):

https://pmc.ncbi.nlm.nih.gov/articles/PMC6445634/

CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

S01 Ep. 5 Complex HCC Patients and the "Grey Zone": What To Do When You Don’t Know What To Do

Fri, 17 Jan 2025 06:40:00 -0000

Treatment of hepatocellular carcinoma (HCC), like that of many other cancers, spans a spectrum from curative to palliative intent. To explore the "grey zone" of treatment goals for intermediate-stage HCC patients, Dr. Sabeen Dhand interviews a panel of experts in the field: medical oncologists Dr. Adam Burgoyne and Dr. Lingling Du, along with interventional radiologists Dr. Kirema Garcia-Reyes and Dr. Zachary Berman.

Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125739

---

This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.

---

SYNPOSIS

The discussion begins with an explanation of the Barcelona-Clinic Liver Cancer (BCLC) staging system. While this system takes into account helpful factors such as liver function, performance status, and tumor burden, it fails to fully capture the true heterogeneity of the HCC patient population. Additional considerations include tumor biology, response to previous treatments, and the location of metastases. The specialists then share their experiences in treating patients with comorbid gastrointestinal cancers and mixed tumors, discuss the benefits of an interventional oncology clinic setting, and highlight virtual opportunities for connecting with tumor boards. They also offer advice on patient education regarding treatment options.

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TIMESTAMPS

00:00 - Introduction to BCLC Staging

03:02 - Impact of Performance Status

06:29 - Predictors of Survival in HCC

09:51 - Palliative versus Curative Treatment Intent

13:55 - Comorbid and Mixed Gastrointestinal Cancers

16:51 - Adverse Effects of Treatment

20:37 - Interventional Oncology in the Clinic Setting

23:06 - Navigating Multiple Provider Viewpoints

28:01 - Complex Case Examples

---

RESOURCES

BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update (Reig et al, 2022):

https://www.journal-of-hepatology.eu/article/S0168-8278(21)02223-6/fulltext

CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

S01 Ep. 4 Curative Intent Therapies for HCC: Today and Tomorrow

Fri, 17 Jan 2025 06:30:00 -0000

For hepatocellular carcinoma (HCC) patients who are not candidates for liver transplant or resection, lesion ablation can be a curative treatment. With multiple ablation options available and still under investigation, it can be challenging to navigate the differences between them. In this episode, Dr. Tyler Sandow hosts a discussion with interventional radiologists Dr. Kirema Garcia-Reyes, Dr. Sabeen Dhand, and Dr. Kevin Burns on the various ablation options for HCC and when to use each one.

Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125738

---

This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.

---

SYNPOSIS

The doctors first discuss Barcelona-Clinic Liver Cancer (BCLC) Stage A patients, where lesion size and location are key factors in deciding between ablation and transarterial therapies. They then compare cryoablation and microwave ablation, highlighting that cryoablation offers better visualization and control of the ablation zone, while microwave ablation is more effective for treating larger lesions.

Dr. Burns introduces histotripsy, a noninvasive treatment that uses ultrasound energy to mechanically ablate tumors. He shares his experiences as an early adopter of this technology and discusses how intraoperative cone beam CT can help treat lesions located near critical structures or those poorly visualized on ultrasound. Finally, Dr. Garcia-Reyes and Dr. Berman provide insights into patient selection, pre-procedural imaging, and technical tips for Y90.

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TIMESTAMPS

00:00 - Introduction

02:04 - Ablation vs Y90 in BCLC A Patients

05:58 - Same-Day Y90

15:55 - Y90 for Large Tumors

17:51 - Ideal Cases for Cryoablation

19:38 - Explanation of Histotripsy

32:09 - Procedural Specifics for Histotripsy

38:21 - Technical Tips for Y90

---

RESOURCES

Including the Hollow Viscera (Stomach or Bowel) within the Ice Ball during Cryoablation: A Review of Adverse Events (Abramyan et al, 2024):

https://www.jvir.org/article/S1051-0443(24)00681-X/abstract

CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

S01 Ep. 3 Combination Therapy and Clinical Trials for Advanced HCC: What They Really Mean

Fri, 17 Jan 2025 06:20:00 -0000

In the past five years, the use of immunotherapeutic agents for advanced cancers has emerged as a promising alternative to tyrosine kinase inhibitors and chemotherapy, making it an exciting time to be practicing oncology. In this episode, Dr. Tyler Sandow interviews oncology experts about the landscape of advanced hepatocellular carcinoma (HCC) and the current state of immunotherapy treatments. He is joined by medical oncologists Dr. Jonathan Mizrah, Dr. Lingling Du, and Dr. Adam Burgoyne, as well as interventional oncologist Dr. Zachary Berman.

Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125737

---

This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.

---

SYNPOSIS

Drs. Burgoyne and Mizrahi provide a primer on immunotherapy and explain how they communicate the principles of this treatment to their patients. Dr. Du discusses the Imbrave clinical trial and how recent studies have shown improved overall survival when immunotherapeutic agents are used, especially when multiple agents targeting various pathways are employed. When choosing between different regimens, the doctors consider factors such as the patient's underlying liver function, symptom burden, and prior treatments.

Importantly, the doctors also discuss contraindications to immunotherapy, including a history of organ transplant, autoimmune disease, and poor performance status—all of which put patients at high risk for deterioration with this treatment. The treatment of patients with poor liver function remains controversial, as underlying cirrhosis may prevent the recovery of liver function. Dr. Berman outlines recent clinical trials studying the effects of transarterial chemoembolization (TACE) combined with immunotherapy. Finally, the doctors discuss the future of HCC treatment and the benefits of continued innovation in both interventional and medical oncology.

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TIMESTAMPS

00:00 - Introduction to Immunotherapy

04:32 - Notable Clinical Trials

13:39 - HCC Etiology and Immunotherapy Outcomes

18:43 - Contraindications for Immunotherapy

23:05 - Adverse Effects from Treatment

25:14 - Combination Therapy

36:22 - Considerations for Immunotherapy Dosing

40:26 - The Future of HCC Treatment

---

RESOURCES

Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma, IMbrave150 Trial (Finn et al, 2020):

https://pubmed.ncbi.nlm.nih.gov/32402160/

Tremelimumab plus Durvalumab in Unresectable Hepatocellular Carcinoma, HIMALAYA Trial (Abou-Alfa et al, 2022):

https://evidence.nejm.org/doi/full/10.1056/EVIDoa2100070

Nivolumab versus sorafenib in advanced hepatocellular carcinoma (CheckMate 459): a randomised, multicentre, open-label, phase 3 trial (Yau, 2022):

https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00604-5/abstract

Nivolumab (NIVO) plus ipilimumab (IPI) vs lenvatinib (LEN) or sorafenib (SOR) as first-line treatment for unresectable hepatocellular carcinoma (uHCC): First results from CheckMate 9DW (Galle, 2024):

https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA4008

Randomized Phase 3 LEAP-012 Study: Transarterial Chemoembolization With or Without Lenvatinib Plus Pembrolizumab for Intermediate-Stage Hepatocellular Carcinoma Not Amenable to Curative Treatment (Llovet, 2022):

https://pubmed.ncbi.nlm.nih.gov/35119481/

EMERALD-1: A phase 3, randomized, placebo-controlled study of transarterial chemoembolization combined with durvalumab with or without bevacizumab in participants with unresectable hepatocellular carcinoma eligible for embolization (Lencioni, 2024):

https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432

CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

S01 Ep. 2 How to Simplify Dosing: Understanding Y-90 Dosimetry from Simple to Complex

Fri, 17 Jan 2025 06:10:00 -0000

Of all the topics covered during interventional radiology training, dosimetry education is often delayed until after IRs enter clinical practice. In this episode, Drs. Tyler Sandow and Sabeen Dhand host a roundtable discussion with experts on the dosimetry fundamentals that all Y90 operators should understand. They are joined by interventional radiologists Drs. Zachary Berman, Kirema Garcia-Reyes, and Siddharth Padia, who provide their expert insights.

Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125736

---

This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.

---

SYNPOSIS

The group agrees that dosimetry is not a one-size-fits-all approach. Dosing strategies depend on factors such as tumor size, perfusion territory, underlying liver function, the choice between glass versus resin spheres, and treatment intent. These considerations are illustrated with real-life case examples. The doctors also explore voxel-based dosimetry, a method for calculating the amount of radiation absorbed by different parts of the tumor. They stress the importance of learning how to perform accurate dosage calculations.

Finally, the conversation touches on data from major Y90 trials, current guidelines, and the evolving perspective on Y90 as a potential curative treatment, rather than merely a bridging therapy.

---

TIMESTAMPS

00:00 - Introduction

01:59 - Dosimetry Education During Training

05:46 - Benefit of Individualized Dosing

11:01 - Complications from High Doses

15:19 - Dosage Calculation Cases

22:51 - Duration of Response to Y90

25:00 - Dosing Based on Treatment Intent

29:11 - Challenging Case Example

42:31 - Voxel-Based Dosimetry

45:15 - Using Dosimetry Software

---

RESOURCES

LEGACY Trial (Salem et al, 2021):

https://pmc.ncbi.nlm.nih.gov/articles/PMC8596669/

Voxel-based tumor dose correlates to complete pathologic necrosis after transarterial radioembolization for hepatocellular carcinoma (Pianka et al, 2024):

https://pubmed.ncbi.nlm.nih.gov/38913189/

RAPY90D Trial (Kappadath et al, 2023):

https://jnm.snmjournals.org/content/64/supplement_1/P268

Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group (Salem et al, 2023):

https://pubmed.ncbi.nlm.nih.gov/36114872/

International recommendations for personalised selective internal radiation therapy of primary and metastatic liver diseases with yttrium-90 resin microspheres (Levillain, 2021):

https://link.springer.com/article/10.1007/s00259-020-05163-5)

CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

S01 Ep. 1 Multidisciplinary HCC Care: Improving the Patient Experience with Combined Clinics

Fri, 17 Jan 2025 06:00:00 -0000

Welcome to the first episode of BackTable Tumor Board, and our first recording session at our new in-person studio! Guest host Dr. Tyler Sandow (interventional radiologist) leads a multidisciplinary discussion about patient care coordination in hepatocellular carcinoma (HCC) diagnosis and treatment, with insights from his colleagues at Ochsner Health– Dr. Steven Young (hepatologist), Dr. Jonathan Mizrahi (medical oncologist), and Deondra Bonds-Adams (patient navigator).

Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125735

---

This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.

---

SYNPOSIS

The team speaks on the value of having multiple specialties weigh in on treatment conversations that are tailored to each patient’s medical history and risk factors, such as underlying cirrhosis and portal hypertension. Deondra highlights the importance of assessing the patient’s understanding of their disease and the role of physician extenders and schedulers in patient education. Dr. Young discusses the value of outreach clinics and streamlining the transplant evaluation process. Finally, Dr. Mizrahi gives advice on building referral networks and establishing early contact with transplant centers.

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TIMESTAMPS

00:00 - Introduction

00:46 - Multidisciplinary Tumor Board

06:00 - Patient Experience in Treatment Pathways

10:10 - Barriers to Treatment

16:03 - Benefits of IR Clinic

19:33 - HCC Screening and Risk Factors

24:08 - Building Referral Networks

30:34 - Strategies for Effective Scheduling

35:43 - The Future of HCC Treatment

---

RESOURCES

CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf