Oncology for the Inquisitive Mind

"I have not failed, I've just found 10,000 ways that won't work!" so said Thomas Edison in describing his journey to the incandescent light bulb. This quote seemed appropraite as Michael and Josh conclude their journey in the neuroendocrine space and discuss neuroendocrine carcinomas (and poorly differentiated metastatic neuroendocrine tumours). Sometimes when you working in the oncological world,...

Neuroendocrine Tumours could be described as an impassable obstacle, more complicated the more you research. That's where Michael and Josh come in, and this week, explore Grade 3 metastatic neuroendocrine tumours. Michael provides a brilliant overview of this well-differentiated cohort and the lack of efficacy platinum chemotherapies have, while Josh discusses CAPTEM (temozolomide and capecitabine...

"We go to the moon and other places not because they are easy, but because they are hard." So spoke US President John F. Kennedy, in a speech that galvanised the American public and fostered widespread support for the space race and the Apollo space program that would culminate in Neil Armstrong and Buzz Aldrin landing on the Moon on July 20, 1969. A similar approach must be taken to the treatment...

Between 1933 and 1944, Americans huddled around their radios to listen to the words of Franklin Delano Roosevelt, the 32nd President of the United States. Covering topics ranging from the 1936 recession to World War II, FDR titled these addresses "Fireside Chats", giving very high-concept topics a more personal, intimate feel. Let it never be said that Oncology for the Inquisitive Mind is above sh...

Neuroendocrine tumours (commonly referred to as NETs) is the topic for this week's episode of Oncology for the Inquisitive Mind. Michael and Josh thought it could be easily covered in a single episode, but they were wrong. This is not dissimilar to the recurrent cancellation of Futurama, a television series with nine lives saved by every network in existence. Neuroendocrine tumours are a diverse,...

Previously, on Oncology for the Inquisitive Mind, Josh and Michael discussed the common systemic therapies available for early and advanced testicular cancer: single-dose carboplatin and bleomycin + etoposide + cisplatin (BEP). However, like the beginning of any good story, this is just the beginning. All the knowledge of chemotherapy in the world is nothing without knowing how to apply it. In thi...

On this, the tenth episode of OncoSnacks, Josh and Michael discuss the management of a common but no less important problem: superficial venous thrombosis and thrombophlebitis. While for the majority of cases the treatment is purely symptomatic, in a small minority of cases superficial venous thromboses can be a precursor of more serious thromboembolic events. This broad range of possible outcomes...

Edward Gibbon, an English historian and politician, once quipped, "History is indeed little more than the register of the crimes, follies, and misfortunes of mankind." This episode, which lacks historians and politicians, covers testicular cancer, a topic humankind has had a love-hate relationship with for millennia. As a historical concept in the middle ages, men who wanted to have a male as an o...

In this episode, the Nautilus reaches its final destination, where Michael and Josh pursue a deeper understanding of ROS1, and KRAS mutated lung cancer. ROS1 reflected less than 3% of non-small cell lung cancer, while KRAS is abundant and can reflect up to 25% of lung cancer patients. The challenge lies in the targets, with the only approved KRAS treatment sotorasib targeting a single KRASG12C mut...

In this episode, Michael and Josh step onto the oncological Nautilus , to begin their journey 20,000 Leagues Under Lung Cancer, to examine non-small cell lung cancer with mutations other than EGFR . The first step on their journey is discussing the anaplastic lymphoma kinase, a tyrosine kinase inhibitor associated with the development of non-small cell lung cancer in younger patients who have neve...

There are cancers that grow slowly. There are cancers that do not grow at all. And then there are cancer's like today's subject, that are notorious not just for their ability to completely overcome a patient in a very small amount of time. Extensive-stage small cell lung cancer remains a very difficult condition to treat, highly prone to relapse and with few effective options beyond - or perhaps e...

Chemotherapy extravasation can occur day or night, and one must always be vigilant. While many agents are irritants and may not pose significant risks, vesicants pose a different story. A tale of danger and intrigue, this situation can lead to the involvement of a friendly neighbourhood surgeon or Spiderman. In worst-case scenarios, significant tissue damage, treatment delay, and a sizeable psycho...

Cancer is thought of as a great killer, an indefatigable bogeyman that claims the lives of everyone it afflicts. However, advances in medicine mean that for more people than ever before, cancer is something that people can survive or at least live with for longer. While an incredible achievement, this does raise many new challenges for patients and physicians alike. And thus, the concept of Cancer...

DCIS (ductal carcinoma in situ) and LCIS (lobular carcinoma in situ) are challenging areas of breast cancer oncology. Michael and Josh return from their short hiatus to find their podcast has been ranked one of the top oncology podcasts by feedspot. Do not fear; they won't rest on their laurels and are ready to roll and bring another exciting episode of management, intrigue, and choose your advent...

Theodore Roosevelt is famously quoted saying: "It is hard to fail, but it is worse never to have tried to succeed." This is what ASCO, oncologists and cancer researchers are faced with daily. As our tour de force of ASCO 2023 ends, and we foresee a future where daily episodes don't arrive, we present our final episode. Michael and Josh have kept three of the most exciting trials until the end...

The epic journey of Josh and Michael across tumour streams at ASCO 2023 is approaching its end. It has been a whirlwind tour through groundbreaking science, hazard ratios and exciting glimpses into a brighter future for cancer patients. However, our intrepid duo's work is not yet done, merely reached its penultimate stage. In today's episode, Josh and Michael examine four notable studies in the sp...

Every epic journey has that moment when the end is in sight. The start of the last lap of the race, the final dramatic encounter with the main villain. On this episode of Oncology for the Inquisitive Mind, that villain is metastatic lung cancer, with a particular focus on EGFR mutant disease. There have been a lot of questions raised about the best next step after the failure of the star of ASCO 2...

Cancer is facing a seismic shift as precision oncology is becoming a reality, and adoption is skyrocketing as new anti-cancer agents are released. It appears that the days of blunt-force chemotherapy could be limited. Paul Ehrlich, the German Chemist, is credited with the term "chemotherapy", but more importantly, the concept of the magic bullet, "zauberkugel", which would allow selective targetin...

ASCO 23 explored novel anti-cancer agents in the genitourinary space. The future of oncology is etching closer daily. In this episode, Michael and Josh dissect ertafitinib, an FGFR inhibitor used in bladder cancer, talazoparib in prostate cancer and immunotherapy and TKI combinations in renal cell cancer. All these studies reflect the desire to target cancers further with some astonishing results....

ASCO 2023 has been an incredible journey, and the latest instalment of Michael and Josh's search for the latest and greatest oncological news is no exception. On this episode, our intrepid duo examine three studies with potentially practice-changing consequences, like Burton and Speke quest for the source of the River Nile. Which, in this ASCO series is literally just another day at the office. Bu...

In this episode, Michael and Josh investigate Lung Oncology research presented at ASCO 23, specifically early lung cancer treatment. They discuss Perioperative Toripalimab, LAG3 inhibitor Relatlimab and the new novel agent BI 764532, a novel DLL3-targeting T cell engaged. Studies: NEOTORCH: https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.36_suppl.425126 NEOPREDICT: https://ascopubs.org/doi/abs/10...

Ovarian, cervical and endometrial cancer need more treatment options. Platinum-based chemotherapy only works for so long. ASCO 23 delivers with the practice-changing MIRASOL study introducing Mirvetuximab Soravtansine, a novel ADC with efficacy in ovarian cancer. Michael and Josh also discuss the Oval Study (ofranergene obadenovec) and immunotherapy in the DUO-O trial and Keynote 826. Not all tria...

Captain's Log: ASCO Day 3. Today's episode brought myriad developments in treating CNS cancers and brain metastases from other distant lands. Some studies offered new and exciting targets for potential treatments. Others purported to provide benefits in new and exciting ways, eschewing infusions and tablets with vaccinations. Still, others repurposed old technology in new ways, investigating uses...

Hormone receptor-positive breast cancer again takes centre stage at the ASCO 23 (American Society of Clinical Oncology) Annual Meeting and has reinvented itself over the last two decades. Improvements are occurring in the adjuvant and neoadjuvant setting for both estrogen (ER) and progesterone (PR) positive and the human epidermal growth factor receptor space (HER2). In this episode, Michael and J...

ASCO 23 (American Society of Clinical Oncology) Annual Meeting in Chicago showcased a plethora of cutting-edge trials and research. Upper gastrointestinal cancers such as gastric, pancreatic and hepatobiliary are usually relegated to the backstage, but this year, several exciting and potentially practice-changing studies (not without their limitations). We explore a new PD-1Toripalimab in gastric...