Plenary Session: Recent Episodes
Vinay Prasad, MD MPH
A podcast on medicine, oncology, & health policy. Host: Vinay Prasad, MD MPH from University of California San Francisco. Tweet your feedback to @Plenary_Session or e-mail plenarysessionpodcast@gmail.com
I discuss RFK Jr.'s confirmation as the US Secretary of Health and Human Services; recent layoffs at the CDC and NIH; and some comments by Harold Varmus in criticism of Jay Bhattacharya.
I discuss the CIA admitting that COVID was a lab leak; Fauci's pardon; NIH meetings; RFK Jr's Senate confirmation hearing; and more.
I discuss the recent reduction in indirect funds for NIH grants and lay out why the NIH is a broken funding system.
I'm talking about USAID and Elon's team of six engineers; the Bobby Kennedy Jr hearings, particularly concerning Samoa; MMR vaccines; DEI; and NIH funding complaints.
I discuss the intense media coverage of Trump and the recent decision to cap indirect costs of NIH grants at 15%.
I discuss Trump's big health care changes: NIH study sections, the MMWR gag order, the US withdrawal from WHO, and more!
Is alcohol healthy for you? I break down everything you need to know about beer, wine, and spirits.
Lecture on systematic review, given by Vinay Prasad MD MPH to students in the UCSF Training in Clinical Research Program, November 2024.
"Masking Mistakes: Lessons from the Science, Policy, and Coverage of COVID-19", the 2024 Brian Shields Lecture on Institutional Ethics which took place on Monday, October 7, 2024 for the Emory Center for Ethics. A conversation with Carlos Del Rio, MD and Vinay Prasad, MD MPH with moderation by Gerard Vong, DPhil, Director of the MA in Bioethics program.
My grand rounds; Beta blockers post MISingle center vs multicenter RCTMasksBoosters and more
I crossover SM podcast; Harvard med students video, Justice curriculum, Masking half the year
Another flawed quality metric. Reviewing the NEJM paper "Beta-Blockers After Myocardial Infarction and Preserved Ejection Fraction".
Goodman and I discuss ash updates.My myeloma talkhttps://www.youtube.com/watch?v=jAz84yCnfjQ
Subscribe to Sensible Med Pod; This is x overPost partum depression, orbita 2 and physics vs medicine
My Lecture in Curacao 4/4 Vaccines, Masks, Mandates, Lockdowns, School closureOther lectures to come
Entresto, Lung Transplants, How to Keep Up with Literature - Lecture to Trainees in Curacao
This is a lecture I gave on November 5, 2023, to pre-medicine undergraduate students at University of California Berkeley.
Prasad is back in Hawaii to give another keynote (good thing they cancelled Dallas not Honolulu). I discuss coffee and colon cancer, and censoring, and Lu177 PSMA
This is a lecture I gave on ethics and institutional review boards in Denmark in September 2023. It is the last of the three lectures I gave.
This is a lecture I gave on the state of immunotherapy in oncology at the Immunotherapy Symposium In Denmark in September 2023. It is the second of three lectures I gave.
The first of the three lectures I gave in Denmark in September 2023 was on the medical evidence behind decision-making by health technology assessment groups.
This is the live recording of a talk given on the great and crazy things we do in medicine, from cancer drugs to boosters and more.
A far reaching discussion btw Mandrola and Prasad on RCTs, Coumadin, ECMO and RCTs for covid shots
Simultaneously released on Sensible Medicine. Time to subscribe to Sensible Medicine substack and podcast.
A sensible medicine crossover episode Follow the sensible medicine podcast feed for more of these discussions
Researchers were too busy counting dead bodies to give the control arm appropriate therapy when their cancer recurred. Disgusting conduct.
I break down ADAURA
Mike Putman, Todd C. Lee, John Mandrola and I debate the recent JAMA paper on RCT Duplicate. This is a spirited round table discussion on the limitations of observational data. If you are reading this, leave a comment as a review!
Early treatment of myeloma, dual vs. single maintenance, and finally transplant or no transplant.
I combine two latest tracks on interpreting medical studies, medical boards, 7 doses of vaccine, and finally Walensky. Stay tuned.
Karmma 3 discussion; then Sensible Medicine on Long COVID, 4th year fellowships and more; Then my breakdown of FDA's NEJM Letter to the Editor
I talk RCTs 101; KM Plots; Blinding: 2:1 randomization: Concealment and more. Then Papa Heme Tells you How to Find your First Job
Dr. Tom Newman UCSF Emeritus Professor & Superb teacher discusses VP's recent Public Health Videos. The two don't fully agree, but the discussion is worth your time.
Mike Putman, asst prof. EBM Rhematologist debates me on value of boosters, observational studies and more.
A new podcast feed called Sensible Medicine is up; here is a sample of what we have to offer
I destroy the trial. Bad control arm. Informative Censoring. No OS gain. Authors DOWNPOWERED TRIAL. Fishy PFS. Fishy HRQoL. This trial should be in trash can.
I break down the GEM CESAR trialK, R, D, Pom, Dara, Dex, R, and Auto and all before you actually have cancerWhat a crazy trial!
This uncontrolled trial of Dara-KRD claims to be looking for cure; Unfortunately, the PI has not thought through what that would look like, and accordingly all the claims are incorrect. Moreover the primary endpt is negative. Sad day for oncology
Sample size games, primary endpoint, head to head trials in oncologyRate this podcast on itunesComing next is Triangle trial
Grand rounds on heme and heme malignancies given 12/16 at University of Southern California (some parts removed)More ASH coming soon
Is it acceptable to take someone with myeloma who has gotten just 2 regimens and put them on a phase 1? VP says hell no.
In this lecture given December 7, 2022, I cover 5 things:VaccinesMaskingLong COVIDSchools/Immunity DebtPaxlovid
Should we treat smoldering MM, a debateLong COVID vs Long URIReview the show; Say Hi at ASH22
Smart Start is a useless lymphoma study; We have to stop putting our careers ahead of patients. In the second part, I discuss the 'experts' featured on STAT. Wowzers.
I will be at ask. Hit me up: plenarysessionpodcast@gmail.com
I am joined by Cornell Professor Paul Fenyves; a practicing internist Dr. Fenyves walks us through COVID19 policy. We will be back soon with more cancer medicine. Including a devastating lymphoma one.
I was invited to give this talk to a UK conference on Myeloma Please LEAVE A REVIEW of this podcast
Lecture I gave this weekend in Hawaii to the Medical Oncology Association; One of the best audiences I've had
I give Grand Rounds to UCSF Neurosurgery on how to read and interpret Neurosurgery Studies (Video and slides coming soon to YouTube) Also I discuss Bob Califf's Promotion of Paxlovid
Learn about UCSF Hematology Oncology Program with Dr. Gerald Hsu, MD PhD Malignant Heme and Program Director
discuss NordICC with the trial PI Power calc specified 50% non-adherence ADR is on par with US studies from the time Colo quality good Perf rate lower than US! How does he counsel individuals & governments What he thinks of USPSTF
A double standard to condemn data with limitations, based on political party, will destroy medicine.
We will back to oncology soon, but this is important
I break down the history and data for the first ever randomized trial of colonoscopy, appearing in NEJM on Oct 9, 2022
Polo Javelin 100 bladder Crossover Control arms How to read and keep up with the literature
I travel to UCSD to interview Dr. Goodman about myeloma, celebrity oncology culture, his career, education, patient care, choosing a specialty and more.
T.O. joins me for the missing episode. These are the unspoken rules of Oncology; We dive deeper into Malignant Book Club.
Timothee Olivier joins me for the 7th installment of our book-club We cover famous trials in oncology
How do careers vary between the academy and industry? We have a panel of the best: Sanam Loghavi from MD Anderson, Aaron Goodman UCSD, and David Steensma Novartis (formerly Farber/ Mayo) and VP
Real talk
Timothee Olivier joinrs me as we explore part 3 of the book Crossover, sample size, observational vs RCTs
T.O. joins me to grill me on the rest of Financial Conflict of Interest and Precision Oncology. We discuss the need for randomization, and when it can be omitted. A must listen for Oncology Fans.
VP discusses the LaceWing study in Blood. A Phase 3 RCT of GILT AZA vs AZA; Medical writers; confounding; table 1; balance; and so much more
Timothee Olivier joins me to discuss recent papers: IMPOWER10 Checkmate 816 Path CR/ EFS/ Surrogates Drug Dosing, cGCSF rules and more Bread and butter oncology
The POLO trial, which we first broke on PS Season 1- is back with null OS results. But the trial authors enter the spin cycle. VP goes line by line.
VP explains H index, total cites, papers, US News and World Report rankings and how evaluates researchers and doctors.
VP addresses what to do you if you get an idea from listening to the show, and deconstructs ECHELON-1. Instead of listening we highly recommend you watch the video on YouTube with graphics. This is worth the watch.
How to think about when and how to do RCTs? What are the limitations to observational studies? Smoking. Parachutes. Dostarlimab. Guarantee Time Bias. Confounding. Multiple Hypothesis testing and more
I make the case why this podcast should be your go to for Med, Onc & Policy. I describe my philosophy of Evidence, Empiricism, and show how this connects to many oncology studies. I answer a bunch of Listener Questions
How to read randomized trials in cancer medicine. Phase 2 vs 3, control arm, crossover, post protocol, censoring (the basics), and how law professors and medical professors are different and why it matters.
What happens when you treat people with $168,000 a year medicine when most of them will never need treatment, and all of them don't need treatment now
I sit down with H Jack West. City of Hope. Thoracic Oncology and we have a long discussion about trials; staging; PDL1 thresholds; Driver mutations and post protocol care; ADAURA; Adjuvant; & More
I discuss the timeline of Ratify and Quantum. Was this an ethical trial? Is it sufficient to say a trial is ethical because 50% of participants get something?
The drug has a high response rate and lots of infections, is it active? Yes; Efficacious? ???? I review ASCO2022 updates
Are the results from Luis Diaz as good as touted. What trial should they do going forward? A 100% CR rate in Stage II and III rectal cancer??
My take on the standing ovation for DESTINY Breast 04 Traztuzumab Deruxtecan vs. Investigator choice after endocrine therapy and 1 or 2 chemotherapies for HER2 low
I break down Richardson, et al. NEJM DETERMINATION Transplanters are determined to keep going, should they be?
Watch the videos b/c I have lots of great visuals My ASCO Coverage continues
The second paper from #ASCO2022 #ASCO22 that I break down This is one of the most technical papers I breakdown on the channel CT DNA used to omit chemo in Stage II colon cancer Read the book Malignant if you learn from this Watch the YouTube Figures https://youtu.be/QxOBIi7I2BU
Continuous vs. Fixed, 3 vs 2, PFS is the primary endpoint No OS Bad crossover Lots to discuss here I will be covering all the major ASCO papers on @PlenarySession Subscribe to my substack https://vinayprasadmdmph.substack.com/
I am joined by Dr. Katie Sharff, infectious disease doc, to discuss two of her papers on myocarditis after COVID-19 vaccination.
https://doi.org/10.1016/j.amjcard.2022.02.039 https://doi.org/10.1101/2021.12.21.21268209
I get back to my roots; I explain surrogate validation and a new JCO paper from the FDA authors on EFS and OS in AML. You won't want to miss it
In this episode I dissect a test negative case control trial; I talk about a famous pancreas cancer study and I revisit the failure of Myeloma trialists
I am joined by Manni Mohyuddin to talk about How I treat frontline transplant eligible myeloma. Vinay Prasad makes the case the entire field of myeloma is corrupt and broken.
This is a compilation of the last week and half of monologues by VP on his Youtube Channel about COVID19 policy
I talk to UCSF Professor Eric Collison about his lab, grant writing, the physician scientist life, cancer, and a doctors duty.
A brilliant talk by one of the most brilliant scientists alive; JPAI lectures VKPrasad lab on all things COVID19; When does the pandemic end? What are the lessons?
Listen in as I give an unscripted lecture to a general audience about COVID-19; What we got right and wrong these last 2+ years.
Kristina Jenei becomes the 4th guest host and flips the tables on me, interviewing me about academic medicine and more...
I perform an analysis of the AGILE trial that came out in NEJM today; I find 6 huge problems. Follow PS on twitter; and write to us to let us know what you think
Timothee Olivier joins me for the 3rd of 9 parts of the Malignant book club - this covers all of Oncology
Pragmatic vs Ideal, Surrogate vs. Hard Endpoints; Time it takes; Ethics; Control arms; Purpose; I cover it all here.
In this book club we discuss Chapters 2 and 3 of Malignant, covering Surrogates and their role in Oncology
This is a brief monologue with Dr. Timothee Olivier, and the audio from a class I taught on RCTs-- when are they needed in biomedicine
Here is the first of a 9 part series on Malignant Book Club with Timothee Olivier from Switzerland
We cover cost of drugs, and intro to cancer drug policy
I am back with Timothee Olivier from Geneva Switzerland to discuss Part 2 of our laboratory work. Can oncologists criticize RCTs? We also announce our new series. A 9 week Malignant Bookclub
Timothee Olivier from Geneva Hospital Switzerland joins me for the first in a series of episodes on updates from VKPrasad laboratory, where we discuss cancer drugs & policy & evidence
Jacob Hale Russell is back from Rutgers law to talk about his new piece in Tablet Magazine.
I am joined for my 4th conversation with Zeb. This is a far reaching conversation where we discuss mandates, vaccines, masking, and why evidence based medicine still has something to offer.
We're back this week with a collection of monologues! We talk about a Paul Offitt quote, COVID boosters for adults and kids, COVID testing, whether this is a pandemic of the unvaccinated, myocarditis and pericarditis, college campus restrictions, and more!
STAT News Op-Ed: https://www.statnews.com/2021/12/23/at-a-time-when-the-u-s-needed-covid-19-dialogue-between-scientists-francis-collins-moved-to-shut-it-down/
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Today we have a short discussion for you of the MEMOIR study, published in The Lancet Oncology: "Effect of immunotherapy time-of-day infusion on overall survival among patients with advanced melanoma in the USA (MEMOIR): a propensity score-matched analysis of a single-centre, longitudinal study". We also have a special treat for you: a lecture Dr. Chris Booth of Queen's University, Kingston, Ontario, Canada recently gave titled "The Emperor Has No Clothes", a critique of the current state of cancer care.
MEMOIR: doi.org/10.1016/S1470-2045(21)00546-5
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Today we have an in-depth, in-person interview with Dr. John Ioannidis of Stanford University. We ask him: where are we now with COVID-19?
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Dr. Zeb Jamrozik, an infectious disease bioethicist at the Monash Bioethics Centre and the University of Oxford, is back again! We discuss Omicron, travel bans, masks, vaccine mandates, and more.
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David Russler-Germain and Papa Heme join VP to discuss the hottest ASH lymphoma papers: POLARIX and 2 CAR-T trials (ZUMA-7 & BELINDA)
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We have an in-person interview for you today! We sit down with Dr. Adil Daud of UCSF to talk all things melanoma. We cover Tebentafusp, nodal dissection, the Will Rogers phenomenon and the effect of stage migration on clinical trials as imaging advances, adjuvant vs I/O, academic training vs apprenticeship for budding oncologists, and more!
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We're back with a hematology/oncology heavy episode! We talk about oral azacitidine for acute myeloid leukemia (AML) and nelarabine for T-cell acute lymphoblastic leukemia (T-ALL) with Dr. Bernie Marini, a Clinical Pharmacist Specialist in Hematology and Associate Professor at University of Michigan Medicine.
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Today we interview Dr. Bill Hall, Associate Professor of Radiation Oncology and Surgery at Medical College of Wisconsin, on his new paper out now in the Journal of Clinical Oncology titled "Value of Neoadjuvant Radiation Therapy in the Management of Pancreatic Adenocarcinoma".
Neoadjuvant: doi.org/10.1200/JCO.21.01220
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Today we interview Dr. Cody Meissner, Chief of the Division of Pediatric Infectious Disease and Professor of Pediatrics at Tufts University School of Medicine. Dr. Meissner is also a member of the US FDA Vaccine Advisory Committee. We talk about the affect of school closures on the health of children, the evidence base for COVID vaccine mandates in children, and the nuance surrounding all of it.
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Dr. Zeb Jamrozik, an infectious disease bioethicist at the Monash Bioethics Centre and the University of Oxford, is back by popular demand! We talk about the failures, both scientific and ethical, of the COVID-19 pandemic.
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We're joined today by Dr. Aaron Goodman, a hematologist/oncologist at the University of California San Diego, to talk about calling out an unethical clinical trial, Melflufen, and academic oncology.
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We're joined by Dr. Bapu Jena of Harvard Medical School to talk about his show, Freakonomics, M.D., and his career at the intersection of economics and medicine.
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We have three topics for you today: We talk about our recent paper on the use of second-line immunotherapy in kidney cancer, the controversy over whether a cancer clinical trial was unethical, and the results of the randomized clinical trial CASSIOPEIA.
Kidney Cancer: doi.org/10.1001/jamanetworkopen.2021.24728 CASSIOPEIA doi.org/10.1016/S1470-2045(21)00428-9
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Today we have an interview with Dr. Zeb Jamrozik, an infectious disease bioethicist at the Monash Bioethics Centre and the University of Oxford. We talk about COVID-19 health policy and where we went wrong, speaking specifically from the values framework of health, fairness, and freedom.
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We have a summary of our thoughts for you on recent news about COVID. We discuss the prospect of FDA authorization of a Moderna booster, 8 lessons for health policy in times of crisis, updates on myocarditis data from Israel and Europe, how our experiences with COVID warn us of the possible end to democracy, how progressivism is dead, why social media should not censor views, the CDC's new masking studies, the slogan "follow the science", weekly testing of vaccinated college students who don't have symptoms, the survival of science after COVID, and the question of requiring a booster to follow the Johnson & Johnson vaccine.
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On today's episode we're joined by a number of special guests: Dr. Christopher Booth and Dr. Adam Fundytus of Queen's University in Kingston, Ontario, Dr. Manju Sengar of the Tata Memorial Centre, and Dr. Aaron Goodman of the University of California at San Diego. We talk about their new papers: "Access to cancer medicines deemed essential by oncologists in 82 countries: an international, cross-sectional survey", "Practicing on the edge of oncology: when standard of care feels uncomfortable", and "Has the Current Oncology Value Paradigm Forgotten Patients’ Time? Too Little of a Good Thing".
Cancer Medicines: doi.org/10.1016/S1470-2045(21)00463-0 Edge of Oncology: doi.org/10.1038/s41571-021-00550-9 Value Paradigm: doi.org/10.1001/jamaoncol.2021.3600
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On today's episode, in honor of him and in recognition of his passing, we have an old interview with Dr. Elihu Estey of the University of Washington on his 40 years of experience as an oncologist, the "Renaissance" of drugs for leukemia, and advice for trainees on how to approach career goals. This interview originally aired as episode 1.49. He will be missed.
This week we take a break from #zercovid to give you another episode that's a deep dive into COVID-19. We start with an interview with epidemiologist and infectious disease expert Dr. Daniel Morgan of the University of Maryland School of Medicine; we talk about cognitive errors in medical decision-making and how it relates to COVID-19 health policy. After that, we have a series of thoughts for you on COVID vaccine mandates for schools, President Biden's vaccine plan, the FDA's vote on boosters, John Ioannidis' new paper on vaccinating students, the Pfizer results for vaccines in kids 5-11, and accepting that COVID is here to stay.
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Today we take a brief break from our #zerocovid mantra to offer you our thoughts on current events. We cover a variety of topics, including: medical doctors in academia, cancelling conferences even for the vaccinated, masking 2-year-olds, equipoise, the CDC Georgia study, myocarditis, booster shots, outdoor masking at Duke, no more zero COVID in Australia, the Bangladesh cluster RCT on masks and its implications for kids in the USA, the resignation of two senior FDA officials, LA schools mandating vaccines, vaccinating college students, and more.
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Today's episode is a lecture our host, Dr. Vinay Prasad of University of California San Francisco, gave recently on censoring patients in Kaplan-Meier plots.
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Today we're joined by social epidemiologist, Dr. Maria Glymour of UCSF. We talk about her work in studying public health interventions for dementia and how her experience in academia has led to her conviction in the necessity of rigorous, quantitative technical skills training for epidemiology PhD students. We touch on how to have a good idea, her advice for PhD applicants, and working in a soft money (grants) vs hard money environment. Finally, we discuss her idea for a stepped-wedge trial approach to evaluate the new Alzheimer's drug, aducanumab.
Aducanumab: https://sites.bu.edu/melodem/files/2021/07/Pragmatic-Study-Designs-to-Accelerate-Aducanumab-Evidence_Glymour.pdf
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We have two oncology conversations for you today. The first is with Dr. Saroj Niraula of the University of Manitoba, and together we discuss the necessity of randomized controlled trials for granting FDA approval of cancer drugs. The second is with Dr. Ghulam Rehman "Manni" Mohyuddin of the University of Utah on a variety of myeloma studies, including LIGHTHOUSE, OCEANS, and HORIZON.
Feasibility of RCTs: doi.org/10.1093/jncics/pkab061 RR of Alternative Treatments: doi.org/10.1002/ijc.33231 Study Time Reduction: doi.org/10.1001/jamainternmed.2018.8351
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Today we interview Dr. Bita Fakhri of UCSF on the current research behind treatments for lymphoma. We touch on CAR-T, ABVD, DA-EPOCH-R, and more. We also talk about histiocytic disorders, Dr. Fakhri's career in academia, and learning through teaching.
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Today we're compiling all our recent monologues on COVID-19. That's right -- we're taking a break from #zerocovid to give you an episode that's #allcovid! We cover a whole range of news and opinions covering the Delta variant. We give an evidence-based-medicine doctor's take on the question: Are RCTs necessary in the age of COVID19? We also talk about how the American Academy of Pediatrics (AAP) lost the narrative. We detail how America failed kids because the AAP, CDC, & the teachers unions all hate Trump more than they love kids. We cover vaccine boosters: are they justified? Is there enough evidence? We detail how to run a randomized controlled trial of a policy intervention. And, finally, we confront the New York Times opinion article "Actually, Wearing a Mask Can Help Your Child Learn". We confront the tough questions: Do children really need to see faces? Why do we even have faces?
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Today we interview Dr. Alan Venook of UCSF, a renowned expert in clinical trial design and gastrointestinal malignancies. We talk about the evolution of the treatment for colorectal cancer over the last few decades, starting with 5FU. We also discuss his time working as an editor for the Journal of Clinical Oncology and we talk about his advice for budding clinical trialists.
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We have two short thinkpieces for you. The first is on the lessons that can be learned, or have been learned along the way, from publishing 300 peer-reviewed papers in medical/scientific journals. The second is on the recent publication with Jenny Gill out now in the International Journal of Cancer, titled "After COVID-19, telemedicine may be used in addition to usual care and not in lieu of: Implications for health systems".
Telemedicine: doi.org/10.1002/ijc.33752
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Today we interview Dr. Josee-Lyne Ethier of Queen's University in Kingston, Ontario, Canada on her new paper "Practice Patterns and Outcomes of Novel Targeted Agents for the Treatment of ERBB2-Positive Metastatic Breast Cancer", out now in JAMA Oncology. We talk about the real-world survival outcomes for pertuzumab and T-DM1, comparing these outcomes to the results of pivotal clinical trials CLEOPATRA and EMILIA.
Practice Patterns and Outcomes: doi.org/10.1001/jamaoncol.2021.2140
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Today's episode is a compilation of a few short monologues. We provide an oncologist's evidence-based medicine perspective on four papers: CheckMate 274, adjuvant nivolumab in urothelial cancer; PARADIGM-HF/Entresto; the POLO trial, olaparib in pancreas cancer; and the paper "An algorithmic approach to reducing unexplained pain disparities in underserved populations".
CheckMate 274: doi.org/10.1056/NEJMoa2034442 PARADIGM-HF: doi.org/10.1056/nejmoa1409077 POLO: doi.org/10.1056/NEJMoa1903387 Knee pain: doi.org/10.1038/s41591-020-01192-7
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Today we sit down (in person!) with Dr. Jeff Bien of Stanford University to break down all the details -- from the methods to the statistical analysis to the conclusions -- of the CheckMate 649 trial, which pitted first-line nivolumab plus chemotherapy against chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma.
CheckMate 649: doi.org/10.1016/S0140-6736(21)00797-2
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Today we have two short monologues for you on recent papers. The first, by popular request, is the problems with the VISION trial, which treated metastatic castration-resistant prostate cancer with lutetium-177–PSMA-617 (Lu-177–PSMA-617) radioligand therapy and standard of care. The second is on the paper recently published in Science titled "Fecal microbiota transplant promotes response in immunotherapy-refractory melanoma patients".
Fecal transplant: doi.org/10.1126/science.abb5920
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In today's quick episode, we talk about our new paper out now in JAMA Network Open titled "The Oncologic Drugs Advisory Committee Votes of April 2021—Implications for the Fate of Accelerated Approval"
ODAC Votes: doi.org/10.1001/jamaoncol.2021.3046
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We have a reverse episode for you today! Emma Greenstreet, a second-year medical student at UCSF, interviews our usual host, Dr. Vinay Prasad on why and how he chose hematology/oncology as a specialty, engaging with criticism, mentorship, medical student rotations, choosing a research project, and urging doctors in academia to aim higher.
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We sat down in person with Dr. Rahul Banerjee, a BMT/CAR-T fellow at UCSF, to talk about all manner of topics including CAR-T, randomized trials in oncology (and, specifically, Dr. Banerjee's two recent papers out now), social media, treating Multiple Myeloma, and how people make career decisions.
What Oncologists Can Learn From COVID-19: doi.org/10.1038/s41571-020-00448-y Are Observational, Real-World Studies Suitable: doi.org/10.1001/jamanetworkopen.2020.12119
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Today we are joined by Dr. Ameet Sarpatwari of Harvard Medical School to discuss how so many great minds in oncology are leaving cancer research in academia for industry. We also talk about the evidence (or lack thereof) behind the recent FDA approval of aducanumab to treat Alzheimer's disease.
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Today we have a short monologue for you on just a few topics: a treatment algorithm for follicular lymphoma and our host Dr. Prasad's new paper out now in the European Journal of Clinical Investigation: "Reliable, cheap, fast and few: What is the best study for assessing medical practices? Randomized controlled trials or synthetic control arms?"
RCTs or Synthetic Control Arms?: doi.org/10.1111/eci.13580
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Today we're back with another real-life (non-virtual!) interview. We're joined by Dr. Nina Shah of UCSF to discuss her career and her work in mutiple myeloma as well as the complexities of advancing your career -- dealing with productivity metrics like the h-index or the Kardashian index, switching institutions, balancing work with your home life, adapting to the changing field of oncology, and more.
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Today we sit down with Dr. George Sledge of the Stanford University Medical Center to hear the story of his career and to discuss the history of breast cancer research and treatment.
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Today we're launching season 4 of Plenary Session! This season we're returning to our love of monologues. On today's episode we talk about highlights from the recent annual meeting of the American Society of Clinical Oncology.
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On today's episode, we interview Dr. Marty Makary of Johns Hopkins School of Medicine and Bloomberg School of Public Health on how he chose his path in medicine, how health care as it is in the United States needs to change, and how groupthink dominated COVID-19 health policy. We discuss a variety of topics from his research on overuse, the prevalence of burnout in healthcare professionals, silos in medicine, to patients' lawsuits against hospitals. We touch on his two books, the latter of which has a new edition coming out next month that addresses COVID-19: Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care, and "The Price We Pay: What Broke American Health Care--and How to Fix It".
Unaccountable: https://www.bloomsbury.com/us/unaccountable-9781608198368/ The Price We Pay: https://www.bloomsbury.com/us/the-price-we-pay-9781635575910/
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Today we have a brief monologue for you on how to think about COVID-19 policy in the context of rare event and declining probabilities. We also touch on what to expect from season 4 of this podcast, as season 3 comes to an end.
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Today's episode is hosted by guest Logan Powell, an incoming medical student at the Texas A&M College of Medicine and creator of this podcast's show notes. He reverse interviews our usual host, Dr. Vinay Prasad, in honor of the one-year anniversary release of Dr. Prasad's book "Malignant: How Bad Policy and Bad Evidence Harm People with Cancer". They explore a few behind-the-scenes stories.
Show notes: www.plenarysessionpodcast.com
Listen to Malignant with a free 30-day trial of Audible: www.audible.com/pd/B08864KFHW/?so…ACX0_195112_rh_us
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Today we try something new. We're joined by five esteemed multiple myeloma experts for a back-and-forth round table discussion on the disease, including initial therapy, high risk, and maintenance. Our guests are Dr. Raj Chakraborty of Columbia University, Dr. Sam Rubinstein of the University of North Carolina Chapel Hill, Dr. Manni Mohyuddin of the University of Utah, Dr. Ben Derman of the University of Chicago, and Dr. Kevin Knopf of Highland Hospital.
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Today we bring back our popular Journal Club with a Fellow segment. We're joined by Dr. Karine Tawagi of the Oschner Clinic in Louisiana to discuss the CLEAR trial: "Lenvatinib plus Pembrolizumab or Everolimus for Advanced Renal Cell Carcinoma" as published in the New England Journal of Medicine.
CLEAR: doi.org/10.1056/NEJMoa2035716
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Our guest today is Dr. Joshua Briscoe of Duke University. We discuss Med-Psych (a joint internal medicine and psychiatry residency) and how it and palliative care connect to the human side to medicine: providing the care for quality of life and dignity that patients actually need, from comfortable bedding to physician-assisted suicide.
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We're joined today by Dr. Aaron Goodman, a hematologist/oncologist at the University of California San Diego, to discuss diffuse large B-cell lymphoma (DLBCL). We talk about bad cancer drugs and bad Twitter users.
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Today we sit down with Dr. Ioana Cristea of the University of Pavia, Italy and the Meta-Research Innovation Center at Stanford to discuss meta-research, reproducibility, and expertise. We also talk about our shared experiences as "early career researchers" (ECRs), also known as Early Stage Investigators, a term coined by the National Institutes of Health to describe researchers who earned their last research degree less than 10 years ago.
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Today we host a Classical Hematology Chat on thrombosis associated with COVID-19 vaccines. We're joined by Drs. Sven Olson and Joseph Shatzel of Oregon Health & Science University as we talk about cerebral venous thrombosis (CVT) and vaccine-induced immune thrombotic thrombocytopenia (VITT).
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Today we are joined by Genève Campbell, scholar of democracy and government, as we discuss sociology and politics in the context of COVID-19.
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Today we sit down with Dr. Bishal Gyawali of Queen's University in Kingston, Ontario, Canada and with Dr. Nathan Cherny of Shaare Zedek Medical Center in Jerusalem, Israel to talk about the European Society of Medical Oncology (ESMO) and the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS), which aims to improve cancer therapy decision-making.
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On today's episode, we sit down with Dr. Cathrine Axfors of the Meta-Research Innovation Center at Stanford (METRICS) to discuss how Sweden responded to COVID-19 and the nation's attention to what policies would be sustainable. We also touch on her paper "Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials" as well as school closures, data to support mask policies, and more!
Hydroxychloroquine: doi.org/10.1038/s41467-021-22446-z
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Today we talk with Dr. Avi Loeb of the Harvard-Smithsonian Center for Astrophysics about astronomy and the culture of the academy, as well as diving into topics discussed in his new book Extraterrestrial: The First Sign of Intelligent Life Beyond Earth.
Extraterrestrial: https://www.hmhbooks.com/shop/books/Extraterrestrial/9780358274551
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Today we talk with Dr. Mark Lythgoe, a Clinical Research Fellow at Imperial College London, on his new paper titled "Race reporting and diversity in US food and drug administration (FDA) registration trials for prostate cancer; 2006-2020", out now in Prostate Cancer and Prostatic Diseases.
Race Reporting: doi.org/10.1038/s41391-021-00361-0
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On today's episode, we invite Dr. Chris Whaley of RAND and Dr. Neeraj Sood of the USC Price School of Public Policy to discuss their new paper titled "Back to School: The Effect of School Visits During COVID-19 on COVID-19 Transmission", out now in the National Bureau of Economic Research.
Back to School: doi.org/10.3386/w28645
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Today our guest is Dr. Paul Edward Sax, Clinical Director of the Infectious Disease Clinic and Professor of Medicine at Harvard Medical School. We talk about all things COVID-19.
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On today's episode, we interview Dr. Roxana Daneshjou, a clinical scholar in dermatology and postdoctoral research fellow at Stanford University. We talk about artificial intelligence in dermatology and beyond.
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On today's episode, we have a short monologue for you on the recent CheckMate 577 study that was recently published in the New England Journal of Medicine. The title of the paper is "Adjuvant Nivolumab in Resected Esophageal or Gastroesophageal Junction Cancer".
CheckMate 577: doi.org/10.1056/NEJMoa2032125
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Today we're joined by Dr. Daniel Meyers of the University of Calgary who's here to discuss his new paper out now in the Journal of Cancer Policy. It's titled "Industry payments to US physicians for cancer therapeutics: An analysis of the 2016–2018 open payments datasets".
Industry payments: doi.org/10.1016/j.jcpo.2021.100283
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Today we sit down with Dr. Kirsten Bibbins-Domingo, Chair of the Department of Epidemiology and Biostatistics and the inaugural Vice Dean for Population Health and Health Equity in the UCSF School of Medicine. We talk about mentorship throughout a career, the unique value of epidemiology and biostatistics, finding passion in your work, disparities in healthcare during the COVID-19 pandemic, and more.
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Today we sit down with Dr. Monica Gandhi, Associate Division Chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/ San Francisco General Hospital, and medical director of the HIV Clinic at SFGH. We talk about ending COVID-19 pandemic restrictions, vaccination boosters, and more. She gives us the motivation we all need right now.
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Today we talk with Dr. Manni Mohyuddin of Kansas University Medical Center on his new paper out now in JAMA Network Open titled "Reporting of Postprotocol Therapies and Attrition in Multiple Myeloma Randomized Clinical Trials: A Systematic Review".
Postprotocol Therapies: doi.org/10.1001/jamanetworkopen.2021.8084
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On today's episode, we interview Dr. Jeffrey Flier, an esteemed endocrinologist and physician researcher who was Dean of the Faculty of Medicine at Harvard University for nine years (2007-2016). We talk about his career in academic medicine as well as the challenges of 2021.
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Today we bring back popular guest Dr. David Russler-Germain, a Hematology/Oncology Fellow at the Washington University School of Medicine in St. Louis, to discuss his thoughts on PhD programs (in response to a listener question) as well as his take on Idecabtagene vicleucel for multiple myeloma.
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Today we talk with Dr. Martin Kulldorff, a Professor of Medicine at Harvard Medical School and Brigham and Women's Hospital, about COVID-19 health policy and about disagreement.
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Today we bring back popular guest Dr. Adam Cifu, a Professor of Medicine at the University of Chicago, to talk about the idea of banning books. the power of social media, and the current state of medical education.
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Today we are joined by Samantha Godwin, a Resident Fellow for the Information Society Project at Yale Law School, to discuss COVID-19 health policy from a legal and philosophical perspective.
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Today we talk again with Dr. David Russler-Germain, a Hematology/Oncology Fellow at the Washington University School of Medicine in St. Louis, this time on the Medical Scientist Training Program (MSTP).
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Today we interview Dr. Tom Beer, the Deputy Director of the Oregon Health & Science University Knight Cancer Institute, about COVID-19 transmission, policy, and vaccines. We also talk about olaparib.
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Today we are joined by guest Dr. Carl Hart, a behavioral neuroscientist and Professor of Psychology at Columbia University. We discuss his research, his philosophies, and his new book "Drug Use for Grown-Ups."
Drug Use for Grown-Ups: https://www.penguinrandomhouse.com/books/534657/drug-use-for-grown-ups-by-dr-carl-l-hart/
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Today we bring back popular guest Dr. Bernie Marini, a Clinical Pharmacist Specialist in Hematology at University of Michigan Medicine, to discuss treatment of Acute Lymphoblastic Leukemia (ALL).
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Today we are joined by genomicist Dr. Nathan Pearson, founder of Root (rootdeep.com), to discuss which genetic alterations in the host predispose to SARS-CoV-2 acquisition and bad outcomes.
Gift of Life: www.giftoflife.org/page/content/covid19faq
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Today we bring back popular guest Jacob Hale Russell, an Associate Professor of Law at Rutgers Law School, for a discussion on expertise, disinformation, and intellectual disagreement.
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On today's episode we talk with popular guest Dr. Chris Booth of Queen's University in Kingston, Ontario, Canada about mapping out a career path after medical school and about his new paper out now in JAMA Oncology titled "Evolution of the Randomized Clinical Trial in the Era of Precision Oncology".
The Oncology RCT: doi.org/10.1001/jamaoncol.2021.0379
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Today we interview Dr. Ghulam Rehman Mohyuddin of Kansas University Medical Center on his new paper out now in The Lancet Haematology titled "Quality of control groups in randomised trials of multiple myeloma enrolling in the USA: a systematic review".
Control Groups: doi.org/10.1016/S2352-3026(21)00024-7
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Today we sit down with Dr. Matthew Smith, an associate professor in the Northeastern University Department of Philosophy and Religion, to discuss the morality and philosophical backbone behind COVID-19 vaccine distribution and how we should define equity; cancel culture and its historical longevity; and the impossibility (at least in the USA) of Zero COVID-19.
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For today's episode we have a short monologue in remembrance of famed cancer researcher Dr. José Baselga.
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Today we interview Dr. Aaron Richterman, an infectious disease specialist at Penn Medicine. We talk about updates on all things COVID-19 and we look back at how treatments, risk assessment, and behavior have changed.
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Today we interview Dr. Bob Wachter, the Chair of the Department of Medicine at University of California San Francisco. We talk about a wide range of topics including medicine, leadership, SARS-CoV-2, and social media.
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On today's episode we interview Youyang Gu, an independent data scientist who created some of the most models of the COVID-19 pandemic. He talks us through how he made the projections. His work is available on his website: https://covid19-projections.com/
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On today's SHORT episode, we talk about censorship, Facebook, Twitter, and the "evildoer" Dr. Marty Makary.
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Today we interview Dr. Robert Freudenthal, a psychiatrist in training at Barnet Enfield and Haringey Mental Health Trust in London, UK. We talk abut the power of the state and its role in public health policy. We focus specifically on how governments worldwide have responded to the COVID-19 pandemic, from extreme lockdowns to harm reduction advisories. We discuss how policy can be medical overreach as well as how it interplays with the criminal justice system and racial and class inequities. Finally, we discuss censorship and the need for trust and honesty in messaging.
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Today we interview Dr. Luc Morris of Memorial Sloan Kettering Cancer Center on his new paper out now in JAMA Oncology titled "Response Rates to Anti-PD-1 Immunotherapy in Microsatellite-Stable Solid Tumors With 10 or More Mutations per Megabase".
Response Rates: doi.org/10.1001/jamaoncol.2020.7684
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Today we interview Dr. Monica Gandhi, Associate Division Chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/ San Francisco General Hospital, and medical director of the HIV Clinic at SFGH, on COVID-19 interventions. We talk about results from the vaccine studies and how vaccination is perceived by the public. We talk about her new paper out now in The Lancet Infectious Disease on the importance of non-pharmaceutical interventions (masking, social distancing, ventilation, hand-washing) in controlling COVID-19. We also talk about the stark difference between messaging created from the point of view of an epidemiologist vs the public health messaging that frontline health care workers deliver directly to patients. We end the interview by talking about schools and the need to re-open them.
Importance of non-pharmaceutical interventions: doi.org/10.1016/S1473-3099(20)30982-8
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Today we interview Dr. Tracy Høeg on her new paper and her ongoing research into COVID-19 transmission in K-12 schools in Wisconsin, USA. Dr. Høeg is an epidemiologist and an interventional sports and medicine spine specialist at Northern California Orthopaedic Associates. Her paper is titled "COVID-19 Cases and Transmission in 17 K-12 Schools - Wood County, Wisconsin, August 31-November 29, 2020" and is published in the CDC's Morbidity and Mortality Weekly Report.
Cases in K-12 Schools: doi.org/10.15585/mmwr.mm7004e3
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On today's episode we interview Dr. Bryan Carmody, commonly known as the Sheriff of Sodium. He's a pediatric nephrologist at Children's Hospital of the King's Daughters in Virginia. We talk with him about the USMLE Steps (Step 1, Step 2, and Step 2 CS), their usefulness, their origins, and how to reform them. We also break down and discuss the inner workings of residency matching and the M.D. and D.O. designations.
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Today we sit down with Dr. Alex John London, the Clara L. West Professor of Ethics and Philosophy and Director of the Center for Ethics and Policy at Carnegie Mellon University, to discuss the role of philosophy, COVID-19 exceptionalism, and various aspects of COVID-19 health policy including masking, vaccination, and schools.
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On today’s episode we review the findings of the Beat AML study as published in Nature Medicine in an article titled “Precision medicine treatment in acute myeloid leukemia using prospective genomic profiling: feasibility and preliminary efficacy of the Beat AML Master Trial”.
Beat AML: doi.org/10.1038/s41591-020-1089-8
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For today's episode, we sit down with Drs. Ade Adamson of the University of Texas at Austin Dell Medical School and Ben Mazer of Johns Hopkins Hospital to discuss their new paper out now in the New England Journal of Medicine titled "The Rapid Rise in Cutaneous Melanoma Diagnoses". It's one of the best papers you'll read all year.
Melanoma Diagnoses: doi.org/10.1056/NEJMsb2019760
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For today's special episode, we sat down with Dr. John Ioannidis of Stanford University for an outdoor in-person interview. We take a deep dive into his work from 2000 all the way up to present day: his career from 2000 to 2010, his move to Stanford, and his work on COVID-19. We take a deep dive into his work on COVID-19: IFR, shielding ratio, the question of whether lockdown works, opening schools, and what public health policy should be.
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On today's episode we're joined by geneticist Dr. Francois Balloux, the Director of the University College London Genetics Institute and professor of computational systems biology, on pandemic mitigation, SARS-CoV-2 variants, how news and social media amplify fear over fact, opening schools, lethality and risk, the origin of SARS-CoV-2, COVID-19 vaccine efficacy and vaccine escape, and more!
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On today's episode we feature an in-depth interview with Dr. Julia Marcus (Associate Professor at Harvard Medical School) and Dr. Stefan Baral (Associate Professor at Johns Hopkins Bloomberg School of Public Health), two infectious disease epidemiologists, on public health messaging around COVID-19 -- what we're getting right and where we're going terribly wrong.
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On today's episode we sit down with Dr. Chris Booth of Queen's University in Kingston, Ontario, Canada to discuss his new paper out now in JAMA Oncology titled "An Analysis of Contemporary Oncology Randomized Clinical Trials From Low/Middle-Income vs High-Income Countries". We also talk about how COVID-19 has affected oncology research. We touch, too, on the topic of evaluating how you spend your time and prioritizing your research.
Contemporary Oncology RCTs: doi.org/10.1001/jamaoncol.2020.7478
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On today's episode we are joined by Jacob Hale Russell, an Associate Professor of Law at Rutgers Law School. We discuss his forthcoming book on skepticism, elites, and expertise, as well as his article out now on StatNews about the myth of COVID-19 denial. We talk about anti-intellectualism and how science ought to be debated in the era of trade-offs and COVID-19.
Straw Man of Pandemic Denial: www.statnews.com/2020/12/23/put-straw-man-pandemic-denial-out-of-its-misery/comment-page-1/
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On today's episode we sit down with Dr. Arye Elfenbein, a cardiologist and "doctorpreneur " to interview him on the bio-tech company he recently co-founded: Wildtype. Wildtype manufactures ex-vivo fish meat for human consumption in fulfillment of their mission to create the cleanest, most sustainable seafood.
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Today we interview Anne Sosin of Dartmouth College on public health policy in Vermont and how the state has uniquely tamed the COVID-19 pandemic.
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Today we sit down with Dr. Matthew Smith, an associate professor in the Northeastern University Department of Philosophy and Religion, for a far-ranging discussion on COVID-19 from a philosopher's point of view.
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Today we are joined by Dr. Aaron Goodman, an Assistant Clinical Professor at the University of California San Diego, who talks with us about hematologic malignancies, transplantation, and our new paper out now in Blood titled "Persistent Challenges with Treating Multiple Myeloma Early".
Persistent Challenges: doi.org/10.1182/blood.2020009752
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Today we talk with Dr. Stephen Bradley, a General Practitioner and Clinical Research Fellow at the University of Leeds, on publishing in medical journals -- peer review, editorial practices, anti-intellectualism, and more!
Notes on Nationalism: www.orwellfoundation.com/the-orwell-foundation/orwell/essays-and-other-works/notes-on-nationalism/
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Today we have for you an episode of random thoughts. We talk over the ramifications of the strict COVID-19 policy that prevents people from visiting their dying loved ones in the hospital. We also talk more about Norman Wang and his surrounding controversy given the recent lawsuit the Center for Individual Rights has filed against the University of Pittsburgh on his behalf.
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On today's episode we interview Dr. Bill Hall, Associate Professor of Radiation Oncology and Surgery at Medical College of Wisconsin, on our new paper out now in The Lancet Oncology titled "Considering benefit and risk before routinely recommending SpaceOAR".
SpaceOAR: doi.org/10.1016/S1470-2045(20)30639-2
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On today's episode we discuss censorship in medicine in all its forms with legal expert Jonathan Darrow, an Assistant Professor at Harvard Medical School.
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On today's episode we talk podcasting and the history of medicine with Dr. Adam Rodman, the creator and host of the wildly popular podcast Bedside Rounds, and a hospitalist at the Beth Israel Deaconess Medical Center.
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On today's episode we discuss all the new drugs for acute myeloid leukemia with Dr. Bernie Marini, a Clinical Pharmacist Specialist in Hematology at University of Michigan Medicine.
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Today's episode is an interview with Dr. Saurabh Jha, an Associate Professor of Radiology at the Hospital of the University of Pennsylvania, on the importance of debate and dialogue both historically and in today's modern context.
This is the second episode in our experiment in breaking our content up into bite-sized, single-topic episodes. What do you think? Do you prefer a shorter, single-focus episode, or do you prefer our old format?
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Now that we are nine months into the COVID-19 pandemic in the United States, we invite Dr. Alasdair Munro, a pediatrics infectious disease expert, back on to the show to discuss recent developments in public health policy concerning the spread of COVID-19, the risk of it, and children. We also talk about the rigorously policed echo chamber of Twitter, specifically #medtwitter, and finding an audience for controversial opinions. This week is also the start of an experiment in breaking our content up into bite-sized, single-topic episodes. What do you think? Do you prefer a shorter, single-focus episode, or do you prefer our old format?
Evidence summary of pediatric COVID-19: https://dontforgetthebubbles.com/evidence-summary-paediatric-covid-19-literature/
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This week we return to our roots of oncology and dissect the recent results from KEYNOTE-177. We also have an in-depth interview with mathematician Dr. Wes Pegden of Carnegie Mellon University on a mathematical approach to the COVID-19 pandemic.
KEYNOTE-177: doi.org/0.1056/NEJMoa2017699 COVID-19 Mathematical Model: https://math.cmu.edu/~wes/covid.html
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We have a short and sweet episode for you this week -- no monologue, just two deep-dives with two stellar guests. Our first interview is with Dr. Zubin Damania (known as ZDoggMD) and we cover everything from making original music to the artistry of professional oratory to the pain of electronic health records. Our second interview is a return to our popular segment Journal Club with a Fellow: We invite on Dr. Karine Tawagi of the Oschner Clinic in Louisiana to discuss the JAVELIN 100 study.
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Our first guests this week are Drs. Adam Cifu and Scott Stern and are on to discuss their new podcast Symptom to Diagnosis -- based on their book of the same name -- about clinical reasoning. Next we bring back political scientist Dr. Vlad Kogan (from episode 3.13) to discuss the need to re-open schools in the context of rising COVID-19 cases and a changing political landscape. Finally we interview Dr. Carycruz Bueno on her critical research into the harms of fully virtual schooling.
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First up this week we interview constitutional law scholar Leah Litman, an Assistant Professor of Law at the University of Michigan, on Dr. Norman Wang and the intricacies of the laws on affirmative action. Next, we talk with Dr. Patrick DeMartino, a pediatric hematology/oncology fellow at Oregon Health & Science University, on his new paper out now in JAMA Internal Medicine: "Potential Cost Implications for All US Food and Drug Administration Oncology Drug Approvals in 2018". Finally, we sit down with Dr. John Mandrola for an in-depth discussion on the intersection of medicine, politics, and advocacy.
Cost Implications: doi.org/10.1001/jamainternmed.2020.5921
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We have a multitude of interviews for you this week. We start by interviewing Dr. Julia Marcus of the Harvard Medical School and Harvard Pilgrim Health Care Institute on messaging around public health interventions during the COVID-19 pandemic. We continue talking about COVID-19 with Anne Sosin and Dr. Elizabeth Carpenter-Song, both of Dartmouth College. They join us on the podcast to discuss how the Northeast region of the United States has uniquely handled COVID-19. Finally, we bring back the Journal Club with a Fellow segment and interview Dr. David Russler-Germain of Washington University School of Medicine in St. Louis on a new paper out now in The Lancet on CAR T-cell therapy in DLBCL: TRANSCEND NHL 001.
TRANSCEND NHL 001: doi.org/10.1016/S0140-6736(20)31366-0
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We talk this week with Dr. Monica Gandhi, Associate Division Chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/ San Francisco General Hospital, and medical director of the HIV Clinic at SFGH. Speaking from decades of experience treating HIV/AIDS patients, she gives us her take on the public health policies enacted in response to the COVID-19 pandemic. We then conclude this week's episode with a Classical Hematology Chat with Dr. Sven Olson of Oregon Health & Science University.
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This week we have two fantastic interviews for you: The first is with Dr. Ben Mazer on the interplay between social media and news; the second is with Dr. Tem Bendapudi on whether Caplacizumab should be the standard of care for thrombotic thrombocytopenic purpura (TTP).
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This week we sit down virtually with Dr. Atle Fretheim, Research Director of the Norwegian Institute of Public Health, to talk about how Norway has responded to the COVID-19 crisis - specifically, how they've handled it when it comes to public schools. We also have an interview with Dr. Anthony "Tony" Letai of the Dana Farber Cancer Center on cancer biology.
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We start this week's episode off with a monologue covering a few current events, notably the recent editorial on the COVID-19 pandemic in the USA published by the New England Journal of Medicine titled "Dying in a Leadership Vacuum". From there we interview Dr. Margaret McCartney on her recent opinion piece in the BMJ titled "We need better evidence on non-drug interventions for covid-19"; we talk about masks, schools, the need for randomized trials, and more. Finally, we interview Dr. Jason Sheltzer on his recent papers on cancer biology and the implications of his findings on clinical medicine.
NEJM editorial: doi.org/10.1056/NEJMe2029812 Non-Drug Interventions: https://blogs.bmj.com/bmj/2020/08/28/margaret-mccartney-we-need-better-evidence-on-non-drug-interventions-for-covid-19/ Dr. Sheltzer's research: https://www.sheltzerlab.org/research You can reach Dr. Sheltzer at sheltzer at cshl dot edu.
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We start this week's episode by interviewing Dr. Alasdair Munro, a pediatrics infectious disease expert, on the risk of spread of COVID-19 in children and through schools. We end with an interview with Dr. Stefan Baral, a field epidemiologist studying COVID-19, on the nature of public health during a global pandemic.
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This week we have a two-hour-long, far-ranging interview with Dr. John Ioannidis of Stanford University on, broadly, meta-research and COVID-19 - including his recent controversies. We end the episode with an interview with Dr. Mary-Elizabeth Percival of the University of Washington on her new paper out now in Haematologica: "Survival of patients with newly diagnosed high-grade myeloid neoplasms who do not meet standard trial eligibility".
High-Grade Myeloid Neoplasms: doi.org/10.3324/haematol.2020.254938
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This week's episode is all about COVID-19. We discuss general COVID-19 health policy and how spread of SARS-CoV-2 has been managed and should be managed; we discuss whether or not schools should be re-opened; and we discuss Dr. Scott Atlas's views. Our special guests are political scientist Dr. Vladimir Kogan, epidemiologist Dr. Daniel Morgan, and health economist Dr. Jay Bhattacharya.
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We start this week's episode by critically examining the new paper titled "Racial/Ethnic Variation in Nasal Gene Expression of Transmembrane Serine Protease 2 (TMPRSS2)" and asking, is it racist? After that, we discuss advances in prostate cancer imaging with two imaging specialists from Memorial Sloan Kettering Cancer Center, Drs. Anton Becker and Sungmin Woo. Finally, we have a far-reaching interview with Dr. Thomas Newman of University of California San Francisco on clinical epidemiology and his new book Evidence-Based Diagnosis: An Introduction to Clinical Epidemiology.
TMPRSS2 and COVID-19: doi.org/10.1001/jama.2020.17386 PSMA PET-CT: doi.org/10.1016/S0140-6736(20)30314-7 Evidence-Based Diagnosis: https://www.cambridge.org/core/books/evidencebased-diagnosis/2807345CA679EC723697ED9C6D98A1AA
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This week's monologue touches on the credibility of expert speakers, evaluating the COVID-19 lockdown as health policy, and the anti-affirmative action white paper written by Dr. Norman Wang and its controversy. In the second half of the episode we interview Professor Darrel Francis of Imperial College London on COVID-19 cardiology and Vascepa.
Anti-Affirmative Action: doi.org/10.1161/JAHA.120.015959
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We have a number of topics for you this week! Among them, we cover the issue of colon cancer screening, especially in the light of Chadwick Boseman's recent passing. We interview Jonathan Darrow, an Assistant Professor at Harvard Medical School and faculty at Brigham and Women's Hospital, on patent litigation and the recent patent appeal for Vascepa. Finally, we interview Dr. Toby Richards, Professor of Surgery, on running clinical trials and, specifically, the results of his recent trial PREVENTT, out now in The Lancet.
PREVENTT: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31539-7/fulltext
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We start this week's episode by revisiting our discussion from last week on the PNAS study on racial concordance and birthing mortality. We continue our theme of critical appraisal by then tearing apart the recent paper published in BMJ titled "Two metres or one: what is the evidence for physical distancing in covid-19?" and its inability to support its colorful figures. We end the monologue with a few thoughts on academics who somehow author one paper a week. Finally, we turn to the last two segments of the show: the first is a discussion with Dr. Bishal Gyawali on his new paper out now in The Lancet Haematology titled "A survey in Nepalese patients with acute leukaemia: a starting point for defining financial toxicity of cancer care in low-income and middle-income countries" and the second is Journal Club with a Fellow, where we interview Dr. Justine Ryu on a paper published in The Lancet titled "Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial".
Racial Concordance: doi.org/10.1073/pnas.1913405117 COVID-19 Risk: doi.org/10.1136/bmj.m3223 Financial Toxicity: doi.org/10.1016/S2352-3026(20)30258-1 HALT-IT: doi.org/10.1016/S0140-6736(20)30848-5
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This week we take a deep dive into two recently published studies, their surrounding controversy, and the broader implications. The first study was published in the journal Proceedings of the National Academy of Sciences of the USA and is titled "Physician–patient racial concordance and disparities in birthing mortality for newborns". The second was published in the New England Journal of Medicine and is titled "Oral Relugolix for Androgen-Deprivation Therapy in Advanced Prostate Cancer", commonly known as the HERO trial. We discuss the HERO trial with Dr. Michael Burns of Northwestern as part of our new segment, Journal Club with a Fellow.
Racial Concordance: doi.org/10.1073/pnas.1913405117 HERO: doi.org/10.1056/NEJMoa2004325
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We have a lot in store for you this week! We start off by evaluating two recently published studies: "Evaluation of Omics-Based Strategies for the Management of Advanced Lung Cancer" (published in the Journal of Clinical Oncology: Oncology Practice) and "The Effect of Advances in Lung-Cancer Treatment on Population Mortality" (published in the New England Journal of Medicine). We talk a bit about tracking down the validity of a reference. We sit down with Dr. Branden Tarlow to discuss his thoughts on PPIs and COVID-19 acquisition. Finally, we conclude the episode by interviewing Dr. Elizabeth Eisenhauer of Queen's University in Kingston, Ontario, Canada on her career in cancer medicine.
Omics-Based Strategies: doi.org/10.1200/OP.20.00117 Population Mortality: doi.org/10.1056/NEJMoa1916623
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We start this week's episode by discussing access to investigational COVID-19 vaccines and recapping the problems with the ADAURA study. We transition from there to a Question of the Week with medical student Audrey Tran of Oregon Health & Science University. Finally, we introduce a new segment - Journal Club with a Fellow. In this inaugural segment we invite Dr. Karine Tawagi of the Oschner Clinic in Louisiana to the podcast to talk about IMbrave150.
IMbrave150: doi.org/10.1056/NEJMoa1915745
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This is the recording of a LIVE episode of Plenary Session in which Dr. Sue S Yom interviewed our host, Dr. Vinay Prasad, on how he built his career and how he conceptualizes his work. There's also a surprise guest near the end! Thank you to Dr. Kaleigh Doke, Dr. Brian Kavanagh, and the Virtual Visiting Professor Network for hosting this special episode.
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This week we respond to several questions sent in by listeners and then we interview Dr. Bishal Gyawali of Queen's University in Kingston, Ontario, Canada on MedTwitter, other recent events, and his recently published paper titled "Assessing the risk-benefit profile of ramucirumab in patients with advanced solid tumors: A meta-analysis of randomized controlled trials".
Ramucirumab: doi.org/10.1016/j.eclinm.2020.100458
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This week we discuss two major papers: The first was just recently released in Nature and it's titled "The National Lung Matrix Trial of personalized therapy in lung cancer". The second is a few years old, but exemplifies the importance of trial design. We discuss the second paper, titled "A Randomized Trial of Intensive versus Standard Blood-Pressure Control" and published in the New England Journal of Medicine with Dr. Mark Friedberg, a health policies and performance measurement researcher.
National Lung Matrix Trial: doi.org/10.1038/s41586-020-2481-8 SPRINT: doi.org/10.1056/NEJMoa1511939
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This week's BONUS episode is a discussion of the National Clinician Scholars Program with Dr. Hilary Seligman, the head of the program at University of California, San Francisco. The deadline for the application for the 2021-2023 cohort is July 15, 2020 (very soon!), though there may be some leniency due to the pandemic.
National Clinician Scholars Program: https://nationalcsp.org/ UCSF National Clinician Scholars Program: https://nationalscholars.ucsf.edu/
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This week we discuss recent research (and the accompanying Twitter thread) on the risk of COVID-19 among users of proton pump inhibitors (PPIs). We also hold a philosophical discussion on the research surrounding time to treatment initiation (TTI) in cancer medicine. We end the episode with an interview with Dr. Lynora Saxinger of the University of Alberta, Edmonton, a specialist in Infectious Diseases.
PPIs and risk of COVID-19: https://twitter.com/BrennanSpiegel/status/1280527527325265920
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This BONUS episode is the recording of a lecture given on June 18, 2020 as part of Stanford's METRICS International Forum. METRICS stands for Meta-Research Innovation Center at Stanford University. This lecture is geared towards a broad audience and aims to provide a general sense of current cancer research. The lecture is titled "Cancer Meta-Research 101".
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This week we respond to some listener feedback from Dr. Christopher Booth and use it to talk about how to be the best hematologist-oncologist. We also discuss the SADAL study on Selinexor for patients with relapsed refractory diffuse large B-cell lymphoma, as published in The Lancet Haematology. Finally, we interview Drs. Eva Katsoulakis and Michael Kelley on their recent paper out in the Journal of Clinical Oncology: Precision Oncology, titled "Comparison of Annotation Services for Next-Generation Sequencing in a Large-Scale Precision Oncology Program".
Selinexor: doi.org/10.1016/S2352-3026(20)30120-4 Annotation Services: doi.org/10.1200/PO.19.00118
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This week we briefly cover updates on the RECOVERY trial before segueing into an interview with Dr. Andrae Vandross on Twitter (specifically #medtwitter), academic discussions, and changing your career to find your calling.
RECOVERY: www.recoverytrial.net/
Malignant audiobook: www.audible.com/pd/B08864KFHW/?so…ACX0_195112_rh_us
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This week's episode is jam-packed with topics! We talk about the RECOVERY trial, the U.S. clinical trial infrastructure, event-free survival (EFS) and cost of care in acute myeloid leukemia, how long it takes to write papers in academic medicine, threats to public health officials, and the application to medicine of Dr. Raj Chetty's work in economics. Finally, we interview this week's special guest, Dr. Ian Tannock, on docetaxel, prostrate cancer, clinical trial appraisal, and his career in medicine.
RECOVERY: https://www.recoverytrial.net/ EFS in AML: doi.org/10.1182/bloodadvances.2019001150
Malignant audiobook: https://www.audible.com/pd/B08864KFHW/?source_code=AUDFPWS0223189MWT-BK-ACX0-195112&ref=acx_bty_BK_ACX0_195112_rh_us
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This week we tackle the topic of tucatinib in HER2-positive breast cancer with brain metastases. We also interview Dr. Cailin O'Connor of the University of California Irvine on her research on misinformation and disinformation. We discuss her recent article in the Boston Review, titled "Hydroxychloroquine and the Political Polarization of Science", as well as her extensive body of work.
HER2CLIMB: doi.org/10.1200/JCO.20.00775 Hydroxychloroquine: http://bostonreview.net/science-nature-politics/cailin-oconnor-james-owen-weatherall-hydroxychloroquine-and-political The Dynamics of Retraction in Epistemic Networks: http://philsci-archive.pitt.edu/17088/ How Misinformation Spreads: https://www.scientificamerican.com/article/how-misinformation-spreads-and-why-we-trust-it/
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We start this week's episode by covering some recent research: After thoroughly critiquing the recent randomized trial of hydroxychloroquine for postexposure prophylaxis for COVID-19, we then discuss the five abstracts selected for plenary sessions at the recent virtual meeting of the American Society of Clinical Oncology. We transition from there to a Question from a Medical Student with Audrey Tran of Oregon Health & Science University on the recent decision to make the USMLE Step 1 exam pass/fail. Finally, we end with an interview with Dr. Jane Zhu, also of OHSU, on her current research and her new paper published in JAMA titled, "Private Equity Acquisitions of Physician Medical Groups Across Specialties, 2013-2016". Dr. Zhu first guest-starred on Plenary Session in episode 1.31.
Hydroxychloroquine: doi.org/10.1056/NEJMoa2016638 JAVELIN: https://meetinglibrary.asco.org/record/186872/abstract ECOG-ACRIN: https://meetinglibrary.asco.org/record/186884/abstract ENDURANCE: https://meetinglibrary.asco.org/record/186906/abstract KEYNOTE-177: https://meetinglibrary.asco.org/record/186928/abstract ADAURA: https://meetinglibrary.asco.org/record/191929/abstract Private Equity Acquisitions: doi.org/10.1001/jama.2019.21844
Listen to the audiobook of Malignant with a free 30-day trial from Audible! https://www.audible.com/pd/B08864KFHW/?source_code=AUDFPWS0223189MWT-BK-ACX0-195112&ref=acx_bty_BK_ACX0_195112_rh_us
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This week we talk all things COVID-19! We start with an in-depth Classical Hematology Chat with Dr. Sven Olson and Dr. Joseph Shatzel of Oregon Health & Science University on thrombosis and anticoagulation in COVID-19, touching on a number of recent studies. We then turn to a conversation with Dr. Walid Gellad of the University of Pittsburgh on new pharmaceutical treatments for COVID-19.
Tang et al. paper: doi.org/10.1111/jth.14768 Prospective autopsy study: doi.org/10.7326/M20-2566 COVID-19 compared to H1N1: doi.org/10.1056/NEJMoa2015432 Hypercoagulability of COVID-19: doi.org/10.1111/jth.14850 JACC letter: doi.org/10.1016/j.jacc.2020.05.001 JACC podcast: https://podcasts.apple.com/us/podcast/association-treatment-dose-anticoagulation-in-hospital/id932118437?i=1000474262300 Venous Thromboembolism in COVID-19: doi.org/10.1111/jth.14888
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This week we discuss why being open-minded enough to agree partially with someone - instead of taking an all-or-nothing approach to a discourse - is important. We also sit down with epidemiologist Dr. Daniel Morgan of the University of Maryland School of Medicine to critique the public health policy concerning COVID-19 transmission.
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This week we have an announcement -- the audiobook of "Malignant: How Bad Policy and Bad Evidence Harm People with Cancer", written and narrated by our host Vinay Prasad, is available now on Amazon, iTunes, and Audible! We also have an in-depth journal club for you on the findings of the PROfound trial as published in a new paper out in the New England Journal of Medicine titled "Olaparib for Metastatic Castration-Resistant Prostate Cancer". Finally, we end the episode with an interview with Dr. Adam Cifu of the University of Chicago on literature, medicine, maintaining a feeling of normalcy and self during COVID-19, and more!
Listen to Malignant with a free 30-day trial of Audible: https://www.audible.com/pd/B08864KFHW/?source_code=AUDFPWS0223189MWT-BK-ACX0-195112&ref=acx_bty_BK_ACX0_195112_rh_us
PROfound: doi.org/10.1056/NEJMoa1911440 Crossover: doi.org/10.1093/annonc/mdy116
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This BONUS lecture was a talk given to the Hematology/Oncology fellows at Oregon Health & Science University. It's part three of a three-part series on clinical trials.
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This week's topic is all things COVID-19 -- we discuss the viral scandal of British epidemiologist Neil Ferguson's actions and how it reflects (or doesn't) on his work, we talk about the nuances of how to end lockdowns, and we bring back Dr. Benjamin Singer, a pulmonary and critical care physician at Northwestern University, to address updates in the ICU management of COVID-19.
Invisible Pandemic: doi.org/10.1016/S0140-6736(20)31035-7
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This week we begin with a monologue on the recent controversy surrounding Dr. John Ioannidis's published opinions on the COVID-19 pandemic. We end with a group discussion with Oregon Health & Science University's Hematology/Oncology fellows on our host's, Vinay Prasad's, new book "Malignant: How Bad Policy and Bad Evidence Harm People with Cancer."
Expressing different views on COVID-19: https://www.statnews.com/2020/04/27/hear-scientists-different-views-covid-19-dont-attack-them/ Malignant: www.amazon.com/Malignant-Policy-Evidence-People-Cancer/dp/1421437635
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This week we have a BONUS episode for you! As a teaser to the forthcoming audiobook of "Malignant: How Bad Policy and Bad Evidence Harm People with Cancer" by Dr. Vinay Prasad (our host), Audrey Tran and Ian Straehley have set the introduction of the book to music they composed and arranged themselves.
You can buy the print version of Malignant from Amazon: https://www.amazon.com/Malignant-Policy-Evidence-People-Cancer-dp-1421437635/dp/1421437635/
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This week we start with an in-depth monologue on various new developments surrounding COVID-19, specifically the new study in NEJM on the compassionate use of remdesivir as well as the CDC's advice for the general public to wear cloth masks. We end with an interview with Dr. Ameet Sarpatwari of Harvard Medical School on how to create a more effective pharmaceutical system, the CREATES Act of 2019, developing fair and equitable drugs to treat COVID-19, and how to create a just system that balances the need for innovation with the need for access. Dr. Ameet Sarpatwari is the Assistant Director of PORTAL.
Compassionate Use of Remdesivir: doi.org/10.1056/NEJMoa2007016 U.S. Gene Therapy Trials: doi.org/10.1001/jama.2019.22214 NIH Fair Pricing Condition: doi.org/10.7326/M19-2576
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This week we have a far-reaching monologue on COVID-19 and how people are reacting to the public health recommendations concerning COVID-19 (such as cancelling conferences and school, maintaining 6+ feet of distance, wearing cloth masks). We end with an insightful interview with Dr. Venk Murthy on polygenic risk score and, at the end, a bit about how the world of science is failing to combat hype.
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This week we discuss several recent articles on the novel coronavirus (SARS-CoV-2) and COVID-19, specifically Dr. Siddhartha Mukherjee's article on the history and science of humanity's history with viruses, Dr. Ezekiel Emanuel's essay on how to fairly allocate dwindling medical resources during this global pandemic, and Dr. John Ioannidis's article on the "evidence fiasco" that has been our response to COVID-19. We end the episode with a Classical Hematology Chat with Drs. Sven Olson and Joseph Shatzel.
Dr. Mukherjee's article: https://www.newyorker.com/magazine/2020/04/06/how-does-the-coronavirus-behave-inside-a-patient Allocation of Medical Resources: doi.org/10.1056/NEJMsb2005114 Dr. Ioannidis's article: https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/
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This week we discuss management of COVID-19 in the intensive care unit with Dr. Benjamin Singer, a pulmonary and critical care physician at Northwestern University. We discuss medications, PPE, ventilators, and more!
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This bonus episode is an interview from March 16, 2020 with Dr. John Townes, the Interim Head for the Division of Infectious Disease and the Medical Director for Infection Prevention and Control here at Oregon Health & Science University. We talk about the novel coronavirus and how healthcare professionals are responding to the COVID-19 pandemic, with a focus on Oregon.
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This week we discuss two recent papers -- one we praise, one we condemn -- and then we turn to a question of the week with medical student Audrey Tran on self-improvement and "refining conviction". The first paper is titled "Patient Experience Captured by Quality-of-Life Measurement in Oncology Clinical Trials" and the second is titled "Overall survival in patients with pancreatic cancer receiving matched therapies following molecular profiling: a retrospective analysis of the Know Your Tumor registry trial".
Quality of Life Measurement: doi.org/10.1001/jamanetworkopen.2020.0363 KnowYourTumor: doi.org/10.1016/S1470-2045(20)30074-7
Vinay's new book, Malignant: www.amazon.com/Malignant-Policy-…cer/dp/1421437635
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This BONUS lecture was a talk given to the Hematology/Oncology fellows here at Oregon Health & Science University. It's part two of a three-part series on clinical trials. This talk is on clinical trial design, specifically crossover and control arms.
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This week we revisit BEACON! The authors of the BEACON study have responded to the Letter to the Editor our host Dr. Vinay Prasad submitted to the New England Journal of Medicine, and we share our thoughts on what they said. We then turn to the FDA's recent approval of neratinib in combination with capecitabine for HER2-positive breast cancer, based on the phase III NALA trial. Finally, we interview Dr. David Carr, a Molecular Pathology Fellow at UC San Diego, on his work in general and, specifically, next-generation sequencing.
BEACON Letters to the Editor: www.nejm.org/doi/full/10.1056/NEJMoa1908075#article_letters NALA: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-neratinib-metastatic-her2-positive-breast-cancer
Vinay's new book, Malignant: www.amazon.com/Malignant-Policy-…cer/dp/1421437635
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Our guest this week is Dr. Michael Hengartner of the Zurich University of Applied Sciences. We interview him on his work studying the long-term consequences and effectiveness of newer-generation antidepressants - specifically focusing on selective serotonin reuptake inhibitors (SSRIs).
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We start this episode by diving deep into KEYNOTE-048, the randomized, open-label, phase 3 study of pembrolizumab alone or with chemotherapy v.s. cetuximab with chemotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck (HNSCC). We transition from there to a continued discussion on careerism in academia and how the motivation behind publishing papers should always stem from the drive to disseminate information, not from the drive to advance your own career. We end the episode with an interview with Dr. Bishal Gyawali of Queen's University in Kingston, Canada on his recent paper out in Nature Cancer on global oncology. Specifically, Dr. Gyawali addresses the need for conducting cancer clinical trials in low- and middle-income countries.
KEYNOTE-048: doi.org/10.1016/S0140-6736(19)32591-7 Opportunities for Cancer Clinical Trials in LMIC: doi.org/10.1038/s43018-020-0030-x
Vinay's new book, Malignant: www.amazon.com/Malignant-Policy-…cer/dp/1421437635
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We have a full slate for you this week! We discuss careerism in medicine, presenting abstracts at conferences, #MedTwitter, and Dr. Califf's opinions on the K-Index. We conclude the episode with our first-ever Classical Hematology Chat, featuring our host Dr. Vinay Prasad, Dr. Sven Olson, and Dr. Joseph Shatzel. The chat is on sickle cell disease.
"A Perspective on the K-Index": doi.org/10.1016/j.jaccas.2020.01.003
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This week we discuss the concept of "thought leaders" and we examine the conclusions about volume CT screening for lung cancer from the NELSON trial. We end with an interview with Dr. Sam Rubinstein, a hematology/oncology fellow at Vanderbilt University Medical Center, on his new paper published in JAMA Network Open titled "Indication of Measures of Uncertainty for Statistical Significance in Abstracts of Published Oncology Trials: A Systematic Review and Meta-analysis".
NELSON: doi.org/10.1056/NEJMoa1911793 Measures of Uncertainty: doi.org/10.1001/jamanetworkopen.2019.17530
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This BONUS episode is the recording of a lecture given to medical students titled "How to Keep Up with the New Information in Medicine." It's a primer on the steps healthcare professionals need to take in order to keep abreast of the latest medical findings.
Vinay's new book, Malignant: www.amazon.com/Malignant-Policy-…cer/dp/1421437635
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We have a variety of topics for you this week! We tackle red light therapy, polatuzumab olatuzumab vedotin in relapsed or refractory diffuse large b-cell lymphoma; we have a hematology/oncology question of the week from Dr. Emerson Chen of OHSU; and we sit down with Dr. Ali Khaki of the Fred Hutchinson Cancer Research Center to discuss his recent paper critiquing TAILORx.
Pola for DLBCL: doi.org/10.1200/JCO.19.00172 Financial COI on Twitter: doi.org/10.1001/jamainternmed.2016.8467 Ignoring Valuable Data: doi.org/10.6004/jnccn.2019.7363
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This week we're treating you to a recording of the Grand Rounds lecture on overdiagnosis and cancer screening that Dr. H Gilbert Welch gave at Oregon Health & Science University on October 30, 2019. Before the lecture, we take a moment to reiterate with renewed vigor our distaste for the POLO trial (first discussed in episode 1.64).
POLO: doi.org/10.1056/NEJMoa1903387
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This BONUS lecture was a talk given to the Hematology/Oncology fellows here at Oregon Health & Science University. It's part one of a three-part series on clinical trials, titled "Thinking Better About Cancer Medicine".
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This week we answer a few questions: the first is from Patreon backer, Harry Hong, on Kaplan-Meier curves. The second is from a student at Mount Sinai Medical School who reached out with some ethical questions they had after the ASH annual meeting on the obligations and responsibilities of peer reviewers. Finally, we end the episode with an interview with Dr. Bishal Gyawali of Queens University in Kingston, Ontario, Canada on his new paper out today in the Journal of the National Comprehensive Cancer Network titled "Response Rates and Durations of Response for Biomarker-Based Cancer Drugs in Nonrandomized Versus Randomized Trials".
Durations of Response: doi.org/10.6004/jnccn.2019.7345
Vinay's new book, Malignant: www.amazon.com/Malignant-Policy-…cer/dp/1421437635
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This week we return to our discussion of going after soft targets vs hard targets, but this time with a focus on how it applies to building a burgeoning career in medicine, in our segment Questions from a Medical Student with Audrey Tran. We end this week's episode with a far-reaching interview with Dr. Ellie Murray (most people know her as Epi Ellie on Twitter and as the co-host of the podcast Casual Inference) on all things epidemiology.
Check out Dr. Murray's excellent podcast here: https://casualinfer.libsyn.com/
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This week we wonder incredulously how this abstract from ASH titled "Time from diagnosis to treatment does not affect outcome in intensively treated patients with newly diagnosed acute myeloid leukemia" was selected as one of the top abstracts from the conference. In the second half of the episode we interview Dr. Sherrie Aspinall of the Veterans Administration on how to use real-world data. Her new paper is titled "Use of targeted therapies for advanced renal cell carcinoma in the Veterans Health Administration".
Time from diagnosis to treatment in AML: https://ashpublications.org/blood/article-lookup/doi/10.1182/blood-2019-123717 Targeted therapies for advanced RCC: doi.org/10.1002/cam4.2531
Vinay's new book, Malignant: www.amazon.com/Malignant-Policy-…cer/dp/1421437635
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We're back in Plenary Session HQ! We have multiple topics for you this week. We cover the use of trastuzumab in later lines of therapy for HER2+ metastatic breast cancer, we take a listener question on Kaplan-Meier curves, and we talk a little about Patreon.
Malignant: www.amazon.com/Malignant-Policy-Evidence-People-Cancer/dp/1421437635
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This BONUS episode is an interview with Dr. Arjun Gupta, a second-year hem/onc fellow at Johns Hopkins University, on his new paper out TODAY in JAMA Oncology titled ''Use of Bone-modifying Agents among Medicare Beneficiaries with Multiple Myeloma''.
Use of bone-modifying agents: doi.org/10.1001/jamaoncol.2019.5426
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This is the last week of pre-recorded episodes -- we'll be back next week with a fresh, hard-hitting monologue. In the meantime, we have three questions of the week for you. Two are inspired by the hematology/oncology boards and are presented by Dr. Sven Olson. Between the two, we have one from Ian Straehely that's inspired by the USMLE Step 2 CK.
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Our host is still out of town, but don't worry -- we have some questions of the week to tide you over. The first is inspired by the hematology/oncology boards, presented by Dr. Sven Olson; the second is inspired by the USMLE Step 2 CK, presented by Ian Straehley; and the third is from Audrey Tran, inspired by her experiences as a med student.
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This week our host is still in Australia, but we have some questions of the week saved for you! The first is inspired by the USMLE Step 2 CK, presented by Ian Straehley; the second is inspired by the hematology/oncology boards, presented by Dr. Sven Olson; and the third is from Audrey Tran, inspired by her experiences as a med student.
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First up this week is Question of the Week inspired by the Hematology/Oncology boards, with Dr. Sven Olson. No monologue on current trials this week because our host is still in Australia, so we conclude the episode with an interview with Dr. Jonathan Kimmelman of McGill University on his extensive work in research ethics, studying the most important issue in cancer medicine today: the risk-benefit of clinical trials and how best to spare patients from the burdens of creating a new drug.
Review of Sunitinib: doi.org/10.1093/jnci/djv292 Benefit, Burden, and Impact: doi.org/10.1177/1740774519873883
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This week we have a question of the week from Ian Straehley, inspired by the USMLE Step 2 CK, as well as an interview with Dr. Robert Hirschtick of Northwestern University on what it means to be a doctor, how you should think as a physician, and his many popular pieces published in journals like JAMA.
"Copy-and-Paste": doi.org/10.1001/jama.295.20.2335 "Extremities": doi.org/10.1001/jama.300.10.1125 "The Quick Physical Exam": doi.org/10.1001/jama.2016.8182 Robiewon on YouTube: www.youtube.com/channel/UC2Ki7Zbo2VCGQAYinsJhU3w "You Did Not Teach Me What You Thought You Did": doi.org/10.1001/jama.2019.15849
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We begin this week's episode by addressing a listener's feedback to our discussion of smoldering multiple myeloma. We then expand on our critique of 'going after the soft targets' (criticizing studies that fall apart with little resistance) by elucidating how to identify and go after hard targets and why it's so important that you do. Finally, we launch into an interview with Dr. H Gilbert Welch that explores his tremendous body of work on the preventable harm that comes from too generous a hand with novel diagnostic advances.
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We begin this week's episode with a thoughtful discussion of the internet's "courageous skeptics". Then, after lamenting the way in which the recent study "Randomized Trial of Lenalidomide Versus Observation in Smoldering Multiple Myeloma" was conducted, we end with an interview with Dr. Andy Saultz on his ongoing campaign for Oregon state representative. We break up the interview with a couple Hem/Onc boards questions of the week from Dr. Emerson Chen.
Lenalidomide in Smoldering Multiple Myeloma: doi.org/10.1200/JCO.19.01740
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This week we give a short monologue on the late Dr. Bernard Fisher's legacy in the field of oncology, and then dive into a far-ranging interview with Dr. Mark Lewis of Intermountain Healthcare on his career, his family, and diagnosing himself with MEN1 syndrome.
Dr. Fisher's obituary in the New York Times: https://www.nytimes.com/2019/10/19/science/dr-bernard-fisher-dead.html
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This week we begin with a critique of the recent perspective article in the New England Journal of Medicine, titled "Talking about Toxicity — 'What We’ve Got Here Is a Failure to Communicate'". After that we interview Dr. Eitan Amir on his paper on undisclosed conflicts of interest among authors of ASCO guidelines. Interspersed between segments of the interview, we invite guest Dr. Sven Olson on to offer a correction to a recent Hem/Onc boards question of the week on Lynch Syndrome (original question posed in episode 2.11) and we invite Ian Straehley on for a question of the week inspired by the USMLE Step 2 CK.
Talking about toxicity: doi.org/10.1056/NEJMp1908310 COI among authors of ASCO guidelines: doi.org/10.1002/cncr.32408 Transparency in medicine: doi.org/10.1002/cncr.32407
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We start this week's episode with a quick breakdown of why the recent BEACON trial is "the worst trial" host VP has ever read. After that, we have two questions of the week: one from medical student Audrey Tran, and one inspired by the Hem/Onc boards from Dr. Sven Olson. We end with an interview with Dr. Jonathan Yeh of Johns Hopkins University School of Medicine on his recent paper: "Has There Been a Shift in Use of Subacute Rehabilitation Instead of Hospice Referral Since Immunotherapy Has Become Available?".
BEACON: doi.org/10.1056/NEJMoa1908075 Subacute Rehabilitation: doi.org/10.1200/JOP.19.00044
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This week we break down the limitations of the recent FLAURA trial and then we're back in the Plenary Session Mobile Command Unit! We have a special guest host, Dr. Christopher Booth of Queen's University in Kingston, Ontario, Canada. He and Dr. Bishal Gyawali, also of Queen's University, conduct a reverse interview with our usual host, Dr. Vinay Prasad of Oregon Health & Science University, on his career, the formation of Plenary Session, and what truly matters in the career of an academic physician.
FLAURA: doi.org/10.1056/NEJMoa1713137 Price of an Anticancer Drug: doi.org/10.1001/jamainternmed.2017.3601 Simply Measurable or Clinically Meaningful? doi.org/10.1200/jco.2011.38.7571 The Emperor Has No Clothes: doi.org/10.1200/JCO.2008.19.5594 Making Room in Oncology: www.medscape.com/viewarticle/917628
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This BONUS episode is an interview with Dr. Michael Raphael of Sunnybrook Health Sciences Centre in Toronto, Ontario on his new paper out today in JAMA Oncology: "The value of progression-free survival as a treatment endpoint among patients with advanced cancer: a systematic review and qualitative assessment of the literature".
Value of PFS: https://jamanetwork.com/journals/jamaoncology/article-abstract/2751879
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This week we sit down with Dr. Jeremy Cetnar, director of the Oregon Health & Science University Hematology & Oncology Fellowship Program. In this far-ranging interview, we discuss what he is looking for when reviewing applications to the fellowship program. We also have two questions of the week: one from Dr. Derrick Tao, inspired by the MKSAP; and one from Dr. Sven Olson on hematology and oncology.
Tweetorials: http://doi.org/10.1056/NEJMp1906790
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On this week's BONUS episode, we sit down with Dr. Huseyin Naci, Assistant Professor of Health Policy at the London School of Economics, to discuss his new paper that came out Wednesday (producer's edit: not "yesterday" as said in the podcast - apologies for the delay!) in the British Medical Journal. The paper's titled "Design characteristics, risk of bias, and reporting of randomised controlled trials supporting approvals of cancer drugs by European Medicines Agency, 2014-16: cross sectional analysis."
RCTS Supporting Approvals: doi.org/10.1136/bmj.l5221
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We begin this week's episode by revisiting last week's topic on the ethics of randomized controlled trials (RCTs) to address some of the controversy stirred up by our episode. We transition from there to an interview with Dr. Dan Morgan of the University of Maryland School of Medicine on hospital transmission and medical overuse. We have two questions of the week, as well -- one from Ian Straehley, inspired by the USMLE Step 2 CK; and one from Audrey Tran, inspired by the life of a medical student.
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After a hiatus from our segment on reviewing recent trials, we return to discuss the need for randomized controlled trials (RCTs). In the wake of the 2019 World Conference on Lung Cancer, we focus on whether a phase III trial of selpercatinib (LOXO-292) in RET rearranged lung cancer is feasible, practical, and ethical. We also have two questions of the week in this episode -- one from Dr. Derrick Tao, inspired by the MKSAP; and one from Dr. Sven Olson on hematology and oncology -- as well as an interview with Dr. Adam Duvall of OHSU on his career in the field of adolescent and young adult (AYA) oncology.
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We have three questions for you this week: one from Ian Straehley, inspired by the USMLE Step 2 CK; one from Dr. Derrick Tao, inspired by the MKSAP; and one from Dr. Sven Olson on hematology and oncology.
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We start this week with two Questions of the Week: the first is from Ian Straehley on the USMLE Step 2 CK, and the second is from Dr. Sven Olson on hematology/oncology. We end with an interview with Dr. Lynn Jansen of OHSU on the therapeutic misconception, optimism bias, and a deep discussion of the ethics of consenting patients for enrollment in early-phase clinical research trials.
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We have three questions for you this week: one from Dr. Derrick Tao, inspired by the MKSAP; one from Ian Straehley, inspired by the USMLE Step 2 CK; and one from Audrey Tran, inspired by her journey through medical school.
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We start this week's episode with a Question of the Week from medical student Audrey Tran on translational research and medical student training. Afterwards, we have an in-depth interview with Dr. Adam Cifu of the University of Chicago on his recent publication: "Physical Examination Pet Peeves".
Pet Peeves: doi.org/10.4300/JGME-D-18-01063.1
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We're back with more questions of the week! Our first question, from Ian Straehley, is inspired by the USMLE Step 2 CK; our second question, from Audrey Tran, is on deciding on a medical specialty. We end the episode with an interview with Dr. Frank Harrell of Vanderbilt University on the Bayesian approach to statistical thinking.
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In this REUP episode, we replay a section of our interview with Dr. Adam Obley of OHSU: a primer on cancer screening. This audio was first aired on episode 2.03.
Not So Silver Lining: doi.org/10.1001/archinternmed.2011.73 Mammography Screening: Truth, Lies and Controversy: www.crcpress.com/Mammography-Screening-Truth-Lies-and-Controversy/Gotzsche/p/book/9781846195853
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In this REUP episode, we replay a section of our interview with Dr. Michael Hayes of Kaiser Permanente. This audio was first aired on episode 2.01. The interview is on the relationship between conflict of interest and editorial stance on tumor-treating fields for glioblastoma multiforme.
TTF: doi.org/10.1016/j.jcpo.2019.100189
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This week we launch a new segment on Plenary Session: Question of the Week! We invite Dr. Sven Olson on to ask a sample hematology/oncology boards question and we invite Audrey Tran on to ask a question from a medical student. Before that, we talk about the legacy of Dr. Charles Moertel and how modern oncologists, in contrast, will be remembered. We end the episode with an interview with Dr. Adam Obley of OHSU -- his fourth appearance on the podcast! -- on cancer screening.
Dr. Moertel's obituary: https://www.nytimes.com/1994/06/29/obituaries/charles-moertel-66-studied-treatment-and-cost-of-cancer.html Faith Lost, a Doctor Turns Bitter: https://www.latimes.com/archives/la-xpm-1993-09-12-mn-34516-story.html Not So Silver Lining: doi.org/10.1001/archinternmed.2011.73 Mammography Screening: Truth, Lies and Controversy: https://www.crcpress.com/Mammography-Screening-Truth-Lies-and-Controversy/Gotzsche/p/book/9781846195853
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This BONUS episode is a recording of a lecture that Dr. Stacie Dusetzina of Vanderbilt University gave for grand rounds at OHSU on June 19, 2019. The lecture is on the cost of prescription drugs and out-of-pocket spending.
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Welcome to season 2! We're starting this season off with a little bit of everything: a critique of the FDA's accelerated approval of selinexor for penta-refractory multiple myeloma; an interview with Dr. John Reneau of Ohio State University on ECHELON-2 (brentuximab vedotin in t-cell lymphomas); an interview with Dr. Michael Hayes of Kaiser Permanente on parachutes in medicine plus the relationship between conflict of interest and editorial stance on tumor-treating fields for glioblastoma multiforme; and an interview with Dr. Stacie Dusetzina - a leading researcher in health care policy and the cost of cancer drugs, and an avid Twitter user - of Vanderbilt University on #MedTwitter.
ECHELON-2: doi.org/10.1016/S0140-6736(18)32984-2 Facing Our Mistakes: doi.org/10.1056/NEJM198401123100211 Parachutes: doi.org/10.9778/cmajo.20170088 TTF: doi.org/10.1016/j.jcpo.2019.100189 Impact of Disclosing Financial Ties: doi.org/10.1001/archinternmed.2010.39
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We begin this week's episode by breaking down the recent phase III trial on voxeletor in sickle cell disease with Dr. Sven Olson of OHSU. Next, we feature guest Dr. David Steensma of the Dana-Farber Cancer Institute in a far-reaching interview on being well-read, running a small lab, humanizing cancer, learning from our past use of erythropoiesis-stimulating agents, understanding the headache of contract research organizations, defining cancer, and more!
Voxeletor in Sickle Cell: doi.org/10.1056/NEJMoa1903212 Don't Mention It: doi.org/10.1200/JCO.2008.17.7238 The Raven: doi.org/10.1200/JCO.2017.76.3458 Erythropoietin Use in Cancer: doi.org/10.1200/JCO.2005.05.036 Contract Research Organizations: doi.org/10.1002/cncr.29994
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This week we begin the episode by discussing MONALEESA-7 and why ribociclib has been shown to increase overall survival while palbociclib has not. We finish the episode with an in-depth interview with Dr. Stacie Dusetzina of Vanderbilt University on her work in pharmacoeconomics, specifically we discuss her work on the market value of cancer drugs.
MONALEESA-7: doi.org/10.1056/NEJMoa1903765 Free drug samples are a marketing tool: doi.org/10.2105/AJPH.2007.114249
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This week we open with a critical take on our current system of disseminating scientific research, specifically focusing on the prevalence of -- and dependence on -- medical writers. In the second half of the episode, we interview Dr. Allen Pannell of the Haslam College of Business at the University of Tennessee on using a Frequentist approach vs a Bayesian approach in the context of a single clinical trial.
Frequentist vs Bayesian: doi.org/10.1136/bmjopen-2018-024256 Dr. Pannell's breast cancer support group: https://www.breastconnect.org/ Dr. Pannell's research project: http://tinyurl.com/peerErPrHer2
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In this BONUS episode we give advice on how to use Twitter effectively: how to focus your content, how to build your Twitter following, and how to conceptualize of the platform as an information network.
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This week we discuss the recent paper "Interpreting the Effectiveness of Cancer Screening From National Population Statistics: Is It Sound Practice?" with its author, Dr. Joaquín Chapa of OHSU. We then revisit the POLO trial with Dr. Emerson Chen of OHSU, who disagrees with last episode's analysis.
Effectiveness of Screening: doi.org/10.1016/j.mayocp.2019.02.016 POLO: doi.org/10.1056/NEJMoa1903387
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This week we cover some of the highlights from this year's ASCO annual meeting. We discuss the POLO study "Maintenance Olaparib for Germline BRCA-Mutated Metastatic Pancreatic Cancer" and the TITAN study "Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer", both recently published in NEJM. We end with a presentation titled "Expedited Program Use and Patient Experience in Trials", which was given in a shortened version at ASCO.
POLO: doi.org/10.1056/NEJMoa1903387 TITAN: doi.org/10.1056/NEJMoa1903307
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We begin this episode by responding to listener feedback from episode 1.61's discussion of clinic appointment time and rates of cancer screening. We also tackle listeners' outcry over our take-down of BILCAP (spoiler alert: BILCAP is still a null trial) and how outcry like this highlights the need to train clinicians to think probabilistically. From there, we move on to discussing the recent paper by Myung Sun Kim in JAMA Network Open on waterfall plots and how they are a visual distortion of response rate. We end the episode with an interview with Dr. Jeff Sharman of Willamette Valley Cancer Institute in Eugene, Oregon on community oncology, enrolling patients in clinical trials, expertise of academia, and using real-world evidence.
Waterfall plots: doi.org/10.1001/jamanetworkopen.2019.3981
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This week we cover three papers -- "Postpublication Metrics of Randomized Clinical Trials With and Without Null Findings" by Murray et al. in JAMA, "Association of Primary Care Clinic Appointment Time With Clinician Ordering and Patient Completion of Breast and Colorectal Cancer Screening" by Hsiang et al. in JAMA Network Open, and "Exceptional responders with invasive mucinous adenocarcinomas: a phase 2 trial of bortezomib in patients with KRAS G12D-mutant lung cancers" by Drilon et al. in Molecular Case Studies. We end with an interview with Dr. Christopher Booth of Queens University in Kingston, Ontario, conducted in the Plenary Session Mobile Command Unit.
Postpublication Metrics: doi.org/10.1001/jama.2019.2994 PCP Appointment Time: doi.org/10.1001/jamanetworkopen.2019.3403 Exceptional Responders: doi.org/10.1101/mcs.a003665
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We revisit I-PREDICT, discuss the "Imputability of Adverse Events to Anticancer Drugs" (a letter published recently in the New England Journal of Medicine), and interview Dr. Daniel Hartung of Oregon State University's College of Pharmacy on his vast knowledge of the cost of drugs, specifically addressing Acthar gel and multiple sclerosis drugs.
Imputability of Adverse Events: doi.org/10.1056/NEJMc1900053
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In this BONUS episode, we interview Palmer Greene, a fourth-year medical student at the University of Chicago Pritzker School of Medicine, on his recent paper: "Should Evidence Come with an Expiration Date?", published in the Journal of General Internal Medicine.
Expiration Date?: doi.org/10.1007/s11606-019-05032-4
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This week we discuss three paired papers on precision oncology published in Nature Medicine and then, later in the episode, go in-depth on the implications of these negative studies with Dr. Talal Hilal of the Mayo Clinic. We also discuss the use of magic mouthwash for oral mucositis with Plenary Session fan, Dr. Arjun Gupta of Johns Hopkins University.
WINTHER: doi.org/10.1038/s41591-019-0424-4 TARGET: doi.org/10.1038/s41591-019-0380-z I-PREDICT: doi.org/10.1038/s41591-019-0407-5 Magic mouthwash: doi.org/10.1001/jamainternmed.2018.6223
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In this BONUS episode, we interview Dr. Talal Hilal of the Mayo Clinic on his paper that was published today in JAMA Oncology, titled "Analysis of Control Arm Quality in Randomized Clinical Trials Leading to Anticancer Drug Approval by the US Food and Drug Administration".
Control Arm Quality: doi.org/10.1001/jamaoncol.2019.0167
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This BONUS episode is the recording of a Grand Rounds lecture that Dr. Christopher Booth of Queen's University in Kingston, Canada gave this morning (May 1, 2019) at OHSU. The title is "Achieving the Achievable: Real World Data and the Search for Meaningful Cancer Care".
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This week we sit down with Dr. Cliff Hudis, the CEO of the American Society of Clinical Oncology, to discuss the role of a professional society, the evolution of oncology, building a career, and more.
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In this week's episode, we break down two recently published papers. The first is "Association of Patient Characteristics and Tumor Genomics With Clinical Outcomes Among Patients With Non–Small Cell Lung Cancer Using a Clinicogenomic Database" by Singal et al., published in JAMA. The second is "Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial" by Palma et al., published in The Lancet.
Characteristics and genomics: doi.org/10.1001/jama.2019.3241 SABR-COMET: doi.org/10.1016/S0140-6736(18)32487-5
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We begin this episode with a discussion of two recent clinical trials in lymphoma: CALGB 50303 and REMoDL-B, respectively published in the Journal of Clinical Oncology and The Lancet Oncology. We include a primer on the history of lymphoma and the development of R-CHOP. We follow that with an in-depth interview with Dr. Ameet Sarpatwari of the Harvard Medical School on Risk Evaluation and Mitigation Strategies (REMS), the Orphan Drug Act, and, broadly, the purpose of the US FDA.
CALGB 50303: doi.org/10.1200/JCO.18.01994 REMoDL-B: doi.org/10.1016/S1470-2045(18)30935-5 Dr. Sarpatwari's online course: https://www.edx.org/course/the-fda-and-prescription-drugs-current-controversies-in-context
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In this week's episode we critique the statistics of the recent trial "Capecitabine compared with observation in resected biliary tract cancer (BILCAP): a randomised, controlled, multicentre, phase 3 study" that was published in The Lancet Oncology. Then, with Dr. Sven Olson of OHSU, we break down the two papers published in NEJM on thromboprophylaxis with direct oral anticoagulants (DOACs) for patients with cancer: "Rivaroxaban for Thromboprophylaxis in High-Risk Ambulatory Patients with Cancer" and "Apixaban to Prevent Venous Thromboembolism in Patients with Cancer".
BILCAP: www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30915-X Rivaroxaban: doi.org/10.1056/NEJMoa1814630 Apixaban: doi.org/10.1056/NEJMoa1814468
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In this BONUS episode, we sit down for a quick interview with Dr. Emerson Chen of OHSU on his recent paper in JAMA Internal Medicine on how using surrogate end points as opposed to overall survival for FDA approval for oncology drugs only results in a reduced drug development time of approximately 11 months.
Study Time Reduction: doi.org/10.1001/jamainternmed.2018.8351
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This week we tackle the recent paper published in the Journal of Clinical Oncology titled "Comparison of Population-Based Observational Studies With Randomized Trials in Oncology" as well as a couple papers lamenting physicians' use of Twitter and the open-access model for journal publishing. We end the episode with an in-depth interview with Dr. Kathryn Schabel of OHSU on orthopedic surgery and how she practices.
Observational Studies vs RCTs: doi.org/10.1200/JCO.18.01074
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We begin this episode by answering questions from a med student who is a Plenary Session fan. We transition from there to a discussion of the recent news stories on the FAA's handling of the Boeing 737 Max controversy and how this reflects on other USA regulatory agencies like the FDA. After a critique of the recent paper "Deleterious Germline Mutations Are a Risk Factor for Neoplastic Progression Among High-Risk Individuals Undergoing Pancreatic Surveillance" published in the Journal of Clinical Oncology, we end with an interview with Dr. Elihu Estey of the University of Washington on his 40 years of experience as an oncologist, the "Renaissance" of drugs for leukemia, and advice for trainees on how to approach career goals.
Pancreatic Surveillance: doi.org/10.1200/JCO.18.01512
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This week we dive deep into an article in JAMA IM on falsified data in meta-analyses. We also discuss the recent JAMA viewpoint "Reducing the Expert Halo Effect on Pharmacy and Therapeutics Committees" with its author, Dr. Stephanie Halvorson of OHSU.
Falsified data: doi.org/10.1001/jamainternmed.2014.7774 Expert Halo Effect: doi.org/10.1001/jama.2018.20789
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This BONUS episode is a lecture on medical reversal that was pre-recorded for a class at Harvard Medical School. The recording was played for students in February of 2019 and followed by a Q&A. The slides referenced are available to Patreon supporters.
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In this bonus episode, we bring back Dr. Tom Beer of OHSU from episode 1.33 to discuss how to manage your personal finances. The interview is aimed at young physicians, but there is something for all audiences as we cover a broad range of topics: paying off loans, optimizing retirement savings, buying a home, and investing.
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This week's episode begins with praise for the recent article by Booth CM, Karim S, and Mackillop WJ on real-world data published in Nature Reviews Clinical Oncology. Next, we tackle the resignation of Scott Gottlieb as FDA commissioner and how we can measure the success of the FDA. Finally, we have an interview with Dr. Deborah Cohen of OHSU on effective communication between the clinician and the patient and how we can use data from the Electronic Health Record to make meaningful improvements in care.
Real-world data: doi.org/10.1038/s41571-019-0167-7
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This BONUS episode is the recording of a lecture given as part of the medical school class Appraising Medical Literature, taught at OHSU. This clip from the class critiques the recent JAMA Pediatrics paper "Association Between Screen Time and Children’s Performance on a Developmental Screening Test".
Screen Time: doi.org/10.1001/jamapediatrics.2018.5056
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In this episode we discuss the controversy over the recent article in NEJM, "Full Study Report of Andexanet Alfa for Bleeding Associated with Factor Xa Inhibitors", with Dr. Tom Deloughery of OHSU. We end with an interview with Dr. John McConnell, also of OHSU, on health economics and Medicaid.
Andexanet Alfa: doi.org/10.1056/NEJMoa1814051
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In the first half of this episode, Dr. Sven Olson of OHSU joins us to help critique the recent NEJM paper, "Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura". In the second half, we interview Dr. Inmaculada Hernández of the University of Pittsburgh on her work on the economic principles behind runaway drug prices.
Caplacizumab: doi.org/10.1056/NEJMoa1806311
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We feature two interviews this week: the first is a hallway conversation with [soon-to-be] Dr. Antonious Hazim of OHSU on the Declaration of Geneva and the second is a discussion with [soon-to-be] Dr. Joshua Niforatos on his recent paper in The American Journal of Emergency Medicine, titled "Financial relationships with industry among guideline authors for the management of acute ischemic stroke".
Financial relationships: doi.org/10.1016/j.ajem.2019.01.037
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This episode features an interview with hematologist Dr. Thomas Deloughery of OHSU. We cover a broad range of topics including 23andMe, wilderness medicine, academia, and Twitter. We'll be back next week with our regular introductory monologue!
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In this episode we interview Dr. Alex Denes of OHSU on his decades-long career in medicine: what practices have changed and what have stayed the same. No monologue this week - we'll be back next week with more insights!
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In this episode we tackle Eli Lilly's drug Lartruvo (olaratumab) and the under-powered phase II trial that led to its FDA accelerated approval; a viewpoint in JAMA on new directions for cancer trials; and gene expression profiling for carcinoma of unknown primary. We end with an interview with Dr. Miriam Knoll of Hackensack Meridian Health on employment after residency or fellowship, residency training, and the medical specialty pipeline.
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This BONUS episode is the recording of a talk given at the Salem City Club on January 11, 2019. It's the talk on medical reversal that has been featured in previous episodes, but this time the format and content have been updated for a broader, more general audience.
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This week we dive into the recent paper by Drs. Cole and Dusetzina titled "Generic Price Competition For Specialty Drugs: Too Little, Too Late?". We also have an interview with Dr. Martin Schreiber of OHSU on his experiences as a trauma surgeon, both stateside and on the battlefield.
Generic Price Competition: https://doi.org/10.1377/hlthaff.2017.1684
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This BONUS episode is the recording of a lecture given to the Bioethics Study Group at OHSU on January 9, 2019 on conflict of interest, specifically in the field of oncology. Backers of our Patreon will be sent accompanying slides.
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In this episode, we discuss two recent papers published in the Journal of Clinical Oncology: ECOG-ACRIN 2511 and the update adding overall-survival and crossover results to KEYNOTE-024. We end with an interview with Dr. Joseph Shatzel of OHSU on mentorship.
ECOG-ACRIN 2511: http://doi.org/10.1200/JCO.18.00264 KEYNOTE-024 update: http://doi.org/10.1200/JCO.18.00149
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In this episode we discuss guarantee-time bias in the context of the recent JAMA Oncology paper titled "Profiling Preexisting Antibodies in Patients Treated With Anti–PD-1 Therapy for Advanced Non–Small Cell Lung Cancer". We also have an interview with Dr. Tom Beer, the Deputy Director of the OHSU Knight Cancer Institute, on clinical trials, leadership, philanthropy, and future directions in cancer research.
Profiling preexisting antibodies: doi.org/10.1001/jamaoncol.2018.5860
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Episode 1.32 ran a little long, so this is episode 1.32.1 - we broke out the interview with Dr. Brian Kavanagh, the Chairman of Radiation Oncology at the University of Colorado, to make the interview more accessible.
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This week we discuss various academic indices including the h-index and the new Altmetric score, and we go over the recent NY Times article on conflict of interest. We end with an interview with Dr. Brian Kavanagh, the Chairman of Radiation Oncology at the University of Colorado.
NY Times: https://www.nytimes.com/2018/12/31/upshot/congratulations-on-the-promotion-but-did-science-get-a-demotion.html
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We begin this episode with a discussion of Dr. Mukherjee's ongoing study combining a ketogenic diet with PI3 kinase inhibition. We continue with a take on a recent reanalysis of COMET-1 and COMET-2, two failed randomized controlled trials of cabozantinib versus prednisone or mitoxantrone-prednisone in metastatic castration-resistant prostate cancer. We end with an interview on instabilities in the health insurance marketplace with Dr. Jane Zhu of OHSU, an expert in the Affordable Care Act.
Keto diet + PI3 kinase: https://www.nytimes.com/2018/12/05/magazine/its-time-to-study-whether-eating-particular-diets-can-help-heal-us.html COMET-1: http://doi.org/10.1200/jco.2015.65.5597 COMET-2: https://doi.org/10.1016/j.eururo.2018.11.033
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This BONUS episode is the recording of a lecture given to the National Breast Cancer Coalition on December 11, 2018. It's on clinical trial endpoints, FDA drug approval, and incentives in oncology. Backers of our Patreon will be sent accompanying slides.
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We begin this episode with a critique of the recent paper in the BMJ, "Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial" and we end it with an interview with Dr. Andre Mansoor, discussing his new book: "Frameworks for Internal Medicine."
Parachutes: https://www.bmj.com/content/363/bmj.k5094
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In this episode we critique two recent FDA drug approvals (venetoclax in combination with azacitidine or decitabine or low-dose cytarabine; glasdegib in combination with low-dose cytarabine -- both for acute myeloid leukemia)and we interview Dr. Chadi Nabhan, the Chief Medical Officer of Cardinal Health, on career transitions. The interview was taped on location at the 2018 annual conference of the American Society of Hematology in San Diego.
This BONUS episode is the recording of a lecture given to hospitalists at Kaiser Permanente on November 14, 2018. It's a slightly different version of the talk on medical reversals that we recorded for episode 1.16. Backers of our Patreon will be sent accompanying slides.
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Having just returned from the 2018 American Society of Hematology (ASH) Annual Meeting, we begin this episode by discussing the abstract of a study that stretches its conclusions. We dedicate most of the episode to an interview with Dr. Sima Desai, the program director for OHSU's Internal Medicine Residency Program. She gives some great insight on the program's inner workings.
ASH abstract: https://ash.confex.com/ash/2018/webprogram/Paper117448.html
We have also launched our Patreon page! Become a patron at www.patreon.com/plenarysession.
In this episode we discuss: Dr. Gilbert Welch's Wikipedia page and how we should keep his decades of work in perspective, a Twitter conversation between experts on differing interpretations of results from next-generation sequencing, the new paper in JAMA titled "Assessment of Pregabalin Postapproval Trials and the Suggestion of Efficacy for New Indications", and finally, along with Dr. Sam Edwards of OHSU, we criticize the recent perspective piece in NEJM titled "Beyond Evidence-Based Medicine".
Welch's Wikipedia: https://en.wikipedia.org/wiki/H._Gilbert_Welch Pregabalin: doi.org/10.1001/jamainternmed.2018.5705 Beyond EBM: doi.org/10.1056/NEJMp1806984
We have also launched our Patreon page! Become a patron at https://www.patreon.com/plenarysession.
In this episode we discuss John Ioannidis' article on the uselessness of medical conferences, published in JAMA: "Are Medical Conferences Useful? And for Whom?", followed by an interview with return-guest Dr. Adam Obley on a few recent clinical trials: Vascepa, fish oil, vitamin D, and methotrexate.
Medical conferences: doi.org/10.1001/jama.2012.360
This BONUS episode is the recording of a lecture given as part of the Biomedical Engineering Seminar series at Oregon Health & Science University on November 9, 2018. The talk is on how to move technological devices to the clinic with fewer reversals.
In this episode, we tackle the recent papers in the New England Journal of Medicine on "Elotuzumab plus Pomalidomide and Dexamethasone for Multiple Myeloma" and "Immunotherapy Combinations in Multiple Myeloma", as well as a comment in The Lancet Oncology's editorial "9 Weeks That Matter for Patients With Gastric Cancer". We conclude with an interview with Dr. Erick Turner of OHSU on the FDA, regulatory capture, selective reporting, and transparency.
Elo-pom-dex: http://doi.org/10.1056/NEJMoa1805762 Immunotherapy combinations: http://doi.org/10.1056/NEJMp1803602 9 weeks that matter: http://doi.org/10.1016/S1470-2045(18)30752-6 Dr. Turner's seminal paper: https://doi.org/10.1056/NEJMsa065779
In this episode we question the conclusions of the phase II trial "Nab-Paclitaxel and Gemcitabine as First-line Treatment of Advanced or Metastatic Cholangiocarcinoma", review the long-term overall survival results from PALOMA-3, discuss Dr. Gyawali et al.'s paper on the need for transparency in reporting harms from cancer drugs, and interview Dr. Talal Hilal from the Scottsdale Mayo Clinic on his advice for trainees.
Nab-paclitaxel and gemcitabine: doi.org/10.1001/jamaoncol.2018.3277 Palbociclib and fulvestrant: doi.org/10.1056/NEJMoa1810527 Reporting harms: doi.org/10.1136/bmj.k4383
We begin this episode analyzing the unrepentant hype of precision oncology in a monologue that was originally one half of a debate titled: "Is Precision Oncology Generating Patient Benefit or Just Hype?" We conclude with an interview with Dr. Andrae Vandross on the mentor/mentee relationship.
This BONUS episode is the recording of a lecture given as part of a Cancer Intersession course for med students at Oregon Health & Science University on October 25, 2018. The talk is an introduction to cancer drug policy.
In this episode we evaluate the IMpassion130 trial on the use of atezolizumab in triple-negative breast cancer. We also interview Dr. Brian Chan of OHSU on a randomized controlled trial he's running that tests whether Dr. Gawande's idea of "hot-spotting" -- tailoring interventions to medically complex patients -- does decrease hospitalizations. IMpassion130: doi.org/10.1056/NEJMoa1809615 Hot-spotting: https://www.newyorker.com/magazine/2011/01/24/the-hot-spotters
This BONUS episode is the recording of a two-part talk addressed to oncology fellows given at Oregon Health & Science University on October 5 and October 12, 2018. The talk is on how to interpret cancer clinical trials.
This BONUS episode is the recording of the Hospitalist Grand Rounds given at Oregon Health & Science University on October 11, 2018. The talk is on medical reversal. Before the talk we discuss the paper "Many Analysts, One Data Set: Making Transparent How Variations in Analytic Choices Affect Results" by Silberzahn et al., published in Advances in Methods and Practices in Psychological Science. Paper: doi.org/10.1177/2515245917747646
In this episode we review the recent paper in Nature Reviews Clinical Oncology by Booth, C.M. and Detsky, A.S. titled "Why patients receive treatments that are minimally effective?". We discuss the failure of CheckMate 331 to meet its primary endpoint despite having received accelerated FDA approval. Finally, we bring back Dr. Adam Obley (from episode 1.01) to talk about low-value healthcare, medical education, social media, and more!
This BONUS episode is the recording of the 22nd annual Pennington Lecture given at Oregon Health & Science University on September 21, 2018. The lecture is on seven myths of medicine and marketing. Before the lecture we read and discuss the editorial "Desperation Oncology" by Tito Fojo, published in Seminars in Oncology.
Listen in for a breakdown of the good and the bad of KEYNOTE-189(trial published in NEJM), a discussion with Dr. Talal Hilal of the Mayo Clinic on the rise of minimal residual disease as a clinical endpoint, and an interview with Dr. Adam Cifu of the University of Chicago Pritzker School of Medicine on medical education, sham trials, and more.
This BONUS episode is the recording of a Grand Rounds talk given at Oregon Health & Science University on September 19, 2018. The talk was inspired by the article by JPA Ioannidis titled "Evidence-based medicine has been hijacked: a report to David Sackett", published May 2016 in the Journal of Clinical Epidemiology.
We discuss Dr. Califf's comment on the "social media peanut gallery of experts", Dr. Drazen's comment on "research parasites" and his retirement from NEJM, the recent paper in JAMA on long-term follow up for antibiotics as compared to appendectomies, and the paper in JAMA Internal Medicine on the relationship between health-related quality of life and progression-free survival. Finally, we interview Dr. Bishal Gyawali on a variety of topics, including cancer groundshot.
Today we tackle some cardiologists' opposition to criticizing clinical trials on Twitter, the PACIFIC trial on durvalumab in stage III non–small-cell lung cancer, and the recent paper in Heart: "Percutaneous Coronary Intervention for Stable Coronary Artery Disease" by R.K. Al-Lamee, A.N. Nowbar, and D.P. Francis. We end with an interview on academic medical publishing with Dr. Rebecca Cooney, North American Executive Editor of The Lancet.
Special episode! We discuss the recent correspondence in NEJM on response rate in phase I clinical trials, the JACOB trial published in The Lancet Oncology on pertuzumab for HER2-positive gastric cancer, and we give an evaluation of MI, stroke, and metastasis as hard endpoints.
In this episode we discuss hyperprolific authors and the recent comment in Nature by JPA Ioannidis, R Klavans, & KW Boyack; NCCN guidelines with fourth-year medical student Jeffrey Wagner; and point-of-care ultrasounds with Dr. Renee Dversdal of OHSU.
In this episode we discuss the USA FDA's recent approval of sunitinib as the adjuvant treatment for patients with resected renal cell carcinoma who are at high risk of relapse. We also interview cardiologist Dr. John Mandrola on new directions forward for evidence-based medicine.
In this episode we break down the RELEVANCE trial published in the New England Journal of Medicine; discuss big data in observational studies with Jenny Gill, MS; and interview Dr. Catherine Livingston of OHSU, an expert in healthcare policy, on her work with the Oregon Health Authority and state Medicaid.
In this episode we cover the cost and efficacy of cancer drugs; review ECHELON-1; interview Dr. Derrick Tao of OHSU about his recent Lancet Oncology paper on poor control arms; and discuss evidence-based medicine with EBM expert and internist at OHSU, Dr. Martha Gerrity.
This week's episode is on nutritional epidemiology by JPA Ioannidis; lenvatinib for hepatocellular carcinoma; nivolumab and ipilimumab for melanoma; and #medtwitter with Dr. Avi O Glasser from OHSU.
We're moving to our new format. We begin with a monologue of the most noteworthy articles in this week's news. We'll be talking about real-world evidence, Right to Try, talazoparib, and the FDA approval for nivolumab in small-cell lung cancer. In the second half of the show, we'll interview Dr. Andrae Vandross, a community oncologist at UCLA Medical Center.
In episode 2, we discuss the fellowship program and then take a deep dive into hype surrounding cancer drugs. Our guest is Jeremy Cetnar, MD from Oregon Health & Science University.
Join us for an introduction to who we are and what our podcast is about, then stick around for a hard-hitting discussion of evidence-based medicine, randomized controlled trials, sham controls, and broad next-generation sequencing in cancer. Our guest is Adam Obley, an Assistant Professor of Medicine at Oregon Health & Science University.