Enjoy this brief behind-the-scenes discussion from ESMO 2025 where we plan our upcoming Best of ESMO episode
#ESMO25 #ESMO26 @melanomamatterspod
Enjoy this trailer of Episode 72 - James takes a test!
For the record, we recorded this episode in February 2024 :) better late than never to get it published!
In this episode, James has no idea what he's in for. Sapna quizzes James on new drug approvals in hematology & oncology in the year 2024 to see if he can guess the cancer type and mechanism of action.
Summary
In this episode, hosts James Larkin & Sapna Patel discuss the Women in Melanoma Conference, highlighting its role in fostering networking and collaboration among female oncologists. They reflect on the evolution of the conference, its impact on participants, and the importance of addressing women's issues in oncology. The discussion also touches on the potential for expanding the initiative beyond the U.S. and the value of creating a supportive community for women in the medical field.
James reveals a lack of stupid human tricks, Sapna reports on her skill with napkin lipstick blots, and the two fawn over word clouds in the shape of the female form (e.g. Figure 1). Moral of the story? Don't tease, and James is the bigger geek... all around
Keywords
melanoma, women in oncology, networking, collaboration, medical conference, women empowerment, survivorship, oncology research, patient care, medical community
Takeaways
The Women in Melanoma Conference was initiated to address the lack of female representation in oncology meetings.
Networking and collaboration are crucial for professional growth in oncology.
The conference has evolved to include a broader range of topics relevant to women in the medical field.
Participants have expressed feelings of camaraderie and support through the conference.
The initiative has led to successful collaborations and publications among attendees.
There is potential for expanding the Women in Melanoma initiative internationally.
The conference addresses both professional and personal challenges faced by women in oncology.
Role-playing exercises have been beneficial for participants in handling difficult conversations.
The conference serves as a platform for discussing patient-centered care and survivorship.
The success of the initiative may inspire similar programs in other medical specialties.
Sound Bites
"It's been a lovely forum."
"There's no reason this has to stay U.S."
"We captured lightning in a bottle here."
Chapters
00:00 Introduction and Icebreakers
02:53 Val Guild & the Inception of WIM
06:53 Networking and Collaboration in Oncology
10:45 Expanding the Women in Melanoma Initiative
14:26 Figure 1. Word Cloud
19:07 Fact Check (there are 2 Fact Checks!)
29:57 Fact Check Within a Fact Check
You wanted it, we gave it... best of ASCO ...colon...2025 :D
In this episode, hosts James and Sapna discuss the key highlights from ASCO 2025, focusing on significant abstracts related to melanoma treatment. They delve into the implications of adrenal insufficiency, the 5 year, final results of Lifileucel, and the ongoing debate between neoadjuvant and adjuvant therapies. The conversation also explores the role of IL-6 in treatment efficacy and the importance of understanding sentinel lymph node positivity. The hosts emphasize the need for innovative clinical trial designs to adapt to emerging data and improve patient outcomes.
Keywords
ASCO 2025, melanoma, neoadjuvant therapy, adrenal insufficiency, lifileucel, immunotherapy, clinical trials, IL-6, treatment outcomes, cancer research
Chapters
00:00 Introduction and Overview of ASCO 2025
03:16 DoorDash!
05:43 Key Highlights from ASCO 2025
08:29 Lifileucel and Its Impact on Treatment
10:53 Long-term Outcomes and Toxicity Considerations
15:49 Exploring Treatment Efficacy in Refractory Populations
17:41 Neoadjuvant and Adjuvant Therapies: A Comparative Analysis
21:07 Investigating GM-CSF's Role in Mitigating Toxicity
22:36 RELA 098: Insights and Implications
25:37 Understanding Sentinel Lymph Node Positivity in Melanoma
26:34 Future Directions in Neoadjuvant Therapy Research
36:18 Fact Check
38:17 Discussion on IPI GM-CSF and Adrenal Insufficiency
42:09 Impact of Adrenal Insufficiency on Patients
45:06 Future Directions in Neoadjuvant Trials
47:26 Wrap-Up and Reflections
Summary
In this episode, Sapna Patel and James Larkin engage with Monty Pal from City of Hope, discussing his unique journey into oncology, the significance of the microbiome in cancer treatment, and the impact of diet and lifestyle on patient outcomes. They explore current research, including clinical trials involving fecal microbiome transplants and the potential of specific bacteria to enhance immunotherapy effectiveness. The conversation highlights the evolving landscape of cancer treatment and the promising future of microbiome research in oncology.
Keywords
oncology, microbiome, cancer treatment, immunotherapy, diet, clinical trials, kidney cancer, melanoma, fecal microbiome transplant, City of Hope
Takeaways
Monty Pal started college at the age of 13, showcasing an unconventional path to medicine.
His journey into oncology was influenced by a pivotal decision to switch from engineering to medicine
Monty has significantly contributed to the growth of the GU oncology program at City of Hope.
The microbiome plays a crucial role in predicting patient outcomes and side effects in cancer treatment.
Dietary fiber intake has been linked to improved clinical outcomes in melanoma patients receiving immunotherapy.
Random probiotics may not be beneficial and could even be harmful to patients.
Research indicates that specific bacteria can enhance the effectiveness of immunotherapy.
The future of cancer treatment may involve turning cold tumors into hot tumors using microbiome interventions.
Titles
The Journey of Monty Pal: From Prodigy to Oncologist
Microbiome and Cancer: Turd Burglars to Treatment
Sound Bites
"I started college when I was 13."
"Fiber seems to be somewhat interesting."
Chapters
00:00 Introduction and Introduction of Monty Pal from City of Hope
01:42 Monty's Journey to Medicine
05:19 GU Oncology at City of Hope
10:28 The Microbiome: A New Frontier in Oncology
14:52 Microbiome Research and Clinical Outcomes
19:21 Lifestyle Factors and the Microbiome
23:51 Intervention Strategies: Fecal Microbiome Transplant and Beyond
24:35 South Park Episode: Turd Burglars
29:58 An Upcoming SWOG trial
32:48 Fact Check
Summary
In this episode of Melanoma Matters, hosts Sapna Patel and James Larkin discuss the Godfather 15 trial, focusing on the neutralizing GDF 15 antibody and its implications in overcoming PD-1 and anti-PD-L1 resistance in solid tumors. They explore the background of GDF-15, its role in immune suppression, and the trial's methodology, including safety and efficacy results. The conversation also touches on the future directions of GDF-15 antibody trials and the importance of understanding treatment resistance in cancer therapy.
Keywords
Melanoma, GDF-15, Godfather 15 trial, immunotherapy, cancer research, PD-1, antibody therapy, clinical trials, immune suppression, treatment resistance
Takeaways
The Godfather 15 trial focuses on neutralizing GDF-15 antibody.
GDF-15 is linked to immune suppression in tumors.
The trial is a phase 1/2 study with multiple dose levels.
Understanding treatment resistance is key in cancer research.
The importance of defining refractory cohorts in trials.
Biological proof of concept is essential in early studies.
Future trials should focus on specific patient populations.
Sound bites
"This is a phase 1/2 study"
"This is the biology we're targeting"
"I think this is obviously just a first step"
Chapters
00:00 Introduction to the Godfather 15 Trial
07:48 Understanding GDF-15 and Its Role in Cancer
11:48 Exploring the Study Design and Methodology
18:42 Results and Efficacy of the GDF-15 Antibody
25:09 Future Directions and Closing Thoughts
Summary
In this conversation, James Larkin and Sapna Patel discuss the consensus definitions for resistance to immune checkpoint inhibitors, focusing on a recent paper from the Journal of Immunotherapy of Cancer. They explore the complexities of primary and secondary resistance, the importance of defining these terms for clinical trials, and the challenges in trial design and control arms. The discussion emphasizes the need for clear definitions to improve patient outcomes and guide future research in oncology.
Keywords
immune checkpoint inhibitors, cancer treatment, resistance, clinical trials, melanoma, PD-1, adjuvant therapy, response rate, tumor sensitivity, oncology
Takeaways
Resistance to immune checkpoint inhibitors is a major challenge in melanoma treatment.
Primary resistance occurs when there is no benefit from treatment, while secondary resistance follows initial benefit.
Defining resistance is crucial for clinical trials and understanding patient populations.
The duration of drug exposure is key in determining resistance types.
Clinical trial design must consider the expectations of efficacy in control arms.
Investigators should be cautious about the definitions of patient populations in trials.
Response rates of 15-20% are considered significant for primary resistance.
Secondary resistance may show higher response rates due to residual sensitivity.
Clear definitions help in layering data for future research.
Collaboration among clinicians, industry, and regulatory bodies is essential for advancing cancer treatment.
Sound Bites
"It's probably the biggest challenge we now have in clinic."
"There's something in the middle."
"I think that's where we might need to be there."
Chapters
00:00 Introduction to Immune Checkpoint Inhibitors and Resistance
08:08 Understanding Resistance: Definitions and Scenarios
14:47 Primary vs. Secondary Resistance in Clinical Trials
22:00 Trial Design and Control Arms in Immunotherapy
30:36 Conclusions and Future Directions
33:28 outro fade long expo.mp4
Summary
In this episode of Melanoma Matters, James Larkin and Sapna Patel discuss the recent advancements in understanding and treating cancer cachexia, particularly focusing on the drug ponsegramab. They explore the implications of cachexia across different cancer types, the role of cytokine GDF-15, and the importance of nutrition and physical activity in managing cachexia. They opine on body weight and protein, as per usual.
Keywords
cancer cachexia, ponsegramab, GDF-15, treatment options, nutrition, clinical trials, melanoma, kidney cancer, pancreatic cancer, weight gain
Takeaways
Cancer cachexia is a significant issue in various cancers.
Ponsegramab shows promise in treating cachexia with meaningful weight gain.
GDF15 is a key cytokine elevated in cancer cachexia.
Historical treatments for cachexia have included progestins, but newer options are emerging.
Nutrition and physical activity are crucial in managing cachexia.
Collaboration between academia and industry is vital for drug development.
The study of Ponsegramab was conducted across multiple institutions.
Cachexia management requires a multifactorial approach.
Clinical trials must consider the contributions of all stakeholders.
Future research is needed to optimize treatment for cachexia.
Sound Bites
"This is about cancer cachexia."
"We do see the sarcopenia."
"Doctors have known about this for 2,000 years."
Chapters
00:00 Introduction to Cancer Cachexia
02:43 Understanding Cachexia in Different Cancers
06:41 The Role of GDF-15 in Cancer Cachexia
10:39 Clinical Trial Insights on Ponsegramab
18:37 Exploring Treatment Implications and Future Directions
24:36 Authorship and Collaboration in Cancer Research
32:47 Fact Check
33:36 Discussion on Cancer Cachexia and Bonsegramab
38:14 Historical Context of Treatment in Kidney Cancer
42:28 Current Guidelines and Future Directions for Cachexia Treatment
Summary
In this conversation, Sapna Patel and James Larkin discuss the recent approval of Opdivo Qvantiq, a subcutaneous formulation of nivolumab, and its implications for oncology treatment. They explore the Checkmate 6-7-T study that led to its approval, the efficacy and safety of the new formulation, and the broader regulatory landscape. The discussion also touches on patient perspectives regarding subcutaneous versus intravenous treatment, the potential for future clinical trials, and the importance of patient choice in treatment options.
Keywords
Opdivo, Qvantiq, subcutaneous formulation, oncology, Checkmate 6-7-T, nivolumab, patient experience, regulatory approval, cancer treatment, clinical trials
Takeaways
The approval of Opdivo Qvantiq represents a significant advancement in oncology.
Subcutaneous formulations offer convenience and the possibility of home treatment.
Patient acceptance of subcutaneous treatment is generally high.
The Checkmate 67T study demonstrated the efficacy of subcutaneous nivolumab.
Regulatory approval for subcutaneous formulations is becoming more streamlined.
Patients may value the social interaction of IV treatments over subcutaneous injections.
The future of clinical trials may need to incorporate both subcutaneous and IV options.
Understanding patient preferences is crucial for treatment decisions.
The role of reimbursement in treatment choice cannot be overlooked.
The transition from IV to subcutaneous treatment may impact patient care dynamics.
Titles
Revolutionizing Cancer Treatment: Opdivo Qvantiq
The Future of Subcutaneous Nivolumab
Sound Bites
"It's a no-brainer for patients."
"The FDA has taken a view there."
"This is not just a flu shot."
Chapters
00:00 Why does J have Napoleon on his wall?
05:36 Dreams of new work office furniture...or gym equipment
08:01 CheckMate 67T
19:31 Patient Perspectives on Subcutaneous vs. Intravenous Treatment
27:43 Regulatory and Approval Insights for Opdivo Qvantig
33:30 Future Directions in Clinical Trials
38:02 Fact Check
38:06 Subcutaneous Treatments in Oncology
41:01 Patient Experience and Acceptance of Subcutaneous Treatments
44:17 The Shift in Oncology Patient Interactions
47:06 Current Landscape of Subcutaneous Drugs in Oncology
In this episode of Melanoma Matters, hosts James Larkin and Sapna Patel pick up with Part 2 of 2 - a deep conversation with Claire Turnbull - about the complexities of cancer screening, overdiagnosis, and the role of genetic testing. They explore the implications of screening practices illustrated by the Gilbert Welch paradigm, the challenges faced in patient management, and the future of genetic testing in oncology. The discussion emphasizes the importance of understanding the risks and benefits associated with genetic testing.
Keywords
melanoma, cancer screening, overdiagnosis, genetic testing, patient management, healthcare, public health, cancer research, screening guidelines, cancer predisposition
Takeaways
• The conversation highlights the importance of understanding the value of cancer screening.
• Overdiagnosis is a significant concern in cancer screening practices.
• Genetic testing plays a crucial role in identifying cancer predisposition.
• Screening should be evaluated rigorously to ensure it benefits patients.
• The implications of false positives in screening can lead to unnecessary anxiety for patients.
• Healthcare providers must be responsible for interpreting test results they order.
• The need for genetic counseling is critical in managing test results and patient care.
• There is a growing concern about the overuse of broad genetic testing panels.
• Future advancements in technology may improve screening methods.
• Public health messaging must address the complexities of cancer screening and genetic testing.
Chapters
00:00 Clare Turnbull - Part 2 of 2
04:05 High penetrance, common SNPs, and in betweens
07:15 The Gilbert Welch Paradigm
12:30 Understanding Lead Time and Overdiagnosis
16:11 Randomized Trials in Screening
19:59 Consequences of Screening: Overdiagnosis and Anxiety
22:22 Debate on Screening Protocols and Their Efficacy
25:37 Need for Evidence-Based Genetic Testing
31:19 Ripple Effects of Genetic Testing on Families
34:00 Fact Check
35:47 Genetic testing for ACC?!
36:34 Clinical Genetics clinics are NOT just reading guidelines...
39:52 David Sackett: Evidence-Based Medicine
43:03 Triggering James: (S)he who orders the test reviews & interprets the test
Summary
In this episode of Melanoma Matters, hosts Sapna Patel and James Larkin welcome Clare Turnbull, a clinical geneticist in London, to discuss her journey from studying mathematics to medicine, her work in cancer genetics, and the impact of COVID-19 on healthcare. The conversation explores the role of genetic testing in melanoma, the challenges of public health in cancer treatment, and the ongoing effects of the COVID-19 pandemic on cancer care and patient outcomes.
Keywords
melanoma, genetics, COVID-19, public health, cancer treatment, screening, early detection, healthcare, epidemiology, clinical genetics
Takeaways
Clare Turnbull transitioned from mathematics to medicine in uni,
She has worked extensively in clinical genetics, focusing on cancer genetics.
COVID-19 significantly impacted healthcare delivery and cancer treatment prioritization, the effects of which will take a long time to bear out.
The importance of genetic testing in melanoma is highlighted, for young onset cases or those with a significant family history.
Public health initiatives are crucial for improving cancer outcomes.
The pandemic created a bulge in cancer mortality due to delayed diagnoses.
Screening for melanoma is essential, but the pick-up rates for genetic mutations are low - a cautionary tale.
Sound Bites
"A can-do attitude, what can I do to help?"
"There will be a bulge of mortality."
"The pick-up rate's pretty low."
Chapters
00:00 Opening theme music (My Favourite Dress...The Wedding Present)
00:48 Introduction of Guest Clare Turnbull
03:27 Clare's Journey in Clinical Genetics
05:36 Genomics England, 100K Genomes Project
06:58 Clare's extraordinary efforts during COVID
12:07 Melanoma and genetic risk(s) versus environmental risk
16:28 The Ripple Effects of Genetic Testing on Families
Summary
On mountain emergencies...Sapna's had them, James denies them...This conversation delves into the treatment options available for patients with advanced melanoma who have progressed after anti PD-1 therapy. The discussion covers various clinical studies, response rates, and the implications of combination therapy post-PD1 progression. James and Sapna conclude that while combination therapies show promise, the responses may not be as robust as those seen in frontline treatments.
Keywords
melanoma, PD-1, treatment, clinical trials, immunotherapy, BRAF, response rates, efficacy, combination therapy, patient outcomes
Takeaways
The conversation focuses on treatment options after PD-1 progression.
Clinical studies provide valuable data on post-PD-1 therapies.
Response rates for combination therapies are generally higher than monotherapy.
BRAF status is a critical factor in treatment decisions.
Randomized studies help clarify the efficacy of different treatment approaches.
Combination therapy may offer better outcomes for patients post-PD-1.
Acquired resistance remains a challenge.
Titles
Exploring Treatment Options Beyond PD-1
The Role of Clinical Trials in Melanoma Therapy
Sound Bites
"What to do post PD-1 exposure?"
"Can you get a response to IPI after PD-1?"
"The primary endpoint was PFS, not ORR... "
Chapters
00:00 Opening theme music (My Favourite Dress by The Wedding Present)
01:25 Mountain rescue quickfire
03:08 Post anti-PD1 studies - the issues
04:13 Pires da Silva retrospective study
08:53 Olson single-arm prospective study (and yes we see you Jason)
10:38 SWOG S1616 randomized ph 2 study
16:35 Conclusions
17:17 Fact Check
Summary
In this episode of Melanoma Matters, host Sapna Patel and James Larkin welcome guest Inge Marie Svane to discuss the evolution and future of cancer immunotherapy, particularly focusing on cellular therapy for melanoma. Inge Marie shares her extensive background in the field, the establishment of a cancer immune therapy center in Denmark, and the historical context of cellular therapy. The conversation delves into the current challenges and innovations in T-cell therapy, regulatory hurdles, and the potential for cellular therapy in other solid tumors. The episode highlights the importance of optimizing treatment strategies and the need for collaboration between academia and industry and regulators to improve patient outcomes.
Keywords
melanoma, cancer immunotherapy, cellular therapy, T-cell therapy, checkpoint inhibitors, clinical trials, patient care, regulatory challenges, cancer vaccines, treatment advancements
Takeaways
Titles
Exploring the Future of Melanoma Treatment
Inge Marie Svane on Cancer Immunotherapy Innovations
Sound Bites
"We need to move forward in all directions."
"The system is completely untrained for academia."
Chapters
00:00 Introduction of Guest Inge Marie Svane
05:37 Historical Perspective on Cellular Therapy for Melanoma
09:04 Optimizing T-Cell Therapy: Challenges and Innovations
20:50 Prospects for Cellular Therapy in Other Solid Tumors
Welcome to Season 2!
In this episode of Melanoma Matters, hosts Sapna Patel and James Larkin engage with Michael Atkins from Georgetown University to discuss the advancements in melanoma and kidney cancer treatments, particularly focusing on immunotherapy and cytokine treatments. They explore the groundbreaking DreamSeq trial that compares immunotherapy and targeted therapy in 1L melanoma.
Have you been holding your breath for a new episode? No more holding, time to exhale... and reflect upon 2024. A trailer for you
Have you been holding your breath for a new episode? No more holding, time to exhale... and reflect upon 2024.
In this episode, hosts Sapna Patel and James Larkin reflect on their professional and personal experiences from 2024, discussing highlights, lowlights, and the impact of loss in the medical community. They share their intentions and goals for 2025, emphasizing personal bests, leadership , and the importance of friendships. The conversation also touches on cultural reflections, including movies, books, and music, culminating in heartfelt poetry for the New Year.
Summary
In another Best of 2024 episode of Melanoma Matters, hosts Sapna Patel and James Larkin discuss key findings from the Society for Melanoma Research (SMR) meeting. They spotlight the TIL for CNS mets study, KEYMAKER U02 Substudy 02D, IMA203, KeyVibe, and the MERLIN 001 study. They emphasize the importance of understanding patient eligibility for clinical trials and the challenges of translating trial results to real-world patient care.
Keywords
melanoma, cellular therapy, brain metastases, clinical trials, treatment efficacy, sentinel lymph node biopsy, immunotherapy, melanoma research, patient care, oncology
Takeaways
Chapters
00:00 Festive Greetings and Holiday Tunes
02:44 TIL for CNS Mets
09:04 KEYMAKER U02: Substudy 02D
12:51 IMA203
16:48 KeyVibe
19:27 MERLIN 001
23:28 Happy Holidays!
Summary
In this episode of Melanoma Matters, hosts Sapna Patel and James Larkin discuss their second episode in the "Best of 2024" series and review the highlights from the 2024 ESMO Congress. They discuss the final analysis of CheckMate 067, long-term data from KEYNOTE 006, DMFS from NADINA, and the KEYMAKER U02 Substudy 02C. The conversation also covers results from CheckMate 76K and KEYNOTE 716, as well as an exploratory analysis from KEYNOTE 054.
Keywords
ESMO 2024, melanoma, CheckMate 067, KEYNOTE 006, NADINA, KEYMAKER U02, CheckMate 76K, KEYNOTE 716, KEYNOTE 054, immunotherapy
Takeaways
The final analysis of CheckMate 067 shows sustained overall survival benefit and demonstrates cure is possible.
Melanoma-specific survival is becoming a critical endpoint in trials.
Long-term data from KEYNOTE 006 confirms durable benefit of pembrolizumab.
The NADINA study presents sustained event-free survival & DMFS benefits.
KEYMAKER U02 highlights the potential of neoadjuvant platforms.
CheckMate 76K and KEYNOTE 716 show consistent results in adjuvant settings.
The importance of staffing clinical trials for long-term follow-up is emphasized.
New endpoints like PRFS2 are being explored in studies.
Chapters
00:00 Introduction and Holiday Reflections
02:46 Key Presentations from ESMO 2024
03:44 CheckMate 067 Final, 10-Year Analysis
07:38 KEYNOTE 006: 10-Year Data
12:34 NADINA DMFS
16:25 KEYMAKER U02: Substudy 02C (Umbrella Neoadjuvant Arms 4, 5, 6)
21:07 CheckMate 76K & KEYNOTE 716
25:03 KEYNOTE 054: 7 Year Follow-up
Summary
In this episode of Melanoma Matters, hosts James Larkin and Sapna Patel record their first in a series of "Best of 2024" and review highlights from the ASCO Annual Meeting. They focus on 4 significant trials: NADINA, COMBI-AD, KEYNOTE 942, and RELATIVITY 048.
James & Sapna discuss the implications of these studies on the melanoma landscape, the importance of long-term follow-up data, and share some light-hearted moments about out-of-office messages.
Keywords
ASCO 2024, melanoma, NADINA trial, neoantigen therapy, checkpoint blockade, out of office messages, long-term follow-up, immunotherapy
Takeaways
Out-of-office messages can be creative and memorable.
The NADINA trial showed a high major pathologic response rate of 60%.
Patient inclusion and trial design in clinical trials can critically affect outcomes (COMBI-AD).
The KEYNOTE 942 trial demonstrated encouraging trends for overall survival.
Triplet checkpoint blockade shows promising PFS results (RELATIVITY 048).
Titles
ASCO 2024 Highlights: Melanoma Trials Reviewed
NADINA, COMBI-AD, KN 942, RELA 048
Chapters
00:00 Introduction and Icebreakers
06:24 ASCO 2024 Highlights: NADINA Trial
13:39 Long-Term Follow-Up: COMBI-AD Study
21:16 Individualized Neoantigen Therapy: KEYNOTE 942
30:23 Triplet Checkpoint Blockade: RELATIVITY 048
31:11 Fact Check Best of 2024: ASCO
31:16 FDA Guidelines on Phase 3 Trials (Listening Series)