1.34 Endpoints in ECOG-ACRIN 2511, Update to KEYNOTE-024, & Mentorship with Dr. Joseph Shatzel
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.
1.33 Guarantee-Time Bias & Trials, Philanthropy, and Cancer Research with Dr. Tom Beer
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.
1.32.1 Radiation Oncology with Dr. Brian Kavanagh
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.
1.32 Rating Metrics, Conflict of Interest in the News, & Radiation Oncology with Dr. Brian Kavanagh
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.
1.31 Ketogenic Diet, COMET-1 and COMET-2, the Health Insurance Marketplace with Dr. Jane Zhu
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.
1.29 RCT of Parachutes and Frameworks for Internal Medicine with Dr. Andre Mansoor
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
1.28 Questionable FDA Drug Approvals and Building a Career with Dr. Chadi Nabhan
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.
1.26 Lesson From an ASH Abstract, Behind the Scenes of a Residency Program with Dr. Sima Desai
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.
1.25 Welch's Legacy, Interpreting NGS, Uncertainty over Pregabalin, Beyond EBM with Dr. Sam Edwards
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".
1.24 Useless Medical Conferences and Dr. Adam Obley on Vascepa, Fish Oil, Vitamin D and Methotrexate
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.
1.22 Elo-Pom-Dex, Immunotherapy Combos, Inherent Bias, and the FDA with Dr. Erick Turner
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.
1.21 Nab-Paclitaxel in CCA, OS of PALOMA-3, Transparency, and Dr. Talal Hilal's Advice for Trainees
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.
1.20 Precision Oncology: Some Benefit, Mostly Hype and Mentorship with Dr. Andrae Vandross
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.
1.18 IMpassion130 and Hot-Spotting with Dr. Brian Chan
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
1.16 BONUS! Crowdsourcing Data Analysis and Medical Reversal: Why 40% of What We Do is Wrong
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
1.15 Minimally Effective Treatments, CheckMate 331, and Dr. Adam Obley on Low-Value Healthcare
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!
1.13 KEYNOTE-189, Dr. Talal Hilal on MRD, and Medical Education with Dr. Adam Cifu
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.
1.12 BONUS! Evidence-Based Medicine Has Been Hijacked in Oncology
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.
1.11 Peanut Gallery, Research Parasites, Appendectomies, HRQoL and PFS, Dr. Bishal Gyawali
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.
1.10 Criticism via Twitter, PACIFIC, PCI for CAD, and Dr. Rebecca Cooney of The Lancet
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.