BackTable Tumor Board

The FLOT regimen is the standard-of-care for upper gastroesophageal malignancies, but what if there were other drug combinations or perioperative strategies that could further improve outcomes? In Part II of our ESMO 2025 recap, medical oncologists Dr. Jun Gong and Dr. Jonathan Mizrahi cover emerging studies and treatments in gastroesophageal cancers. --- SYNPOSIS The discussion provides an overview of pivotal trials, including MATTERHORN, which demonstrated improved overall survival with durvalumab plus FLOT, and FORTITUDE-10, which highlights ongoing challenges in treatment efficacy with FGFR2b inhibitors. This episode also explores the role of lenvatinib-based combinations for esophageal squamous cell carcinoma and practical considerations for integrating checkpoint inhibitors into real-world clinical practice. --- TIMESTAMPS 00:00 - Introduction01:23 - The MATTERHORN Study03:24 - PD-L1 Status and Clinical Implications07:09 - FORTITUDE-101 and 102 Studies: Discrepancies and Insights on FGFR2b Inhibition11:15 - LEAP-014 and 015 Studies: The Role of Lenvatinib14:57 - Conclusion and Final Thoughts --- RESOURCES Phase III MATTERHORN Studyhttps://dailynews.ascopubs.org/do/matterhorn-durvalumab-chemotherapy-demonstrates-superior-efs-over-standard-care ESOPEC Phase III Trialhttps://pmc.ncbi.nlm.nih.gov/articles/PMC4952147/ FORTITUDE-101 Trialhttps://clinicaltrials.gov/study/NCT05052801 FORTITUDE-102 Trialhttps://clinicaltrials.gov/study/NCT05111626 LEAP-014 Phase III Studyhttps://ascopubs.org/doi/10.1200/JCO.2022.40.4_suppl.TPS367 LEAP-015 Studyhttps://ascopubs.org/doi/10.1200/JCO-25-00748

Get caught up on the cutting edge colorectal cancer trial data from ESMO 2025 with this 30-minute BackTable Tumor Board recap! Featuring medical oncologists Dr. Jonothan Mizrahi and Dr. Jun Gong. --- SYNPOSIS The doctors discuss the DESTINY-CRC02 trial with focus on HER-2 positive metastatic colorectal cancer, the DYNAMIC-III and Pegasus studies regarding CTDNA-guided therapies, and the pivotal STELLAR-303 study for treatment-refractory microsatellite stable colorectal cancer. They also review the implications of NICHE-2 and FOxTROT studies on neoadjuvant chemotherapy versus immunotherapy for MSI high patients. Emphasis is placed on the real-world practice applications of these study findings, potential treatment shifts, and how these new trial results will impact future guidelines in colorectal cancer care. --- TIMESTAMPS 00:00 - Introduction01:25 - Overview of ESMO 2025 Annual Congress13:50 - cTDNA Monitoring in Clinical Practice16:24 - STELLAR-303 Study: Immunotherapy in MSS Colorectal Cancer20:40 - Neoadjuvant Immunotherapy for MSI High Colorectal Cancer26:39 - DESTINY-CRC02 Study: Final Analysis29:30 - Conclusion and Outro --- RESOURCES DESTINY-CRC02 Trialhttps://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00380-2/abstract DYNAMIC-III Trialhttps://www.nature.com/articles/s41591-025-04030-w STELLAR-303 Trialhttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02025-2/abstract

For the small subset of pancreatic cancer patients whose cancer is detected early and remains localized, there are now opportunities to offer treatment and improve outcomes. In this episode of the BackTable Tumor Board Podcast, Ochsner medical oncologist Dr. Jonathan Mizrahi and MD Anderson surgical oncologist Dr. Rebecca Snyder discuss the contemporary management of localized pancreatic cancer. --- SYNPOSIS Dr. Snyder and Dr. Mizrahi break down the categories of resectable, borderline resectable, and locally advanced pancreatic cancer; and explain the current treatment strategies that are tailored to each stage. The discussion highlights the role of neoadjuvant therapy, the potential benefits of radiation for certain subpopulations, and the importance of a multidisciplinary team approach for optimal patient care. The doctors also cover pivotal clinical trials, ongoing research, and future directions in the field, including targeted therapies and biomarker development, to inform best practices in treating patients with localized pancreatic cancer. --- TIMESTAMPS 00:00 - Introduction02:24 - Defining Resectable, Borderline, and Locally Advanced Pancreatic Cancer11:10 - Neoadjuvant Therapy for Resectable Pancreatic Cancer17:16 - Ongoing Clinical Trials: FOLFIRINOX and Gemcitabine Nab-Paclitaxel23:04 - The Role of Radiation in Pancreatic Cancer Treatment26:52 - Treating Locally Advanced Pancreatic Cancer34:49 - Future Directions and Targeted Therapies --- RESOURCES APOLLO Randomized Phase II Studyhttps://clinicaltrials.gov/study/NCT04858334 PRODIGE 29-UCGI 26 (NEOPAN) Phase III Trialhttps://ascopubs.org/doi/10.1200/JCO-24-02210 ALLIANCE A021806 Phase III Trialhttps://doi.org/10.1245/s10434-024-15817-5 NORPACT-1 Phase II Trialhttps://pubmed.ncbi.nlm.nih.gov/38237621/ Dutch Randomized Phase III PREOPANC Trialhttps://pubmed.ncbi.nlm.nih.gov/32105518/ SWOG S1505 Randomized Clinical Trialhttps://pubmed.ncbi.nlm.nih.gov/32740235/ ALLIANCE A021501 Phase II Randomized Clinical Trialhttps://pubmed.ncbi.nlm.nih.gov/35834226/ LAP07 Randomized Clinical Trialhttps://pubmed.ncbi.nlm.nih.gov/27139057/ LAP100 Phase III Trialhttps://clinicaltrials.gov/study/NCT06958328 Meta-analysis on Arterial Resections in Pancreatic Cancerhttps://pmc.ncbi.nlm.nih.gov/articles/PMC12070998/ PANOVA-3 Phase III Studyhttps://ascopubs.org/doi/10.1200/JCO-25-00746 NRG-GI011 Clinical Trial: Openinghttps://www.nrgoncology.org/patients/patient-study-webpages/nrg-gi011-testing-higher-dose-rt-for-locally-advanced-pancreatic-cancer

Metastatic pancreatic cancer is no longer a ‘one size fits all’ diagnosis. In this episode of the BackTable Tumor Board Podcast, medical oncologist Dr. Jon Mizrahi and Dr. Shubham Pant, a professor of GI Medical Oncology at MD Anderson Cancer Center, discuss the evolving landscape of systemic therapy for advanced pancreatic cancer.---SYNPOSISThe doctors cover the current options for first- and second-line chemotherapy treatments, the significance of molecular profiling and germline testing, and the emerging potential of targeting KRAS mutations. The discussion also highlights the importance of supportive and palliative care for patients, focusing on pain management, nutritional support, and the role of pancreatic enzymes. The conversation concludes with speculation on the future of pancreatic cancer treatment and the need for improved access to clinical trials.---TIMESTAMPS00:00 - Introduction02:32 - First-Line Therapy Options10:31 - Second-Line Therapy Options20:18 - Challenges in Pancreatic Cancer Immunotherapy26:47 - Supportive Care and Quality of Life35:57 - Disparities in Pancreatic Cancer Treatment38:58 - Conclusion and Future Directions---RESOURCESAdagrasib Clinical Trialhttps://www.clinicaltrials.gov/study/NCT05853575

Is the open thoracotomy becoming outdated as robotic surgery and advanced ablation techniques take center stage in lung cancer treatment? In the final discussion of the 2025 NSCLC Creator Weekend™ series, our virtual tumor board of interventional radiologists and pulmonologists from leading medical institutions discuss recent surgical and interventional advancements in the treatment of lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS The conversation covers the contemporary role of PET scans, endobronchial ultrasound (EBUS), mediastinal staging, and the importance of perioperative systemic therapy. The doctors explore surgical and non-surgical methods for treating lung cancer, including lymph node dissection, criteria for resection, and the advantages of minimally invasive approaches such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgeries. A key focus of this episode is the decision-making process for treating multifocal lung cancers while preserving lung function, and the use of combined therapies like ablation and radiation. The episode concludes with a detailed case study illustrating the long-term management of a patient with multiple lung adenocarcinomas over several years, highlighting the multidisciplinary approach required in such complex scenarios. --- TIMESTAMPS 00:00 - Introduction10:07 - Patient Selection and Comorbid Conditions27:29 - Surgical Margins and Resection Strategies42:11 - Understanding Upstaging in Cancer Treatment53:27 - Technical and Clinical Resectability56:13 - Case Study: Managing Multifocal Lung Cancer01:11:41 - Long-Term Outcomes and Treatment Strategies --- RESOURCES CALGB 140503 Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa2212083 JCOG0802 Trialhttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02333-3/abstract

Why might simultaneous ablation and biopsy be the new standard for high-probability lung cancer cases where surgery isn’t an option? In the penultimate episode of the 2025 NSCLC Creator Weekend™ series, our multidisciplinary tumor board panel discusses the intricacies and decision-making processes surrounding biopsy and ablation procedures in thoracic oncology. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Topics include the prioritization of treatment versus tissue acquisition, the nuances of bronchoscopic versus percutaneous biopsies, and the latest advancements in robotic and cryo-biopsy techniques. The experts also share their approaches to managing pneumothorax, the value of multidisciplinary collaboration, and case studies that highlight personalized patient care. Listeners gain valuable insights into the evolving landscape of thoracic oncology procedures and the importance of patient-centered decision-making. --- TIMESTAMPS 00:00 - Introduction04:12 - Cryobiopy vs. Non-Cryobiopsy08:43 - Biopsy and Ablation: Strategies and Considerations15:31 - Post-Therapy Imaging and Follow-Up25:18 - Treatment Options and Patient Decisions27:08 - Evaluating Ablation Techniques28:59 - Managing Lung Cancer Recurrence39:41 - Case Study: Young Male with Ground Glass Nodule43:15 - Concluding Thoughts

Collaboration between interventional radiology and radiation oncology has enabled high-dose brachytherapy in central lung lesions that were previously untreatable. This episode of the 2025 NSCLC Creator Weekend™ series offers a deep dive into recent advancements in lung ablation and brachytherapy techniques for primary lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Key discussion points include ablation zone sizes, confirmation methods for effective treatment, and the integration of different modalities such as microwave and cryoablation. Our tumor board panel also explores the practical and logistic challenges of implementing high-dose brachytherapy, especially for central lesions, and its role in palliative care. Despite the intricate processes and potential complications like pneumothorax, these methods show promising local control rates and provide crucial options for non-operative candidates. --- TIMESTAMPS 00:00 - Introduction and Overview of Lung Ablation07:01 - Microwave Ablation and Ground Glass Attenuation17:53 - Artificial Pneumothorax Techniques27:09 - Technical Aspects and Innovations32:35 - Bronchial Brachytherapy Techniques37:47 - Conclusion and Credits --- RESOURCES 2021 Central Lesion Studyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8186067/

Why might the standard RECIST criteria fail to accurately track success after tumor ablation, and what should you look for instead? In the 4th installment of the 2025 NSCLC Creator Weekend™ series, hosts Drs. Scott Genshaft and Kavi Krishnasamy are joined by specialists from UCLA and USC to discuss and debate advanced treatment options for primary lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS The panel, including interventional radiologists, pulmonologists, and a radiation oncologist, discusses the intricacies of photon versus proton therapies, the physics behind radiation treatment, and the evolving landscape of ablation technologies. The conversation covers the efficacy and limitations of different treatments, patient selection criteria, and the role of newer technologies like electroporation and robotic-assisted bronchoscopy in enhancing precision and outcomes. Additionally, the panel addresses the practical challenges of intraprocedural imaging, the importance of adequate margins, and the complexities of managing local recurrences and radiation-induced toxicities. --- TIMESTAMPS 00:00 - Tumor Ablation and Recurrence Rates12:53 - Advancements in Ablation Technologies23:31 - Bronchoscopic Approaches in Lung Cancer Treatment38:46 - Challenges in Radiation Dose and Delivery49:21 - Ablation and Radiation Margins01:07:19 - Final Thoughts --- RESOURCES Thierry de Baere Paper on Ablation Margins https://pmc.ncbi.nlm.nih.gov/articles/PMC9815739/

How do leading oncologists interpret the abundance of molecular tests, genomic data, and biomarkers to create a lung cancer patient’s treatment plan? In this episode of the 2025 NSCLC Creator Weekend™ series, our tumor board discusses the complexities of lung cancer treatment, including new systemic therapies, lung cancer staging, and the role of molecular diagnostics and liquid biopsies. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS The panel, featuring specialists from various institutions, discusses the specifics of sequencing therapies, the impact of targeted and immunotherapies, and the nuances of treating different patient profiles, including non-smokers and those with specific genetic mutations. The conversation also touches on the integration of new staging systems, the benefits of multidisciplinary clinics, and the ongoing evolution of cancer treatment trials. The discussion aims to provide clarity on the latest advancements and future directions in managing lung cancer, emphasizing the importance of tailored treatment plans and the potential of emerging technologies. --- TIMESTAMPS 00:00 - Introduction05:16 - Molecular Diagnostics and Liquid Biopsy21:43 - Targeted Therapy Options27:29 - Managing Toxicities and Treatment Strategies33:13 - Challenges with Immunotherapy in Special Cases34:07 - Lung Transplantation in Cancer Patients48:38 - Multidisciplinary Clinics and Collaboration01:06:29 - Future Directions --- RESOURCES ADAURA Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa2027071 Gomez NSCLChttps://pmc.ncbi.nlm.nih.gov/articles/PMC5143183/

When cancer spreads to the brain, what is the best approach: immediate local treatment or systemic immunotherapy first? Part two of the 2025 NSCLC Creator Weekend™ series focuses on a complex case involving a 75-year-old woman with a history of breast malignancy, presenting with new dyspnea and a large mass in the left lower lobe. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Our mock tumor board consists of surgeons, medical oncologists, and radiation oncologists to deliberate and determine the best treatment plan. The specialists explore diagnostic and treatment options, including neoadjuvant chemoimmunotherapy, invasive mediastinal staging, and the potential for surgical resection or radiation therapy. --- TIMESTAMPS 00:00 - Introduction05:01 - Approach to Isolated Brain Metastasis09:09 - Radiation Therapy Considerations12:06 - Imaging and Follow-Up Strategies14:39 - Resectability and Surgical Decisions19:10 - Conclusion --- RESOURCES PACIFIC Clinical Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa1709937