Healthcare Unfiltered

Vivek Subbiah, MD, associate professor in the department of investigational cancer therapeutics, MD Anderson, is the world-renowned guest on the show this week to tackle the world of precision medicine in cancer. He begins by explaining how precision medicine is more than simply a “fancier” mechanism of treatment than chemotherapy, why tumor sequencing is important even though there aren’t drugs available for every possible mutation, how much the field has advanced even in the past 10 years, the intricacies of designing clinical trials, and lots more.

For another lively debate, Chadi brings on two lymphoma experts to talk about what to do with peripheral T-cell lymphoma (PTCL) patients after an achieved remission: Barbara Pro (@bpromd), MD, Northwestern University, and Mehdi Hamadani (@MediHumdani), MD, Medical College of Wisconsin. The two doctors share how they counsel and treat patients in uncertain situations, including the “right” circumstances to watch-and-wait, autologous transplant, allogeneic transplant, or maintenance chemotherapy.

Chadi welcomes back Rafael Fonseca, (@Rfonsi1), MD, interim director of Mayo Clinic Cancer Center, and Aaron Goodman (@AaronGoodman33), MD, hematologist, University of California San Diego, to debate whether smoldering multiple myeloma should be treated. They begin by agreeing on a definition of the disease, listing patient characteristics that may warrant consideration for early intervention, and stating the importance of improving the ability to predict progressing disease. The trio then debate treatment in specific example circumstances and the overall consensus within the myeloma world, the practicality of clinical trials for smoldering disease, and so much more in this testy and thought-provoking dialogue.

Is it a coincidence that many clinicians are talented musicians? These doctors don’t believe so! In this exclusive roundtable pow-wow, Chadi hosts a range of crafty and passionate oncologists that share a similar dedication to music. Conversations on musical inspirations and favorite artists are interwoven with music samples and personal anecdotes in this truly lighthearted, uninhibited jam session like you’ve never heard.

In this captivating episode, Chadi shares the microphone with Nancy Olivieri (@DrNancyOlivieri), MD, professor of medicine, pediatrics, and public health science at the University of Toronto, to recount her famous clash with a pharmaceutical company (among other entities) that tried to silence her for reporting on adverse effects related to an experimental drug. Dr. Olivieri became famous for raising doubts about a drug that was being studied to treat patients with thalassemia. In great and juicy detail, Dr. Olivieri provides the timeline of events, including bouts with the company’s CEO as well as her own academic institution, and the legal battles that ensued.

Alan Skarbnik (@ASkarbnik), MD, director of the lymphoma and CLL program, Novant Health (Charlotte, NC), and Aaron Goodman (@AaronGoodman33), MD, hematologist, University of California San Diego, join the show for a long-awaited debate: treating double-hit lymphoma with R-CHOP vs dose-adjusted (DA)-EPOCH-R. The conversation gets testy when the trio describe double-hit lymphoma in terms of histology and phenotype, the limitations of retrospective analyses when it comes to establishing a standard of care for this type of lymphoma, an intense breakdown of the CALGB 50303 study as it relates to the treatment argument and toxicity profiles, and so much more.

To tackle the complicated world of neuroendocrine tumors (NETs), Chadi is joined by Pamela Kunz (@PamelaKunzMD), MD, Director of the Center for GI Cancers at Yale Cancer Center; as well as the Vice Chief of Diversity, Equity, and Inclusion for medical oncology at Yale Cancer Center. Dr. Kunz begins by shedding light on potential reasons for higher incidence of NETs in the past three decades and the boom of FDA approvals in the last decade, as well as the latest therapies and clinical trials with the most potential to move the needle for patient care. Then, Chadi and Dr. Kunz highlight the priorities of a new committee she has helped form for diversity, equity, and inclusion within the institution – including data collection, increasing the diversity of the faculty, and creating a culture of respect.

Vincent Rajkumar (@VincentRK), MD, Mayo Clinic, and Editor-in-Chief of Blood Cancer Journal, rejoins the show to answer some critically important questions related to medical publications and information reliability in the pandemic and post-pandemic world. As a consumer of medical news, which sources of information should you take seriously? Should you ignore press releases and pre-prints in favor of abstracts or papers? Should peer-reviewed literature be your only source of reliable information? Together, Chadi and Dr. Rajkumar put on their critical appraisal hats to rate various sources and determine when to adapt new guidelines or recommendations for patient care.

Chadi dives into the world of nutrition and dieting with Kevin Bass, MD, PhD student in Texas; Ethan Weiss, MD, cardiologist; and Aaron Goodman, MD, hematologist and current subscriber to the Ketogenic diet. The groups begins with a history of the “Keto” diet and how it has transformed into a popular diet for weight loss, what goes into the traditional Keto diet and how to do it effectively, controversy surrounding the diet and whether it is associated with adverse health effects, reasons to follow and not follow the diet, and numerous misconceptions about low-carb diets in general.

To provide an update on the COVID spike and response in India over the past 6 weeks since Chadi’s previous episode, Aju Mathew (@ajumathew_), MD, oncologist practicing in southern India, joins the show. Dr. Mathew begins by describing the tradeoffs of moving home to practice in India while leaving his academic career behind in the US, offers critical remarks on India’s government use of resources to combat COVID up to and during the “tsunami,” shares how vaccine hesitancy around the world bled into India’s population, provides a status on the current vaccine and resource availability in the country as well as the percentage of the population vaccinated, and plenty more.