Every year, Josh and Mike cross their fingers and pray to Father Conference-Leave that they can make the pilgrimage to one of the two central sites of Oncology: Madrid for ESMO or Chicago for ASCO. Unfortunately, to this point, Father Conference-Leave has not delivered, and 2023 is no different. However, the cold and wind will not stop our intrepid hosts from parsing the avalanche of potentially practice-changing studies, agents and professional development about to descend on the Windy City

So, consider today's episode what our American listeners would call an "appetizer," a taste of what may be coming from the American Society of Clinical Oncology Annual Meeting for 2023. This will be followed by a string of episodes breaking the aforementioned avalanche down and examining it with a fine tooth comb, with one episode dedicated to each tumour stream. So, do not adjust your set, as there will be a huge amount of Oncology content coming your way. As well as some helpful hints about North American geography.

Many thanks to Merck for supporting this episode. Merck provided virtual access to ASCO 2023, but did not review or approve any part of OftiM's coverage of ASCO.

Peripheral neuropathy is a common adverse reaction of multiple agents used to treat and cure cancer, including the platinum, taxanes and vinca alkaloids classes. It doesn't matter which way you turn in medical oncology; these chemotherapy classes are as ubiquitous for cancer treatment as the sun is to plant photosynthesis. This week on OncoSnacks, Michael and Josh investigate what to do when a patient has peripheral neuropathy and examine existing evidence for prevention, treatment and duration of this sequelae.

It is always nice to be able to say the phrase: "This cancer has an excellent prognosis." That is the case with endometrial cancer, which for the majority of sufferers, can be cured and carries an excellent survival. However, there are cases that unfortunately present late, and for these patients, the outlook is significantly more grim.

Some oncologists have little experience treating advanced endometrial cancer; for those listeners, this episode is specifically for you! In our 40th episode, Josh will discuss the foundations of endometrial cancer treatment, a topic that is vital but very boring, much like Josh himself. Michael will discuss the new frontier of immunotherapy in dMMR endometrial cancer, something that is transformative and very exciting but also unfortunately irrelevant to the majority of patients, much like Michael.

COSA President-elect (Clinical Oncology Society Australia), Professor Sabe Sabesan, is the oncologist and doctor we all dreamed of being when starting our medical training. This is a story of adversity, compassion and drive without compromise. Sabe's global journey has taken him to some of the remotest places on earth, with each inflection point creating new challenges and opportunities. Michael and Josh are the OFTIM team and are humbled to share Sabe's story, a tale many of us can only aspire to achieve.

On Oncology for the Inquisitive Mind, we like to focus on cancer and available treatment options. However, every oncologist is at his or her best when working hand-in-hand with other specialities. In this, our seventh episode of OncoSnacks, Michael and Josh interview Dr Mark Nolan, a non-invasive cardiologist with a special interest in anti-cancer treatment-induced cardiotoxicity. Mark provides an engaging, comprehensive overview of the diagnosis and management of cardiotoxicity, focusing on the two usual culprits: anthracyclines and anti-HER2 agents. A must-listen for anyone who has been confronted with a left ventricular ejection fraction (LVEF) of 40%...I mean 30%... oh, now it's 20%..

Adenoid Cystic Carcinoma (ACC) is a rare cancer commonly found in the head and neck region, arising from glandular salivary tissue. Like many orphan cancers, effective treatments in the metastatic setting are needed desperately. The 5-year survival rate is 80% and declines over time. In this special subseries: Rare Cancer Snapshots, Michael and Josh pour over the evidence for ACC, pathophysiology and the treatment paradigm to date.

Lutetium PSMA (Lutetium-177), theranostic medicine and future advances in prostate cancer are coming to an oncology centre near you faster than you can say "novel drug development" and "progression-free survival". This week Michael and Josh conclude their epic prostate cancer trilogy by exploring theranostic medicine and radioactive drug development while looking at the past of the cytotoxic world and the role of cabazitaxel. To ensure we keep your attention, six trials are discussed today, and a shout out to TheraP, the Australian phase 2 trial from the land down under.

very feast needs a palate cleanser. Every great work of theatre needs an intermission. Every sports event needs a half-time show. In this way, Oncology for the Inquisitive Mind is no different to Hamilton or the Super Bowl. Here, we provide a little deviation from our ongoing Prostate Cancer Saga to interview Dr Jenny Liu, Oncologist and early drug development (EDD) researcher extraordinaire. Our discussions range from her slightly unusual path to oncology, her previous research and how it is still making waves in the oncological community, and her other great passion: mentorship. Suppose you are interested in Phase One trials, mentorship opportunities (especially in Australia), or simply enjoy Josh dredging up dirt on highly accomplished clinicians. In that case, this is the episode for you!

In the second episode of our prostate-cancer series, we investigate the inevitability of castration resistance: the biochemical, radiological and clinical progression of prostate cancer despite the best efforts of the heroic MDT. While this space will likely change in the coming years, with many novel anti-androgen agents displaying efficacy in the HSPC space, the current standards of care for patients include docetaxel and the dynamic duo of abiraterone + prednisolone and enzalutamide. These latter two agents are frequently used in the first line when a patient cannot or is unlikely to tolerate docetaxel chemotherapy.

However, there can only be one Lord of the Anti-Androgens, and today Josh and Michael will reveal their preferred agent. Listen on to find out which, and please, contain your excitement.

Endocrinopathies in immunotherapy-related cancer treatment are common, and most of us will experience patients with hyperthyroidism and hypothyroidism regularly and recurrently in everyday practice. The incidence is variable, with some sources stating as high as 40% and others as low as 10%; either way, oncologists and trainees are likely to be close allies with their friendly neighbourhood endocrinologist. This week on Oncosnacks, Michael and Josh are interviewing Dr Dahlia Davidoff, an endocrinologist at North Shore Private Hospital in Sydney. Dahlia completed her specialist training through the prestigious Alfred Health and is currently a PhD student researching endocrine cancers at the Kolling Institute of the University of Sydney.

J.R.R. Tolkien. George Lucas. Steven Spielberg. With such seminal trilogies as Star Wars achieving a permanent place in the psyche of everyday life, who would have thought there would be room for more? But fear not, because Michael and Josh are here with their take on the age-old formula, with the first in a trilogy of episodes on prostate cancer!

Ageism is an inherent bias seen throughout medicine, with cancer adding complexity to an already difficult set of circumstances. Despite our best efforts, we all must face growing older, with time itself being that unstoppable force. Over 50% of all new cancer diagnoses are in the over-65 age bracket, which will climb as ageing populations become a reality across the globe.

This week, Michael and Josh interview the charismatically delightful Dr Michael Krasovitksy, a staunch supporter and advocate of self-empowerment, geriatric oncology and self-determination in the oncological world. Multiple thought-provoking topics are covered, including ageism, toxicity, symptom management, geriatric oncology, holistic medicine and how to combat the creeping presence of frailty. We also debate the age-old question: When do we not treat, and how does one have this conversation with the outcome being a guaranteed ticket to "shuffle off this mortal coil"?

This episode of OncoSnacks pays homage to the lack of eyebrows, eyelashes and hair many patients face when undergoing cancer treatment and the resultant alopecia. While chemotherapy is the most wanted agent, it alone is not to blame. Michael and Josh explore the hairy situation of hair loss that faces many of our patients as they navigate a new world of outpatient clinic appointments, infusion centres and a new reality in how they live and look. No eyebrows were injured during the making of this episode.

Today, our intrepid trio once more plunge down 20,000 leagues, exploring the confusing depths, hoping to answer one question: is there any evidence to support using systemic therapy in patients with potentially resectable oligometastatic colorectal cancer? The answer will take them to many dark, barely-explored corners of their profession and will raise more questions than answers. Following in the forebears of many explorers, it may drive them completely mad, or at least madder than they already are. But, to paraphrase Captain Nemo of the Nautilus: "the Earth does not want new continents, but new evidence for patients with resectable metastatic colorectal cancer."

Michael and Josh welcome back Dr Andrew Jensen to help explore part two of OftiM's Head and Neck Cancer exploration party. With localised treatments done and dusted, the metastatic space is a daunting heterogeneous disease group. Twenty years ago, head and neck treatment relied on tried and true chemotherapy, but the last fifteen years have shown great strides regarding treatment options and outcomes. The first leap forward was cetuximab added to a chemotherapy backbone, making it the weapon of choice for oncologists worldwide. But like all great civilisations, pembrolizumab now dominates, showing how it can be effective when combined with existing treatment options.

30 episodes ago, two young doctors took their first steps into the podcasting sphere, stumbling like two newborn foals birthed into a paddock full of fully functioning stallions, presenting a niche. Since then, they have blossomed before your ears into two vaguely competent podcasters, still finding their feet but growing in confidence, if not skill. Our continued existence, we owe entirely to you, our wonderful audience. You are the reason we continue to front up to our microphones every week, often wearing our pyjamas but that's beside the point. What we're trying to say is thank you, from the bottom of our hearts.

This episode of OncoSnacks kicks off Michael and Josh's sojourn into the wide world of immune-mediated adverse effects. Inevitably, as most blowhards do, they begin with the lungs. Immune-mediated pneumonitis is not as common as endocrine-axis abnormalities, dermatitis or colitis, but it can be insidious and devastating in equal measure. Such is the potential impact that must be considered in any patient who has received immunotherapy and presents with dyspnoea or a dry cough. Listen on to find out more, and you will also learn what irAEs and Senator Joseph McCarthy have in common.

Five hundred years ago, Christopher Columbus set forth to explore unknown lands. You might be asking, what do Chris and metastatic hormone receptor-positive breast cancer have in common? The answer lies in his diaries, a tale of two men, with one aptly providing anatomical details of our subject today. While we spend little time exploring Christopher, Michael and Josh meet and greet three famed Cyclin Dependant Kinase Inhibitors (CDK4/6) commonly known as Ribociclib, Abemaciclib and Palbociclib. While not all equal in stature, they have revolutionised metastatic breast cancer and now stand as first-line therapy and the gold standard of treatment. Tune in to find out why!