Ep. 59 Evolving Treatment Paradigms in Hepatocellular Carcinoma: What's on the Horizon? with Dr. A Craig Lockhart and Dr. Lingling Du

Ep. 60 PARP Inhibitors: Clinical Trials & Real-World Applications with Dr. Neeraj Agarwal and Dr. Arun Azad

Keeping patients on PARP inhibitors long enough to see real benefit often comes down to proactive side effect management. In this episode of BackTable Urology, Dr. Neeraj Agarwal and Dr. Arun Azad join host Dr. Alan Tan to discuss practical, evidence-based strategies for managing hematologic and GI toxicities in advanced prostate cancer patients receiving PARP inhibitors. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by an educational grant from Pfizer. --- Timestamps 00:00 - Introduction 06:17 - Managing Anemia 11:12 - Side Effect Profiles 19:33 - Transfusions vs ESAs 26:43 - Docetaxel vs PARP Inhibitors 30:27 - Side Effect Management Pearls 40:18 - Team Based Monitoring 52:27 - Tissue Versus Liquid 01:01:24 - Genetic Counseling Workflow 01:07:07 - Trial Equity and Access --- More about this episode The doctors discuss the importance of close anemia monitoring during the critical first 3 to 4 months of therapy, maintaining dose intensity, proactive antiemetic use, and the role of exercise and resistance training in combating fatigue. The conversation also covers differences in toxicity profiles between PARP agents, the value of multidisciplinary care teams, molecular advances in molecular and germline testing, and the evolving landscape of emerging therapies in prostate care. --- Resources Talazoparib plus enzalutamide in men with metastatic castration-resistant prostate cancer: final overall survival results from the randomised, placebo-controlled, phase 3 TALAPRO-2 trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00684-1/abstract BRCAAway: A randomized phase 2 trial of abiraterone, olaparib, or abiraterone + olaparib in patients with metastatic castration-resistant prostate cancer (mCRPC) bearing homologous recombination-repair mutations (HRRm). https://ascopubs.org/doi/10.1200/JCO.2024.42.4_suppl.19 --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Ep. 59 Evolving Treatment Paradigms in Hepatocellular Carcinoma: What's on the Horizon? with Dr. A Craig Lockhart and Dr. Lingling Du

With new systemic and liver-directed approaches under investigation, which targets and treatment strategies are most likely to shape HCC care? In this final episode of the BackTable 2026 HCC Creator Weekend™, Drs. Lingling Du, A. Craig Lockhart, and Jon Mizrahi focus on the future of hepatocellular carcinoma beyond established PD-1/CTLA-4 regimens. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 01:34 - Beyond PD-1 and CTLA-4: Anti-TIGIT plus Atezolizumab 03:24 - Combination Strategies: Immunotherapy plus Radioembolization 09:14 - SBRT in Oligometastatic Disease 10:55 - Neoadjuvant Immunotherapy in HCC 12:07 - Targeted Therapies: ctDNA, CAR T-cells & GPC3 15:18 - Liver Transplant & Immunotherapy 23:07 - Future Directions and Closing Thoughts --- More about this episode The clinicians discuss promising results from emerging immune checkpoint targets like anti-TIGIT and note ongoing interest in other targets like TIM-3. They emphasize combining systemic immunotherapy with liver-directed therapies like Y90 across heterogeneous patient groups and discuss potential neoadjuvant approaches for resectable cases, despite limited benefit seen in adjuvant studies. Additionally, they outline early-phase cellular and targeted strategies, such as GPC3-directed bispecifics and CAR T-cell therapies, noting tolerance challenges tied to liver function and the risks of using immunotherapy after liver transplant. --- Resources TIGIT plus atezolizumab phase II study https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00679-X/fulltext LEAP-002 Trial https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(23)00469-2/abstract EMERALD-1 Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02551-0/abstract --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Ep. 58 Advanced Hepatocellular Carcinoma: Navigating Second-Line Therapy Options with Dr. A. Craig Lockhart and Dr. Lingling Du

When first-line treatment for advanced hepatocellular carcinoma (HCC) fails and the disease progresses, what options are available for second-line therapy? In this episode of the BackTable 2026 HCC Creator Weekend™, Drs. Lingling Du, A. Craig Lockhart, and Jon Mizrahi explore the uncertain landscape of second-line treatment after first-line immunotherapy, such as atezolizumab and bevacizumab or the STRIDE regimen, including practical considerations for choosing which second-line therapy to use. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 01:15 - Second-Line Treatment for HCC: Lenvatinib vs Ramucirumab 04:28 - Tolerability And Sequencing Reality: Cabozentinib 06:35 - Treatment Options for Rapid Progression After Atezolizumab + Bevacizumab 11:40 - Practical Tyrosine Kinase Inhibitor Dosing for HCC 13:44 - Next-Generation Sequencing vs Biopsy In HCC Practice 19:10 - Future Biomarker Clinical Trials: Risks and Impact on Practice 24:31 - Role of Second-Line Immunotherapy in HCC --- More about this episode The doctors discuss real-world dosing strategies for tyrosine kinase inhibitors (TKI), management of rapid progression, and the limited utility of next-generation sequencing and biopsy in HCC. They also highlight ongoing biomarker clinical trials and the evolving role of second-line immunotherapy. They note that few patients reach third-line therapy due to declining performance status and liver function, as well as mixed results from adding CTLA-4 inhibitors after disease progression. --- Resources HIMALAYA Clinical Trial https://www.annalsofoncology.org/article/S0923-7534(24)00049-8/fulltext --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Ep. 57 First-Line Therapy for Advanced Hepatocellular Carcinoma: Decisions in the Real World with Dr. A. Craig Lockhart and Dr. Lingling Du

Learn how a “watershed” clinical trial in 2020 completely overturned a decade of standard care for liver cancer. In this inaugural episode of the BackTable 2026 HCC Creator Weekend™ , medical oncologists Dr. John Rahi, Dr. Craig Lockhart, and Dr. Lingling Du review the evolution of first-line systemic therapy for hepatocellular carcinoma (HCC), highlighting immune checkpoint inhibitors as a major change from the TKI era. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 03:24 - Early Immunotherapy Momentum 07:03 - Long Term Survival Tails 14:13 - Autoimmune Disease Nuances 22:45 - Combining With Liver Directed Therapy 25:29 - Ideal Candidate for Ipi Nivo 26:54 - Wrap Up and Takeaways --- More about this episode The doctors discuss key data from IMbrave150 (atezolizumab/bevacizumab vs sorafenib), HIMALAYA (STRIDE: tremelimumab plus durvalumab vs sorafenib), and CheckMate 9DW (ipilimumab/nivolumab vs physician’s choice TKI, largely lenvatinib), noting improved survival, high response rates with ipi/nivo, and long-term survival “tails.” They cover negative/neutral TKI-IO trials (LEAP-002, COSMIC-312) and focus on patient selection nuances including EGD/variceal bleeding risk with bevacizumab, hypertension/proteinuria, platelet thresholds, autoimmune disease considerations, Child-Pugh status, liver function preservation, and preferences when combining systemic therapy with liver-directed procedures like Y90. --- Resources IMbrave150 https://www.nejm.org/doi/full/10.1056/NEJMoa1915745 Himalaya Study https://evidence.nejm.org/doi/full/10.1056/EVIDoa2100070 CHeckmate 040 https://jamanetwork.com/journals/jamaoncology/fullarticle/2771012 --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Ep. 56 Breast Cancer Precision Medicine: Biomarkers & Treatments with Dr. Jessica Treviño Jones

Here’s a practical guide on how biomarkers can guide treatment and cut costs for your breast cancer patients. In this episode of the BackTable Tumor Board Podcast, Dr. Lindsay Peterson and Dr. Jessica Trevino Jones review the role of precision medicine and biomarkers in early-stage and metastatic disease, specifically in breast cancer. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 05:30 - Genomic Testing in the Metastatic Setting 11:47 - Liquid vs Tissue Biopsy 17:51 - Testing and Treatment for Triple Negative Metastatic Breast Cancer 21:20 - Precision Medicine and Patient Education 27:01 - Path CR and Residual Disease: Clinical Trials 37:01 - Neratinib in Triple Positive Breast Cancer and Brain Metastasis 39:55 - Genomic Tests: Oncotype and MammaPrint 43:45 - Importance of Clinical Trials and Wellness Support --- More about this episode Dr. Peterson and Dr. Trevino Jones discuss the optimal timing for tumor genomic testing in ER-positive/HER2-negative and triple-negative metastatic breast cancer, and examine the decision-making process between liquid biopsy and tissue biopsy for biomarker analysis. The conversation also highlights how these technological advances can expand treatment options and help reduce financial toxicity for patients. Additionally, the doctors emphasize the importance of patient education about clinical trials, address common misconceptions, and discuss the integration of prevention, nutrition, exercise, and wellness support into comprehensive cancer care. --- Resources OFSET Clinical Trial https://clinicaltrials.gov/study/NCT05879926 SWOG 2206 Clinical Trial https://www.swog.org/clinical-trials/s2206 Pembrolizumab vs. Observation in People With Triple-negative Breast Cancer Who Had a Path CR https://clinicaltrials.gov/study/NCT05812807 KETNOTE-522 Clinical Trial https://clinicaltrials.gov/study/NCT03036488 https://www.nejm.org/doi/full/10.1056/NEJMoa1910549 --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app