Healthcare Unfiltered

Brothers Rakesh Popat, PhD, multiple myeloma expert, and Sanjay Popat, PhD, thoracic oncologist, join the show for a special discourse on surrogate endpoints and patient benefit. The conversation fluctuates between the “assumption” that surrogate endpoints translate to better survival; breakdowns of the utility and association with overall survival of PFS, ORR, and MRD in the latest literature; reimbursement intricacies and issues surrounding surrogate endpoint criteria; and the need for stronger confirmatory trials after accelerated approvals, along with plenty more important points for consideration. Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Returning to the show is Adam Cifu, MD, University of Chicago, to tell us about his exciting new podcast venture. “The Clinical Excellence Podcast” is dedicated to discussing issues with clinicians, patients, and researchers studying the doctor-patient relationship. Dr. Cifu shares the tricky conversations that doctors and patients have (eg, terminating patient relationships, burnout, second opinions, caring for colleagues, and others), how those will be featured on the podcast, topics that may or may not be off limits, and other avenues of discussions you can expect as a listener. Listen to “The Clinical Excellence Podcast.” https://podcasts.apple.com/us/podcast/the-clinical-excellence-podcast/id1644154355 Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA"

Chadi hosts a roundtable of five guests—four first-timers and one recurring guest—to discuss the challenges of international medical graduates (IMGs) in oncology and medicine in general in the US. Led by Ayesha Butt, MBBS, Department of Internal Medicine, Yale School of Medicine, the group discusses the findings of a recent nationwide survey, published in JCO Oncology Practice, that uncovered bias against IMGs in the hem/onc fellowship recruitment process. Additionally, they cover the struggles of acquiring a Visa to work in the US as well as to return to the US after a visit home, their personal stories experiencing bias, the need to “cast a wider net” when considering a pool of applicants for fellowship positions, and ways to overcome bias against IMGs, along with many other important discussion points. Read the article “Bias Against International Medical Graduates in the Hematology/Oncology Fellowship Recruitment Process: Findings From a Nationwide Survey of Fellowship Program Directors.” https://ascopubs.org/doi/full/10.1200/OP.22.00219 Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA"

Chadi hosts a roundtable of five guests—four first-timers and one recurring guest—to discuss the challenges of international medical graduates (IMGs) in oncology and medicine in general in the US. Led by Ayesha Butt, MBBS, Department of Internal Medicine, Yale School of Medicine, the group discusses the findings of a recent nationwide survey, published in JCO Oncology Practice, that uncovered bias against IMGs in the hem/onc fellowship recruitment process. Additionally, they cover the struggles of acquiring a Visa to work in the US as well as to return to the US after a visit home, their personal stories experiencing bias, the need to “cast a wider net” when considering a pool of applicants for fellowship positions, and ways to overcome bias against IMGs, along with many other important discussion points. Read the article “Bias Against International Medical Graduates in the Hematology/Oncology Fellowship Recruitment Process: Findings From a Nationwide Survey of Fellowship Program Directors.” https://ascopubs.org/doi/full/10.1200/OP.22.00219 Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA"

Making her long-awaited return to the show is Stacie Dusetzina, PhD, Professor of Health Policy and the Ingram Professor of Cancer Research, Vanderbilt University Medical Center – this time to discuss and simplify the Inflation Reduction Act that was recently signed into law. She begins by giving the background inspiration of the Act, whether reducing inflation is the true purpose of the Act, how the Act impacts Medicare and negotiating drug prices, how the drugs to be negotiated are selected, what those negotiations will look like, and the ins-and-outs of the other consequences of the Act on healthcare (ie, Medicare Part D redesign), among other items. As always, let me know what you think; visit my website at www.chadinabhan.com and follow me on twitter @chadinabhan

In this change-of-pace episode, Chadi hosts show-regular Aaron Goodman and his wife: Amalia Aleck, MD, UC San Diego. The couple sit down for a casual conversation on how they met and their love story, applying for residencies and full-time employment as a couple, balancing their professional and family lives together and the inherent sacrifices they’ve had to make, the dynamics of “Papa Hem” on Twitter and their relationship on this platform, her support of his musical ambitions, and many other “behind-the-curtain” anecdotes that you don’t want to miss. Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Christopher Booth, MD, Professor in the Departments of Oncology and Medicine as well as a Health Services Researcher, Queen's University (Canada), brings a different perspective to the show on healthcare policy and where the cancer system may be failing patients. Dr. Booth shares the “desert island” hypothetical scenario he used in a previous publication in which he asked oncologists all over the world for their 10 cancer drugs they would take to the “island” to help their patients. Then, he shares his thoughts on the relatively novel concepts of the “value crisis” and “time toxicity” he sees in cancer care, how to reconcile benefit to individual patients vs patient populations, the translation from efficacy to effectiveness within treatments, ways to temper patient expectations when it comes to hype vs hope for treatments and recovery goals, and a whole lot more. Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Dr. Myriam Chalabi, a GI oncologist at the Netherlands Cancer Institute, joins the show after making waves at the latest ESMO Congress for her NICHE-2 study – an assessment of neoadjuvant immune checkpoint inhibition in locally advanced dMMR colon cancer. She shares the initial inspiration to give neoadjuvant immunotherapy for dMMR tumors, the surprisingly positive early results that led to expanding the study, her feelings and expectations leading up to her talk at ESMO, and her reaction to the Twitter phenomenon with the “Chalabi Plot” – how the medical community was in awe of her rare and exceptional waterfall plot. This episode is a good reminder of the value in executing a well-designed clinical trial and the benefits that patients stand to gain from good science. Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

To tackle the relatively unknown topic of Hyperemesis Gravidarum (HG), Chadi invites four experts from the Hyperemesis Education & Research (HER) Foundation: Kimber MacGibbon, RN, executive director and co-founder; Aimee Brecht-Doscher, MD, adviser and long-time supporter; Kelly Ryerson, MBA, chair of the board of directors; and Marlena Fejzo, PhD, survivor of HG and research advisor. The group begins by defining HG—with respect to the traditional definition as well as the modern understanding—and its prevalence among pregnant women today. The conversation evolves into the myths and misconceptions surrounding HG, the current research landscape and funding availability, progress in identifying and sequencing an important gene, drug development updates, and a whole lot more. Read more about the HER Foundation website. https://www.hyperemesis.org/ Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Recurring guest Mikkael A. Sekeres, MD, Professor of Medicine and Chief of the Division of Hematology, Sylvester Comprehensive Cancer Center, is today’s guest of honor to discuss and spotlight his just-published book: Drugs and the FDA: Safety, Efficacy, and the Public's Trust. Dr. Sekeres begins by sharing an anecdote of his experience on the FDA Oncologic Drugs Advisory Committee (ODAC) for Avastin as an inspiration to write the book. Then, he delves into the detailed process of becoming an ODAC member and how conflicts of interest are handled in the screening process, how personal experience bias (rather than data) may influence ODAC members to vote to approve a drug, financial compensation allotted to ODAC members, and how ODAC members balance science with humanity when considering drugs for approval. The conversation ends with a commentary on the good and bad of DTC advertising, the future of clinical trial phasing and designing, and a few other interesting discussion points. Order Drugs and the FDA: Safety, Efficacy, and the Public's Trust. https://www.amazon.com/Drugs-FDA-Safety-Efficacy-Publics/dp/0262047314 Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA