As we prepare for another round oncology series in the weeks to come, we thought we would pause and go back to to the basics. We previously released this episode as Episode 020. This episode is a must-listen for anyone who talks to patients about chemotherapy! —— Picture this: it's day 1 of fellowship and your attending needs you to "get consent for treatment." Huh? How do you educate your patient? We share our tips! In this episode, we discuss the fundamentals and some of our favorite...

We started this conversation last week! This week, we focus on how to approach warfarin and enoxaparin failure! Be sure to check out Episode 079 for part 1! Content: - What do you do about "wafarin failure"? - What about lovenox failure? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter:...

It’s time for another Heme Consult series, this time focusing on another common question we see in the hospital and in clinic: “is this anticoagulation failure?” In this two-part series, we break down how we approach the workup to determine exactly this. In this episode, we discuss "DOAC failure". Content: - How to approach a "DOAC failure" situation - When to consider warfarin ** Want to review the show notes for this episode and others? Check out our website: ...

In this FINAL episode of our DLBCL series, we build on our conversation from last week, focusing on the management of relapsed DLBCL. If you have not done so already, we recommend you check out Episode 077! Content: - Treatment with selective antibodies against CD19 - How to approach relapsed disease after CAR-T - Use of BiTE therapy - Role of allo? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love...

In our last episode, we discussed our approach to primary refractory DLBCL. This week, we start our conversation about relapsed DLBCL! This is an important and complex discussion, so we have split it into two episodes to help you follow along. If you have not done so already, we recommend you check out episode 076 for a discussion about the primary refractory setting. Content: - Approach to relapsed disease (after 12 months) - How to approach relapse with CNS involvement - Role of CAR-T...

This week, we pick up on our discussion about management of DLBCL, focusing on the primary refractory setting. A big part of this discussion is the role of CAR-T therapy. If you have not done so already, we highly recommend you check out episode 075 for the fundamentals of CAR-T before proceeding with this episode! Content: - Definitions for "primary refractory" vs. "relapsed" disease - How do we approach patients with primary refractory disease? - What are the treatment regimens for...

In this week’s episode, we pause from our discussion about DLBCL to talk about the fundamentals of CAR-T, BiTE and autologous transplants, which will lay the foundation for subsequent discussions about DLBCL. These therapies are the talk of the town and have changed/will continue to change our approach to hematologic malignancies - definitely an episode you don’t want to miss. Content: - What is CAR-T? - How are CAR-T cells manufactured? - What are commercially available CAR-T cell...

This week, we continue our conversation about DLBCL, this time focusing our attention on the management of early stage disease. In this week’s episode, we delve into the management of advanced stage DLBCL. If you have not done so, we highly recommend you listen to our hemepath series before proceeding with this episode. Furthermore, if you have not listened to the introduction to DLBCL episode (https://www.thefellowoncall.com/tfocpodcast/dlbclintro) or our early stage DLBCL episode...

This week, we continue our conversation about DLBCL, this time focusing our attention on the management of early stage disease. If you have not done so, we highly recommend you listen to our hemepath series (https://www.thefellowoncall.com/rotationguide-intro-to-hematopathology) before proceeding with this episode. Furthermore, if you have not listened to the introduction to DLBCL episode (Episode 072; https://www.thefellowoncall.com/tfocpodcast/dlbclintro), we highly recommend doing so,...

This week, we kick off a new series focusing on diffuse large B-cell lymphoma. In this first episode, we discuss the basics that everyone needs to understand before diving into the management of this disease. We highly recommend listening to our hemepath series before proceeding with this DLBCL series: https://www.thefellowoncall.com/rotationguide-intro-to-hematopathology Content: - Approach to workup for a patient with suspected lymphoma - FNA vs. Core vs. Excisional biopsy for...

We revisit a topic covered previously as part of our “Heme/Onc Emergencies” series: heparin-induced thrombocytopenia (HIT) in Episode 017. As part of our return, we dive deeper into the pathophysiology, principles of diagnosis, and management of HIT to help you to better understand how to approach the question of “is this HIT?” as a Hematology consultant and, more importantly, how to guide management based on your index of suspicion. Content: - What is the pathogenesis of HIT? - What are...

This week in our hematological consultation series, we continue our discussion on von Willebrand disease (vWD), this time focusing on the type 2 subtypes and we also discuss management. In case you missed it, we recommend checking out episode 069 for Part I of this vWD series, covering taking a bleeding history and about Type 1 and Type 3 disease. Content: - What testing do we send for suspected vWD (refresher) - What to do if type 2 vWD is suspected? - What are the different subtypes of...

We resume our hematological consultation series with an overview of von Willebrand disease, the most common inherited bleeding disorder. In this episode, we talk about the initial steps we should take to evaluate suspected von Willebrand disease (vWD) and how to differentiate the various subtypes. We will focus on vWD type 1 and 3! Be sure to tune in next week as we discuss vWD type 2 and management. Content: - Taking a bleeding history - What is von Willebrand factor? - What tests should...

This week, we complete our breast cancer series, focusing on triple-negative breast cancer (TNBC). The last few months have been quite the journey! Please continue to refer to our shownotes to help navigate this complex disease treatment paradigm. Content: - What is the data about recurrence of disease of TNBC? - The history of how we got to our current standards of care - Important trials to support our current treatment paradigm ** Want to review the show notes for this episode and...

We are not yet done with our breast cancer series, but we could not wait to share this incredibly personal conversation with a patient with a recent breast cancer diagnosis. This week, we sit down with Kaele Leonard, who herself is a Pulmonary/Critical Care fellow at Vanderbilt University Medical Center who was diagnosed with breast cancer in her early 30s. As physicians, we don’t always get to hear what the journey through diagnosis, treatment, and follow up looks like from a patient’s...

This week, we continue our discussion about metastatic breast cancer, focusing on HER2+ disease. Content: - What is the data about recurrence of disease of different breast cancer subtypes? - The history of how we got to our current standards of care - Important trials to support our current treatment paradigm ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a...

After several weeks of covering localized disease, this week, we shift our discussion to metastatic breast cancer, focusing first on ER+ disease. Content: - Importance of taking a biopsy at time of disease progression - What endocrine therapy backbone do we choose in metastatic ER+ disease? - What agents can we add to endocrine therapy for metastatic ER+ disease? - What is "visceral crisis"? ** Want to review the show notes for this episode and others? Check out our website: ...

This week, we round out our discussion on the early stage breast cancer, turning our attention to the triple negative subtype. Once again, there are a lot of trials and data, but be sure to check out the show notes for the highlights! Content: - What is TNBC? -What is the data to support the use of neoadjuvant therapy in this disease? - What is "pathologic CR" and how is different than "residual cancer burden"? - Can we ever omit neoadjuvant therapy? - What are our options for...

We continue on our journey through early stage breast cancer, this time turning our attention to HER2+ disease. There is a lot of data in this episode, as you will both hear and see. To make this easier, we highlight key takeaways to make understanding this even easier. Content: - What is HER2? - Discovery of trastuzumab - Data for use of trastuzumab in adjuvant and neoadjuvant setting - Data for use of pertuzumab in adjuvant and neoadjuvant setting - Data and use of trastuzumab...

This week’s episode is part 4 of 5 of a joint mini-series with our friends Two Onc Docs. In today’s episode, we will be recapping the current treatment of resectable NSCLC and discussing KEYNOTE 671, which was presented at ASCO 2023, looking at neoadjuvant chemo+immunotherapy followed by adjuvant immunotherapy. We also discuss the use of the “interaction test,” “multiplicity,” and it’s important role in understanding subgroup analyses. Content: - A quick recap of the current standard of...

This week’s episode is part 2 of 5 of a joint mini-series with our friends Two Onc Docs. In today’s episode, we recap the current treatment of classical hodgkin’s lymphoma and then dive into the the SWOG 1826 plenary session abstract from the ASCO 2023 annual meeting. We also cover the concept of “p-values” and what it means when trials say “the median was not reached.” Content: - A quick recap of the current standard of care for classical hodgkin's lymphoma - A review of the recent SWOG...

We are taking a small pause from our breast cancer series to discuss an important topic that is so critical to understand for clinical practice, no matter what discipline of medicine you are in: the fundamentals of transfusion medicine. This topic often shows up quite frequently on board exams, as well. In this episode, we talk about terms such as “type and screen” and more. Content: - What is a "type and screen"? - What does this process entail? - What is the difference between this and...

Surprise! The teams at Two Onc Docs and The Fellow on Call are teaming up for his special series! Each episode will focus on a single abstract, poster, or oral presentation from ASCO 2023, and will feature a quick review of any guidelines and management pointers relevant to the disease state under study, followed by an overview of the study design and findings, and finally a discussion of the implications of the research on clinical practice. We expect to release episodes on June 12, 14,...

This week, we continue discussing the management of early stage ER+/HER2- breast cancer. If you have not done so already, be sure to check out Episode 057 for the first part of this discussion. Content: - Who warrants chemotherapy? - Who benefits from gene expression assays? - What are important gene expression assays used clinically? - Post-treatment surveillance and survivorship - Targeted agents in the adjuvant setting ** Want to review the show notes for this episode and others?...

After several weeks of incredible discussions with our special guests, it’s time that we dive into the medical oncology regarding breast cancer. We start our discussion with the first of our two-part discussion on early stage (AKA non-metastatic) ER+/HER2- breast cancer. Content: - What information do we need to consider in patients with HR+ breast cancer? -What is the role of chemotherapy? -If chemotherapy is indicated, what are the treatment options? Why? -Anti-estrogen therapy...