The OJC S4E7: Adjuvant Aspirin, ctDNA Controversy, AI Pathology + ASCO Guidelines

Send us Fan MailIn this episode, the Oncology Journal Club team take a whistle-stop tour through some of the latest evidence in breast, colorectal, lung and thyroid cancer, with plenty to discuss around AI pathology, access to palliative care and the ever-changing world of ASCO Guidelines.We kick things off with a lively deep dive into SERENA-6 and the idea of switching treatment when an ESR1 mutation emerges — before the cancer has actually progressed — in first-line treatment of hormone receptor-positive advanced breast cancer. The team get into the biology behind the approach, the potential benefits for patients and, importantly, what we’re really measuring when treatment changes halfway through the journey.Next up is a deceptively simple question with potentially big implications: could aspirin have a role as adjuvant treatment after colorectal cancer surgery? The ASCOLT translational work, alongside signals from other trials, raises the possibility that benefit may be concentrated in patients with particular PIK3CA mutations rather than applying to everyone. But that leads to a very real-world question: if the treatment is cheap but the testing isn’t, how do we make precision prevention accessible — and when should we start?We then turn to PD-L1-high advanced non-small cell lung cancer, where a systematic review and meta-analysis suggests that chemoimmunotherapy may offer better survival than PD-1/PD-L1 inhibitor monotherapy. But, as always, the numbers are only part of the story — particularly when we’re treating older or less-fit patients in the real world.And in our Quick Bites, we look at why so many patients never receive systemic treatment, why early palliative care is still underused, the potential of faster respiratory pathways to improve access, AI-powered pathology, and new ASCO Guidelines.If you enjoy sharp takes on new oncology papers — and  what they actually mean for patients and practice — subscribe, share the episode with a colleague and leave us a review to help others find the show.The Oncology Journal Club Podcast is hosted by Professor Craig Underhill, Dr Kate Clarke and Professor Chris Jackson, and proudly produced by The Oncology Network.Visit oncologynetwork.com.au for Show Notes, to send us Voice Notes and more information.