S3E6 The Oncology Journal Club

Hosted by Professor Craig Underhill, Dr Kate Clarke & Professor Christopher Jackson | Proudly produced by The Oncology Network

Welcome to the Oncology Journal Club Episode 6! This is where we take a famously different approach to oncology research.

Has non-operative management finally found its place in treating certain cancers? This episode unpacks compelling new data that might challenge the surgeon’s traditional role for some patients with mismatch repair deficient tumours. While rectal cancer patients show remarkable complete response rates to immunotherapy, the story gets more complex across different cancer types – raising fascinating questions about tumour biology, patient selection and the future of organ preservation.

We explore the delicate art of discussing immunotherapy outcomes with patients, navigating that narrow path between hope and realism. When treatments occasionally produce dramatic responses but more commonly offer limited benefits, how do oncologists communicate effectively without creating unrealistic expectations? Our hosts share practical strategies for these challenging conversations, emphasising that truly patient-centred care requires ongoing dialogue about prognosis.

The oncology research world is evolving too, with updated CONSORT and SPIRIT guidelines transforming how clinical trials are designed and reported. These frameworks now mandate greater transparency, clearer safety reporting and increased patient involvement in study design – potentially leading to more trustworthy and applicable research outcomes.

Plus, we examine an intriguing Chinese trial showing remarkable survival benefits from low-dose continuous capecitabine combined with aromatase inhibitors for metastatic breast cancer – a potential game-changer for resource-limited settings.

From this year’s AACR meeting, we highlight what might be the first change in standard of care for locally advanced head and neck cancer in two decades, along with promising targeted therapies for specific molecular subtypes of lung cancer.

Join our expert hosts Professor Craig Underhill, Dr. Kate Clarke and Professor Christopher Jackson as they navigate these developments with their trademark blend of critical analysis, clinical wisdom and humour.

About The Oncology Journal Club:

We have taken an old concept and updated it with a new format. In each episode, a team of expert contributors will review topical journal papers and interview special guests who are leaders in their fields to help keep you informed of the latest developments on the go.

We hope you enjoy listening and find this a valuable and entertaining resource.

PAPERS:

CJ: Cercek A, et al. Nonoperative Management of Mismatch Repair-Deficient Tumors. N Engl J Med. 2025 Apr 27. doi: 10.1056/NEJMoa2404512. Epub ahead of print. PMID: 40293177. Access online here.

Kate: Hong RX, et al. Metronomic Capecitabine Plus Aromatase Inhibitor as Initial Therapy in Patients With Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer: The Phase III MECCA Trial. J Clin Oncol. 2025 Apr 10;43(11):1314-1324. doi: 10.1200/JCO.24.00938. Epub 2025 Jan 2. PMID: 39746176; PMCID: PMC11974638. Access online here.

Craig: Hopewell S, et al. CONSORT 2025 Statement: Updated Guideline for Reporting Randomized Trials. JAMA. 2025 Apr 14. doi: 10.1001/jama.2025.4347. Epub ahead of print. PMID: 40228499. Access online here.

Chan AW, et al. SPIRIT 2025 statement: updated guideline for protocols of randomized trials. Nat Med. 2025 Apr 29. doi: 10.1038/s41591-025-03668-w. Epub ahead of print. PMID: 40295741. Access online here.

QUICK BITES:

Kate: Su HI, et al. Fertility Preservation in People With Cancer: ASCO Guideline Update. J Clin Oncol. 2025 Apr 20;43(12):1488-1515. doi: 10.1200/JCO-24-02782. Epub 2025 Mar 19. Erratum in: J Clin Oncol. 2025 Apr 16:JCO2500662. doi: 10.1200/JCO-25-00662. PMID: 40106739. Access online here.

Llombart-Cussac A, et al. Second-Line Endocrine Therapy With or Without Palbociclib Rechallenge in Patients With Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: PALMIRA Trial. J Clin Oncol. 2025 Apr 28:JCO2401865. doi: 10.1200/JCO-24-01865. Epub ahead of print. PMID: 40294349. Access online here.

Robertson JFR, et al. Fulvestrant Versus Anastrozole in Endocrine Therapy-Naïve Women With Hormone Receptor-Positive Advanced Breast Cancer: Final Overall Survival in the Phase III FALCON Trial. J Clin Oncol. 2025 May;43(13):1539-1545. doi: 10.1200/JCO.24.00994. Epub 2025 Jan 7. Erratum in: J Clin Oncol. 2025 Mar 10;43(8):1045. doi: 10.1200/JCO-25-00116. PMID: 39772884. Access online here.

CJ: Boulanger MC, et al. Patient and Caregiver Experience With the Hope and Prognostic Uncertainty of Immunotherapy: A Qualitative Study. JCO Oncol Pract. 2025 Feb;21(2):178-187. doi: 10.1200/OP.24.00299. Epub 2024 Jul 22. PMID: 39038253; PMCID: PMC11751125. Access online here.

Schofield PE, et al. Hope, optimism and survival in a randomised trial of chemotherapy for metastatic colorectal cancer. Support Care Cancer. 2016 Jan;24(1):401-408. doi: 10.1007/s00520-015-2792-8. Epub 2015 Jun 21. PMID: 26093975. Access online here.

AACR:

PBS UPDATE:

First targeted therapy for EGFR Exon 20 insertion non-small cell lung cancer PBS listed. Oncology Network. Published May 1, 2025. Access online here.

TEAM:

Craig Underhill

Professor Craig Underhill

Professor Craig Underhill completed his Bachelor of Medicine and Surgery in 1987 at Melbourne University. He completed medical oncology training in Melbourne and worked as the Senior Clinical Research Registrar at Guy’s Hospital, London.

In 1998 arrived in Albury-Wodonga and established a medical oncology practice and clinical trials unit which has developed expertise and infrastructure to ensure the initiation of high quality trials. The research Unit lead by Dr Underhill has twice been awarded NSW Premier’s Award for Innovation in Cancer Clinical Trials, the inaugural award in 2009 and then again in 2012.

Dr Underhill is the VCCC Regional Oncology Lead and advocates for the increased access to clinical trials for regional Victorians and leads the VCCC teletrials program.

You can find Craig on X/Twitter here: @CraigUnderhill

Kate Clarke

Dr. Kate Clarke

Dr Kate Clarke (MBChB (Otago), FRACP) is a proud New Zealander with a real love for beautiful Aotearoa. Dr Clarke continues to work at being Tangata Tiriti. Much of her research and patient advocacy has an equity focus. Dr Clarke is grateful to her patients, students, whanau and colleagues for the knowledge and awhi they share. Ehara taku toa, he takitahi, he toa takitini.

Dr Clarke completed her medical training in Otago, Wellington and London. She has a holistic approach and is passionate about patient-centred care, and believes patients can and should play an active role in their healthcare. Her clinical experience covers a broad range of solid tumour malignancies with special clinical interest in colorectal cancer, upper gastrointestinal cancers and breast cancer.

Chris ‘CJ’ Jackson

Professor Christopher Jackson

Chris Jackson is Professor of Medical Oncology at the University of Otago, Dunedin, and a medical oncologist at Dunedin Hospital and Mercy Cancer Care. He specialises in GI cancers and melanoma, teaches medical students and specialists-in-training, and is heavily involved in both national and international cancer policy, leadership and research.

He was previously the medical director of the Cancer Society of NZ, and his advocacy led to the funding of new cancer drugs, to the development of a new national cancer plan, and to the birth of the national cancer agency Te Aho o Te Kahu. He currently chairs the agency’s clinical committee and serves on the advisory board. In addition, he is on the programme board of the International Cancer Benchmarking Project, and is a founding member of the Common Sense Oncology movement.

Chris is a self-confessed Radiohead tragic, and recent convert to Crossfit (even though you didn’t ask).

Connect with CJ on X/Twitter: @drkiwicj

PRODUCER:

Rachael Babin

Rachael Babin is Host of The Oncology Podcast, Editor-in-Chief of The Oncology Newsletter, and Publisher of Oncology News Australia and The Oncology Network.

With a background in oncology communications and academic publishing, Rachael is happiest sitting behind the mic chatting to interesting people about the impact their work makes in oncology.

Connect on Twitter: @OncologyNewsAus