Justine Cohen's guest appearances

Justine Cohen

J. Brown Yoga Talks

Blood & Cancer

Daring to be Human

Bernie Sanders

Charles Eisenstein

Eddie Stern

Ethan Nichtern

Rob Walker

Jill Miller

Scott Johnson

Elena Brower

Douglas Rushkoff

Matthew Remski

Lucas Rockwood

Amy Ippoliti

Leslie Kaminoff

Judith Hanson Lasater

Sadie Nardini

OwlTail

Michael Ponte

You are listening to the free version of J. Brown Yoga Talks. To hear the rest of our conversation, please subscribe to podcast premium at: https://www.jbrownyoga.com/premium.   Justine Wiltshire Cohen and Michael Ponte, owner and manager at Down Under Yoga School of Yoga in Boston, talk with J about what how things have been going since Justine was last on the show three years ago and what they are doing to meat the challenge of the pandemic crisis. They discuss Down Under’s transition to making their teachers employees, responding to the needs of teachers and staff, important keys to their success, efforts they are making to survive the shut down, and the core principles that are guiding their choices.

You are listening to the free version of J. Brown Yoga Talks. To hear the rest of our conversation, please subscribe to podcast premium at: <a href="https://www.jbrownyoga.com/premium" rel="nofollow" target="_blank">https://www.jbrownyoga.com/premium</a>. <a href="https://www.downunderyoga.com/boston-yoga-teacher/justine-wiltshire-cohen" rel="noopener nofollow" target="_blank">Justine Wiltshire Cohen</a> and <a href="https://www.downunderyoga.com/boston-yoga-teacher/michael-ponte" rel="noopener nofollow" target="_blank">Michael Ponte</a>, owner and manager at <a href="https://www.downunderyoga.com/" rel="noopener nofollow" target="_blank">Down Under Yoga School of Yoga</a> in Boston, talk with J about what how things have been going since Justine was last on the show three years ago and what they are doing to meat the challenge of the pandemic crisis. They discuss Down Under’s transition to making their teachers employees, responding to the needs of teachers and staff, important keys to their success, efforts they are making to survive the shut down, and the core principles that are guiding their choices.

Justine Cohen and Michael Ponte - "Weathering the Storm"

Justine V. Cohen, DO, of the University of Pennsylvania, Philadelphia, joins Blood &amp; Cancer host David H. Henry, MD, also of the University of Pennsylvania, to discuss a recent melanoma case in the adjuvant setting and when to consider targeted therapies or immune checkpoint inhibitors for these patients.  Plus, in Clinical Correlation, Ilana Yurkiewicz, MD, of Stanford (Calif.) University, talks about what happens when a patient’s anxiety threatens to get in the way of the clinician’s decision making. Time stamps:  Meet the guest (00:51) This Week in Oncology (03:02) Interview with Dr. Justine Cohen (05:48) Clinical Correlation (26:25)  This week in Oncology FDA approves rivaroxaban for VTE prevention in hospitalized, acutely ill patients by Lucas Franki FDA approval for the new indication is based on results from the phase 3 MAGELLAN and MARINER trials, which included more than 20,000 hospitalized, acutely ill patients. Therapies for melanoma  Classes of therapies for adjuvant melanoma include immune checkpoint inhibitors and targeted therapies. Historically, high-dose interferon was the only available therapy for melanoma. This was associated with a lot of toxicities, without great benefits in terms of overall survival. About 50% of melanomas are BRAF mutated and amendable to adjuvant treatment with the combination of BRAF/MEK inhibitors.  Immunotherapy can be used in BRAF mutated patients or BRAF wild type (no mutation).   Ipilimumab (anti-CTLA4) demonstrated recurrence-free survival benefit and an overall survival benefit.  Toxicity = grade 3 or grade 4 immune-related side effects.   Nivolumab and pembrolizumab (anti-PD1) have taken the place of ipilimumab.  They are associated with lower rates of toxicities (14%-15%).   Side effects of immunotherapy: “itis” (fever, ocular toxicity, lung, colon, rash, many others). These side effects may persist despite cessation of immunotherapy unlike targeted therapies, in which side effects resolve after stopping. Treatment decisions following adverse events depend on how much therapy is delivered prior to the event and the severity of toxicity.    Drug Class Mechanism of action Interferon Antiviral ·   Inhibits protein synthesis ·   Inactivates viral RNA ·   Enhances phagocytic and  cytotoxic mechanisms   Ipilimumab Checkpoint inhibitor ·   IgG1 monoclonal antibody against cytotoxic T-lymphocyte antigen 4   Nivolumab Checkpoint inhibitor ·   Human IgG4 monoclonal antibody against programmed death 1 (PD-1)   Pembrolizumab Checkpoint inhibitor ·   Human IgG4 monoclonal antibody against programmed death 1 (PD-1) Dabrafenib Targeted therapy ·   BRAF inhibitor   Vemurafenib Targeted therapy ·   BRAF inhibitor Trametinib Targeted therapy ·   MEK inhibitor  Show notes by Emily Bryer, DO, resident in the department of internal medicine, University of Pennsylvania, Philadelphia. References Weber J et al. Adjuvant nivolumab versus ipilimumab in resected stage III or IV melanoma. N Engl J Med. 2017;377:1824-35. Eggermont AMM et al. Adjuvant pembrolizumab versus placebo in resected stage III melanoma. N Engl J Med. 2018;378:1789-1801. Long GV et al. Adjuvant dabrafenib plus trametinib in stage III BRAF-mutated melanoma. N Engl J Med. 2017;377:1813-23.   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgehemonc Ilana Yurkiewicz on Twitter: @ilanayurkiewicz

<a href="https://www.med.upenn.edu/apps/faculty/index.php/g348/p8222258" rel="nofollow" target="_blank">Justine V. Cohen, DO</a>, of the University of Pennsylvania, Philadelphia, joins Blood &amp; Cancer host <a href="http://bit.ly/2MFDfzm" rel="nofollow" target="_blank">David H. Henry, MD</a>, also of the University of Pennsylvania, to discuss a recent melanoma case in the adjuvant setting and when to consider targeted therapies or immune checkpoint inhibitors for these patients.  Plus, in Clinical Correlation, <a href="https://stanford.io/2RXPixR" rel="noopener nofollow" target="_blank">Ilana Yurkiewicz, MD</a>, of Stanford (Calif.) University, talks about what happens when a patient’s anxiety threatens to get in the way of the clinician’s decision making. Time stamps: <ul> <li>Meet the guest (00:51)</li> <li>This Week in Oncology (03:02)</li> <li>Interview with Dr. Justine Cohen (05:48)</li> <li>Clinical Correlation (26:25)</li> </ul> This week in Oncology <a href="http://bit.ly/32mPQhQ" rel="nofollow" target="_blank">FDA approves rivaroxaban for VTE prevention in hospitalized, acutely ill patients</a> by Lucas Franki FDA approval for the new indication is based on results from the phase 3 MAGELLAN and MARINER trials, which included more than 20,000 hospitalized, acutely ill patients. Therapies for melanoma <ul> <li>Classes of therapies for adjuvant melanoma include immune checkpoint inhibitors and targeted therapies.</li> <li>Historically, high-dose interferon was the only available therapy for melanoma. This was associated with a lot of toxicities, without great benefits in terms of overall survival.</li> <li>About 50% of melanomas are BRAF mutated and amendable to adjuvant treatment with the combination of BRAF/MEK inhibitors. <ul> <li>Immunotherapy can be used in BRAF mutated patients or BRAF wild type (no mutation).</li> </ul> </li> <li>Ipilimumab (anti-CTLA4) demonstrated recurrence-free survival benefit and an overall survival benefit. <ul> <li>Toxicity = grade 3 or grade 4 immune-related side effects.</li> </ul> </li> <li>Nivolumab and pembrolizumab (anti-PD1) have taken the place of ipilimumab. <ul> <li>They are associated with lower rates of toxicities (14%-15%).</li> </ul> </li> <li>Side effects of immunotherapy: “itis” (fever, ocular toxicity, lung, colon, rash, many others). These side effects may persist despite cessation of immunotherapy unlike targeted therapies, in which side effects resolve after stopping.</li> <li>Treatment decisions following adverse events depend on how much therapy is delivered prior to the event and the severity of toxicity.</li> </ul> Drug Class Mechanism of action Interferon Antiviral ·   Inhibits protein synthesis ·   Inactivates viral RNA ·   Enhances phagocytic and  cytotoxic mechanisms Ipilimumab Checkpoint inhibitor ·   IgG1 monoclonal antibody against cytotoxic T-lymphocyte antigen 4 Nivolumab Checkpoint inhibitor ·   Human IgG4 monoclonal antibody against programmed death 1 (PD-1) Pembrolizumab Checkpoint inhibitor ·   Human IgG4 monoclonal antibody against programmed death 1 (PD-1) Dabrafenib Targeted therapy ·   BRAF inhibitor Vemurafenib Targeted therapy ·   BRAF inhibitor Trametinib Targeted therapy ·   MEK inhibitor Show notes by Emily Bryer, DO, resident in the department of internal medicine, University of Pennsylvania, Philadelphia. References Weber J et al. Adjuvant nivolumab versus ipilimumab in resected stage III or IV melanoma. <a href="https://www.nejm.org/doi/pdf/10.1056/NEJMoa1709030" rel="nofollow" target="_blank">N Engl J Med. 2017;377:1824-35</a>. Eggermont AMM et al. Adjuvant pembrolizumab versus placebo in resected stage III melanoma. <a href="https://www.nejm.org/doi/10.1056/NEJMoa1802357" rel="nofollow" target="_blank">N Engl J Med. 2018;378:1789-1801</a>. Long GV et al. Adjuvant dabrafenib plus trametinib in stage III BRAF-mutated melanoma. <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1708539" rel="nofollow" target="_blank">N Engl J Med. 2017;377:1813-23</a>. For more MDedge Podcasts, go to <a href="https://www.mdedge.com/podcasts" rel="nofollow" target="_blank">mdedge.com/podcasts</a> Email the show: <a href="mailto:podcasts@mdedge.com">podcasts@mdedge.com</a> Interact with us on Twitter: <a href="http://bit.ly/35FjoJK" rel="noopener nofollow" target="_blank">@MDedgehemonc</a> Ilana Yurkiewicz on Twitter: <a href="http://bit.ly/2HWHUMt" rel="noopener nofollow" target="_blank">@ilanayurkiewicz</a>

Choosing a melanoma therapy with Dr. Justine Cohen