The Oncology Podcast
The Oncology Podcast including The Oncology Journal Club Podcast by Professor Craig Underhill, Dr Kate Clarke and Professor Christopher Jackson; and Supportive Care Matters by Dr. Bogda Koczwara.
Oncology News and Expert Analysis from a unique Australian viewpoint.
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The Oncology Podcast
S3E11 The Oncology Journal Club Podcast: End of Year Special!
Welcome back to The Oncology Journal Club podcast — our favourite episode of the year!
Hosted by Professor Craig Underhill, Dr Kate Clarke and Professor Christopher Jackson.
The team reflect on the achievements of 2025, highlighting key developments, initiatives and papers that have made — and will continue to make — a real impact on clinical practice. As CJ says, it’s a privilege to work in what is the “single most innovative and thoughtful field in all of medicine” — and we are indeed lucky to have our brains tickled every month by this wonderful podcast.
And of course, it wouldn’t be OJC without some laughs and a few naughty jokes — and this year, we even have the inaugural OJC Christmas haiku!
Thank you for listening. We hope you enjoy the final episode of The Oncology Journal Club for 2025.
Visit oncologynetwork.com.au for Show Notes and more information.
Proudly produced by the team at the Oncology Network
Welcome to the Oncology Journal Club Podcast, end of year special episode. I'm your producer Rachel Bevin from the Oncology Network. Today we're bringing festive cheer as the team review their highlights from the year, covering systemic changes to top papers of 2025, some of their key blow-your-own trumpet achievements, as well as some Christmas-themed fun. With thanks as ever to our incredible hosts who donate their time to keep us updated and entertained throughout the year. Professor Craig Underhill, Dr. Kate Clark, and Professor Christopher Jackson. And thanks to you, our listeners. We really appreciate you staying tuned in and every comment, like, and suggestion we receive. So thank you very much. For show notes and more information, head over to oncology network.com.au. So, settle in and let's unwrap some standout studies together.
SPEAKER_02:G'day, g'day, g'day. Can you believe it? It's almost Christmas, and this is probably my favourite episode of the year. I'm actually wearing a silly hat for to mark the occasion. How are you going over the other side of the ditch, Kate Clark?
SPEAKER_03:Oh look, I'm buggered, but it's my own fault. I've just come back from the very exciting San Antonio uh and and it seemed like a really good idea to do a clinic straight off the plane. So pity pity the fool. But it was a great trip.
SPEAKER_02:And CJ, how are you going?
SPEAKER_01:Happy Christmas. Now, Craig, has it occurred to you that this is a audio podcast rather than a visual podcast? Yeah. So there's not really much point in wearing a silly hat if we can't actually see it.
SPEAKER_02:I know, it's just to get me in the mood. Because I'd always feel like I just did a I just did a Zoom meeting before we came on the call and I put as my backdrop the Grinch, Christmas Grinch. So yeah, I thought I'd, you know, try and festive it up a bit. And it's a the hat's about as tall as I am.
SPEAKER_01:Or it could quite be a a festive sorting hat from Harry Potter. That would be another way of describing it.
SPEAKER_02:So all right, before we're gonna get into a whole lot of data and look a bit of a look back at some of the incredible advances we've seen in oncology this year. But I just did want to mention in the last episode, Chris, you asked me one of your usual insightful questions about antibody drug conjugates. And do we need to give both drugs at the same time with the same expensive molecule, or can we just give them separately as separate products at the same time? And I actually found this is my Christmas gift to you. I'll send you this paper in Nature Reviews Cancer called Unveiling the Molecular and Imological Drivers of Antibody Drug Conjugates in Cancer Treatment. So there's a whole review all about this exact question. So maybe we'll discuss that in our forthcoming episode in 2026. It was quite an interesting paper. We could do that as a short bite, maybe.
SPEAKER_01:Well, it's such a good question. I can't even actually remember asking it. But uh it's uh sounds like a sort of paper which I'll be reading after lunch on Christmas Day just to help me get into my somnolent state.
SPEAKER_02:All right. So we're gonna talk about some impactful developments, and I was thinking that we could think about not just we're gonna get into discussion about at a tumour level some of the practice changes or biggest breakthroughs, but but in terms of systems level, Chris, there is one very obvious exciting development in 2025, and that would be common sense oncology.
SPEAKER_01:Yeah, well, common sense oncology has been a really great initiative over the course of the last couple of years. It's been slowly building up speed. Um, and this last year in particular, we published a number of papers, one of which was a Common Sense Oncology checklist for analysing randomised controlled trials. So if you are um interested in having a structured framework for looking at how to um critically appraise an RCT, we've got that checklist which is in Lambster Oncology, just uh Google search lambs to oncology CSO RCT checklist and come up with the paper. There's uh a bunch of stuff on there which is worth going through, which really helps you take it through.
SPEAKER_02:Or you can click on the link with the side.
SPEAKER_01:Yeah. Um and also there's uh discussion points for um plenary discussions as well, which helps you discuss papers at a meeting, which has got a similar idea to it. And also just presented at San Antonio Breast Cancer Symposium uh by my colleague and co-lead for the patient priorities subgroup, is one on what patients value the most in terms of designing uh and participating in randomised control trials uh as well. So it's a patient-led framework uh for conducting common sense oncology clinical trials. We really hope that will get picked up and that's just under review at the moment in a particular journal with four letters to its name, uh not the red journal. And hopefully we'll share that next year.
SPEAKER_02:And I also like the the paper on um how to present a plenary at ASCO, those who cracker. Because it's not that you know many of us get that opportunity, but it was a pretty good framework as well. So well done common sense oncology. And Cake, thinking at a sort of system, so what did what did you think of some of the most impactful things 2025?
SPEAKER_03:2025, look, I was at San Antonio most impressed by the knowledge and the skill set that the advocates now bring alongside their lived experience. So the breast advocates, the women, mostly women living with breast cancer, just knock it out of the park in terms of thinking really sensibly about evidence. And there's a particular um group that I thought was really interesting, which is called Patient-Centered Dosing Initiative, which is to move away from maximum tolerated dose, because actually that's maximum tolerated for whom and for how long. And as our drugs get better, we have to think about how women can live alongside it. And that's being driven by patients for patients. And and I just I thought that was an incredible that was for me perhaps the penny drop of the year, was how um when you design trials that include patients in the design, that you actually get more useful data out of it.
SPEAKER_02:Yep. Fantastic. Um I'm gonna do a shout out to Cancer Australia. Um firstly declare a conflict as I sit on their advisory board. But the release of the cancer plan occurred uh just on two years ago, November 2023, and I think they've now produced some pretty important work that will influence uh cancer care in Australia and possibly elsewhere going forward. So, firstly, they released a national framework for genomics and cancer control. Um, so that's a a policy guide to try and make uh provide equitable access to personalised cancer care. And also uh in a safe and culturally appropriate way, because they've really embedded some of the issues around First Nations uh data governance and ownership in that framework as well. They've launched a national cancer data framework, and so in Australia we have a federated system with both the federal government and state governments involved in cancer care, and um, there's public and private, and there's not a lot of uh linked up uh data uh sets. So this was to try and create a cancer data ecosystem supporting reporting and benchmarking, and was developed by Cancer Australia, but in partnership with the Cancer Council of Australia and the Australian Institute of Health and Welfare, and there was you know widespread uh consultation and underpinning it is actually some priorities for action and an implementation plan as well. So hopefully going forward we can get much better um cancer data in Australia. So you don't have that federated system, so perhaps it's much less of an issue in NZ than it is. No, Chris is looking quizzical.
SPEAKER_01:Well, many things in New Zealand we've got right. Actually, Craig, every patient in New Zealand's got a single unique identifier for their national health index, which is also linked to hospitalisation data, no matter where you are in the country. Uh, it can be linked to geolocation by where you live, which then gets high-level data around socioeconomic status and the like. So you can calculate rurality, you can calculate treatments received, that kind of thing at a meta-level, which is kind of cool. We're trying to get also national patient-level chemotherapy prescribing data too. And we've already got national patient-level radiation data also. So we're quite a long way down that um data journey.
SPEAKER_02:They've also uh there's a whole suite of implementation activities uh under the improving First Nations cancer outcomes budget measures. A whole lot of money put into actually trying to make some meaningful change to the cancer outcomes in our First Nations people think it's really important. Launched the Australian Comprehensive Cancer Network a bit over a year ago. So that's uh aiming to link up all the cancer services uh across the country with the more comprehensive centres as sort of the pivot of that, but trying to provide improved network care right across the country. And lastly, they led on the launch of the lung cancer screening program, which is, you know, being done in other countries. This is the first one in the year of digital health, and they're already getting some real-time uh results and uh numbers of patients screened the detection rate of lung cancers, and that sh program should actually drive quite substantial increases in survival in lung cancer with a shift to early detection, should save hundreds of lives in Australia per year. So it's only just kicked off July 1, but there's tens of thousands of patients already been screened and many can't early cancers being detected, and anecdotally surgeons saying, Oh, it's so nice to be doing curative operations in lung cancer. So we'll see with the fullness of time, but hopefully a successful prevention programme.
SPEAKER_01:So I've just um been spending a bit of time over the last uh month or so on the road looking at a number of different things, Craig's and Craig, and one of the things I've got to do is go to COSA and also have a bit of time looking at the Australian Cat's Control Plan also. Now, cats control plans aren't particularly unique to Australia. I mean, there's what 190 odd countries and 140 odd or 120 odd of them have got cats control plans. What really stands out about Australia's Cat Control Plan is it's genuinely an exemplar. So some of the things which make a great cats control plan is the specificity of it, the governance of it, and also funding of it, which Australia just does in spades. So you've got a really clear accountability structure for delivering it for who's the custodian of that. And then as you just mentioned, the funding initiatives to address the um inequalities is actually quite outstanding because most um funding things at government levels go in political cycles of one to three years, and you guys have got a five to ten year cancer control plan with a budget. And I just can't stress how rare that is. So you guys are really at the very cutting edge of cancer control plans, and that comes from the ground too. When I was at COSA, I was just really impressed by the depth and sophistication of everything along the supportive care and as well the the nutrition, the psychological support, the patient navigation. You know, you guys are really doing just some fantastic, outstanding stuff.
SPEAKER_02:Yeah, that's good to know, Chris. It's a lot small to do, and that's you know, that's not a big budget. There's a lot of countries with much bigger budgets put against their national cancer plans, but at least we do have a budget. And um I think those first two years have provided some foundational work. It's clever how they've got two year goals, five year goals, ten year goals, and so seems to be tracking quite well.
SPEAKER_01:Yeah, it's those smart goals, isn't it?
SPEAKER_02:You know, the specificity, the measurability, and the accountabilities and good buy-in, I think, around the country to fundamentally cancer control is not rocket science, right?
SPEAKER_01:You know, we know the things that we need to do. It's a matter of actually getting it done, coordinating it, and funding it are the critical bits, but actually they're the hard bits. The the delivery is really hard.
SPEAKER_02:Yeah. Yeah, absolutely. All right. What about at a tumour label? What what do you think some of the big practice changes this year? Who wants to go first? Chris?
SPEAKER_01:Yeah, well, look, it's been a good year for uh GI cancer. We've made advances in overall survival in a couple of tumours. I think ones which really stand out to me are the Matterhorn study. So this was uh the addition of Divillamab to uh flot in receptable gastric and GEJ adenocarcinoma. I mean, the headline is that adding perioptive devilimab to standard of care, perioptor flot for receptable gastric or OG cancer improved uh both DFS and OS. This was a randomised phase three double-blind placebo-controlled study of around 900 patients. Primary input was EFS, which was positive with a hazard ratio of 0.71. The two-year EFS was adding about 9% in terms of EFS, uh, but OS was positive with a hazard ratio of 0.78, uh, with three-year OS being plus seven percent. So to put that in context, surgery 23%, five-year survival, adding ECF added about 13%, added flot over ECF that added about 10%, and this adding IO is adding about 7%. Uh, what if our regular listeners, a very thoughtful Australian oncologist, said, yep, but what about people getting at the salvage context? Is that an issue? I think it probably is, but I think it's hard to walk past 7% improvement in overall survival in a tumour, so you're now getting up to above 50-60%, which is really good in this otherwise hard-to-treat um cancer. So that's I think encouraging and will rapidly become a standard. Unfortunately, at the moment, it costs$350,000 for the course, so it's currently unaffordable. Uh, and so we're looking forward to uh registration and governments negotiating some uh deals on that uh because that's a criminal price right now. Uh the other big one was ExerciseMab, which is a therapeutic um intervention of three years of structured exercise, uh, which is delivered intravenously. No, sorry, wait, it's delivered in a community outpatient setting. No, wait, it's delivered in a community outpatient gym with structured supervision over three years and that improved overall survival again by around about uh 7%, 6-7%, 6-7%, 6.4%. Um 6-7%. We we're cool here. It's important though to notice that even this intervention of exercising mab did have some harms and trade-offs, and there was an increase in musculoskeletal adverse events, 11% versus 18%, any grade adverse events. So these exercise investigators uh also did look for harms, so very good on them.
SPEAKER_02:Um and just to say, it was a fair bit of exercise, wasn't it? That's the only way. It was, yeah. Patients really have to get into training and build up their exercise tunnels. It's several hours a week, isn't it?
SPEAKER_01:It was one and a half hours above. I imagine it in Mets, but it's roughly one and a half hours above your baseline. So it's above what you're doing. So I think again, good luck. Three times a week. Three times a week, yeah. And uh so structured exercise, getting it done matters. The structured component, because of course, telling a patient to exercise that was the control arm. And so the structured exercise component improves OES by more than oxalyplatin does in stage three. And this intervention works in stage two as well. Fortunately, you don't have to choose between chemo or exercise, you can indeed do both, uh, and we should. Uh, and so now there's regulatory challenges in terms of getting PBS approval for exercise a MAB and similarly pharmac approval for exercise MAB. And I've been telling all of the uh people in our health system that the three-year structured intervention costs less than a single vial of Catruder in terms of the cost. Uh, and when people think about it in those frames, they start to say, Oh gosh, I don't think we could afford not to. Uh and so now it's all in the delivery, which as we just said in the cat's control planning is the hardest piece of all.
SPEAKER_02:And in our context, it's gonna be who's responsible for that? Is it the state hospital-based health service or is this uh outpatient-based federal government responsibilities? But it's good when people start squabbling over money because it means that you know things something works.
SPEAKER_01:That's right. It's not a question of if it works, it's how we're gonna m uh get it across the line, isn't it?
SPEAKER_02:And is it transferable to other cancers as well? So that's uh one of the other questions. The answer's probably yes, and there'll probably never be another study.
SPEAKER_01:Probably not, but you know, the tenacity of these investigators to undertake the study over a 17-year period uh and just to move from observational data, which is of course confounded by um the fit and well people did more exercise, therefore they lived longer, uh, to show that actually an intervention, which is the standard, actually improves OS. So the tenacity of the investigators is is to be applauded. Chris Booth, Common Sense, the granddaddy of Common Sense Oncology, was the PI for that as well. So a really good, good study, which I think will change practice. And of course, there was an Australian uh lead to that as well. That was Jeanette Vardy. Uh so a big shout out to Jeanette as well, who presented at COSA, led the Australian uh component of that study.
SPEAKER_02:Fantastic. So a bit of a big year for new drugs, but also new interventions, let's say, in GI cancers. Okay, breast cancer's had a pretty big year.
SPEAKER_03:Yeah, it it has. And I want to talk about well I want to talk about sex and then sexiness. So the the first one uh in terms about sex, most of the products do you ever not want to talk about programming. Yeah, or or vaginas. Yeah, so the first the first one um the first one I want to talk about is uh the products thereof. So that the positive trial was this is a trial looking at whether it was oncologically safe for women to pause their hormonal treatment after a breast cancer, uh early breast cancer diagnosis to achieve pregnancy, breastfeed if they wanted to, and then go back onto the hormonal therapy and pleasantly it is safe, and there were no excess uh breast cancer events after those. So that was that's wonderfully reassuring news. The other, I think, theme of San Antonio was two themes. One theme we'll come back to in a second, but the first theme was that we all wish that someone had done proper trials on the safety of HRT a hundred years ago, because of course all women have been told how unsafe it is, how we're all going to die of endometrial cancer, and then we're all gonna die of breast cancer and then dementia. Now, properly designed trials suggest that even in women who have a high risk uh for breast cancer, so for example, BRCA1 and two carriers, that combined estrogen progesterone therapy does not change risk at all. And estrogen-only therapy in those women who don't need uterine protection is probably protective. So it feels to me like yet again women's bodies are assumed rather than studied. And so I think I would quite actually like to have some real data. We were laughing that we're probably going to be at a point where we start giving estrogen to treat breast cancer shortly. It feels like we've completely got the wrong end of the stick. But you know, so it's very exciting.
SPEAKER_02:Maybe it maybe because if you get a mutation in the receptor, maybe that's Yeah.
SPEAKER_03:Exactly. So it feels like we've had the wrong end of the stick for a while, and it's really exciting to see some data coming. And it does, of course, uh help all my personal biases as it's soon to be a 50-year-old woman, but it is it's fantastic. Fantastic to have data that reinforces your biases, isn't it? Isn't it? Isn't it so reassuring? And then the the other theme of every breast beating over the last 18 months feels like the destiny for breast cancer treatment is we have destiny. Trastesim of Direxa T can in second line. We have Destiny 09, tristesm of Drexide T can in first line with the longest PFS of any any trial I think I've ever seen. Years and years and years, such that experts are now talking about whether we should be using an induction, using trastasmidorox T can as an induction therapy, because what community can afford three and a half or four years of tristasheroxy T can for every patient? Neoadjuvant tristashan, in addition to standard therapy, destiny 11, increased PCR rates and suggestion to an EFS improvement. And then very recently published only this week, the destiny 05. So in those women, now this was in a very high-risk population. So women who had residual node positivity after their dual antibody-containing uh neoadjuvant chemotherapy, or those women who presented with inoperable disease, which these days in breast cancer is very rare, thankfully, were randomized to uh trastism drugs TKN or uh trastisma intanzene, which is our standard post-Catherine and again trustisma drugs TK1. It does feel very much like this is the sexiest agent that we have in breast cancer at the moment. Yeah. Two very, very disparate themes of intensine.
SPEAKER_01:What makes a molecule sexy, Kate?
SPEAKER_03:When it when it works. Yeah. So I I like my molecules like my men, I like them efficient and hard work.
SPEAKER_01:Nothing to do with their strength or their dosing or the occupancy.
SPEAKER_00:We're gonna have to put a timestamp on this one and say, what about the biospecifics, Kate? Double occupancy.
SPEAKER_03:I'm more worried about the cytotoxic leakage.
SPEAKER_02:And anyone's saying payload at this point.
SPEAKER_03:Brilliant. Made so much funnier by that hat crate, honestly. You know, he look he looks like a green spark with sperm, just so you know.
SPEAKER_00:Oh dear. Well, maybe that's what a content water got this episode, guys.
SPEAKER_03:If you have access to San Antonio and haven't watched it yet, do have a look at the insightful third to last session regarding the the the whole year update.
SPEAKER_02:Oh, okay. So we might put the link. Okay, pick on the link, we'll put those in the notes for people to have a look at it. That's a really useful little tip summary there from San Antonio. So it covers not just San Antonio information, it's really the year in breast cancer.
SPEAKER_03:The whole year from bench side through to bedside, early and late disease. Fantastic years. Yeah.
SPEAKER_02:Great. Thank you for highlighting that. I'm just gonna cover a couple of things in bladder cancer and then lung cancer. So Chris talked about this CT DNA guided adjuvant, tisilisimab versus placebo in resected bladder cancer from ESMO. So that's bet was quite a nifty study using um if for patients who are CT DNA positive after resection of the bladder cancer, they randomized to receive a tisoluzimab or placebo, and it showed quite a substantial uh improvement in survival, doubling of disease-free survival and close to a 50% increase in uh two-year overall survival. The nifty thing was that for the patients who are CT DNA negative, they did really very well with very few of those patients subsequently relapsing. So this looks like a CT DNA product that might have a high specificity and looks like it may uh, if that's an affordable test, maybe something that's becomes um standard of care after surgery. There was also, we should mention, following on from 2024's publication of perioperative develliumab with neoagivent chemotherapy and operable cisplatinum eligible patients, which again should showed a clear survival advantage. There was a perioperative study without chemotherapy, so that's pretty landmark, and that's using immune checkpoint inhibitor Pembrozenab plus the antibody drug conjugate Infortomab verdotin. I think this was presented at the ESMO meeting in October, and it showed a 60% improvement in events, in front of free survival and a 50% increase in overall survival in patients uh following uh radical cysteomy who weren't suitable have cisplatin-based chemotherapy. So, in both of those populations, probably some new standards if the health system uh can afford it. Then in lung cancer, there was really a plethora of new information at both ASCO and ESMO, with both not so much in the conjugated antibodies, but I would say more in the targeted therapy. So I think this highlighted that in lung cancer, we're not just treating non-small cell lung cancer or small cell lung cancer now. You know, there really is these important uh driver mutations and subpopulations of non-small cell lung cancer. And so if we can find a target that's now um increasingly uh uh active and beneficial targeted therapies. So many of them are still at the phase two level, but with the fullness of time, there's I think the general sense of hope and excitement in lung cancer that there'll be significant new treatments in the near future. But uh the one study I wanted to highlight was the long-term results from Checkmate 816. This is a neoadjuvant study giving immunotherapy to people uh who had risks um potentially resectable non-small cell lung cancer. And so this was the five-year overall survival data, which was a positive study. So at a median follow-up of 68 months. Um the neoadjuvant volume ab in chemotherapy showed a survival benefit of reached versus 73 uh months, the five-year overall survival rates of 65% versus 55%. Now, there's a couple of adjuvant studies with the teaser listen, I didn't meet those overall survival uh endpoint. And so again, it sort of fits. We're seeing this across cancers that probably this neo-adjuvant or perioperative approach when people have still intact uh immune systems and uh lymph node fields may be the way to go and uh maybe the more beneficial approach. So is Navolume ab available on your side of the Tasman in this setting, do you know?
SPEAKER_03:No, self-funded guest. So we have uh available quite broad access now in the metastatic setting. And for those who have had radical chemoradiotherapy without progression as per Pacific, but at the moment, no periopta. I don't think it's far away, to be honest. Like it feels like a very sensible next cab off the rank.
SPEAKER_02:Okay. Before we leave the tumors, Chris, one of the GI papers I thought you might mention is aspirin. Does it three CA mutated colorectal cancer? Yeah. That's standard of care in those people.
SPEAKER_01:Uh the difficulty thing so this just to briefly r recap was looking at two particular clusters of PIC3 kinase mutations in people with uh stage three. I can't call if it's stage two or just stage three. Stage one to three, thank you, Craig. Stage one to three, uh cold lung cancer and found the. Uh found the edge of an aspirin uh improved overall survival, whereas it was negative in the all-comer studies like Ascolch uh, for example, which was an AGITG study. Uh and there were two particular clusters of PIC3 kinase mutations of five of them, I think, were in total. And uh so you really have to test those before you bother prescribing aspirin. And the trick is getting that routinely funded again for stage one, two, and three colon cancers. Now New Zealand is trying very hard to get that funded, but it's currently not. And I've tried for a couple of patients to get it done on panel testing rather than whole genome, and it's still pretty difficult. In fact, several people are not even bothering to respond to my emails when I email labs about whether or not it's in their panels. And others will just give you pick three chinoids, literally just the one, which isn't quite the point. So talk to your local friendly uh molecular testing uh place and see if you can get it done in your stage one through three. Uh, but I think it will be impactful because it's quite a cheap medicine.
SPEAKER_02:Yeah. And so you think that's standard of care if you I do, yeah.
SPEAKER_01:I think it is standard if you can get it. So I think standard of care, there's a difference between availability and accessibility. Uh and I think this is a test which is now available, uh, but it's not one which is accessible to most patients at the moment. And so we need to make sure it's accessible.
SPEAKER_02:Hence my mention of the Australia's National Genomic Framework, which is aiming to make these tests uh accessible to all. Kate, I think you were going to talk about the the NZO and meeting.
SPEAKER_03:NZ NZSO, New Zealand Society of Oncology, is an increasingly fascinating meeting. It's a group of clinicians and scientists all pulling in the same direction, many of whom share the same joy and frustrations of working in a New Zealand system. It's it's a wonderful meeting. I think the one of the things that is unique is that we are learning how to work in a genuinely, you know, genuinely understand that that we work in a Māori context in Altiarua, and that's a blessing and teaches us things that are sometimes quite difficult to learn in other contexts, and it has it has provided us with a strength.
SPEAKER_01:Yeah, I think NTSO is a meeting full of humility, actually. You have got, you know, some extraordinarily wonderful and talented New Zealand oncologists and research scientists who get together, and what they do is they platform other people. They lift up the junior, juniors, the postdocs, the med students, they make sure the internationals get all the exposure they can, and all of our incredibly amazing talented people very much just take a facilitatory uh perspective to make sure that others shine. Uh it's a meeting of extraordinary fun, and people are again voting with their feet and are turning up and increasing numbers every year. So the meeting in Auti Borti Dunedin uh this year was the largest one we've ever had at 350 participants, which actually rivals a number of international meetings, including Aortic, which I think runs at about 400 and is the African Continental Oncology Research Meeting, too, and certainly it's driving AGUITG in terms of size too. So it's a really, really, really good meeting. If you get a chance to go, do it's not a uh how should I treat this cancer meeting. It's very much a translational science collaboration meeting, and uh it just has the very best people going to that meeting every year. So it's a real treat. I love that meeting a lot.
SPEAKER_03:Yeah, and I think as the other shout out is that quite possibly because a lot of people have got visiting New Zealand on their bucket list, that we get incredible, uh really generous uh international speakers. So this year, oh I don't want to I don't want to list them all in case I miss somebody important, but you know, several of my heroes I got to meet in person, and that was pretty, pretty exciting.
SPEAKER_02:That's cool. I need an invitation. Note it. Uh well I just wanted to blow the trumpet of our revitalized programme. A couple of papers published in high impact journals, uh, which we've covered on the podcast, and that was Oliver Klein leading this most circuit study, which was IP NEVO in some rare cancers, and he's been publishing serially different the results in different groups. So we had recently in Jammer Oncology the advanced ovarian and endometrial clear cell cancers, and then we've had recently the advanced DMMR, MSI high non-colorectal cancers published as well. And there was there's been some terrific feedback, including a a letter to the editor in response to the Giny clear cell carcinoma paper, just really highlighting the high quality of the study that Oliver set up with some robust biomarker studies, substudies incorporate into it, which will be hypothesis generating for future um studies as well. So it's great that a whole lot of bunch of regional patients were able to access this trial and were able to participate in their own cities rather than having to drive to metropolitan centres or choosing not to drive to metropolitan centres to access these trials. So That's it. And Chris, I think you you're by the body trumpet would be the C all that CSO stuff that you mentioned at the start.
SPEAKER_01:Yeah, well, there's that. But I think structurally New Zealand, the uh the big thing that's happened the last um twelve months is the largest ever investment in Pharmac that we've seen in either Kate or Maya's professional lifetime, actually. And that's led to over two and a half thousand patients getting uh access to better cancer drugs than have ever happened before in a six hundred million dollar investment, which is on a background of one billion dollars uh per annum. So it's the biggest uplift we've seen, and that was preceded by another 170 million just prior to that, so eight hundred million in the course of a couple of years, which is uh unprecedented. That's my question.
SPEAKER_02:Don't tell me you're going to vote for the Conservative government.
SPEAKER_01:No, I didn't say that. I what I said was that the investment uh is is outstanding there as a result of that. Now, how we got there is checkered in terms of how we got that money, but fundamentally uh the cancer agency uh wrote a report that was supported by some fantastic academics in Australia, Canada uh and UK. That was co-written by me. And that convinced the then Labour government to fund some uh drugs, and then the uh New Zealand Conservative Party uh committed to some even more, so we then got them. And one of the things I'm most proud about is not just the fact we've got the drugs, but that the Kiwi leaders who were in charge of those drugs actually used the opportunity to enhance distributive care. And so we're now opening new chemo units uh up and down the country and making chemo uh closer to home for so many, many more people. Uh I think uh the northern region's done 11 new units uh over the course of this last year, which just means that people don't have to travel, costs go down, accessibility goes up, means more people get access to standard treatment as well, and people not who just get the drugs, but people who are getting their standard treatment also benefit too. Uh so I'm really proud of that initiative. It was a policy initiative, it was a lobbying initiative, it was a political initiative, it was an academic initiative, uh, and it was a leadership initiative of the people who are involved. So it was right across right across the pathway, uh, and New Zealand is better off for it. It's been the biggest transformation of medical oncology. Yes, we now all have wait lists, yes, we now all have staffing pressures, but it's a nice problem to have uh and it's one that we are still going to solve yet.
SPEAKER_02:Fantastic. All right. It's a Christmas episode. Do we have a song?
SPEAKER_00:Well, I've got a haiku. Does that count?
SPEAKER_02:Explain haiku. Wow. To the non non-uh kiwis.
SPEAKER_01:Time out into chat GPT. Uh explain haiku.
SPEAKER_02:So like ahaka?
SPEAKER_01:A haiku is a very short, tightly structured poem that comes from Japanese poetry. Oh. Its power is restraint, saying something meaningful with almost no wasted words. Evidence-based minimalism. Three lines, five syllables, seven syllables in the second line, five and the third line, so five seven five. So we sing it or you just go really, I will put on my very serious haiku voice. Okay.
SPEAKER_02:Fascinating.
SPEAKER_01:This is the OJC haiku. Bingo cards fill fast. Manageable, trend in favour. Follow-up, independent. Kate names late effects. Tell it feels, we blush, we learn. Outcomes are people. Craig clears his throat once. Common sense before new hype. Truth takes time. That is the OJC Christmas hike.
SPEAKER_02:Wow. The OJC Christmas bomb. Well done. Round of applause for British.
SPEAKER_01:Let's do a lightning round, okay? Lightning round.
SPEAKER_00:Real quick answers.
SPEAKER_01:I'll I'll throw the questions out, Craig, because you're usually the guys asking the questions, but I'll take the microphone. Craig, what are you most proud of this year?
SPEAKER_02:Daughter graduating from environmental science at Melbourne University. She wants to be the next David Atmora.
SPEAKER_01:Does she? Nice. And I think I'll be pretty proud proud to have you as my dad.
SPEAKER_02:You don't really know me too.
SPEAKER_01:She's done well. Kate, what surprised you most in 2025?
SPEAKER_03:Oh. The spontaneous uh singing of a wiater, which is just a song in Maori with normally has a uh a message in order to support each other when we were talking about the death of a friend and colleague. And it was 300 people breaking into song spontaneously, is pretty awesome.
SPEAKER_01:Wow. It was again in ZSO. Yeah. What a beautiful meeting. Uh Kate Craig and Kate. Craig, you may not recycle your answer. What are you most grateful for at the U225?
SPEAKER_02:I think we're living living in a peaceful place and being able to travel and come back to that peaceful place.
SPEAKER_03:Kate We had this conversation at dinner the other day, seven uh breast cancer oncologists, and we were, you know, negatives, positives, negatives, positives. And we kept coming back to the reason we do our job. And it was that we get to meet the most amazing people every day and be there with them through the most impactful times in their lives. And so that was something that was keeping us all alive. So I think I'm I'm most grateful for my patience, actually.
SPEAKER_01:Oh, that's nice. What is your biggest hope for 2026?
SPEAKER_02:Me? Haven't thought about this. Well peace, I guess. Just hope that we can turn things around, stop some of the wars that are going on at the moment. Uh and don't have new ones. I think it's a pretty, you know, interesting place. So let's all stick together. No wars.
SPEAKER_01:We are currently in history at one of the highest periods of conflict in world history right now, uh, in terms of lives lost per year, uh as well as number of conflicts. So it's extraordinary where we are right now in 2020 2025. So wishing for peace is something that would bring well.
SPEAKER_02:It's a bit of a cliche, but it's probably something that you maybe don't always wish for, but this feels like appropriate.
SPEAKER_01:Time to wish for that. I think people fundamentally want, you know, place to live, place to work, meaningful work, place to worship, place to love, uh, a place to bring up their family. You know, that's what people want. I mean, I think the things that um unite us are bigger than the things that divide us. And it's good for us all to reflect on that, I think. Kate, what's your biggest hope for 26?
SPEAKER_03:I want more kindness and and more acknowledgement of what you've just said is that 99.99% of humans are just magic and want exactly the same thing as the other 99.99% of humans and don't feel a need to screw over or upset the other uh humans. And we are at the moment there. There are seem to be of some very loud voices trying to upset us all and trying to split us up. And I think we need to remember that we're actually very much all the same. Yeah.
SPEAKER_01:Indeed. All right. All that levity, some light ones. Craig, what was your Spotify listening age this year on your line?
SPEAKER_02:Well, I don't use Spotify, I do Apple iTunes, and I got the wrap-up of this year, and my daughter grabbed it and she goes, Dad, 18 of the 20, your 20 uh top 20 songs are all Beyonce. So we did go to the Beyonce concert, so it was sort of wall-to-wall uh Renaissance and cowboy card that I garden to or jog to or just listen to. So I think she's just incredible.
SPEAKER_01:That's true, I call it Beyonce too. Yeah. Kate, what what's your Spotify listening age this year?
SPEAKER_03:So you know me well, Chris, and you know that inside me is a very flamboyant gay man who happens to be 71. I think it's my love for musicals. Well, yeah, probably. Some of them are actually one of my favourite songs ever is Elton John and George Michael's version of Don't Let the Sun Go Down on Me. So, you know, and I'm one of those people who will listen to something over and over again if I know it, that song will give you that feeling. And now that we've kicked our son off our Spotify, his tastes are quite disparate from mine. He is not a 71-year-old uh man with a ponch of show tunes.
SPEAKER_02:And Chris, what's yours?
SPEAKER_01:Uh I was 87 because I quite like classical music and uh I listen to it an awful lot when I um am working. So it unfortunately excuse me that way. So it was Wolfgang, Omadeus Mozart, and Radiohead for my two big listeners. All right, I'm gonna round out uh by saying uh this year uh I am grateful for uh all the incredible, uh brilliant, tenacious researchers who have uh worked hard on the research studies that we've discussed this year, those who have campaigned for funding, both uh government and community uh funding to get those research studies done, to the research nurses who make them happen. And of course, of course, of course, to the participants uh in those studies who give so selflessly of their time uh to help advance medical knowledge uh get further uh every single year. So hopefully uh tomorrow will be better uh than it is today. Uh, I'm grateful for the academic cooperative groups who keep the engines of academic uh research going. That keeps our field being the single most innovative and thoughtful field in all of medicine and makes us very lucky to uh have our brains tickled on every single occasion. I'm not grateful for Elsevier and the charges they make and the way in which they keep that academic information away from people. I'm grateful for the uh enthusiasm of people in low middle end countries I've seen uh towards solving important problems for the communities that they face. Uh, and I'm very, very grateful to our listeners for tuning in, for downloading, uh, for giving us a reason to turn up uh and a bit of a giggle and keep this podcast going. And and I'm very, very grateful uh for the opportunity to do the job that I do.
SPEAKER_02:Great. Thank you. We um had a discussion just before we came on air that this is being recorded the day after the terrible uh massacre at Bonday Beach, terrible anti-Semitic attack on the Jewish community in Sydney. So we just want to acknowledge that, send our thoughts to the families, friends of people affected, the Jewish community right across not just Australia, but I guess internationally as well. And a plea for unity rather than inflammatory comments and division at this time. We all need to, as Kate said earlier, 99.9% of us all want the same thing. And it's probably uh there'll be a lot of reflection on that, I think, over the holiday period uh coming up. And lastly, then big thank you to all the listeners, all the people who've uh downloaded, uh sent us messages, suggested topics right throughout this year. Thanks to all of you. If you're enjoying the podcast, please share it with your colleagues. Um and we hope you all have a very safe and healthy Christmas holiday period um and a happy and healthy 2026. Thank you, uh producer with the most tests, uh Rachel Babin.
SPEAKER_04:It's an absolute pleasure, as always. We learned so much from producing this show, and we're very grateful to the three of you for donating your time and your expertise through the year, and uh looking forward to more awesome podcasts next year.
SPEAKER_02:Fantastic. Thank you, Dr. Kate Clark. Merry Christmas, and um and Professor CJ. What's that? He's doing a love heart song.
SPEAKER_01:Am I doing that right? Love heart. I mean, you've got the silly hat, so I just didn't have to the hands on. Love heart, love you, Craig, love you, Kate, love you, Rach. Thanks so much. Thank you, listeners. Have a great holiday, catch you next year.
SPEAKER_02:And see you next year for more exciting oncology updates.
SPEAKER_01:You'll hear us next year. We might not see you physically.
SPEAKER_02:That'd be a bit creepy if we could see you on the desky thing that we were up on. Yeah, bye.
SPEAKER_04:Thank you for tuning in to the Oncology Journal Club Podcast, proudly brought to you by the Oncology Podcast, part of the Oncology Network. For healthcare professionals seeking regular news updates and insightful discussions, we invite you to join our community at Oncolynetwork.com.au. Your free registration includes a complimentary subscription to our weekly publication, the Oncology Newsletter, a valuable resource to stay updated on the latest advancements in the field. We value your input and welcome your feedback and paper recommendations via our social media channels, email, and websites. Your insights help shape the conversation and drive the direction of future episodes. This is Rachel Babbin, signing off for the Oncology Journal Club Podcast.