OBR Peer-Spectives: Recent Episodes
OBR Oncology
Peer-Spectives is a podcast series that is moderated by Robert Figlin, MD, and features various oncology thought-leaders covering the latest clinical developments in a wide range of tumor types.
The prospective randomized NHS-Galleri multicancer early detection trial didn’t meet its primary endpoint, but it did uncover a lot more early-stage cancers than predicted. Eric Klein, MD, and Robert Figlin, MD, talk about what the data reveal about cancer biology and for screening programs.
Data presented at the 2026 American Society of Clinical Oncology Annual Meeting add to the “ever-shifting and chaotic space” that is CLL care, says Matthew Lunning, DO. He discusses how new findings are affecting practice with Robert A. Figlin, MD.
New treatments for patients with microsatellite instability–high colorectal cancer are drastically changing outcomes. Nicholas James Hornstein, MD, PhD, discusses recent advances and key findings from the 2026 American Society of Clinical Oncology Annual Meeting with Carolina Bernabe Ramirez, MD
In the wake of recent key data about ESR1-mutated metastatic breast cancer, treatment decisions have become more complicated. “In current clinical practice, this is not a straightforward decision,”
Marla Lipsyc-Sharf, MD, explains to Robert A. Figlin, MD.
“In breast cancer now, all of our treatment for hormone receptor–positive metastatic
disease is a bit of a moving target because of new therapies that are available,”
explains Hope S. Rugo, MD, division chief of breast medical oncology and the Women’s
Cancers Program director at the City of Hope Comprehensive Cancer Center in Duarte,
California. She discusses the “ever-changing” landscape involving the PI3
kinase/AKT/mTOR pathway with Robert A. Figlin, MD, the Steven Spielberg Family
Chair in Hematology-Oncology at Cedars-Sinai Cancer in Los Angeles. Dr. Rugo details
key considerations that she uses for decision making in practice. “And I think we just
want to be cautious about toxicity for these patients and really know that we’re
benefiting them, rather than using up treatments,” she explains.
As the management of patients with ESR1-mutated metastatic breast cancer evolves,
various questions have emerged in clinical practice. “It's a complex situation,” explains
Hope S. Rugo, MD, division chief of breast medical oncology and the Women's Cancers
Program director at the City of Hope Comprehensive Cancer Center in Duarte,
California. She discusses how recent advances have changed treatment decisions with
Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at
Cedars-Sinai Cancer in Los Angeles. “I think it's important to keep in mind that today we
just have single-agent oral SERDs, and people like to give combinations,” Dr. Rugo
notes. But what combinations to give and when remains unclear. “I think how we're
going to decide is that we're going to wait and see what's approved and then look at
patients to try and figure out what to do,” she offers.
How are oncologists currently approaching the care of patients with ESR1-mutated advanced breast cancer in practice? Erin Frances Cobain, MD, associate professor at the University of Michigan Rogel Cancer Center in Ann Arbor, speaks with Wassim Mchayleh, MD, MBA, the clinical program director of the breast cancer program at AdventHealth Cancer Institute and associate professor of medicine at the University of Central Florida in Orlando, about how to best use oral selective estrogen receptor degraders. “And the big question is ‘Can we use SERDs in combination, or are SERDs effective in patients without an ESR1 mutation?’ Can we go outside the current approved guidelines? And I think that’s the biggest question that everyone is asking today,” notes Dr. Mchayleh.
Combination regimens improve survival in advanced EGFR-mutated NSCLC, but they also increase toxicity. Jorge Nieva, MD, shares how he talks with patients about potential adverse events. He
describes the options available for prophylaxis and how he treats the toxicities that do arise.
Tackling central nervous system (CNS) disease in EGFR-mutated non-small cell lung cancer “is a huge problem, both from a quality-of-life perspective for patients and also from a longevity perspective,” explains Sid Devarakonda, MD, director of thoracic medical oncology at Swedish Cancer Institute in Seattle and clinical associate professor at Washington State University. He speaks with Aakash Desai, MD, MPH, associate director of the Phase 1 and Precision Oncology program at the University of Alabama at Birmingham, about how CNS metastases inform choices between regimens. Dr. Devarakonda also discusses how the recent U.S. Food and Drug Administration approval of subcutaneous amivantamab (Rybrevant Faspro) may change his approach. “[Y]ou still need to be comfortable managing some of the toxicities that still persist, even with the subcutaneous formulation, but it's terribly convenient from a practical perspective,” he notes.
Dr. Desai and Dr. Devarakonda reported various financial relationships.
With multiple regimens available for advanced EGFRm NSCLC, selecting the best regimen for an individual patient is key. Jorge Nieva, MD, tells host Aakash Desai, MD, MPH, that the question
shouldn’t be about who needs more efficacy, but rather understanding a patient’s personality and goals.
Progress in cancer care means that millions of patients are living longer lives, albeit without hope of a cure. What role can oncologists and other physicians play in helping to navigate these uncertain futures? “What is our obligation to them? How do we understand them and their needs and respond to them?” asks Sunita Puri, MD, author of That Good Night: Life and Medicine in the Eleventh Hour and associate professor of medicine and director of the inpatient palliative care service at the University of California Irvine School of Medicine. She discusses how she uses “radical honesty” with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer Center in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology. Dr. Puri explains how she admits her own limitations when helping patients who are grappling with questions about what treatments mean for quality vs quantity of life. “I want to be a resource to you, but I also want you to know I share in your uncertainty because I’m not sure what’s going to happen next.”
Dr. Puri reported no relevant financial relationships.
Dr. Figlin reported various financial relationships.
A recent study found a link between mRNA vaccination and improved cancer immunotherapy response. The preclinical data demonstrated impressive results, leading to big questions.
“We believe that [vaccination] actually does generate and even converts the cold tumors to hot tumors,” Steven H. Lin, MD, PhD, a physician-scientist and radiation oncologist at the University of Texas MD Anderson Cancer Center in Houston, tells Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer Center in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology.
Survival data from the KEYNOTE-905 trial and insights into the use of circulating tumor DNA to guide treatment decisions from IMvigor011 made big waves in bladder cancer care at the European Society of Medical Oncology Annual Congress. “Overall, this is going to change the standard of care for muscle-invasive bladder cancer,” says Amanda Nizam, MD, a genitourinary medical oncologist at the Cleveland Clinic Taussig Cancer Institute. She and Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology, discuss how the findings are being incorporated into clinic and what questions remain. “I am continually surprised by the changes taking place in bladder cancer management,” notes Dr. Figlin.
Dr. Nizam reported various financial relationships.
Dr. Figlin reported various financial relationships.
Options for the treatment of acute myeloid leukemia (AML) are rapidly expanding, says Amir Fathi, MD, associate professor of medicine at Harvard Medical School in Boston and program director of the Center for Leukemia at Massachusetts General Hospital. “Over the course of the last 10 to 12 years, there have been a series of approvals, predominantly for targeted therapies,” he explains. Speaking with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology, Dr. Fathi outlines how and when to look for mutations in AML and key considerations for various targeted therapies. He also shares what developments he is anticipating. “I’m most excited about where we’re moving in the upfront setting.”
Dr. Fathi reported various financial relationships.
Dr. Figlin reported various financial relationships.
The artificial sweetener sucralose may impair the efficacy of cancer immunotherapy, according to a recent study published in Science. Although further research is needed before these findings can be translated into actionable information for patients, the investigation highlights that “the science of nutrition in cancer is actually quite poor,” says senior author Diwakar Davar, MD, associate professor and clinical director of the melanoma and skin cancer program at the University of Pittsburgh School of Medicine Hillman Cancer Center in Pennsylvania. Dr. Daver shared why he and his colleagues chose to explore the potential effects of sucralose on cancer treatment, and what research is next, with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair. “What I think we are hoping to try to do is actually just kickstart a movement to get people to focus on nutrition,” Dr. Daver explained. “We spend $1 billion to try to get a hazard ratio of 0.8, and here it appears that if you eat just a little less of this, you can maybe double your likelihoods of success.”
Dr. Davar reported various financial relationships.
Dr. Figlin reported various financial relationships.
New survival data from the FLAURA2 and MARIPOSA trials represent “a massive advance for our patients” in terms of frontline treatment for EGFR-mutated non-small cell lung cancer says Sandip P. Patel, MD, professor of medicine at the University of California San Diego. However, the findings have led to new questions about sequencing. “Just like in chess, when you make a move, you’re restricted in the moves that you can make afterward,” he explains to Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair. Discussions have become “much more nuanced,” and “thinking about the patient holistically becomes even more important in the setting of all these excellent treatment options for our patients,” Dr. Patel shares.
Dr. Patel reported scientific advisory income from Amgen, AstraZeneca, BeiGene, Bristol Myers Squibb, Certis, Eli Lilly, Jazz, Genentech, Illumina, Merck, Pfizer, Natera, and Tempus.
Dr. Figlin reported various financial relationships.
The development of oral selective estrogen receptor degraders (SERDs) represents substantial progress for patients with metastatic breast cancer who have ESR1 mutations. “I’m extremely excited because they’re the most effective form of endocrine therapy today,” says Wassim Mchayleh, MD, MBA, the clinical program director of the breast cancer program at AdventHealth Cancer Institute and associate professor of medicine at the University of Central Florida in Orlando. He spoke with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology about SERDs that are currently available and those in development. When it comes to weighing toxicity, “across the board, they are very well-tolerated endocrine therapies with a very low discontinuation rate,” Dr. Mchayleh noted. In addition to recent key clinical trial results, he also looked ahead to what data may help establish the drug class as a replacement for the current standard of care.
Dr. Mchayleh reported various financial relationships.
Dr. Figlin reported various financial relationships.
From a “game-changer” in triple-negative disease to broader paradigm shifts and practice changes, the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting was pivotal for breast cancer care, says Sara M. Tolaney, MD, MPH, chief of the Division of Breast Medical Oncology at the Dana-Farber Cancer Institute in Boston, Massachusetts. Dr. Tolaney broke down some of the top data at ASCO 2025 with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles, California, and Steven Spielberg Family Chair in Hematology-Oncology. She singled out findings from the ASCENT-04 trial, the plenary session on SERENA-6, and the DESTINY-Breast09 trial. “I think it’s been a very exciting ASCO for breast cancer overall, with just so much exciting data,” Dr. Tolaney concluded.
Results from the phase 3 ATOMIC trial are practice changing for colorectal cancer care and raise broader questions about immunotherapy use in patients with mismatch repair deficiencies across tumor types. Frank A. Sinicrope, MD, a professor of oncology and medicine at the Mayo Clinic Comprehensive Cancer Center in Rochester, Minnesota, presented the findings at the 2025 American Society of Clinical Oncology Annual Meeting. He discussed the significance of the ATOMIC results and next steps with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology. “I think that microsatellite instability is a terrific predictive biomarker for immunotherapy, and all of these patients should get immunotherapy in some form or another,” Dr. Sinicrope noted.
“An increasingly unrealistic set of performance expectations” is putting a strain on oncologist faculty members, says Clifford Hudis, MD, CEO of the American Society of Clinical Oncology (ASCO). He discussed the mounting challenges for academic cancer physicians and how ASCO is working to address them with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology. Dr. Hudis explained that academic oncologists are expected to be clinicians, researchers, teachers, and administrators. “And in most cases, there just isn’t a pay line and salary support for all four of those jobs, nor are there enough hours in the week for somebody to do all four of those jobs in a superb way,” he said. When it comes to ASCO’s ability to enable proactive change, Dr. Hudis explains that “we don’t have an enforcement mechanism. All we can do is shine a very bright light on reality and then ask for collective action to identify best approaches.”
Dr. Hudis reported no relevant financial relationships.
Dr. Figlin reported various financial relationships.
“For the first 15 years of my career, we had nothing new” in bladder cancer care, said Jonathan E. Rosenberg, MD, chief of the genitourinary oncology service at Memorial Sloan Kettering Cancer Center in New York City. Now, “the pace of change has been dizzying,” he told Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology. Speaking at the 2025 American Society of Clinical Oncology Annual Meeting, Dr. Rosenberg discussed key studies that have recently changed practice and what questions still remain. For certain laboratory testing and other concerns, “it’s a bit of the Wild West right now,” he noted.
Findings from the SERENA-6 trial, which examined switching therapies in patients with breast cancer ahead of disease progression, made headlines during the 2025 American Society of Clinical Oncology Annual Meeting. However, big questions remain. “I don’t know for sure if the approach is practice changing yet. I think the approach is practice confounding,” said Stephanie Graff, MD, director of breast oncology at Brown University Health Cancer Center in Providence, Rhode Island. Dr. Graff discussed the high-profile data with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology. The trial showed a progression-free survival benefit when patients switched from an aromatase inhibitor to camizestrant, based on circulating tumor DNA information. And yet, issues with the study’s design may make taking the results into clinic challenging. “We don’t have clear evidence on how changing based on molecular therapy changes overall survival,” said Dr. Graff. “I think we’re going to get there, but I don’t know that the point we are at with SERENA-6 has us there.”
From digitizing its guidelines to potential embedding them in EMRs, the National Comprehensive Cancer Network (NCCN) is working to “make the workflow easier and better” for oncologists, Crystal S. Denlinger, MD, FACP, CEO of the NCCN, told Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology, at this year’s American Society of Clinical Oncology (ASCO) Annual Meeting. Dr. Denlinger broke down the organization’s current priorities and key initiatives, including how the network is tackling preauthorization challenges and helping to educate clinicians about changes to best practices. She notes that initiatives to ensure NCCN guidelines are available, useful, and up to date are crucial because “I truly believe that guideline-concordant care is one of the ways in which we can cure cancer.”
“Is it time to do something big and different? That’s always a good question to ask,” said W. Kimryn Rathmell, MD, PhD, MMHC, the immediate former director of the National Cancer Institute (NCI) and the current CEO of The Ohio State University Comprehensive Cancer Center–James Cancer Hospital and Solove Research Institute. At the 2025 American Society of Clinical Oncology Annual Meeting, Dr. Rathmell spoke with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles, and Steven Spielberg Family Chair in Hematology-Oncology, about how the NCI can adapt to the current environment. She also shared her thoughts on educating the next generation of cancer physicians. “How can we help enable them to look at every patient creatively and to think about how we incorporate all this immense amount of knowledge that we’re trying to impart with them?” she asked.
A late-breaking abstract presented at the 2025 American Society of Clinical Oncology Annual Meeting (LBA3) showed that rusfertide significantly increased hematocrit control and improved symptoms for patients with polycythemia vera, a chronic leukemia. “We thought if we could use our understanding of iron regulation, then we could change the game a little bit,” said Andrew Kuykendall, MD, assistant member in the Department of Malignant Hematology at the Moffitt Cancer Center in Tampa, Florida. He told Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology, about the rationale behind the trial, broke down key findings, and shared what comes next in this area of research. “I think it is very important that we continue to follow these patients. And this is an ongoing trial that has a part two to it, which is a long-term safety assessment period,” he explained.
When it comes to building support for cancer research in the current environment, “the message that we have had in our field is a good one. But we may need to craft a better message,” says Robert A. Winn, MD, director and Lipman Chair in Oncology at the Virginia Commonwealth University Massey Cancer Center in Richmond. Dr. Winn lays out a strategy designed to show the American public the benefits in oncology already yielded from previous investments in science, alongside what can be done if support continues. He tells Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology, that “we’ve talked about the facts, but we have not been effective at telling the story of the big dream of how science could really impact lives.” From the fight for equitable access to cancer care advances to recruiting the next generation of researchers, Dr. Winn stresses that he will continue to fight for progress. “I’m going to continue to ring that bell until I can’t anymore,” he explains.
Dr. Winn reported no relevant financial relationships.
Dr. Figlin reported various financial relationships.
The addition of perioperative durvalumab in gastric and gastroesophageal junction cancer improved event-free survival, according to findings from the MATTERHORN study. “This trial will be an important milestone,” said Yelena Y. Janjigian, MD, chief of the Gastrointestinal Oncology Service at Memorial Sloan Kettering Cancer Center in New York City, who presented the findings at the 2025 American Society of Clinical Oncology Annual Meeting. She spoke with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology, about the significance of the data. “We demonstrated improvement in event-free survival, and this is the first regimen in the perioperative setting to do so,” Dr. Janjigian noted. She also shared next steps for the research and broader questions that the data raise across oncology.
Dr. Janjigian reported various financial relationships.
Dr. Figlin reported various financial relationships.
Data from the SERENA-6 trial, presented at the 2025 American Society of Clinical Oncology Annual Meeting, have the potential to dramatically change advanced estrogen receptor–positive, HER2-negative breast cancer care, says William J Gradishar, MD, the Betsy Bramsen Professor of Breast Oncology at Northwestern University Feinberg School of Medicine in Chicago. The study showed benefit in switching therapies based on circulating tumor DNA evidence of ESR1 mutation, ahead of disease progression. “If we find that the magnitude of benefit seems to be as meaningful as it’s been reported to be, then I think what we will find in practice is more and more people will be doing next-generation sequencing testing, doing it earlier, and doing it more frequently to identify these mutations and act upon them,” Dr. Gradishar told Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology. Dr. Gradishar also discussed key drugs in development, including selective estrogen receptor degraders, and questions about the sequencing of new treatments. “There may be diminishing returns, as we’ve seen with other drugs,” he noted.
Editor’s Note: This interview was recorded shortly before the 2025 American Society of Clinical Oncology Annual Meeting.
Big questions associated with ESR1 mutations in patients with hormone receptor–positive breast cancer may soon have answers. New data are “going to take the whole breast oncology field from one place and put it in a different place. It’s going to be an inflection point in our history of treating breast cancer,” says Jason Aboudi Mouabbi, MD, assistant professor in the Department of Breast Medical at the University of Texas MD Anderson Cancer Center in Houston. Speaking with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology, Dr. Mouabbi outlined current challenges in identifying and responding to the development of ESR1 mutations. Dr. Figlin and Dr. Mouabbi also discussed how eagerly anticipated findings may transform practice and important aspects of mutational testing to consider.
Dr. Mouabbi reported consulting fees from GE Healthcare, Genentech, AstraZeneca, Gilead, Novartis, Fresenius Kabi, BostonGene, and Cardinal Health.
Dr. Figlin reported various financial relationships.
The approach to ESR1 and PIK3CA mutations in patients with hormone receptor–positive metastatic breast cancer continues to evolve. What role does circulating tumor DNA (ctDNA) play in treatment decisions? How should oncologists best approach patients with PIK3CA mutations who subsequently develop ESR1 mutations? VK Gadi, MD, PhD, professor and director of medical oncology and deputy director of the University of Illinois Cancer Center in Chicago, discusses with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology, how recent data are informing care for patients with comutations. “We now have at least one ESR1-targeting drug out there, and more to come,” Dr. Gadi explains. “Elacestrant is the drug I’m of course referencing, and that is used essentially like a single agent and works well for those patients. Even when they have, for example, PIK3CA mutations present.” He and Dr. Figlin consider when to act on ctDNA findings and potential future strategies.
Dr. Gadi reported no relevant financial relationships.
Dr. Figlin reported various financial relationships.
The last few years have seen “a remarkable change in both our approach and management of EGFR lung cancer,” says Shirish M. Gadgeel, MD, division head for hematology/oncology and associate director of Patient Experience and Clinical Care at the Henry Ford Cancer Institute in Detroit. He discusses key considerations for managing EGFR-mutated non-small cell lung cancer with Robert A. Figlin, MD, the interim director and Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. Dr. Gadgeel describes considerations for leptomeningeal metastases, important treatment toxicities, and exciting advances on the horizon.
Dr. Gadgeel reported various financial relationships.
Dr. Figlin reported various financial relationships.
When it comes to tackling fertility issues associated with cancer, “oncology clinicians are often reluctant to talk about this because it is really not our wheelhouse,” says Alison Wakoff Loren, MD, MSCE, chief of the Division of Hematology Oncology, director of Blood and Bone Marrow Transplantation, and the C. Willard Robinson Professor of Hematology-Oncology at Penn Medicine in Philadelphia. Dr. Loren and colleagues recently updated American Society of Clinical Oncology guidelines for fertility preservation in people with cancer. She discusses the key changes with Robert Figlin, MD, interim director at Cedars Sinai Cancer Center in Los Angeles and the Steven Spielberg Family Chair in Hematology-Oncology. “This is a really important topic that I think sometimes gets lost in the shuffle of the hecticness of a young person’s cancer diagnosis,” Dr. Loren explains. Increased awareness among oncologists is a crucial step that can lead to faster referrals and interventions, she says. “You better be ready for the conversation,” she urges.
Dr. Loren reported research funding from Equillium (Inst).
Dr. Figlin reported various financial relationships.
“Second-line [estrogen receptor (ER)]-positive breast cancer has just become very complicated,” says Erika P. Hamilton, MD, the director of breast cancer and gynecologic cancer research at Sarah Cannon Research Institute in Nashville. She discusses the role of ESR1 mutations in selecting appropriate treatments and combination regimens for patients with ER-positive breast cancer who have disease progression with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles, and Steven Spielberg Family Chair in Hematology-Oncology. From when and how best to assess for ESR1 mutations to which trials inform current treatment options in clinic, Dr. Hamilton walks through the complex decision-making process. She also shares which trial readouts she is looking forward to seeing and how social media is influencing patient choices.
Dr. Hamilton reported various financial relationships.
Dr. Figlin reported various financial relationships.
Burnout among oncologists is a serious concern, and artificial intelligence (AI) represents a potential solution, says Debra Patt, MD, PhD, MBA, a practicing oncologist and breast cancer specialist in Austin, Texas, who also serves as the chair of the AI task force for the American Society of Clinical Oncology. Technological advances are poised to improve cancer care while reducing the documentation burden for oncologists, she tells Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles, and Steven Spielberg Family Chair in Hematology-Oncology. Dr. Patt describes the various practical ways in which AI is already changing oncology clinics, but acknowledges a generational divide that will need to be bridged: “I would say that the youngest generation of oncologists that is coming out, they are digital natives. They have grown up with this,” she explains. But for those who have been in practice longer, “Change management for us looks a little bit different than it does for the younger generation of oncologists that just sort of do this naturally.”
Dr. Patt reported no relevant financial disclosures.
Dr. Figlin reported various financial relationships.
The standard approach of “7 + 3” chemotherapy in acute myeloid leukemia (AML) treatment has been in place for 50 years. But that may soon change, says Maximilian Stahl, MD, a member of the Adult Leukemia Group at the Dana-Farber Cancer Institute in Boston and a member of the faculty at Harvard University. “My prediction is that in 10 years, you will not see much 7 + 3 anymore. Maybe not even 10 years, maybe five years,” he tells Robert A. Figlin, MD, the interim director and Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. Dr. Stahl describes how targeted therapies such as menin inhibitor revumenib (Revuforj), which was recently approved by the U.S. Food and Drug Administration, are transforming AML care. Although currently indicated for relapsed/refractory disease, trials are exploring frontline use. “Pretty much, if you can think of any combination treatment in your head, that is already an ongoing clinical trial,” Dr. Stahl explains. He outlines how targeted therapies have already changed practice and looks to what advances are likely in the near future.
Dr. Stahl reported a consulting or advisory role with the Boston Consulting Group, Clinical Care Options, Curis Oncology, GlaxoSmithKline, Haymarket, Kymera, Novartis, and Sierra Oncology.
Dr. Figlin reported various financial relationships.
Oncologist burnout and career dissatisfaction are a “huge problem,” says Robin T. Zon, MD, president of the American Society of Clinical Oncology (ASCO). Dr. Zon sits down with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles, to discuss revelations from a recent ASCO report. “ASCO recognizes that if, in fact, we are going to accomplish our mission, we have to pay very close attention to what is happening to the workforce and the burnout that is associated with that,” Dr. Zon explains. She shares insights into common underlying causes and lays out a plan of attack for improvement. With an emphasis primarily on organizational, and not individual, reforms, Dr. Zon pledges that ASCO will remain focused on burnout and job dissatisfaction. “We are going to continue to have interventions. And we will continue to give voice to our members at all levels.”
Dr. Zon reported various financial relationships.
Dr. Figlin reported various financial relationships.
When it comes to end-of-life care for patients with cancer, “I think that there is a real deficit in
our training,” says Nathan I. Cherny, MD, director of the Cancer Pain and Palliative Medicine
Service at Shaare Zedek Medical Center in Jerusalem, Israel. Dr. Cherney and colleagues
recently examined factors contributing to oncologists overtreating patients at the end of life. He
discusses key findings and ways to address this continued problem with Robert A. Figlin, MD,
the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center
in Los Angeles. “When one reads practice guidelines, they never include a section of when
further treatment is more likely to be harmful than helpful,” Dr. Cherny notes. “Unless it appears
in every illness guideline, the message does not necessarily get through that this is something
that is really important.”
Dr. Cherny reported serving as a consultant for and owning stock in Canopy Care.
Dr. Figlin reported various financial relationships.
Recent advances in hormone receptor–positive, HER2-negative metastatic breast cancer have led to questions about the timing of genetic testing and the optimal treatment choices for patients. “I, like many others, have changed my personal practice,” says Azka Ali, MD, a medical oncologist at the Cleveland Clinic Taussig Cancer Institute in Ohio. She and Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles, discuss what newly approved medications for patients with PIK3CA mutations mean for oncologists. “I think the breast cancer landscape is changing faster than we can all keep up with it,” Dr. Ali explains. She breaks down current genetic testing concerns and how she approaches treatment decisions that sometimes take place in a “data-free zone.”
Dr. Ali reported no relevant financial disclosures.
Dr. Figlin reported various financial relationships.
The European Society for Medical Oncology (ESMO) Resilience Task Force recently released recommendations intended to reduce burnout in oncology worldwide. One of the task force’s members, Konstantinos Kamposioras, MD, PhD, a consultant in medical oncology at the Christie NHS Foundation Trust in Manchester in the United Kingdom, explains to Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles, how those recommendations came to be and what institutions should do to help care for cancer care providers. They discuss differences between young oncologists and late-career specialists and consider solutions beyond those laid out in the ESMO guidance. “I’m wondering whether we have not done a good enough job having our primary care colleagues help us manage our cancer cases,” Dr. Figlin speculates.
Dr. Kamposioras reported no relevant financial relationships.
Dr. Figlin reported various financial relationships.
When it comes to the treatment of EGFR-mutated metastatic non-small cell lung cancer (NSCLC), osimertinib (Tagrisso) is an “old friend,” says Kamya Sankar, MD, assistant professor and co–medical director of the Thoracic Disease Research Group at Cedars-Sinai Cancer Center in Los Angeles. Recent approvals by the U.S. Food and Drug Administration have introduced several “new friends,” in the form of amivantamab (Rybrevant) and lazertinib (Lazcluze). Dr. Sankar talks with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology also at Cedars-Sinai Cancer Center, about how to choose among osimertinib monotherapy, osimertinib plus chemotherapy, or amivantamab plus lazertinib. Without overall survival data available for all choices, Dr. Sankar explains how she and her patients decide which treatment is best, as well as how to consider sequential therapy after disease progression.
Dr. Sankar reported no relevant financial relationships.
Dr. Figlin reported various financial relationships.
“Cancer clinical research has been largely privatized,” explains Joseph Unger, PhD, MS, associate professor in the cancer prevention program at the Fred Hutchinson Cancer Center in Seattle. Dr. Unger and colleagues recently assessed patient enrollment in industry-sponsored and federally sponsored clinical trials. They found an 8:1 ratio favoring participation in research backed by industry. This raises significant concerns, he tells Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. Dr. Unger explains what he sees as the root causes for the current imbalance, potential negative effects, and possible solutions for how to “rebalance the portfolio.” “I’m doing whatever I can to help illustrate what the issues are through my research,” he notes.
Dr. Unger reported a consulting/advisory role with AstraZeneca and Loxo/Lilly.
Dr. Figlin reported various financial relationships.
Treatment approaches for patients with hormone receptor (HR)-positive, HER2-negative breast cancer have rapidly evolved, thanks in part to data from three key studies. Erin Frances Cobain, MD, associate professor at the University of Michigan Rogel Cancer Center in Ann Arbor, explains how findings from the KEYNOTE-756, monarchE, and NATALEE clinical trials are influencing decision-making for these patients. She and Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles, discuss the evolving role of immunotherapy and how to choose between CDK4/6 inhibitors, given the recent U.S. Food and Drug Administration approval of adjuvant ribociclib for patients with early breast cancer who are at high risk for recurrence. Dr. Cobain acknowledges that these and other findings have led to “challenging discussions,” even if those conversations are ultimately beneficial.
Dr. Cobain reported various financial relationships.
Dr. Figlin reported various financial relationships.
Approvals of antibody-drug conjugates (ADCs) for metastatic breast cancer have introduced complex questions about HER2 expression. “It’s certainly been a changing landscape, which has been confusing for all of us,” explains Ian Krop, MD, PhD, director of the clinical trials office, chief clinical research officer, and associate director for clinical sciences at Yale Cancer Center in New Haven, Connecticut. He and Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles, discuss how oncologists should best approach HER2 testing, ADC sequencing, and toxicity concerns. When it comes to answering key questions, “We're a little data-poor in some ways because this is such a rapidly evolving field,” Dr. Krop explains. He also considers what’s next for ADCs in breast cancer, including the potential for those treatments to move into the curative early-disease setting.
Dr. Krop reported various financial relationships.
Dr. Figlin reported various financial relationships.
Newly approved targeted therapies for patients with advanced hormone receptor (HR)-positive, HER2-negative breast cancer are changing care. “We have an abundance of opportunities, but challenges with having to choose the right opportunity at the right time,” says Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. Dr. Figlin discusses how to navigate new options with Manali Bhave, MD, a breast medical oncologist and assistant professor at the Emory University School of Medicine in Atlanta. Dr. Bhave stresses that disease progression in breast cancer can’t be addressed with a one-size-fits- all option. “Where do we go from here? I think it is largely dependent on clinical factors, patient comorbidities, and even biomarker status,” she explains. Dr. Bhave and Dr. Figlin discuss recent developments in targeted therapies and important challenges. “We’ve come a long way in treating metastatic HR-positive, HER2-negative breast cancer as more of a chronic disease,” she says.
Dr. Bhave reported consulting fees from Lilly, Novartis, and AstraZeneca.
Dr. Figlin reported various financial relationships.
Data on the use of durvalumab after chemoradiotherapy transformed the standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC). “This is a real practice-changing observation from the PACIFIC trial,” said Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. He recently spoke with Meghan Mooradian, MD, an instructor at Harvard Medical School in Boston, about her team’s recent research assessing the protocol established by the PACIFIC study. “We really are hoping for a cure,” she said in describing how she makes decisions related to the timing of durvalumab after chemoradiotherapy. Dr. Mooradian also addressed toxicity concerns and shared what she sees as lingering questions related to disease progression. “What should we really be using next?” she asked.
Dr. Mooradian reported consulting or advisory roles with AstraZeneca, the Bristol Myers Squibb Foundation, Istari Oncology, Regeneron, and Xilio Therapeutics; and other relationships with Aptitude Health, Curio Science, DAVA Oncology, and OncLive/MJH Life Sciences.
Dr. Figlin reported various financial relationships.
Results of the phase 3 LAURA clinical trial, presented at the 2024 American Society of Clinical Oncology Annual Meeting, showed that osimertinib significantly improves progression-free survival in patients with unresectable stage III EGFR-mutant non-small cell lung cancer (NSCLC) after chemoradiotherapy. “The benefits of osimertinib in this patient population when compared to placebo are just incredibly dramatic,” noted Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. He spoke with lead study author Suresh S. Ramalingam, MD, the Roberto C. Goizueta Distinguished Chair for Cancer Research and the executive director at the Winship Cancer Institute of Emory University in Atlanta, about how oncologists should adjust their practice in the wake of these key findings. Dr. Ramalingam tackled questions about the optimal duration of osimertinib therapy, toxicity concerns, and notable benefits seen in the LAURA data. “Osimertinib reduced both intrathoracic progression and extrathoracic progression, particularly intracranial progression,” he noted.
Dr. Ramalingam reported research funding from Amgen, AstraZeneca/MedImmune, Bristol Myers Squibb, Merck, Pfizer, and Takeda; travel, accommodations, and other expenses from AbbVie; and a relationship with the American Cancer Society.
Dr. Figlin reported various financial relationships.
“I think the antibody-drug conjugates (ADCs) for physicians, and certainly patients too, are a little bit tough to wrap your head around,” says Erika P. Hamilton, MD, the director of breast cancer and gynecologic cancer research at Sarah Cannon Research Institute in Nashville. She discusses how TROP2-targeting ADCs currently fit into practice with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. From how to “choose the right patient for the right treatment at the right time” to important toxicity concerns, Dr. Hamilton shares her “elevator pitch” to patients when it comes to ADCs. “I think a very easy way to really talk about the activity at this point is just the fact that they’re beating naked chemotherapy. So they are performing better than chemotherapy and, for the most part, comparing favorably in terms of side effects for patients as well.”
Dr. Hamilton reported various financial relationships.
Dr. Figlin reported various financial relationships.
Various survivorship guidelines for pediatric patients have been established, but “such guidelines do not exist in the adult world,” says Smita Bhatia, MD, MPH, director of the Institute for Cancer Outcomes and Survivorship and the Gay and Bew White Endowed Professor in Pediatric Oncology at the University of Alabama at Birmingham. With the number of adult cancer survivors rapidly rising, the time is now for major oncology societies to help create long-term health recommendations, she tells Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. Dr. Bhatia and Dr. Figlin discuss the critical need to explore how recent advances in cancer care, such as targeted treatments and immunotherapies, may affect the future health of survivors. “If we don’t start by constructing large cohorts and following them long term, we will have lost this opportunity that exists right now,” she explains.
Dr. Bhatia is an Associate Editor for Journal of Clinical Oncology. Journal policy recused the author from having any role in the peer review of the manuscript discussed.
Dr. Figlin reported various financial relationships.
Obstacles to “achieving a good, peaceful death” prevent many patients with cancer from the “dignified end” that they deserve, says Sunita Puri, MD, a palliative care physician and author. She and Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles, discuss frustrations and concerns about systemic failures in cancer care when it comes to death and dying. “We need to have this national dialogue around this topic,” argues Dr. Figlin. “It can’t be under the covers, where we don’t talk about it.”
Dr. Puri reported no relevant financial disclosures.
Dr. Figlin reported various financial relationships.
When it comes to the treatment of patients with relapsed/refractory chronic lymphocytic leukemia (CLL), "within the last eight months or so, we have had some exciting new events," says Daniel A. Ermann, MD, a hematologist-oncologist and assistant professor at the University of Utah Huntsman Cancer Institute in Salt Lake City. The U.S. Food and Drug Administration approved pirtobrutinib for previously treated CLL in December 2023 and approved the CAR-T therapy lisocabtagene ciloleucel for relapsed/refractory disease in March 2024. These new options for patients with unmet needs present "a difficult choice, and it is a little bit of a balance," Dr. Ermann explains. He discusses key considerations for treatment selection with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles.
Oncologists are struggling with the rising cancer mortality rate among millennial patients. "I think treating people our own age is definitely a trigger for a lot of people," said Sunita Puri, MD, a palliative-care physician and author. She spoke with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles, about her recent article in The Atlantic, "The Silence Doctors Are Keeping About Millennial Deaths." Dr. Puri explained how age bias and other factors have led to challenges in providing the care that younger adults with terminal cancer both want and need. "We should be matching up medical treatment with the values of the patient. Younger people, in my experience, don't want to be protected from the truth," she said.
Dr. Puri and Dr. Figlin discussed how certain training can help and which misperceptions should be challenged. "I think we're socialized as doctors to equate treatment, survival, benefit, and cure as our scope of care. But part of our care is absolutely seeing and hearing the person in front of us and understanding that person as a distinct individual."
Thoracic oncology was a major focus of the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting, says Sandip P. Patel, MD, a medical oncologist and professor of medicine at the University of California San Diego. Practice-changing data were presented in both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), Dr. Patel told Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles.
The biggest data at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting in kidney cancer focused on biomarkers, says Brian I. Rini, MD, chief of clinical trials and the Ingram Professor of Cancer Research at the Vanderbilt-Ingram Cancer Center in Nashville. He discussed data from KEYNOTE-426 and several other key trials with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles.
Enfortumab vedotin plus pembrolizumab (EV/pembro) has “become the elephant in the room” when it comes to bladder cancer care, says Jonathan E. Rosenberg, MD, chief of genitourinary oncology service at Memorial Sloan Kettering Cancer Center in New York City. At the 2024 American Society of Clinical Oncology Annual Meeting, he discussed recent key advances in urothelial carcinoma treatment with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles.
Immunotherapy in “Hardest Stage” of NSCLC: Putting Recent Advances Into Practice
Our host, Robert A. Figlin, MD, FACP, welcomes Melissa L. Johnson, MD, as a guest
From ASCO 2024.
When it comes to the use of antibody-drug conjugates (ADCs) in breast cancer care, "we're past the inflection point," says Hope S. Rugo, MD, a breast cancer oncologist and professor of medicine in the Division of Hematology and Oncology at the University of California San Francisco Helen Diller Family Comprehensive Cancer Center.
From ASCO 2024
The time it takes for a novel cancer therapy to go from investigational new drug application to U.S. Food and Drug Administration (FDA) approval is typically longer than a decade. “There has to be a better way,” says Bob T. Li, MD, PhD, MPH, a medical oncologist at Memorial Sloan Kettering Cancer Center in New York City and associate professor of medicine at Cornell University in Ithaca, New York.
From ASCO 2024, Dr. Robert Figlin speaks with Dr. Samer Al Hadadi from University of Arkansas.
"Very Important" Myeloma Data: ASCO Highlights, Smoldering Challenges, and More.
From ASCO 2024, Dr. Robert Figlin talks with Dr. Lauren Averett Byers from MD Anderson Cancer Center.
Durvalumab's Benefit in SCLC "Beyond What We Might Have Expected"
From ASCO 2024
New Standard of Care in Melanoma? Neoadjuvant Immunotherapy Offers "Fantastic" Potential, Expert Says.
Dr. Robert Figlin speaks with Dr. Christian Blank from Leiden University
From ASCO 2024, Dr. Robert Figlin welcomes Dr. Aditya Bardia from UCLA Health Jonsson Comprehensive Cancer Center.
Should All Breast Cancer Patients Get T-DXd? "Results of DESTINY-Breast06 Do Suggest That"
Especially in rural areas, the growing oncologist shortage has “gotten to crisis level,” says Harsha Vyas, MD, president and founding partner of Cancer Center of Middle Georgia in Dublin. “We just don’t have enough supply of medical oncologists/hematologists,” he tells Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. Dr. Vyas puts forth his ideas for potential solutions, ranging from medical school debt repayment to congressional intervention. As Dr. Figlin notes, “we need to rethink” current approaches because there’s a “storm” on the horizon and “we’re all seeing it coming.”
Dr. Vyas reported no relevant financial relationships.
Dr. Figlin reported various financial relationships.
The development of noncovalent Bruton tyrosine kinase (BTK) inhibitors and other advances in chronic lymphocytic leukemia treatment signify that the “future is really exciting,” says Jennifer A. Woyach, MD, professor in the Division of Hematology at The Ohio State University in Columbus. Dr. Woyach speaks with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles, about the potential of moving these new drugs into the frontline setting and other questions related to BTK inhibitor resistance.
Dr. Woyach reported various financial relationships. Dr. Figlin reported various financial relationships.
Given recent data, how should oncologists choose a tyrosine kinase inhibitor (TKI) in patients with EGFR-mutated non-small cell lung cancer (NSCLC), and when should chemotherapy be introduced? “It’s better to have choices than not,” explains Paul Bunn, MD, the Dudley Chair in Cancer Research at the University of Colorado in Aurora. Dr. Bunn discusses how recent trials influence treatment decisions in NSCLC with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. Dr. Bunn stresses why molecular testing is so crucial and previews what additional findings are likely to further change practice in patients with EGFR-mutated NSCLC.
The treatment of biochemical recurrence in prostate cancer “is set for rapid development over the next few years,” says Edwin M. Posadas, MD, medical director of the Center for Uro-Oncology Research Excellence at the Samuel Oschin Comprehensive Cancer Center at Cedars-Sinai Medical Center. Data from the recent EMBARK trial have changed practice for the treatment of men with high-risk features. Dr. Posadas discusses these findings and related advances with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. They also consider how the growing role of prostate-specific membrane antigen (PMSA) positron emission tomography (PET)-CT is “really impacting” care for patients with prostate cancer who have biochemical recurrence. Dr. Posadas explains why the best approach for patients with negative PSMA PET-CT results who have high-risk features remains “a point of great discussion.”
The U.S. Food and Drug Administration’s recent accelerated approval of a tumor-infiltrating lymphocyte therapy in metastatic melanoma “is a real milestone,” after the approach was “pending for decades,” explains Jeffrey S. Weber, MD, PhD, deputy director at the NYU Langone Perlmutter Cancer Center. Dr. Weber, who was part of the team to first work with the treatment in the late 1980s, discusses the breakthrough with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. They examine what this accelerated approval means for practice and consider the "incredibly expensive cost” associated with the treatment. They also consider the evolving role of high-dose interleukin-2 in this patient population.
Recent advances in metastatic urothelial carcinoma have meant that optimistic outcomes are “not as much of a fairytale,” says Robert Dreicer, MD, deputy director of the UVA Cancer Center and professor of medicine and urology at the University of Virginia School of Medicine in Charlottesville. From the recent approval of enfortumab vedotin plus pembrolizumab to other key findings recently presented at the American Society of Clinical Oncology Genitourinary Cancers Symposium, Dr. Dreicer discusses “paradigm-shifting” advances with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. Dr. Dreicer explains the “deal-breaker” that renders one treatment strategy “a relative no-brainer” for certain patients, as well as what upcoming data are likely to change practice even more.
Recent approvals by the U.S. Food and Drug Administration (FDA) and findings from pivotal clinical trials have changed care for patients with breast cancer that has progressed after frontline hormone therapy. Ruth M. O’Regan, MD, chair of medicine and Charles H. Dewey Professor at the University of Rochester in New York, highlights which recent developments regarding second- and third-line treatments are most essential. She and Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles, discuss which newly approved drugs are making a difference in patients with actionable mutations, as well as those without. Dr. O’Regan also details which soon-to-be reported studies she is awaiting in 2024.
Recent data on the use of immunotherapy and targeted treatments in patients with advanced non-small cell lung cancer (NSCLC) have introduced a myriad of questions. These include controversial topics and difficult decisions, like when to incorporate CTLA-4 inhibition and what patients can expect from immuno-oncology monotherapy in the metastatic setting. Edward B. Garon, MD, MS, professor in the department of medicine in hematology/oncology and director of the thoracic oncology program at the Jonsson Comprehensive Cancer Center at the University of California Los Angeles, discusses key challenges in NSCLC care with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. From optimal strategies in second-line settings to promising clinical trials, Dr. Garon shares how he applies emerging information in practice.
Belzutifan was recently approved by the U.S. Food and Drug Administration (FDA) for use in previously treated adults with advanced renal cell carcinoma. How should this drug best be incorporated into practice? Eric Jonasch, MD, professor in the Department of Genitourinary Medical Oncology at the University of Texas MD Anderson Cancer Center in Houston, and Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles, discuss how the medication might be used in clinic. Dr. Jonasch also provides insight into the LITESPARK-005 study, which led to the FDA approval, as well as other ongoing trials that may further change the landscape of kidney cancer care.
CDK4/6 inhibitors “have really been a game changer” in metastatic breast cancer, according to Komal Jhaveri, MD, clinical director for early drug development and section head for endocrine therapy research at Memorial Sloan Kettering in New York City. However, optimal treatment strategies have been complicated by a lack of head-to-head trials. Dr. Jhaveri speaks with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles, about how “practice patterns have slightly shifted” despite challenges in assessing efficacy across regimens and approaches. Dr. Jhaveri also discusses her work on the INAVO120 study, which found a benefit in adding a PI3K inhibitor to the combination of CDK4/6 inhibitors and hormone therapy. The trial reported a “monstrously important clinical hazard ratio,” according to Dr. Figlin, and may help clarify best practices moving forward.
From compelling data presented at the San Antonio Breast Cancer Symposium to the recent U.S. Food and Drug Administration approval of capivasertib, 2023 saw numerous key advances in breast cancer care. Aditya Bardia, MD, MPH, director of the breast cancer research program at Massachusetts General Hospital and associate professor at Harvard Medical School in Boston, and Robert A. Figlin, MD, the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, discuss how several notable developments are already impacting practice. Dr. Bardia explains why genotyping is essential, provided it is available and affordable, and what recent changes have meant for the “roadmap” he presents to patients with metastatic disease. He also considers what 2024 may have on tap for this rapidly changing field.
From the use of prostate-specific membrane antigen (PSMA) positron-emission tomography (PET) to advancements in targeted treatments, prostate cancer care is quickly evolving. Edwin M. Posadas, MD, director of the Experimental Therapeutics Program and director of the Center for Urologic Oncology Research Excellence at Cedars-Sinai in Los Angeles, speaks with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai, about how he is already implementing promising new data into practice. Although Dr. Posadas notes that although immunotherapy approaches in prostate cancer have been “a bit of a disappointment” so far, he sees “a lot of exciting research going on.” He explains why he doesn’t “like to wait” when expanding his therapeutic armamentarium and why he prefers to be “proactive rather than reactive” when it comes to molecular profiling and other approaches.
Results of the recent EMBARK study show that both enzalutamide plus leuprolide and enzalutamide monotherapy significantly improved metastasis-free survival compared with leuprolide alone in patients with prostate cancer who have high-risk biochemical recurrence. Lead author Stephen Freedland, MD, associate director for education and training and director of the Center for Integrated Research in Cancer and Lifestyle at Cedars-Sinai Cancer Center in Los Angeles, speaks with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai, about how these findings should be applied in practice. Although the data represent a significant advance, Dr. Freedland suggests even more progress ahead, asking "This is the new standard, but for those [who] are really high-risk, how can we do even better?”
Studies involving high-risk, early-stage ER-positive breast cancer are among the most eagerly anticipated at this year’s San Antonio Breast Cancer Symposium (SABCS), to be held Dec. 5-9. Virginia Kaklamani, MD, professor of medicine in the division of hematology and medical oncology at the University of Texas Health Sciences Center San Antonio and leader of the breast cancer program at the Mays Cancer Center, discusses which data she thinks has the best chance of changing practice soon. She also speaks with Bob Figlin, MD, the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, about key research into HER2-positive disease, brain metastases, and local therapy to watch for at this year’s conference.
Last month, a U.S. Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) determined that progression-free survival (PFS) could not be reliably interpreted in a confirmatory clinical trial for sotorasib (Lumakras) used to treat KRAS G12C–mutated locally advanced or metastatic non-small cell lung cancer (NSCLC). Ravi A. Madan, MD, senior clinician at the National Cancer Institute’s Center for Cancer Research and chair of the ODAC, speaks with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles, about broader implications from the 2-10 vote against the sotorasib data. They discuss the specific rationale behind the decision, as well as what this means for clinical practice in the short term and big picture solutions to help improve future trials.
How should results of the FLAURA2 clinical trial be applied in practice? The study examined the use of osimertinib plus chemotherapy in the first-line treatment of EGFR-mutated advanced non-small cell lung cancer (NSCLC) compared with osimertinib alone and found that progression-free survival was significantly improved with the combination treatment. Pasi A. Jänne, MD, PhD, director of three cancer centers at the Dana-Farber Cancer Institute in Boston, including the Lowe Center for Thoracic Oncology, shares his team’s findings with Bob Figlin, MD, the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles. They discuss toxicity concerns, best practices for treatment assessment, and how to identify patients for whom the new strategy may yield the best results.
“Therapies are improving dramatically” in mantle cell lymphoma (MCL), according to Michael Wang, MD, professor in the department of lymphoma/myeloma, division of cancer medicine at the University of Texas MD Anderson Cancer Center in Houston. Dr. Wang presented updates on major advances in MCL at the recent Society of Hematologic Oncology (SOHO) annual meeting. Here, he speaks with Bob Figlin, MD, the Steven Spielberg family chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, about which promising regimens from recent studies are most appropriate for certain age groups. Dr. Wang and Dr. Figlin also discuss common challenges when approaching newly diagnosed patients, as well as how to process the “explosion” of new information in MCL.
Recent advances have provided new options for when and how best to treat patients with chronic lymphocytic leukemia (CLL). Trials of combination strategies have shown promise in providing patients the potential for unmaintained remissions. Marco Ruella, MD, an assistant professor of medicine in hematology-oncology at the Perlman School of Medicine at the University of Pennsylvania and scientific director of the lymphoma program, speaks with Robert Figlin, MD, the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, about the current state of CLL care and what changes are likely in the near future. Although satisfied in many ways with recent progress, Dr. Ruella argues in favor of moving past simply “maintaining the disease at long-term” and, instead, pushing for a cure.
Dr. Ruella reports relationships with AbClon, BMS, Bayer, NanoString, and UPenn/Novartis.
Dr. Figlin has reported relationships with numerous companies.
The World Conference on Lung Cancer (World Lung) will be held in Singapore, September 9–12. The current president of International Association for the Study of Lung Cancer (IASLC), Heather A. Wakelee, MD, division chief of medical oncology at the Stanford Cancer Institute in California, shares which presentations and findings she is most looking forward to at this year’s event. She speaks with Robert Figlin, MD, the StevenSpielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, about steps being taken to ensure that key information from the conference is communicated quickly, clearly, and effectively to community oncologists around the world. They also discuss specific issues that will be addressed in Singapore, including a focus on lung cancer screening and why overcoming obstacles to more widespread uptake is crucial.
Updates to the American Society for Clinical Oncology’s (ASCO’s) living guidelines for therapy in patients with stage IV non-small cell lung cancer (NSCLC) with driver alterations were recently released. Dwight H. Owen, MD, MS, from The Ohio State University Comprehensive Cancer Center – James, examines the new recommendations that he and his team introduced with Bob Figlin, MD, the Steven Spielberg family chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles. They discuss how the living guidelines are updated and the rationale for what gets included, a process Dr. Figlin notes is “critical to the practicing oncologist.” Dr. Owen describes three new additions that are “really impactful” and his hopes for how these will directly improve patient care.
In early July, beloved surgeon and breast cancer advocate Susan Love, MD, MBA, died at age 75 years, after a recurrence of leukemia. Dr. Love’s legacy extends beyond the lives of her patients and into the approaches and attitudes of her fellow physicians. Stephanie Graff, MD, medical advisor to the Dr. Susan Love Foundation for Breast Cancer Research and director of breast oncology at the Legorreta Cancer Center at Brown University in Providence, Rhode Island, shares memories and insights about Dr. Love with Bob Figlin, MD, the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer in Los Angeles. They discuss why talking less, listening more, and “rattling” the right cages are key lessons oncologists can take away from “a giant in cancer care” and mentor, who is already sorely missed.
HER2 inhibitors dramatically changed care for many breast cancers; however, less is known about HER3, which acts in concert with HER2. Does HER3 have the same potential to reshape treatment strategies? Erika Hamilton, MD, director of breast cancer and gynecologic cancer research at Sarah Cannon Research Institute in Nashville, talks with Bob Figlin, MD, the Steven Spielberg family chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, about HER3, how it works, and how new antibody-drug conjugates (ADCs) that target HER3 are already showing activity in hard-to-treat disease. She also explains how sequencing ADC therapies may work and what other changes could be next.
Although findings have suggested that adjuvant osimertinib is beneficial in early-stage non-smallcell lung cancer (NSCLC), some concerns have persisted. Balazs Halmos, MD, MS, associate director of clinical science, and director of both thoracic oncology and clinical cancer genomics at Montefiore Einstein Cancer Center in New York, says that “all these doubts have been shifted away,” given recent data presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting. Dr. Halmos speaks with Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer in Los Angeles, about data from the ADAURA trial and other studies. Dr. Halmos says that the new evidence is “not just practice-affirming” butcan be considered “practice-expanding,” resulting in complicated questions that necessitate morethorough collaborations among oncologists, surgeons, pathologists, and radiologists.
How should community oncologists best approach ESR1 mutations in breast cancer, given the latest findings? Recent data presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting and elsewhere have shed light on issues related to ESR1 testing and treatment selection. Bob Figlin, MD, the Steven Spielberg Family Chair in hematology oncology at Cedars-Sinai Cancer in Los Angeles, speaks with Hope Rugo, MD, professor of medicine in the division of hematology and oncology, department of medicine, and director of breast oncology and clinical trials education at the University of California San Francisco Helen Diller Family Comprehensive Cancer Center, about how to put new findings into practice. Dr. Rugo provides key recommendations, as she explains that “It’s really important that we don’t just throw drugs together in clinical practice.”
Recent results demonstrated that mRNA vaccination improved recurrence-free survival among patients with melanoma. This has led to questions about what’s next for this promising intervention. Bob Figlin, MD, the Steven Spielberg Family Chair in hematology-oncology at Cedars Sinai Cancer in Los Angeles, welcomes Jeffrey Weber, MD, PhD, deputy director, professor, and co-director of the melanoma research program at NYU Langone’s Perlmutter Cancer Center, todiscuss potential timing for FDA approval and additional cancers that may see benefit from a vaccine strategy.
Within the last few years, an “explosion of data” regarding adjuvant and neoadjuvant treatment for resectable lung cancer has contained “major wins” for patient care. Although exciting, the rapid advancement has led to questions about when chemotherapy and chemoimmunotherapy should be adopted or avoided. Bob Figlin, MD, the Steven Spielberg Family Chair in hematology-oncology at Cedars Sinai Cancer in Los Angeles, and Charu Aggarwal, MD, MPH, the Leslye M. Heisler Associate Professor for Lung Cancer Excellence at the University of Pennsylvania’s Abramson Cancer Center in Philadelphia, discuss how to apply key recent findings. They also share “the special sauce” that allows Dr. Aggarwal’s team to make the best determination for surgical timing.
As treatment options increase for patients with CLL, so do questions about which interventions, if any, are right for which patients and when. Bob Figlin, MD, and Nicole Lamanna, MD, discuss key considerations, ranging from cardiac toxicity to why Dr. Lamanna “won't just treat for a symptom.”
With more than 10 known driver mutations in non-small cell lung cancer (NSCLC), testing is ever more critical, says Heather Wakelee, MD, division chief of medical oncology at Stanford University and president of the International Association for the Study of Lung Cancer. Listen as she and Peer-Spectives host Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology Oncology at Cedars-Sinai Cancer, talk about how she manages patients with metastatic disease or those who need adjuvant treatment, when she starts targeted therapy or immunotherapy, and more. “We can drastically change the course of disease for a patient by giving them the appropriate targeted treatment. So that testing is so critical,” Dr. Wakelee said.
Treatment options are expanding quickly in early non-small cell lung cancer. Listen as Heather Wakelee, MD, division chief of Medical Oncology at Stanford University and president of the International Association for the Study of Lung Cancer, describes how she’s using new agents and incorporating trial findings into practice. She and host Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology Oncology at Cedars-Sinai Cancer, explore the growing roles for neo- and adjuvant therapy and how to select patients for each therapeutic approach.
After a decade of limited gains in metastatic pancreatic cancer, Zev Wainberg, MD, professor of medicine and co-director of the GI oncology program at the University of California, Los Angeles, presented the results of the NAPOLI-3 trial at the ASCO Gastrointestinal Cancers Symposium last month. The data showed an improvement in overall survival and usher in a new standard for the hard-to-treat disease. Listen as Dr. Wainberg talks with Bob Figlin, MD,Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer, and host of OBR’s Peer-Spectives podcast, about those data and which patients should receive the regimen. They also talk about what advances might be coming next in the metastatic setting and in earlier disease, and what factors influence Dr. Wainberg’s treatment choices.
The landscape for breast cancer treatment is shifting quickly, with an ever-increasingemphasis on targeted and hormonal therapies. Listen as Virginia Kaklamani,MD, professor of medicine in the division of hematology oncology at UT Health San Antonio, and medical directorof the breast oncologyprogram at UT Health San Antonio, MD Anderson Cancer Center,talks with Bob Figlin, MD, Steven Spielberg Family Chair in Hematology-OncologyatCedars-Sinai Cancer,about key findings coming out of the 2022 San Antonio Breast Cancer Symposium. She shares how she’ll use elacestrant following updated results from the EMERALD trial, how to select patients for ovarian suppression, and the expanding role of CDK4/6 inhibitors. “[T]here's no role for combination chemotherapy in first-line [estrogen receptor]-positive metastatic breast cancer anymore –even in patients that are deemed to have visceral crisis,”she said.
Listen as Gabriela Hobbs, MD, clinical director of the leukemia atMass General, talks with Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology Oncology at Cedars-Sinai Cancer in Los Angeles, about the latest progress in the treatment of myelofibrosisand how she both assesses new patients and plans their treatment. New agents, including JAK2 inhibitors,are not curative but can have substantial effects on patients and open up further treatment options. Dr. Hobbs also talks about new drug classes on the horizon and what to expect at the upcoming ASH meeting.
Melissa Johnson, MD,a medical oncologist with Tennessee Oncology and Director of Lung Cancer Research at Sarah Cannon Research Institute in Nashville,joins host Robert Figlin, MD, Steven Spielberg Family Chair in HematologyOncologyat Cedars-Sinai Cancer, to talk about KRAS G12C inhibition in non-small cell lung cancer (NSCLC)treatment. She talks about how she uses sotorasib (Lumakras), which is U.S. Food and Drug Administration (FDA)approved for second-line treatment, why plasma-based genetic testing is so important, and how she explains to patients that even though she can’t start them off with this drug in the first-line, having it in reserve is a good plan.
The key steps to launching a successful and professionally fulfilling hematology/oncology fellowship is to “reflect, project, and adapt,” according to Gerald Hsu, MD, PhD, associate clinical professor of medicine and director of the Hematology/Oncology Fellowship Program at UCSF. Dr. Hsu spoke with Robert Figlin, MD, to discuss how new fellows can best navigate the opportunities they’re presented with. Dr. Hsu recommends reflecting on your areas of passion and interest, projecting what you’ll need 10 years down the road, and adapting your goals as your priorities and interests evolve.
Tejas Patil, MD, assistant professor of medical oncology at the University of Colorado Cancer Center, talks with Robert A. Figlin, MD, about new targeted therapies for non-small cell lung cancer (NSCLC), particularly tepotinib (Tepmetko) for MET exon 14 and sotorasib (Lumakras) for KRAS G12C. The MET exon 14 skip mutation has attracted renewed attention because tepotinib and capmatinib (Tabrecta), which both target this mutation, recently received FDA approvals. But MET can be disrupted in other ways, as well. Listen as Dr. Patil discusses the different types of MET alterations, how to identify MET activation in patients, and best practices for using tepotinib to treat MET activation that arises as a resistance mechanism to the EGFR inhibitor osimertinib (Tagrisso).
Tejas Patil, MD, assistant professor of medical oncology at the University of Colorado Cancer Center, talks with Robert A. Figlin, MD, about new targeted therapies for non-small cell lung cancer (NSCLC), particularly tepotinib (Tepmetko) for MET exon 14 and sotorasib (Lumakras) for KRAS G12C. The MET exon 14 skip mutation has attracted renewed attention because tepotinib and capmatinib (Tabrecta), which both target this mutation, recently received FDA approvals. But MET can be disrupted in other ways, as well. Listen as Dr. Patil discusses the different types of MET alterations, how to identify MET activation in patients, and best practices for using tepotinib to treat MET activation that arises as a resistance mechanism to the EGFR inhibitor osimertinib (Tagrisso).
Jonathan Cohen, MD, MS, Associate Professor, Hematology and Medical Oncology, Emory University School of Medicine, , joins OBR Editor-in-Chief Robert Figlin, MD, to talk about mantle cell lymphoma. Dr. Cohen describes the key to making a correct diagnosis and what the best frontline treatment approaches are for different patient groups. He also talks about how BTK inhibitors and CAR T-cell therapy are shifting the treatment landscape and what he’s anticipating will be presented at upcoming conferences. “One of the things I know I've learned about mantle cell lymphoma is that if you wait six months, something new will come down the come down the pipeline,” Dr Cohen said.
Jonathan Cohen, MD, MS, Associate Professor, Hematology and Medical Oncology, Emory University School of Medicine, , joins OBR Editor-in-Chief Robert Figlin, MD, to talk about mantle cell lymphoma. Dr. Cohen describes the key to making a correct diagnosis and what the best frontline treatment approaches are for different patient groups. He also talks about how BTK inhibitors and CAR T-cell therapy are shifting the treatment landscape and what he’s anticipating will be presented at upcoming conferences. “One of the things I know I've learned about mantle cell lymphoma is that if you wait six months, something new will come down the come down the pipeline,” Dr Cohen said.
Bob Figlin, MD, and Toni Choueiri, MD, the director of the Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute, discuss the early results from the COSMIC-313 trial, which Dr. Choueiri presented at ESMO 2022. The trial enrolled previously untreated patients with metastatic clear cell renal cell cancer who were classified as intermediate- to poor-risk. Standard of care doublet therapy, nivolumab (nivo) plus ipilimumab (ipi), was compared with triplet therapy, consisting of nivo-ipi plus cabozantinib. Triplet therapy improved progression-free survival compared with doublet therapy, specifically in the intermediate-risk group. Dr. Choueiri also discussed the complicated landscape in RCC and how practicing oncologists can evaluate patients for appropriate treatments as well as how to communicate effectively with patients about the factors that contribute to that decision.
Bob Figlin, MD, and Toni Choueiri, MD, the director of the Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute, discuss the early results from the COSMIC-313 trial, which Dr. Choueiri presented at ESMO 2022. The trial enrolled previously untreated patients with metastatic clear cell renal cell cancer who were classified as intermediate- to poor-risk. Standard of care doublet therapy, nivolumab (nivo) plus ipilimumab (ipi), was compared with triplet therapy, consisting of nivo-ipi plus cabozantinib. Triplet therapy improved progression-free survival compared with doublet therapy, specifically in the intermediate-risk group. Dr. Choueiri also discussed the complicated landscape in RCC and how practicing oncologists can evaluate patients for appropriate treatments as well as how to communicate effectively with patients about the factors that contribute to that decision.
| Bob Figlin, MD, and Jamie Von Roenn, MD, discuss strategies for learning about the oncology specialty earlier in the training pipeline, particularly for under-represented groups. They also look at opportunities for oncology fellows to build skills in different career areas. |
| Bob Figlin, MD, and Jamie Von Roenn, MD, discuss strategies for learning about the oncology specialty earlier in the training pipeline, particularly for under-represented groups. They also look at opportunities for oncology fellows to build skills in different career areas. |
Gerald Hsu, MD, PhD, UCSF’s hematology/oncology fellowship program director, joins Robert Figlin, MD, to talk about what fellowship programs are looking for in applicants, how trainees can find programs that are a good fit, and why preparing for an interview improves the odds you land at the right spot for you.
Michael B. Atkins, MD, and Robert Figlin, MD, discuss results from the EVEREST clinical trial as well as new data on TKIs, immunotherapy, and HIF-2 inhibitors. They also discuss adjuvant therapy and how depth of response differs between immunotherapy and TKIs, and look ahead to what the future holds.
Danielle Brander, MD, talks with Robert Figlin, MD, about selecting frontline treatments for CLL and how she talks with patients about their treatment options. “What I think is unique about the last few years is we’ve seen multiple randomized trials in the frontline setting that have shown not only superior progression-free survival … but several of those randomized studies also showing improvement in overall survival versus chemoimmunotherapy,” Dr. Brander said. “I think it’s really important for us to be considering these novel treatment options.”
William Gradishar, MD, talks with Robert Figlin, MD, about breast cancer research highlights from the 2022 American Society of Clinical Oncology Annual Meeting, including results from DESTINY-Breast04 and new data on CDK4/6 inhibitors from the PALOMA-2 and MAINTAIN trials.
Michael B. Atkins, MD, talks with Robert A. Figlin, MD, about the importance of sequencing therapies for patients with BRAF-positive metastatic melanoma. Data from the DREAMSeq trial, which Dr Atkins updated at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting, show a significant survival advantage at two years for patients who receive ipilimumab plus nivolumab prior to receiving a BRAF/MEK inhibitor. But not all patients fit that paradigm. Listen as Dr Atkins shares which patients he starts on immunotherapy and when he thinks is the best time for crossover to a targeted agent.
Listen in as Roy Herbst, MD, PhD, shares with Robert Figlin, MD, how he approaches treatment for patients with early-stage non-small cell lung cancer after the ADAURA and CHECKMATE-816 trials. They discuss different factors that influence use of adjuvant and neoadjuvant treatments, including stage, EGFR mutation status, and PD-L1 status.
Lori Leslie, MD, and Robert Figlin, MD, discuss the latest drugs and clinical trial data on CLL treatment. Dr. Leslie shares her strategy for sequencing agents, including various BTK inhibitors and venetoclax, and how she decides on treatment in patients whose disease progresses or are refractory.
Sapna Patel, MD, Associate Professor at MD Anderson Cancer Center, and Robert Figlin, MD, Deputy Director at Cedars-Sinai Cancer, discuss the clinical implications of the DREAMseq trial, showing patients with BRAF-mutant metastatic melanoma live longer if they receive first-line ipilimumab plus nivolumab.
Rana McKay, MD, Allan Pantuck, MD, and Robert Figlin, MD, discuss the recent update to the Keynote-564 study investigating adjuvant pembrolizumab in RCC and the impact on high-, medium-, and low-risk patients. They also talk about the Disease-Free Survival (DFS) endpoint, discussing the study with patients, and the recent NCCN guidelines update.
Daniel Petrylak, MD, Professor of Medicine at the Yale Cancer Center, and Robert Figlin, MD, of Cedars-Sinai Cancer discuss recent developments at ASCO GU in muscle-invasive bladder cancer and in particular the EV-103 clinical study while also discussing the future of MIBC treatment.
Ghassan Abou-Alfa, MD and Robert Figlin, MD, discuss the presentation of the HIMLAYA clinical study at ASCO GI ’22 and how this regimen may fit in the liver cancer treatment landscape
Frederick Locke, MD and Robert Figlin, MD discuss ZUMA-7 and when to start thinking about integrating CAR-T into B-cell lymphoma treatment algorithms, the role of BMT in these patients, and how recent data presented at ASH ’21 shows that CAR-T cell therapies can work well in relapsed/refractory B-cell lymphoma.
Lajos Pusztai, MD, and Robert Figlin, MD, discuss the practicality of neoadjuvant I-O as demonstrated in KEYNOTE-522 and the application of the Oncotype DX 21-gene signature test in the RxPONDER study, both presented at the 2021 San Antonio Breast Cancer Symposium.
Naval Daver, MD, and Robert Figlin, MD, discuss FLT3, TP53, and venetoclax combinations in the management of AML patients and what to look forward to at ASH 2021.
Kathryn Arbour, MD, joins host Robert Figlin, MD, to discuss the importance of the KRAS-targeted drug, sotorasib, in the treatment of non-small cell lung cancer.
Kathryn Arbour, MD, joins host Robert Figlin, MD, to discuss the role next-generation sequencing plays in lung cancer care, the responses seen with the KRAS-targeted drug, sotorasib, in CodeBreaK100, and what optimal use of the drug will look like down the road.
Andrew Armstrong, MD and Robert Figlin, MD discuss the ARCHES study investigating the role of enzalutamide in metastatic hormone-sensitive prostate cancer, followed by a discussion of the latest treatment trends in non-metastatic hormone-sensitive prostate cancer.
Robert Coleman, MD and Robert Figlin, MD, discuss the evolving role of bevacizumab in ovarian cancer, recently presented clinical studies such as BOOST and EFFORT, and the challenge of treating the PARP-refractory setting in advanced ovarian cancer.
Jeffrey Crawford, MD, and Robert Figlin, MD, discuss highlights from ASCO ’21 including immunotherapy, adjuvant and neoadjuvant therapy ie IMpower010 and Checkmate-816, and finish up with a discussion regarding molecular tests, MYLUNG, and NGS as it applies to NSCLC.
Andrew Hendifar, MD, and Robert Figlin, MD, discuss highlights from the 2021 ASCO annual meeting, including immunotherapy in MSI-H/dMMR metastatic CRC patients, looking for DEEPER responses in RAS-wild type tumors, the need for testing for HER2+ CRC patients, and liquid biopsy and the CHRONOS trial.
Erika Hamilton, MD, of the Sarah Cannon Research Institute, and Robert Figlin, MD, of Cedars-Sinai Medical Center, discuss breast cancer research from the 2021 annual meeting of the American Society of Clinical Oncology, including adjuvant and neo-adjuvant breast cancer, metastatic disease, the role of CDK 4/6 inhibitors and PARP inhibitors, the potential of SERDs, and a negative study.
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center speaks with Melissa Johnson, MD, Program Director, Lung Cancer Research, Sarah Cannon Research Institute, discuss the different driver mutations in Non Small Cell Lung Cancer (NSCLC) and how to use them to guide treatment
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center speaks with Melissa Johnson, MD, Program Director, Lung Cancer Research, Sarah Cannon Research Institute, discuss clinical progress in Small Cell Lung Cancer (SCLC)
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Arjun Balar, MD, Director, Genitourinary Medical Oncology Program, NYU Langone's Perlmutter Cancer Center, discuss clinical progress in bladder cancer
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Neeraj Agarwal, MD, Professor of Medicine, Huntsman Cancer Institute, Presidential Endowed Chair of Cancer Research , Co-Leader, HCI Experimental Therapeutics Program, Director, Center of Investigational Therapeutics, Director, Genitourinary Oncology Program, Huntsman Cancer Institute, University of Utah, discuss clinical progress in prostate cancer
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Toni Choueiri, MD, Director of the Lank Center for Genitourinary (GU) Oncology at Dana-Farber Cancer Institute, discuss clinical progress in renal cell carcinoma (RCC)
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and David Sallman, MD, Assistant Member, Department of Malignant Hematology, Moffitt Cancer Center discuss CAR T as it pertains to clinical advances in leukemia
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Bradley McGregor, MD, Clinical Director, Lank Center for Genitourinary Oncology, Professor of Medicine, Harvard Medical School, discuss Checkmate 9ER and other I-O studies as they pertain to the management of RCC patients
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Victoria Villaflor, MD, Clinical Professor, Director Head and Neck Oncology at City of Hope, discuss unresectable stage III Non Small Cell Lung Cancer (www.azioinpractice.com)
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Geoffrey Ku, MD, Medical Oncologist, Memorial Sloan Kettering Cancer Center, discuss recent clinical developments in gastric and esophageal cancer
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Sara Hurvitz, MD, Associate Professor of Medicine, Geffen School of Medicine, UCLA, Medical Director, Jonsson Comprehensive Cancer Center Clinical Research Unit, discuss breast cancer patient types, challenges, and treatment advances.
Roy Herbst, MD, and Robert Figlin, MD, discuss the implications of the ADAURA study investigating the use of Tagrisso (osimertinib) in stage I-III EGFR+ NSCLC patients
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Nancy Lin, MD, Associate Professor of Medicine, Harvard Medical School Associate Chief, Division of Breast Oncology Dana-Farber Cancer Institute, discuss novel agents and recent clinical developments in breast cancer
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Edward Garon, MD, Director of Thoracic Oncology Program, Jonsson Comprehensive Cancer Center, Associate Professor of Medicine, David Geffen School of Medicine, UCLA, discuss promising agents in development for the management of NSCLC from ASCO20
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Constantine Tam, MD, Haematologist and Disease Group Lead, Low Grade Lymphoma and Chronic Lymphocytic Leukemia, Peter MacCallum Cancer Centre, discuss the progress in Waldenstrom macroglobulinemia from ASCO20
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and David Ilson, MD, Attending Physician, Memorial Sloan Kettering Cancer Center, Professor of Medicine, Weill Cornell Medical College, discuss the progress in colon and rectal cancer presented at ASCO20
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Jeffrey A. Meyerhardt, Professor, Medicine, Harvard Medical School, Active Medical Staff, Medical Oncology, Dana-Farber Cancer Institute, discuss the progress in CRC presented at ASCO20
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and BJ Rimel, MD, Assistant Professor, Obstetrics and Gynecology, Cedars-Sinai Medical Center, discuss recent clinical studies in ovarian cancer and how recent developments are impacting the way ovarian cancer patients are treated.
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Tian Zhang, MD, Assistant Professor of Medicine, Duke University School of Medicine, discuss the progress in RCC presented at ASCO GU '20
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Daniel Petrylak, MD, Professor of Medicine, Medical Oncology and Urology, Co-Leader, Cancer Signaling Networks, Yale Cancer Center, discuss the progress in prostate cancer presented at ASCO GU '20
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Zev Wainberg, MD, Assistant Professor of Medicine at UCLA and Co-Director of the UCLA GI Oncology Program, discuss the progress in colorectal cancer presented at ASCO GI '20
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Michael Yang, MD, Department of Lymphoma and Myeloma, Division of Cancer Medicine, MD Anderson, discuss recent clinical advances in mantle cell lymphoma
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Courtney DiNardo, MD Associate Professor, Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discuss the latest clinical developments in AML
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Lori Leslie, MD, Medical Oncologist, Regional Cancer Care Associates, discuss clinical highlights in the treatment of CLL
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Michael Jain, MD, Assistant Member, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, discuss the role of CAR-T and the treatment of lymphoma and off-the-shelf CAR-T
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Geoffry R. Oxnard, MD, Associate Professor of Medicine, Associate Professor of Medicine, Dana Farber Cancer Instituate, Harvard Medical School, discuss integrating liquid biopsies into lung cancer care
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Marwan Fakih, MD, Professor, Department of Medical Oncology & Therapeutics Research, City of Hope, discuss colorectal cancer clinical updates from ESMO 19
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Bradley Monk, MD, FACOG, FACS, Professor and Director of the Division of Gynecologic Oncology at Creighton University School of Medicine, discuss ovarian cancer clinical updates from ESMO 19
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Scott Kopetz, MD, PhD, FACP, Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, MD Anderson, provide CRC clinical update post World GI '19.
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Daneng Li, MD, Assistant Clinical Professor, Department of Medical Oncology & Therapeutics Research, City of Hope, discuss HCC highlights from ASCO 2019.
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Edward Garon, MD, Associate Professor of Medicine, Geffen School of Medicine at UCLA, discuss lung cancer highlights from ASCO 2019.
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Neelima Denduluri, MD, Medical Oncologist, Virgina Cancer Specialists, discuss breast cancer highlights from ASCO 2019.
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Bradley McGregor, MD, Clinical Director, Lank Center for Genitourinary Oncology, Professor of Medicine, Harvard Medical School, discuss urothelial cancer clinical highlights from ASCO 2019.
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Vincent Chung, MD, Associate Clinical Professor, Department of Medical Oncology & Therapeutics Research, City of Hope, discuss pancreatic cancer highlights from ASCO 2019.
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Howard Hochster, MD, Professor of Medicine Associate Director for Clinical Research and Director, GI Oncology, Rutgers Cancer Institute, discuss gastric/GE junction cancer clinical highlights from ASCO 2019.
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Toni Choueiri, MD, Director of the Lank Center for Genitourinary (GU) Oncology at Dana-Farber Cancer Institute, discuss Keytruda's approval in renal cell carcinoma (RCC).
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Rana McKay, Assistant Professor of Medicine, University of California San Diego, discuss renal cell carcinoma (RCC) clinical highlights from ASCO GU 2019
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Axel Grothey, MD, Director of GI Research, West Cancer Center, University of Tennessee, discuss new data from the BEACON study and the role of I-O and HIPEC in colorectal cancer
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Richard Finn, MD, Professor of Medicine at the Geffen School of Medicine, UCLA, discuss hepatocellular carcinoma (HCC) clinical highlights from ASCO GI 2019
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Tanios Bekaii-Saab, MD, Professor, Mayo Clinic College of Medicine and Science, discuss biliary tract and GE junction cancer clinical highlights from ASCO GI 2019
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Frederick Locke, MD, Program Co-Leader, Immunology, Moffitt Cancer Center discuss CAR-T clinical highlights from ASH 2018
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Sagar Lonial, MD, Professor and Chair, Hematology & Medical Oncology, Chief Medical Officer, Winship Cancer Institute of Emory University, discuss ALCYONE, GRIFFIN, and maintenance therapy (TOURMALINE-MM3), and other multiple myeloma clinical studies presented at the American Society of Hematology 2018 meeting
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Debu Tripathy, MD, Professor and Chairman, Department of Breast Medical Oncology, Division of Cancer Medicine, MD Anderson, discuss IMpassion130, SOLAR-1 and other breast cancer clinical studies presented at the meeting
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Barbara Burtness, MD, Professor of Medicine (Medical Oncology) at the Yale University School of Medicine, discuss Keynote-048 and other H&N clinical studies presented at the meeting
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center and Bradley Monk, MD, FACOG, FACS, Professor and Director of the Division of Gynecologic Oncology at Creighton University School of Medicine, discuss BRCA1+ ovarian patients, PARP inhibitors and the results of the SOLO-1 clinical trial
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center speaks with Melissa Johnson, MD, Associate Director, Lung Cancer Research, Sarah Cannon Research Institute about targeted therapy, prevention, I-O in NSCLC, and I-O in SCLC.
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center speaks with Paul Bunn, MD, Distinguished Professor, Division of Medical Oncology, University of Colorado about prevention, I-O in NSCLC, and I-O in SCLC.