Oncology Peer Review On-The-Go

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In a cobranded episode between Oncology On the Go, hosted by CancerNetwork®, and the American Society for Transplantation and Cellular Therapy’s (ASTCT) program ASTCT Talks, Terri Lynn Shigle, PharmD, and Vinita Pai, PharmD, MS, BCPPS, spoke about the use of CAR T-cell therapy for pediatric populations with hematologic malignancies. Their discussion explored how real-world data compare with clinical trial findings, strategies for mitigating toxicities in pediatric patients, considerations for ensuring long-term survivorship, and other key areas.

The hosts began with an overview of how far the cellular therapy field has progressed since the FDA approval of tisagenlecleucel (tisa-cel; Kymriah) for patients up to 25 years old with B-cell precursor acute lymphoblastic leukemia (ALL) that is refractory in second or later relapse in August 2017. Despite the availability of several cell therapy products in the modern oncologic field, however, tisa-cel remains the primary FDA-approved option for pediatric patients, illustrating a gap in pediatric-specific care.

Pai highlighted several factors associated with response to CAR T therapy, including prior nonresponse to blinatumomab, the number of prior therapies, bone marrow disease burden, active extramedullary disease at infusion, and adequate fludarabine exposure during lymphodepleting chemotherapy. Furthermore, the hosts discussed how logistical hurdles like financial burden and proximity to cell therapy centers represent barriers to treatment for pediatric and adult patients alike, although catheter placement during leukapheresis serves as a unique challenge when treating younger populations.

According to Pai, future initiatives in the field may include investigating more optimal timing of leukapheresis for pediatric populations and determining the right time for transplant depending on a patient’s extent of relapse. She also discussed emerging strategies, including dual-antigen CAR-T cells, natural killer cell therapies, and off-the-shelf allogeneic CAR T cells, which warrant further investigation.

Shigle is a clinical pharmacy specialist in the Stem Cell Transplantation & Cellular Therapy Department at The University of Texas MD Anderson Cancer Center. Pai is an associate clinical professor in the Division of Pharmacy Practice and Science at The Ohio State University.

Reference
O'Leary MC, Lu X, Huang Y, et al. FDA approval summary: tisagenlecleucel for treatment of patients with relapsed or refractory B-cell precursor acute lymphoblastic leukemia. Clin Cancer Res. 2019;25(4):1142-1146. doi:10.1158/1078-0432.CCR-18-2035

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In the newest edition of Oncology On the Go, Joshua Richter, MD, and Marco Davila, MD, PhD, spoke about the current multiple myeloma treatment landscape and highlighted practical considerations for administering CAR T-cell therapy to patients. Their discussion touched upon several critical subtopics ranging from optimizing operational and referral workflows to dismantling barriers to treatment access in rural settings.

When it comes to navigating the multiple myeloma treatment algorithm, both hosts emphasized early evaluation to determine patient suitability for CAR T-cell therapy, which may help identify those who are most likely to experience the greatest responses with minimal toxicity. Regarding the question of sequencing different modalities, Richter pointed to data demonstrating the utility of administering CAR T-cell therapies prior to bispecific antibodies.

Acknowledging that the average patient enrolled on a clinical trial may not align with what is typically seen in real-world practice, the hosts discussed “reassuring” data that those who do not meet certain eligibility criteria may nevertheless benefit from CAR T-cell therapy. Additionally, on the topic of maintaining an effective referral relationship between community oncologists and CAR-T centers, Davila noted that academic cell therapy clinicians may have an incumbent responsibility to consider how to improve access to treatment and make it easier for others to refer patients to care.

“CAR T-cell therapy is now deeply entrenched in the world of relapsed multiple myeloma [and] soon to be likely entrenched in the newly diagnosed world. These are therapies that I think we're all going to need to embrace whether it's from an academic standpoint or a community standpoint,” Richter concluded. “Having that ongoing communication back and forth, especially as the field is moving so quickly, is absolutely key in providing optimal care for our patients.”

Richter is an associate professor of Medicine in the Division of Hematology and Medical Oncology at The Tisch Cancer Institute, as well as the director of Multiple Myeloma at the Blavatnik Family - Chelsea Medical Center at Mount Sinai. Davila is the senior vice president and associate director for Translational Research, a professor of Oncology, chief of Lymphoma/Multiple Myeloma Service, and Rustum Family Endowed Chair in Translational Research at Roswell Park Comprehensive Cancer Center.

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At the 2026 National ICE-T Conference in Orlando, CancerNetwork® sat down with a variety of expert researchers and clinicians to discuss the latest developments in immune effector therapy across different hematologic oncology populations. Sessions at the meeting covered practical considerations for integrating CAR T-cell therapies, bispecific antibodies, and other modalities into the treatment of those with multiple myeloma, lymphoma, and other hematologic malignancies.

First, Benjamin Diamond, MD, an assistant professor of Clinical Medicine, a member of the Sylvester Myeloma Institute, and a member of the Myeloma Genomic Lab at the University of Miami Miller School of Medicine, spoke about his presentation reviewing bispecific antibodies for the management of multiple myeloma. In his session, Diamond stated that bispecific T-cell engagers are altering the landscape of multiple myeloma care and will eventually become an option in the frontline setting. With many products to choose from, Diamond emphasized sequencing these novel therapies wisely and stressed aggressive infection prophylaxis as a mandatory facet of care.

Next, Tiba Al Sagheer, PharmD, BCOP, BCACP, a pharmacy quality improvement coordinator for transplant and cellular therapy at Miami Cancer Institute of Baptist Health South Florida discussed her presentation focused on defining new thresholds for monitoring and mitigating toxicities associated with CAR T-cell therapy. She described considerations for balancing early toxicity intervention against the risk of blunting efficacy depending on the specific CAR T-cell product used during treatment. Ultimately, she noted that that there is still no definitive answer or threshold for initiating prophylaxis for toxicity associated with CAR T, and that differentiating between immune effector cell (IEC)–associated hemophagocytic lymphohistiocytosis (HLH)–like syndrome (IEC-HS) and cytokine release syndrome (CRS) represents an ongoing challenge in the field.

Finally, Nikesh N. Shah, MD, and Carlos Silva Rondon, MD, shared their perspectives on a debate regarding the roles of bispecific antibodies and CAR T-cell therapies in relapsed/refractory follicular lymphoma. In his presentation, Shah, a hematologist-oncologist at Tampa General Hospital who specializes in hematologic malignancies, including aggressive lymphomas and acute lymphoblastic leukemia, took the position that bispecific antibodies should be used prior to CAR T-cell therapy for most patients, although both treatments have utility in the field. Silva Rondon, a hematologist, oncologist, and bone marrow transplant specialist at Moffitt Malignant Hematology and Cellular Therapy at Memorial Healthcare System/Memorial Cancer Institute in Pembroke Pines, advocated for CAR T-cell therapy during the debate but acknowledged that both modalities can make up a complementary strategy for overcoming relapsed/refractory follicular lymphoma.

References

Diamond B. Bispecific antibodies for the management of multiple myeloma. Presented at the 2026 National ICE-T Conference; July 18, 2026; Orlando, FL.
Sagheer TA. Thresholds and therapeutics: a precision approach to CAR T toxicity management. Presented at the 2026 National ICE-T Conference; July 18, 2026; Orlando, FL.
Shah N. Debate: bispecific antibodies vs CAR-T in follicular lymphoma. Presented at the 2026 National ICE-T Conference; July 18, 2026; Orlando, FL.
Silva C. CAR-T cell therapy for relapsed follicular lymphoma. Presented at the 2026 National ICE-T Conference; July 18, 2026; Orlando, FL.

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Following the FDA approval of allogeneic regulatory T cell–containing immunotherapy with hematopoietic stem and progenitor cell (HSPC) and T cells-vldq (Tregzi; Orca-T), CancerNetwork® spoke with Wendy Stock, MD, about what this decision means for the treatment of patients undergoing hematopoietic stem cell transplantation for different hematologic malignancies. Additionally, she discussed how this option fits into the treatment landscape alongside other options like posttransplant cyclophosphamide (PTCy) and other next steps for improving outcomes associated with matched donor transplants.

Stock reviewed findings from the phase 3 Precision-T trial (NCT05316701) that supported the approval of Orca-T, noting that the data appeared to be “effective across all populations” for patients with acute myeloid leukemia, acute lymphoblastic leukemia, high-risk myelodysplastic syndrome (MDS), and mixed-phenotype acute leukemia. Furthermore, she detailed what adoption of Orca-T might look like on an operational level, described the agent’s ability to reduce the risk of graft-versus-host disease, and emphasized referring patients early to transplantation.

The approval, Stock said, marks the beginning of potentially allowing “higher-risk populations to move forward with the knowledge that it is possible to undergo transplant safely.” She noted that the FDA’s decision may inspire the field of transplant graft engineering to look more carefully at other options that might further improve transplantation outcomes.

“Over the last 10 years, we have had incredibly exciting, still-to-be-tweaked methods for improving outcomes for patients undergoing transplant, which is such an important procedure for curing or [achieving] long-term survival for patients with acute leukemias and high-risk myelodysplastic syndromes,” Stock said. “This is a big advance, and it needs to be studied further, including comparisons with other major improvements in the world of transplant, such as PTCy.”

Stock is the Anjuli Seth Nayak Professor of Medicine, cochair of the Leukemia Committee for the National Cancer Institute–supported Alliance for Clinical Trials in Oncology, and coleader of the Clinical and Experimental Therapeutics Research Program at the University of Chicago Medicine Comprehensive Cancer Center.

References

FDA approves allogeneic regulatory T cell-based immunotherapy with HSPC and T cells-vldq for use in matched donor hematopoietic stem cell transplantation for adults with hematologic malignancies. News release. FDA. June 30, 2026. Accessed July 15, 2026. https://tinyurl.com/38s3wznr
Meyer EH, Salhotra A, Gandhi AP, et al. Orca-T vs allogeneic hematopoietic stem cell transplantation (Precision-T): a multicenter, randomized phase 3 trial. Blood. 2026;147(11):1168-1177. doi:10.1182/blood.2025031313

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Experts discuss diagnosing and treating insomnia in patients with cancer through methods like sleep hygiene, CBT-I, and pharmacotherapy.

Insomnia is one of the most common symptoms oncologists are asked to manage, yet it’s often treated reactively with medication rather than through a structured, history-driven approach. In this episode of Oncology On the Go, Daniel C. McFarland, DO, sat down with psychiatrist and psycho-oncologist Virginia C. O’Brien, MD, to unpack how clinicians can more effectively evaluate and treat insomnia in patients with cancer.

The conversation opened with a foundational distinction: primary vs secondary insomnia, and why secondary insomnia—driven by anxiety, depression, pain, or cancer treatment itself—is far more common in oncology populations. O’Brien emphasized that the most frequent clinical mistake is jumping straight to a prescription instead of taking a thorough sleep history, including which phase of sleep is disrupted (falling asleep, staying asleep, or early waking) and whether the problem is affecting daytime functioning.

From there, the discussion moved through practical sleep hygiene strategies clinicians can share with patients, such as limiting caffeine and screens, managing pets and partners in the bedroom, and setting a consistent nighttime routine. Then, they dove into cognitive behavioral therapy for insomnia (CBT-I), the first-line recommended treatment. O’Brien explained how sleep restriction works, why it’s often impractical during active chemotherapy, and how free digital tools like CBT-i Coach can help fill access gaps.

The latter part of the discussion tackled pharmacologic management in detail: when medications are appropriate for acute insomnia; how to sequence options from least to most habit-forming; and specific guidance on trazodone (Desyrel), ramelteon (Rozerem), zolpidem (Ambien; including FDA dosing warnings for women), benzodiazepines, and newer orexin receptor antagonists. Special attention was given to older patients, those with a fall risk, and patients with a history of substance use disorder.

The experts closed with guidance on when to refer to a sleep medicine specialist, including STOP-BANG screening for obstructive sleep apnea and red flags for parasomnias like REM sleep behavior disorder.

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In this episode of Oncology On the Go, CancerNetwork® spoke with Kim Stravers, an International End-of-Life Doula Association (INELDA)–certified end-of-life doula, educator, and trainer based in the Phoenix Valley, to explore how death doulas support patients with cancer and their families across all stages of the disease trajectory.

Stravers opened by defining the scope of end-of-life doula work, clarifying that doulas provide nonmedical emotional, practical, and relational support to people confronting their mortality and those who care for them. She distinguished the role from hospice nursing and palliative care by emphasizing that doulas never act in a clinical capacity; they instead function as neutral companions who facilitate difficult conversations, help patients clarify their values and wishes, and advocate for individual autonomy across medical and personal decision-making. She also discussed her volunteer work within an interdisciplinary hospice team in Phoenix and described her invitation to speak at Grand Rounds for the Palliative Care Department at Mayo Clinic Arizona to introduce the role to clinical providers.

When addressing cancer-specific experiences, Stravers noted that patients often come to her late in their trajectory, frequently within the 6-month hospice eligibility window, and described nonpharmacological techniques she uses to support breakthrough pain and existential distress, including body scans and guided visualization. She also shared a detailed patient case involving a woman with pancreatic cancer and Lynch syndrome whose daughter previously died of the same disease, describing how the shared diagnosis intensified the patient's anticipatory anxiety and how weekly doula visits helped provide periods of calm.

Additional topics included the credentialing landscape for end-of-life doulas, which currently lacks a national licensure body, with organizations such as INELDA offering varied training and certification pathways. Stravers also addressed the portrayal of a death doula in the television drama The Pitt, affirming elements she found accurate while flagging several areas she viewed as outside the appropriate scope of doula practice.

Stravers holds certification through INELDA, where she also serves as an educator and trainer, as well as proficiency through the National End-Of-Life Doula Alliance (NEDA).

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Experts discuss the evolving frontline CML treatment landscape, the impact of asciminib, and clinical strategies for achieving treatment-free remission.

Once considered a terminal diagnosis, chronic myeloid leukemia (CML) in chronic phase has been fundamentally rewritten as a highly manageable chronic condition. In this episode of Oncology on the Go, Joshua Zeidner, MD, and Jorge E. Cortes, MD, sat down to explore the rapidly shifting therapeutic paradigm of frontline CML management.

The discussion tracked the monumental evolution of treatment from early bone marrow transplants to the introduction of imatinib (Gleevec) and subsequent generations of tyrosine kinase inhibitors (TKIs). The experts dove deep into the practice-changing data from the phase 3 ASC4FIRST trial (NCT04971226), analyzing how the newly introduced STAMP inhibitor, asciminib (Scemblix), is challenging traditional treatment sequencing due to its superior efficacy and highly favorable toxicity profile.

In the ASC4FIRST trial, the major molecular response (MMR) rate was 74.1% with asciminib vs 52.0% with other investigator-selected TKIs. The MMR rate at week 96 was consistently higher with asciminib vs other investigator-selected TKIs and imatinib across all assessed demographic and prognostic subgroups. Overall, investigators concluded that asciminib demonstrated a favorable risk-benefit profile compared with other standard therapies and presented a “valuable frontline option” for patients with CML in chronic phase.

Zeidner and Cortes also shared practical clinical insights on:

Shared Decision-Making: Tailoring frontline selections based on patient lifestyle, comorbidities, and preferences.
Navigating Milestones: Balancing strict NCCN/European LeukemiaNet molecular response guidelines with individualized, real-world context.
The Art of Discontinuation: Using strategic timing and criteria (such as achieving sustained MR4.5) to optimize success rates for treatment-free remission.
The Next Frontier: Managing resistance mutations and mapping out second- and third-line therapies in an evolving post-asciminib landscape.

Zeider is professor of medicine, chief of Leukemia Research, and director of Clinical Cancer Research Commercial Integration at the University of North Caroline-Chapel Hill Cancer Therapeutics Research Program. Cortes is associate director for Translation at the University of Alabama O’Neal Cancer Center.

To watch the full discussion, visit: https://www.cancernetwork.com/between-the-lines/oncology-on-the-go-frontline-chronic-myeloid-leukemia-in-chronic-phase-optimizing-treatment

Reference
Cortes JE, Hughes TP, Wang J, et al. Asciminib demonstrates superior efficacy and safety in newly diagnosed chronic myeloid leukemia in the ASC4FIRST trial. Blood. 2026;147(3):1433-1446. doi:10.1182/blood.2025029210

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In this episode of Oncology On the Go, CancerNetwork® joined Matthew Matasar, MD, chief of the Division of Blood Disorders at Rutgers Cancer Institute/Jack & Sheryl Morris Cancer Center, and professor of medicine at Rutgers Robert Wood Johnson Medical School, as he dove into the practice-changing data reshaping the management of aggressive and indolent B-cell lymphomas. Fresh off the presentations at the 2026 American Society of Clinical Oncology (ASCO) Annual Meetingand the 2026 European Hematology Association (EHA) Congress, Matasar broke down the most talked-about datasets in the field.

Matasar began by sharing his expert clinical perspectives on the phase 3 frontMIND trial (NCT04824092) evaluating tafasitamab (Monjuvi) plus lenalidomide (Revlimid) and rituximab (Rituxan) with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in newly diagnosed high-risk diffuse large B-cell lymphoma (DLBCL), which were concurrently published in The Lancet.1,2 He assessed how to balance the regimen’s progression-free survival benefit against incremental toxicities and scheduling demands. Furthermore, the conversation explored encouraging data regarding bispecific antibody combinations for older or frail patient populations, as well as innovative engineering strategies aimed at overcoming the challenging "fratricide" phenomenon in cellular therapies for relapsed T-cell lymphoma.

“In terms of how we move from putative success with these studies into wider deployment, I am encouraged by the pace of community adoption of bispecific antibodies not just in lymphoma—where we have seen a very nice uptake over the last year—but in other disease states, including solid tumor malignancies,” Matasar said regarding the growth of bispecific antibodies in the field. “As the clear need to deploy these agents in a broader range of patients grows, the lymphoma community is going to benefit from that work, and we’ll see our community partners become increasingly capable of delivering these treatments. My expectation is that by the time these studies read out positively in the years to come, we will have an oncology community that is ready to meet those data where they are and deploy them in the best service of our patients.”

References
1. Lenz, G, Trněný M, Burke JM, et al. frontMIND: phase 3 study of tafasitamab (Tafa) plus lenalidomide (Len) and R-CHOP for patients (pts) with newly diagnosed diffuse large B-cell lymphoma (DLBCL). J Clin Oncol. 2026;44(suppl 17):LBA7000. doi:10.1200/JCO.2026.44.17_suppl.LBA7000

Lenz, G, Trněný M, Burke JM, et al. Tafasitamab plus lenalidomide and R-CHOP versus R-CHOP for first-line treatment of patients with high-risk diffuse large B-cell lymphoma (frontMIND): a global, phase 3, randomised, double-blind, placebo-controlled trial. Lancet. 2026;407(10547):P2528-2541. doi:10.1016/S0140-6736(26)00866-4

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In a special edition of Oncology On the Go, Chinmay Jani, MD, joined CancerNetwork® in the studio to speak about different research initiatives he is involved with across precision oncology. He discussed ongoing work dedicated to validating and applying artificial intelligence (AI)–based tools in clinical work as well as overcoming immunotherapy resistance among patients with lung cancer.

Jani, chief fellow in Hematology and Oncology at University of Miami Sylvester Comprehensive Cancer Center, first detailed findings from a study he presented at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting evaluating AI decision support in the context of EGFR-mutated non–small cell lung cancer (NSCLC). Although AI systems aligned with expert decision-making in frontline treatment, significant divergence was observed in second-line care, highlighting a need for more rigorous validation and clinical safeguards when integrating AI into oncologic decision-making. Improving documentation and using tools more ethically, Jani said, will also be critical for future applications of AI in field.

Jani also spoke about the rapidly evolving thoracic oncology field based on research he and colleagues are leading at the University of Miami. Different investigations are exploring potential advancements in precision medicine, overcoming immunotherapy resistance, and early cancer detection to help elevate outcomes among patients with lung cancer. Looking ahead, Jani emphasized how novel therapeutics like tarlatamab-dlle (Imdelltra) and the incorporation of liquid biopsy may assist with the goal of turning lung cancer into “a chronic disease” where patients can survive not just for a few month or years but for decades.

According to Jani, other key concerns in the field include the evolving landscape surrounding adolescent and young adult (AYA) patients, who may require different types of molecular testing and therapeutic needs compared with adult populations. Being able to detect more fusions and alterations that may inform therapeutic strategies via circulating tumor DNA plus circulating tumor RNA or through wider minimal residual disease testing, he said, represents another ongoing goal in terms of precision medicine.

Reference
Jani C, Pérez-Granado J, Kalucha A, et al. Evaluating AI decision support in a rapidly evolving therapeutic landscape: EGFR-mutant metastatic NSCLC. J Clin Oncol. 2026;44(suppl 16):1630. doi:10.1200/JCO.2026.44.16_suppl.1630

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Cancer is never convenient, and it never arrives when a patient is truly prepared, according to Daniel C. McFarland, DO, who began the most recent episode of Oncology On the Go with this sentiment. When individuals enter the high-stakes, highly coordinated world of oncology, they do so under extreme duress, often presenting the versions of themselves that are most under stress. In this environment, clinical teams frequently encounter behaviors that get unfairly lumped into the vague and pejorative category of the “difficult patient.” What happens when these challenges stem from an underlying personality disorder rather than just temporary situational anxiety?

In this episode, McFarland was joined by psycho-oncology expert Kaleena Chilcote, MD, to unpack the inner workings of personality styles and disorders within oncologic science. Together, they explored the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) diagnostic framework, spanning the eccentric, dramatic, and anxious categories. They discussed how these enduring, pervasive traits impact a patient’s health care journey.

Shifting the conversation away from the stigma of labels, McFarland and Chilcote delivered actionable, real-world advice for oncology teams. They discussed how to utilize objective, descriptive charting; initiate a pause to check your own provider emotions; and build highly consistent, structured boundaries. From managing frequent phone calls to intentionally scheduling short, high-frequency touchpoints, the pair provided a roadmap for turning interpersonal conflict into therapeutic collaboration, proving that underneath the defense mechanisms, every patient has a uniquely valuable strength to connect with.

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being a psycho-oncology editorial advisory board member for the journal ONCOLOGY®. Chilcote is director of Psycho-Oncology in the Department of Palliative and Supportive Care at the Taussig Cancer Center, part of the Cleveland Clinic.

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In a live X Spaces discussion hosted by CancerNetwork® in collaboration with the American Society for Transplantation and Cellular Therapy (ASTCT), Marc J. Braunstein, MD, PhD, and Sofia Zahid, MD, highlighted noteworthy presentations and abstracts in hematologic oncology at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting.Together, they discussed the data that may shake up clinical practice across different multiple myeloma, leukemia, and lymphoma populations.

Braunstein is an associate professor in the Department of Medicine and course co-director of the Hematology/Oncology System at NYU Grossman Long Island School of Medicine, as well as the fellowship program director of Hematology/Oncology at NYU Langone Health. Zahid is a first-year fellow at NYU Grossman Long Island School of Medicine.

The discussion focused on the following abstracts:

· Abstract 7512

o Combining belantamab mafodotin-blmf (Blenrep) with daratumumab (Darzalex), lenalidomide (Revlimid), and dexamethasone produced rapid activity among patients with transplant-ineligible newly diagnosed multiple myeloma in the phase 1/2 BelaDRd study (EUCT-2024-515634-32).

o The progression-free survival (PFS) benefits observed in the trial support further evaluation of the quadruplet in a phase 3 study compared with other novel combination regimens in NDMM.

· Abstract 6505

o Revumenib (Revuforj) maintenance therapy after allogeneic stem cell transplantation showed feasibility in a heavily pretreated cohort of patients with acute myeloid leukemia (AML).

o Outcomes appeared favorable vs historical cohorts, supporting prospective assessment of maintenance menin inhibition among those with AML.

· Abstract 1503

o In a retrospective analysis of electronic medical records for 293 patients who received CAR T-cell therapy for lymphoma (n = 175), multiple myeloma (n = 106), or B-cell acute lymphoblastic leukemia (n = 12), outpatient monitoring was associated with significantly fewer hospital days without increased emergency department visits or 30-day mortality.

o These findings show the potential for lower healthcare utilization for patients who receive CAR T-cell therapy in the outpatient setting.

· Abstract LBA7000

o Adding tafasitamab (Monjuvi) and lenalidomide to rituximab (Rituxan), cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) significantly improved PFS vs R-CHOP alone among those with newly diagnosed diffuse large B-cell lymphoma (DLBCL) in the phase 3 frontMIND trial (NCT04824092).

o The data may support tafasitamab plus lenalidomide and R-CHOP as a potential new standard of care in the frontline treatment of patients with cell-of-origin subtypes of high-risk DLBCL.

References

Terpos E, Ntanasis-Stathopoulos I, Gavriatopoulou M, et al. Belantamab mafodotin with daratumumab, lenalidomide, and dexamethasone in transplant-ineligible, newly diagnosed multiple myeloma patients: phase 1/2 BelaDRd study. J Clin Oncol. 2026;44(suppl 16):7512. doi:10.1200/JCO.2026.44.16_suppl.7512
Goulart H, Okeleji O, DiNardo CD, et al. Revumenib as maintenance for AML following allogeneic stem cell transplantation. J Clin Oncol. 2026;44(suppl 16):6505. doi:10.1200/JCO.2026.44.16_suppl.6505
Bowen SG, Abdallah N, Pritchett JC, et al. Impact of outpatient CAR T-cell therapy administration on healthcare utilization in patients with hematologic malignancies. J Clin Oncol. 2026;44(suppl 16):1503. doi:10.1200/JCO.2026.44.16_suppl.1503
Lenz, G, Trněný M, Burke JM, et al. frontMIND: phase 3 study of tafasitamab (Tafa) plus lenalidomide (Len) and R-CHOP for patients (pts) with newly diagnosed diffuse large B-cell lymphoma (DLBCL). J Clin Oncol. 2026;44(suppl 17):LBA7000. doi:10.1200/JCO.2026.44.17_suppl.LBA7000

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In a conversation with CancerNetwork®, Nathan Goodyear, MD, spoke about the role that exercise and lifestyle intervention can play in the treatment of patients with cancer. He described how prescribed exercise may serve as a biologically interventional therapy that can help prolong longevity, reduce the risk of recurrence; and supplement the efficacy of standard therapeutic approaches like chemotherapy, immunotherapy, and surgery.

Goodyear, an integrative medicine physician at the Williams Cancer Institute, pointed to literature indicating the potential benefits of structured exercise programs across different cancer populations. For example, data from the phase 3 CHALLENGE trial (NCT00819208) highlighted a lower risk of death and reduced recurrence following a 3-year structured program among patients with stage II and III colorectal cancer. Furthermore, the OPTIMUS trial (NCT02950324) demonstrated that a short-term exercise program that takes place before surgery or alongside chemotherapy can increase CD8-positive T-cell infiltration while decreasing immunosuppressive cells, effectively turning “cold” tumors “hot.”

Additionally, Goodyear addressed some preconceptions surrounding the potential role of exercise in oncologic care, defending it as a prescribable therapy that necessitates a deliberate, properly applied approach to achieve success among patients. He discussed the importance of structuring individualized exercise-based regimens by considering performance status and other physical patient characteristics. He also noted how exercise intervention may mitigate immunosenescence and accelerated aging may be associated with one’s disease and anti-cancer therapy.

“Surgery, chemotherapy, and radiation…have efficacy; there’s no question about that. They also promote senescence and accelerated aging. What if we’re able to bring in these therapies that can work to break those cycles, like exercise?” Goodyear stated. “If it improves the outcome, helps the patient heal better, empowers their immune system in intended [and] direct ways that are reproducible in the research, and if it helps to block that accelerated aging, we reengage the immune system, countering the immunosenescence that is accelerating that process called inflammation.”

References

Courneya KS, Vardy JL, O’Callaghan CJ, et al. Structured exercise after adjuvant chemotherapy for colon cancer. N Engl J Med. 2025;393(1):13-25. doi:10.1056/NEJMoa2502760
Rayner CJ, Bartlett DB, Allen SK, et al. Prehabilitation during neoadjuvant chemotherapy results in an enhanced immune response in esophageal adenocarcinoma tumors: a randomized controlled trial. J Sport Health Sci. 2025;14:101063. doi:10.1016/j.jshs.2025.101063

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In a recent interview with CancerNetwork®, Nicholas Hornstein, MD, PhD, an assistant professor at the Donald and Barbara Zucker School of Medicine of Hofstra University and Northwell Health, discussed emerging data and clinical shifts in the care of patients with gastrointestinal (GI) cancers ahead of the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting.

Advancements in Colorectal Cancer
Hornstein highlighted the increasing integration of targeted therapies into the first-line setting for patients with colorectal cancer (CRC). For those with BRAF V600E-mutated metastatic disease, data from the phase 3 BREAKWATER trial (NCT04607421) support moving targeted therapy into the first line.1 He noted that initiating these therapies early is critical, as a significant percentage of patients may experience rapid clinical decline and lose the opportunity for second-line treatment if targeted options are delayed.

In the HER2-positive space, clinicians currently utilize tucatinib (Tukysa)-based regimens or fam-trastuzumab deruxtecan-nxki (Enhertu). Hornstein also anticipated the arrival of bispecific antibodies, such as zanidatamab-hrii (Ziihera), which are expected to gain approval in upper GI cancers before moving into the CRC landscape.

The Role of ctDNA and Pancreatic Cancer
Regarding localized disease, Hornstein discussed the potential for circulating tumor DNA (ctDNA) to guide adjuvant therapy for patients with stage II colon cancer. Data from trials like CIRCULATE (NCT05174169) are expected to further clarify how ctDNA can assist in the escalation or de-escalation of treatment.2 In pancreatic cancer, the phase 3 RASolute 302 trial (NCT06625320) investigating daraxonrasib is poised to change the standard of care for patients with second-line pancreatic cancer immediately upon an anticipated regulatory approval.3

Barriers to Precision Medicine
A primary unmet need that Hornstein identified was the low rate of biomarker testing; currently, only about half of patients with metastatic disease receive necessary sequencing or microsatellite instability testing. Hornstein emphasized that multidisciplinary cooperation and improved systems are essential to ensure all patients with targetable mutations receive appropriate care. Finally, he highlighted the development of large language model tools to assist clinicians with data ingestion and clinical trial matching.

References
1. Kopetz S, Wasan HS, Yoshino T, et al. BREAKWATER: primary analysis of first-line (1L) encorafenib + cetuximab (EC) + FOLFIRI in BRAF V600E-mutant metastatic colorectal cancer (mCRC). J Clin Oncol. 2026;44(suppl 2):13. doi:10.1200/JCO.2026.44.2_suppl.13

Dasari A, Yu G, Kopetz S, et al. NRG-GI008: colon adjuvant chemotherapy based on evaluation of residual disease (CIRCULATE-NORTH AMERICA). J Clin Oncol. 2026;44(suppl 16):TPS3686. doi:10.1200/JCO.2026.44.16_suppl.TPS3686
Wolpin B, Wainberg ZA, Hendifar A, et al. Daraxonrasib, a RAS(ON) multi-selective inhibitor vs chemotherapy in previously treated metastatic pancreatic adenocarcinoma (mPDAC): Primary and final analysis from the phase 3 RASolute 302 study. J Clin Oncol. 2026;44(suppl 17):LBA5. doi:10.1200/JCO.2026.44.17_suppl.LBA5

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In a cobranded episode between Oncology on the Go, hosted by CancerNetwork®, and the American Society for Transplantation and Cellular Therapy (ASTCT)’s program ASTCT Talks, Mitchell E. Horwitz, MD, highlighted key developments and ongoing initiatives related to allogeneic and cord blood transplantations among patients with different hematologic malignancies. The conversation touched upon the impact of omidubicel-onlv (Omisirge) on patient outcomes, current research on reducing the risk of graft-versus-host disease (GVHD) among transplantation recipients, and strategies for providing effective prophylaxis during treatment, among other topics.

According to Horwitz, omidubicel has served as an “important graft source” for pediatric patients while improving cord blood transplantation for adults since its FDA approval in April 2023 for patients 12 years and older with hematologic malignancies. He also spoke to the importance of the FDA’s approval of the agent in December 2025 for patients with severe aplastic anemia and no compatible donors following reduced intensity conditioning. Regarding those with severe aplastic anemia, he noted that omidubicel may considerably improve the feasibility of cord blood as a graft source for transplantation.

Beyond these approvals, Horwitz described ongoing work dedicated to reducing the risk of GVHD following cord blood-derived transplantation, citing a pilot study that he and colleagues are conducting to determine the feasibility of adding a co-stimulatory blocking monoclonal antibody to help further limit this risk. Additionally, he emphasized surveilling for viruses like Epstein-Barr virus, HHV-6, and cytomegalovirus to mitigate the risks of delayed immune recovery following transplantation.

“It’s important to have all these [graft sources], whether it be cord blood, mismatched family members, mismatched unrelated donors, and matched siblings…to be made available [and] studied extensively,” Horwitz concluded. “We need to find what the best niche would be for each of these graft sources and make sure that [they] are utilized at the various institutions. The nuances, such as infection prophylaxis or infection monitoring, [should become] familiar to the transplant centers. By doing that, we can continue this trend of having a graft source for everyone and improving outcomes.”

Horwitz is a professor of Medicine, Hematologic Malignancies and Cellular Therapy at Duke University School of Medicine and cellular therapy and stem cell specialist at Duke Cancer Institute.

References

FDA approves cell therapy for patients with blood cancers to reduce risk of infection following stem cell transplantation. News release. FDA. April 17, 2023. Accessed May 20, 2026. bit.ly/3UEO3kp
FDA approves first cellular therapy to treat patients with severe aplastic anemia. News release. FDA. December 8, 2025. Accessed May 20, 2026. https://tinyurl.com/yuu377yt

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Results from the first-in-human, phase 1 MYTHIC trial (NCT04855656) demonstrated that combining the WEE1 inhibitor zedoresertib with the PYKMT1 inhibitor lunresertib achieved an overall response rate (ORR) of 18.5% via RECIST criteria in patients with CCNE1, FBXW7, and PPP2R1A-altered cancers.1 In patients with resistant/refractory ovarian cancer, the ORR was 33.3% across all dose levels and 50% at the potential recommended phase 2 dose.

These data were presented by Timothy A. Yap, MBBS, PhD, FRCP, at the 2026 American Association for Cancer Research (AACR) Annual Meeting. Following his presentation, Yap joined CancerNetwork® for a discussion where he highlighted some of the most interesting takeaways from the trial. According to Yap, the disease states evaluated in this trial represent areas of unmet need where no specific standard-of-care options can target these alterations.

Notably, based on results from this trial, the FDA granted fast track designation to lunresertib in combination with zedoresertib in patients with genomic-defined platinum-resistant ovarian cancer.2

Yap is a medical oncologist and physician-scientist, as well as the Random Horne, Jr. Endowed Professor for Cancer Research and vice president and head of Clinical Development in the Therapeutics Discovery Division at UT MD Anderson Cancer Center.

References
1. Yap TA, Aggarwal R, Fontana E, et al. First data disclosure of the Phase I trial of the first in class combination of WEE1 inhibitor zedoresertib with PKMYT1 inhibitor lunresertib in patients with advanced solid tumors harboring CCNE1, FBXW7, or PPP2R1A genomic alterations. Presented at the 2026 AACR Annual Meeting; April 17-22, 2026; San Diego, CA. Abstract CT022.

Following oral presentation of phase I Data at AACR 2026, Debiopharm announces FDA fast track designation for lunresertib in combination with zedoresertib for genomic-defined platinum-resistant ovarian cancer. News release. Debiopharm. April 20, 2026. Accessed May 4, 2026. https://shorturl.at/n1bWn

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Following the 2026 National ICE-T Conference in Charlotte, North Carolina, Zahra Mahmoudjafari, PharmD, MBA, BCOP, FHOPA, and Barry Paul, MD, spoke with CancerNetwork® about high-level takeaways that emerged during the meeting. They discussed how CAR T-cell therapies, bispecific antibodies, and other novel modalities currently fit into the treatment paradigm across multiple myeloma, leukemia, lymphoma, and other hematologic oncology populations.

The experts first discussed ideas from a session dedicated to innovations in CAR T cells and cellular therapies, with Mahmoudjafari emphasizing ongoing work exploring novel constructs such as dual-targeting chimeric antigen receptors (CARs) that may overcome antigen escape. According to Paul, a need remains for determining appropriate biomarkers to identify patients who are most likely to derive long-term benefit from agents like ciltacabtagene autoleucel (Carvykti).

Regarding another session related to bispecific antibodies and T-cell–engaging agents, Mahmoudjafari described how many new off-the-shelf therapeutic options are challenging clinicians to rethink care delivery models that can provide both high acuity monitoring and outpatient flexibility. Paul also stressed the importance of determining whether fixed-duration therapy with bispecific antibodies may provide similar benefits as indefinite therapy while avoiding the risks of overtreatment.

Looking beyond the most recent meeting in April, Mahmoudjafari and Paul outlined the potential themes of the upcoming National ICE-T Conference in Orlando, Florida, which will take place this July. The next meeting, Mahmoudjafari said, will continue to build upon the field’s shift from innovation to implementation of novel cellular therapies by focusing on operationalizing treatment delivery models across different settings. Paul stated that the meeting in Orlando will help further delineate new targets for developing therapies that may be more effective and less toxic for patients.

Mahmoudjafari is a clinical pharmacy manager in the Division of Hematologic Malignancies and Cellular Therapeutics at the University of Kansas Health System. Paul is an assistant professor of cancer medicine at Atrium Health Levine Cancer Institute of Wake Forest University School of Medicine.

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In a conversation with CancerNetwork®, Diane Simeone, MD, discussed the implications of daraxonrasib demonstrating meaningful improvements in survival among patients with metastatic pancreatic ductal adenocarcinoma (PDAC) in the phase 3 RASolute 302 trial (NCT06625320). Topline findings from the trial showed that the novel multiselective RAS(ON) inhibitor approximately doubled the median overall survival (OS) compared with investigator’s choice of chemotherapy, with survival benefits extending to those with different RAS mutations and RAS wild-type disease.

Simeone spoke about the significance of these results in the context of the pancreatic cancer field, breaking down how daraxonrasib’s mechanism of action as a pan-RAS inhibitor may open a “new fronter” beyond standard-of-care chemotherapy and platinum-based regimens. She also touched upon the prominent toxicities that have emerged with daraxonrasib, including rashes, while emphasizing the balancing of risk and benefit as part of further optimizing RAS therapeutics.

The discussion also highlighted strategies for expanding genetic testing for patients with pancreatic cancer, as Simeone described the importance of receiving second opinions at comprehensive cancer centers where multidisciplinary teams can guide patients towards personalized treatment plans. She also mentioned how initiatives such as the Pancreatic Cancer Early Detection (PRECEDE) Consortium represent viable opportunities for continuing to elevate the quality of care for patients.

“This has been a Holy Grail type of thing, where people have been wanting to target KRAS but it’s been a challenge. This has been a breakthrough,” Simeone said regarding the results seen with daraxonrasib. “While the effect is dramatic in patients with metastatic cancer—and unfortunately that’s still half of patients who walk in the door with pancreatic cancer—applying this therapy to stage I cancer could be even more profound and drive cures. Investment in early detection, partnered with these advances in therapeutics, is where we will see the most significant progress in increasing survival rates.”

Simeone is the director of the Moores Cancer Center at University of California San Diego Health.

Reference
Daraxonrasib demonstrates unprecedented overall survival benefit in pivotal phase 3 RASolute 302 clinical trial in patients with metastatic pancreatic cancer. News release. Revolution Medicines. April 13, 2026. Accessed April 29, 2026. https://tinyurl.com/44t5vh5d

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In a special cobranded episode between Oncology On the Go, hosted by CancerNetwork®, and the American Society for Transplantation and Cellular Therapy (ASTCT)’s program ASTCT Talks, host Rahul Banerjee, MD, FACP, spoke with colleague Hitomi Hosoya, MD, PhD, about a study she and coauthors published in Blood. In their study, Hosoya and colleagues assessed the underlying mechanisms of CAR T-cell–related lymphomas developing in the gastrointestinal tract. The study focused on a particular case involving a 50-year-old patient with relapsed/refractory multiple myeloma who developed T-cell lymphoma after receiving cellular therapy in the seventh-line setting.

The discussion began with an overview of the patient’s treatment course, who initially responded well to seventh-line CAR T-cell therapy and experienced grade 1 cytokine release syndrome with no neurotoxicity. Two months after initiating this line of therapy, the patient experienced diarrhea and subsequent hospitalization. Following multiple endoscopies and the use of steroids and other biologic agents, the patient’s diarrhea persisted, which resulted in notable weight loss and cachexia. A biopsy revealed that the patient had developed T cell infiltration in the small intestine, which correlated with an eventual diagnosis of T-cell lymphoma.

After the patient’s diagnosis, Hosoya outlined her team’s decision to administer cyclosporine to help mitigate and eventually resolve the patient’s diarrhea. Beyond this symptom management, she highlighted the challenges of treating those with GI-related T-cell lymphomas based on a lack of sufficient treatment protocols and clinical experience across the country. Overall, she emphasized teamwork as an essential component of managing and further understanding CAR T-cell lymphomagenesis.

Banerjee is an assistant professor in the Clinical Research Division at the Fred Hutchinson Cancer Center and a member of the ASTCT Content Committee. Hosoya is a principal investigator in Hematology & Cellular Therapy at Cedars-Sinai Medical Center and an instructor of Blood and Marrow Transplant and Cellular Therapy at Stanford University.

Reference
Hosoya H, Bastidas Torres AN, Fernandez-Pol S, et al. Long-term follow-up of gastrointestinal CAR T-cell lymphoma: homing, clonal expansion, and response to cyclosporine. Blood. 2026;147(11):1191-1198. doi:10.1182/blood.2025031423

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At the 3rd Biennial Miami Precision Medicine Conference, CancerNetwork® spoke with a variety of researchers and clinicians who presented on different topics regarding the use of targeted therapies across several cancer types. Faculty from the University of Miami Sylvester Comprehensive Cancer Center shared key advances and ongoing initiatives across pancreatic cancer, sarcomas, genitourinary malignancies, and other diseases.

First, Jashodeep Datta, MD, an associate professor of surgery, a co-leader of the Gastrointestinal Site Disease Group, an associate director of Translational Research, and Sylvester Pancreatic Cancer Research Institute DiMare Family Endowed Chair in Immunotherapy, discussed his presentation on overcoming a historical “moratorium” associated with immunotherapy in pancreatic cancer. Based on recent data, he noted that current goals include analyzing distinct subpopulations of patients who respond to immunotherapy and understanding the biology of why they respond to inform the design of novel therapeutic approaches. Looking towards the future, Datta described how mRNA vaccines may play a larger role in advancing personalized patient care.

Next, Steven Bialick, DO, a gastrointestinal and sarcoma and connective tissue medical oncologist, spoke about his presentation on diagnosing and treating patients with sarcomas. He highlighted how markers like microsatellite instability-high status may help identify patients who are suitable candidates to receive immunotherapies like pembrolizumab (Keytruda). Overall, he emphasized the practice of thorough molecular testing to help navigate a treatment landscape that has “changed so dramatically” over the years.

Finally, Jaime Merchan, MD, director of the Phase 1 Program and a tenured professor of medicine at the University of Miami Miller School of Medicine, talked about his presentation on the development of novel targeted therapies in genitourinary malignancies, which included bladder and kidney cancers. He described strategies for using new HIF-2⍺ inhibitors alongside therapeutic standards like tyrosine kinase inhibitors. Additionally, he detailed how other investigational drug classes, including oncolytic viruses and T-cell engagers, may fit into the treatment paradigm for these genitourinary cancers.

References

Datta J. Mission impossible? Strategies for precision immunotherapy in pancreatic cancer. Presented at the 3rd Biennial Miami Precision Medicine Conference; April 11-12, 2026; Fort Lauderdale, FL.
Bialick S. Precision oncology in the diagnosis and management of sarcoma patients. Presented at the 3rd Biennial Miami Precision Medicine Conference; April 11-12, 2026; Fort Lauderdale, FL.
Merchan J. Genitourinary cancers: bladder and kidney. Presented at the 3rd Biennial Miami Precision Medicine Conference; April 11-12, 2026; Fort Lauderdale, FL.

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In a conversation with CancerNetwork®, Shari Goldfarb, MD spoke about key developments and challenges regarding the treatment of younger populations with breast cancer. Key areas across the field included the rising incidence of disease, including HER2-positive and triple-negative subtypes; expanding opportunities for clinical trial enrollment; and preserving fertility among patients undergoing treatment, among other focuses.

Although it’s not entirely clear why breast cancer diagnoses are becoming more common in younger groups, Goldfarb noted that a combination of genetic and environmental factors may be driving this increase. Beyond facilitating yearly mammograms among average-risk individuals starting at age 40, she said that knowing one’s family history and genetic risk may also inform personalized screening approaches.

Goldfarb also described how patients in their 20s to 40s may be underrepresented in breast cancer clinical trials due to enrollment criteria typically requiring postmenopausal status, which may be amended by expanding eligibility to patients who receive medically suppressive therapy. The conversation also touched upon providing supportive care for younger patients with breast cancer, as Goldfarb emphasized prompt fertility consultations following diagnosis for patients who desire to have children as well as other services related to integrative medicine and social work.

Additionally, Goldfarb reviewed strategies for mitigating chemotherapy-induced alopecia, highlighting how modalities like scalp cooling may reduce hair loss and improve hair regrowth. In the end, she noted the importance of employing a multi-disciplinary approach to ensure whole-person care and meet the emotional and psychological needs of patients who undergo treatment.

“Patients should always advocate for themselves…If something is different in your body, you should make sure to bring it to a doctor's attention,” Goldfarb stated. “[Patients should] make sure they get imaging or a biopsy if they need it. [They should not] wait because early diagnosis helps with finding things at an earlier stage and [yielding] better prognosis.”

Goldfarb is an assistant attending physician specializing in breast cancer at Memorial Sloan Kettering Cancer Center.

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In this episode recorded at the 2026 American Psychosocial Oncology Society (APOS) annual meeting, Daniel C. McFarland, DO, sat down with Kelly Irwin, MD, to address one of the most challenging topics in oncology: suicide risk. The conversation aimed to equip oncologists with the tools and confidence to navigate the emotional complexities of cancer care.

Key Discussion Points:

Understanding the Risk: Patients with cancer experience more than double the risk of completed suicide compared with the general population. The risk is highest during the first month following a diagnosis—a 12-fold increase in some studies—and remains elevated for the first year.
Identifying High-Risk Factors: Beyond a prior suicide attempt (the No.1 risk factor), specific contributors include advanced-stage disease, financial distress, and cancers that impact core identity or physical function, such as head and neck or pancreatic cancers.
The Power of Asking: Both experts emphasized that a clinician asking about suicide does not increase the risk. Irwin advises clinicians to trust their instincts and use a continuum of questioning, starting with general feelings of hopelessness and moving toward specific plans and access to "means" (such as firearms or medication).
The "Don’t Worry Alone" Rule: Irwin urged clinicians never to handle these concerns in isolation. She recommended involving social workers, nurses, and family members, noting that in life-threatening situations, clinician-patient confidentiality (HIPAA) can be "broken" to ensure safety.
Relieving Suffering and Building Connection: The primary goal is to make the "unbearable bearable". Irwin highlighted that even small, non-transactional gestures—like a "thinking of you" message—can significantly decrease suicide risk by reinforcing a patient's sense of belonging and mattering.

Available Resources:
· National Mental Health Hotline: Call or text 988

· Connect with a crisis counselor: Text HOME to 741741

· Samaritans Hotline and Website: (877)870-4673; https://samaritanshope.org/our-services/24-7-helpline/

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being a psycho-oncology editorial advisory board member for the journal ONCOLOGY®. Irwin is an instructor in psychiatry at Harvard Medical School and a faculty psychiatrist at the Massachusetts General Hospital (MGH) Cancer Center and MGH Schizophrenia Program, where she founded the Cancer Prevention Program.

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In a conversation with CancerNetwork®, Julian Hong, MD, MS, discussed considerations for optimizing care among patients with mental health disorders (MHDs) who are undergoing treatment for cancer. He spoke in the context of a study he and coauthors published in Cancer, which showed that patients with cancer and a mental health condition experience an increased risk of all-cause mortality.

Specifically, findings from the study demonstrated that early MHDs conferred a heightened all-cause mortality risk in the initial 12 to 35 months of cancer diagnosis (HR, 1.51; 95% CI, 1.47-1.56). This trend diminished over time, with gradually reduced risks observed from 36 to 59 months (HR, 1.17; 95% CI, 1.11-1.24) and from 60 to 120 months after that initial period (HR, 0.95; 95% CI, 0.89-1.01). Furthermore, the risk of all-cause mortality was even higher for patients with an early MHD and receipt of psychotropic medications at 12 to 36 months (HR, 2.67; 95% CI, 2.52-2.83), 36 to 60 months (HR, 1.25; 95% CI, 1.07-1.46), and 60 to 120 months (HR, 1.01; 95% CI, 0.82-1.25).

“We’re…trying to combine different types of data to identify earlier mental health diagnoses. Even what can feel like small amounts of time—weeks and months—can make a huge difference for people who are going through these conditions,” Hong stated regarding the next steps for research in the field. “It’s one thing to help identify some of these issues and some of these implications of different conditions, but at the end of the day, the goal is to intervene on these things and do a better job of taking care of patients.”

Hong is an associate professor of radiation oncology in the Baker Computational Health Sciences Institute at the University of California, San Francisco (UCSF), and head of Artificial Intelligence at UCSF Helen Diller Family Comprehensive Cancer Center.

Reference
Ganjouei AA, Zack T, Friesner I, et al. Association of mental health disorders and all-cause mortality for patients with cancer: large-scale analysis of University of California Health System data. Cancer. 2026;132(5):e70254. doi:10.1002/cncr.70254

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In this episode of Oncology on The Go, created in collaboration with the American Psychosocial Oncology Society, Daniel C. McFarland, DO, and Ilana M. Braun, MD, dove into the complexities of cannabis use within the oncology landscape. They explored the tension between rising public popularity and the need for rigorous scientific scrutiny in symptom management.

Key Discussion Points:

The 2024 ASCO Guidelines: Braun highlighted the first-of-its-kind clinical guidelines from the American Society of Clinical Oncology, which acknowledge medicinal utility for chemotherapy-induced nausea, vomiting (as an adjunct), and non-cancer pain.
Routes of Administration: McFarland and Braun compared oral, combusted, and vaporized methods, noting that while oncologists favor oral routes, they are subject to "first-pass metabolism," which can delay relief.
Safety and Clinical Concerns: There are potential negative impacts on outcomes for patients using immune checkpoint inhibitors.
- Risks may impact patients with a personal or family history of psychosis when using THC-predominant products.
- - There are possible dangers linked to e-cigarette or vaping use-associated lung injury (EVALI) from informally sourced products.
- Addressing "Cancer-Directed" Claims: The pair addressed the misconception that cannabis treats the cancer itself, noting that ASCO explicitly discourages using it as a replacement for conventional treatments like chemotherapy or surgery.
- The Future of Research: The discussion concluded with the potential impact of reclassifying cannabis to Schedule III, which could reduce red tape and enable high-quality comparative efficacy trials for sleep, anxiety, and depression.

The conversation emphasized a "harm reduction" approach, urging oncologists to provide stigma-free, evidence-based education while respecting patient autonomy.

Reference

Braun IM, Bohlke K, Abrams DI, et al. Cannabis and cannabinoids in adults with cancer: ASCO guideline. J Clin Oncol. 2024;42(13):1575-1593. doi:10.1200/JCO.23.02596

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During a visit to Columbia University Irving Cancer Research Center, experts across hematologic oncology shared their perspectives on key trends and developments in their respective fields. These conversations explored novel therapeutic approaches and translational research that may advance the paradigm across different leukemia, multiple myeloma, and lymphoma populations.

First, Nicole Lamanna, MD, an associate clinical professor of medicine in the Hematologic Malignancies Section of the Hematology/Oncology Division at Irving Medical Center, discussed relevant advancements in the management of chronic lymphocytic leukemia (CLL). She described how the FDA approval of fixed-duration acalabrutinib (Calquence) plus venetoclax (Venclexta) may affirm a shift away from standard chemoimmunotherapy in the field. Her discussion also emphasized evaluating the adverse effects and benefit/risk profiles of drug classes such as BTK inhibitors and BCL-2 inhibitors during the treatment decision-making process.

Next, Rajshekhar Chakraborty, MD, an assistant professor of medicine in the Division of Hematology/Oncology at Irving Medical Center, touched upon critical themes related to the use of bispecific antibodies for patients with multiple myeloma and other plasma cell disorders. Educating providers on the utility of bispecific antibodies in earlier treatment settings, he noted, is one of the important challenges that the field must address to expand usage of these therapies in community practices. He also highlighted findings from the phase 3 MajesTEC-3 trial (NCT05083169) and how they support the clinical utility of teclistamab-cqyv (Tecvayli) plus daratumumab and hyaluronidase-fihj (Darzalex Faspro) for patients with relapsed/refractory disease.

Finally, Hua-Jay “Jeff” Cherng, MD, an assistant professor of medicine in the Lymphoma Program in the Division of Hematology and Oncology at Irving Medical Center, detailed translational work that may shape clinical practice in the lymphoma space. He spoke about research aiming to move markers like ctDNA and minimal residual disease from “the bench to the bedside” as part of clinical decision-making for patients with diffuse large B-cell lymphoma (DLBCL). Other future focuses, Cherng said, include leveraging molecular genotyping to improve outcomes for higher-risk subgroups or even replacing chemotherapy with less toxic targeted agents.

References

CALQUENCE® plus venetoclax approved in the US as first all-oral, fixed-duration combination for patients with chronic lymphocytic leukemia in the 1st-line setting. News release. AstraZeneca. February 20, 2026. Accessed March 11, 2026. https://tinyurl.com/38zbx96s
Mateos MV, Bahlis N, Perrot A, et al. Phase 3 randomized study of teclistamab plus daratumumab versus investigator’s choice of daratumumab and dexamethasone with either pomalidomide or bortezomib (DPd/DVd) in patients (pts) with relapsed refractory multiple myeloma (RRMM): results of MajesTEC-3. Blood. 2025;146(suppl 2):LBA-6. doi:10.1182/blood-2025-LBA-6

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In a conversation with CancerNetwork®, Sagar Lonial, MD, FACP, FASCO, discussed the potential implications of the FDA approving iberdomide plus daratumumab (Darzalex) and dexamethasone for patients with relapsed/refractory multiple myeloma. He spoke in context of the FDA accepting a new drug application for the iberdomide regimen based on data from the phase 3 EXCALIBER-RRMM trial (NCT04975997).

Lonial discussed the potential benefits that iberdomide could offer based on its properties as a CELMoD. He noted how the potency, safety profile, and targeting capabilities of this drug class may differentiate it from previous standards such as immunomodulatory drugs.

Regarding the supporting findings from the EXCALIBER-RRMM trial, Lonial stated that the study was the “first test case” for using minimal residual disease (MRD) as an early end point for approval. In September 2025, investigators announced that iberdomide-based therapy showed a significant improvement in MRD-negative status vs daratumumab, bortezomib (Velcade), and dexamethasone.

The potential approval of iberdomide in this multiple myeloma population, Lonial said, would open the door for using the agent in combination with other immunotherapies. Noting that T-cell engagers are “perfect partners” for the CELMoD class, Lonial emphasized the utility of combination regimens across the field.

“Recognizing that we have agents that can reset or augment immunity and partnering them [are important]. People always want to say it's a black and white world; you're either going to use this, or you're going to use this. To me, it's about combination therapy,” Lonial stated. “Having this tool belt with many drugs and putting them together in combinations is how we get to [a] cure.”

Lonial is a professor and chair of the Department of Hematology and Medical Oncology and the Anne and Bernard Gray Family Chair in Cancer at Emory University School of Medicine, and the chief medical officer at Winship Cancer Institute of Emory University. He is also a member of the International Myeloma Foundation scientific board.

References

U.S. Food and Drug Administration accepts Bristol Myers Squibb's new drug application for iberdomide in patients with relapsed or refractory multiple myeloma. News release. Bristol Myers Squibb. February 17, 2026. Accessed March 5, 2026. https://tinyurl.com/4c8mb6ex
Bristol Myers Squibb announces phase 3 EXCALIBER-RRMM study evaluating iberdomide in combination with standard therapies demonstrated a significant improvement in minimal residual disease negativity rates in relapsed or refractory multiple myeloma. News release. Bristol Myers Squibb. September 23, 2025. Accessed March 5, 2026. https://tinyurl.com/5n9768k5

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Daniel C. McFarland, DO, and Boris Kiselev, MD, highlighted the need for oncologists to recognize and address depression for patients with cancer.

In a new episode of Oncology on the Go created in collaboration with the American Psychosocial Oncology Society, host Daniel C. McFarland, DO, spoke with Boris Kiselev, MD. Together, they explored the complex intersection of oncology and psychiatry. The conversation challenged the oversimplification of “cancer-related sadness” to provide clinicians with a framework for distinguishing between normative grief and clinical Major Depressive Disorder (MDD).

The conversation focused on:

The Diagnostic Continuum: Depression exists on a spectrum ranging from normative sadness—encompassing a healthy, waxing-and-waning response to trauma—to pathological MDD.
Differentiating Grief vs Depression:
- Grief/Normative Sadness: Often occurs in waves, improves over time, and does not typically affect a patient’s functional ability. It is often a response to the loss of one’s “pre-cancer self”.
- - Clinical Depression: Marked by anhedonia (loss of pleasure), persistent feelings of guilt or worthlessness, and a fundamental change in identity where the patient no longer “feels like themselves”.
- The “Quantum” Observation Effect: Patients often present differently to oncologists than they do to mental health professionals. In the oncology clinic, patients may unconsciously “shield” their distress to ensure that their treatment plan remains unchanged.
- The Power of the Story: The experts emphasized that the oncologist-patient relationship is therapeutic. Allowing patients to “tell their story” rather than jumping straight to clinical data builds trust with them and uncovers hidden psychological pressure points.

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being the psycho-oncology editorial advisory board member for the journal ONCOLOGY. Kiselev is a consult liaison psychiatrist at Atrium Health Carolinas Medical Center, an assistant professor in the Psycho-oncology Program in the Department of Supportive Oncology at Atrium Health Levine Cancer Institute, and an assistant professor in Internal Medicine.

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Sarah Poland, MD, lead author of a recently published article in the journal ONCOLOGY titled Advances in Immunotherapy for Breast Cancer, highlighted key findings from her review in a conversation with CancerNetwork®.1 Throughout the discussion, she spoke about:

Shifting Perspectives on Immunogenicity: Historically, breast cancer was considered a “cold,” poorly immunogenic tumor due to low tumor mutational burden (TMB) and few tumor-infiltrating lymphocytes (TILs). Poland highlighted how clinical research has shifted this perspective, particularly through the study of triple-negative breast cancer (TNBC), which often exhibits higher PD-L1 expression and immune infiltration.

Key Clinical Milestones: The review highlighted foundational data that established immunotherapy as a standard of care:

Early-Stage TNBC: The phase 3 KEYNOTE-522 trial (NCT03036488) established pembrolizumab (Keytruda) plus chemotherapy as a standard neoadjuvant treatment for stage II to III TNBC.2
Metastatic TNBC: The phase 3 KEYNOTE-355 trial (NCT02819518) demonstrated the benefit of pembrolizumab in PD-L1–positive metastatic disease.3

Managing Toxicity and Rechallenge: Poland addressed the feasibility of pembrolizumab rechallenge after an immune-related adverse effect (irAE), emphasizing that while possible, it requires a highly individualized approach based on the severity and timing of the initial toxicity.

The Future Landscape: Beyond PD-1/PD-L1 inhibitors, the discussion covered emerging technologies that are poised to redefine treatment:

Antibody-Drug Conjugates (ADCs): Exploration of novel combinations of ADCs with immunotherapy.
Emerging Modalities: The potential role of bispecific antibodies and vaccine trials utilizing tumor antigens.
Subtype Expansion: Emerging evidence supporting the efficacy of immunotherapy in hormone receptor–positive and HER2-positive subtypes, moving beyond the traditional focus on TNBC.

Unmet Educational Needs: Poland emphasized the importance of resources that connect providers and patients, particularly in translating complex trial data into clinical practice and addressing patient concerns regarding the newest therapies and trials.

Poland is from the Department of Medicine in the Section of Hematology/Oncology at The University of Chicago.

References

Poland S, de Oliveira Andrade M, Nanda R. Advances in immunotherapy for breast cancer. Oncology (Williston Park). 2026;40(1):8-15. doi:10.46883/2026.25921061
Schmid P, Cortes J, Pusztai L, et al. Pembrolizumab for early triple-negative breast cancer. N Engl J Med. 2020;382(9):810-821. doi:10.1056/NEJMoa1910549
Cortes J, Rugo HS, Cescon DW, et al. Pembrolizumab plus chemotherapy in advanced triple-negative breast cancer. N Engl J Med. 2022;387(3):217-226. doi:10.1056/NEJMoa2202809

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At the 2026 Tandem Meetings, CancerNetwork® spoke with a variety of experts who presented on key developments and advancements across hematologic oncology. As part of different oral presentations and poster sessions, researchers and clinicians shared updated findings that may influence the management of myelodysplastic syndromes (MDS), leukemia, lymphoma, and other blood cancer types.

First, Fernando Duarte, head of the Bone Marrow Transplant Service at Walter Cantídio University Hospital (HUWC), hematologist and professor at the Federal University of Ceará, and president of the Brazilian Society of Cell Therapy and Bone Marrow Transplant, highlighted his presentation analyzing trends associated with allogenic hematopoietic cell transplantation (allo-HCT) among patients with MDS or myeloproliferative neoplasms (MPN) and other types of MDS. Data from the Brazillian SBTMO and CIBMTR registry revealed that patients receiving allo-HCT for MDS/MPN were typically older with worse performance statuses. Additionally, MDS/MPN independently predicted worse overall survival (OS) and relapse-free survival outcomes.

Next, Alfonso Molina, MD, MPH, a third-year Hematology and Medical Oncology fellow at Stanford University, detailed results from a phase 1 trial (NCT05507827) assessing Orca-T, an investigational allogeneic T-cell immunotherapy, among those with high-risk B-cell acute lymphoblastic leukemia (B-ALL). Treatment with Orca-T yielded disease-free survival and OS in all (100%) 18 evaluable patients after a median follow-up of 14 months (range, 3-35), which occurred without graft failure, significant graft-versus-host-disease, or severe CAR-mediated toxicity.

Finally, Irtiza N. Sheikh, DO, an assistant professor in the Department of Pediatrics - Patient Care, Stem Cell Transplantation and Cellular Therapy Section of the Division of Pediatrics at The University of Texas MD Anderson Cancer Center, discussed his presentation exploring differences in outcomes with lisocabtagene maraleucel (Breyanzi; liso-cel) across various treatment settings and patient populations with large B-cell lymphoma. Data demonstrated that among patients younger than 50 years old, liso-cel produced enduring responses across real-world and clinical trial settings, which were comparable to outcomes in overall populations.

References

Duarte FB, Garcia YDO, Hamerschlak N, et al. Comparative outcomes of allogeneic hematopoietic cell transplantation in myelodysplastic/myeloproliferative neoplasms and other myelodysplastic syndromes: Brazilian Sbtmo/CIBMTR registry analysis. Presented at: 2026 Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR; February 4-7, 2026; Salt Lake City, UT. Presentation 63.
Molina A, Shiraz A, Kanegai A, et al. Mature outcomes from the phase I trial of Orca-T and allogeneic CD19/CD22 CAR-T cells for adults with high-risk B-ALL. Presented at: 2026 Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR; February 4-7, 2026; Salt Lake City, UT. Presentation 31.
Sheikh IN, Patel K, Perales MA, et al. Clinical outcomes of lisocabtagene maraleucel (liso-cel) in YOUNGER PATIENTS (Pts) with relapsed or refractory (R/R) large B-cell lymphoma (LBCL). Presented at: 2026 Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR; February 4-7, 2026; Salt Lake City, UT. Poster 210.

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In a conversation with CancerNetwork®, Manoj Bhasin, PhD, MS, spoke about findings from a study in which he and colleagues developed a single-cell atlas characterizing the dysregulation of the bone marrow immune microenvironment in newly diagnosed multiple myeloma. Findings published in Nature Cancer showed that the immune system has a broad, treatment-independent influence on outcomes in newly diagnosed multiple myeloma.

Bhasin began by detailing the background and methodology of his study, in which an Immune Atlas of multiple myeloma helped generate profiles of 1,397,272 single cells from the bone marrow of 337 patients with newly diagnosed disease to characterize immune and hematopoietic cell populations. He also broke down specific analyses of certain aspects of the immune microenvironment, such as signaling evaluations demonstrating active intercellular communication involving a proliferation-inducing ligand and B cell maturation antigen potentially associated with tumor growth and survival.

Looking ahead, Bhasin described a need to research additional factors, including those beyond the bone marrow, which may help clinicians further optimize therapeutic strategies for patients with multiple myeloma.

“Maybe the biggest thing we want to say from this study is that the immune system is a critical player in the outcome of multiple myeloma, its emergence, and its therapeutic response. It is not a byproduct; it is a major driver of the outcomes,” Bhasin stated. “[Not] all high-risk multiple myeloma lesions are the same. We should look at the immune imprints of them, further comprehensively study them, and then help in designing immune therapies that fix the immune dysregulation that is associated with each cytogenetic alteration [instead of] thinking that all high-risk cytogenetic lesions of myeloma are all the same.”

Bhasin is a professor in the Department of Pediatrics and in the Department of Biomedical Informatics at Emory University School of Medicine, and director of Genomics, Proteomics, Bioinformatics and Systems Biology and the Aflac Director of the Single Cell Biology Program at Children’s Healthcare of Atlanta.

Reference
Pilcher WC, Yao L, Gonzalez-Kozlova E, et al. A single-cell atlas characterizes dysregulation of the bone marrow immune microenvironment associated with outcomes in multiple myeloma. Nat Cancer. 2026;7:224-246. doi:10.1038/s43018-025-01072-4

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In a conversation with CancerNetwork®, Ram Prakash Thirugnanasambandam, MBBS, discussed the evolving roles that artificial intelligence (AI)–based tools may play in palliative care and the management of different hematologic malignancies. He spoke in the context of a publication he authored, The Role of Artificial Intelligence in Palliative Oncology: Zeroing in on Hematologic Malignancies,which was featured in the November/December 2025 issue of the journal ONCOLOGY®.

Thirugnanasambandam, a fellow of Internal Medicine, Hospice and Palliative Medicine, and Geriatric Medicine at the University of Miami, outlined the paper’s aim to explore how AI can assist with patient-centric goals of care like symptom management as well as decision-making support among clinicians. In the context of palliative medicine, AI has demonstrated utility as a supportive tool that can help with marking patients who may benefit from a palliative care conversation. Such tools have also assisted with identifying symptoms such as pain, dyspnea, anxiety, or psychosocial distress, allowing providers to form a more proactive approach to patient care.

According to Thirugnanasambandam, implementing AI into one’s workflow may help accurately predict disease subtypes and burdens among patients with leukemia, lymphoma, or multiple myeloma. He noted that predictive analytic capabilities may also facilitate effective management of cytopenias, transplant-related needs, infections, and other treatment-related toxicities.

Thirugnanasambandam also discussed some of the ethical considerations surrounding the growth of AI-based tools, highlighting information privacy concerns and potentially biased datasets as notable issues with these platforms. Although AI may assist with decision-making, Thirugnanasambandam stated that it ultimately cannot replace a human’s nuanced clinical judgment and empathy.

“I want readers to take away a sense of balance,” Thirugnanasambandam said regarding his publication. “We’ve done the article to help clinicians be more comfortable in engaging with AI. We need to apply it critically, not as replacing judgment or decision-making skills, but more as an adjunct.”

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Emphasizing the evidence-based nature of medicine, Nathan Goodyear, MD, explained that integrative oncology uses many of the same parameters and key clinical thresholds among patients undergoing treatment for a diagnosis of cancer that his conventional oncologist colleagues use.

In this episode of Oncology on the Go, Goodyear, an integrative medicine physician at the Williams Cancer Institute, discussed key clinical efficacy and safety thresholds that integrative oncologists use for flagship integrative therapies, emerging localized and combinatory immunotherapy options in this clinical landscape, and a focus on reestablishing trust through patient-doctor relationships.

Regarding clinical thresholds, he explained that integrative care uses guidelines such as the CTCAE to follow adverse effects (AEs). RECIST criteria are also employed to ascertain clinical outcomes and utilize imaging to gauge responses in a way that is not arbitrary but translatable.

Next, Goodyear discussed combinatory regimens with immunotherapy backbones, such as pulsed electric fields (PEF) with intratumoral immunotherapy, as well as anti-CD40/CpG immunotherapies, to help generate an intratumoral response prior to resection, particularly in “immune desert” tumors. He noted how these strategies may also mitigate the possibility of postoperative recurrence.

Finally, he touched upon the evolving role of doctors as collaborators with their patients as opposed to a paternalistic and authoritative role over the course of their treatment. Driven by growing demands for a greater desire to preserve quality of life during care, Goodyear explained that his institution aims to “innovate, elevate, and empower” by bringing emergent innovative strategies to patients, elevating their immune system through immune responses, and empowering patients to undergo the healing process in tandem with a reduction of AEs.

Goodyear concluded by reiterating the importance of patient-centric care, particularly as it pertains to the restoration of trust in medicine, as well as a return to a doctor’s intended rule as a healer.

For more expert-level discussions across the oncology paradigm, check out the newest podcast series on CancerNetwork®, RadOnc on the Run. Join host and ONCOLOGY® editor-at-large Brandon Mancini, MD, MBA, FACRO, as he speaks with colleagues about the latest advancements and hottest research in the radiation oncology space.

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In a conversation with CancerNetwork®, Kandace P. McGuire, MD, and Paschalia Mountziaris, MD, PhD, highlighted the use of L-Dex bioimpedance spectroscopy as a method for detecting lymphedema earlier in patients who undergo surgery for breast cancer. The experts discussed seamlessly integrating this novel modality into standard vitals workflows and detailed other considerations for improving long-term survivorship outcomes via proactive lymphatic care.

McGuire began by breaking down why detection of lymphedema typically occurs later after its development, describing how a sentinel lymph node biopsy and additive radiation can cause lymphatic damage and obstruction that correspond with symptoms months to years down the road. At her institution, bioimpedance spectroscopy, the use of a small electrical signal measuring “bioimpedance”, is employed at various points before and after breast cancer surgery to easily determine the likelihood of developing lymphedema through a nursing visit. According to Mountziaris, having a noninvasive method like this provides a “valuable tool” for informing patients of their risks of experiencing lymphedema.

The experts also discussed a need to develop a more nuanced method for detecting potential lymphedema among patients with a higher body mass index and spoke about fostering communication across the breast surgery oncology team, the plastic/reconstructive team, and physical rehabilitation specialists to monitor abnormal fluid changes in patients. Looking ahead, they emphasized making bioimpedance spectroscopy more accessible as a key goal in lymphedema care.

“We are privileged that McGuire and I have a great team and that I have the equipment that we’re able to provide these things for our patients. From my standpoint, some of these patients appear—to me, by measurements, and everything else—to have been cured of their lymphedema after these interventions,” Mountziaris stated. “Getting an L-Dex score on them is just another way to demonstrate that we did bring them to stage 0 or no lymphedema.”

McGuire is professor of surgery and chief of breast surgery at Virginia Commonwealth University (VCU) Massey Cancer Center. Mountziaris is assistant professor of surgery in the Division of Plastic and Reconstructive Surgery at VCU Massey Cancer Center.

Reference
VCU Massey now offers new technology for early detection of lymphedema. News release. December 8, 2025. Accessed January 14, 2026. https://tinyurl.com/2ktfzf5k

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In a conversation with CancerNetwork®, Nathan Goodyear, MD, provided an overview of how to implement integrative modalities that may effectively supplement standard-of-care oncologic therapies. Beyond the use of intravenous vitamin C and other flagship strategies at his institution, Goodyear addressed potential misconceptions and biases surrounding integrative oncology and discussed how to re-engage patients back into evidence-based care.

Goodyear, an integrative oncologist at the Williams Cancer Institute, described how conventional modalities like surgery and radiotherapy may damage the immune system during cancer treatment, and how integrative strategies aim to re-engage and stimulate areas like the gut microbiome to safeguard patient quality of life. He touched upon how practices such as fecal transplantation, fasting, and intratumoral pulsed electric field (PEF) therapy can convert unresponsive diseases into “hot” tumors that immunologically react to treatment.

Looking across the medical field entirely, Goodyear described how certain “camps” may perceive integrative oncology as an “alternative” form of medicine. Citing an article published in JAMA Network Open showing how patient trust in US hospitals decreased from 71.5% in 2020 to 40.1% in 2024, Goodyear noted how such divisiveness among healthcare providers may have played a role in losing the support of patients.

As part of mitigating the prejudicial, marginalizing attitudes towards integrative care as well as the infighting among physicians, Goodyear emphasized building bridges across holistic care, conventional oncology, and other fields to properly advance the treatment of patients. Having an open dialogue and debating the science behind new integrative modalities, he explained, will help in advocating for patients and establishing trust in their care teams.

“We must re-engage with [patients] through the science, through public debate and discourse with other doctors; that will re-engage the patient,” Goodyear stated. “More importantly, I think that will re-engage the patient’s trust in doctors. When we restore a doctor-patient relationship, medicine is going to get better, and patients are going to get better.”

Reference
Perlis RH, Ognyanova K, Uslu A, et al. Trust in physicians and hospitals during the COVID-19 pandemic in a 50-state survey of US adults. JAMA Netw Open. 2024;7(7):e2424984. doi:10.1001/jamanetworkopen.2024.24984

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In a conversation with CancerNetwork®, Jose G. Trevino, II, MD, FACS, spoke about the current state of the pancreatic ductal adenocarcinoma (PDAC) paradigm as well as next steps for improving the prognosis of patients who present with this disease. Throughout the discussion, Trevino outlined the roles that surgical oncologists can play in disease management, the different demographic and socioeconomic drivers of disparate patient outcomes, and translational research focusing on factors like the tumor microenvironment.

Trevino stressed the idea of pancreatic cancer care as a “team science,” rejecting a “silo mentality” that involves handing off a patient from one department to the next. Because surgical approaches by themselves have remained “limited” in pancreatic cancer for the past 20 to 30 years, he emphasized continued collaboration with medical oncologists, radiation oncologists, and translational scientists to enhance patient quality of life.

Regarding disparities, Trevino noted the importance of recognizing various barriers to treatment access among those in rural communities as well as unequal outcomes across different racial and ethnic groups of patients, including worse survival among Black populations. Additionally, in the face of continuously rising PDAC incidence, he stressed additional training across the board on how to detect the red flags associated with disease.

“…There has to be a ton of education for our patients and our physicians who see patients on a primary level to know what those red flags are when a patient comes to their clinic. Early detection of early lesions that could eventually turn into pancreatic adenocarcinoma is going to be the key to survival, ultimately. [If we] catch it before it becomes a cancer, we solve a huge problem,” Trevino stated. “Early detection of early lesions is key.”

Trevino is chair of the Division of Surgical Oncology and an associate professor in the Department of Surgery at VCU School of Medicine as well as surgeon-in-chief and Walter Lawrence, Jr., Distinguished Professor of Oncology at VCU Massey Cancer Center.

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After the 2025 American Society of Hematology (ASH) Annual Meeting had passed, the data were out, and the hematologist/oncologists of the world had time to digest the practice changes that awaited them upon their returns home. Rahul Banerjee, MD, FACP, and Brooke Adams, PharmD, BCOP, took part in an X Spaces discussion hosted by CancerNetwork® in collaboration with The American Society for Transplantation and Cellular Therapy (ASTCT) to highlight these potential changes.

Adams and Banerjee discussed abstracts from the meeting, including the phase 3 MajesTEC-3 trial (NCT05083169), which evaluated teclistamab-cqyv (Tecvayli) plus daratumumab (Darzalex) in patients with relapsed/refractory multiple myeloma who progressed on at least 1 prior line of therapy.1 A significant progression-free survival benefit was observed with the experimental combination compared with standard of care in this population.

They also discussed data from cohort A of the phase 2 IFM2021-01 trial (NCT05572229), which evaluated subcutaneous teclistamab in combination with subcutaneous daratumumab in patients with newly diagnosed multiple myeloma. Results demonstrated that the combination was effective and safe in the frontline treatment of patients who were ineligible for transplant.2

The discussion also covered the broader treatment landscape, as the experts compared the use of bispecific antibodies with BCMA-directed CAR T-cell therapies. Frontline bispecific strategies for transplant-ineligible populations were also topics of conversation, as well as post-transplant consolidation with bispecifics. Ultimately, they stated that multiple myeloma care is undergoing a paradigm shift toward deeper minimal residual disease negativity, possible treatment de‑escalation, and even serious use of the word “cure” for the disease.

Banerjee is an assistant professor in the Clinical Research Division at the Fred Hutchinson Cancer Center, and Adams is a clinical pharmacist in the Department of Stem Cell Transplant and Cellular Therapy and coordinator of the PGY-2 Oncology Residency at Orlando Health. Both are also members of the ASTCT content committee.

References
1. Mateos M-V, Bahlis N, Perrot A, et al. Phase 3 randomized study of teclistamab plus daratumumab versus investigator’s choice of daratumumab and dexamethasone with either pomalidomide or Bortezomib (DPd/DVd) in patients (Pts) with relapsed refractory multiple myeloma (RRMM): Results of majestec-3. Blood. 2025;146(suppl 2):LBA-6. doi:10.1182/blood-2025-LBA-6 2. Manier S, Lambert J, Marco M, et al. A phase 2 study of teclistamab in combination with daratumumab in elderly patients with newly diagnosed multiple myeloma: the IFM2021-01 teclille trial, cohort A. Blood. 2025;146(suppl 1):367. doi:10.1182/blood-2025-367

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This episode of the collaborative podcast between Oncology on the Go and the American Psychosocial Oncology Society (APOS), hosted by Daniel C. McFarland, DO, features Michelle B. Riba, MD, and focuses on integrating psychosocial care into oncology for clinicians.

The discussion emphasizes that psychosocial issues profoundly impact both quality of life and cancer-related outcomes, making their assessment an integral part of care, not merely ancillary. The distress thermometer was developed by the NCCN in the late 1990s as a 0-to-10 scale, dubbed the "fifth vital sign". The term "distress" was chosen over psychiatric labels to capture the wide array of patient concerns, including pain, fatigue, sleep, spiritual, practical, and family issues.

Distress screening is now mandated at regular appointments in all cancer centers in the US. Clinicians are encouraged to screen for more specific issues like depression (linked to poor adherence and survival), anxiety (which can impede treatment adherence), and substance use. Oncologists are the doctors most able to consider a patient's totality of symptoms, and their role is integral to supporting psychosocial referrals.

To address the practical delivery of care, the collaborative care model is being advocated as a public health, population-based approach. Key components include:

Use of a standardized screening tool.
Management by a dedicated care manager.
Weekly consultation between the care manager and a consultant psychiatrist for triage and treatment advice.

The model allows oncologists to bill for care and learn more about these issues while ensuring patients receive evidence-based treatments. The clinicians concluded that fundamentally, mental health needs to be aligned alongside cancer care.

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being the psycho-oncology editorial advisory board member for the journal ONCOLOGY. Riba is director of the PsychOncology Program, a clinical professor, and the associate chair for Integrated Medical and Psychiatric Services in the Department of Psychiatry at the University of Michigan Rogel Cancer Center, and psycho-oncology editorial advisory board member for the journal ONCOLOGY.

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At the 2025 American Society of Hematology Annual Meeting & Exposition (ASH), CancerNetwork® sat down with a variety of researchers and clinicians to discuss potential advancements across hematologic oncology care. These experts shared their findings related to investigational therapeutic regimens and strategies that may prove impactful across different multiple myeloma, lymphoma, and leukemia populations.

First, Krina K. Patel, MD, MSc, highlighted findings from the phase 2 iMMagine-1 study (NCT05396885) assessing treatment with anitocabtagene autoleucel (anito-cel) among patients with relapsed/refractory multiple myeloma. According to Patel, an associate professor in the Department of Lymphoma/Myeloma in the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center in Houston, Texas, the novel cellular therapy elicited an overall response rate (ORR) of 96% and a stringent complete response or CR rate of 74% among the evaluable patients. She also discussed how anito-cel’s unique mechanism of action may show efficiency compared with other cellular therapy products while reducing the risk of cytokine release syndrome and other delayed toxicities.

Next, Manali Kamdar, MD, spoke about data from a long-term follow-up phase 2/3 study (NCT03435796) based on the phase 3 TRANSFORM trial (NCT03575351) evaluating lisocabtagene maraleucel (liso-cel; Breyanzi) vs standard-of-care therapy for patients with relapsed/refractory large B-cell lymphoma (LBCL). Long-term follow-up showed that liso-cel continued to elicit improvements in progression-free survival and overall survival across this population. Kamdar, the clinical director of Lymphoma Services at the University of Colorado Anschutz School of Medicine, touched upon the patient subpopulations who are most suitable to receive liso-cel while emphasizing the agent’s curative potential in the second-line setting.

Finally, Wei Ying Jen, BM BCh, MA, MMed, MRCP, FRCPath, detailed results from the phase 1/2 SAVE trial (NCT05360160), which showed responses with an all-oral combination of revumenib (Revuforj), decitabine/cedazuridine (Inqovi), and venetoclax (Venclexta) for patients with newly diagnosed acute myeloid leukemia. Jen, an assistant professor in the Department of Leukemia in the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center in Houston, Texas, noted how an all-oral regimen may offer an “advantage” compared with standard intensive chemotherapy, which requires patients to travel to the hospital to undergo an infusion.

References
1. Patel K, Dhakal B, Kaur G, et al. Phase 2 registrational study of anitocabtagene autoleucel for the treatment of patients with relapsed and/or refractory multiple myeloma: updated results from iMMagine-1. Blood. 2025;146(suppl 1):256. doi:10.1182/blood-2025-256 2. Kamdar M, Solomon S, Arnason J, et al. Lisocabtagene maraleucel (liso-cel) versus standard of care (SOC) for second-line relapsed or refractory large B-cell lymphoma (LBCL): First Results from long-term follow-up of TRANSFORM. Blood. 2025;146(suppl 1):3710. doi.10.1182/blood-2025-3710 3. Jen WY, DiNardo CD, Short NJ, et al. Phase II study of the all-oral combination of revumenib (SNDX-5613) with decitabine/cedazuridine (ASTX727) and venetoclax (SAVE) in newly diagnosed AML. Blood. 2025;146(suppl 1):47. doi:10.1182/blood-2025-47

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In the most recent ONCOLOGY On the Go hosted in collaboration with the American Psychosocial Oncology Society, Daniel C. McFarland, DO, spoke with Charles S. Kamen, PhD, MPH, about health equity for sexual and gender minority groups in oncology.

Sexual and gender minority groups, who constitute approximately 9.3% of the US population, experience significant and preventable disparities across all stages of the cancer care continuum, according to Kamen.1 He detailed how these inequities are largely driven by minority stress: the chronic psychological and emotional burden resulting from anticipated and experienced prejudice, discrimination, and stigma within health care settings.2

McFarland and Kamen highlighted that a lack of comprehensive sexual and gender minority training in medical education often leaves clinicians feeling unprepared, compounding the patient’s anxiety and mistrust.

The path to correcting these disparities requires a fundamental shift to cultural humility: the readiness to acknowledge one’s own lack of knowledge and learn directly from the patient’s lived experience. The most critical, actionable step discussed was the systematic, safe, and affirmative collection of Sexual Orientation and Gender Identity (SOGI) data.3

Kamen emphasized that SOGI data is a clinical tool, not just a demographic marker. When collected routinely—ideally non-verbally via intake forms—SOGI data are used to:

Ensure Biologically Appropriate Surveillance: Confirming that all necessary cancer screenings are offered based on the patient’s existing organs, regardless of current gender identity.
Facilitate Relationship-Centered Care: Appropriately recognizing and engaging the patient’s partners and chosen family; a critical component of sexual and gender minority support networks.
Tailored Psychosocial Navigation: Moving beyond a general "disparities mindset" to an "equity mindset" by using SOGI data to connect patients with LGBTQ-specific psychosocial resources that directly address discrimination-related distress drivers.

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being the psycho-oncology editorial advisory board member for the journal ONCOLOGY. Kamen is an associate professor in the Department of Surgery, Cancer Control (SMD) and holds joint appointments as an associate professor at the Center for Community Health and Prevention and the Department of Psychiatry (SMD) at the University of Rochester Medical Center.

References

Jones JM. LGBTQ+ identification in U.S. rises to 9.3%. News release. Gallup. February 20, 2025. Accessed December 3, 2025. https://tinyurl.com/48n8j8bd
Minority stress. American Psychological Association. Updated November 15, 2023. Accessed December 3, 2025. https://tinyurl.com/5n888ynr

Learning resources — collecting sexual orientation and gender identity data. National LGBTQIA+ Health Education Center. Accessed December 3, 2025. https://tinyurl.com/4btrn5y3

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As part of a visit to Georgia Cancer Center in Augusta, Georgia, CancerNetwork spoke with a variety of experts and faculty members regarding ongoing research and future initiatives dedicated to improving outcomes across different patient populations. These conversations touched upon potential developments in diseases including non–small cell lung cancer (NSCLC), multiple myeloma, and acute myeloid leukemia (AML).

First, Girindra Raval, MD, an associate professor in the Department of Medicine: Hematology and Oncology of the Medical College of Georgia at Augusta University, discussed current studies at his institution that may help optimize treatment for patients with lung cancer. This research ranged from retrospective trials analyzing how demographic features may influence outcomes to biomarker-based assessments intended to augment the efficacy of immunotherapy. Looking towards the future, Raval stated that determining how to sequence and de-escalate treatment amidst several available therapeutic options will be a key concern in the field.

Additionally, Amany Keruakous, MD, director of Myeloma Research at Georgia Cancer Center and assistant professor in the Department of Medicine: Hematology and Oncology at the Medical College of Georgia of Augusta University, detailed strategies for mitigating current challenges in multiple myeloma care. She emphasized fostering collaborative relationships between colleagues in community settings and academic institutions to help reduce barriers to treatment access among patients. Furthermore, she noted the importance of conducting additional clinical trials at community centers.

Finally, Daniel Peters, MD, an assistant professor at the Medical College of Georgia at Augusta University and bone marrow transplant & cellular therapy faculty member at Georgia Cancer Center, focused on key developments across the AML space. At his institution, Peters and colleagues are evaluating potential drivers of immune dysfunction, which may inform less intensive cellular therapy approaches or determine who is suitable to receive autologous types of treatment. Peters also discussed how additional research set for presentation at meetings like the 2025 American Society of Hematology Annual Meeting and Exposition (ASH) may affirm a shift away from 7+3 intensive chemotherapy for patients who are younger and fit with newly diagnosed AML.

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In a collaborative podcast with the American Psychosocial Oncology Society hosted by Daniel C. McFarland, DO, guests Louis P. Voigt, MD, and Yesne Alici, MD, discussed the ethical and clinical complexities of assessing decision-making capacity (DMC) in oncology, emphasizing its role as the ethical core of person-centered care. The discussion began by dissecting modern medicine’s need for formal DMC assessment. Voigt framed DMC as a fundamental issue of patient rights and respect, asserting that every human being has absolute rights and that the integrity of a person requires honoring their self-determination. He advocated for clinicians to act as professionals, earn trust, customize their approach based on individual needs through precision medicine, and demonstrate humility by re-explaining information when a patient cannot summarize their understanding.

Alici provided a detailed clinical framework for DMC, defining it as a person’s ability to decide on the specific issue at hand while appreciating the foreseeable consequences. She outlined the 4 key elements, or pillars, of the assessment: the patient’s ability to understand the information, to appreciate the risks and benefits, to provide a rationalization for the decision to ensure no delusional thinking interferes, and to communicate a consistent choice. She clarified that DMC is decision-specific and time-dependent, emphasizing that conditions like dementia, schizophrenia, major depression, or even a central nervous system malignancy do not automatically mean a patient lacks capacity; it must be assessed for each situation and may be restored if cases like delirium are reversible. She cautioned that clinicians must be mindful of potential mislabeling when patients with aphasia interact, as simple gestures may not fully represent informed consent.

Finally, the experts addressed the crucial implications that follow an assessment of incapacity. Voigt highlighted that a lack of DMC is not a "stop sign"; decisions must still be made, requiring the health care team to look to a designated proxy or the patient’s next-of-kin. He stressed the need for hospitals to establish system-wide processes and workflows to prepare all stakeholders for these contingencies and help patients become familiar with advanced directives, thereby reducing the immense emotional burden placed on surrogates who must perform substituted judgment. McFarland concluded that being aware of DMC elevates the quality of care, reinforces an ethical climate, and enhances the entire organization.

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being a psycho-oncology editorial advisory board member for the journal ONCOLOGY. Voigt is an intensivist and chair of the Ethics Committee at Memorial Sloan Kettering Cancer Center (MSKCC). Alici is vice chair of Clinical Operations in the Department of Psychiatry and Behavioral Sciences, clinical director, associate attending psychiatrist, and medical director of the Biobehavioral Health Clinic at MSKCC.

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In a conversation with CancerNetwork®, Michael Barish, PhD, spoke about an investigational CAR T-cell therapy that he and colleagues are developing as a treatment for patients with glioblastoma. He and his team designed the agent to harness chlorotoxin, an amino acid peptide toxin component of scorpion venom, as a vehicle for intratumoral delivery of therapy for this patient population.

Barish, a chair in the Department of Neurosciences/Developmental & Stem Cell Biology at City of Hope, discussed the background and mechanisms surrounding this novel compound, which he and colleagues evaluated as part of a phase 1 trial (NCT04214392). Early findings published in Cell Reports Medicine showed that among 4 patients with recurrent glioblastoma, 3 (75%) achieved a best response of stable disease. Additionally, the chlorotoxin-directed cellular therapy was found to be well-tolerated with no dose-limiting toxicities. Although responses were not as strong as Barish and colleagues had hoped, he described how the study nevertheless demonstrated the safety and feasibility of this CAR T-cell therapy formulation.

After establishing the safety of the novel agent in patients with recurrent glioblastoma, Barish highlighted how next steps for research included engineering different versions of the chlorotoxin and modifying the T cells that express the chimeric receptor. He stated these reconfigurations may help yield additional power and efficacy of the cellular therapy in future studies. Overall, Barish noted how the potential therapeutic application of the neurotoxin represented a “proof of principle.”

“[V]enoms of many invertebrates are, in fact, very powerful biologically. In a sense, evolution has honed them to be relatively specific. Neurobiology is very much driven by the specificity of different toxins for different ion channels,” Barish stated. “This idea—that one could use biological products efficiently this way for something as heterogeneous as glioblastoma—might be an example of how it could be more efficacious for other solid tumors as well.”

Reference
Barish ME, Aftabizadeh M, Hibbard J, et al. Chlorotoxin-directed CAR T cell therapy for recurrent glioblastoma: interim clinical experience demonstrating feasibility and safety. Cell Rep Med. 2025;6(8):102302. doi:10.1016/j.xcrm.2025.102302.

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The latest episode of Oncology On the Go focused on survivorship and supportive care. Stemming from conversations with leading clinicians in the field, the compilation highlights gaps and educational insights into multiple areas.

Covering topics like nutrition, oncodermatology, body image, sexual health, and mortality, these conversations explored how to truly optimize multidisciplinary cancer care.

Declan Walsh, MD, chair of the Department of Supportive Oncology at Atrium Health Levine Cancer Institute:

1:01-2:44: What is the importance of developing and managing supportive care at major oncology centers, and how can it be adapted across the US?

2:45-4:19: Supportive care is one piece of the multidisciplinary team. How can clinicians work with supportive care specialists to ensure that patients are receiving all the help that they need?

Denise Reynolds, RD, of Atrium Health Levine Cancer Institute:

4:20-5:46: Some adverse effects (AEs) include severe nausea and vomiting. What nutritional strategies do you recommend to ensure adequate intake?

5:47-7:29: Taste and smell changes are common AEs. What advice do you give to patients to help cope and combat them?

Adam Friedman, MD, FAAD, professor and chair of dermatology, director of the Residency Program, and director of translational research at George Washington Medical Faculty Associates in Washington, DC:

7:30-9:24: Your study found that a significant proportion of respondents, including those who have been previously treated for cancer, would decline anti-cancer therapies due to dermatologic AEs like hair loss. What are some crucial communication strategies oncologists should employ to address this?

9:25-11:37: What should all oncology clinicians know about how to manage mild to moderate dermatologic AEs?

11:38-24:54: Daniel C. McFarland, DO, the director of the Psycho-Oncology Program at Wilmot Cancer Center; a medical oncologist who specializes in head, neck, and lung cancer; and the psycho-oncology editorial advisory board member for the journal ONCOLOGY®, spoke with different psycho-oncology colleagues regarding topics like body image, sexual health, and mortality.

These colleagues included Michelle Fingeret, PhD, founder of Fingeret Psychology Services; Christian J. Nelson, PhD, chief of Psychiatry Service, attending psychologist, and codirector of the Psycho-Oncology of Care and Aging Program at Memorial Sloan Kettering Cancer Center; and William S. Breitbart, MD, attending physician and the Jimmie C. Holland Chair in Psycho-Oncology at Memorial Sloan Kettering Cancer Center.

All psycho-oncology episodes are now available on our website.

Reference
Menta N, Vidal SI, Whiting C, Azim SA, Desai S, Friedman A. Perceptions and knowledge of dermatologic side effects of anti-cancer therapies: a pilot survey. J Drugs Dermatol. 2025;24(8):e57-e58.

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Following a fruitful European Society of Medical Oncology (ESMO) Congress 2025 for gastrointestinal malignancies, CancerNetwork® organized an X Spaces discussion hosted by 3 experts. They were Nicholas J. Hornstein, MD, an assistant professor at the Donald and Barbara Zucker School of Medicine of Hofstra University and Northwell Health; Timothy Brown, MD, an assistant professor in the Department of Internal Medicine and the associate program director of the Hematology & Oncology Fellowship at UT Southwestern Medical Center; and Udhayvir S. Grewal, MD, an assistant professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine.

Each doctor focused on a specific disease type, highlighting the most important abstracts in colorectal cancer, pancreatic neuroendocrine tumors (NETs), and upper gastrointestinal cancers.

The Phase 3 MATTERHORN Trial (NCT04592913)
Results from MATTERHORN demonstrated that adding durvalumab (Imfinzi) to 5-fluorouracil, leucovorin (folinic acid), oxaliplatin, and docetaxel (FLOT) improved overall survival (OS) compared with FLOT plus placebo in patients with resectable gastric/gastroesophageal junction (GEJ) adenocarcinoma, regardless of pathological status.1

In the intention-to-treat population, the median OS was not reached in either arm, and the hazard ratio (HR) was 0.78 (95% CI, 0.63-0.96; P = .021). Notably, the improvement was observed regardless of PD-L1 status; in patients with PD-L1–positive disease, the HR was 0.79 (95% CI, 0.63-0.99), and in patients with PD-L1–negative disease, the HR was 0.79 (95% CI, 0.41-1.50).

“This, I believe, will seal durvalumab plus FLOT as the standard of care for resectable [gastric/GEJ] cancers,” said Brown.

The Observational ASPEN Study (NCT03084770)
The ASPEN study showed that active surveillance was a safe approach for patients with low-grade, asymptomatic, nonfunctioning pancreatic neuroendocrine tumors (NETs) fewer than 2 centimeters in size.2

Of the 1000 patients enrolled in the trial, 20 patients died, of whom 18 underwent active surveillance and 2 underwent surgery. Nineteen of the deaths were unrelated to pancreatic NETs; 1 death in the surgery arm was related to a pancreatic NET. After surgery, 5 patients had disease relapse or progression. With a median follow-up of 42 months (IQR, 25-60), the OS analysis showed a P value of 0.530.

“This really settles the debate on whether or not to surgically operate on patients with a [pancreatic NET] size of [fewer] than 2 centimeters and shows that active surveillance is a safe option for these patients with pancreatic NETs [fewer] than 2 centimeters in size and non-functional NETs,” said Grewal.

Data From the Phase 2/3 FOxTROT (NCT00647530) and Phase 2 NICHE-2 (NCT03026140) Trials
Neoadjuvant nivolumab (Opdivo) plus ipilimumab (Yervoy) achieved a clinically meaningful and statistically significant improvement in long-term outcomes, including responses and survival, compared with chemotherapy strategies in patients with mismatch repair deficient (dMMR) or microsatellite instability–high (MSI-H) locally advanced colon cancer.3

In NICHE-2, neoadjuvant nivolumab plus ipilimumab achieved a 3-year disease-free survival (DFS) rate of 100% compared with 80% (95% CI, 73%-85%) with all chemotherapy strategies in FOxTROT (P <.001). Nivolumab plus ipilimumab maintained a 100% DFS rate in patients with clinical stage T3 and T4 disease in NICHE-2, whereas FOxTROT achieved DFS rates of 84% (95% CI, 76%-90%) and 70% (95% CI, 58%-80%), respectively (P <.001).

Additionally, nivolumab plus ipilimumab achieved a pathologic complete response (pCR) rate of 72.3%, with a pathologic partial response (pPR) rate of 25.5% and no response in 1.1%. Chemotherapy achieved a pCR rate of 4.3%, a pathologic pPR rate of 2.6%, and a mild to no response rate of 91.4%.

“Overnight, this should change the standard of care, even if the FDA hasn’t caught on yet, at least from my perspective. If I find out about a [patient with] MSI-H disease before they go to the [operating room], I’m probably running [to give them ipilimumab plus nivolumab],” said Hornstein.

References
1. Tabernero J, Al-Batran S-E, Wainberg ZA, et al. Final overall survival (OS) and the association of pathological outcomes with event-free survival (EFS) in MATTERHORN: a randomised, phase III study of durvalumab (D) plus 5-fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT) in resectable gastric / gastroesophageal junction (G / GEJ) adenocarcinoma. Presented at: ESMO 2025 Congress; October 17–21, 2025; Berlin, Germany. Abstract LBA81.

Partelli S, Andreasi V, Zerbi A, et al. Management of asymptomatic sporadic nonfunctioning pancreatic neuroendocrine neoplasms ≤2 cm: a prospective international observational multicentric cohort study ASPEN study. Presented at: ESMO 2025 Congress; October 17–21, 2025; Berlin, Germany. Abstract LBA36.
Seligmann J, van den Dungen LDW, Balduzzi S, et al. Comparison of outcomes in clinical trials of locally advanced dMMR colon cancer: data from the FOxTROT and NICHE-2 trials. Presented at: ESMO 2025 Congress; October 17–21, 2025; Berlin, Germany. Abstract 7240.

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As part of the European Society for Medical Oncology (ESMO) Congress 2025,CancerNetwork® spoke with a variety of experts about key takeaways from different late-breaking abstracts, oral presentations, and other sessions focused on potential advancements across cancer care. Presenting investigators highlighted updated results from clinical trials evaluating novel therapeutic strategies across different cancer populations, including breast cancer and lung cancer.

Phase 3 VIKTORIA-1 Trial
Sara A. Hurvitz, MD, FACP, the Smith Family Endowed Chair in Women’s Health and senior vice president and director of the Clinical Research Division at the Fred Hutch Cancer Center, and tumor chair in breast oncology for the ONCOLOGY® editorial advisory board, first discussed findings from the phase 3 VIKTORIA-1 trial (NCT05501886). Her presentation highlighted how VIKTORIA-1 was “the first study to demonstrate a statistically significant and clinically meaningful improvement in progression-free survival [PFS] with PAM inhibition” for patients with PIK3CA wild-type advanced breast cancer.

Data from the trial showed that gedatolisib plus fulvestrant (Faslodex) and palbociclib (Ibrance) produced a median PFS of 9.3 months (95% CI, 7.2-16.6) vs 2.0 months (95% CI, 1.8-2.3) with fulvestrant alone (HR, 0.24; 95% CI, 0.17-0.35; P <.0001). Additionally, gedatolisib plus fulvestrant yielded a median PFS of 7.4 months (95% CI, 5.5-9.9), reducing the risk of progression or death by 67% vs fulvestrant monotherapy (HR, 0.33; 95% CI, 0.24-0.48; P <.0001).

Phase 1/2 SOHO-01 Trial
Next, Xiuning Le, MD, PhD, spoke about her presentation on data from the phase 1/2 SOHO-01 trial (NCT05099172). In her presentation, Le, an associate professor in the Department of Thoracic/Head and Neck Medical Oncology of the Division of Internal Medicine at the University of Texas MD Anderson Cancer Center, described sevabertinib as a “potential new targeted therapy for patients with HER2-mutant non–small cell lung cancer [NSCLC].”

Among 81 patients with previously treated HER2-mutated advanced NSCLC who received sevabertinib in cohort D, the study treatment produced an overall response rate (ORR) of 64% (95% CI, 53%-75%) and a median duration of response (DOR) of 9.2 months (95% CI, 6.3-13.5). Among 55 patients who received prior HER2 antibody drug conjugates (ADCs) in cohort E, the ORR was 38% (95% CI, 25%-52%), and the median DOR was 8.5 months (95% CI, 5.6-16.4). Moreover, regarding 73 patients with treatment-naive disease in cohort F, these respective values were 71% (95% CI, 59%-81%) and 11.0 months (95% CI, 8.1-not evaluable).

Phase 3 evERA Trial
Finally, Erica Mayer, MD, MPH, director of breast cancer research at Dana-Farber Cancer Institute and associate professor of Medicine at Harvard Medical School, detailed results from the phase 3 evERA trial (NCT05306340). In her presentation, Mayer stated that giredestrant plus everolimus (Afinitor) may “represent a new, effective, all-oral treatment option in the post-CDK 4/6 inhibitor setting” for those with estrogen receptor (ER)–positive, HER2-negative advanced breast cancer.

Across the intent-to-treat population, data revealed a median PFS of 8.77 months (95% CI, 6.60-9.59) with giredestrant plus everolimus vs 5.49 months (95% CI, 4.01-5.59) with standard endocrine therapy plus everolimus (HR, 0.56; 95% CI, 0.44-0.71; P <.0001). Among patients with ESR1-mutated disease, the median PFS was 9.99 months (95% CI, 8.08-12.94) vs 5.45 months (95% CI, 3.75-5.62) in each respective arm (HR, 0.38; 95% CI, 0.27-0.54; P <.0001).

References
1. Hurvitz SA, Layman RM, Curigliano G, et al. Gedatolisib plus fulvestrant, with & without palbociclib, vs fulvestrant in patients with HR+/HER2-/PIK3CA wild-type advanced breast cancer: first results from VIKTORIA-1. Presented at the European Society for Medical Oncology (ESMO) Congress 2025; October 17-21, 2025; Berlin, Germany. Abstract LBA17. 2. Le X, Kim TM, Dong X, et al. Sevabertinib (BAY 2927088) in advanced HER2-mutant non-small cell lung cancer (NSCLC): results from the SOHO-01 study. Presented at the European Society for Medical Oncology Congress 2025; October 17-21, 2025; Berlin, Germany. Abstract LBA75. 3. Mayer E, Tolaney SM, Martin M, et al. Giredestrant (GIRE), an oral selective oestrogen receptor (ER) antagonist and degrader, + everolimus (E) in patients (pts) with ER-positive, HER2-negative advanced breast cancer (ER+, HER2– aBC) previously treated with a CDK4/6 inhibitor (i): Primary results of the phase III evERA BC trial. Presented at the European Society for Medical Oncology Congress 2025; October 17-21, 2025; Berlin, Germany. Abstract LBA16.

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In a discussion with CancerNetwork®, Anne Chiang, MD, PhD, spoke about the current treatment landscape for those with small cell lung cancer (SCLC) as well as next steps for elevating the quality of care among patients. She began by outlining the evolution of therapeutic standards in the field, with atezolizumab (Tecentriq)- and durvalumab (Imfinzi)-based regimens emerging as key frontline strategies and lurbinectedin (Zepzelca) and tarlatamab-dlle (Imdelltra) demonstrating utility as second-line therapies.

Regarding novel treatments that may hold promise in the SCLC field, Chiang, an associate professor of medicine in the Section of Medical Oncology at Yale School of Medicine, highlighted her work on the phase 2 SWOG S2409 PRISM trial (NCT06769126). Here, Chiang and colleagues plan to collect tissue from more than 800 patients undergoing frontline induction therapy with chemoimmunotherapy to inform subsequent biomarker-directed treatment, which may help elucidate factors of disease heterogeneity in the process.

The conversation also focused on considerations for improving the care of those with lung cancer in community-based settings, as Chiang emphasized spreading knowledge of therapeutic advances to a broader patient population. She noted that there is “still a bit of nihilism about the prognosis” of patients with SCLC, describing a need to further leverage the field’s understanding of biology to impart the benefits of immunotherapy to more patients. Chiang also detailed the importance of employing patient-reported outcomes to hear directly from the patient, which may ensure their inclusion in the shared decision-making process and optimize strategies for mitigating potential adverse effects during treatment.

“Understanding and leveraging the biology is important. We are going to need to understand how to sequence therapies, and that involves understanding which patients are at higher risk,” Chiang stated regarding future initiatives in the field. “We need to look at high-risk populations—for example, patients with brain metastases—and understand which therapies are especially useful for them.”

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In a conversation with CancerNetwork®, Jorge Cortes, MD, explored the evolution of the chronic myeloid leukemia (CML) landscape. Specifically, he highlighted how the development of ibrutinib (Gleevec) paved the way for other tyrosine kinase inhibitors (TKIs) and described where research must go next in terms of implementing fixed-duration therapy and targeting genetic abnormalities.

Cortes, the director, and Cecil F. Whitaker Jr., GRA Eminent Scholar Chair in Cancer at the Georgia Cancer Center, began by detailing the standards of care that existed before the development of imatinib. He noted that many patients did “not have great options,” as neither interferon nor transplant was associated with “good” outcomes.

Following its approval for patients with CML in 2001, imatinib became what Cortes described as a “groundbreaker” in the field. He explained how imatinib’s newfound status as a standard of care in CML would signal the advancement of a second generation of TKIs, which included agents like dasatinib (Sprycel), nilotinib (Tasigna), and bosutinib (Bosulif). Even with the subsequent development of third-generation TKIs, Cortes stated that researchers are continuing to improve and innovate to help provide patients with enhanced quality of life.

Looking towards the future, Cortes observed 2 major goals to achieve in CML research. The first objective is to stop therapy more effectively and give a greater portion of patients a more precisely defined duration of treatment. He noted that approximately 25% to 30% of patients today can effectively discontinue therapy without having to resume treatment, which wasn’t even considered a possibility in the field 20 years ago. Moreover, he emphasized that finding the therapeutic options that work best in a subset of patients with recently discovered genetic abnormalities may yield a breakthrough.

“In terms of whether we are getting closer to a cure, I think we are. We can stop therapy effectively in some patients, which is equivalent to a cure,” Cortes said. “If [a patient has] done well, and you can stop therapy and the disease doesn't come back, that's essentially what we think about as a cure. We are there, just not on as many patients as we want.”

Reference
Center for Drug Evaluation and Research: Application Number: NDA 21-335. FDA. May 10, 2001. Accessed October 6, 2025. https://tinyurl.com/44xh2u9j

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In a special co-branded episode between Oncology On the Go, hosted by CancerNetwork®, and the American Society for Transplantation and Cellular Therapy (ASTCT)’s program, ASTCT Talks, for American Pharmacists Month, a panel of oncology pharmacists discussed optimal strategies for using cellular therapies as treatment for patients with solid tumors. The panel included Brooke Adams, PharmD, BCOP, a board-certified oncology pharmacist specializing in stem cell transplantation and cellular therapy at the Orlando Health Cancer Institute in Orlando, Florida; Natalie Brumwell, PharmD, BCOP, a board-certified oncology pharmacist specializing in cellular therapy at Memorial Sloan Kettering Cancer Center in New York, New York; and Bryant A. Clemons, PharmD, a board-certified oncology pharmacist specializing in hematology, blood and marrow transplantation, and cellular therapy at the University of Kentucky’s Markey Cancer Center in Lexington, Kentucky.

The discussion focused on the use of the first commercially available tumor-infiltrating lymphocytes (TILs) for patients with unresectable or metastatic melanoma, lifileucel (Amtagvi), which the FDA granted accelerated approval statusto in February 2024.1 The panelists first reviewed supporting data from the phase 2 C-144-01 trial (NCT02360579), in which lifileucel demonstrated an objective response rate of 31.5% (95% CI, 21.1%-43.4%), and a median duration of response that was not reached (NR; 95% CI, 4.1 months-NR) at the time of the approval. Additionally, the group highlighted considerations for dosing interleukin-2 (IL-2), including management of toxicities and when to hold or discontinue further doses.

Following a thorough breakdown of the proper conditions for using lifileucel in melanoma, the panelists concluded by discussing how to build upon an “exciting time for cellular therapy in solid tumors.” As part of optimizing the dosing of lifileucel and other cellular therapies in these patient populations, the experts exchanged ideas on how practices can collaborate across institutions and departments to expand access to novel treatments while helping providers develop comfort in administering these agents.

Reference
FDA grants accelerated approval to lifileucel for unresectable or metastatic melanoma. News release. FDA. February 16, 2024. Accessed September 30, 2025. https://tinyurl.com/2kweca6x

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In a conversation with CancerNetwork® following the FDA approval of the gemcitabine intravesical system (Inlexzo; formerly TAR-200) for patients with high-risk, Bacillus Calmette-Guérin (BCG)–unresponsive non–muscle-invasive bladder cancer (NMIBC), Gary Steinberg, MD, discussed how this regulatory decision may impact the treatment paradigm.

Steinberg, a professor in the Department of Urology at Rush University, highlighted an unmet need for those with BCG-unresponsive, high-grade NMIBC. With a different mechanism of action compared with prior therapeutic choices in the field, he stated that the gemcitabine intravesical system may allow patients and physicians to benefit tremendously. Based on supporting data from the phase 2 SunRISe-1 trial (NCT04640623), he described how the gemcitabine intravesical system may replace prior standards such as intravesical gemcitabine plus docetaxel.

The conversation also touched upon considerations for preventing the risk of progression to metastatic disease with delayed cystectomy, as Steinberg emphasized following up with patients via cystoscopies, urinary cytologies, CT scans, or MRI imaging after treatment with the intravesical system. Steinberg also detailed strategies for mitigating urinary frequency, dysuria, and other toxicities associated with the therapy. He noted a “fine line” regarding bladder medication administration to older patient populations, as these practices may cause adverse effects such as dry mouth, constipation, and blurry vision.

Looking ahead, Steinberg illustrated a need to clarify the immunologic effects of regimens like the gemcitabine intravesical system, which can inform the use of additional therapeutic combinations down the road. He highlighted how other novel agents like cretostimogene grenadenorepvec (CG0070) may further improve outcomes in the NMIBC landscape.

“One of the key questions that we all need to ask with all our treatments is not about the patients who respond, but about the patients who do not respond,” Steingerg stated regarding the potential next steps for research. “We can begin to understand mechanisms of resistance so that we can target those mechanisms of resistance and treat them better.”

Reference
U.S. FDA approval of INLEXZO (gemcitabine intravesical system) set to transform how certain bladder cancers are treated. News release. Johnson & Johnson. September 9, 2025. Accessed September 22, 2025. https://tinyurl.com/4zjz22z7

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In the recent episode of Oncology-on-the-Go, in collaboration with the American Psychosocial Oncology Society (APOS), Daniel C. McFarland, DO, welcomes William S. Breitbart, MD, to discuss how clinicians can address patients’ existential concerns. While oncologists often focus on treatment and the drive for life, the core concern for many patients remains mortality. Breitbart’s work in meaning-centered therapy provides a framework for these difficult conversations.

Breitbart emphasizes that patients grappling with fear, uncertainty, and depression may not always express it directly. The goal of meaning-centered therapy is to help patients find a sense of purpose and peace, even as they face a terminal illness. This approach is not about eliminating suffering, but about helping patients find meaning in their experiences. The conversation covers the practical application of these principles, including how to bring up topics of death and dying, and the importance of validating a patient's fears without resorting to platitudes.

The discussion also touches on the concept of “existential guilt,” which Breitbart links to the human awareness of one’s own existence and mortality. He notes that many clinicians are drawn to oncology or psycho-oncology because of their own personal experiences with death and illness. Overall, the episode is a reminder for oncologists and their multidisciplinary team members to look beyond the treatment and its clinical outcomes, and engage in human conversations that can significantly improve a patient’s quality of life, emotional support, and overall well-being.

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At the Society of Hematologic Oncology 2025 Annual Meeting, CancerNetwork® spoke with a variety of experts about notable clinical developments and trial results across the hematologic oncology landscape. Throughout the meeting, clinicians and researchers discussed the latest data and initiatives in myelofibrosis, multiple myeloma, lymphoma, and other types of blood cancer.

Francesca Palandri, MD, PhD, an adjunct professor in the Department of Medical and Surgical Sciences at the University of Bologna in Bologna, Italy, shared insights from a session focused on exploring predictive markers for the efficacy of ruxolitinib (Jakafi) among patients with myelofibrosis.1 Noting variance in response rates as well as possibilities of disease progression or treatment discontinuation associated with ruxolitinib, Palandri emphasized the importance of assessing predictors of response to better orient clinical decision-making strategies regarding the agent’s use. She also highlighted how factors such as cytopenic phenotype, higher peripheral blast counts, and higher burden of disease may impact response rates and survival among patients.

Additionally, Sundar Jagannath, MD, a professor of Medicine specializing in hematology and medical oncology at the Icahn School of Medicine at Mount Sinai and The Tisch Cancer Institute, spoke about his presentation on potentially defining a cure in the management of multiple myeloma.2 He described the importance of “chang[ing] the dialogue” in multiple myeloma to give hope to patients and encourage physicians to engage in patient care more optimally. By defining a cure in multiple myeloma, Jagannath stated, it may be possible to offer more finite durations of treatment and stop therapy with the confidence that patients will not relapse.

Finally, Adam J. Olszewski, MD, an associate professor of medicine at The Warren Alpert Medical School of Brown University, discussed his work on the phase 3 SUNMO trial (NCT05171647).3 Findings from this presentation showed that mosunetuzumab-axgb (Lunsumio) plus polatuzumab vedotin-piiq (Polivy; M-Pola) reduced the risk of progression or death by 59% vs rituximab (Rituxan) with gemcitabine and oxaliplatin (R-GemOx) in relapsed/refractory large B-cell lymphoma (LBCL). Olszewski also outlined next steps for refining treatment strategies in this patient population.

References
1. Palandri F. Predictive markers for ruxolitinib in MF. Presented at the Society of Hematologic Oncology 2025 Annual Meeting; September 3-6, 2025; Houston, TX. 2. Jagannath S. Is it time to say “CURE” in multiple myeloma? Presented at the Society of Hematologic Oncology 2025 Annual Meeting; September 3-6, 2025; Houston, TX. 3. Westin J, Zhang H, Kim W, et al. Mosunetuzumab plus polatuzumab vedotin is superior R-GemOx in transplant-ineligible patients with R/R LBCL: primary results of the phase III SUNMO trial. Presented at the Society of Hematologic Oncology 2025 Annual Meeting; September 3-6, 2025; Houston, TX. Abstract ABCL-1492.

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In this episode, CancerNetwork® spoke with Joseph S. Wallins, MD, MPH, cardiology fellow at Weill Cornell Medicine, about a review of cardiotoxicities associated with breast cancer treatment he coauthored in the June 2025 issue of ONCOLOGY® titled, “Cardio-Oncology Considerations for Breast Cancer: Risk Stratification, Monitoring, and Treatment.” Therein, he touched upon data for risk stratification tools for oncologists, as well as the development of cardiovascular testing for individual treatment regimens.

Wallins discussed the basis for conducting the systemic review as well as noteworthy cardiotoxicities associated with specific classes of breast cancer therapies. Specifically, he highlighted an increase in cancer remission and survivorship for breast cancer, which has, in turn, created alternative health risks impacting survival outcomes, such as cardiovascular risks. Citing a study showing a nearly 2-fold risk in cardiovascular-related fatalities for breast cancer survivors vs the general population, he suggested that the review was warranted to identify cardiotoxicities, strategies for preventing and managing them, and tools for risk stratification and monitoring.

Wallins further outlined considerations for optimizing risk stratification and monitoring strategies in patients at risk of experiencing cardiovascular toxicities as well as treatments that may help with their prevention or mitigation. To that end, he discussed identifying patients who are at a higher risk before initiating treatment and outlined risk assessment tools that serve to do so. Furthermore, he suggested that patients who experience a greater than moderate risk for cardiovascular issues should undergo cardioprotective strategies and have in-depth conversations with providers regarding treatment risks.

He concluded by highlighting future steps to enhance cardiovascular outcomes for patients with breast cancer, among additional key takeaways. Of note, Wallins expressed that genetic testing may help elucidate cardiomyopathy-associated genes while calling for a more personalized approach to risk stratification and more sensitive and specific imaging techniques to better identify at-risk patients. Finally, he emphasized a need for upfront risk assessment to identify patients at a higher risk who could benefit from additional testing as well as more pronounced collaboration between oncologists and cardiologists.

Reference
Bradshaw PT, Stevens J, Khankari N, Teitelbaum SL, Neugut AI, Gammon MD. Cardiovascular disease mortality among breast cancer survivors. Epidemiology. 2016;27(1):6-13. doi:10.1097/EDE.0000000000000394

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In a recent episode of the Oncology-on-the-Go podcast in collaboration with the American Psychosocial Oncology Society (APOS), host Daniel C. McFarland, DO, was joined by Christian J. Nelson, PhD, to discuss the often-overlooked subject of sexual health issues for men after cancer treatment. The discussion emphasized the importance of a nuanced approach to men's health, particularly in the context of genitourinary cancers like prostate and testicular cancer.

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer in addition to being the psycho-oncology editorial advisory board member for the journal ONCOLOGY®. He opened the conversation by highlighting that while cancer’s physical effects are well-documented, the mental and emotional toll is equally significant and often underappreciated in male patients. He highlighted that the field of psycho-oncology, which began with breast cancer, is now expanding to address men’s specific needs. Men, he noted, are less likely to seek mental health support, yet have a higher risk of suicide, particularly at key moments in their cancer journey like diagnosis and recurrence.

Nelson, chief of Psychiatry Service, attending psychologist, and codirector of the Psycho-Oncology of Care and Aging Program at Memorial Sloan Kettering Cancer Center, underscored that cancer treatments, especially for prostate cancer, often have profound adverse effects (AEs) that impact a man’s sense of self and masculinity.

He detailed the effects of radical pelvic treatments and androgen deprivation therapy (ADT), which can lead to urinary incontinence, erectile dysfunction, and changes in sexual function and body image. These AEs can lead to feelings of being "broken," "inadequate," or "deflated."

The pair discussed the "double-edged sword" of normalizing cancer, where patients are told their prognosis is good but are left unprepared for the life-altering AEs. This can lead to a sense of cognitive dissonance and isolation. The conversation stressed the need for clinicians to proactively normalize discussions about sexual health, making it clear that these are standard and expected aspects of the cancer experience.

Both clinicians suggested that establishing a trusting relationship with patients is paramount and that referrals to psycho-oncology should be framed as an essential, not optional, component of treatment. They also recommend that clinicians consistently check in with their male patients about emotional and sexual well-being, even long after treatment has ended, to ensure they’re coping with the lasting impacts of their experience.

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In a conversation with CancerNetwork®, Geraldine O’Sullivan Coyne, MD, MRCPI, PhD, spoke about her new appointmentas the principal investigator and director of Clinical Research at the Northwell Health unit of the Southern Texas Accelerated Research Therapeutics (START) Center for Cancer Research. Based on a strategic partnership formed between Northwell Health and START in May 2024, she will oversee early-phase clinical trial development at New York’s first START research site at the R.J. Zuckerberg Cancer Center in New Hyde Park.

Coyne began by sharing her excitement to put all her efforts into making the unit a “good opportunity” to consider patients who reside in community settings for enrollment in new clinical trials. Although large academic centers may offer possibilities for enrolling in trials, Coyne highlighted how many patients may need to travel or leave their social networks behind as they undergo treatment, thus illustrating a need for expanded options in the community setting.

“Having the privilege to be able to bring trial opportunities into the community—into the heart of the community—is what we are aiming to do,” Coyne stated about her new role. “We do believe that this will [allow] patients to access novel and powerful therapies that are now increasingly part of a personalized treatment paradigm for patients with advanced malignancies.”

Emphasizing the pursuit of early-phase clinical investigations, Coyne described how the new unit may leverage START’s expertise to advance novel molecules across all stages of the drug development pipeline up to regulatory approval. She noted that being able to safely create and refine new therapeutic approaches in the community setting lies at the heart of a successful collaboration between Northwell Health and START.

“A lot of the excitement surrounding the START unit and Northwell Health collaboration with them is exploring these novel molecules that will hopefully continue to build on the pursuit in oncology drug development, which has been finding better and more targeted therapies for patients in their treatment journey,” Coyne said.

Reference
Olt B. Northwell names Geraldine O’Sullivan Coyne, MD, PhD, to lead clinical trials at new START center. News release. Northwell Health. July 22, 2025. Accessed August 12, 2025. https://tinyurl.com/bdcua8ck

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In the inaugural podcast episode created in collaboration with the American Psychosocial Oncology Society (APOS), Daniel C. McFarland, DO, and Michelle Fingeret, PhD, explored the critical, yet often overlooked, issue of body image in patients with cancer. McFarland opened the discussion by acknowledging the significant psychosocial challenges clinicians face and highlighted the therapeutic power of the patient-oncologist relationship, which extends beyond medical treatments.

Fingeret defined body image as a person’s total relationship with their body, encompassing not only appearance but also function and sensory experiences. She emphasized that body image changes are universal experiences for patients with cancer that affect all aspects of their lives. Despite their prevalence, Fingeret suggested that many clinicians feel ill-equipped to address these issues, and that patients are often reluctant to raise the topic due to feelings of shame or a desire not to "burden" their health care providers.

The discussion delved into the spectrum of body image concerns, ranging from mild distress to severe functional impairment. Fingeret distinguished between clinical body dysmorphic disorder and other changes patients experience, stressing that their distress is a valid reaction to actual bodily alterations. She provided a framework for clinicians to assess a patient's concerns, urging them to listen carefully to the language patients use. Patients may describe their bodies with inflammatory words like "deformed" or use avoidance strategies, such as refusing to look in a mirror. Fingeret noted how these are important cues that signal a need for a deeper conversation.

Practical advice was also offered on how to initiate these conversations. Instead of normalizing a patient’s concerns with platitudes like "Your hair will grow back," clinicians should validate their feelings by creating a safe space for them to talk openly. Simple, curious questions—such as "How does that make you feel?" or "Have you looked at yourself in the mirror?"—can open the door to a more meaningful dialogue. The goal of intervention, Fingeret explained, is not to force the patient to love their body, but to help them achieve a greater level of body image acceptance.

The conversation concluded with a focus on redefining success. McFarland noted that patients often hope to "go back to where they were before," an unrealistic goal. Fingeret reinforced this point, stating that a key part of the work is helping patients develop flexible, realistic expectations. Success is often found in incremental progress, such as reducing avoidance behaviors or finding more fulfillment in social relationships, rather than in the complete elimination of body image distress.

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head and neck and lung cancer. He is also the psycho-oncology editorial advisory board member for the journal ONCOLOGY. Fingeret is the founder of Fingeret Psychology Services and specializes in body image and cancer.

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In a conversation with CancerNetwork® at the 2025 National Immune Cell Effector Therapy (ICE-T) Conference, Tiba Al Sagheer, PharmD, BCOP, BCACP; Rebecca Gonzalez, PharmD, BCOP, FASTCT; and Syeda Saba Kareem PharmD, BCOP, spoke about their presentations on managing adverse effects (AEs) across different hematologic malignancy populations. At the meeting, Al Sagheer, Gonzalez, and Kareem presented their ideas for treating patients with lymphoma, leukemia, and multiple myeloma, respectively.

Al Sagheer is a Pharmacy Quality Improvement Coordinator and Transplant/Cellular Therapy and Hematology Clinical Pharmacy Specialist at Miami Cancer Institute of Baptist Health South Florida. Gonzalez is a clinical pharmacy specialist in Blood and Marrow Transplantation and Cellular Immunotherapy at Moffitt Cancer Center. Kareem is a clinical pharmacy supervisor in Malignant Hematology at Moffitt Cancer Center.

Across different disease states, the presenters outlined the most common toxicities associated with CAR T-cell therapy, bispecific antibodies, and other novel immunotherapies. Additionally, they described strategies for reducing the severity of AEs such as cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome as well as other oral, dermatological, and nail toxicities. Other key considerations for preserving quality of life among those receiving cellular therapy included risk stratifying patients based on tumor burden and inflammatory markers at baseline to inform prophylactic measures.

Each presenter shared key takeaways for treating patients who experience treatment-related AEs based on their individual presentations. Al Sagheer emphasized that it is not “one size fits all” when it comes to therapy, as providers must tailor their use of specific drugs, prophylactic measures, and anti-infective medication to each individual patient. Kareem noted that cellular therapy represents an evolving field, as toxicity mitigation strategies will continue to change over time as new data emerge. Finally, Gonzalez underscored the intimate nature of the cellular therapy field, which presents opportunities to collaborate with other institutions and receive guidance on managing complex cases.

References
1. Al Sagheer T. Mastering the management of adverse effects from cellular therapies in lymphoma. Presented at the 2025 National Immune Cell Effector Therapy (ICE-T) Conference; July 26, 2025; Orlando, FL. 2. Gonzalez R. Navigating the challenges: managing adverse effects of cellular therapies in ALL. Presented at the 2025 National Immune Cell Effector Therapy (ICE-T) Conference; July 26, 2025; Orlando, FL. 3. Kareem SS. Management of adverse events of CAR-T and T-cell engagers in myeloma. Presented at the 2025 National Immune Cell Effector Therapy (ICE-T) Conference; July 26, 2025; Orlando, FL.

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In a discussion with CancerNetwork®, Jacob Sands, MD, assistant professor of Medicine at Harvard Medical School, thoracic oncologist at the Dana-Farber Cancer Institute, and investigator of the phase 2 TROPION-Lung05 trial (NCT04484142) and phase 3 TROPION-Lung01 trial (NCT04656652), which supported the accelerated approval of datopotamab deruxtecan-dlnk (dato-DXd; Datroway) in pretreated EGFR-mutant metastatic NSCLC in June 2025, discussed safety and efficacy considerations for the agent’s use.1-3

He began by outlining a combined cohort of the TROPION-Lung05 and TROPION-Lung01 trials, which collectively showed an efficacy benefit with dato-DXd in patients with EGFR-mutant disease vs docetaxel. In the combined cohort, the median progression-free survival with dato-DXd reached 5.8 months, and the median overall survival was 15.6 months. Additional efficacy data revealed an objective response rate of 45% (95% CI, 35%-54%) and a median duration of response of 6.5 months (95% CI, 4.2-8.4).

Furthermore, Sands highlighted the most common toxicities observed with dato-DXd in this population, which included stomatitis, interstitial lung disease (ILD), and ocular toxicities. He also reviewed management strategies to mitigate their incidence and severity. Specifically, remedies include prophylaxis, oral hygiene, and dose reductions for stomatitis; using preservative-free eye drops and ophthalmology visits for ocular toxicity management and prevention; and monitoring for any incidence of high-grade ILD.

He then touched upon next steps for research in this disease state, including the phase 2 ORCHARD trial (NCT03944772) evaluating dato-DXd with osimertinib (Tagrisso) in the second-line setting after progression on osimertinib and the phase 3 TROPION-Lung15 trial (NCT06417814), which is evaluating chemotherapy vs dato-DXd alone or with osimertinib.4,5

Sands concluded by discussing the implications for toxicity management in patients who experience responses that exceed median outcomes, suggesting that the toxicity profile may be more severe for this group. Emphasizing the broadness of outcomes with any drug, he expressed that patients with experiences that deviate from the observed median outcome are an important consideration for clinical practice.

References

Sands J, Ahn MJ, Lisberg A, et al. Datopotamab deruxtecan in advanced or metastatic non-small cell lung cancer with actionable genomic alterations: results from the phase II TROPION-Lung05 study. J Clin Oncol. Published online January 6, 2025. doi:10.1200/JCO-24-01349
Ahn MJ, Tanaka K, Paz-Ares L, et al. Datopotamab deruxtecan versus docetaxel for previously treated advanced or metastatic non-small cell lung cancer: the randomized, open-label phase III TROPION-Lung01 study. J Clin Oncol. Published online September 9, 2024. doi:10.1200/JCO-24-01544
FDA grants accelerated approval to datopotamab deruxtecan-dlnk for EGFR-mutated non-small cell lung cancer. News release. FDA. June 23, 2025. Accessed July 29, 2025. https://tinyurl.com/mtay7ab9
Yu HA, Goldberg SB, Le X, et al. Biomarker-directed phase II platform study in patients with EGFR sensitizing mutation-positive advanced/metastatic non-small cell lung cancer whose disease has progressed on first-line osimertinib therapy (ORCHARD). Clin Lung Cancer. 2021;22(6):601-606. doi:10.1016/j.cllc.2021.06.006
A study to investigate the efficacy and safety of dato-DXd with or without osimertinib compared with platinum based doublet chemotherapy in participants with EGFR-mutated locally advanced or metastatic non-small cell lung cancer (TROPION-Lung15). ClinicalTrials.gov. Updated July 16, 2025. Accessed July 29, 2025. https://tinyurl.com/56z3dmsp

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At the 2025 Kidney Cancer Research Summithosted by KidneyCAN, CancerNetwork® spoke with a variety of leading experts about key developments in the research and management of kidney cancer. Throughout the meeting, presenters shared their findings related to updated clinical trial results, personalized cancer vaccines, potential biomarkers of interest, and other advancements in the field.

Thomas Powles, MBBS, MCRP, MD, discussed outcomes from a quality-adjusted survival time without symptoms or toxicity (Q-TWiST) analysis of the phase 3 LITESPARK-005 trial (NCT04195750), in which investigators evaluated treatment with belzutifan (Welireg) vs everolimus (Afinitor) among patients with advanced renal cell carcinoma (RCC). Powles, a professor of genitourinary oncology, lead for Solid Tumor Research, and director of Barts Cancer Institute at St. Bartholomew’s Hospital, Queen Mary University of London, stated that these data demonstrate how belzutifan is more active and better tolerated than everolimus in this patient population.

David A. Braun, MD, PhD, assistant professor at Yale School of Medicine and member of the Center of Molecular and Cellular Oncology within the Yale Cancer Center, detailed his presentation on a personalized neoantigen cancer vaccine as a treatment for those with RCC. Based on his presentation, Braun highlighted how neoantigen vaccines may effectively yield T-cell responses in patients, illustrating a need for additional, larger studies to elucidate the clinical activity of this modality in an adjuvant setting.

Additionally, Wenxin (Vincent) Xu, MD, a medical oncologist at Dana-Farber Cancer Institute and an assistant professor of medicine at Harvard Medical School, spoke about his presentation on how kidney injury molecule-1 (KIM-1) may serve as a prognostic biomarker of response to therapy in patients with RCC. His research posed questions on how KIM-1 can inform the use of adjuvant therapy or specific therapeutic combinations like nivolumab (Opdivo) plus ipilimumab (Yervoy) for this patient population.

Eric Jonasch, MD, gave an overview of his presentation focused on the Kidney Cancer Research Consortium, a research partnership spanning 7 institutions dedicated to facilitating mechanistic, hypothesis-testing clinical trials in RCC. Jonasch, a professor in the Department of Genitourinary Medical Oncology of the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, described how this collaboration aims to link identifiable biological characteristics of RCC subtypes to specific treatment strategies while developing predictive biomarkers.

KidneyCAN is a nonprofit organization with a mission to accelerate cures for kidney cancer through education, advocacy, and research funding. You can learn more about KidneyCAN’s work here: https://kidneycan.org/
References
1. Powles T, de Velasco G, Choueiri TK, et al. Quality-adjusted time without symptoms or toxicity (Q-TWiST) analysis of belzutifan versus everolimus in previously treated advanced renal cell carcinoma (RCC): LITESPARK-005 (LS-005). Presented at the 2025 Kidney Cancer Research Summit; July 17-18, 2025; Boston, MA. Abstract 13.

Braun DA. Personalized vaccines in kidney cancer: a journey from concept to clinic. Presented at the 2025 Kidney Cancer Research Summit; July 17-18, 2025; Boston, MA.
Xu W. From bench to bedside: advancing KIM-1 as a tool for clinical decision-making. Presented at the 2025 Kidney Cancer Research Summit; July 17-18, 2025; Boston, MA.
Jonasch E. Building the infrastructure for discovery: a clinical trial consortium to accelerate kidney cancer research. Presented at the 2025 Kidney Cancer Research Summit; July 17-18, 2025; Boston, MA.

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In this episode, CancerNetwork® spoke with breast oncologists Heather McArthur, MD; Erika Hamilton, MD; Hope Rugo, MD; and Paolo Tarantino, MD, PhD, about advances in breast cancer. These developments included recent drug approvals and ongoing research for therapeutic approaches, particularly in the areas of antibody-drug conjugates (ADCs) and CDK4/6 inhibitors, based on presentations they gave at the 25th Annual International Congress on the Future of Breast Cancer (IBC) East in New York City.

Initially, McArthur, Komen Distinguished Chair in Clinical Breast Cancer Research at the Harold C. Simmons Comprehensive Cancer Center, discussed immunotherapy use in high-risk triple-negative and HER2-positive disease, the evolving role of adjuvant CDK4/6 inhibition in HER2-negative breast cancer, and potentially transformative advancements in early breast cancer treatment.

She highlighted the FDA approval for pembrolizumab (Keytruda) in early-stage triple-negative breast cancer, promising clinical trials in estrogen receptor (ER)–positive high-risk early-stage breast cancer, and data from an investigator-initiated trial to treat HER2-positive disease. Additionally, she highlighted an 8.5% improvement in pathological complete response with pembrolizumab added to immunotherapy in the phase 3 KEYNOTE-756 trial (NCT03725059), adding that a further event-free survival benefit may complicate the landscape for CDK4/6 inhibition based on lung and liver toxicities associated with the coadministration of these inhibitors with immunotherapy.1

McArthur expressed further excitement for ADC-based combinations for triple-negative disease, as well as in the high-risk residual disease setting. In addition, she highlighted potential advancements in de-escalation strategies and further considerations for ADCs in the HER2-positive and hormone receptor (HR)–positive spaces.

Then, Hamilton, director of Breast Cancer and Gynecologic Cancer Research at the Sarah Cannon Research Institute, highlighted emerging therapies for early breast cancer, as well as her use of datopotamab deruxtecan-dlnk (dato-DXd; Datroway) and fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu) given their recent approvals in various breast cancer subtypes. She also touched upon challenges with respect to the implementation of new therapies for early breast cancer into clinical practice.

She initially highlighted new data from the phase 3 VERITAC-2 trial (NCT05654623) presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting.2 Specifically, findings showed that vepdegestrant, an oral proteolysis-targeting chimera (PROTAC), exhibited an efficacy advantage over fulvestrant (Faslodex) in patients with ESR1-mutant ER-positive, HER2-negative advanced or metastatic disease. Moreover, she highlighted data from the phase 3 DESTINY-Breast09 (NCT04784715) of T-DXd in various combinations for patients with HER2-positive metastatic breast cancer.3

Hamilton further highlighted her implementation of T-DXd into clinical practice, citing her use of the agent in patients with metastatic disease, including those with HER2-low and HER2-ultralow breast cancer. She further differentiated dato-DXd from T-DXd, suggesting that they were different classes of drugs due to their different targets: TROP2 vs HER2. She concluded by highlighting an unmet need regarding sustained benefit from endocrine therapy in HR-positive disease, as well as for ADC sequencing and mechanisms of resistance.

Afterward, Rugo, division chief of Breast Medical Oncology, Women’s Cancer Program Director, and professor in the Department of Medical Oncology and Therapeutics Research at City of Hope, discussed efficacy and safety considerations for CDK4/6 inhibitors in early breast cancer treatment. Specifically, she highlighted their high tolerability despite adverse effects and costs associated with their use. Rugo further touched upon a reduction of recurrence rates associated with CDK4/6 inhibition, although longer-term follow-up data were warranted to optimize the duration of therapy and elucidate survival outcomes.

Finally, Tarantino, a research fellow at the Dana-Farber Institute, concluded by discussing sequencing strategies for ADCs, as well as which breast cancer settings or patient populations will experience the greatest impact with this treatment modality. Tarantino discussed his use of the “sandwich strategy,” where he switches the mechanism of action of treatment after using a TOPO1 ADC. Furthermore, Tarantino highlighted data from the DESTINY-Breast09 and phase 3 ASCENT-04 (NCT06100874) trials, which displayed the enhanced efficacy of 2 ADC combination therapies.4 He concluded by discussing future considerations for combining multiple ADCs.

**References

1. Cardoso F, O'Shaughnessy J, Liu Z, et al. Pembrolizumab and chemotherapy in high-risk, early-stage, ER+/HER2- breast cancer: a randomized phase 3 trial. Nat Med. 2025;31(2):442-448. doi:10.1038/s41591-024-03415-7

Hamilton E, De Laurentiis M, Jhaveri K, et al. Vepdegestrant, a PROTAC estrogen receptor (ER) degrader, vs fulvestrant in ER-positive/human epidermal growth factor receptor 2 (HER2)–negative advanced breast cancer: results of the global, randomized, phase 3 VERITAC-2 study. J Clin Oncol. 2025;43(suppl 17):LBA1000. doi:10.1200/JCO.2025.43.17_suppl.LBA1000
Tolaney S, Jiang Z, Zhang Q, et al. Trastuzumab deruxtecan (T-DXd) + pertuzumab (P) vs taxane + trastuzumab + pertuzumab (THP) for first-line (1L) treatment of patients (pts) with human epidermal growth factor receptor 2–positive (HER2+) advanced/metastatic breast cancer (a/mBC): interim results from DESTINY-Breast09. J Clin Oncol. 2025;43(suppl 17):LBA1008.
Tolaney SM, de Azambuja E, Kalinsky K, et al. Sacituzumab govitecan (SG) + pembrolizumab (pembro) vs chemotherapy (chemo) + pembro in previously untreated PD-L1–positive advanced triple-negative breast cancer (TNBC): Primary results from the randomized phase 3 ASCENT-04/KEYNOTE-D19 study. J Clin Oncol. 2025;43(suppl 17):LBA109. doi:10.1200/JCO.2025.43.17_suppl.LBA109

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Following the FDA approval of taletrectinib (Ibtrozi) for patients with locally advanced or metastatic ROS1-positive non–small cell lung cancer (NSCLC), CancerNetwork® spoke with Jorge Nieva, MD, about how this regulatory decision may impact the treatment paradigm for this disease.

The approval was supported by findings from the phase 2 TRUST-I trial (NCT04395677) and the phase 2 TRUST-II trial (NCT04919811). The total efficacy population included 157 patients who had no prior treatment with a ROS1 tyrosine kinase inhibitor (TKI) and 113 who were previously treated with a ROS1 TKI.

Topline results showed an objective response rate (ORR) of 90% (95% CI, 83%-95%) in TRUST-I and 85% (95% CI, 73%-93%) in TRUST-II among patients who had no prior treatment. Of those with pretreated disease, the respective ORRs were 52% (95% CI, 39%-64%) and 62% (95% CI, 46%-75%) in each study population.

According to Nieva, an associate professor of clinical medicine at the Keck School of Medicine of the University of Southern California, taletrectinib may offer advantages over other therapies in the ROS1-positive metastatic NSCLC space based on its improved central nervous system (CNS) toxicity profile and “excellent” response and progression-free survival data. He stated that taletrectinib would become the go-to first-line agent in his practice. Additionally, he discussed strategies for mitigating toxicities related to taletrectinib such as nausea and diarrhea, and highlighted the need for additional research to improve immunotherapy options in NSCLC.

“I’m very happy that we have choices for patients, and I’m very happy that we have such a wide variety of drugs, but we still need to do better, and we need to find better ways of using these agents because they’re still not cures for the majority of patients,” Nieva stated. “While these drugs can be helpful at debulking tumors, we still need to do a lot more work [to do] on making this a disease of the past for those patients who have it.”

Reference
FDA approves taletrectinib for ROS1-positive non-small cell lung cancer. News release. FDA. June 11, 2025. Accessed July 8, 2025. https://tinyurl.com/yc4f379m

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The medical oncology board examinations are a pivotal time in a clinician's career. However, preparing for and taking this exam comes as a crucial moment when residents/fellows begin their transition to attending.

While in theory, the process of taking an exam and then beginning a new job sounds simple, it is quite complex. The hematology/oncology boards require rigorous preparation. The exam is followed by the new attending position, where clinicians, for the first time, are on their own, making treatment decisions and leading a team.

ONCOLOGY® spoke with leading clinicians as well as those who are just beginning their careers about this time, and how they handled studying while experiencing personal and professional changes.

Eric K. Singhi, MD, assistant professor in the Department of General Oncology, Division of Cancer Medicine, and assistant professor in the Department of Thoracic/Head and Neck Medical Oncology at The University of Texas MD Anderson Cancer Center, focused on:

· His transition from fellow to attending (0:58)

· Where students should focus their efforts on studying (2:11)

· Advice he would give to those currently studying (2:47)

Nicholas James Hornstein, MD, PhD, assistant professor at Northwell Health Cancer Institute, discussed:

· Studying for the boards while balancing a new career (3:18)

· Specific study areas the exam focuses on (5:43)

Marc J. Braunstein, MD, associate professor in the Department of Medicine at NYU Grossman Long Island School of Medicine, fellowship program director in hematology/oncology at NYU Langone Health - Long Island, and codirector of the Hematology-Oncology System at NYU Grossman Long Island School of Medicine, highlighted:

· How to prepare fellows for the career transition (7:11)

· Advice he gives about this transition (8:17)

Nerea M. Lopetegui-Lia, MD, assistant professor in the College of Medicine at The Ohio State University Comprehensive Cancer Center-The James, spoke about:

· Best review practices for the exam (9:01)

· Advice she would give to those studying (10:15)

MinhTri Nguyen, MD, a medical oncologist with Stanford Medicine, focused on:

· As a leadership coach, helping prepare residents/fellows for the career transition (11:36)

· Advice he would give to those studying (14:34)

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In a conversation with CancerNetwork®, Benjamin Golas, MD, spoke about the current treatment landscape for patients with peritoneal carcinomatosis, discussing how the use of pressurized intraperitoneal aerosolized chemotherapy (PIPAC) may offer improvements in clinical outcomes.

Golas is the chief of Surgical Oncology of the Central Region for Hackensack Meridian Health.

According to Golas, standard therapeutic approaches include combining cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC), which may cause collateral damage to healthy tissue while eliciting toxicities such as nausea, vomiting, and bone marrow suppression. Additionally, certain surgical procedures may last up to 14 hours and confer an extensive morbidity profile, thereby increasing complication rates.

Golas described how PIPAC, a minimally invasive laparoscopic technique, may help avoid pain and other adverse effects associated with surgery while facilitating more direct delivery of chemotherapy in the peritoneal cavity. He noted that treatment with PIPAC typically takes 45 minutes to an hour, allowing some patients to return home on the same day of the procedure.

Although clinicians are still learning the correct indications for PIPAC, Golas stated that any patient with peritoneal carcinomatosis should be a candidate to receive treatment with this strategy. Furthermore, he described how the next steps for improving outcomes in this population include finding new ways to incorporate PIPAC into more extensive treatment plans for patients.

“PIPAC is a new treatment and a new potential option that doesn't replace systemic chemotherapy, but I do think it can work in conjunction with systemic chemotherapy. We can offer this bimodal approach where we're directly treating the peritoneal disease and offering [intravenous] chemotherapy,” Golas stated. “We clearly have a long way to go in terms of clinical trials and learning what the best ways are to use this. But there are patients out there who will benefit from that, so I think referral to a center that focuses and has expertise in PIPAC for patients with peritoneal carcinomatosis is critical.”

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In the wake of the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, CancerNetwork® put together an X Spaces discussion hosted by Stephen Liu, MD, and Joshua Sabari, MD, to highlight the most intriguing and practice-changing lung cancer abstracts. Discussed topics ranged from long-term follow-up with commonplace therapies to an analysis of what time of day is the best to administer immunochemotherapy.

Liu, an associate professor of Medicine at Georgetown University, and the director of Thoracic Oncology and head of Developmental Therapeutics at the Georgetown Lombardi Comprehensive Cancer Center, and Sabari, an assistant professor in the Department of Medicine at the NYU Grossman School of Medicine, and the director of High Reliability Organization Initiatives at the Perlmutter Cancer Center, shared expert insights on the latest non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) breakthroughs.

Trials of note that they discussed included:

The phase 3 DeLLphi-304 trial (NCT05740566) - Tarlatamab (Imdelltra) versus chemotherapy (CTx) as second-line (2L) treatment for small cell lung cancer (SCLC): primary analysis of Ph3 DeLLphi-304.1

The phase 3 IMforte trial (NCT05091567) - Lurbinectedin (Zepzelca; lurbi) + atezolizumab (Tecentriq; atezo) as first-line (1L) maintenance treatment (tx) in patients (pts) with extensive-stage small cell lung cancer (ES-SCLC): primary results of the phase 3 IMforte trial.2

The phase 3 CheckMate 816 trial (NCT02998528) - Overall survival with neoadjuvant nivolumab (Opdivo; NIVO) + chemotherapy (chemo) in patients with resectable NSCLC in CheckMate 816.3

The phase 3 PACIFIC15 trial (NCT05549037) - Randomized trial of relevance of time-of-day of immunochemotherapy for progression-free and overall survival in patients with non–small cell lung cancer.4

The phase 3 Beamion LUNG-1 trial (NCT04886804) - Patient-reported outcomes (PRO) evaluating physical functioning and symptoms in patients with pretreated HER2-mutant advanced non–small cell lung cancer (NSCLC): results from the Beamion LUNG-1 trial.5

The phase 3 ARTEMIA trial (NCT06472245) - Phase 3 trial of the therapeutic cancer vaccine OSE2101 versus docetaxel in patients with metastatic non–small cell lung cancer and secondary resistance to immunotherapy.

References
1. Rudin C, Mountzios G, Sun L, et al. Tarlatamab versus chemotherapy (CTx) as second-line (2L) treatment for small cell lung cancer (SCLC): primary analysis of Ph3 DeLLphi-304. J Clin Oncol. 2025;43(suppl 17):LBA8008. doi:10.1200/JCO.2025.43.17_suppl.LBA8008 2. Paz-Ares L, Borghaei H, Liu SV, et al. Lurbinectedin (lurbi) + atezolizumab (atezo) as first-line (1L) maintenance treatment (tx) in patients (pts) with extensive-stage small cell lung cancer (ES-SCLC): primary results of the phase 3 IMforte trial. J Clin Oncol. 2025;43(suppl 16):8006. doi:10.1200/JCO.2025.43.16_suppl.8006 3. Forde PM, Spicer JD, Provencio M, et al. Overall survival with neoadjuvant nivolumab + chemotherapy in patients with resectable NSCLC in CheckMate 816. J Clin Oncol. 2025;43(suppl 17):LBA8000. doi:10.1200/JCO.2025.43.17_suppl.LBA8000 4. Zhang Y, Huang Z, Zeng L, et al. Randomized trial of relevance of time-of-day of immunochemotherapy for progression-free and overall survival in patients with non-small cell lung cancer. J Clin Oncol. 2025;43(suppl 16):8516. doi:10.1200/JCO.2025.43.16_suppl.8516 5. Sabari JK, Nadal E, Hendriks L, et al. Patient-reported outcomes (PRO) evaluating physical functioning and symptoms in patients with pretreated HER2-mutant advanced non-small cell lung cancer (NSCLC): results from the Beamion LUNG-1 trial. J Clin Oncol. 2025;43(suppl 16):8620. doi:10.1200/JCO.2025.43.16_suppl.8620 6. Liu SV, Guibert C, Tostivint EP, et al. Phase 3 trial of the therapeutic cancer vaccine OSE2101 versus docetaxel in patients with metastatic non-small cell lung cancer and secondary resistance to immunotherapy. J Clin Oncol. 2025;43(suppl 16):TPS8651. doi:10.1200/JCO.2025.43.16_suppl.TPS8651

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In the third edition of a special podcast series, CancerNetwork® spoke with Daniel Morgensztern, MD; Mary Ellen Flanagan, NP; and Janelle Mann, PharmD, BCOP, about optimal strategies for incorporating different therapeutic agents into lung cancer care. As part of the latest discussion, the group highlighted the relevant efficacy data, administration protocols, and toxicity management considerations associated with TROP2-directed antibody-drug conjugates (ADCs) in patients with non–small cell lung cancer (NSCLC).

Morgensztern is a professor of Medicine and the clinical director of Thoracic Oncology in the Division of Oncology at Washington University School of Medicine in St. Louis. Flanagan is a nurse practitioner in the Division of Thoracic Oncology at Washington University. Mann is a clinical oncology pharmacist at Siteman Cancer Center of Washington University School of Medicine and manager of Clinical Pharmacy Services at Barnes-Jewish Hospital.

Morgensztern opened the discussion by highlighting the characteristics of prominent TROP2-targeting ADCs in NSCLC management, which included sacituzumab govitecan-hziy (Trodelvy), datopotamab deruxtecan-dlnk (Datroway), and sacituzumab tirumotecan (sac-TMT). Additionally, he reviewed data from clinical trials assessing these ADCs across different NSCLC populations, including the phase 3 EVOKE-01 trial (NCT05089734) showing a numerical overall survival (OS) improvement with sacituzumab govitecan vs docetaxel.

Regarding the safety profiles of these ADCs, Flanagan described the unique toxicities associated with the agents’ payloads as well as potential off-target effects. On top of myelosuppression, fatigue, and diarrhea, she stated that these therapies may cause more visceral organ toxicities like keratitis of the eye and interstitial lung disease. According to Flanagan, some prophylactic measures in the event of certain toxicities include frequent salt and baking soda mouth rinses as well as oral dexamethasone.

Mann then outlined the dosing variability considerations and supportive care measures surrounding the use of agents like sacituzumab govitecan. She emphasized continuously re-educating patients about expected toxicities and supportive care strategies as they undergo these infusion-based therapies to help avoid surprise instances of ocular toxicity, diarrhea, and other adverse effects.

Reference
Paz-Ares LG, Juan-Vidal O, Mountzios GS, et al. Sacituzumab govitecan versus docetaxel for previously treated advanced or metastatic non-small cell lung cancer: the randomized, open-label phase III EVOKE-01 study. J Clin Oncol. 2024;42(24):2860-2872. doi:10.1200/JCO.24.00733

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CancerNetwork®, in collaboration with The American Society for Transplantation and Cellular Therapy (ASTCT), organized an X Space hosted by Rahul Banerjee, MD, FACP; Taha Al-Juhaishi, MD; and Muhammad Salman Faisal, MD. This expert panel convened to discuss key presentations and abstracts of interest at the 2025 American Society of Clinical Oncology (ASCO) Annual Meetingfeaturing noteworthy developments in modalities like CAR T-cell therapy and transplantation across multiple myeloma, lymphoma, and other disease types.

Banerjee is an assistant professor in the Clinical Research Division at the Fred Hutchinson Cancer Center in Seattle, Washington. Al-Juhaishi is the associate director of the Hematopoietic Stem Cell Transplantation and Cell Therapy Program at Oklahoma University Health Stephenson Cancer Center and an assistant professor of medicine at the University of Oklahoma College of Medicine. Faisal is a hematologist/oncologist at Oklahoma University Health Stephenson Cancer Center and serves as an ambassador for ASCO.

The group highlighted several late-breaking abstracts, plenary sessions, and poster presentations focused on significant clinical trial data and other findings across the hematologic oncology landscape. Topics of interest included the following:

· Phase 1b/2 CARTITUDE-1 trial (NCT03548207, NCT05201781)

o Long-term follow-up showed that approximately one-third (33%; n = 32) of patients with relapsed/refractory multiple myeloma maintained progression-free status for at least 5 years following a single infusion of ciltacabtagene autoleucel (cilta-cel; Carvykti).

o An equal likelihood of progression-free survival occurred in patients with high-risk cytogenetics or extramedullary plasmacytomas.

o With a median follow-up of 61.3 months, the median overall survival (OS) with cilta-cel was 60.7 months (95% CI, 41.9-not evaluable [NE]).

· Real-world axicabtagene ciloleucel (axi-cel; Yescarta) use

o Across inpatient and outpatient treatment settings, safety and efficacy outcomes were comparable for patients who received axi-cel for relapsed/refractory large B-cell lymphoma.

o Multivariate analysis showed no associations between intended care setting and cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome.

o Investigators noted that these real-world data support the consideration of axi-cel in appropriate outpatient settings.

· Phase 1b/2 NEXICART-2 trial (NCT06097832)

o Investigators assessed NXC-201, a sterically optimized CAR T construct, as a treatment for patients with relapsed/refractory light chain amyloidosis, a population with no FDA-approved options.

o Among 12 patients who received the agent at 450 x 106 cells, 100% achieved rapid and deep hematologic responses at a median time to first and best response of 7 and 26 days, respectively.

o With a median follow-up of 121 days (range, 29-289), no hematologic relapses or progression had occurred.

References
1. Voorhees P, Martin T, Lin Y, et al. Long-term (≥5 year) remission and survival after treatment with ciltacabtagene autoleucel (cilta-cel) in CARTITUDE-1 patients (pts) with relapsed/refractory multiple myeloma (RRMM). J Clin Oncol. 2025;43(suppl 16):7507. doi: 10.1200/JCO.2025.43.16_suppl.7507

Furqan F, Hemmer M, Tees M, et al. Trends and outcomes by inpatient and outpatient infusion of axicabtagene ciloleucel (axi-cel) in the US for patients (pts) with relapsed/refractory large B-cell lymphoma (R/R LBCL). J Clin Oncol. 2025;43(suppl 16):7023. doi:10.1200/JCO.2025.43.16_suppl.7023
Landau H, Hughes C, Rosenberg A, et al. Safety and efficacy data from Nexicart-2, the first US trial of CAR-T in R/R light chain (AL) amyloidosis, Nxc-201. J Clin Oncol. 2025;43(suppl 16):7508. doi:10.1200/JCO.2025.43.16_suppl.7508

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In this episode, CancerNetwork® spoke with Eric Winer, MD, director of the Yale Cancer Center; president and physician-in-chief at Smilow Cancer Hospital; deputy dean for cancer research, Alfred Gilman Professor of Pharmacology, and Professor of Medicine at Yale School of Medicine; and chair of the association board for the American Society of Clinical Oncology (ASCO), about the current state of oncologist burnout, steps that can be taken to ameliorate it, and how it currently impacts professionals in the field.

Causes of workplace burnout that authors identified in a paper published in the Journal of Clinical Oncology in January 2025 included the use of electronic health records, staffing levels, payer authorizations, hours worked, and age. Additionally, published results from the survey revealed a 14% increase in the rate of oncologists who experienced workplace burnout from 2013 to 2023 (P <.01). Moreover, a significant correlation between being a caregiver for someone at home and workplace burnout was observed.

Winer began by defining workplace burnout, emphasizing that it is not exclusive to oncology, and that many oncologists resist burnout by focusing on the mission-driven nature of the work. Then, he speculated how oncologist burnout may have increased from 2013 to 2023, suggesting that it may have been related to a larger societal trend due to increased awareness of it. Furthermore, he suggested that the COVID-19 pandemic may have exacerbated fatigue, as well as the growing utilization of telehealth and documentation, which take oncologists away from personal engagement with patients.

He then explored how the workforce might be impacted by burnout, highlighting a sizeable percentage of oncologists who claim to be nearing retirement age. Based on this trend, there may be a need for workforce expansion, as well as the need to embrace a more multidisciplinary approach to help oncologists deliver patient care. Winer concluded by outlining how he mitigates burnout personally, as well as his thoughts regarding how oncology has progressed since his career began.

Reference
Schenkel C, Levit LA, Kirkwood K, et al. State of professional well-being, satisfaction, and career plans among US oncologists in 2023. J Clin Oncol. Published online January 29, 2025. doi:10.1200/OA.24.00010

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Ahead of the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, CancerNetwork® spoke with a variety of oncology experts about the late-breaking abstracts, plenary sessions, and other key presentations that may shift the paradigm across different cancer care fields. They highlighted anticipated clinical trial results that may transform the standard of care for gynecologic malignancies, lung cancer, and other disease types.

Rachel N. Grisham, MD, section head of Ovarian Cancer and director of Gynecologic Medical Oncology at MSK Westchester of Memorial Sloan Kettering Cancer Center, shared her anticipation of findings from the phase 3 ROSELLA trial (NCT05257408) assessing relacorilant plus nab-paclitaxel in patients with platinum-resistant ovarian cancer. She stated she was excited to see if the data may represent a new opportunity for this patient population.

Next, MinhTri Nguyen, MD, a medical oncologist and hematologist at Stanford Health Care, highlighted a few breast cancer presentations to look out for. These topics included a plenary session on data from the phase 3 SERENA-6 study (NCT04964934) evaluating camizestrant in combination with CDK4/6 inhibitors for those with hormone receptor–positive, HER2-negative advanced breast cancer harboring emergent ESR1 mutations.

Additionally, Eric K. Singhi, MD, assistant professor in the Department of General Oncology in the Division of Cancer Medicine, and assistant professor in the Department of Thoracic/Head and Neck Medical Oncology at The University of Texas MD Anderson Cancer Center, spoke about a range of potentially practice-changing results in the lung cancer field. For example, he described a session focused on primary results of the phase 3 IMforte trial (NCT05091567) assessing lurbinectedin (Zepzelca) plus atezolizumab (Tecentriq) for those with extensive-stage small cell lung cancer (ES-SCLC). According to Singhi, data from IMforte may shift the paradigm of maintenance therapy for this SCLC population.

In the world of head and neck cancer, Douglas R. Adkins, MD, associate professor of Internal Medicine, Division of Oncology, Section of Medical Oncology at Washington University School of Medicine in St. Louis, Missouri, highlighted the session on the phase 3 NIVOPOSTOP GORTEC 2018-01 trial (NCT03576417). Investigators of this study evaluated nivolumab (Opdivo) in combination with chemoradiotherapy for those with resected head and neck squamous cell carcinoma. Adkins noted his excitement to see how these data may impact the standard of care, particularly for patients in Europe, where investigators conducted the study.

As part of an Oncology Decoded discussion, Benjamin Garmezy, MD, the associate director of genitourinary research and executive cochair of the Genitourinary Cancer Research Executive Committee at Sarah Cannon Research Institute (SCRI) and medical oncologist at SCRI Oncology Partners specializing in genitourinary cancers, discussed key abstracts in bladder cancer. One specific presentation included additional findings from the phase 3 NIAGARA trial (NCT03732677), which may show how circulating tumor DNA can influence treatment decision-making regarding perioperative durvalumab (Imfinzi) for patients with muscle-invasive bladder cancer.

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In a conversation with CancerNetwork®, Viviana Cortiana, MS4, and Yan Leyfman, MD, spoke about their manuscript titled “Artificial Intelligence in Cancer Care: Addressing Challenges and Health Equity,” which they published in the April 2025 issue of ONCOLOGY®.
Cortiana is a medical student in the Department of Medical and Surgical Sciences at the University of Bologna. Leyfman is a resident physician from the Icahn School of Medicine of the Mount Sinai Health System.

Cortiana highlighted how artificial intelligence (AI)–based tools may mitigate the overdiagnosis of cancers, although she noted a need to validate these devices with diverse and high-quality datasets to avoid the risk of biased models. Additionally, she described how developing population-specific AI models may improve predictive accuracy in diagnosis as well as treatment planning, which can especially benefit patients in low- and middle-income countries.

As part of ethically applying the use of AI to oncology and delivering equitable cancer care, Leyfman emphasized core pillars such as data security, transparency, clinical validation, and combatting algorithmic bias. Furthermore, he stated that potential applications of these tools include mobile diagnostics, cloud-based platforms, and remote consultation, which can help increase access to care. Regarding the potential next steps in the field, he highlighted that global partnerships with parties such as tech companies, governments, and non-governmental organizations may assist with the funding and deployment of AI tools, especially for underserved regions.

“The future of AI in oncology is increasingly promising, not just in pushing the boundaries of what's possible in cancer care but also making sure that more precise and more accessible worldwide therapies are available,” Leyfman stated. “AI has the potential to fundamentally change how we detect, treat, and monitor [cancer], but realizing that promise, especially in a way that's equitable, will require collaboration, validation, thoughtful implementation, and a commitment to leaving no patient behind.”

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In a conversation with CancerNetwork®, Viviana Cortiana, MS4, medical student in the Department of Medical and Surgical Sciences at the University of Bologna, and Yan Leyfman, MD, a resident physician from the Icahn School of Medicine of the Mount Sinai Health System, discussed their publication in the March 2025 issue of ONCOLOGY titled “Expanding horizons in T-cell lymphoma therapy: a focus on personalized treatment strategies.” Throughout the discussion, the authors spoke about the current lymphoma landscape, CAR T-cell therapy, and the evolving understanding of the tumor microenvironment.

Specifically, Cortiana covered a shift from histology-based classification to molecular tumor type classification using next-generation sequencing, as well as a growing interest in biomarker-driven therapies. Regarding the limited efficacy of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in T-cell lymphoma, she listed potential advances in combination therapies for angioimmunoblastic T-cell lymphoma (AITL), which include combining P13K and HDAC inhibition as well as CD30- and TRBC1-targeting CAR T-cell therapies.

Furthermore, Leyfman discussed strategies that “reprogram” the microenvironment to address malignant T cells, particularly through epigenetic and adoptive cell therapies. Leyfman concluded by discussing future implications for T-cell lymphoma treatment, emphasizing an emergence of precision medicines and armored CAR engineering strategies.

Authors of the manuscript published in ONCOLOGY outlined the available treatment options for peripheral T-cell lymphoma (PTCL), which include targeted therapies through EZH2 inhibition, chemotherapy with CHOP, CAR T-cell therapies, and allogenic stem cell transplantation. Additionally, they highlighted encouraging results from clinical trials evaluating epigenetic-targeted therapies through the identification of molecular aberrations, which can help tailor treatments to individual patients.

Furthermore, the article explored limitations of chemotherapy as well as autologous stem cell transplantation (ASCT), which may not be feasible for older patients or those with comorbidities. Authors suggested that targeted therapies may enhance tumor specificity while reducing systemic toxicity. Given the risks associated with ASCT, they emphaisized a focus on the incorporation of optimized treatment strategies, such as novel pharmaceuticals and combination therapies, into clinical practice for patients with PTCL.

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In a special co-branded episode between Oncology On the Go hosted by CancerNetwork® and the American Society for Transplantation and Cellular Therapy (ASTCT)’s program ASTCT Talks, Nora M. Gibson, MD, MSCE, and Taha Al-Juhaishi, MD, spoke about real-world applications of betibeglogene autotemcel (beti-cel; Zynteglo) as a treatment for patients with beta (β)-thalassemia. They spoke in the context of a study that Gibson presented at the 2025 Tandem Meetings, which evaluated patients who received commercial beti-cel in a single-center cohort following the agent’s FDA approval in August 2022.

Nora is a fourth-year fellow in bone marrow transplant and cellular therapy at the Children's Hospital of Philadelphia (CHOP), with a background in clinical research and epidemiology. Al-Juhaishi is the Associate Director of the Hematopoietic Stem Cell Transplantation and Cell Therapy Program at Oklahoma University Health Stephenson Cancer Center and an assistant professor of Medicine at the University of Oklahoma College of Medicine.

Findings from Gibson’s study revealed that among 10 patients who underwent stem cell collection at CHOP from 2022 to 2024, beti-cel yielded consistent red blood cell transfusion independence, with investigators noting prolonged platelet engraftment time and high platelet transfusion requirements. Beyond these findings, the conversation focused on how beti-cel compares with other currently available gene therapies for patients with hemoglobin disorders as well as non-curative therapies like allogeneic stem cell transplantation. Gibson and Al-Juhaishi also discussed strategies for mitigating occlusive disease and other potential toxicities associated with beti-cel.

“It's a really exciting time to be working in this field where we finally have really good options for these patients. From our experience and from clinical trials, beti-cel and likely exagamglogene autotemcel [Casgevy]...are very effective, curative therapies for thalassemia in the real-world setting, and we've seen very similar results in sickle cell disease,” said Gibson. “These therapies have been really life-changing for our patients, and they've had a huge reduction in their symptoms and a huge reduction in their burden of health care that's required.”

References
1. Gibson NM, Friedman DF, Elgarten CW, et al. Post-approval, real-world experience with betibeglogene autotemcel for transfusion-dependent beta thalassemia. Transplantation and Cellular Therapy. 2025;31(2):S254. doi:10.1016/j.jtct.2025.01.386.

FDA approves first cell-based gene therapy to treat adult and pediatric patients with beta-thalassemia who require regular blood transfusions. News Release. FDA. August 17, 2022. Accessed April 21, 2025. https://tinyurl.com/3vrkk8kz

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In an interview with CancerNetwork®, William Kennedy, MD, a neuro-radiation oncologist at the Ivy Brain Tumor Center, provided expert insights into the current state of radiosurgery for central nervous system (CNS) tumors. Highlighting a diverse array of available radiosurgery platforms, he explained that institutions like the Ivy Brain Tumor Center frequently use noninvasive surgical techniques with complex monitoring systems.

Kennedy further underscored the critical importance of having a nuanced understanding of each technology's capabilities and limitations, as well as those of the practicing oncologist. Emphasizing a high patient volume and a wide variety of cases at his own practice, he suggested that the expertise of the staff at the Ivy Brain Tumor Center positions them at the forefront of radiosurgery development.

According to Kennedy, novel therapeutic strategies under development at Ivy Brain Tumor Center include the investigational agent AZD1390, which is being assessed in combination with radiotherapy after surgery for patients with newly diagnosed or recurrent glioblastoma.

Despite the benefits that technology provide for research advancement and treatment, Kennedy posited that the multidisciplinary team is essential in ensuring the successful delivery of novel radiosurgery techniques. This integrated approach ensures that each patient benefits from an individualized plan that leverages the full potential of modern radiosurgery.

“[D]espite all the great technologies that we have here at Ivy, what I think makes this place great, what makes me proud to work here, and what means the most for our patients is how closely we providers communicate with each other and how closely knit of a team we are,” Kennedy stated. “Being available, showing up to the tumor board, always picking up the phone when your colleague calls to discuss a tough case, and never being afraid to ask for help—all those things I have learned since I have been in practice here. Those are what make the difference, more than anything.”

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In a conversation with CancerNetwork®, Oluwadamilola “Lola” Fayanju, MD, MA, MPHS, FACS, discussed the key findings from a study she published in JAMA Network Open, which demonstrated that most patients with inflammatory breast cancer do not receive all available types of guideline-concordant care they are eligible for. Additionally, data showed disparities regarding receipt of modality-specific therapy among patients who were Black, Asian, Hispanic, or other racial minority populations.

Based on these findings, Fayanju highlighted potential next steps for mitigating these gaps in care for certain patients with breast cancer. These strategies included revising stringent inclusion criteria for clinical trial enrollment, which may disproportionately exclude racial minority populations who have higher rates of diabetes or other medical conditions. Fayanju also emphasized educating clinicians across different oncology specialties to recognize how different populations present with inflammatory breast cancer and better understand the context in which patients receive treatment.

“I hope [the study] makes some people angry…Frustration can be a wonderful fuel,” Fayanju stated regarding her research. “[By] recognizing that there isn't as much guideline-concordant care receipt amongst all people as there should be and the hope that's provided when we achieve concordant care, we can mitigate and eliminate racial disparities. I hope [that] will motivate people to think about how we can get more guideline-concordant care to more people and how we can incorporate diverse populations in the development of guidelines for concordant care at the beginning. Then, how can we also develop treatments that achieve efficacious results across diverse populations?”

Fayanju is the Helen O. Dickens Presidential Associate Professor, chief in the Division of Breast Surgery at Penn Medicine, surgical director of Rena Rowan Breast Center, director of Health Equity Innovation at Penn Center for Cancer Care Innovation (PC3I), and senior fellow at Leonard Davis Institute of Health Economics (LDI), Perelman School of Medicine at the University of Pennsylvania.

Reference
Tadros A, Diskin B, Sevilimedu V, et al. Trends in guideline-concordant care for inflammatory breast cancer. JAMA Netw Open. 2025;8(2):e2454506. doi:10.1001/jamanetworkopen.2024.54506

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The International Psycho-Oncology Society (IPOS) deemed April 9th, 2025, the first-ever World Psycho-Oncology Day (WPOD). This day was meant to spread awareness of the importance of prioritizing psychosocial care for patients with all types of cancer as well as to honor Jimmie C. Holland, MD.
Prior to WPOD, CancerNetwork® spoke with Cristiane Decat Bergerot, PhD, BS, MS, a psychologist and the head of supportive care at Grupo Oncoclinicas in Brazil, and a member of IPOS, about the importance of psychosocial care and the impact it has on patients with cancer.
As stated by Bergerot and listed on the official IPOS website, the primary goals of WPOD are as follows: raise awareness, honor Jimmie Holland, engage stakeholders, promote action, and support fundraising efforts.1 These goals are geared towards paying homage to the history of psycho-oncology and pushing for a more advanced future.
“We aim to empower patients, caregivers, and healthcare professionals, fostering a future where psychosocial support is an integral part of oncology worldwide,” Bergerot said.
Psycho-oncology has become more prevalent as a cancer care field since Jimmie C. Holland, MD, worked to help found it in the 1970s. Holland, a “pioneer” of psycho-oncology, was the first ever Chief of Psychiatry Services—a department that was the first of its kind anywhere in the world—at Memorial Sloan Kettering Cancer Center, and a founding member of IPOS.
Bergerot stated that, in her work, she sees that patients who receive psychological support exhibit improved pain management and quality of life. Trials now focus more on end points such as quality of life and patient-reported outcomes, and guidelines have emerged to create standards of care. The National Comprehensive Cancer Network and the American Society of Clinical Oncology each offer guidelines that detail how to manage patient distress as they progress through cancer therapy.2,3 Distress screenings and earlier recommendations for palliative care have also become more standard in treatment.
As for the future, Bergerot highlighted that psychosocial care needs to be more integrated into care as a necessary, rather than optional, component. New developments around the world, however, have created a landscape where telehealth and new research demonstrate the potential to help psycho-oncology grow rapidly.
References
1. World Psycho-Oncology Day (WPOD). IPOS. Accessed April 2, 2025. https://tinyurl.com/43c9rr2c

Distress during cancer care. NCCN. 2024. Accessed April 2, 2025. https://tinyurl.com/ycxxvnmt
Andersen BL, Lacchetti C, Ashing K, et al. Management of anxiety and depression in adult survivors of cancer: ASCO guideline update. J Clin Oncol. 2023;41(18):3426-3453. doi:10.1200/JCO.23.00293

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CancerNetwork® visited Sibley Memorial Hospital of Johns Hopkins Medicine to speak with a variety of experts about therapeutic advancements and ongoing research initiatives across several different cancer fields. As part of each discussion, clinicians highlighted how collaboration across different departments has positively impacted treatment planning, decision-making, and outcomes at their institution.

These experts included the following:

· Rachit Kumar, MD, an assistant professor of Radiation Oncology and Molecular Radiation Sciences at Johns Hopkins School of Medicine and a radiation oncologist specializing in genitourinary and gastrointestinal cancers at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center for Sibley Memorial Hospital and Suburban Hospital;

· Michael J. Pishvaian, MD, PhD, director of Gastrointestinal, Developmental Therapeutics, and Clinical Research Programs, and associate professor of Oncology at Johns Hopkins School of Medicine;

· Nina Wagner-Johnston, MD, a professor of Oncology and the director of Lymphoma Drug Development at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, director of Hematologic Malignancies National Capital Region, and co-director of Clinical Research for Hematologic Malignancies;

· Valerie Lee, MD, an assistant professor of Oncology at Johns Hopkins University School of Medicine and a medical oncologist at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital;

· Armine Smith, MD, the director of urologic oncology at the Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, and an assistant clinical professor of Urology at the Brady Urological Institute of Johns Hopkins University School of Medicine;

· Pouneh Razavi, MD, the director for Breast Imaging in the National Capital Region and an instructor in Radiology and Radiological Science;

· and Curtiland Deville Jr., MD, medical director of the Johns Hopkins Proton Therapy Center and clinical director of Radiation Oncology at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital.

Altogether, their insights demonstrated how multidisciplinary teamwork has improved outcomes ranging from patient survival to healthcare resource utilization across a wide range of diseases including breast cancer, gastrointestinal cancer, genitourinary cancer, hematologic malignancies, and others.

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In a conversation with CancerNetwork®, Leticia Nogueira, PhD, MPH, highlighted the findings and implications of a study she publishedthat evaluated how exposure to wildfires affected post-operative length of stay (LOS) among patients who were recovering from surgery for non–small cell lung cancer (NSCLC). Data from this study showed that patients who underwent curative-intent surgery at facilities exposed to a wildfire disaster experienced a longer LOS compared with similar patients who received treatment during times when no disasters occurred.

According to data published in Journal of the National Cancer Institute, the LOS was 7.45 days (SE, 0.22) for patients treated at facilities without wildfire exposure vs 9.42 days (SE, 0.25) among those who underwent surgery at facilities with exposure (P <.0001). Sensitivity analyses showed no significant difference for in-hospital mortality among patients with (10.5%) or without wildfire exposure (10.8%; P = .76).

According to Nogueira, scientific director of Health Services Research at the American Cancer Society, future research may further assess whether a longer LOS may impact survival among this patient population. Additionally, other efforts may focus on determining strategies for protecting the health and safety of patients during a climate disaster.

Describing an “inescapability” of climate or environmental hazards across all populations, Nogueira emphasized the importance of collaboration among different medical and research institutions to improve disaster preparedness and mitigation strategies. These shared efforts may reduce the impact of wildfires and similar climate hazards across treatment facilities and patient populations.

“We know that disasters are becoming more common. We know that their frequency, their intensity, and their behavior continue to change. The only way that we can figure out what’s going to work and what’s going to improve quality of care and patient outcomes is knowledge,” Nogueira stated. “Prioritizing this type of research and understanding that all of us are a patient at some point, that we are all eventually vulnerable, [is important].”

Reference
Nogueira LM, Yabroff KR, Yates E, Shultz JM, Valdez RB, Nori-Sarma A. Facility exposure to wildfire disasters and hospital length of stay following lung cancer surgery. JNCI. Published online March 11, 2025. doi:10.1093/jnci/djaf040

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In the second edition of a special podcast series, CancerNetwork® spoke with Daniel Morgensztern, MD; Mary Ellen Flanagan, NP; and Janelle Mann, PharmD, BCOP, about the best practices for incorporating recently approved bispecific antibodies into cancer care. This discussion focused on clinical trial results, administration protocols, and adverse effect (AE) management strategies related to the use of tarlatamab-dlle (Imdelltra) for patients with small cell lung cancer (SCLC).

The conversation opened with Morgensztern highlighting tarlatamab’s mechanism of action as an agent that targets DLL3. He then reviewed prior efficacy data that the therapy demonstrated in the phase 1 DeLLphi-300 trial (NCT03319940) and the phase 2 DeLLphi-301 trial (NCT05060016). Of note, the FDA approved tarlatamab as the first available T-cell engager immunotherapy for patients with extensive-stage SCLC who have progressed on prior platinum-containing chemotherapy in May 2024 based on data from the DeLLphi-301 trial.

Additionally, Flanagan detailed strategies for monitoring and mitigating the most common AEs associated with tarlatamab in this patient population, which include cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome. Mann then outlined considerations for properly dosing and administering the agent, highlighting factors that clinicians should keep in mind when continuing treatment in an inpatient or outpatient setting.

The group also spoke about clinical decision-making related to patients who have brain metastases, which included processes for adjusting the dose of tarlatamab and sequencing the bispecific agent with radiotherapy.

Reference
FDA grants accelerated approval to tarlatamab-dlle for extensive stage small cell lung cancer. News release. FDA. May 16, 2024. Accessed March 14, 2025. https://tinyurl.com/48k34rw5

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Molecular differences in the profiles of low grade serous ovarian cancer (LGSOC) and high-grade SOC substantiate the need to find unique, differentiated treatment options for each epithelial ovarian cancer subtype, according to Kathleen N. Moore, MD, MS.

CancerNetwork® spoke with Moore, Virginia Kerley Cade Endowed Chair of Cancer Development, associate director of Clinical Research at the Stephenson Cancer Center, director of the Oklahoma TSET Phase I Program and professor in the Section of Gynecologic Oncology the University of Oklahoma Health Sciences Center, about distinguishing low grade serous ovarian cancer from other types of ovarian cancer, current treatment options and clinical trials evaluating new regimens, as well as managing treatment in younger patients with or those seeking to preserve fertility.

Moore began by differentiating LGSOC from high grade SOC, stating that this disease typically occurred in younger patients and was primarily characterized by MAP kinase alterations, specifically KRAS and BRAF mutations. She then discussed the emergence of endocrine therapies in this indication owing to the presence of estrogen receptors.

Additionally, first line treatment was discussed, with the standard of care defined by primary cytoreduction followed by paclitaxel and carboplatin. She then highlighted multiple clinical trials assessing alternative treatment in this indication, particularly involving the use of letrozole (Femara).

Other clinical trials evaluated the use of CDK4/6 inhibition plus fulvestrant or BRAF and MEK inhibition with letrozole, with Moore emphasizing the potential for these studies to shift the treatment paradigm in the frontline setting. Furthermore, she suggested that CDK4/6 inhibition may help enhance responses in patients with recurrent LGSOC.

Moore then highlighted treatment concerns for younger patients and those seeking to preserve fertility, while expressing the importance of understanding a patient’s goals, which may help optimize outcomes. She concluded by reiterating the importance of designing trials and tailoring treatment considering the molecular profile of LGSOC.

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In a recent episode of Oncology on the Go, several oncologists discussed the impact of the COVID-19 pandemic on oncology care, 5 years later. Each doctor discussed a different aspect of multidisciplinary care, including medical oncology, radiation oncology, and epidemiology.

CancerNetwork® spoke with leading clinicians including:

· Aditya Bardia, MD, MPH, FSCO, professor in the Department of Medicine, Division of Hematology/Oncology, and director of Translational Research Integration at the University of California Los Angeles Health Jonsson Comprehensive Cancer Center;

· Ritu Salani, MD, director of Gynecologic Oncology at the University of California Los Angeles, and ONCOLOGY® editorial advisory board member;

· Scarlett Lin Gomez, PhD, MPH, a professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco (UCSF), and co-leader of the Cancer Control Program at UCSF Helen Diller Family Comprehensive Cancer Center

· Marwan F. Fakih, MD, professor in the Department of Medical Oncology & Therapeutics Research, associate director for Clinical Sciences, medical director of the Briskin Center for Clinical Research, division chief of GI Medical Oncology, and co-director of the Gastrointestinal Cancer Program at City of Hope Comprehensive Cancer Center;

· Elizabeth Zhang-Velten, MD, a radiation oncologist at Keck Medicine of University of Southern California;

· Frances Elain Chow, MD, neuro-oncologist at the University of Southern California (USC) Norris Comprehensive Cancer Center

· James Yu, MD, MHS, FASTRO, assistant professor adjunct, Department of Radiation Oncology, Smilow Cancer Hospital at Saint Francis Hospital, and ONCOLOGY® editorial advisory board member.

The COVID-19 pandemic disrupted routine cancer care in a number of ways. Many patients were unable to receive timely screening, diagnosis, and treatment, Fakih noted. Additionally, Bardia stated that the pandemic led to a decrease in the number of patients participating in clinical trials.

One of the most significant changes in oncology care, according to Salani, has been the increased use of telehealth. Telehealth has allowed patients to receive care from the comfort of their own homes, which has been especially beneficial for patients who live in rural areas or who have difficulty traveling. Telehealth has also made it easier for patients to connect with their doctors and to receive support from other members of their care team.

For Gomez, the COVID-19 pandemic also highlighted the importance of addressing the structural and social drivers of health. These are the conditions in which people are born, grow, live, work, and age that can affect their health. For example, people who live in poverty or who lack access to healthy food are more likely to develop cancer. The pandemic has led to a renewed focus on addressing these disparities.

Overall, the COVID-19 pandemic has had a profound impact on oncology care. However, it has also led to a number of positive changes, such as the increased use of telehealth and the focus on addressing the structural and social drivers of health. In the years to come, it will be important to continue to build on these changes in order to improve the lives of patients with cancer.

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CancerNetwork®, in collaboration with The American Society for Transplantation and Cellular Therapy (ASTCT), organized an X Space hosted by Rahul Banerjee, MD, FACP, an assistant Professor in the Clinical Research Division at the Fred Hutchinson Cancer Center in Seattle, Washington, and Shernan Holtan, MD, the chief of Blood and Marrow Transplantation and professor of Medicine at Roswell Park Comprehensive Cancer Center.
The conversation took place during the 2025 Tandem Meeting and highlighted many significant presentations and posters on CAR T-cell therapies and transplantation, Banerjee’s and Holtan’s respective areas of expertise.
The following trials were discussed:
LBA1 - Phase II Multicenter Trial of Idecabtagene Vicleucel (Ide-cel) Followed By Lenalidomide Maintenance for Multiple Myeloma Patients with Sub-Optimal Response after an Upfront Autologous Hematopoietic Cell Transplantation: Top Line Results from the BMT CTN 1902 Clinical Trial1
“This [study] is nice because it merges 2 worlds. It's like a tandem—but not really a tandem—because you're not doing 2 transplants back-to-back. You're doing a transplant followed by CAR T-cell therapy,” said Banerjee.
Abstract 50 - CAR T Cell Therapy in Early Relapsed/Refractory Large B-Cell Lymphoma: Real World Analysis from the Cell Therapy Consortium2
“In a relatively small cohort, [investigators] found no difference in 9-month survival whether someone got their [CAR T cells] in second-line therapy vs third-line therapy from a statistical perspective. If you look at the curves, it looks like there is a potential benefit to second-line therapy, but there was not enough statistical power to determine a difference,” said Holtan.
Poster 340 - CD83 Expression By Human Breast Cancer Mediates Effective Killing By CAR T3
“If there's a way to do [the therapy] armored and have a paracrine delivered in real time—and not given to the whole body—[so] the patient [would] have all the adverse effects and cytokine release syndrome release on their own…that would be awesome,” stated Banerjee.
Poster 317 - Risk Factors for Immune Effector Cell-Associated Enterocolitis (IEC-colitis) in Patients with Relapsed Myeloma Treated with Ciltacabtagene Autoleucel (cilta-cel)4
“From the best that we can tell, ironically, corticosteroids aren't the fix that we want them to be [for immune effector cell-associated colitis]…We were like ‘Diarrhea, whatever. Let's give some steroids and treat it like gut graft-versus-host-disease,’ but these patients [didn’t] respond as well [to that],” said Banerjee.
Poster 572 - Post-CAR-T Driving Restrictions Appear Unnecessary after Week 4: Data from the US Multiple Myeloma Immunotherapy Consortium5
“Patients and their caregivers [who have] put their life aside for 4 weeks just to get through CAR T-cell therapy and the Risk Evaluation and Mitigation Strategies requirements are now being told ‘You're free to go, but you can't drive for 4 weeks, which means you can't get your own groceries or…go to doctor's appointments by yourself.’ Basically, we argue…that this [requirement] is not evidence-based,” stated Banerjee.

Presentation 58 - Physical Function Measures Identify Non-Hodgkin Lymphoma Patients at High Risk of Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) and 1-Year Mortality after Chimeric Antigen Receptor T (CAR-T) Cell Therapy6
“This [presentation] highlights that even within a high [CAR-HEMATOTOX group], those patients were at extraordinarily high risk of not benefitting from CAR T-cell therapy, and these tests are so simple to do. It’s going to be interesting to see if others can reproduce this,” said Holtan.
Poster 618 - Comparison of Outcomes after Hematopoietic STEM Cell Transplantation (HCT) for Myelodysplastic Syndrome (MDS) Patients Older or Younger THAN 65 YEARS Old. a Retrospective Analysis of the Latin America Registry7
“My personal hope for this space is that our field can come up with more novel conditioning regimens such that we can ablate the marrow without causing those gastrointestinal toxicities or other organ toxicities [while] doing that so effectively that we don't even need maintenance therapies for a lot of conditions,” stated Holtan.
Presentation 39 - Determinants of Immune Suppression Discontinuation in the Modern Era: A CIBMTR Analysis of 18,642 Subjects8
“I’m going to make a provocative prediction for the next paper [approximately 10 years from now]. I predict that steroids won’t be the first-line therapy for acute or chronic graft-versus-host-disease,” Holtan said.
Poster 516 - Patient Experiences with Chronic Graft-Versus-Host Disease and Its Treatment in the United States: A Retrospective Social Media Listening Study9
“We can still work together to make life as good as we possibly can [for patients], to improve physical function, to take away some of this mental distress, and then work together for advocacy too. [We can] help with peer support, help with resources, and help relieve some of that misunderstanding in the community,” stated Holtan.
References
1. Garfall AL, Pasquini MC, Bai L, et al. Phase II multicenter trial of idecabtagene vicleucel (ide-cel) followed by lenalidomide maintenance for multiple myeloma patients with sub-optimal response after an upfront autologous hematopoietic cell transplantation: top line results from the BMT CTN 1902 clinical trial. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Abstract LBA-1.
2. Rojek AE, Ahmed N, Gomez-Llobell M, et al. CAR T cell therapy in early relapsed/refractory large B-cell lymphoma: real world analysis from the cell therapy consortium. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Abstract 50.
3. Betts BC, Davilla ML, Linden AM, et al. CD83 expression by human breast cancer mediates effective killing by CAR T. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 340.
4. Chang Lim KJ, Chhabra S, Corraes ADMS, et al. Risk factors for immune effector cell-associated enterocolitis (IEC-colitis) in patients with relapsed myeloma treated with ciltacabtagene autoleucel (cilta-cel). Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 317.
5. Banerjee R, Richards A, Khouri J, et al. Post-CAR-T driving restrictions appear unnecessary after week 4: data from the US multiple myeloma immunotherapy consortium. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 572.
6. Herr M, McCarthy P, Jacobsen H, et al. Physical function measures identify non-Hodgkin lymphoma patients at high risk of immune effector cell-associated neurotoxicity syndrome (ICANS) and 1-year mortality after chimeric antigen receptor T (CAR-T) cell therapy. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Presentation ID 58.
7. Duarte FB, Garcia YDO, Funke VAM, et al. Comparison of outcomes after hematopoietic STEM cell transplantation (HCT) for myelodysplastic syndrome (MDS) patients older or younger THAN 65 YEARS Old. A retrospective analysis of the Latin America registry. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 618.
8. Pidala J, DeFlilipp Z, DeVos J, et al. Determinants of immune suppression discontinuation in the modern era: a CIBMTR analysis of 18,642 subjects. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Presentation ID 39.
9. Cowden M, Derrien-Connors C, Holtan S, et al. Patient experiences with chronic graft-versus-host disease and its treatment in the United States: A retrospective social media listening study. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 516.

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In a conversation with CancerNetwork®, Marwan G. Fakih, MD, spoke about the FDA approval of sotorasib (Lumakras) plus panitumumab (Vectibix), and how it may affect the treatment paradigm for patients with KRAS G12C-mutant metastatic colorectal cancer (CRC).

Fakih is a professor in the Department of Medical Oncology & Therapeutics Research, associate director for Clinical Sciences, medical director of the Briskin Center for Clinical Research, division chief of GI Medical Oncology, and co-director of the Gastrointestinal Cancer Program at City of Hope Comprehensive Cancer Center in Duarte, California.

According to Fakih, the approval of this combination regimen is a “welcome step” for those with metastatic CRC harboring KRAS G12C mutations. Based on supporting data from the phase 3 CodeBreaK 300 trial (NCT05198934), sotorasib/panitumumab may prolong progression-free survival (PFS) and reduce disease burden in patients while offering improvements in other outcomes vs prior standards of care (SOC) like trifluridine/tipiracil (Lonsurf) and regorafenib (Stivarga).

Topline data at the time of the approval showed a median PFS of 5.6 months (95% CI, 4.2-6.3) with sotorasib at 960 mg plus panitumumab vs 2.0 months (95% CI, 1.9-3.9) in the SOC arm, in which patients were assigned to receive trifluridine/tipiracil or regorafenib (HR, 0.48; 95% CI, 0.30-0.78; P = .005). Additionally, the overall response rate was 26% (95% CI, 15%-40%) vs 0% (95% CI, 0%-7%) in each respective arm.

Looking ahead, Fakih highlighted the potential next steps for research associated with the sotorasib combination as well as other novel therapeutic strategies in the gastrointestinal cancer space. For example, he described the phase 3 CodeBreaK 301 study (NCT06252649), which will evaluate sotorasib/panitumumab as frontline therapy when administered in combination with folinic acid, fluorouracil, and irinotecan (FOLFIRI) vs FOLFIRI plus bevacizumab (Avastin) in metastatic KRAS G12C-mutant CRC. Other novel agents under development in the space include RAS inhibitors and immunotherapy regimens combining CTLA-4 inhibitors with anti–PD-L1 agents.

References
1. FDA approves sotorasib with panitumumab for KRAS G12C-mutated colorectal cancer. News release. FDA. January 16, 2025. Accessed February 12, 2025. https://shorturl.at/1WviB

Kim TW, Price T, Grasselli J, et al. A phase 3 study of first-line sotorasib, panitumumab, and FOLFIRI versus FOLFIRI with or without bevacizumab-awwb for patients with KRAS G12C–mutated metastatic colorectal cancer (CodeBreaK 301). J Clin Oncol. 2025;43(suppl 4):TPS326. doi:10.1200/JCO.2025.43.4_suppl.TPS326

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Following the 2024 Marginal Zone Lymphoma (MZL) Workshop, CancerNetwork® spoke with multiple attending clinicians about insights they shared regarding the disease state, covering the significance of the workshop and its contribution to advancing research in areas such as prognostic factors and managing adverse events (AEs) related to the disease.

Thomas Habermann, MD, professor of Medicine at the Mayo Clinic in Rochester, Minnesota, member of the Lymphoma Research Foundation’s Scientific Advisory Board, and MZL Workshop co-chair, spoke about the significance of the MZL Workshop. He highlighted the complexity of these types of diseases, which he believed warranted the establishment of the group.

According to Habermann, MZL is a “heterogenous group of disorders” that most contemporaries in the field “don’t quite appreciate.”

Next, Julie M. Vose, MD, MBA, George and Peggy Payne chair in oncology and chief of Hematology and Oncology at the University of Nebraska Medical Center, and co-editor-in-chief of ONCOLOGY®, spoke about how the MZL Workshop contributes to advancing research and improving outcomes for patients with MZL. She emphasized a need to be more inclusive when enrolling patients with MZL in clinical trials.

Then, James R. Cerhan, MD, PhD, professor of Epidemiology at the Mayo Clinic College of Medicine and Science, and Ralph S. and Beverly Caulkins Professor of Cancer Research, spoke about addressing research questions in MZL epidemiology to further disease understanding. He emphasized a need to further study newly identified risk factors of the disease, as well as identifying new treatment targets for patients with MZL.

Additionally, Alexandar Tzankov, MD, surgical pathologist and head of the Department of Histopathology and Autopsy at the Institute of Medical Genetics and Pathology at University Hospital Basel, and chair for the European Bone Marrow Working Group, discussed how prognostic factors for MZL may influence treatment. He described how the limited number of studies done with relatively small subsets of patients makes prognoses challenging, as prognostic factors have not been sufficiently explored.

Finally, Andrew D. Zelenetz, MD, PhD, medical director of Quality Informatics at Memorial Sloan Kettering Cancer Center, outlined challenges related to AE management of treatments for MZL. He emphasized that safety management practices for MZL are comparable with other B-cell lymphomas, suggesting that use of bridging therapy for CAR T cells and step-up dosing for bispecific antibodies may help with mitigating AEs.

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In the first edition of a special 3-part podcast series, CancerNetwork® spoke with Daniel Morgensztern, MD; Mary Ellen Flanagan, NP; and Janelle Mann, PharmD, BCOP, about best practices for implementing recently approved bispecific antibodies into cancer care. Their initial discussion focused on the clinical trial results, administration protocols, and toxicity management strategies related to the use of amivantamab-vmjw (Rybrevant) for patients with EGFR-mutated non–small cell lung cancer (NSCLC).

Morgensztern is a professor of Medicine and clinical director of Thoracic Oncology in the Division of Oncology at Washington University School of Medicine in St. Louis. Flanagan is a nurse practitioner in the Division of Thoracic Oncology at Washington University in St. Louis. Mann is a clinical oncology pharmacist at Siteman Cancer Center of Washington University School of Medicine in St. Louis and manager of Clinical Pharmacy Services at Barnes-Jewish Hospital.

Morgensztern began by giving an overview of amivantamab’s mechanism of action and highlighting supporting data for the agent when administered alone or in combination with other agents.

The FDA initially approved amivantamab monotherapy for patients with EGFR exon 20 insertion–mutant NSCLC in May 2021 based on data from the phase 1 CHRYSALIS trial (NCT02609776). Furthermore, the agency approved amivantamab/chemotherapy as frontline treatment for patients with NSCLC harboring EGFR exon 20 insertion mutations in March 2024 based on data from the phase 3 PAPILLON trial (NCT04538664). Findings from the phase 3 MARIPOSA trial (NCT04487080) also supported the FDA approval of amivantamab plus lazertinib (Lazcluze) for those with EGFR-mutant NSCLC in August 2024.

Additionally, Mann reviewed key dosing considerations as patients receive amivantamab via intravenous infusion. She detailed the use of premedication such as diphenhydramine (Benadryl) to supplement amivantamab while monitoring for toxicities during the initial infusion period, which may necessitate additional dosing adjustments. Flanagan added to the conversation surrounding infusion-related reactions by describing strategies for mitigating the risk of venous thromboembolism, cutaneous toxicities, and other adverse effects.

References
1. RYBREVANTTM (amivantamab-vmjw) receives FDA approval as the first targeted treatment for patients with non-small cell lung cancer with EGFR exon 20 insertion mutations. News release. The Janssen Pharmaceutical Companies of Johnson & Johnson. May 21, 2021. Accessed January 29, 2025. https://tinyurl.com/3d8wtu4m

FDA approves amivantamab-vmjw for EGFR exon 20 insertion-mutated non-small cell lung cancer indications. News release. FDA. March 1, 2024. Accessed January 29, 2025. https://tinyurl.com/msw4u5yk
RYBREVANT® (amivantamab-vmjw) plus LAZCLUZE™ (lazertinib) approved in the U.S. as a first-line chemotherapy-free treatment for patients with EGFR-mutated advanced lung cancer. News release. Johnson & Johnson. August 20, 2024. Accessed January 29, 2025. https://tinyurl.com/yxc8u8t4

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In collaboration with KidneyCAN, CancerNetwork® spoke with Eric Jonasch, MD, a professor in the Department of Genitourinary Medical Oncology of the Division of Cancer Medicine, and the director of the von Hippel Lindau Center at the University of Texas MD Anderson Cancer Center in Houston, Texas, about the missions and goals of the Kidney Cancer Research Consortium.

Jonasch is the principal investigator of an effort, supported by a Department of Defense (DoD)–funded grant, that aims to improve the treatment of patients with renal cell carcinoma (RCC) by developing a network of clinical trial centers that have expertise in both developing and executing new research efforts.

“We want to do the clinical trials that the industry wouldn’t do otherwise and do the trials that are going to allow us to gain knowledge faster,” Jonasch said. “We do this by, number one, using novel agents; number 2, using more efficient and innovative clinical trial designs; and, number 3, incorporating correlative studies, including biopsies and various other circulating biomarkers analyses that allow us to get smarter faster.”

Many of the ongoing and recently completed trials in the kidney cancer space focused heavily on immune therapy, utilizing checkpoint-blocking antibodies like nivolumab (Opdivo) and pembrolizumab (Keytruda) or CTLA-4–blocking agents like ipilimumab (Yervoy). Of the studies moving the space forward, Jonasch highlighted an ongoing phase 1b/2 trial (NCT05501054) evaluating ipilimumab, nivolumab, and ciforadenant (CPI-444), an A2A inhibitor, in RCC along with other trials.

During the discussion, Jonasch mentioned the initiative to incorporate biopsies in treatment more frequently, particularly through giving a pre- and post-biopsy to see how the results change during therapy. This approach gives investigators an opportunity to see how cancer cells interact with immune cells.

Additionally, Jonasch stated that they wish to expand their efforts to the broader kidney cancer community, as currently, work in the consortium only takes place in 7 “ivory tower” institutions that may be difficult to access for some patients. One of the ways they’re combatting this barrier is through working with the Veterans Affairs hospital system. Once that effort is complete, Jonasch hopes the consortium will be able to start helping more patient groups.

Reference

Beckermann K, Rini B, Haas N, George D, Jonasch E. Phase 1b/2 trial of ipilimumab, nivolumab, and ciforadenant (INC) (adenosine A2a receptor antagonist) in first-line advanced renal cell carcinoma. Oncologist. 2023;28(suppl 1):S13–4. doi:10.1093/oncolo/oyad216.022.

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In a conversation with CancerNetwork®, Shewetal Mehta, PhD, spoke about her research team’s focuses in moving novel brain cancer therapies down the pipeline as part of an early phase clinical trials program at the Ivy Brain Tumor Center.

Mehta, the deputy director and pre-clinical core leader at the Ivy Brain Tumor Center of Barrow Neurological Institute in Phoenix, Arizona, underscored a scientifically rigorous, patient-driven philosophy that drives her team members to deliver timely answers to those with brain cancer via work in a clinical lab and a pre-clinical arm. This collaboration helps identify therapeutic agents that may demonstrate activity in the brain while determining patient populations who are suitable to enroll on clinical trials.

As part of her institution’s early phase trial program, Mehta specifically highlighted work associated with a phase 0/1 clinical trial (NCT06072586) evaluating BDTX-1535, a brain-penetrant fourth-generation EGFR inhibitor, for those with recurrent high-grade glioma harboring oncogenic EGFR alterations or fusions.1 Investigators are incorporating liquid biopsy, sampling cerebrospinal fluid from patients on treatment to monitor potential evolutions or changes in brain tumors.

Regarding biomarker testing, Mehta described the roles that gene sequencing and immunohistochemistry can play in identifying targetable alterations in patients with brain cancer. She mentioned vorasidenib (Voranigo), which received approval from the FDA in August 2024, as an example of a targeted therapy that may be suitable for use in patients who are found to have actionable IDH mutations.

“Over the last year, we’ve seen that we were capable of not just doing these early phase clinical trials [but of entering] this phase of moving drugs into phase 3 [studies]. That’s exciting,” Mehta stated regarding her outlook on the current state of brain cancer treatment. “Right now, we are excited about these new classes of agents that are within the space, like the proteolysis targeting chimeras, protein degraders, and antibody-drug conjugates, which have shown amazing promise in the rest of the oncology space.”

References

Study of BDTX-1535 in recurrent high-grade glioma (HGG) participants with EGFR alterations or fusions. ClinicalTrials.gov. Updated January 15, 2025. Accessed January 15, 2025. https://tinyurl.com/m6kwr2b3
FDA approves vorasidenib for grade 2 astrocytoma or oligodendroglioma with a susceptible IDH1 or IDH2 mutation. News release. FDA. August 6, 2024. Accessed January 20, 2025. https://tinyurl.com/25r9fkvy

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CancerNetwork® spoke with Michael P. Bogenschutz, MD, director of the NYU Langone Center for Psychedelic Medicine and professor of Psychiatry at NYU Grossman School of Medicine, about psilocybin-assisted psychotherapy (PAP) in managing psychological challenges associated with serious cancer diagnoses following the publication of a pooled analysis of 2 phase 2 trials assessing the regimen in this patient population.

In these trials, 87 patients were randomly assigned 1:1 to receive either psilocybin first (n = 45) or control therapy with niacin or low-dose psilocybin first (n = 42) followed by crossover. A total of 79 patients completed at least 1 assessment after the first dose.

He began by touching upon the significance of the results, highlighting an improvement in multiple psychiatric symptoms including anxiety (P = .0049), depression (P = .0007), interpersonal sensitivity (P = .0005), obsession-compulsion (P = .0002), hostility (P = .009), and somatization (P < .0001). Then, Bogenschutz discussed the potential for PAP to reduce an unmet need for patients seeking effective medication to mitigate cancer-related psychological challenges, highlighting limitations of both antidepressants and anxiety medication in this population.

Next, Bogenschutz discussed implementing PAP into clinical practice for patients with cancer-related psychological challenges. In particular, he expressed that integration could occur through in-house operation, which may build the capacity to provide PAP within cancer centers, or through a referral system to a licensed practitioner trained to administer psilocybin.

Additionally, he described potential adverse effects associated with psilocybin use, highlighting acute mind-altering and sympathomimetic effects. He then expressed the importance of psychotherapy as a means of supplementing the use of psilocybin, which may help patients better attain positive mental health outcomes than with psilocybin alone. He concluded by highlighting the lasting effects of psilocybin dosing, which may persist for months after a single dose, as well as areas for future research in assessing PAP. Specifically, he emphasized exploring ideal treatment parameters and the full psychopathological scope of the agent.

Reference
Petridis PD, Grinband J, Agin-Liebes G, et al. Psilocybin-assisted psychotherapy improves psychiatric symptoms across multiple dimensions in patients with cancer. Nat Mental Health. 2024;2:1408-1414. doi:10.1038/s44220-024-00331-0

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Following the 2024 San Antonio Breast Cancer Symposium (SABCS), Paolo Tarantino, MD, and Matteo Lambertini, MD, PhD, co-hosted a live X Space with CancerNetwork® and spoke about updated trial findings that may impact the breast cancer treatment paradigm.

Tarantino is a clinical research fellow at Dana-Farber Cancer Institute and Harvard Medical School. Lambertini is an associate professor and consultant in medical oncology at the University of Genova – IRCCS Policlinico San Martino Hospital in Genova, Italy.

Tarantino and Lambertini highlighted data from various studies that investigators presented at the Symposium, which included results on the use of treatment modalities such as antibody drug conjugates and CDK4/6 inhibitors. Some presentations of interest included the following:

· Phase 3 DESTINY-Breast06 Trial (NCT04494425)
o Patients with hormone receptor (HR)–positive, HER2-low or HER2-ultralow metastatic breast cancer were assigned to receive fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu) or physician’s choice of therapy.

o Treatment with T-DXd improved progression-free survival (PFS) among patients with a time to progression on frontline endocrine therapy of less than 6 months (HR, 0.38; 95% CI, 0.25-0.59), 6 to 12 months (HR, 0.69; 95% CI, 0.43-1.12), and more than 12 months (HR, 0.67; 95% CI, 0.51-0.88).

o PFS improved with T-DXd regardless of disease burden.

· Phase 3 EMBER-3 Trial (NCT04975308)
o Investigators evaluated 3 treatment arms—imlunestrant (LY3484356) monotherapy, fulvestrant (Faslodex) or exemestane (Aromasin), and imlunestrant in combination with abemaciclib (Verzenio)—among patients with estrogen receptor (ER)–positive, HER2-negative advanced breast cancer.

o Across the overall population, imlunestrant monotherapy improved PFS compared with standard endocrine therapy (HR, 0.87; 95% CI, 0.72-1.04; P = .12).

o Imlunestrant plus abemaciclib also showed a PFS improvement vs endocrine therapy across the overall population (HR, 0.57; 95% CI, 0.44-0.73; P <.001).

· Phase 2 SOLTI-VALENTINE Trial (NCT05569811)
o Patients with primary operable HR–positive/HER2-negative breast cancer were assigned to receive patritumab deruxtecan (HER3-DXd) alone, HER3-DXd plus letrozole (Femara), or standard multiagent chemotherapy.

o HER3-DXd monotherapy yielded a pathologic complete response (pCR) rate of 4.0% (95% CI, 0.5%-13.7%) and an objective response rate (ORR) of 70.0% (95% CI, 55.4%-82.1%); the respective rates in the chemotherapy arm were 4.2% (95% CI, 0.1%-21.1%) and 70.8% (95% CI, 48.9%-87.4%).

o Combining HER3-DXd with letrozole produced a pCR rate and ORR of 2.1% (95% CI, 0.1%-11.1%) and 81.3% (95% CI, 67.4%-91.1%), respectively.

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In a conversation with CancerNetwork®, Rachel A. Millstein, PhD, MHS; Loren Winters, NP; and Amy Comander, MD, discussed their article titled Implementing a Multidisciplinary Lifestyle Medicine Clinic for Cancer Survivorship, which was published in the November 2024 issue of ONCOLOGY®. The authors detailed the implementation of a novel oncology-based multidisciplinary lifestyle medicine clinic that may help enhance the quality of life (QOL) among survivors of cancer.

Millstein is a psychologist in the Behavioral Medicine Program and an assistant professor in the Department of Psychiatry at Massachusetts General Hospital. Winters is an oncology nurse practitioner and assistant director of the Lifestyle Medicine Program at Massachusetts General Hospital. Comander is the medical director of Mass General Cancer Center-Waltham, director of the Breast Oncology Program at Newton-Wellesley Hospital, and director of the Lifestyle Medicine Program at Massachusetts General Hospital.

Millstein outlined the rationale for this publication on the development of a multidisciplinary lifestyle medicine clinic, highlighting a need to boost general awareness and support for lifestyle medicine consultations and health behavior change in cancer survivor care. Winters then explained how the multidisciplinary clinic works in alignment with 6 key pillars of lifestyle medicine, as team members aim to promote physical activity, plant-predominant diets, restorative sleep, stress management, avoidance of risky substances, and social connections to enhance QOL among cancer survivors.

Additionally, Comander highlighted how the lifestyle medicine program optimizes health and well-being by matching patients to the specific services they require, which may include the help of team members such as board-certified physicians, nurse practitioners, registered dietitians, and clinical psychologists. Millstein and Winters then detailed the improvements in health behaviors associated with 2 patient cases at their program, demonstrating the potential benefits of implementing broad and diverse lifestyle medicine tools in oncology-supportive care.

Looking ahead, Comander described the importance of addressing gaps in education, a lack of programs focused on areas such as weight management, and other barriers to the implementation of lifestyle medicine in oncology care. Finally, each author expressed her hope to see more colleagues, clinics, and programs incorporate lifestyle medicine as part of elevating QOL among survivors of cancer. The authors invite listeners to contact them if they would like to find ways to implement lifestyle medicine in their respective centers.

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CancerNetwork® spoke with Natasha Bahri, MD, MS, and Daneng Li, MD, about their Hot Topics article titled Casting a Wide NET: When Is the Optimal Time for 177Lu-Dotatate Treatment?, which was published in the November 2024 issue of ONCOLOGY®. Their article focused on findings related to the use of 177Lutetium-Dotatate (177Lu-dotatate; Lutathera) in patients with neuroendocrine tumors (NETs) and whether these data supported the use of the novel radioligand therapy for this population.

Bahri is a PGY-5 chief fellow in Medical Oncology and Hematology at City of Hope National Medical Center in Duarte, California. Li is an associate professor in the Department of Medical Oncology & Therapeutics Research at City of Hope Comprehensive Cancer Center in Duarte, California, and a gastrointestinal editorial board member of ONCOLOGY.

Bahri and Li discussed findings from the phase 3 NETTER-1 trial (NCT01578239) assessing 177Lu-dotatate for those with inoperable, locally advanced or metastatic, grade 1/2 midgut NETs following progression on long-acting repeatable octreotide therapy. Although these findings established a significant efficacy signal with the radioligand therapy, Li noted that questions remained regarding the sequencing of 177Lu-dotatate alongside other therapies in the treatment landscape.

The conversation also covered efficacy, safety, and quality-of-life (QOL) data from the phase 3 NETTER-2 trial (NCT03972488), in which investigators assessed high-dose octreotide with or without 177Lu-dotatate among patients with locally advanced or metastatic, well-differentiated, somatostatin receptor–positive gastroenteropancreatic NETs. Although data showed improvements in efficacy with the 177Lu-dotatate combination, there did not appear to be significant differences regarding QOL outcomes between arms.

“We’re waiting for further long-term follow-up information as there was no difference in the QOL metrics. It’s important to think about how these patients’ goals align with the therapy that we’re giving, and if we’re not seeing a difference in the quality of life quite yet, [we need to] look at individual patients, see what their goals are, and match them up to the therapy that we’re giving them,” Bahri stated.

Although the NETTER-1 and NETTER-2 trials demonstrate “great” results associated with efficacy end points such as progression-free survival, the authors noted that it is crucial to weigh these benefits with the potential toxicities when determining suitable candidates for treatment with 177Lu-dotatate.

“There’s a lot of nuances in terms of who is the ideal patient that’s going to maximally benefit [while] minimizing any risk of serious toxicity in those patients. As a result of that, we’re helping to improve their outcomes to the highest bars possible, whether it’s quality of life or survival,” Li concluded.

References
1. Strosberg J, El-Haddad G, Wolin E, et al; NETTER-1 Trial Investigators. Phase 3 trial of 177Lu-Dotatate for midgut neuroendocrine tumors. N Engl J Med. 2017;376(2):125-135. doi:10.1056/NEJMoa1607427

Singh S, Halperin D, Myrehaug S, et al; NETTER-2 Trial Investigators. [177Lu]Lu-DOTA-TATE plus long-acting octreotide versus high-dose long-acting octreotide for the treatment of newly diagnosed, advanced grade 2-3, well-differentiated, gastroenteropancreatic neuroendocrine tumours (NETTER-2): an open-label, randomised, phase 3 study. Lancet. 2024;403(10446):2807-2817. doi:10.1016/S0140-6736(24)00701-3

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CancerNetwork® spoke with Rachel A. Greenup, MD, MPH, an associate professor of surgery (oncology), section chief of Breast Surgery, and co-director of the Center for Breast Cancer at the Yale School of Medicine, about the rationale behind conducting a study evaluating the lived experiences among women of color following breast cancer mastectomy, as well as data collection strategies employed during the study and key themes outlined in questionnaire responses.

First, Greenup, senior author of the study, emphasized that disparities persist for women of color following mastectomy for breast cancer, both in those seeking breast reconstructive surgery and those choosing to forego it, which is an act called “living flat.” She explained that many of the stories behind these disparities were left untold, and this study was seeking to unearth them.

She then explained that women of color who underwent a mastectomy for breast cancer were sampled for the study. The patient population included women from her institution and survivors willing to share their experiences.

Expressing that her team strove to let the stories of these women speak for themselves, she discovered 2 major findings during her research. The first theme that emerged was a cultural stigma surrounding cancer diagnoses among minority groups, which impact knowledge of family history as well as timely screening, care, and support for their disease. The second major theme that her study revealed was spirituality as a driver for many of the decisions following mastectomy.

Greenup further emphasized a need for cultural, racial, and ethnic inclusion during clinical trials, which extends to anticipating differences in cancer developments among diverse populations. She concluded by encouraging all patients to share their family history of cancer, regardless of background, as it can impact screening and prevention measures.

“I would encourage all families and all individuals from different cultural backgrounds to share their family history of cancer. It has a critical impact in terms of screening and cancer prevention for other family members,” Greenup said. “It can be difficult to have those conversations, but it is information that can be powerful for future prevention.”

Reference
Khubchandani JA, Suttiratana SC, Washington R, et al. Living flat: stories from women of color after mastectomy. Ann Surg Oncol. Published online October 15, 2024. doi:10.1245/s10434-024-16337-y

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CancerNetwork, in a partnership with KidneyCAN, spoke with 2 genitourinary oncologists, Elizabeth P. Henske, MD, and Jason Muhitch, PhD, about how advocacy and funding through interdisciplinary collaboration between patient advocates, researchers, and physicians have resulted in numerous clinical breakthroughs in kidney cancer.

Henske is a professor of medicine at the Harvard Medical School, an associate member of the Broad Institute of MIT and Harvard, director of the Center for LAM Research and Clinical Care, and a physician at Brigham and Women’s Hospital and Dana-Farber Cancer Institute. Muhitch is an associate professor of Oncology, co-chair of the Genitourinary Translational Research Group, deputy director of Graduate Studies, and a member of the Department of Immunology at Roswell Park Comprehensive Cancer Center at Roswell Park Comprehensive Cancer Center.

First, the state of kidney cancer advocacy was discussed, with Muhitch emphasizing multidisciplinary collaboration and the role of conferences, such as the Kidney Cancer Research Summit (KCRS) and the International Kidney Cancer Symposium, in bringing these groups together. Henske emphasized the strength of the advocacy network for kidney cancer, particularly as a mechanism for exchanging information, offering patient support and education, and facilitating research.

Next, funding was touched upon, with Henske expressing her interest in conveying the importance and urgency of kidney cancer research to Congress. Muhitch agreed, suggesting that the meetings with congressional offices offer opportunities to explain how funding can impact kidney cancer outcomes and scientist training, as well as the strength of patient advocacy in influencing Congress.

Muhitch and Henske then discussed the Kidney Cancer Research Program, which has enabled significant increases in funding for kidney cancer research, helped to facilitate clinical breakthroughs for common kidney cancer types, and set a foundation for exploring different kidney cancer variants. The discussion then turned to encouraging research for renal cell carcinoma , which Muhitch expressed can be attributed to partnership award recipients who went on to conduct research evaluating biomarkers predictive of patient responses to immunotherapies.

Regarding additional funding mechanisms, Henske and Muhitch discussed numerous private foundations providing smaller research grants. Henske explained that these smaller grants are instrumental in taking the first steps to explore rarer kidney cancer subtypes, with Muhitch explaining that the earlier funding can formulate research that leads to greater funding from the Kidney Cancer Research Program.

KidneyCAN is a nonprofit organization with a mission to accelerate cures for kidney cancer through education, advocacy, and research funding. Learn more about KidneyCAN’s mission and work here.

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In a conversation with CancerNetwork® at the 2024 Annual Oncology Clinical Practice and Research Summit, Andrew M. Evens, DO, MBA, MSc, spoke about a session he moderated at the meeting, in which he and other panelists highlighted ongoing efforts to improve the quality of care for cancer survivors at his institution.

Evens is the deputy director for Clinical Services at Rutgers Cancer Institute and the system director of Medical Oncology and the oncology lead at RWJBarnabas Health Medical Group. He is also the associate vice chancellor for Clinical Innovation and Data Analytics at Rutgers Biomedical and Health Sciences.

Evens contextualized the presentation by describing various gaps in care for survivors of cancer, particularly among adolescent and young adult populations or those who become “lost in transition” as they switch from pediatric to adulthood survivorship. He emphasized a growing effort to mitigate the risks of post-acute or late effects following prior anti-cancer therapy, which can include cardiac disease, lung disease, or increased infections associated with chemotherapy or radiation.

As part of elevating the level of care for cancer survivors, Evens described the collaborative efforts across different departments at his institution, including medical, surgical, and radiation oncologists; pharmacists; nurses; pathologists; and members of the clinical research team. Other international research projects, including those formed in association with the National Cancer Institute, aim to elucidate the granularity of treatment-related toxicity, which may help inform better survivorship care strategies.

“Survivorship includes many factors,” Evens said. “There are physical and emotional factors, and we want to do everything we can as a comprehensive cancer program, and to do what’s best for the patient in a holistic manner. [Beyond the] cancer, it also means the emotional factors and health behavior modifications. For the rest of their life, [we want to] help the patient in every way possible so they can live the most fruitful life. A high quality of life is what we strive for.”

ReferenceEvens A, Cole P, Ligresti L, Manne S. Cancer survivorship: scale, scope, and partnerships for patient-centered care. Presented at the 2024 Annual Oncology Clinical Practice and Research Summit; November 15-16, 2024; New Brunswick, NJ.

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During Pancreatic Cancer Awareness Month, CancerNetwork® spoke with Kelly A. Rone, DNP, RN, AGNP-c, about the current state of pancreatic cancer, emphasizing risk factors, diagnostic challenges, and treatment planning. Rone is an advanced practice nurse of gastrointestinal oncology at Mayo Clinic in Phoenix, Arizona.

Rone initially discussed patient counseling for risk factors, making a distinction between modifiable risk factors—such as smoking, drinking, and obesity—and nonmodifiable risk factors, which primarily include genetic syndromes. Rone then highlighted a need for more effective screening methods, highlighting a lack of screening tools that have been proven to be highly effective, as well as the tendency for pancreatic cancer to be identified at a later stage.

Rone then touched upon treatment-emergent adverse effects (AEs), as well as how her practice manages them. She particularly placed emphasis on appetite loss, which may prove difficult for patients attempting to recover from cancer treatment. Additionally, Rone suggested various methods to encourage food consumption in spite of appetite loss.

Rone expressed that she connects patients with pancreatic cancer to palliative care frequently, explaining that patients can benefit from involvement in terms of managing AEs and extending life expectancy. Furthermore, she stressed a need to correct misconceptions of palliative care as exclusively entailing pre-hospice care, highlighting benefit in all patients regardless of disease stage.

Rone iterated that addressing psychosocial needs for patients varies depending on a patient’s circumstances. Rone then suggested that viewing patients as individuals with lives beyond their cancer diagnosis can help humanize them and can help to foster more meaningful discussions regarding cancer treatment than electronic health records alone.

Then, Rone expressed a desire to find ways to detect pancreatic cancers sooner by developing biomarkers, highlighting how pancreatic cancer may be paired with several vague symptoms that make early detection difficult. Rone explained that early detection of pancreatic cancers can be associated with better outcomes.

She further expressed a need to elicit better treatment outcomes for pancreatic cancer based on low responsiveness to chemotherapy. Rone concluded by emphasizing a need for education regarding 2 distinct types of pancreatic cancer––pancreatic adenocarcinoma and pancreatic neuroendocrine cancer––to better manage patient expectations.

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In a conversation with CancerNetwork® during Pancreatic Cancer Awareness Month, Tanios S. Bekaii-Saab, MD, spoke about various developments in the pancreatic cancer treatment field. Throughout the discussion, Bekaii-Saab weighed the benefits of currently available chemotherapeutic regimens for patients with metastatic disease, discussed research on the potential for precision medicine in those with KRAS wildtype pancreatic ductal adenocarcinoma (PDAC), and detailed ongoing initiatives to improve outcomes among those with RAS mutations and other targetable genomic alterations.

Bekaii-Saab is the David F. and Margaret T. Grohne Professor of Novel Therapeutics for Cancer Research, chair and consultant in the Division of Hematology and Medical Oncology at Mayo Clinic in Arizona, and co-leader of Advanced Clinical and Translational Science at Mayo Clinic Cancer Center.

Given the prevalence of RAS mutations and other alterations in patients with pancreatic cancer, Bekaii-Saab especially emphasized the use of genomic analysis to inform personalized treatment decision-making in the field. Screening patients to detect aberrations such as microsatellite instability-high tumors, BRAF 600E mutations, KRAS G12C mutations, and NRG1 fusions can open the door for the development and use of targeted agents, which may consequently improve patient outcomes.

Looking ahead, Bekaii-Saab noted the need to adapt the therapies that have shown activity in the later stages of the disease to earlier treatment settings. Although “great work” has been achieved with chemotherapy and surgical techniques, he highlighted the importance of bringing targeted agents to earlier lines of therapy to further increase the likelihood of positive outcomes for patients.

“I have never been more optimistic. I’m always the eternal optimist, but I’m even more optimistic today that we’re going to move the needle for our patients with pancreatic cancer and continue to enhance that likelihood of living longer, having a better quality of life, or even increasing the level of a cure for this cancer,” Bekaii-Sabb stated. “Certainly, the future looks bright. We’re chipping away, one drug at a time. We can now remove that whole concept of nihilism in pancreatic cancer and look quite optimistically on the future.”

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As part of Oncology On the Go, CancerNetwork® spoke with Andrew M. Evens, DO, MBA, MSc, about developments in the treatment landscape for adolescents and young adults (AYA) with lymphoma. He highlighted collaboration between adult and pediatric oncologists that may better standardize treatment for this population.

Evens is the deputy director for clinical services at the Rutgers Cancer Institute and system director of medical oncology and oncology lead at RWJBarnabas Health Medical Group.

Of note, Evens discussed an effort to “harmonize” efforts between adult and pediatric oncologists in treating AYA patients who may receive different treatment regimens, despite being similar in age. Furthermore, he highlighted 2 prominent trials that illustrated collaborative efforts from both adult and pediatric oncologists: the phase 3 SWOG S1826 trial (NCT03907488) and the phase 3 AHOD2131 trial (NCT05675410).

Regarding the SWOG trial, Evens highlighted the greater efficacy and tolerability of nivolumab (Opdivo) with doxorubicin hydrochloride (Adriamycin), vinblastine sulfate, and dacarbazine (AVD) vs the standard of care brentuximab vedotin (Adcetris) plus AVD.

“You could say it was, generally speaking, a double winner. [The nivolumab combination] was more effective at 2 years; the progression-free survival [PFS] was greater than 90%, [which was] a remarkable output. When I say a double winner, it was also largely better tolerated. There was less neuropathy, [fewer] infections, and less sepsis [vs brentuximab vedotin plus AVD]. Surprisingly, to a certain extent, [there were] not many immune-related adverse events outside of thyroid [events],” Evens said.

Furthermore, Evens discussed how collaboration between adult and pediatric oncology has impacted developments in the AYA lymphoma sphere. He placed a particular emphasis on the efforts of the Lymphoma Research Foundation, which convened multiple AYA lymphoma symposiums and established an AYA consortium. He then outlined unmet needs for this patient population, which included mitigating late toxicities following treatment and addressing inconsistencies in guidelines for lymphoma treatment in the AYA group.

Evens then discussed mitigating disparities and addressing barriers to care, underscoring a need to navigate the complexities of treatment for a patient population with a myriad of stressors. He concluded by highlighting resources available to AYA lymphoma groups, which include educational, medical, and psychosocial resources to best educate patients and express to them that they are not alone.

“At the end of the day, be an advocate. Be an advocate for yourself. Be an advocate for others and know that there are [many] resources and people out there to help. We want to make sure nobody has to go through this alone, and that they have the medical and other psychosocial resources available to them,” Evens concluded.

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CancerNetwork® sat down with Kelley A. Rone, DNP, RN, AGNP-c, to discuss the importance of speaking compassionately and ensuring patient awareness when leading end-of-life discussions among those with gastrointestinal (GI) cancers. The discussion also focused on combating burnout in the clinic, using opioids to help manage pain and other symptoms, and educating all members of a multidisciplinary team on initiating end-of-life conversations with their patients.

Rone is an advanced practice nurse (APN) in GI oncology at the Mayo Clinic in Phoenix, Arizona.

As part of leading these end-of-life conversations, Rone emphasized the necessity of addressing the discomfort patients tend to feel when talking about the fact that they may die from their cancer. Speaking with these patients may involve being open about the possibility of terminating therapy early if treatment-related toxicity such as fevers, diarrhea, and pain outweigh any potential efficacy or diminish quality of life. Additionally, Rone highlighted how APNs may be more comfortable with speaking about death than other team members.

Rone also discussed the importance of managing fatigue and pain as patients near the end of their lives. In her role, she initiates education on pain management early in end-of-life care discussions to make patients feel more comfortable about receiving opioids for symptoms.

When working with other members of a multidisciplinary care team, Rone illustrated the challenge of having physicians understand that their treatments may fail in younger patients and helping other oncologists become more experienced in speaking about death with patients. Regarding the idea of mitigating burnout and maintaining one’s mental well-being, Rone described how her role has given her perspective on what is truly important about life.

“This [role] helps you appreciate the finality of life. You don’t get upset about [minor] things after you see a 39-year-old with metastatic cancer,” Rone stated. “You learn to have an appreciation for the good things and not dwell so much on the bad things.”

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CancerNetwork® spoke with John Paul Diaz, MD, about uterine transposition, a surgical technique aiming to preserve fertility in women undergoing radiotherapy for pelvic tumors. Diaz is the chief of gynecologic oncology, director of robotic surgery, director of the Center of Excellence in Minimally Invasive Gynecologic Surgery at Baptist Health, and lead physician for Clinical Trials in Gynecologic Oncology at Miami Cancer Institute.

Of note, Diaz discussed the outcomes associated with 2 procedures conducted at his practice, as well as challenges associated with the development and implementation of the procedure. Additionally, he spoke about the next steps in developing and raising awareness of the procedure.

Diaz foregrounded the discussion by highlighting the simplicity of the procedure, which he stated was similar to a hysterectomy. Unlike a hysterectomy, uterine transposition entails a temporary relocation of the uterus to the anterior abdominal wall, which preserves it for fertility while removing it from the radiation field.

Furthermore, Diaz described the collaboration between Baptist Health and Memorial Sloan Kettering Cancer Center, including a partnership with Mario M. Leitao, Jr., MD, FACOG, FACS, who holds the largest series in the United States in performing uterine transpositions. He explained that the collaboration was conducive for expanding patient populations that may benefit from this surgery.

Diaz then underlined outcomes related to 2 uterine transposition procedures he conducted at Baptist Health. He described a favorable outcome with one patient who had completed the procedure 3 months prior who may be able to become pregnant in the future. The second patient was undergoing radiotherapy, with plans to undergo the second stage of the surgery in following months.

Diaz then highlighted a distinction between uterine transposition and other fertility preservation measures in that it preserves the entire uterus so patients can still carry a child, whereas other radiation therapy techniques do not. He then highlighted patients who are eligible for this procedure, particularly among women who want to preserve their fertility with pelvic tumors requiring radiation that might otherwise sterilize the uterus.

Challenges related to the development and implementation of the procedure were discussed, with particular emphasis placed upon quality of life following treatment. Additionally, he emphasized the idea of patient-driven improvements in treatment outcomes, which he hoped could be applied to help more women preserve their fertility.

Diaz continued by emphasizing the novelty of the procedure, explaining that experiences with it are growing while surgery success rates increase with global collaboration and technique sharing. He followed by underscoring the primary goal of cancer eradication, stressing that treatment for progressing disease takes precedence over fertility, and in those situations, fertility may be compromised.

He further outlined key short-term outcomes in patients undergoing uterine transposition, particularly as they related to maintaining uterine perfusion and mitigating post-operative complications. For long-term outcomes, he highlighted the goal for patients to be disease-free and capable of carrying a live birth.

Additionally, Diaz underscored a challenge related to raising awareness for this procedure, highlighting efforts he has undertaken to inform surgeons in the colorectal cancer field about the availability of this procedure as an option for this patient population. He suggested that colleague identification of eligible patients, effective referral, and increased proliferation of procedure knowledge may be effective in overcoming this challenge.

Diaz concluded by highlighting next steps for the procedure as they relate to expanding access for patients, increasing knowledge of the procedure among physicians, and developing novel techniques for uterine preservation during radiotherapy. He highlighted the “exciting” development of this procedure, which he suggested might have been inconceivable a few years ago, in achieving better outcomes for young women diagnosed with pelvic tumors.

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In a conversation with CancerNetwork®, Ginger J. Gardner, MD, FACOG, spoke about current research and advocacy efforts to improve clinical outcomes among patients with gynecological cancers. With diagnoses of gynecologic malignancies on the rise around the world, Gardner also highlighted the next steps for raising awareness in the field and addressing gaps in care.

Gardner is a gynecologic surgeon at Memorial Sloan Kettering Cancer Center, as well as the chair of the board for the Foundation for Women's Cancer (FWC).

According to Gardner, approximately 115,000 of those in the United States and 1 million patients across the world are diagnosed with gynecologic cancer. Additionally, she highlighted a growing incidence of uterine cancers, which included a 2-fold increase in mortality among patients who are Black in the United States compared with other populations.

As part of raising awareness in this patient population and advancing potential therapeutic solutions, Gardner described ongoing initiatives at FWC to facilitate collaboration among scientists, researchers, and gynecologic oncology providers to help improve outcomes. Regarding potential treatment innovations, she also highlighted clinical trials designed to assess various disease prevention methods and other therapies like targeted agents, PARP inhibitors, and antiangiogenic treatments.

Looking ahead, Gardner detailed other potential developments in the gynecologic cancer space that she is excited about. For example, she spoke about future efforts to further uncover the tumor biology and molecular heterogeneity associated with these malignancies, which may help providers optimize treatment plans for patients.

“We are seeing some impact in improvement for gynecologic cancers with innovation in many of our disciplines; that includes disease prevention and innovative modalities related to treatment, inclusive of surgical innovation, new targeted therapies, refining radiation treatment, and ultimately patient-reported outcomes. We need to keep our eye on the ball for where we’re going next,” Gardner stated. “It is hard to dial it into just 1 or 2 snapshots, but I am so thankful that we have this time together to talk about the importance of gynecologic health awareness and research because it is important that we raise this conversation.”

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In a special co-branded episode between Oncology On the Go hosted by CancerNetwork®and the American Society for Transplantation and Cellular Therapy (ASTCT)’s program ASTCT Talks, Alexis K. Kuhn, PharmD, BCOP, spoke with Katie Bruce, PharmD, BCPPS, and Susie Long, PharmD, about the use of approved cell-based gene therapies for patients with sickle cell disease, beta thalassemia, adrenoleukodystrophy (ALD), and metachromatic leukodystrophy (MLD). These panelists shared the pharmacist’s perspective on ensuring quality care with these ex vivo gene therapies across all treatment phases, including mobilization, conditioning, and infection prophylaxis.

Kuhn is an ambulatory Pediatric Hematology/Oncology/BMT Pharmacist at the Mayo Clinic in Rochester, Minnesota, and an assistant professor of Pharmacy at the Mayo Clinic College of Medicine. Bruce is a pediatric clinical pharmacy specialist at the Sarah Cannon Pediatric Hematology/Oncology & Cellular Therapy program of Tristar Centennial Medical Center in Nashville, Tennessee. Long is a pediatric clinical pharmacist in the Blood and Marrow Team at the University of Minnesota Masonic Children's Hospital.

Specifically, the panelists spoke about the use of agents like elivaldogene autotemcel (Skysona) and atidarsagene autotemcel (Lenmeldy), which are FDA-approved for ALD and MLD, respectively. They also discussed the use of exagamglogene autotemcel (Casgevy) and lovotibeglogene autotemcel (Lyfgenia), which the FDA approved for treating patients 12 years and older with sickle cell disease in December 2023. The conversation broke down each stage of treatment, detailing optimal strategies for the cell manufacturing and storing processes as well as the management of toxicities like cytopenias. They also reviewed key considerations during the post-infusion period that may help maximize the quality of life for patients after they complete their therapy.

“It has been so amazing to be able to be a part of gene therapy and gene editing,” Bruce stated regarding the potential long-term impacts of these treatments. “We have patients who are able to hold full-time jobs they never were able to have before. We have patients who are climbing mountains and backpacking through Europe, which would have never been an option before because their sickle cell disease would have prevented them from [doing] that…. It’s not an easy process, and it has a lot of steps for the patient to go through, but the reward at the end of it all is worth it.”

References

bluebird bio receives FDA accelerated approval for SKYSONA® gene therapy for early, active cerebral adrenoleukodystrophy (CALD). News release. bluebird bio, Inc. September 16, 2022. Accessed October 7, 2024. https://tinyurl.com/mp8crxes
FDA approves first gene therapy for children with metachomatic leukodystrophy. New release. FDA. March 18, 2024. Accessed October 7, 2024. https://tinyurl.com/mrh659yk
FDA approves first gene therapies to treat patients with sickle cell disease. News release. FDA. December 8, 2023. Accessed October 7, 2024. https://tinyurl.com/3zbdnf4c

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CancerNetwork® collaborated with CURE® to speak with Samantha Shenoy, NP, MSN, a nurse practitioner at the Cancer Immunotherapy Clinic of University of California San Francisco (UCSF) Health, about the role she plays when treating patients with multiple myeloma who are receiving talquetamab-tgvs (Talvey). Of note, emphasis was placed on managing treatment-emergent adverse effects (TRAEs) and toxicities that may impact quality of life.

Shenoy foregrounded the discussion by outlining the role of nurses in facilitating the management of toxicities and providing education to patients in both an inpatient and outpatient capacity. She subsequently discussed common skin, oral, and dermatologic toxicities, as well as how they impact patient quality of life.

Furthermore, she touched upon taking an aggressive approach to addressing early-grade cytokine release syndrome (CRS), placing an emphasis on close adherence to UCSF clinical guidelines for treating it. Additionally, Shenoy acknowledged the possibility of neurological effects occurring as a result of treatment with talquetamab, although she stated she has not observed any in her experiences with using the bispecific.

Shenoy disclosed talquetamab-related monitoring parameters, indicating that taste changes and weight loss were notable risks. Particularly for weight loss, she mentioned that she regularly checks in with patients about their eating habits and weight. Furthermore, methods for living with taste changes were discussed, which included recommendations for prophylactics, dietary modifications, and dry mouth remedies.

Shenoy continued by suggesting that the efficacy seen with talquetamab, particularly as part of a combination therapy, makes it an impactful agent. Citing her experience as part of the phase 1 TRIMM-2 trial (NCT04108195), where talquetamab was assessed in combination with daratumumab (Darzalex) in relapsed or refractory multiple myeloma, she claimed that combination therapies for bispecifics would become the new standard in this patient population.

She concluded by expressing her passion for educating patients about management strategies for multiple myeloma. Additionally, she further illustrated the sentiment through her experience witnessing patients continue treatment for several years while overcoming toxicities associated with talquetamab.

“I feel passionately about the fact that we can educate patients who are struggling at the beginning [to] hang in there. It is not going to last forever,” Shenoy stated. “I can imagine how frustrating it is [when you are not] able to taste, your mouth is dry, and your hands are peeling. Just know that it is not forever.”

Reference
Dholaria, BR, Weisel K, Mateos MV, et al. Talquetamab (tal) + daratumumab (dara) in patients (pts) with relapsed/refractory multiple myeloma (RRMM): updated TRIMM-2 results. J Clin Oncol. 2023;41(suppl 16). doi:10.1200/JCO.2023.41.16_suppl.8003

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In a conversation with CancerNetwork®, Yoshie Umemura, MD, offered various perspectives on progressing in the brain cancer treatment field. In addition to detailing institution-level advances in delivering multidisciplinary care, she highlighted her personal growth as she advanced in the neuro-oncology field while giving key advice to aspiring researchers who are in the early stages of their careers.

Umemura, the chief medical officer of the Ivy Brain Tumor Center, division chief of Neuro-Oncology, and the William and Joan Shapiro chair of Neuro-Oncology at Barrow Neurological Institute, first described what drew her to studying neurology and eventually specializing in neuro-oncology, emphasizing the potential to form close connections with patients during treatment. Additionally, her collaborative approach to care and her institution’s emphasis on multidisciplinary practice have helped in yielding various accomplishments, which included expediting the development of an investigator-initiated trial during the COVID-19 pandemic.

The conversation also focused on the personal aspects of Umemura’s neuro-oncology career. Delving into her experiences with immigrating to the United States when she was a high school student, she recalled feeling like an outsider as she learned to speak English and began to study neurology. However, she noted how several role models and mentors in the field have offered her guidance, which helped her grow and take on more leadership positions over time.

Continuing to build upon the theme of collaboration in brain cancer research, Umemura emphasized the necessity of finding mentors even outside of one’s institution to advance in the field. Additionally, as part of paying it forward to a new generation of neuro-oncologists, researchers should also become open to guiding others once they have gained enough experience.

“When you are at a conference and you meet someone you think you might click with, you’re intrigued about, or you’re impressed with, you can shoot an email and ask them if they would be open to chatting with you about a question or mentoring you,” Umemura said. “[You should also] pay it forward. Always be open to mentoring others; I think that’s the only way to move forward….It [speaks] to the collaborative aspect and how to operate as an outsider. You’re not an outsider as long as you make the connection; you can just wedge yourself in.”

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CancerNetwork® spoke with James R. Berenson, MD, about the potential role that JAK inhibitors may play in the treatment of patients with multiple myeloma. The conversation focused on the rationale for researching this drug class as well as ongoing initiatives to assess the utility of agents like ruxolitinib (Jakafi) for this patient population.

Berenson, founder, medical and scientific director, and president and chief executive officer of the Institute for Myeloma and Bone Cancer Research and private practitioner in West Hollywood, California, described the factors associated with the overexpression of JAK in the bone marrow, which may constitute a prime survival factor for multiple myeloma. This overexpression may affect the checkpoint inhibitor proteins in the body, resulting in resistance to standard anti-myeloma therapies such as immunomodulatory drugs.

Additionally, he mentioned a patient case that had involved a scenario in which JAK-mutated multiple myeloma progressed following prior treatment with lenalidomide (Revlimid). According to Berenson, the disease’s resistance to lenalidomide was primarily associated with proteins driven by JAK; subsequent treatment involving JAK inhibition proved successful in restoring the efficacy of lenalidomide.

Based on a rationale to target JAK overactivity in the bone marrow and results from this patient case, Berenson and colleagues have focused on researching ruxolitinib as a therapeutic candidate for potentially improving outcomes in multiple myeloma via JAK inhibition. Findings from a phase 1 trial (NCT03110822), for example, have demonstrated that the efficacy and tolerability of ruxolitinib plus methylprednisolone can be extended with lenalidomide in those with multiple myeloma. Additionally, other ongoing trials aim to combine ruxolitinib with agents such as selinexor (Xpovio).

“The question is, where will ruxolitinib sit in the sequencing of treatment of [patients with] multiple myeloma? Where will selinexor be?” Berenson stated. “At this point, there's certainly been low use of these drugs, especially ruxolitinib in multiple myeloma. We hope, with a more positive signal, these drugs will move further up in the algorithm of how you treat multiple myeloma.”

Reference

Berenson JR, Limon A, Rice S, et al. A phase I trial evaluating the addition of lenalidomide to patients with relapsed/refractory multiple myeloma progressing on ruxolitinib and methylprednisolone. Target Oncol. 2024;19(3):343-357. doi:10.1007/s11523-024-01049-w

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In a conversation with CancerNetwork®, Nader Sanai, MD discussed the current state of the glioblastoma field, highlighting ongoing research efforts to help improve outcomes among patients with this disease.

Sanai is the director of the Ivy Brain Tumor Center and J.N Harber Professor of Neurological Surgery, Francis and Dionne Najafi chair for Neurosurgical Oncology, and chief of neurological oncology at Barrow Neurological Institute.

Specifically, Sanai described plans to assess treatment with niraparib (Zejula) compared with temozolomide (Temodar) in a population of patients with newly diagnosed MGMT unmethylated glioblastoma as part of the phase 3 Gliofocus study (NCT06388733).1 He contextualized the rationale for conducting this study by focusing on findings from a proof-of-concept hybrid study (NCT05076513) and detailing how they supported additional investigation into the utility of niraparib.

According to findings from this proof-of-concept study presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting, the median overall survival (OS) was 20.3 months among patients who received niraparib in combination with radiotherapy.2 Additionally, data showed that niraparib reached drug concentrations in Gadolinium-nonenhancing newly diagnosed glioblastoma tissue exceeding those of any other evaluated PARP inhibitors; investigators identified no new safety signals after combining niraparib with radiotherapy in this population.

With the Gliofocus trial, Sanai and co-investigators aim to provide a clinically meaningful quality of life benefit with niraparib-based therapy beyond a marginally valuable statistical advantage. By evaluating treatment with niraparib, investigators look to improve historical survival rates reported with standard-of-care options among patients with unmethylated disease.

“What we’re looking to do with this trial is set a benchmark that’s clinically relevant for patients and providers. The [OS] target for the study is 18 months, which is to effectively convert [a] 12-month natural history to a natural history closer to the methylated glioblastoma population,” Sanai said. “We think that is a meaningful transformation of a difficult patient population, a significant chunk of survival time that would be beneficial to patients, providers, and caregivers. Importantly, [it may also mean] an advantage for quality of life, which is of paramount importance for this patient population.”

References

A study comparing niraparib with temozolomide in adult participants with newly-diagnosed, MGMT unmethylated glioblastoma. ClinicalTrials.gov. Updated June 24, 2024. Accessed September 16, 2024. https://tinyurl.com/y25er8p9
Sanai N, Umemura Y, Margaryan T, et al. Niraparib efficacy in patients with newly-diagnosed glioblastoma: Clinical readout of a phase 0/2 "trigger" trial. J Clin Oncol. 2024;42(suppl 16):2002. doi:10.1200/JCO.2024.42.16_suppl.2002

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In a conversation with CancerNetwork®, Georgios Evangelou, MD, MSc spoke about his manuscript titled Neoadjuvant Capecitabine Plus Temozolomide in Atypical Lung NETs, which he and his coauthors published in the July issue of ONCOLOGY®.

Evangelou, a medical oncologist and consultant in the 3rd Department of Medicine at Sotiria General Hospital in Athens, Greece, reviewed the results of a case study involving the use of neoadjuvant capecitabine (Xeloda) plus temozolomide (Temodar; CAPTEM) for a 62-year-old woman with well-differentiated atypical carcinoid. The patient was asymptomatic at diagnosis, with imaging revealing an atypical bronchial neuroendocrine tumor (NET) as well as a pancreatic mass indicating another NET.

This patient subsequently underwent treatment with CAPTEM, which resulted in minor volume reductions of masses in the left lower lobe and subcarinal lymph node after 6 months of therapy. Although the pancreatic mass increased in size, Evangelou and colleagues excised it via central pancreatectomy, allowing the patient to resume treatment with CAPTEM for 6 additional months and undergo lobectomy with lymph node dissection. Further use of CAPTEM produced a partial response in the mediastinal lymph nodes and a 21% reduction in the size of the primary tumor.

Following treatment, the patient was able to recover without any significant complications. Additionally, follow-up scans revealed no avid lesions, and there were no signs of disease recurrence at 24 months after the lobectomy. Based on the results of this case study, the authors noted how neoadjuvant therapy may significantly impact the management of patients with atypical carcinoids, although larger clinical trials may be necessary to affirm the potential survival benefit of CAPTEM.

“I hope that others will recognize the potential value of CAPTEM as a neoadjuvant treatment in similar cases. Sometimes, these cases are very difficult to manage; you need the neoadjuvant treatment because it can offer tumor shrinkage. Eventually, it can lead to radical excision of the disease,” Evangelou said. “We need larger studies to better understand the effectiveness of the regimen as a neoadjuvant treatment.”

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In a conversation with CancerNetwork®, Jessica Cheng, MD, spoke about her work in the growing field of physical medicine and rehabilitation (PMR) and how it may improve quality of life outcomes among patients with cancer.

Above all else, Cheng, an assistant clinical professor in the Department of Supportive Care Medicine at City of Hope, emphasized how supportive care through PMR aims to ensure patient function. By developing a whole-person approach that focuses on the musculoskeletal and nervous systems, those involved in the field may minimize adverse effects and help patients participate in day-to-day activities more easily. Additionally, Cheng highlighted how this modality can involve the efforts of a comprehensive multidisciplinary team including physical therapists, occupational therapists, and speech therapists as well as those involved in disciplines such as integrative medicine, neurology, and orthopedics.

As part of ensuring function in patients who undergo therapy for cancer, Cheng discussed the importance of integrating exercise into their care routines. She highlighted how exercise in preparation for surgery, stem cell transplantation, or other treatment modalities may help patients recover from their treatment more quickly and yield improvements in the pathologic complete responses and other outcomes.

In terms of the next steps for aiding the growth of PMR across the country, Cheng detailed ongoing plans for a trial assessing the utility of cancer rehabilitation in patients with breast cancer and gynecologic cancer undergoing chemotherapy before surgery. Adopting a catchphrase of “prehab for all,” Cheng said that she wants all patients to be armed with the knowledge of PMR so that they can gain control over their lives and be able to pursue meaningful activities during their treatment courses.

“I hope that oncologists and rehabilitation physicians alike will see that there’s an opportunity with cancer prehabilitation to enable [patients] to get their cancer treatment, get through it better, and recover better,” Cheng said. “That’s my hope: that this [field] will spread even more like wildfire than it already is.”

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In a special co-branded episode between Oncology On the Go and the American Society for Transplantation and Cellular Therapy (ASTCT)’s program ASTCT Talks, Rahul Banerjee, MD, FACP, and Noopur Raje, MD, discussed the risk of secondary malignancies in patients with multiple myeloma who receive CAR T-cell therapy.

Banerjee is an assistant professor in the Clinical Research Division of Fred Hutchinson Cancer Center and an assistant professor in the Division of Hematology and Oncology at the University of Washington. Raje is the director of the Center for Multiple Myeloma at Massachusetts General Hospital Cancer Center and a professor of medicine at Harvard Medical School.

Banerjee and Raje spoke in the context of prior advisories from the FDA on the potential development of secondary T-cell malignancies in patients who receive CAR T-cell therapy for hematologic cancers. Specifically, the agency required a boxed warning for secondary T-cell malignancy risksfor BCMA- or CD19-targeting therapies in April 2024.1 The conversation also touched upon reports of secondary malignancies in cases and trials such as CARTITUDE-1 (NCT04181827), in which second primary cancers were highlighted in 9 patients who received treatment with ciltacabtagene autoleucel (Carvykti).2

Considering these reports and warnings, Banerjee and Raje emphasized shared treatment decision-making with patients after assessing the risks and benefits of CAR T-cell therapy compared with other agents like bispecific antibodies. They also reviewed optimal strategies for monitoring and referring patients based on the incidence of certain toxicities.

“[Treatment with] CAR T cells requires planning, and we need to have good control of the disease. We need to have 4 to 6 weeks of a lead time to get these effective treatments to our patients, so early referral is a good idea,” Raje said. “[For example], if you see chronic diarrhea in someone that is way out of the window of what you would expect, referring back to the CAR T-cell center is important so that we don’t miss some of these toxicities.”

References1.FDA requires boxed warning for T cell malignancies following treatment with BCMA-directed or CD19-directed autologous chimeric antigen receptor (CAR) T cell immunotherapies. News release. FDA. April 18, 2024. Accessed August 22, 2024. https://tinyurl.com/5n8pm5ca

San-Miguel J, Dhakal B, Yong K, et al. CIlta-cel or standard care in lenalidomide-refractory multiple myeloma. N Engl J Med. 2023;389(4):335-347. doi:10.1056/NEJMoa2303379

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In a conversation with CancerNetwork®, Brian A. Van Tine, MD, PhD, spoke about the FDA accelerated approval of afamitresgene autoleucel (afami-cel; Tecelra) for patients with metastatic or unresectable synovial sarcoma expressing MAGE-A4. He discussed the data from the phase 2 SPEARHEAD-1 trial (NCT04044768)supporting the agent’s use in this patient population and highlighted how this approval might pave the way for other potential developments in the sarcoma landscape.

Van Tine, a professor of medicine and pediatrics and a medical oncologist at Siteman Cancer Center of Washington University in St. Louis, detailed results from SPEARHEAD-1 leading to the FDA’s approval of afami-cel. Based on these findings and the agent’s potential availability as a one-time intravenous fusion, afami-cel may offer improvements in quality of life to patients with synovial sarcoma compared with standard treatment options such as chemotherapy.

Topline data from cohort 1 of the SPEARHEAD-1 trial showed that treatment with afami-cel produced an objective response rate of 43% among 44 evaluable patients, which included a complete response rate of 4.5%. Additionally, the median duration of response was 6 months (95% CI, 4.6-not reached). Of patients with a response, durable responses lasting for 12 months or longer occurred in 39%.

In terms of other potential benefits following the accelerated approval of afami-cel, Van Tine said that the T-cell therapy may increase treatment access to specific subsets of patients. For those who are unable to relocate and live near certain treatment centers during their therapy, afami-cel may offer a more readily accessible alternative that can allow patients to undergo treatment at home. Van Tine also described how this accelerated approval may “open the gateway” for other advancements related to the use of afami-cel and similar agents in solid tumors.

“We’re all working hard to get these therapies open at our institutions,” Van Tine said regarding the next steps for increasing access to afami-cel following the accelerated approval. “Knowing who [has] HLA-A02–positive [disease], knowing who has synovial sarcoma, and being ready to trigger the screening for MAGE-A4 is in every patient's best interest. If you’re one of the patients who have synovial sarcoma, you need to know your status [to determine] how we’re going to integrate this into your care plan.” Reference*Adaptimmune receives U.S. FDA accelerated approval of TECELRA® (afamitresgene autoleucel), the first approved engineered cell therapy for a solid tumor. News release. Adaptimmune Therapeutics. August 2, 2024. Accessed August 14, 2024. https://tinyurl.com/mw6k4hjh

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CancerNetwork® spoke with Ritu Salani, MD, about the expanded FDA approval of dostarlimab-gxly (Jemperli) in combination with carboplatin/paclitaxel for patients with primary advanced or recurrent endometrial cancer.1

Salani, a board-certified gynecologic oncologist and director of Gynecologic Oncology at the University of California, Los Angeles Health, discussed the clinical benefit the dostarlimab combination showed for patients with endometrial cancer, particularly those with mismatch repair-deficient (dMMR) tumors, in the phase 3 RUBY trial (NCT03981796). Data leading to the approval showed a statically significant progression-free survival (PFS) and overall survival (OS) benefit in patients with dMMR or microsatellite-instability high (MSI-H) endometrial cancer, as well as for those across the overall population.

Noting the significant impact dostarlimab had on survival benefit without significant added toxicity, which investigators reported as early as March 2023, Salani said it was “wonderful” to have a relatively short turnaround time in making the combination therapy available for patients with primary advanced or recurrent endometrial cancer. Beyond the particular benefit among patients with dMMR tumors, she expressed the need to improve outcomes for patients with mismatch repair-proficient (pMMR) or microsatellite stable (MSS) tumors, who did not experience as much of a pronounced benefit from treatment with dostarlimab.

Salani also addressed the role of immunotherapy in subsequent lines of treatment following frontline therapy. Being thoughtful about sequencing agents in this setting may be an optimal strategy to give patients the greatest survivability and quality of life. She also considered alternative treatment strategies for certain patients, such as those with pMMR tumors.

“The thing that is interesting is the study highlighted patients who had residual disease or measurable disease present when they were getting this therapy, and that seems to be where the most significant impact [is],” Salani said. “Seeing more data on the right selection of patients will be really important. There are other avenues of treatment for these patient populations, particularly the pMMR population, where you might see some other therapies that may have an equally profound impact as immunotherapy. Maybe that will lend itself to leading immunotherapy for second-line treatment, if needed.”

Reference
FDA expands endometrial cancer indication for dostarlimab-gxly with chemotherapy. News release. FDA. August 1, 2024. Accessed August 15, 2024. https://tinyurl.com/mtr6tpyp

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In a conversation with CancerNetwork®, Catherine J. Wu, MD, spoke about the ongoing development of cancer vaccines as a potentially “cross-cutting” therapeutic strategy for treating patients with cancer.

Wu, chief of the Division of Stem Cell Transplantation and Cellular Therapies and a Lavine Family Chair for Preventative Cancer Therapies at Dana-Farber Cancer Institute, and also a professor of medicine at Harvard Medical School, discussed how neoantigens may show promise as possible targets for immunotherapy, which may make it feasible to treat broad swaths of patient populations through vaccination. Specifically, she highlighted the KRAS mutation as a potential area of focus based on its frequent expression in diseases such as gastrointestinal cancers, myeloma, and other solid tumors.

Findings from previous studies published in recent years also appear to support further research on the use of vaccines to manage cancer. For example, Wu brought up a study conducted by Memorial Sloan Kettering Cancer Center, in which investigators evaluated the potential utility of a personalized RNA neoantigen for those with pancreatic cancer. Data from this study indicated that the median recurrence-free survival was not reached in patients with vaccine-expanded T cells compared with 13.4 months in those without vaccine-expanded T cells (P = .003).

“There have been very promising studies,” Wu said. “There are many conceptual reasons for why cancer vaccines would partner well with other forms of immunotherapy such as immune checkpoint blockade. Increasingly, one can envision how it can be coupled together with cellular therapy.”

In terms of other research, Wu described how ongoing efforts aim to meet various time and cost considerations as vaccine-based therapy becomes more widely adopted in the cancer field. She underscored the necessity of developing a rapid manufacturing process and deploying vaccines to patients as quickly as possible. Additionally, she highlighted the progress in developing mRNA-based vaccines in light of the COVID-19 pandemic, suggesting that this modality may hold promise in the management of cancer.

Reference

Rojas LA, Sethna Z, Soares KC, et al. Personalized RNA neoantigen vaccines stimulate T cells in pancreatic cancer. Nature. 2023;618(7963):144-150. doi:10.1038/s41586-023-06063-y

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CancerNetwork® spoke with Kamran Idrees, MD, MSCI, MMHC, FACS; Natalie A. Lockney, MD; and Milad Baradaran, PhD, DABR, about the potential utility of intraoperative radiation therapy (IORT) among patients with pancreatic cancer. The group detailed the design and mechanism, gradual technical advancements, and trial data supporting the application of this radiotherapy modality for this patient population.

Idrees is the chief in the Division of Surgical Oncology & Endocrine Surgery, an associate professor of surgery, an Ingram Associate Professor of Cancer Research, and director of Pancreatic and Gastro-Intestinal Surgical Oncology at Vanderbilt University Medical Center. Lockney is an assistant professor in radiation oncology and the program director for the radiation oncology medical residency at Vanderbilt University Medical Center. Baradaran is the head of quality assurance operations and assistant professor in the Department of Radiation Oncology at Vanderbilt University Medical Center.

As part of this discussion revolving around IORT, the group outlined the optimal conditions for using this technique depending on the extent of disease resectability in patients. Specifically, Idrees categorized patients as belonging to one of 3 major groups: those with metastatic disease, those with resectable disease, and those with borderline resectable or locally advanced disease. When considering these factors, patients with borderline resectable disease may be suitable to undergo IORT in combination with chemotherapy, radiotherapy, and surgery.

The conversation also focused on a particular case involving a patient with pancreatic cancer who received IORT at their institution. Based on the outcome of this case, they highlighted how multidisciplinary collaboration in combination with careful patient selection may offer surgical resection through IORT.

“[There] has to be a multidisciplinary team approach to carefully select these patients and [determine] who can benefit from this procedure,” Idrees said. “For the families and the physicians who are taking care of [patients with] pancreatic cancer, it’s valuable to obtain a second opinion, even if [the tumor is] initially deemed unresectable. What’s unresectable in one surgeon’s hands may be resectable in a different team,” he added.

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In a conversation with CancerNetwork®, Nausheen Ahmed, MD, spoke about optimizing monitoring strategies for patients with B-cell non-Hodgkin lymphoma who undergo treatment with CAR T-cell therapy.

Ahmed, an associate professor in the Division of Hematologic Malignancies and Cellular Therapeutics at the University of Kansas Medical Center, discussed the possibility of offering more flexible monitoring periods for patients in the context of findings from a real-world studypublished in Blood Advances.1 Data from her study showed that the occurrence of new onset cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) was rare at more than 2 weeks following CAR T-cell therapy infusion. Additionally, late non-relapse mortality generally resulted from infectious complications.

The FDA implemented a Risk Evaluation and Mitigation Strategy (REMS) to help manage the risk of severe CRS and ICANS by requiring patients to reside within 2 hours of an authorized treatment center for 4 weeks following CAR T-cell therapy infusion.2 According to the study authors, this mitigation strategy may create significant barriers to CAR T-cell therapy access among certain patients and caregivers who need to relocate as part of a treatment plan.

Findings from Ahmed’s study supported the development of individualized monitoring strategies depending on the stability of the patient. She and her coauthors proposed a 2-week monitoring period for patients while allowing for an optional increase to 4 weeks based on factors such as physician comfort and availability of local community oncology support. As Ahmed emphasized during the discussion, having flexibility in these monitoring periods could help mitigate financial and geographic obstacles preventing adequate access to CAR T-cell therapy among patients.

“There has to be more of a hybrid model of care. There has to be more involvement of our referring doctors or community doctors in detecting and managing these infections or working with the specialized center in order to bypass the [emergency room] and other strategies to help these patients,” Ahmed said. “If there is enough data to say that the patients do not need extra restrictions beyond 2 weeks, which is what our studies show, then reconsidering the requirements will be one step towards decreasing disparities in access.”

References

Ahmed N, Wesson W, Lutfi F, et al. Optimizing the post-CAR T monitoring period in recipients of axicabtagene ciloleucel, tisagenlecleucel, and lisocabtagene maraleucel. Blood Advances. Published online July 24, 2024. doi:10.1182/bloodadvances.2023012549
Risk Evaluation and Mitigation Strategies (REMS) for autologous chimeric antigen receptor (CAR) T cell immunotherapies modified to minimize burden on healthcare delivery system. FDA. June 26, 2024. Accessed July 23, 2024. https://tinyurl.com/2m284rjy

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At the 2024 Kidney Cancer Research Summit (KCRS), CancerNetwork® spoke with various experts in the kidney cancer field about potential advancements in disease detection and updated efficacy data on immunotherapy and other treatment strategies in patients with renal cell carcinoma (RCC).

Karl Semaan, MD, MSc, a postdoctoral oncology research fellow at Dana-Farber Cancer Institute, discussed the implications of findings related to the use of an investigational tissue-informed liquid biopsy epigenomic profiling tool for detecting sarcomatoid differentiation in RCC.1 According to Semaan, this method may avoid the sampling errors and spatial heterogeneity challenges associated with traditional biopsy strategies.

Additionally, Neil J. Shah, MBBS, an assistant attending physician from Memorial Sloan Kettering Cancer Center, spoke about data from a real-world study evaluating treatment patterns and outcomes in those with metastatic RCCfollowing prior receipt of immunotherapy and tyrosine kinase inhibitors (TKIs).2 Data showed no differences in overall survival (OS) outcomes across different immunotherapy- and TKI-containing regimens. Based on these findings, Shah emphasized a need for additional novel therapeutic approaches to help improve outcomes in later-line settings of treatment.

Bradley A. McGregor, MD, director of Clinical Research for the Lank Center of Genitourinary Oncology and medical oncologist specializing in genitourinary malignancies at Dana-Farber Cancer Institute, highlighted findings from his presentation on a phase 1b study (NCT04627064) evaluating treatment with abemaciclib (Verzenio) in a pretreated metastatic clear cell RCC population.3 Among 11 patients who received abemaciclib, 1 had stable disease, 8 had progressive disease, and 2 were not evaluable for response. Additionally, the median progression-free survival (PFS) and overall survival (OS), respectively, was 1.8 months (95% CI, 1.5-1.9) and 9.1 months (95% CI, 2.1-15.3).

Although abemaciclib monotherapy yielded no responses in the study, McGregor highlighted the potential clinical utility of administering the agent in combination with other therapies. Findings from his presentation suggested that CDK4/6 inhibitors may demonstrate a synergistic effect when combined with HIF-2α inhibitors, which is a potential strategy that investigators are evaluating with belzutifan (Welireg) and palbociclib (Ibrance) combination therapy as part of the phase 1/2 LITESPARK-024 trial (NCT05468697).

References

Semaan K, Zarif TE, Eid M, et al. Liquid biopsy epigenomic profiling for the detection of sarcomatoid renal cell carcinoma. Presented at the 2024 Kidney Cancer Research Summit; July 11-12, 2023; Boston, MA. Abstract 44.
Shah N, Sura S, Shinde R, et al. Real-world treatment patterns and clinical outcomes of metastatic renal cell carcinoma patients post immune-oncology (IO) and Vascular Endothelial Growth Factor (VEGF) receptor targeted therapies. Presented at the 2024 Kidney Cancer Research Summit; July 11-12, 2023; Boston, MA. Abstract 36.
McGregor BA, Xie W, Xu W, et al. Phase IB trial of abemaciclib in advanced renal cell carcinoma. Presented at: 2024 Kidney Cancer Research Summit; July 11-12, 2024. Boston, MA.

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As part of the Breaking Barriers: Women in Oncology program, CancerNetwork® spoke with Julie M. Vose, MD, MBA, and Avyakta Kallam, MD, about the evolution of their careers in the hematology-oncology space, including some of the critical advances and challenges associated with their work in the lymphoma field.

Vose is division chief, Neumann M. and Mildred E. Harris Professor at the University of Nebraska Medical Center, and co-editor-in-chief of ONCOLOGY®. Kallam is an assistant professor in the Division of Lymphoma and Department of Hematology & Hematopoietic Cell Transplantation from City of Hope in Duarte, California.

Vose and Kallam discussed how they first developed a passion for researching lymphoma, which led them to become involved in various breakthroughs related to the use of treatment strategies such as autologous stem cell transplantation, bispecific antibodies, and CAR T-cell therapy. The conversation highlighted how this evolution of therapy options has helped improve patient outcomes while reducing hospitalization periods and minimizing toxicity.

The discussion also extended to the topic of overcoming various physical and social barriers while trying to advance in the lymphoma field. For example, Kallam described her experience with moving to the United States from India to complete her medical training, which involved adapting to a new culture and a new style of approaching treatment.

In the early stages of Vose’s career, there were far fewer women involved in oncology and medicine in general, contributing to the challenge of needing to work extremely hard to prove that she was equal to her male colleagues. Vose noted in the early days, she was considered a rarity in the field as one of very few women.

Vose and Kallam also brought up how their mentors have given them key pieces of advice from mentors that have stuck with them throughout their careers. They, in turn, offered wisdom to any woman looking to advance in the hematology-oncology space.

“The biggest piece of advice [I received] is to see the patient as a person—not just as a patient—to be able to get to know them and their families understand some of their struggles so that you can relate to them as a person,” Vose said.

The conversation also focused on the challenge of achieving work/life balance while making advances in the lymphoma space. Dedicating time to hobbies and finding support from friends and family members emerged as potential strategies for balancing professional responsibilities with one’s personal life.

“Life is too unpredictable to not do things that you enjoy doing,” Kallam said, recounting a bit of advice she had received from one of her mentors. “What we’re doing is important; we are impacting lives. We’re doing a lot of research, but at the same time, keep in mind to have fun along the way.”

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Tycel Phillips, MD, spoke with CancerNetwork® ahead of the FDA’s accelerated approval of epcoritamab-bysp(Epkinly) for patients with relapsed/refractory follicular lymphoma to discuss how this agent may impact the treatment paradigm.

Phillips, an associate professor in the Division of Lymphoma and Department of Hematology & Hematopoietic Stem Cell Transplantation at City of Hope in Duarte, California, reviewed data from the phase 1/2 EPCORE NHL-1 trial (NCT03625037), which ultimately supported the approval of epcoritamab in the aforementioned population. Topline results reported at the time of the agent’s approval showed an overall response rate (ORR) of 82% (95% CI, 74.1%-88.2%), with 60% of patients experiencing a complete response. Additionally, the median duration of response was not reached (NR; 95% CI, 13.7-NR).

Beyond the supporting data, Phillips highlighted how this approval may increase availability of treatment options for patients with follicular lymphoma, especially those who lack access to alternative therapies. He stated that readily available off-the-shelf bispecific antibodies like epcoritamab may bridge the gap for patients who are unable to access CAR T-cell therapies or travel to a major academic center for treatment.

Phillips also detailed strategies for mitigating some of the common toxicities that may occur following treatment with epcoritamab, which include cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. Although Phillips said that epcoritamab is usable in the third-line setting, he noted that bispecific antibodies like it “have a lot of potential for upward mobility,” as he anticipates further assessment of these treatments in the first or second line.

“As community oncologists get more and more comfortable with these drugs and have the structure to set up to safely administer [them] for the first month when most of the complications happen, more and more patients will be able to be treated, which will be a great benefit based on what we’ve seen in early response rates for these drugs,” Phillips said regarding the utility of bispecific antibodies like epcoritamab. “There’ll be a big benefit for the patient population in the long term as more community settings implement these drugs into their clinical practice.”

Reference

FDA grants accelerated approval to epcoritamab-bysp for relapsed or refractory follicular lymphoma. News release. FDA. June 26, 2024. Accessed June 26, 2024. https://tinyurl.com/26s9myey

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In a conversation with CancerNetwork®, James B. Yu, MD, MHS, FASTRO, and Julian C. Hong, MD, MS, spoke about their study titled AI Use in Prostate Cancer: Potential Improvements in Treatments and Patient Care, which was published in the May issue of the journal ONCOLOGY®.

Yu is a radiation oncologist in the Department of Radiation Oncology at Smilow Cancer Center Hospital at Saint Francis Hospital and an adjunct assistant professor of Medical Oncology at Yale School of Medicine. Hong is an assistant professor in the Department of Radiation Oncology of Bakar Computational Health Sciences Institute at the University of California, San Francisco (UCSF).

Yu and Hong focused on the growing overlap between the advancement of artificial intelligence (AI)–based tools and the prostate cancer treatment field. In their study, they detailed AI-based developments related to diagnostic image analysis, the ability to “predict” prostate cancer outcomes, evaluating prostate cancer histopathology, and defining tumors and normal tissue to help plan radiation oncology treatment strategies. Additionally, they reviewed how these tools make use of machine learning algorithms, a subset of AI in which computers can assess data and interact with users without explicit instructions.

“We’re trying to incorporate AI and machine learning into more trials to make these types of predictions because, at the end of the day, we’re trying to deliver better care and improve outcomes for patients…. It takes trials to figure those things out, so it’s a little bit of a work in progress.” Hong said, regarding potential next steps for improving the utility of these tools in the prostate cancer field.

According to the authors, pushing the boundaries of AI would need to involve building upon prior retrospective data with additional sources of information to affirm that such tools can impact patient care. Additionally, the discussion highlighted potential future implications related to data ownership or privacy and how patients and physicians interact with these programs as AI becomes more prevalent in medical practice.

“We’re not going to be replaced [by AI]. There will always be the need for the human connection any time there’s disease or cancer,” Yu said. “It’s a super exciting area, and the more people understand the limitations of AI rather than thinking of it as a panacea, the more the field will move forward.”

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At the 2024 European Hematology Association (EHA) Congress, CancerNetwork® spoke with a variety of experts in the hematologic oncology space about optimizing outcomes across different patient populations and subgroups based on updated research they presented at the meeting.

Manali Kamdar, MD, an associate professor of medicine-hematology and clinical director of Lymphoma Services at the University of Colorado Anschutz Medical Campus, in Colorado, spoke about data from the phase 1 TRANSCEND NHL 001 trial (NCT02631044) supporting the use of lisocabtagene maraleucel (liso-cel; Breyanzi) in earlier lines of therapy for patients with relapsed/refractory mantle cell lymphoma (MCL).1

Specifically, Kamdar highlighted how research should continue to focus on the potential utility of liso-cel in MCL subgroups such as those with TP53 mutations or blastoid morphology. Additionally, she stated that liso-cel may need to be further tested in earlier lines of therapy for patients with diffuse large B-cell lymphoma, including those with double-hit lymphoma.

Michael R. Grunwald, MD, chief of the Leukemia Division and director of the Transplantation and Cellular Therapy Program at Atrium Health’s Levine Cancer Institute, in North Carolina, discussed findings from the Prospective Observational Study of Patients With Polycythemia Vera (PV) in US Clinical Practices Trial (REVEAL) exploring risk factors for disease progression in patients with polycythemia vera (PV).2

According to Grunwald, a history of thromboembolic events, elevated white blood cell counts, and higher variant allele frequencies may contribute to a patient’s likelihood of experiencing progression to myelofibrosis or acute myeloid leukemia (AML). Additionally, he highlighted ongoing research into the potential molecular factors that may prognosticate disease transformation in PV among a small cohort of patients enrolled on the REVEAL trial.3

Harry P. Erba, MD, PhD, a professor of medicine in the Division of Hematologic Malignancies and Cellular Therapy and the director of the Leukemia Program and Phase I Development in Hematologic Malignancies at Duke Cancer Institute, in North Carolina, discussed the clinical implications of data from the phase 3 QuANTUM-First study (NCT02668653).4

Specifically, findings demonstrated that continuation therapy with quizartinib (Vanflyta) elicited a more pronounced survival benefit vs placebo in patients with newly diagnosed FLT3-ITD–positive AML who did not undergo allogeneic hematopoietic stem cell transplant (allo-HSCT). However, Erba noted that survival outcomes were not significantly different in the quizartinib and placebo arms among patients who received allo-HSCT.

References

Palomba ML, Siddiqi T, Gordon LI, et al. Subgroup analyses in patients with R/R MCL treated with lisocabtagene maraleucel by prior lines of therapy and response to Bruton tyrosine kinase inhibitor from the TRANSCEND NHL 001 MCL cohort. Presented at the European Hematology Association (EHA) 2024 Congress; Madrid, Spain; June 13-16, 2024. P1126.
Grunwald M, Zwicker J, Gerds A, et al. A real-world evaluation of risk factors for disease progression in patients with polycythemia vera (PV) enrolled in REVEAL. Presented at the 2024 European Hematology Association (EHA) Congress; June 13-16, 2024; Madrid, Spain. Abstract P1047.
Crowgey E, Timmers C, Xue Z, et al. Analysis of molecular mechanisms and predictive biomarkers of disease transformation in polycythemia vera. Presented at the 2024 European Hematology Association (EHA) Congress; June 13-16, 2024; Madrid, Spain. Abstract S217.
Sekeres MA, Erba H, Montesinos P, et al. QuANTUM-First: efficacy in newly diagnosed patients with FMS-like tyrosine kinase 3-internal tandem duplication–positive (FLT3-ITD+) acute myeloid leukemia (AML) who received continuation therapy. Presented at the 2024 European Hematology Association (EHA) Congress; June 13-16, 2024; Madrid, Spain. Abstract S142.

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Following the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting, Neil M. Iyengar, MD, and Paolo Tarantino, MD, co-hosted a live X Space with CancerNetwork® and discussed the latest trial updates that may impact clinical practice in the breast cancer field.

Iyengar is an associate attending physician at Memorial Sloan Kettering Cancer Center and a co-editor-in-chief of ONCOLOGY®. Tarantino is a clinical research fellow at Dana-Farber Cancer Institute and Harvard Medical School.

Iyengar and Tarantino discussed data regarding several trials and studies presented at the meeting. These presentations included:

· Phase 3 DESTINY-Breast06 Trial (NCT04494425)1
o Investigators evaluated treatment with trastuzumab deruxtecan (T-DXd; Enhertu) compared with investigator’s choice of chemotherapy among patients with hormone receptor (HR)–positive, HER2-low or HER2-ultralow metastatic breast cancer.

o The median progression-free survival (PFS) was 13.2 months with T-DXd compared with 8.1 months in patients who received chemotherapy across the HER2-low population (HR, 0.62; 95% CI, 0.51-0.74; P <.0001).

o Primary analysis overall survival (OS) data show favorable trends in the T-DXd arm across the HER2-low group (HR, 0.83; 95% CI, 0.66-1.05; P = .1181) and the intent-to-treat (ITT) population (HR, 0.81; 95% CI, 0.65-1.00). However, the OS data only reached 40% maturity at the time of the analysis.

· Phase 3 postMONARCH Study (NCT05169567)2

o Patients with HR-positive, HER2-negative breast cancer and disease progression on CDK4/6 inhibitors and endocrine therapy were assigned to receive abemaciclib (Verzenio) or matched placebo plus fulvestrant (Faslodex).

o The median PFS per investigator assessment was 5.6 months (95% CI, 5.4-9.2) with abemaciclib-based therapy vs 3.9 months (95% CI, 3.7-5.4) with placebo plus fulvestrant (HR, 0.66; 95% CI, 0.48-0.91; P = .01).

o The investigator-assessed objective response rate (ORR) was 17% vs 7% in each respective arm.

· Phase 2 SACI-IO HR+ Trial (NCT04448886)3
o Investigators assessed sacituzumab govitecan-hziy (Trodelvy) alone or in combination with pembrolizumab (Keytruda) for HR-positive, HER2-negative metastatic breast cancer regardless of PD-L1 status.

o Combination therapy yielded a numerical improvement in median PFS (8.12 months; 95% CI, 4.51-11.12) compared with sacituzumab govitecan monotherapy (6.22 months; 95% CI, 3.85-8.68), although this improvement did not reach statistical significance (HR, 0.81; 95% CI, 0.51-1.28; P = .37).

o Immature OS data presented at the meeting highlighted a median OS of 18.52 months (95% CI, 16.55-not applicable [NA]) vs 17.96 months (95% CI, 12.50-NA) in each respective arm (HR, 0.65; 95% CI, 0.33-1.28; P = .21).

References

Curigliano G, Hu X, Dent RA, et al. Trastuzumab deruxtecan (T-DXd) vs physician’s choice of chemotherapy (TPC) in patients (pts) with hormone receptor-positive (HR+), human epidermal growth factor receptor 2 (HER2)-low or HER2-ultralow metastatic breast cancer (mBC) with prior endocrine therapy (ET): primary results from DESTINY-Breast06 (DB-06). J Clin Oncol. 2024;42(suppl 17):LBA1000. doi:10.1200/JCO.2024.42.17_suppl.LBA1000
Kalinsky K, Bianchini G, Hamilton EP, et al. Abemaciclib plus fulvestrant vs fulvestrant alone for HR+, HER2- advanced breast cancer following progression on a prior CDK4/6 inhibitor plus endocrine therapy: primary outcome of the phase 3 postMONARCH trial. J Clin Oncol. 2024;42(suppl 17):LBA1001. doi:10.1200/JCO.2024.42.17_suppl.LBA1001
Garrido-Castro A, Kim, SE, Desrosiers J, et al. SACI-IO HR+: a randomized phase II trial of sacituzumab govitecan with or without pembrolizumab in patients with metastatic hormone receptor-positive/HER2-negative breast cancer. J Clin Oncol. 2024;42(suppl 17):LBA1004. doi:10.1200/JCO.2024.42.17_suppl.LBA1004

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In a conversation with CancerNetwork®, Jagoda Misniakiewicz, a clinical pharmacy specialist in the Clinical Pharmacy and Outcomes Sciences Department at Hollings Cancer Center of the Medical University of South Carolina, spoke about the use of fruquintinib (Fruzaqla) as a treatment option for those with metastatic colorectal cancer (CRC).

The FDA previously approved fruquintinib as a treatment for those with metastatic CRC and prior treatment with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy and anti-VEGF therapy in November 2023.1

Misniakiewicz detailed the agent’s mechanism of action as a potent, orally available small molecule kinase inhibitor and its potential to inhibit blood vessel growth, thereby yielding vascular regression, normalization, and construction. Additionally, the clinical benefit of switching from intravenous therapy to this oral treatment appears to extend to any patient who has progressed on prior therapy, although she noted that there are currently no specific biomarkers or tumor characteristics that would make patients suitable candidates for fruquintinib.

The discussion also focused on the efficacy and safety data supporting the clinical utility of fruquintinib in this patient population. Specifically, Misniakiewicz highlighted the “exciting” progression-free survival (PFS) findings from the phase 3 FRESCO-2 trial (NCT04322539), which may affirm fruquintinib as a “promising treatment option” for those with refractory disease.

According to previous findings from the FRESCO-2 trial published in Lancet Oncology, the median PFS was 3.7 months (95% CI, 3.5-3.8) with fruquintinib plus best supportive care vs 1.8 months (95% CI, 1.8-1.9) with placebo plus best supportive care (HR, 0.32; 95% CI, 0.27-0.39; P <.0001).2 Additionally, the median overall survival (OS) was 7.4 months (95% CI, 6.7-8.2) vs 4.8 months (95% CI, 4.0-5.8) in each respective arm (HR, 0.66; 95% CI, 0.55-0.80; P <.0001). PFS and OS benefits across various patient subgroups—in which investigators stratified patients based on previous treatment with trifluridine/tipiracil (Lonsurf) or regorafenib (Stivarga), RAS mutation status, and duration of metastatic disease—were comparable with those observed in the intent-to-treat population.

“The truth is that treatment options for metastatic [CRC] are limited, and the approval of fruquintinib will hopefully bridge that gap a little bit,” Misniakiewicz said. “Oral agents have changed the landscape of treatment for patients with cancer. Furthermore, targeted agents allow us to tailor therapy with the goal of improving clinical outcomes while minimizing off target toxicities; fruquintinib will hopefully allow us to do this in patients with metastatic colorectal cancer.”

References

Takeda receives U.S FDA approval of Fruzaqla (fruquintinib) for previously treated metastatic colorectal cancer. News release. Takeda. November 8, 2023. Accessed June 6, 2024. https://bit.ly/3SwkD8U
Dasari A, Lonardi S, Garcia-Carbonero R, et al. Fruquintinib versus placebo in patients with refractory metastatic colorectal cancer (FRESCO-2): an international, multicentre, randomised, double-blind, phase 3 study. Lancet. Published online June 15, 2023. doi:10.1016/S0140-6736(23)00772-9

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In a conversation with CancerNetwork®, Terence T. Sio, MD, MS, discussed how technological advancements in radiation oncology have impacted the modern treatment landscape for patients with non–small cell lung cancer (NSCLC).

Sio, a professor of radiation oncology at Mayo Clinic in Phoenix, Arizona, first outlined the use of immunotherapy and other systemic treatment options for this patient population. He detailed how the use of these modalities and other factors such as the risk of radiation-induced pneumonitis often inform the extent of subsequent radiotherapy. Treatment decision making may also involve collaboration with surgeons and medical oncologists as part of a multidisciplinary tumor board, which meets regularly at his institution to determine suitable strategies for those who require more than 1 course of therapy.

Additionally, Sio spoke about currently prevalent radiotherapy treatment strategies for patients with NSCLC as well as possible toxicities that may be associated with these modalities. In terms of novel technology in the field, he highlighted the development of proton beam radiotherapy and the potential advantages it may offer over other therapies.

According to Sio, use of proton beam radiotherapy may reduce excess radiation that usually extends beyond the targeted tumor, effectively lowering the risk of adverse effects (AEs) during treatment. Specifically, proton beam radiotherapy may benefit patient subgroups including those who have previously experienced a heart attack or those who are older and frailer. With an adequate treatment plan that encompasses the use of proton beam radiation, Sio stated that it may be possible to treat these subgroups with fewer AEs than those observed in patients who undergo standard radiotherapy.

“We can actually be helping some of the patients who otherwise may not be able to stand as intensive of a method of combining radiation and chemotherapy for their lung cancer treatments,” Sio said regarding the use of proton beam radiotherapy in this population. “Right now, we have shown that proton [beam radiotherapy] has a role in lung cancer treatments.”

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Through elaborate multidisciplinary collaboration, institutions with National Accreditation Program for Rectal Cancer (NAPRC) standards can deliver a “high level of care” in the surgical treatment of patients with rectal cancer, according to Steven Wexner, MD, PhD, and Arielle Kanters, MD.

In a conversation with CancerNetwork®, Wexner and Kanters detailed the history and advancement of the NAPRC as an interdisciplinary initiative to improve the outcomes of those undergoing surgery for rectal cancer.

Wexner is the chair in the Department of Colorectal Surgery and director of the Ellen Leifer Shulman & Steven Shulman Digestive Disease Center at Cleveland Clinic, Florida, the founding chair of the NAPRC for the American College of Surgeons Commission on Cancer, and part of the executive committee of the Commission on Cancer. Kanters is a colorectal surgeon, associate fellowship program director, and surgeon leader of the NAPRC program at Cleveland Clinic Main Campus.

Wexner spoke about the inspiration for developing the NAPRC as a mission to elevate the level of surgical outcomes in patients with rectal cancer across the United States to those he observed in European countries such as the United Kingdom and Scandinavia. He enlisted leaders from organizations including the Society of Surgical Oncology and the College of American Pathologists to outline and apply appropriate standards for surgical care in rectal cancer.

Additionally, Kanters highlighted how enforcing precise guidelines and compliance measures through the NAPRC program facilitates multidisciplinary efforts with colleagues who specialize in radiology and pathology. She stated that these principles help individuals develop their skills across each department, thereby maintaining a high level of treatment for patients with rectal cancer.

Findings from a study published in the Journal of the American College of Surgeonsindicated that mortality and complication rates appeared to be lower for patients who received surgery for rectal cancer at NAPRC-accredited institutions compared with those who were treated at non-accredited practices.

Wexner and Kanters also discussed how potential advancements related to the use of neoadjuvant or adjuvant therapy may further improve patient outcomes in the field. Additionally, they spoke about updated research on immunotherapy and other modalities that they anticipate at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting.

Reference

Harbaugh CM, Kunnath NJ, Suwanabol PA, Dimick JB, Hendren SK, Ibrahim AM. Association of National Accreditation Program for Rectal Cancer Accreditation with outcomes after rectal cancer surgery. J Amer College Surg. Published March 28, 2024. doi:10.1097/XCS.0000000000001064

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In a conversation with CancerNetwork® at Memorial Sloan Kettering Cancer Center (MSKCC), Neil M. Iyengar, MD, spoke about developments and challenges in his career as a medical oncologist and clinical investigator as well as ongoing research efforts in improving outcomes among patients with breast cancer.

Iyengar, a breast oncologist in in the Department of Medicine at MSKCC and Weill Cornell Medicine in New York City, New York, as well as the co–editor-in-chief of the journal ONCOLOGY®, detailed his work in the emerging field of exercise oncology. Based on preclinical data supporting the potential anti-tumor effects of exercise, he and his colleagues are organizing several clinical trials to validate whether exercise intervention can improve cancer-specific end points. Although some findings may support implementing exercise as part of a cancer treatment plan, Iyengar noted the observational and self-reported nature of the prior data and said that it would be necessary to test exercise intervention in the same way “you would develop any new drug for treating cancer.”

Additionally, Iyengar discussed the fulfillment of ensuring patient care, a passion that has fueled his interest in lifestyle interventions such as exercise oncology. He highlighted how his cancer treatment philosophy extends beyond the goal of reducing tumor volumes to safeguarding the patient’s physical and emotional well-being.

“You can certainly hammer away at a tumor and give all kinds of chemotherapy and anti-cancer therapies, but if that [patient] is feeling miserable and has no quality of life and a short duration of response to that therapy, that’s not necessarily the type of outcome that I would consider to be successful,” Iyengar said. “If you’re able to either control or cure a cancer while also improving a [patient’s] quality of life and general well-being, that’s the kind of outcome that I strive for. When I see that in my patients and in the patients of my colleagues, that certainly brings a lot of fulfillment.”

Iyengar also highlighted how he found excitement and passion in off-hours responsibilities to help achieve work-life balance. Looking ahead, he spoke about data on anti-estrogen agents, antibody drug conjugates, and other breast cancer treatment strategies that he is looking forward to hearing at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting.

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In a discussion with CancerNetwork® at John Theurer Cancer Center, Gregory Charak, MD, highlighted advancements in surgical treatment strategies for patients with colorectal cancer (CRC) as well as other ongoing challenges in the field.

Specifically, Charak, a board-certified colorectal surgeon at Palisades Medical Center and Hackensack University Medical Center of Hackensack Meridian Health, described how minimally invasive strategies such as laparoscopic and robotic surgery have become more prevalent in the field, which have appeared to confer improvements in pain and length of hospital stay for patients. Although these minimally invasive techniques are typically preferred in this population compared with open surgery, Charak stated that he would still employ the latter depending on factors such as tumor size.

Charak also discussed the rise in CRC incidence among younger populations, which has impacted how practices conduct screening. He highlighted that patients who are in their late 20s or 30s receive recommendations to undergo colonoscopy in the event of weight changes or blood appearing in their stool, noting that he would not hesitate to perform screening even if there’s a small but real possibility of disease.

Regarding other treatment modalities in this population, Charak emphasized the potential benefits of neoadjuvant therapy. Administering neoadjuvant treatment with agents including cytotoxic chemotherapy and immunotherapy, for example, may help achieve negative-margin resections, thereby yielding less morbidity for patients.

“It’s a very exciting time to be a surgical oncologist. [There are] tremendous new treatment modalities coming down the pike. Immunotherapy, in particular, is extremely exciting because it’s such an elegant way to treat cancer: to harness and augment the body’s own defense system to eliminate a cancer rather than using cytotoxic chemicals or invasive surgery,” Charak said. “It’s a beautiful thing. If we can get it to apply to more and more tumors and figure out how to make it work, it couldn’t be more exciting.”

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During the 2024 Oncology Nursing Society Congress, CancerNetwork® spoke with multiple registered nurses about research they presented on safely administering treatment options such as CAR T-cell therapy and bispecific T-cell engager (BiTE) therapy in patients with multiple myeloma and other malignancies.

Ishmael Applewhite, BSN, RN-BC, OCN, a registered nurse at the University of Rochester Medical Center, highlighted the management of adverse effects including peripheral neuropathy in patients with multiple myeloma undergoing treatment with ciltacabtagene autoleucel (cilta-cel; Carvykti). He discussed these treatment strategies in the context of a presentation he gave on findings from the phase 3 CARDITUDE-4 trial (NCT04181827), in which investigators assessed treatment with cilta-cel in those who were refractory to lenalidomide (Revlimid).1

According to Applewhite, cilta-cel may offer “another path” aside from standard treatment options such as chemotherapy and give “more time” to patients with multiple myeloma.

Additionally, Leslie Bennett, MSN, RN, a nurse coordinator at Stanford Healthcare, highlighted the importance of identifying and mitigating cranial nerve palsy (CNP) in patients with multiple myeloma who are treated with cilta-cel. At the conference, Bennett presented data on CNP outcomes across various studies, which included the phase 1/2 CARTITUDE-1 trial (NCT03548207), phase 2 CARTITUDE-2 trial (NCT04133636), and phase 3 CARTITUDE-4 trial (NCT04181827).2

According to findings from this presentation, patients had CNP onset at a median of approximately 3 weeks after beginning treatment with cilta-cel. Most cases of CNP tended to occur in male patients.

Kathy Mooney, MSN, RN, ACNS-BC, BMTCN®, OCN®,clinical program director at Johns Hopkins Hospital and Johns Hopkins Health System, spoke about a study designed to evaluate the feasibility and safety of using BiTE therapy to treat those with cancer in an outpatient setting.3 Mooney emphasized multidisciplinary collaboration among nurses, pharmacy providers, and social workers as part of monitoring patients for toxicity as they undergo treatment with BiTE agents.

References

Applewhite I, Elfrink G, Esselmann J, Lonardi C, Florendo E, Sidiqi MH. Efficacy and adverse events after ciltacabtagene autoleucel treatment in the CARTITUDE-4 as-treated population consisting of patients with lenalidomide-refractory multiple myeloma who received 1-3 prior lines of therapy. Presented at: 2024 Oncology Nursing Society Congress; April 24-28, 2024; Washington, DC.
Bennett L, Kruyswijk S, Sidana S, et al. Incidence and management of cranial nerve impairments in patients with multiple myeloma treated with ciltacabtagene autoleucel in CARTITUDE studies. Presented at: 2024 Oncology Nursing Society Congress; April 24-28, 2024; Washington, DC.
Mooney K, Allen N, Anderson K, Zukas A. Taking a BiTE out of hospital admission days using a team approach to managing patients at risk for treatment related toxicities. Presented at: 2024 Oncology Nursing Society Congress; April 24-28, 2024; Washington, DC.

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In a conversation with CancerNetwork® at John Theurer Cancer Center, Timothy Chen, MD, highlighted various novel treatment strategies that have impacted his care of patients with brain tumors and other types of cancer.

Chen, a board-certified radiation oncologist and medical director of the Central Nervous System Program at Jersey Shore University Medical Center and the director of Proton Therapy in the Department of Radiation Oncology at Hackensack Meridian Health, first discussed his use of the novel stereotactic radiosurgery modality ZAP-X for patients with brain tumors. According to Chen, this tool may allow for practices to administer radiation at submillimeter precision, which can spare normal tissue from receiving excess radiation.

Another technology that Chen highlighted included GammaTile, a radiation treatment that was developed for the management of brain tumors. He said that this collagen tile may help with administering strong radiation to precisely where the tumor is located, while also protecting healthy tissues to minimize the adverse effects from radiation therapy. Specifically, Chen stated that GammaTile may be beneficial for those with larger, difficult-to-treat tumors.

Finally, Chen discussed the potential applications of proton therapy and how it may improve outcomes in patients compared with standard radiotherapy. According to Chen, proton therapy serves a “great purpose” with what he described as a precise depth charge that can minimize toxicity during treatment.

Additionally, Chen described how proton therapy may help reduce the probability of developing mutations or secondary cancers among pediatric patients. He highlighted the potential benefit of this modality based on a specific case in which a pediatric patient with myxopapillary ependymoma experienced improvements in pain and urinary control following proton therapy.

Regarding these novel forms of therapy, Chen emphasized the notion of multidisciplinary care and said that practices should “work together as a team” when operating these technologies.

“[With] all this technology, it's not just used as it is; the technology brings us to work together,” Chen said. “I think multidisciplinary care is the future. People are no longer siloed…. We all work together.”

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The robotic-assisted biopsy platform Ion is a “game-changer” for patients with lung cancer, as it provides a quicker, less invasive surgical method for conducting a lung biopsy, according to Richard Lazzaro, MD.

In a conversation with CancerNetwork, Lazzaro, the chief of Thoracic Surgery at the Southern Region of RWJBarnabas Health, spoke about his experience with adopting the Ion robotic bronchoscopy platform for the early detection of lung cancer at Monmouth Medical Center. He highlighted how the tool may enable practices to acquire tissue and perform disease staging with fewer complications, which may particularly benefit those who plan to undergo induction chemotherapy or immunotherapy.

In terms of other potential advancements in the lung cancer surgery field, Lazzaro discussed how he anticipates the use of video-assisted thoracoscopic (VATS) surgery to evolve. Specifically, he mentioned the development of technologies such as augmented reality as tools that may help minimize the variability of surgical procedures.

Regarding his practice, Lazzaro highlighted how a multidisciplinary thoracic tumor board—including medical oncologists, radiologists, pathologists, and pulmonary physicians, among others—has helped in producing long-term survival improvements. He emphasized collective discussions and shared decision-making as part of determining appropriate courses of care for his patients. When it comes to a multidisciplinary approach, Lazzaro stated that “you want to take care of patients” like they were part of “your family.”

Overall, Lazzaro noted how the lung cancer treatment landscape has changed over time. He emphasized referring patients for CT scans as well as evaluations at nodule or thoracic oncology clinics as part of a multidisciplinary strategy.

“The management of lung cancer is different than it was even 5 years ago. If we can detect lung cancer early, we have options for treating patients today that we never had before,” Lazzaro said. “This is the time where we really need to make a huge difference in lung cancer.”

Reference

Latest most advanced treatments for lung cancer now available at Monmouth Medical Center. News release. RWJBarnabas Health. January 22, 2024. Accessed April 17, 2024. https://tinyurl.com/ty8st3hm

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During the 2024 Society of Surgical Oncology Annual Meeting (SSO), CancerNetwork® spoke with a variety of surgical oncology expertsregarding the topline data they presented. Each conversation also expanded upon how these results can be implemented into the clinical space and the next research steps.

First, Adrienne Bruce Shannon, MD, a complex general surgical oncology fellow at Moffitt Cancer Center, discussed findings from her presentation highlighting responses to neoadjuvant immune checkpoint inhibitors among select patients with mismatch repair deficient (dMMR) gastroesophageal cancer.1

Looking ahead, Shannon described her aim to optimize treatment strategies for this patient population, which may include assessing whether single-agent treatment can be efficacious while avoiding toxicity associated with combination regimens.

Next, Sean Dineen, MD, an associate member in the Gastrointestinal Department, section leader for Peritoneal Disease, and the program director for the Complex General Surgical Oncology Fellowship at Moffitt Cancer Center, spoke about his session, which was aimed at determining appropriate conditions for using cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC) for those with colorectal cancer (CRC) and peritoneal metastases.2

Dineen highlighted that there is “good evidence” in support of HIPEC as a “valid treatment option” and emphasized the need to encourage medical oncologists to refer patients for consideration of surgery. Additionally, he spoke about other advancements he hopes to see in this patient population, including the development of markers of various disease volumes that can help identify potential recurrence in those who receive surgery.

Finally, Muhammad Talha Waheed, MD, a research fellow in the Department of Surgical Oncology at City of Hope National Medical Center in Duarte, California, detailed findings from a retrospective analysis indicating disparate treatment access and cancer-related mortality based on racial-economic segregation.3

Specifically, data showed that those who lived in Black and poor majority areas were less likely to receive care that was in accordance with various treatment guidelines while having worse overall survival outcomes. Regarding the next steps, Waheed described his intentions of sharing his findings with policymakers who may create legislature intended to mitigate the disparities observed in the analysis.

References

Shannon AB, Mehta RJ, Mok SR, et al. Pathologic response to neoadjuvant immunotherapy in DNA mismatch repair protein-deficient gastroesophageal cancers. Presented at the Society of Surgical Oncology 2024 Annual Meeting; March 20-23, 2024; Atlanta, GA. Abstract 94.
Dineen S. Optimal tumor burden for CRS/HIPEC in colorectal cancer. Presented at the Society of Surgical Oncology 2024 Annual Meeting; March 20-23, 2024; Atlanta, GA.
Waheed MT, Sullivan KM, Haye S, et al. Impact of racialized residential segregation on guideline concordant cancer care and survival. Presented at the Society of Surgical Oncology (SSO) 2024 Annual Meeting; March 20 – 23, 2024; Atlanta, GA; abstract E126.

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As part of Breaking Barriers: Women in Oncology, Maha H. Hussain, MD, and Sarah E. Fenton, MD, PhD, spoke with CancerNetwork® about developments in their careers and the evolution of research in the genitourinary oncology (GU) field. Additionally, they discussed their personal experiences in the field, which ranged from applying key pieces of advice from former mentors, handling challenges, and maintaining a healthy work/life balance.

Hussain is a Genevieve E. Teuton Professor of Medicine at Northwestern Medicine, and her mentee and fellow colleague, Fenton, is an assistant professor of Medicine at Northwestern Medicine.

The conversation partly focused on how the GU oncology landscape has evolved over time. According to Hussain, funding for new research and clinical trials has grown due to partnerships with pharmaceutical companies, which has accompanied a growth in median survival for patients with metastatic castration-resistant and metastatic hormone-sensitive prostate cancer. Looking ahead, Fenton said she hopes to see a greater proportion of patients achieve improved disease control, thereby leading to more treatment discontinuations or longer treatment-free intervals.

Additionally, Fenton described some of the advice she received that impacted the trajectory of her career and helped her decide to specialize in GU oncology.

“You need to stick with things that are important to you, worth your time, and are going to help people,” Fenton said. “That is the best piece of advice that Maha has given me as I’ve been moving through and thinking about what projects I’m going to start and where I am going to work hard.”

Hussain and Fenton also spoke about some of the personal challenges they have encountered in genitourinary oncology, including the difficulty of balancing their personal lives with professional aspirations. Both spoke to the importance and possibility of caring for their families while establishing priorities for their work.

“You can parallel-track your career and your personal life. I would say motherhood is wonderful; it’s a wonderful opportunity to be a mother,” Hussain said. “At the same time, it was a wonderful opportunity to be a physician and move the field there and work hard. Don’t forget that your personal life is very important because a happy personal life also reflects on your work life.”

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In a conversation with CancerNetwork®, Rian M. Hasson Charles, MD, MPH, FACS, spoke about her career in thoracic surgery and her visions for increasing equitable care in the field as part of a new, first-of-its-kind role at Brigham and Women’s Hospital. She will serve as the inaugural vice chair for Diversity, Equity, and Inclusion (DEI) in the Department of Surgery as well as an associate surgeon in the Division of Thoracic Surgery.

Hasson contextualized the acceptance of her new role by highlighting her previous experiences in lung cancer surgery, which included pursuing a psychology major at University of California, Berkeley and working as an attending physician at Dartmouth Hitchcock Hospital. At Dartmouth, she formed a DEI program for the public health school and pursued initiatives designed to spread access to care for patients with lung cancer.

As part of her new role at Brigham and Women’s Hospital, Hasson aims to reduce significant disparities in care across areas surrounding the academic center, grow a diverse workforce, and form connections with members in the community.

Hasson also described some of the barriers she experienced and overcame as a woman in oncology. She offered advice to other aspiring surgeons in the field, emphasizing the importance of paying attention to the family, friends, and partners who can support them during their journey.

“The world is your oyster. This position is a dream position for me because it’s bringing together everything that I love to do,” Hasson said.

“I encourage people to find their focus, find their passion, find the thing that keeps them up at night or that wakes them up in the morning. You can do whatever you set your mind to. With today’s resources, there should be nothing that limits you. There may be things that seem like they’re discouraging, but you have the power to overcome those and collaborate with people that will help generate success,” she added.

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In a conversation with CancerNetwork®, Gregory Peter Kalemkerian, MD, spoke about the publication of updated guidelines for managing small cell lung cancer (SCLC) with systemic therapy, which was developed by the American Society of Clinical Oncology (ASCO) in collaboration with Ontario Health (Cancer Care Ontario).1

Kalemkerian, a clinical professor at The University of Michigan and senior author of the guidelines, discussed developments in the SCLC field that inspired the creation of the revised guidelines since the last publication from ASCO in 2015.2 Although the latest guidelines contained recommendations concerning treatment modalities such as surgery and radiotherapy, Kalemkerian said that the biggest advances related to the integration of immunotherapy into frontline treatment for patients with extensive-stage SCLC (ES-SCLC).

Specifically, Kalemkerian highlighted the use of immunotherapeutic agents such as durvalumab (Imfinzi) and atezolizumab (Tecentriq), which have demonstrated long-term improvements in survival of those with ES-SCLC. The guideline authors issued a strong recommendation backed by high-quality evidence for the frontline use of carboplatin plus etoposide or cisplatin plus atezolizumab or durvalumab followed by maintenance immunotherapy in patients with ES-SCLC who have no contraindications to immunotherapy.1 Additionally, there was no evidence supporting the continuation of immunotherapy for those with relapsed SCLC and progressive disease following maintenance immunotherapy based on an informal consensus.

With respect to other updates in the guidelines, Kalemkerian spoke about optimal treatment strategies for patients with poorer performance statuses as well as the potential role of biomarkers in SCLC. Although there are currently no validated biomarkers that have demonstrated utility in the management of SCLC, he stated that it was necessary to overhaul how practices understand how diseases like SCLC develop and grow to help improve patient outcomes.

“I would like people to pay attention to SCLC a little bit,” Kalemkerian said. “Non–small cell lung cancer has gotten a lot of the press and hype over the last 20 years or so since targeted therapy came out for that disease. Before that, we all thought SCLC was where we were going to be making advances, and we were wrong. We’re on the cusp of understanding the disease better and utilizing that understanding to advance newer strategies for trying to treat these patients.”

References

Khurshid H, Ismaila N, Bian J, et al. Systemic therapy for small-cell lung cancer: ASCO-Ontario Health (Cancer Care Ontario) guideline. J Clin Oncol. 2023;41(35):5448-5472. doi:10.1200/JCO.23.01435
Rudin CM, Ismaila N, Hann CL, et al. Treatment of small-cell lung cancer: American Society of Clinical Oncology endorsement of the American College of Chest Physicians Guideline. J Clin Oncol. 2015;33(34):4106-4111. doi:10.1200/JCO.2015.63.7918.

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CancerNetwork® collaborated with OncLive® to speak with Edward S. Kim, MD, MBA, and Richard T. Lee, MD, about ongoing initiatives to expand integrative oncology for patients with cancer at City of Hope.

Kim is the physician-in-chief and senior vice president at City of Hope Orange County as well as the Construction Industries Alliance City of Hope Orange County physician-in-chief chair. Lee is the Cherng Family Director’s Chair of the Center for Integrative Oncology and a medical director of Supportive & Integrative Medicine in the Department of Supportive Care Medicine as well as a clinical professor of Supportive & Integrative Medicine at City of Hope.

The discussion partly focused on how integrative oncology is practiced at City of Hope. The institution’s style of integrative care derives inspiration from traditional Eastern medicine and encompasses modalities such as acupuncture, meditation, yoga, and massages to help treat patients with cancer more holistically. Lee cited updates in integrative therapy guidelines published by the Society for Integrative Oncology (SIO) in partnership with the American Society of Clinical Oncology (ASCO) to illustrate how integrative care can benefit patient quality of life.1 For example, he highlighted that there was strong evidence in support of implementing mindfulness-based interventions to help reduce anxiety and stress among patients.

“These types of integrative therapies are a great way to complement many of the standard-of-care options that we have and provide even further benefit in controlling these symptoms and allowing patients to have a better quality of life as they go through treatment and as they head into survivorship,” Lee said.

The conversation also pertained to the institution’s efforts to expand the Cherng Family Center for Integrative Oncology, a first-of-its-kind national integrative oncology program, following receipt of a $100 million gift from Andrew and Peggy Cherng, co-founders and co-chief executive officers at Panda Express, supporting its creation.2 This initiative will include conducting rigorous research in a clinical program that may inform future integrative oncology guidelines, pursuing natural product drug development, and instituting educational programs that may train future integrative oncologists.

"The only way we're going to be able to increase access to these important programs to more people is to do the rigorous, level 1 research that’s needed in order to prove that there is a benefit of any particular area,” Kim said. “Because if we’re rigorous and we show the results are positive, then we would expect them to be on the guidelines like the National Comprehensive Cancer Network, and then payers would then provide support to patients who want to have these services.”

References

Carlson LE, Ismaila N, Addington EL, et al. Integrative oncology care of symptoms of anxiety and depression in adults with cancer: Society for Integrative Oncology–ASCO guideline. J Clin Oncol. 2023;41(28):4562-4591. doi:10.1200/JCO.23.00857
Logsdon Z. City of Hope receives $100 million gift to create first-of-its-kind national integrative oncology program. News release. City of Hope. September 12, 2023. Accessed March 13, 2024. https://tinyurl.com/26y3xj87

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Monique Gary, DO, MSc, FACS spoke with CancerNetwork® about estimated increases in cancer burden across the world and the potential rises in cancer inequities among underserved populations, and discussed mitigating these disparities from an oncology and primary care perspective.

Gary, a board-certified breast surgical oncologist and medical director of the Grand View Health/Penn Cancer Network cancer program, talked about growing cancer burden in the context of a World Health Organization (WHO) surveythat projected future cancer risks. According to findings from the survey, there was an estimated 20 million new cancer cases and 9.7 million deaths from cancer in 2022. Authors estimated that 1 in 5 people will develop cancer, with 1 in 9 men and 1 in 12 women estimated to die from their disease. Additionally, more than 35 million new cancer cases were projected in 2050, representing a 77% increase from the estimated 20 million cases in 2022.

In particular, Gary highlighted a rise in cancer diagnoses among younger patients, including those without family history or hereditary mutations. In addition to environmental factors such as poor air quality and health conditions like obesity, she emphasized health system inequities in certain countries as obstacles that may contribute to rising cancer burden. Due to a lack of financial protection, some patients may lack adequate access to early detection and therapy for cancer.

Part of addressing these inequities, Gary said, requires primary care physicians redefining their perspective of cancer and not dismissing younger people who present with cancer symptoms. In addition to increasing screening for younger populations, she stated that it was necessary for oncologists to lean into available research and encourage patients to enroll on clinical trials.

“It's not just the job of advocacy groups and societies; it's the job of every clinician,” Gary said regarding what needed to be done to address the growth in cancer incidence and disparities. “The individuals who have been disadvantaged already, those [patients] who have a higher mortality and are diagnosed at a later stage of disease…don't have the access. This disparity is going to get wider and wider; we'll do something about it. And that should inspire everyone because there's something for everyone to do.”

Reference

World Health Organization. Global cancer burden growing, amidst mounting need for services. February 1, 2024. Accessed March 5, 2024. https://shorturl.at/pLNU7

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In a conversation with CancerNetwork®, Robert A. Winn, MD, spoke about current obstacles in achieving equitable care for patients with cancer and discussed how initiatives from community health centers and federal bodies alike may help increase access to anti-cancer therapy.

Winn, director and Lipman Chair in Oncology at Virginia Commonwealth University (VCU) Massey Comprehensive Cancer Center, senior associate for Cancer Innovation, and professor of pulmonary disease and critical cancer medicine at VCU School of Medicine, began the discussion by defining health equity as a principle. By eliminating disparities that impact access to treatment for certain populations, it may be possible for all patients to receive the same kind of care and potentially experience the same outcomes as part of an “even playing field.”

According to Winn, initiatives that may promote health equity in oncology include the ruling from the Centers for Medicare & Medicaid Services (CMS) allowing for the reimbursing of navigation services to help patients and their families access treatment for cancer and other serious diseases.1 Although Winn said that the field was trending towards the goal of health equity, he stated that more progress was necessary for biomarker testing in lung cancer and other malignancies. Additionally, increasing access to new treatments, technologies, and screening mechanisms across different communities represented another challenge concerning progress.

Winn also spoke about educating others on cancer-related disparities, including his colleagues and other resourceful groups in cancer care. He detailed his experiences with working on the yearly American Association for Cancer Research (AACR) Cancer Disparities Progress Reports since the first was published in 2020, which he described as an element that he hopes will educate people and spread awareness. In addition to collaboration among professional bodies including the Association of American Cancer Institutes and the American Society of Clinical Oncology, Winn highlighted local efforts in spreading awareness and improving progress towards health equity.

“By not sitting on our heels and waiting for the community to come to us, but by going out to the community and talking about the importance of screening, talking about the importance of finding a new drug and what that means, and talking about these new technologies, we've actually gotten a very robust group of community members who are actually by our sides and actually making other people aware out in the community,” Winn said regarding Facts & Faith Fridays, an initiative from Massey Comprehensive Cancer Center in collaboration with local faith-based leaders designed to spread awareness of anti-cancer treatment.2 “That has resulted in very positive outcomes for us.”

References

CMS finalizes physician payment rule that advances health equity. News release. Centers for Medicare & Medicaid Services. November 2, 2023. Accessed February 27, 2024. http://tinyurl.com/4p7dhr7h
Facts & Faith Fridays. VCU Massey Comprehensive Cancer Center. Accessed February 27, 2024. http://tinyurl.com/5wetmdyz

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Starting April 1, 2024, Diane M. Simeone, MD will start her new position as director of the University of California San Diego (UCSD) Health Moores Cancer Center.1

In a conversation with CancerNetwork®, Simeone highlighted her excitement to be working with an institution that she said aligns with her goals and values. During her time as director, she said that she wants to focus more on early detection of pancreatic cancer, which may help save many patients. Additionally, some of her short- and long-term goals include submitting a Cancer Center Support Grant to the National Institutes of Health and expanding clinical trial efforts at UCSD. She also discussed ongoing projects she will aim to work on, such as the UC Pancreatic Cancer (UCPCC) Consortium and the Pancreatic Cancer Early Detection (PRECEDE) Consortium.2,3

Prior to beginning her new position at UCSD, Simeone has been the Laura and Isaac Perlmutter Professor of Surgery, director of the Pancreatic Cancer Center, and the associate director of translational research at Perlmutter Cancer Center at New York University Langone Health. Additionally, she was previously the chair of the scientific and medical advisory board of the Pancreatic Cancer Action Network and a member of the scientific advisory board for the Let’s Win Pancreatic Cancer online community.

“It was clear that everybody is aligned with this mission and understands the importance of how we care for patients with cancer and do research at the cancer center,” Simeone said during the interview. “There seems to be a clear commonality of thinking on their vision of being at the forefront of advancing science and, most importantly, how we apply to take care of patients. Patients are always the driving force. That's always the center of what we need to be thinking about.”

References

World-renowned surgeon named new director of Moores Cancer Center at UC San Diego Health. News release. University of California San Diego. January 8, 2024. Accessed January 25, 2024. http://tinyurl.com/4986f4cb
UC Pancreatic Cancer Consortium. University of California Health. Accessed January 25, 2024. http://tinyurl.com/3szdvyxv
PanCAN’s Precision Promise adaptive clinical trial platform –. Pancreatic Cancer Action Network. Published April 27, 2016. Accessed January 25, 2024. http://tinyurl.com/fpax5hhd

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After the 2024 Gastrointestinal Cancers Symposium, Jun Gong, MD, and Daneng Li, MD, sat down to discuss the most relevant trial data to have come from the conference. They convened for a live X Space hosted by CancerNetwork®.

During the discussion, they covered different trials across the gastrointestinal space, which included those evaluating different disease states from hepatocellular carcinoma (HCC) to colorectal cancer (CRC), and those assessing circulating tumor DNA (ctDNA) dynamics.

Gong, a hematologic oncologist focusing on gastrointestinal and genitourinary cancers at Cedars-Sinai Medical Center, and Li, an associate professor in the Department of Medical Oncology and Therapeutics Research at City of Hope, each gave their perspective on the clinical trial data and discussed if they had implemented any of these study treatments into clinical practice.

The studies they covered included:

Phase 3 NETTER-2 Trial(NCT03972488)1:
Investigated lutetium Lu 177 dotatate (Lutathera) plus octreotide vs octreotide alone for advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs).
Lutetium Lu 177 significantly improved progression-free survival (PFS) and overall response rate (ORR) compared with octreotide alone.
The agent may be considered for patients with high-grade GEP-NETs who desire significant tumor shrinkage.
Phase 3 EMERALD-1 Trial (NCT03778957)2:
Studied transarterial chemoembolization (TACE) plus durvalumab (Imfinzi) with or without bevacizumab (Avastin) for unresectable HCC.
Durvalumab/bevacizumab plus TACE improved PFS compared with placebo plus TACE.
TACE may be preferred over transarterial radioembolization (TARE) due to faster patient recovery.
Phase 3 CheckMate-8HW Trial3:
Evaluated nivolumab (Opdivo) plus ipilimumab (Yervoy) vs chemotherapy for first-line treatment of microsatellite instability-high/mismatch repair deficient metastatic CRC.
Nivolumab/ipilimumab demonstrated superior PFS compared with chemotherapy.
Chemotherapy may no longer be the standard first-line treatment for this patient population.
BESPOKE Study (NCT04264702)4:
Assessed the impact of minimal residual disease (MRD) detected by ctDNA on disease recurrence in patients with stage II and III CRC receiving adjuvant chemotherapy.
MRD positivity was associated with worse disease-free survival (DFS).
ctDNA clearance at 12 weeks indicated improved DFS.
GALAXY Trial5:
ctDNA is a promising biomarker that can be used to predict recurrence in patients with CRC.
Patients with ctDNA-positive disease had a worse DFS than patients with ctDNA-negative disease.
This suggests that ctDNA may be useful for making treatment decisions, but more research is needed before it can be used in clinical practice.
Phase 3 FRESCO-2 Trial (NCT04322539)6:
Fruquintinib (Fruzaqla) improved the quality of life in patients with metastatic CRC when combined with best supportive care and significantly improved quality-adjusted time without symptoms of disease or toxicity compared with placebo and best supportive care.
The study showed positive effects on PFS, response rate, disease control, and duration of response with the fruquintinib combination.
The findings from this trial supported the FDA approval of fruquintinib for metastatic CRC in November 2023.7

References

Singh S, Halperin D, Myrehaug S, et al. [177Lu]Lu-DOTA-TATE in newly diagnosed patients with advanced grade 2 and grade 3, well-differentiated gastroenteropancreatic neuroendocrine tumors: primary analysis of the phase 3 randomized NETTER-2 study. J Clin Oncol. 2024(suppl 3):LBA588. doi:10.1200/JCO.2024.42.3_suppl.LBA588
Lencioni R, Kudo M, Erinjeri J, et al. EMERALD-1: a phase 3, randomized, placebo-controlled study of transarterial chemoembolization combined with durvalumab with or without bevacizumab in participants with unresectable hepatocellular carcinoma eligible for embolization. J Clin Oncol. 2024;42(suppl 3):LBA432. doi.10.1200/JCO.2024.42.3_suppl.LBA432
Andre T, Elez E, Van Cutsem E, et al. Nivolumab (NIVO) plus ipilimumab (IPI) vs chemotherapy (chemo) as first-line (1L) treatment for microsatellite instability-high/mismatch repair-deficient (MSI-H/dMMR) metastatic colorectal cancer (mCRC): First results of the CheckMate 8HW study. J Clin Oncol. 2024;42(suppl_3):LBA768. doi.10.1200/JCO.2024.42.3_suppl.LBA768
Kasi P, Aushev V, Ensor J, et al. Circulating tumor DNA (ctDNA) for informing adjuvant chemotherapy (ACT) in stage II/III colorectal cancer (CRC): interim analysis of BESPOKE CRC study. J Clin Oncol. 2024;42 (suppl _3):9. doi:10.1200/JCO.2024.42.3_suppl.9
Yukami H, Nakamura Y, Mishima S, et al. Circulating tumor DNA (ctDNA) dynamics in patients with colorectal cancer (CRC) with molecular residual disease: Updated analysis from GALAXY study in the CIRCULATE-JAPAN. J Clin Oncol. 2024;42(suppl_3):6. doi:10.1200/JCO.2024.42.3_suppl.6
Stintzing S, Tabernero J, Satoh T, et al. Quality-adjusted time without symptoms of disease or toxicity (Q-TWiST) analysis of fruquintinib + best supportive care (BSC) compared with placebo + BSC in metastatic colorectal cancer (mCRC): results from the FRESCO-2 trial. J Clin Oncol. 2024;42(suppl 3):116. doi:10.1200/JCO.2024.42.3_suppl.116
FDA approves fruquintinib in refractory metastatic colorectal cancer. FDA. News release. November 8, 2023. Accessed February 7, 2024. https://shorturl.at/isJW2

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In a conversation with CancerNetwork®, Lisa Carter-Bawa PhD, MPH, APRN, ANP-C, FAAN, spoke about factors that may contribute to feelings of stigmatization surrounding a lung cancer diagnosis, which may impact an individual’s decision to undergo screening for potential disease.

Specifically, Carter-Bawa, director of the Cancer Prevention Precision Control Institute at the Hackensack Meridian Health Center for Discovery and Innovation, detailed the stigmatization related to smoking and how public discourse in the context of lung cancer may impart feelings of shame or blame surrounding the development of one’s disease. As part of an effort to combat the stigmatization that at-risk populations may experience, she discussed the use of a digital, public-facing health communication and decision support tool named LungTalk. The tool was designed to provide an individually tailored experience that can help people understand more about lung health and lung cancer screening while encouraging shared decision-making with an informed clinician.

According to findings published in JTO Clinical Research and Reports, applying the Lung Cancer Stigma Communications Assessment Tool to LungTalk as part of a language, imagery, and context audit led to a revision of the digital tool in which potentially stigmatizing terms such as “smoker” were replaced with person-first language. Authors of the report concluded that adjusting public messaging surrounding at-risk individuals to be more empathic in conjunction with outreach and education efforts from clinicians may play a role in destigmatizing lung cancer.

Carter-Bawa also spoke about ongoing initiatives intended to address the low rates of lung cancer screening among screening-eligible African-American patients. Efforts such as community advisory councils and interactions with churches and other faith-based organizations aim to spread knowledge about lung cancer even beyond screening-eligible individuals.

“I would love for my colleagues to take away envisioning a world where stigma in lung cancer doesn't exist—that it's just a historical blip that we look back on—and that we are treating people equitably across the board,” Carter-Bawa said. “[A world where] we're using person-first language and not referring to people as smoker and nonsmoker in our scientific communication, our medical communication, or layman communications.”

Reference

Carter-Bawa L, Ostroff JS, Hoover K, Studts JL. Effective communication about lung cancer screening without iatrogenic stigma: a brief report case study using the lung cancer stigma communications assessment tool of LungTalk. JTO Clin Res Rep. 2023;4(11):100585. doi:10.1016/j.jtocrr.2023.100585

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Although strides have been made with Bruton tyrosine kinase (BTK) inhibitors and CAR-T cell therapy, relapse and resistance remain significant hurdles in treating patients with mantle cell lymphoma (MCL). The Lymphoma Research Foundation's 2023 MCL Scientific Consortium and Workshop addressed these complexities, aiming to dissect the intricate biology of MCL and propel progress towards a cure.

CancerNetwork® spoke with leaders in the MCL field to better understand the aim of the consortium and the advancements they hope to see in the space. The journal ONCOLOGY® published these findings in the February 2024 issue. The interviews included Elias Campo, MD, PhD, research director and professor of anatomic pathology at the Hospital Clinic of the University of Barcelona; Michael Wang, MD, professor in the Department of Lymphoma and Myeloma at The University of Texas, MD Anderson Cancer Center; Martin Dreyling, MD, PhD, professor of Medicine in the Department of Medicine and head of the Medical Clinic 3 at the University of Munich-Grosshadern in Germany; and Julie M. Vose, MD, MBA, Neumann M. and Mildred E. Harris Professor and division chief in the Division of Hematology at the University of Nebraska Medical Center and coeditor in chief of ONCOLOGY.

The consortium touched on t(11;14), which dysregulates cyclin D1 and fuels uncontrolled cell growth. Additionally, research presented at the consortium revealed other molecular pathways contributing to treatment resistance and relapse, highlighting the heterogeneous nature of the disease. This heterogeneity underscored the need for personalized treatment strategies and biomarker-based prognostics, a notion further emphasized by multiple findings on the predictive value of specific gene mutations.

Beyond understanding the inner workings of MCL, presentations also focused on novel therapeutic avenues. Specifically, there were encouraging data on the potential of next-generation BTK inhibitors including acalabrutinib (Calquence) to overcome resistance.

Challenges such as the limitations of current risk stratification models remain, underscoring the need for robust biomarkers to guide early interventions and optimize treatment selection. Additionally, the consortium featured a discussion on addressing a lack of diversity in clinical trial populations, which may help increase treatment access for those with various medical conditions.

“…The patient population that has a disease is not always [represented] in the clinical trials. That’s why it’s important to be able to have a diversity of patients in clinical trials: to test these new therapies because [patients] may have other medical conditions that would change the outcome of trials and not be necessarily representative of the entire patient population with that disease,” Vose said. “It’s important to try to advance the treatment of a very diverse patient population through these clinical trial mechanisms.”

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Integrative therapies have been proven to help reduce the adverse effects (AEs) of anxiety and depression in patients with cancer, according to Linda E. Carlson, PhD, RPsych.

Carlson, Enbridge Research Chair in Psychosocial Oncology and a professor in the Department of Oncology, Cumming School of Medicine at the University of Calgary, explained how different therapies such as mindfulness-based interventions, yoga, and relaxation could work to manage anxiety and depression in patients with cancer. Specifically, she talked about the new recommendations published by The Society for Integrative Oncology (SIO) in collaboration with the American Society of Clinical Oncology (ASCO), which highlighted integrative approaches to managing AEs related to anxiety and depression.1

During the interview, Carlson spoke about the current guidelines, which recommendations clinicians can begin to use in their everyday practices, and what aspects future research should focus on. Specifically, she highlighted the benefits of yoga, tai chi, and relaxation as possible therapies that can help mitigate the AEs of anxiety and depression.

“For the clinician, [it’s important to understand] that these options are available and that they’re evidence-based,” Carlson said.

“Then, [it’s important to figure] out where in your local area these kinds of treatments are available. Many comprehensive cancer centers have integrative therapies; they have yoga, tai chi, mindfulness-based interventions, relaxation, and imagery. Many counselors can offer those kinds of services and cognitive behavioral therapy. Being aware that [these options are] effective and that they are first-line treatments, finding out where they’re available, knowing how patients can access them, facilitating the treatments in whatever way [clinicians] can, and advocating for more of these programs within cancer treatment centers will be important.”
Carlson is also the past president of SIO and a current editorial advisory board member of ONCOLOGY®.

Reference
Carlson LE, Ismaila N, Addington EL, et al. Integrative oncology care of symptoms of anxiety and depression in adults with cancer: Society for Integrative Oncology–ASCO guideline. J Clin Oncol. 2023;41(28):4562-4591. doi:10.1200/jco.23.00857

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In a conversation with CancerNetwork® prior to the FDA approval of pembrolizumab (Keytruda) plus chemoradiotherapyin FIGO stage III to IVA cervical cancer,Jyoti S. Mayadev, MD, spoke about how the regimen’s approval would be a “major step” for the aforementioned population and how she planned to integrate it into her care.1

Mayadev, a board-certified radiation oncologist and professor of radiation medicine and applied sciences at the University of California, San Diego School of Medicine, stated that the approval would be a “huge win” with respect to progression-free survival (PFS) based on supporting findings from the phase 3 KEYNOTE-A18 trial (NCT04221945). According to data presented at the 2023 Annual Global Meeting of the International Gynecologic Cancer Society (IGCS),treatment with pembrolizumab plus chemoradiotherapy produced a significant PFS benefit compared with chemoradiation alone (HR, 0.70; 95% CI, 0.55-0.89; P = .0020).2 Additionally, findings from a subgroup analysis highlighted that the PFS benefit with the pembrolizumab-based combination extended to those with FIGO stage III to IVA disease (HR, 0.58; 95% CI, 0.42-0.80).1

Mayadev also described the tolerability and quality-of-life benefits associated with the pembrolizumab combination in the KEYNOTE-A18 trial. Additionally, she stated that potential next steps for research may involve integrating adaptive technology to potentially reduce toxicity following chemoradiation among patients with cervical cancer.

“Uptake of any new agent requires a multidisciplinary team approach. It requires workflows,” Mayadev said regarding her strategy for adopting the newly approved regimen in her clinic. “For our particular institution, we would somewhat seamlessly go into the FDA approval. At the same time, we would try to help others in the community. We, as a scientific global community for gynecologic oncology and radiation oncology, will come together and start to incorporate how we can move forward with the FDA approval.”

References

FDA approves pembrolizumab with chemoradiotherapy for FIGO 2014 stage III-IVA cervical cancer. News release. January 12, 2024. Accessed January 15, 2024. https://bit.ly/3NZNGPb
Lorusso D, Xiang Y, Hasegawa K, et al. ENGOT-cx11/GOG-3047/KEYNOTE-A18: A randomized, double-blind, phase 3 study of pembrolizumab plus chemoradiotherapy for high-risk locally advanced cervical cancer. Presented at 2023 Annual Global Meeting of the International Gynecologic Cancer Society; November 5-7, 2023; Seoul, South Korea. Abstract SE004/1614.

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In a conversation with CancerNetwork®, Sarah Donahue, MPH, NP, discussed strategies for managing adverse effects (AEs) associated with different drug classes for patients with metastatic breast cancer, ranging from antibody drug conjugates (ADCs) to CDK4/6 inhibitors.

With respect to ADCs, Donahue, a nurse practitioner at University of California, San Francisco, and member of the Oncology Nursing Society, highlighted common AEs following treatment with trastuzumab deruxtecan (T-DXd; Enhertu) and sacituzumab govitecan-hziy (Trodelvy). In particular, she spoke about the necessity of managing nausea associated with T-DXd by helping patients schedule doses with antiemetic drugs, as well as mitigating fatigue and improving quality of life in the process. For those who are treated with sacituzumab govitecan, Donahue spoke about mitigating abdominal cramping at her infusion center and administering loperamide to help patients manage acute diarrhea.

Donahue also discussed her methods for managing toxicity related to CDK4/6 inhibitors including palbociclib (Ibrance), ribociclib (Kisqali), and abemaciclib (Verzenios). Among patients with hormone receptor (HR)–positive breast cancer, treatment with palbociclib and ribociclib, when given in combination with hormonal therapy, may result in fatigue, hot flashes, and arthralgia. According to Donahue, encouraging patients to exercise often may combat fatigue while mitigating arthralgia associated with an aromatase inhibitor. Moreover, she stated that loperamide may help manage potential diarrhea following treatment with abemaciclib.

Overall, Donahue underscored the importance of keeping patients on treatments with CDK4/6 inhibitors and other treatments by being communicative with them regarding the potential to alleviate AEs. She suggested that such openness may give patients the confidence to ask providers for guidance on how to manage their disease.

“The main thing that I find most helpful for my patients is to explain the potential [adverse] effects, explain that there’s something that we can do about them—that we can intervene. If they reach out to us sooner, we can help them more,” Donahue concluded. “I hope that the providers who are listening to this now can help to empower their patients to reach out and to ask for advice. That’s the best thing that they can do to keep them on these medications longer. They can work well; we can show that in studies. But if we can’t keep [patients] on the medications, then what are we doing?”

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In a recent conversation with CancerNetwork®, Sara A. Hurvitz, MD, FACP, senior vice president and director of the Clinical Research Division at Fred Hutch Cancer Center and head of the Division of Hematology and Oncology at the University of Washington Department of Medicine, discussed new treatment options for patients with metastatic HER2-positive breast cancer.

In the discussion, Hurvitz highlighted findings from the phase 3 HER2CLIMB-02 trial (NCT03975647), which assessed the efficacy and safety of tucatinib (Tukysa) plus ado-trastuzumab emtansine (Kadcyla; T-DM1) in patients with HER2-positive breast cancer, specifically those with brain metastases.

Patients enrolled in this trial experienced a significant improvement in progression-free survival (PFS) with the tucatinib-based regimen. Data presented at the 2023 San Antonio Breast Cancer Symposium (SABCS) highlighted that the median time to disease progression or death was 9.5 months (95% CI, 7.4-10.9) and 7.4 months (95% CI, 5.6-8.1 in the experimental arm and placebo arm, respectively (HR, 0.76; 95% CI, 0.61-0.95; P = .0163). In patients with brain metastases, the median time to disease progression or death was 7.8 months (95% CI, 6.7-10.0) and 5.7 months (95% CI, 4.6-7.5) in the experimental arm and placebo arm, respectively (HR, 0.64; 95% CI, 0.46-0.89). Investigators reported that toxicity in the experimental arm was generally manageable and reversible.

“This was a study that only enrolled patients who were naive to trastuzumab deruxtecan [T-DXd; Enhertu],” Huvitz said. “We know that T-DXd has substantial improvements in PFS and survival, so having so many patients receive this [agent] after progression is certainly going to impact our ability to observe survival differences. About 15% of patients in each arm also went on to receive tucatinib. These are pretty exciting results for our patients, especially those with brain metastases. This study did enroll, as I said, patients with brain metastases, who comprised 44% or so of the entire population enrolled in this study. These are interesting data, and we'll see if this regimen is ultimately approved.”

Reference
Hurvitz SA, Loi S, O’Shaughnessy J, et al. HER2CLIMB-02: randomized, double-blind phase 3 trial of tucatinib and trastuzumab emtansine for previously treated HER2-positive metastatic breast cancer. Presented at the 2023 San Antonio Breast Cancer Symposium; December 5-9, 2023; San Antonio, TX. Session GS01-10.

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In a conversation with CancerNetwork®, Amy Tiersten, MD, spoke about how findings from the phase 1/2 ASPIRE trial (NCT03304080) may support anastrozole (Arimidex) plus palbociclib (Ibrance), trastuzumab (Herceptin), and pertuzumab (Perjeta) as a first-line treatment for patients with hormone receptor (HR)–positive, HER2-positive metastatic breast cancer.

Data presented at the 2023 San Antonio Breast Cancer Symposium (SABCS)highlighted a clinical benefit rate of 97% (95% CI, 83%-100%; P <.0001) and an objective response rate of 73% (95% CI, 54%-88%) in patients who received the experimental regimen. Moreover, investigators reported a median time to overall response of 2.8 months (95% CI, 2.7-5.2) and a median duration of response of 37.8 months (95% CI, 14.0-not estimable).

The anastrozole-based combination produced a median progression-free survival (PFS) of 21.2 months (95% CI, 18.4-57.2), with PFS rates of 46.1% (95% CI, 30.2%-70.4%) at 24 months and 24.6% (95% CI, 10.4%-58.3%) at 48 months. Additionally, the median overall survival had not been reached at the time of the analysis; only 1 of 30 patients died after more than 2 years of study treatment.

Based on these findings, Tiersten, a professor of Medicine and clinical director of Breast Medical Oncology at Mount Sinai Hospital, spoke to the importance of having an alternative treatment option outside of chemotherapy in this patient population. She stated how administering this study regimen in the frontline may help patients avoid some of the common toxicities associated with chemotherapy, thus benefitting their quality of life.

“It’s hugely important if we can have that kind of clinical benefit rate and the duration of the response and have patients avoid the toxicities of chemotherapy such as hair loss, neutropenia, fever, and nausea—all the known [adverse] effects that come with chemotherapy,” Tiersten said. “Quality of life is always important, but it’s especially important in a group of patients in whom we’re not treating with curative intent and have many lines of therapy ahead of them. If we can delay more toxic therapy by as much as we can, that would only be a win for the patients.”

Reference

Patel R, Cascetta K, Klein P, et al. A multicenter, phase I/II trial of anastrozole, palbociclib, trastuzumab, and pertuzumab in hormone receptor (HR)-positive, HER2-positive metastatic breast cancer (ASPIRE). Presented at the 2023 San Antonio Breast Cancer Symposium; December 5-9, 2023; San Antonio, TX; abstract RF02-01.

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In a conversation with CancerNetwork®, Rakshanda Rahman, MD, FRCS, FACS, discussed a wide range of surgical therapy strategies and other developments in the breast cancer space, ranging from factors that should be considered for surgical decision-making to the evolution of artificial intelligence (AI) in the field.

Rahman, a professor of Breast Surgical Oncology at Texas Tech University Health Sciences Center and the medical director of UMC Cancer Center, spoke about challenges associated with barriers to treatment, stating how some patients, particularly those residing in rural counties, may not have sufficient access to the latest technologically advanced care as those in other communities. She also emphasized the value of giving early breast cancer screenings to patients to match them with appropriate systemic therapies.

“We need to keep increasing the advocacy towards screening for patients,” Rahman said. “There are still a lot of misgivings in people’s minds. They may be scared of radiation or do not have time; there are lots of reasons why people choose to not have a screening. Nothing makes a bigger difference to mortality from breast cancer like screening does. All these advancements are great, but if patients do one thing, they should get screened.”

Rahman also discussed her adoption of a genomic profiling test at her clinic to more accurately predict patients who may benefit from treatment with chemotherapy or endocrine therapy. Additionally, she spoke to the use of advanced screening technologies that allow for the detection of tiny tumors, although this may present some logistical challenges for surgically removing a tumor of that size. She also highlighted her use of MOLLI®, a magnetic device that she said has produced quicker operating times compared with a standard wire-based procedure.

With respect to AI, Rahman said that processing blood tests with an algorithm may help identify genes that could affect a patient’s disease, thereby allowing practices to discern what makes a tumor develop resistance. Additionally, certain AI tools may reduce the number of imaging tests needed for a patient, thus reducing health care costs in the process. However, Rahman cautioned that these AI programs should be used responsibly, as to not replace the “human connection” that underscores the doctor/patient relationship.

Reference

MOLLI: precision surgery made simpler. MOLLI Surgical Inc. Accessed December 13, 2023. https://shorturl.at/mvCM6

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In a recent discussion with CancerNetwork®, Joleen Hubbard, MD, research collaborator with Mayo Clinic and deputy director for clinical research at Allina Health Cancer Institute in Minneapolis, Minnesota, discussed new opportunities for patients with colorectal cancer (CRC).

In the discussion, Hubbard highlighted the potential of trastuzumab deruxtecan-nxki (Enhertu; T-DXd) in patients with HER2-expressing metastatic CRC based on studies including the phase 2 DESTINY-CRC01 trial (NCT03384940), which assessed the efficacy and safety of the agent in those who progressed after 2 or more prior regimens.1 These trials may play a role in continuing HER2 inhibition downstream after the FDA approval of trastuzumab (Herceptin) plus tucatinib (Tukysa) in patients with metastatic HER2-positive CRC.2

Hubbard also discussed the phase 3 MOUNTAINEER-03 study (NCT03043313) and its effects in the CRC space.3 This trial assessed the safety and efficacy of frontline tucatinib and trastuzumab in patients with treatment-refractory, RAS wild-type, HER2-positive metastatic CRC. Primary endpoints for this analysis showed a clinically meaningful overall response rate of 38.1% and a median duration of response of 12.4 months. Additionally, the treatment combination was well tolerated.

She said she is “optimistic” that moving HER2-directed therapy to the first-line setting, as seen in the MOUNTAINEER-03 study, may help outcomes for patients with metastatic CRC.

“It’s a very exciting space,” Hubbard said. “Because it’s only 5% to 8% of patients [who have CRC], it may not get as much attention, but there’s 150,000 new cases of [CRC] diagnosed each year. So, 5% to 8% of that is a large number of patients [whom] we need to be looking at, studying, and potentially impact with these treatments.”

References

Yoshino T, Di Bartolomeo M, Raghav K, et al. Final results of DESTINY-CRC01 investigating trastuzumab deruxtecan in patients with HER2-expressing metastatic colorectal cancer. Nat Commun. 2023;14(1):1-13. doi:10.1038/s41467-023-38032-4
Seagen announces FDA accelerated approval of Tukysa (tucatinib) in combination with trastuzumab for people with previously treated RAS wild-type, HER2-positive metastatic colorectal cancer. News release. FDA. January 19, 2023. Accessed December 6, 2023. https://bwnews.pr/3Xpzbqn
Bekaii-Saab TS, Van Cutsem E, Tabernero J, et al. MOUNTAINEER-03: phase 3 study of tucatinib, trastuzumab, and mFOLFOX6 as first-line treatment in HER2+ metastatic colorectal cancer—Trial in progress. J Clin Oncol. Published online January 24, 2023. doi:10.1200/jco.2023.41.4_suppl.tps261

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CancerNetwork® spoke with Govindarajan Narayanan, MD about his practice becoming the first in the United States to successfully surgically treat a patient with a liver tumor using the Epione robot, as well as the process of transitioning from CT-based image guidance to the robotic workstation in his care.1

Narayanan, a professor of Radiology and an interventional radiologist at Miami Cardiac and Vascular Institute and the chief of Interventional Oncology at Miami Cancer Institute, both of Baptist Health South Florida, described how the use of Epione may save significant amounts of time while performing microwave ablation, cryoablation, and irreversible electroporation (IRE). Developers designed the robotic device to simplify several probe procedures, helping make large tumors more predictable to manage.2

According to Narayanan, Epione is suitable for use in any patient for whom his practice typically performs image-guided ablations. Additionally, the device may “level the playing field” by allowing those with less experience to give highly accurate surgery, thereby increasing the availability of physicians who can offer these treatments across multiple practices.

Narayanan also described some of the potential challenges associated with adopting the Epione robot in clinic, such as adapting to the physical space that it occupies in the operating room. The device may also pose a steep learning curve with respect to procedures involving multiple needles such as cryoablation and IRE, as it is necessary to set a path that won’t cause any deflections of the needle.

Looking ahead, Narayanan said that future technological developments may allow users to operate the robot remotely, allowing patients to receive surgery at a treatment center even if a practicing physician is not physically present.

“It’s very exciting to be at the forefront of bringing such a cutting-edge technology to mainstream clinical practice,” Narayanan said. “Everything is done with one click, so it saves a significant amount of time. And because you’re not doing multiple check scans when you place the needles, you’re saving on radiation time.”

References

First patient treated in the United States with Quantum Surgical’s Epione® robot. News release. Quantum Surgical. May 24, 2023. Accessed November 6, 2023. https://shorturl.at/lzH01
Epione. Quantum Surgical. Accessed November 7, 2023. https://shorturl.at/dqyL6

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During an overview of the current standard of care for patients with colorectal cancer (CRC), Tanios S. Bekaii-Saab, MD noted that as molecular testing becomes more important, researchers are looking into how to best personalize therapy for optimal outcomes. He spoke with CancerNetwork® as part of an Around the Practice® program focused on testing and treatment options for patients with metastatic CRC.

When discussing the future direction of CRC care strategies, it is possible that treatment will be tailored to the individual based on mutation status, such as BRAF V600E, said Bekaii-Saab, leader of the Gastrointestinal Cancer Program and medical director of the Cancer Clinical Research Office, and vice chair and section chief for Medical Oncology in the Department of Internal Medicine at the Mayo Clinic.

Bekaii-Saab noted that his institution is investigating select treatments in earlier lines of therapy, as chemotherapy plus or minus a biologic is the current standard of care. He also highlighted the importance of a multidisciplinary team approach, as he knows working with radiologists, and surgeons is important to provide patients with the best care.

At the time of the interview, fruquinintib (Fruzaqla) was pending approval for patients with previously treated metastatic CRC. On November 8, 2023, fruquintinib was granted approval based on results from the phase 3 FRESCO-2 trial (NCT04322539).1,2 Investigators of the trial reported a median overall survival of 7.4 months (95% CI, 6.7-8.2) in the fruquintinib arm vs 4.8 months (95% CI, 4.0-5.8) in the placebo arm (HR, 0.66; 95% CI, 0.55-0.80; P <.0001).

Fruquintinib will now join trifluridine/tipiracil (Lonsurf) or regorafenib (Stivarga) as part of the second-line landscape and beyond for patients with previously treated CRC, Bekaii-Saab explained.

In closing, he stated that he is optimistic about the future of CRC treatment, as there is the potential for the development of new targeted therapies, immunotherapies, and gene editing therapies that will lead to more personalized and effective treatments for CRC patients.

“The biggest takeaway from the discussion with my esteemed colleagues today relates to further understanding the complexities that have emerged with the availability of multiple targeted options in metastatic CRC,” he concluded.

References
1. Takeda receives U.S FDA approval of Fruzaqla (fruquintinib) for previously treated metastatic colorectal cancer. News release. Takeda. November 8, 2023. Accessed November 8, 2023. https://bit.ly/3SwkD8U

Dasari A, Lonardi S, Garcia-Carbonero R, et al. Fruquintinib versus placebo in patients with refractory metastatic colorectal cancer (FRESCO-2): an international, multicentre, randomised, double-blind, phase 3 study. Lancet. Published online June 15, 2023. doi:10.1016/S0140-6736(23)00772-9

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Kristen K. Ciombor, MD, MSCI, an assistant professor in the Division of Hematology/Oncology in the Department of Medicine at the Vanderbilt University Medical Center, recently spoke at an Around the Practice discussion regarding updates in the world of metastatic colorectal cancer (CRC).

In this episode of the ONCOLOGY® On the Go Podcast, she discusses treatment updates, molecular testing options, and emerging targets in CRC. Ciombor also highlighted ongoing research in the space, including the phase 3 BREAKWATER (NCT04607421)1 trial and the phase 3 MOUNTAINEER-03 (NCT05253651)2 trial. She also discussed some of the most important presentations from the 2023 European Society for Medical Oncology (ESMO) Congress, including those covering the phase 2 MOUNTAINEER study (NCT03043313)3 and the phase 3 KEYNOTE-811 trial (NCT03615326).4 Additionally, she spoke about her work in the phase 2 ECOG-ACRIN trial (NCT04751370) assessing neoadjuvant nivolumab (Opdivo) plus ipilimumab (Yervoy) in patients with microsatellite instability-high or mismatch repair deficient rectal cancer.5

“I’m hoping that we see more treatment options for patients [and that] we identify more patient subtypes that we can target and find actionable alterations for,” Ciombor said.

References

Kopetz S, Grothey A, Yaeger R, et al. BREAKWATER: randomized phase 3 study of encorafenib (enco) + cetuximab (cetux) ± chemotherapy for first-line (1L) treatment (tx) of BRAF V600E-mutant (BRAFV600E) metastatic colorectal cancer (mCRC). J Clin Oncol. Published online May 28, 2021. doi:10.1200/jco.2021.39.15_suppl.tps3619
Bekaii-Saab TS, Van Cutsem E, Tabernero J, et al. MOUNTAINEER-03: phase 3 study of tucatinib, trastuzumab, and mFOLFOX6 as first-line treatment in HER2+ metastatic colorectal cancer—Trial in progress. J Clin Oncol. Published online January 24, 2023. doi:10.1200/jco.2023.41.4_suppl.tps261
Strickler JH, Cercek A, Siena S, et al. Tucatinib plus trastuzumab for chemotherapy-refractory, HER2-positive, RAS wild-type unresectable or metastatic colorectal cancer (MOUNTAINEER): a multicentre, open-label, phase 2 study. Lancet Oncol. Published online May 24, 2023. doi:10.1016/S1470-2045(23)00150-X
Janjigian YY, Kawazoe A, Bai Y, et al. embrolizumab plus trastuzumab and chemotherapy for HER2+ metastatic gastric or gastroesophageal junction (mG/GEJ) adenocarcinoma: Survival results from the phase III, randomized, double-blind, placebo-controlled KEYNOTE-811 study. Ann Oncol. 2023;34(suppl 2):S851-S852. doi:10.1016/j.annonc.2023.09.1424
Ciombor KK, Hong SC, Eng C, et al. EA2201: An ECOG-ACRIN phase II study of neoadjuvant nivolumab plus ipilimumab and short course radiation in MSI-H/dMMR rectal tumors. J Clin Oncol. Published online June 2, 2022. doi:10.1200/jco.2022.40.16_suppl.tps3644

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As part of an Around the Practice program, CancerNetwork® spoke with Misako Nagasaka, MD, PhD, about her current treatment strategies for patients with lung cancer as well as relevant updates and potential advancements in the non–small cell lung cancer (NSCLC) space.

Nagasaka, a thoracic oncologist and associate clinical professor at the University of California, Irvine, discussed sequencing immunotherapy and chemotherapeutic agents depending on factors including EGFR and ALK mutations as well as a patient’s PD-L1 status. She also spoke to the importance of multidisciplinary collaboration at her practice with pulmonologists and surgeons for treating patients in the neoadjuvant and adjuvant settings.

Following the FDA approval of pembrolizumab (Keytruda) plus chemotherapyfor patients with resectable NSCLC in October 2023, Nagasaka stated that she was excited to treat those who may benefit from this regimen. The regulatory agency based its approval on data from the phase 3 KEYNOTE-671 trial (NCT03425643), which assessed the regimen among 797 patients with resectable stage II, IIIA, or IIB NSCLC.

The median overall survival was not reached (NR; 95% CI, NR-NR) among patients receiving pembrolizumab compared with 52.4 months in those receiving placebo (95% CI, 45.7-NE; HR, 0.72; 95% CI, 0.56-0.93; P = .0103). Additionally, the median event-free survival was NR (95% CI, 34.1 months to NE) vs 17.0 months (95% CI, 14.3-22.0) in each respective arm (HR, 0.58; 95% CI, 0.46-0.72; P <.0001).

Looking ahead at ongoing research efforts, Nagasaka said that her institution is assessing how the gut microbiome may influence a patient responds to treatment, as well as any adverse effects [AEs] they may experience during therapy. Additionally, she spoke about the initiation of the phase 2 PALOMA-2 trial (NCT05498428), which will evaluate amivantamab-vmjw (Rybrevant) administered subcutaneously to those with advanced or metastatic solid tumors, including a population of patients with NSCLC harboring EGFR mutations.

“I’m very excited [to initiate the PALOMA-2 trial] because from preliminary data that I’ve seen, [AE] rates are decreased. That’s really important for patients,” Nagasaka said.

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Sexual dysfunction is a common problem for patients with and survivors of cancer that often remains undertreated. It can manifest in a variety of ways, including reduced libido, sexual pain, and vaginal dryness. Jennifer A. Vencill, PhD, LP, takes a biopsychosocial approach to sexual health, helping to address the psychological aspects of sexual dysfunction.

In this episode of the ONCOLOGY On the Go Podcast, Vencill, a psychologist and sex therapist from the Mayo Clinic, spoke with CancerNetwork® about the multidisciplinary approach her team takes to address sexual dysfunction in patients, which includes a psychologist/sex therapist, medical providers, nurse educators, and pelvic floor physical therapists who can provide comprehensive care and support to help patients manage sexual dysfunction and improve their quality of life.

Often, patients will avoid seeking help as there are social stigmas associated with sexual dysfunction, Vencill says. She emphasizes the importance of talking about sexual health openly to her patients and colleagues, as well as educating the public about these challenges. Sometimes these diagnoses may be overlooked, as medical oncologists do not have much time with patients during follow-up appointments, as patients and clinicians may be more concerned about treatment options or risk of recurrence than asking about sexual health.

To help diagnose the sexual dysfunction, Vencill will refer patients to get a full body check-up to ensure there are no underlying physical issues. This is where the pelvic floor physical therapist comes into play, as they will help address any physical needs while Vencill can address mental needs. Once that is done, she will begin to treat them and help them to adapt to a “new normal” following their cancer treatment.

Looking towards the future, Vencill hopes to see a more normalized and open dialogue about sexual health. She also encourages patients with cancer and survivors to be flexible and adaptable in their sexual relationships, as their sexual experiences may change after cancer treatment.

“[Life during or after treatment] requires some flexibility, some adaptability, some rethinking of the script that they were used to around sex,” Vencil said. “When we get stuck in those rigid scripts, we often don’t have much room for growth and exploration. The new sexual normal after cancer treatment might look very different from what you’re used to. Sometimes that's a good thing.”

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During Breast Cancer Awareness Month 2023, Rebecca M. Shulman, MD, an assistant professor in the Department of Radiation Oncology at Fox Chase Cancer Center, and Zachary Kiss, DO, a third-year resident physician in radiation oncology at Fox Chase, spoke about findings from their study, which assessed how BRCA1/2 mutations in patients with breast cancer do not appear to affect treatment outcomes with radiotherapy.

Shulman and Kiss presented these findings as part of a poster session at the 2023 American Society for Radiation Oncology (ASTRO) Annual Meeting.

Disease-free survival (DFS) outcomes following radiation were reported to be comparable between patients with no BRCA mutations (n = 1482) and those with BRCA-mutated disease (n = 77; P = .26). Additionally, those with BRCA1/2 mutations tended to be younger (P = .004), have higher clinical stage disease (P <.006), and were more likely to undergo mastectomy (P <.001) than patients without mutated disease.

An analysis of patients with BRCA-mutated disease also indicated that those with BRCA1 mutations (n = 31) tended to be younger than those with BRCA2 mutations (n = 46; P = .006). Moreover, a higher proportion of patients with BRCA1 mutations had estrogen receptor– or progesterone receptor–negative disease (P <.001) and higher T stage (P = .032).

Shulman and Kiss also spoke about how next steps for research may include investigating potential additional mutations and other factors that may affect sensitivity to radiotherapy among patients with disease harboring BRCA mutations. They also discussed other presentations at this year’s ASTRO meeting that may support advancement towards individualized treatment approaches in patients with breast cancer.

“Investigating the genetic and biochemical basis of cancer is a monumental task, requiring patients, ingenuity, and a continuing investment of time and resources,” Shulman said. “It’s important to communicate that progress in cancer treatment has been enormous, but that it is also incremental by nature and will require the efforts of many researchers pursuing many different ideas.”

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In this episode of the ONCOLOGY On the Go Podcast, Arvind N. Dasari, MD, and Cathy Eng, MD, speak to data supporting fruquintinib (Elunate), a VEGFR-1, -2, and -3 inhibitor as a potential treatment for patients with metastatic colorectal cancer (CRC).

Dasari is an associate professor in the Department of Gastrointestinal Medical Oncology in the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center in Houston, Texas. Eng is a David H. Johnson Chair in Surgical and Medical Oncology, a professor of medicine, co-leader of the Gastrointestinal Cancer Research Program, co-director of gastrointestinal oncology, and director of the Young Adults Program at Vanderbilt-Ingram Cancer Center in Nashville, Tennessee, and co-chair of the National Cancer Institute Gastrointestinal Steering Committee.

These experts reviewed data from the phase 3 FRESCO-2 trial (NCT04322539), which assessed the efficacy of fruquintinib compared with placebo among patients with heavily pretreated metastatic, refractory CRC. The median overall survival (OS) in the fruquintinib and placebo arms, respectively, were 7.4 months (95% CI, 6.7-8.2) and 4.8 months (95% CI, 4.0-5.8), meeting the trial’s primary end point (HR, 0.66; 95% CI, 0.55-0.80; P <.0001). According to findings from a quality-of-life (QOL) analysis of the FRESCO-2 trial, QOL and time to deterioration appeared to improve in the fruquintinib arm, as well.

The discussion also focused on how fruquintinib may impact the treatment landscape if it were to receive approval from the FDA in the previously described patient population.

“I’ve been impressed, and I am eagerly awaiting the potential approval, given the efficacy and the good [adverse effect] profile,” Dasari said. “I think [fruquintinib] will be a standard of care for patients with metastatic colorectal cancer.”

Eng also discussed the agent’s potentially implications in select patient subgroups.

“We need to find additional treatment options for microsatellite instability [MSI]–stable patients,” Eng noted. “[Fruquintinib] just gives another opportunity to them, with good [QOL] and improved [OS]. By improving their [OS], it improves their own personal [QOL], as well as their ability to potentially participate in another clinical trial.”

The FDA granted priority review to fruquintinib for patients with previously treated metastatic CRC in May 2023. The regulatory agency set a Prescription User Fee Act date of November 30, 2023 for fruquintinib in this indication.

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CancerNetwork® spoke with experts across multiple disciplines about the far-reaching impacts of the ongoing shortages of chemotherapy drugs including carboplatin and cisplatin, and how practices may be able to mitigate these challenges in the short and long term.

Michael Ganio, PharmD, MS, BCPS, FASHP, described the causes of carboplatin and cisplatin being in short supply across the United States and how the FDA is working with Chinese manufacturers to import these chemotherapy agents. Ganio, senior director of Pharmacy Practice and Quality at the American Society of Health-System Pharmacists, stated that communication is paramount among all members of a care team to help prevent critical errors while treating patients with limited supplies of these drugs. He also spoke about how reaching out to local representatives may help address the issues resulting from these shortages.

“Advocacy is needed,” Ganio said. “Our policymakers need to know that these shortages are having a real-world impact, and that they need to be addressed.”

Brian Slomovitz, MD, MS, FACOG, spoke about how he is managing the ongoing shortages in the context of his gynecologic cancer care, including swapping one platinum-based drug for another during treatment. Slomovitz, a gynecologic oncologist, director of Gynecologic Oncology, and co-chair of the Cancer Research Committee at Mount Sinai Medical Center in Miami Beach, Florida and a professor of Obstetrics and Gynecology at Florida International University, also described the challenges many practices across the country have due to lacking platinum-based drugs altogether.

“I know there are institutions that don't have [platinum-based chemotherapy],” Slomovitz said. “There are institutions that aren't able to give their patients the best standard-of-care therapy and aren't able to enroll patients in trials because of lack of therapy.”

Lucio N. Gordan, MD, addressed the financial impacts of these shortages, discussing how his practice has managed the rising prices of carboplatin and cisplatin in the country. Gordan, president and managing physician at Florida Cancer Specialists & Research Institute who sees patients in the state-wide practice's Gainesville Cancer Center, stated that efforts from major oncology organizations may help increase adequate access to chemotherapy drugs.

“It's very important that the large practices and institutions in the country stay united,” Gordan said. “The Community Oncology Alliance [COA], American Society of Clinical Oncology [ASCO], and others are trying to push legislation that would protect the consumer, the patients, and us to make sure that we have a proven supply.”

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As part of a CancerNetwork® Frontline Forum program, Alexander I. Spira, MD, PhD, FACP; Millie Das, MD; Joshua K. Sabari, MD; and Misako Nagasaka, MD, PhD, reviewed updates in the management of EGFR exon 20 non–small cell lung cancer (NSCLC), and how these findings may apply to clinical practice.

Spira, codirector of the Virginia Cancer Specialists Research Institute and director of the Thoracic and Phase I Program, and Das, a clinical associate professor of Medicine and Oncology at Stanford Health, led one part of the discussion regarding the evolution of molecular profiling and next-generation sequencing in the NSCLC space. Moreover, they spoke to clinical and non-clinical factors informing treatment decision-making in the second-line setting. Additionally, they reviewed data from the phase 1 CHRYSALIS trial (NCT02609776) assessing amivantamab as a treatment for patients with disease progression following chemotherapy.

According to data from the CHRYSALIS trial, amivantamab elicited an objective response rate of 40% (95% CI, 29%-51%), and a median duration of response of 11.1 months (95% CI, 6.9-not reached). Additionally, the clinical benefit rate was 74% (95% CI, 63%-83%). Common any-grade adverse effects (AEs) in the study’s safety population that were associated with EGFR inhibition included rash (86%), paronychia (45%), stomatitis (21%), pruritus (17%), and diarrhea (12%).

Sabari, a thoracic medical oncologist at Perlmutter Cancer Center of NYU Langone Health, and Nagasaka, a thoracic oncologist at the University of California, Irvine, also discussed clinical updates in the EGFR exon 20 NSCLC population. They spoke about potential novel treatment options including mobocertinib (Exkivity), as well as potential next steps in research such as moving drugs to earlier lines of treatment and obtaining a better understanding of mechanisms of acquired resistance to treatment.

According to findings from a phase 1/2 trial (NCT02716116), mobocertinib produced an ORR of 28% (95% CI, 20%-37%) by independent-review committee assessment and 35% (95% CI, 26%-45%) per investigator assessment in a cohort of platinum-pretreated patients with EGFR exon 20 insertion mutations. Common AEs reported in the trial included diarrhea and rash.

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As part of a CancerNetwork® Frontline Forum program, Joselle Cook, MBBS; Matthew James Pianko, MD; Luciano Costa, MD, PhD; and Timothy Schmidt, MD, reviewed key data updates and real-world practice findings in newly diagnosed multiple myeloma (NDMM), and how they may impact patient subgroups including those with transplant-ineligible NDMM.

Cook, a hematologist specializing in the management of patients with multiple myeloma at the Mayo Clinic in Rochester, Minnesota; and Pianko, a hematologist in the Division of Hematology and Oncology at The University of Michigan-Ann Arbor, led one part of the discussion. They discussed efficacy results from studies including the phase 3 MAIA study (NCT02252172), which assessed daratumumab (Darzalex) plus lenalidomide (Revlimid) and dexamethasone vs lenalidomide plus dexamethasone in previously untreated multiple myeloma. They also spoke about the selection of patients with transplant ineligible multiple myeloma for triplet vs doublet induction therapy regimens and potential disparities in care for patients of racial and ethnic minorities.

“We need trials to accommodate patients who are working [and patients] who are unpartnered, [and] we need to do more to understand the biologic drivers [of multiple myeloma] in Black patients,” Cook said. “Even though we have this explosion of [new] therapies onto the scene, we still have so much to do to make access to these novel treatments accessible and more equitable for everyone.”

Costa, a professor of Medicine and director of the Multiple Myeloma Program at The University of Alabama at Birmingham, and Schmidt, assistant professor in the Division of Hematology, Medical Oncology, and Palliative Care within the Division of Medicine at The University of Wisconsin, also discussed updates in the multiple myeloma space, which included a review of findings from the phase 2 GRIFFIN trial (NCT02874742). In this trial, investigators assessed daratumumab plus lenalidomide, bortezomib (Velcade), and dexamethasone as a treatment for patients with transplant-ineligible NDMM. Costa and Schmidt also spoke about approaching consolidation and maintenance therapy for patients with transplant-ineligible NDMM.

“As we’re trying to move treatments into earlier lines of therapy—particularly things like bispecifics and CAR T—improving access is [something] that we as a field and as a community need to address,” Schmidt said.

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In a Twitter Spaces edition of the Oncology-On-The-Go podcast, Rafael Fonseca, MD and Krina Patel, MD, MSc spoke with CancerNetwork® about how key findings from multiple myeloma trials presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meetingmay impact the treatment paradigm.

Fonseca, director of Innovation and Transformation Relationships at the Mayo Clinic in Phoenix, Arizona and Patel, an associate professor in the Department of Lymphoma/Myeloma in the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, detailed results from the phase 1b RedirecTT-1 trial (NCT04586426) assessing teclistamab-cqyv (Tecvayli) plus talquetamab in those with relapsed/refractory multiple myeloma.

In the RedirectTT-1 trial, investigators reported an objective response rate (ORR) of 86.6% across all dose levels and 96.3% at the recommended phase 2 dose. Additionally, the combined complete response (CR) or stringent CR rate was 40.2% and 40.7% at each respective dose level.

Another trial of interest that Fonseca and Patel discussed included the phase 2 LINKER-MM1 trial (NCT03761108), evaluating linvoseltamab (REGN5458) in relapsed/refractory multiple myeloma. In the study, the agent elicited an ORR of 71% at the 200 mg dose level. Moreover, the CR rate was 14%, the very good partial response (PR) rate was 29%, and the PR rate was 12%. The estimated 6-month progression-free survival (PFS) rate among patients receiving the regimen was 72.7%.

Fonseca and Patel also discussed results from the phase 3 CARTITUDE-4 trial (NCT04181827), comparing ciltacabtagene autoleucel (cilta-cel; Carvykti) with standard of care in lenalidomide (Revlimid)-refractory multiple myeloma. In patients receiving cilta-cel, the median PFS was not reached (NR, 95% CI, 22.8 months-not estimable [NE]) vs 11.8 months (95% CI, 9.7-13.8) among those receiving standard of care. The 12-month PFS rate in each respective arm was 76% vs 49%.

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In a conversation with CancerNetwork® during July’s Sarcoma Awareness Month 2023, Brian Van Tine, MD, PhD, spoke about developments in the sarcoma research space and discussed where future research needs to be focused in order to push the needle forward in the treatment of this patient across numerous sarcoma subgroups.

Van Tine, a professor of medicine in the Division of Oncology, Section of Medical Oncology at Washington University School of Medicine’s Siteman Cancer Center, discussed his research on nirogacestat as a treatment for desmoid tumors as part of the phase 3 DeFi trial (NCT03785964) as well as sitravatinib for managing well-differentiated or dedifferentiated liposarcoma.

He also spoke about other areas of interest in the sarcoma space, including the development of an adoptive T-cell therapy for patients with synovial sarcoma in a phase 1 trial (NCT03132922). Moreover, in the advanced leiomyosarcoma space, he indicated that investigators are assessing unesbulin in combination with dacarbazine as part of another phase 3 trial (NCT05269355).

Concerning the potential next steps in the sarcoma space, Van Tine highlighted several possible developments including research centered on circulating tumor DNA, metabolic therapies, and immunotherapies. He also voiced his hope of advancing vaccine-based technologies in the field within the next 5 years with the hope of delivering individualized neoantigens via injection to sarcomas.

“The best part is when, all of a sudden, you see that look in a patient's face when you get to tell them that they tried something that was ultra-new, and it worked,” Van Tine commented when discussing the development of new treatment options for patients with sarcomas. “We don't do this for us. We do this because we're dedicated to this community. When you actually get the opportunity to see it work, it's almost as exciting for us as it is for the patient.”

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In a conversation with CancerNetwork® during June’s National Cancer Survivor Month, Lindsay Morton, PhD, spoke about her research on the long-term risks of developing second cancers among cancer survivors.

Morton, director of the Radiation Epidemiology Branch and head of the Cancer Survivorship Research Unit at the National Cancer Institute and member of the Lymphoma Research Foundation’s Scientific Advisory Board, discussed treatment exposure, genetics, and lifestyle elements including smoking as factors that may confer a risk for secondary cancers. She also detailed findings from her studies on second cancer risk factors across several disease types and treatment options, including potential risks associated with immunosuppression for solid organ transplant recipients.

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Ritu Salani, MD, and Tanios S. Bekaii-Saab, MD, FACP, spoke with CancerNetwork® about key findings presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting, and how they may affect clinical practice for gynecologic cancer and gastrointestinal cancer.

Salani, the Gynecologic Oncology Fellowship Director at University of California Los Angeles (UCLA) Health and the Gynecologic Oncology editorial board member for the journal ONCOLOGY®, discussed presentations on the treatment of ovarian cancer and other gynecologic malignancies. These included data on dostarlimab-gxly (Jemperli) in advanced or recurrent endometrial cancer in the phase 3 RUBY trial (NCT03981796),mirvetuximab soravtansine-gynx (Elahere) in folate receptor alpha–high platinum-resistant ovarian cancer in the phase 3 MIRASOL trial (NCT04209855), and a bevacizumab (Avastin)-based regimen in newly diagnosed ovarian cancer in the phase 3 DUO-O trial (NCT03737643).

Bekaii-Saab, leader of the Gastrointestinal Cancer Program at the Mayo Clinic Comprehensive Cancer Center; medical director of the Cancer Clinical Research Office; vice chair/section chief for Medical Oncology, Department of Internal Medicine, at Mayo Clinic, Phoenix, Arizona; and the Gastrointestinal Cancer chair for the ONCOLOGY® tumor board, detailed findings from presentations in the gastrointestinal cancer space. He discussed data on fam-trastuzumab deruxtecan-nxki (Enhertu) in HER2-positive metastatic colorectal cancer (CRC) in the phase 2 DESTINY-CRC02 study (NCT04744831),sotorasib (Lumakras) in advanced solid tumors with KRAS G12C mutations in the phase 1b/2 CodeBreaK 101 trial (NCT04185883), and bevacizumab plus atezolizumab (Tecentriq) in metastatic CRC in the phase 2 AtezoTRIBE trial (NCT03721653).

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Margaret Rosenzweig, PhD, CRNP-C, AOCNP, FAAN, spoke with CancerNetwork® about findings from the CONNECT study (NCT02712229), a study she authored that aimed to assess the benefit of palliative care intervention in patients with advanced cancer.

Rosenzweig, the distinguished service professor of nursing and a professor of medicine at the Hillman Cancer Center Acute & Tertiary Care, University of Pittsburgh, described the potential benefits of more frequently involving oncology nurses in discussions on advanced care planning, and helping patients make decisions on what treatment options best suit them. She also addressed some of the logistical challenges, including provider shortages and implementing training for infusion room nurses.

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Rakhshanda Rahman, MD, FRCS, FACS, interviewed with CancerNetwork® regarding advancements in the systemic and surgical de-escalation of breast cancer treatment, which include wire-free markers that help define the extent of a tumor during surgery.

Rahman, a professor of Breast Surgical Oncology at Texas Tech University Health Sciences Center and the medical director of UMC Cancer Center, discussed de-escalation techniques including cryoablation that may aid with de-escalation beyond surgery as well as challenges surrounding physicians’ understanding of how to use new technology and educating patients on the safety and benefits of treatment options.

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Javier Orozco-Mera, MD, FACS, MSc, a neurosurgeon in the Department of Neurosurgery at Hospital Universitario del Valle “Evaristo García,” University of Valle, spoke with CancerNetwork® about his study titled, Signaling Pathways in the Relapse of Glioblastoma, which was published in the journal ONCOLOGY®.

In his study, Orozco-Mera and his colleagues identified a several signaling pathways and molecular processes that are involved in glioblastoma relapse, including markers such as O-6-methylguanine-DNA methyltransferase, micro-RNA, EGFR, and P53.

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In a Twitter Spaces edition of the Oncology On-The-Go podcast, Ritu Salani, MD, and Dana Chase, MD, spoke with CancerNetwork® about findings presented at the Society of Gynecologic Oncology (SGO) 2023 Annual Meeting on Women’s Cancer,and how they may impact clinical practice.

Salani, the Gynecologic Oncology Fellowship Director at University of California Los Angeles (UCLA) Health and the Gynecologic Oncology editorial board member for the journal ONCOLOGY®, and Chase, associate professor of UCLA Obstetrics and Gynecology in the Division of Gynecologic Oncology, reviewed data from trials including the phase 3 NRG GY018 trial (NCT03914612),the phase 3 RUBY trial (NCT03981796), and the phase 3 ENGOT-OV16/NOVA study (NCT01847274).

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Fareed Khawaja, MBBS, assistant professor in the Department of Infectious Diseases, Infection Control, and Employee Health at The University of Texas MD Anderson Cancer Center, and Marilyne Daher, MD, medical resident in the Department of Internal Medicine at Baylor College of Medicine, spoke with CancerNetwork® about their study titled COVID-19 Vaccination in Patients with Cancer and Recipients of Cellular Therapy, which was published in the journal ONCOLOGY®.

In their study, Khawaja and Daher gave an overview of the current COVID-19 vaccines that are available in the United States, published data on vaccine efficacy and safety in patients with cancer, current vaccination guidelines, and future strategies for preventing COVID-19–related complications.

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In a conversation with CancerNetwork® during March’s Myeloma Awareness Month, Krina Patel, MD, MSc, spoke about disparities in outcomes and clinical trial access for patients with multiple myeloma.

Patel, associate professor in the Department of Lymphoma/Myeloma in the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, discussed previous research focusing on how factors including gender, race, and ethnicity correlated with treatment outcomes with autologous hemopoietic stem cell transplantation and CAR T-cell therapy.

She also detailed ongoing efforts from organizations such as the FDA and the International Myeloma Foundation on increasing enrollment of underserved patient groups on clinical trials as well as financial initiatives that may help to reduce barriers to treatment including transportation.

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As part of Kidney Cancer Awareness Month 2023, Santosh Rao, MD, spoke with CancerNetwork® about recent developments and initiatives that have helped to advance integrative and palliative care for patients with kidney cancer, including developments that read out of the Annual Society for Integrative Oncology (SIO) International Conference and evidence supporting the use of non-clinical tools such as acupuncture, reflexology, acupressure, and massages.

Rao, medical director of integrative oncology for University Hospitals Connor Whole Health and president-elect for the SIO, outlined palliative care strategies employed at University Hospitals and described ongoing research and pain management guidelines that aim to improve integrative care in kidney cancer.

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Minh-Tri Nguyen, MD, a hematology and oncology fellow at Cleveland Clinic Taussig Cancer Institute, spoke with CancerNetwork® about his study titled Shorter Time to Treatment Is Associated With Improved Survival in Rural Patients With Breast Cancer Despite Other Adverse Socioeconomic Factors, which was published in the journal ONCOLOGY®.

In his study, Nguyen and his colleagues explored factors including time to treatment initiation as predictors of overall survival in rural and nonrural patients with breast cancer. Overall, their research suggested that improving time to treatment initiation can mitigate socioeconomic disparities observed in rural cancer care.

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In a Twitter Spaces edition of the Oncology On-the-Go podcast, Kevin Kalinsky, MD, MS, and Jane Meisel, MD, of Emory Winship Cancer Institute, spoke with CancerNetwork® about how the FDA approval of sacituzumab govitecan-hziy (Trodlevy) for advanced or metastatic hormone receptor–positive, HER2-negative breast cancer will impact the treatment paradigm.

Kalinsky, an associate professor in the Department of Hematology and Medical Oncology and director of Breast Medical Oncology, and Meisel, an associate professor in the Department of Hematology and Medical Oncology and in the Department of Gynecology and Obstetrics, discussed data from the phase 3 TROPiCS-02 trial (NCT03901339) that led to the approval and what unmet needs still exist in the space.

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Julianne Cooley, MS, a computational and data science research specialist at the California Cancer Reporting and Epidemiologic Surveillance in the University of California Davis Comprehensive Cancer Center, spoke with CancerNetwork® about her research on cervical cancer screening and survival rate patterns among patients 65 years and older.

In her study, Cooley explored how survival rates among older patients with late-stage cervical cancer diagnoses were lower compared with those of younger patients, and how the current screening paradigm may be impacting this older population.

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Yancey Warren, Jr, MD, MAT, a breast surgery oncology fellow at Brown University, and Lejla Hadzikadic-Gusic, MD, MSc, associate professor of surgery, Division of Surgical Oncology at Atrium Health Levine Cancer Institute, spoke with CancerNetwork® about their study titled Integrative Oncology in Young Women with Breast Cancer, which was published in the journal ONCOLOGY®.
In their study, the authors explored the potential benefit of integrative oncology strategies to better establish referral practices for Levine Cancer Institute and define optimal timing for treatment in young patients with breast cancer.
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During the 2022 San Antonio Breast Cancer Symposium (SABCS), CancerNetwork® spoke with several multidisciplinary oncology experts from the Mayo Clinic in Rochester, Minnesota about their respective key takeaways from the presentations on developments in the breast cancer space, including surgery, radiotherapy, and biomarker research.
Judy C. Boughey, a surgical oncologist of the Division of Breast and Melanoma Surgical Oncology and the Department of Surgery, discussed her research on the impact of breast conservation therapy on local recurrence rates in multiple ipsilateral breast cancer in the phase 2 ACOSOG Z11102 (Alliance) trial (NCT01556243).
Robert Mutter, MD, an associate professor of the Department of Radiation Oncology, spoke about his work on a randomized phase 2 trial assessing the use of conventional vs hypofractionated proton radiotherapy following a mastectomy among patients with breast cancer.
Siddhartha Yadav, MD, MBBS, a medical oncologist and assistant professor of Medicine and Oncology, highlighted data from the population-based CARRIERS study, assessing germline pathogenic variants and other factors as risks for contralateral breast cancer.
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Ibrahim Halil Sahin, MD, a medical oncologist specializing in gastrointestinal oncology and an assistant professor at the University of Pittsburgh Medical Center, Hillman Cancer Center, spoke with CancerNetwork® about his manuscript titled Minimal Residual Disease–Directed Adjuvant Therapy for Patients With Early-Stage Colon Cancer: CIRCULATE-US, which was recently published in the journal ONCOLOGY®.

In the article, Sahin and his colleagues explored postoperative circulating tumor DNA dynamics in early-stage colon cancer and investigated escalation and de-escalation approaches using ctDNA status as a surrogate for minimal residual disease status.

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As part of the Between the Lines™ video series, Bruce Cheson, MD, FACP, FAAAS, FASCO, a board certified hematologist at the Center for Cancer and Blood Disorders in Bethesda, Maryland, spoke with Steven Park, MD, an oncologist and vice chair of Research at the Atrium Health Levine Cancer Institute and a clinical professor of Medicine at Wake Forest University. These experts shared their insight on the phase 1/2 E7438-G000-101 (NCT01897571) clinical trial and highlighted key data on tazemetostat (Tazverik), an EZH2 inhibitor, in relapsed or refractory follicular lymphoma.

In the video series, Cheson and Park discussed the following:

· Overview of relapsed/refractory follicular lymphoma and available treatment options

· Tazemetostat trial data and propensity score-matched analysis

· Role of tazemetostat treatment moving forward

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Daniel C. McFarland, DO, and Dr. Kirk Harris, MD, both of the University of Rochester, spoke with CancerNetwork® about their manuscript titled, “Cancer Pain and Opioid Use Disorder,” which was recently published in the journal ONCOLOGY®.

In the review, the authors explore current approaches for screening of opioid use disorder, evaluation of psychosocial stressors, factors that qualify the disorder, and management of patients suffering with addiction.

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Coauthors Dori Beeler, PhD, of the Levine Cancer Institute; Shelley Wang, MD, MPH, of The University of Texas MD Anderson Cancer Center; and Viraj A. Master, MD, PhD, of the Winship Cancer Institute of Emory University, spoke with CancerNetwork® about their review published in the journal ONCOLOGY® titled Cancer-Related Fatigue Outcome Measures in Integrative Oncology: Evidence for Practice and Research Recommendations.

In the article, the authors and their colleagues explored negative impacts, mechanisms, and measurement concerns surrounding cancer-related fatigue. They also proposed strategies for standardization and future directions in the space.

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Robert Stuver, MD, and Zachary D. Epstein-Peterson, MD, spoke with CancerNetwork® about a review article on the treatment of peripheral T-cell lymphoma published in the journal ONCOLOGY®.

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Juan Pablo Alderuccio, MD, assistant professor of medicine in the Division of Hematology, Department of Medicine at the Sylvester Comprehensive Cancer Center of the University of Miami Miller School of Medicine in Florida, spoke with CancerNetwork® about his review published in the journal ONCOLOGY® titled, Current Treatments in Marginal Zone Lymphoma.

In the article, Alderuccio explored current approaches to the diagnosis and treatment of marginal zone lymphoma. He also touched on his strategies for treating localized versus advanced disease and novel emerging strategies clinicians practicing in the community should be aware of.

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Kira MacDougall, MD, a first year fellow at the University of Oklahoma, and Muhammad Rafay Khan Niazi, MD, a third year resident of Internal Medicine at Staten Island University Hospital, spoke with CancerNetwork® about research published in the journal ONCOLOGY® titled, The Prognostic Significance of Peripheral Blood Biomarkers in Patients With Advanced Non–Small Cell Lung Cancer Treated With Pembrolizumab: A Clinical Study.

MacDougall and Niazi discuss the clinical utility of absolute lymphocyte count (ALC) and the ratio of absolute neutrophil count to ALC for predicting outcomes with pembrolizumab (Keytruda) in advanced non–small cell lung cancer. They also talked about future research in the space and what unanswered questions remain in this treatment setting.

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Kirk E. Cahill, MD, and Sonali M. Smith, MD, both of the Department of Medicine, Section of Hematology/Oncology at the University of Chicago Medicine Comprehensive Cancer Center in Chicago, Illinois, spoke about their manuscript titled, ‘Follicular Lymphoma: a Focus on Current and Emerging Therapies,’ that was recently published in the journal ONCOLOGY®.

In the review, the authors explore current approaches to the diagnosis and treatment of follicular lymphoma, with a focus on emerging investigational therapies and novel combination strategies. Some areas of unmet need they touch on in the paper include precision approaches to individual patients, trial end points with quality-of-life measures, and guidance for sequencing of available regimens and agents.

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In the inaugural Twitter Spaces edition of the Oncology Peer Review On-The-Go podcast hosted by CancerNetwork®, Paolo Tarantino, MD, a clinical research fellow at Dana-Farber Cancer Institute, and Sara M. Tolaney, MD, MPH, chief of the Division of Breast Oncology and associate director of the Susan F. Smith Center for Women’s Cancer at Dana-Farber as well as an associate professor of medicine at Harvard Medical School, reviewed presentations in breast cancer research from the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting.

During the live event, Tarantino and Tolaney discussed the phase 3 DESTINY-Breast04 trial (NCT03734029), of fam-trastuzumab-nxki (Enhertu) vs chemotherapy for patients with HER2-low, hormone receptor–positive metastatic breast cancer. The co-hosts also reviewed surprising results from phase 3 PALOMA-2 trial (NCT01740427), which failed to show an overall survival benefit with use of palbociclib (Ibrance) plus letrozole in patients with estrogen receptor–positive/HER2-negative advanced breast cancer vs letrozole alone.

Additionally, Tolaney discussed her presentation of the phase 3 monarchE trial (NCT03155997) that explored adjuvant abemaciclib (Verzenio) in patients with hormone receptor–positive, HER2-negative, node-positive high-risk early breast cancer.

Overall, both investigators said they enjoyed coming back to in-person conferences and how they hope the trend of practice-changing trials continues with future conferences.

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Suneel D. Kamath, MD, of the Cleveland Clinic Taussig Cancer Institute in Cleveland, Ohio, spoke with the editorial team of the journal ONCOLOGY® about his published manuscript titled, ‘Association of Financial Conflicts of Interest With Academic Productivity Among Junior Faculty in Hematology and Oncology.’

Suneel and colleagues set out to determine how financial conflicts of interest could be used as a surrogate for the trajectory of early-career oncologists and junior faculty at academic institutions. He touched on how understanding relationships between clinicians and industry is important for both drug development as well as the early academic productivity of individual investigators.

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Nora Janjan, MD, MPSA, MBA, who sits on the editorial advisory board for the journal ONCOLOGY®, spoke about her perspective titled, ‘Academic Promotion and Oncology Drug Development: Role, Responsibilities, and Integrity.’

In the article, Janjan explores the role conflicts of interests (COIs) play in research integrity and how individual investigators are upholding their end of the deal by practicing safe reporting of relationships with the industry. Her narrative complements a cross-sectional study of junior faculty at major academic cancer centers to evaluate patterns of COIs with years of clinician experience to determine if increasing COIs and industry funding correlate with greater academic success.

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This week, CancerNetwork® spoke with Judd W. Moul, MD, editorial board member for the journal ONCOLOGY® and James H. Semans, MD, Distinguished Professor of Urologic Surgery at Duke University School of Medicine, leads a discussion with medical student Kostantinos E. Morris, from Duke University School of Medicine, on research recently published in the journal ONCOLOGY®titled, ‘Successful Diagnosis and Treatment of Occult Prostate Cancer Despite Multiple Negative Prostate Biopsies and Negative Prostate MRIs.’

The manuscript was based on the case of a patient who presented to their clinic with elevated prostate-specific antigen (PSA) levels and multiple imaging tests that appeared to indicate an absence of malignancy. Their discussion includes why they continued to investigate the cause of the elevated PSA levels, how they overcame the patient’s hesitation for more testing, and the ultimate outcome of the case.

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Paul G. Richardson, MD, and Christina Gasparetto, MD, offer insights into the use of proteasome inhibitors in relapsed or refractory multiple myeloma.

As part of its Between the Lines™ video series, CancerNetwork® spoke with Paul G. Richardson, MD, clinical program leader and director of Clinical Research for the Jerome Lipper Multiple Myeloma Center at Dana-Farber Cancer Institute in Boston, Massachusetts, and Christina Gasparetto, MD, professor of medicine at Duke University Medical School in Durham, North Carolina, about recent updates in the use of proteasome inhibitors for patients with multiple myeloma.

In the video series, Richardson and Gasparetto discussed the following:

· Overview of proteasome inhibitor therapy in multiple myeloma

· Real-world data with proteasome inhibitors

· The phase 3 TOURMALINE-MM1 trial (NCT01564537) of ixazomib therapy in relapsed/refractory multiple myeloma

· Ixazomib plus pomalidomide and dexamethasone in patients with relapsed or refractory multiple myeloma

Be sure to tune in to other videos in the CancerNetwork® Between the Lines™ series.

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This week, CancerNetwork turns to the second part of its 3-part series focused on colorectal cancer. Tanios Bekaii-Saab, MD, a gastrointestinal cancers (GI) medical oncologist at the Mayo Clinic Cancer Center, continues the conversation with Kristen Ciombor, MD, MSCI, a GI medical oncologist and associate professor of medicine at Vanderbilt-Ingram Cancer Center, and John Strickler, MD, a GI medical oncologist, associate professor of medicine, and co-leader of the Molecular Tumor Board at Duke University School of Medicine.

This episode’s discussion turns to the GOZILA platform and its international collaboration. The experts expand on this platform, what it means for drug development, and examine genetic testing in GI malignancies.

Tune in next week for the third and final part of this conversation on colorectal cancer.

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This week, CancerNetwork looks at the final part of its 3-part series focused on colorectal cancer. Tanios Bekaii-Saab, MD, a gastrointestinal cancers (GI) medical oncologist at the Mayo Clinic Cancer Center, concludes his conversation with Kristen Ciombor, MD, MSCI, a GI medical oncologist and associate professor of medicine at Vanderbilt-Ingram Cancer Center, and John Strickler, MD, a GI medical oncologist, associate professor of medicine, and co-leader of the Molecular Tumor Board at Duke University School of Medicine.

This conversation focuses on resistance to targeted therapies in metastatic colorectal cancer, and the importance of addressing it. The experts also discuss EGFR resistance, EGFR rechallenging after prior progression, and rising HER2 amplification.

Thanks for tuning in to this series on colorectal cancer from CancerNetwork. Visit cancernetwork.com to catch up on any episodes you missed and to read more about these topics published in the journal ONCOLOGY.

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This week, CancerNetwork kicks off the first of a 3-part podcast series focused on colorectal cancer. Tanios Bekaii-Saab, MD, a gastrointestinal cancers (GI) medical oncologist at the Mayo Clinic Cancer Center, leads a conversation with Kristen Ciombor, MD, MSCI, a GI medical oncologist and associate professor of medicine at Vanderbilt-Ingram Cancer Center, and John Strickler, MD, a GI medical oncologist, associate professor of medicine, and co-leader of the Molecular Tumor Board at Duke University School of Medicine.

This conversation focuses on the current molecular treatment landscape of advanced colorectal cancer and the need for the COLOMATE platform. Among other things, the experts detail this platform and expand on its impact for patients, as well as the evolving world of colorectal cancer.

Make sure to tune in next week for part 2 of this conversation on colorectal cancer.

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As part of its OncView™ program, CancerNetwork hosted a discussion Lori Wirth, MD, associate professor of medicine at Harvard Medical School and medical director of the Center for Head and Neck Cancers at Massachusetts General Hospital in Boston, who shared her perspective on updates in the treatment of second-line radioiodine-refractory differentiated thyroid cancer, or DTC.

In the video series, some of the content discussed included: · Presentation and Disease Course of Differentiated Thyroid Cancer

· Frontline Treatment Options for RAI-refractory DTC

· Treatment Options in RAI-refractory DTC in Second Line and Beyond

· Facing Unmet Needs and Ongoing Trials in RR-DTC

To watch more videos in the CancerNetwork® OncView™ series, visit cancernetwork.com/oncview.

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As part of its OncView™ video series, CancerNetwork® spoke with David H. Aggen, MD, PhD, of the Memorial Sloan Kettering Cancer Center, Robert S. Alter, MD, of the John Theurer Cancer Center, Arnab Basu, MD, MPH, of the O’Neal Comprehensive Cancer Center, Mehmet Asim Bilen, MD, of Winship Cancer Institute, and Chung-Han Lee, MD, MPH, of Memorial Sloan Kettering Cancer Center, who shared their thoughts on recent advances in treatment options for metastatic renal cell carcinoma (RCC) and commented on emerging data in the field.

To watch more videos in the CancerNetwork® OncView™ series, visit cancernetwork.com/oncview.

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OncView™ Podcast: Mobocertinib Use in Platinum-Pretreated Patients With EGFR Exon 20 Insertion–Positive mNSCLC

As part of its OncView™ video series, CancerNetwork® spoke with Gregory Riely, MD, PhD, vice chair of Clinical Research in the Department of Medicine at Memorial Sloan Kettering Cancer Center in New York, and Tarek Mekhail, MD, a hematologic oncologist from Advent Health in Florida, about patients with EGFR exon 20 insertion-positive metastatic non–small cell lung cancer who recieved mobocertinib.

In the video series, Gregory Riely, MD, PhD, and Tarek Mekhail, MD, discussed the following:

Mobocertinib Use in mNSCLC: EXCLAIM Cohort Study Design
Efficacy Data From the EXCLAIM Cohort in mNSCLC
EXCLAIM Cohort: Mobocertinib Safety Data in mNSCLC
EXCLAIM Cohort in mNSCLC: Treatment Selection and Management
mNSCLC: Biomarker Testing and Patient Adherence to TKIs
Next Steps in the Management of EGFR Exon 20 Insertion–Positive mNSCLC

To watch more videos in CancerNetwork®’s OncView™ series, visit cancernetwork.com/oncview.

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This week, CancerNetwork® spoke with Christine Chung, DO, of the Swedish Medical Center, Englewood, Colorado, about “Characterization of Blood-Based Molecular Profiling in Pancreatic Adenocarcinoma,” a retrospective review published in the journal ONCOLOGY.

Chung detailed this research, which characterizes the mutational landscape of patients with metastatic pancreatic adenocarcinoma who received blood-based molecular profiling. A total of 77 consecutive patients were included in the analysis.

Chung also spoke about pancreatic adenocarcinoma, the study’s main findings, and how this research can inform future treatment decision-making processes moving forward.

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This week, CancerNetwork® spoke with Muhammad Niazi, MD, resident in internal medicine at Staten Island University Hospital, and Alexander Bershadskiy, MD, attending physician at Staten Island University Hospital, about a meta-analysis published in ONCOLOGY titled, “Efficacy of PARP Inhibitors as Maintenance Therapy for Metastatic Castration-Resistant Prostate Cancer: A Meta-Analysis of Randomized Controlled Trials.”

The final analysis evaluated 3 randomized clinical trials. A fixed model showed a statistically significant improvement in overall survival for patients with metastatic castration-resistant prostate cancer treated with PARP inhibitors.

The authors provided a detailed background on PARP inhibitors and further detailed the results of this research, focusing on survival increases with PARP inhibitor treatment for this patient population.

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As part of its OncView™ video series, CancerNetwork® spoke with Zofia Piotrowska, MD, an assistant professor of medicine at Harvard Medical School and a lung cancer medical oncologist at Massachusetts General Hospital, about recent data and review updates in the treatment landscape for patients with non-small-cell lung cancer and exon 20 insertions.

In the video series, Piotrowska discussed the following:

· Overview of Advanced NSCLC with EGFR Mutations Including Exon 20 Insertions

· Testing for the EGFR Exon 20 Insertion

· Historical Treatment Approach for EGFR Exon 20 Insertions in NSCLC

· Amivantamab for the Treatment of EGFR Exon 20 Insertions in NSCLC

· Mobocertinib for the Treatment of EGFR Exon 20 Insertions in NSCLC

· Treatment Selection for Patients With EGFR Exon 20 Insertions in NSCLC

· Unmet Needs and Future Directions

To watch more videos in CancerNetwork®’s OncView™ series, visit cancernetwork.com/oncview.

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As part of its Between the Lines™ video series, CancerNetwork® spoke with Liliana Bustamante, MD, hematologist and medical oncologist at Florida Cancer Specialists in Fort Myers, Florida and Richard Kim, MD, service chief of Medical Gastrointestinal Oncology and senior member in the Gastrointestinal Oncology Department at the Moffitt Cancer Center in Tampa, Florida, about the prognostic potential of circulating tumor DNA (ctDNA) as a biomarker for patients with oligometastatic colorectal cancer.

In the video series, Bustamante and Kim discussed the following:

· Presentation: ctDNA Assays For Patients With CRC Undergoing Resection of Metastases

· Key Takeaways: ctDNA Assays For Patients With CRC Undergoing Resection of Metastases

· ctDNA as a Biomarker in CRC

· ctDNA Assays in CRC: Interpreting Clinical Findings

· ctDNA Assays in CRC: Impact on Clinical Practice

· Next Steps in Using ctDNA as a Biomarker in CRC

· Recap: Prognostic Potential of ctDNA for Oligometastatic Colorectal Cancer

To watch more videos in CancerNetwork®’s Between the Lines™ series, visit cancernetwork.com/between-the-lines.

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As part of its OncView™ video series, CancerNetwork® spoke with John Kirkwood, MD, PhD, director of the melanoma center at the University of Pittsburgh Medical Center Hillman Cancer Center, about using immunotherapy for treating melanoma and how to monitor responses in patients properly.

In the video series, Kirkwood discussed the following:

· Treatment Options for Melanoma

· Considerations for Immunotherapy Use When Treating Melanoma

· Monitoring Responses to Melanoma Therapy

· Pseudoprogression in Melanoma Therapy

· ctDNA for Melanoma Treatment Monitoring

· Using ctDNA to Monitor Patients With Melanoma

· Taking Drug Holidays Amidst Melanoma Therapy

· Duration of Treatment for Melanoma

To watch more videos in CancerNetwork®’s OncView™ series, visit cancernetwork.com/oncview.

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As part of its OncView™ video series, CancerNetwork® spoke with Roy Herbst, MD, PhD, chief of medical oncology at Yale Cancer Center and Smilow Cancer Hospital in New Haven, Connecticut, about currently available treatment options and strategies in immunotherapy for treating non–small cell lung cancer (NSCLC).

In the video series, Herbst discussed the following:

· Treatment Options in Non–Small Cell Lung Cancer

· Monitoring Response to Therapy in NSCLC

· Role of ctDNA in Monitoring Treatment Response in NSCLC

· Clinical Decision-Making in NSCLC

· Recap: Monitoring With ctDNA for Immunotherapy Response in Lung Cancer

To watch more videos in CancerNetwork®’s OncView™ series, visit cancernetwork.com/oncview.

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This week, CancerNetwork spoke with Matthew Matasar, MD, a lymphoma specialist and chief of the Medical Oncology Service at Memorial Sloan Kettering Cancer Center Bergen, about research from the December issue of ONCOLOGY titled, “Real-World Assessment of Patient Care and Practice Efficiency With the Introduction of Subcutaneous Rituximab.”

The retrospective, observational analysis examined patient care delivery and practice efficiency changes using real-world data. Patients with diffuse large B-cell lymphoma, follicular lymphoma, or chronic lymphocytic leukemia who received a rituximab-containing regimen were eligible for the study.

Matasar touched on subcutaneous rituximab, the role it can play in treatment, the time savings associated with its use, and more.

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CancerNetwork spoke with Jun Gong, MD, a practicing medical oncologist who specializes in the treatment of genitourinary cancers at Cedars-Sinai Medical Center, regarding a perspective piece titled, “Cisplatin Neoadjuvant Chemotherapy in an Aging Population With Muscle-Invasive Bladder Cancer.”

Gong’s perspective focuses on an article published in the January issue of ONCOLOGY titled, “Use of Neoadjuvant Chemotherapy in Elderly Patients With Muscle-Invasive Bladder Cancer: A Population-Based Study, 2006-2017.”

In this conversation, Gong overviewed the research and touched on some of the clinically relevant findings. He then detailed his perspective and expanded on cisplatin-based chemotherapy, how age fits into the treatment equation, and where research should focus moving forward in muscle-invasive bladder cancer.

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CancerNetwork® recently spoke with Ofer Sharon, MD, CEO of OncoHost, about interim results from the prospective PROPHETIC trial to predict how patients with non–small cell lung cancer respond to immunotherapy.

Sharon first described OncoHost and the mission of this clinical stage precision oncology company. Then, he touched on the key details of this research, with a focus on the PROphet diagnostic platform at the center of this ongoing multicenter clinical trial, as well as what comes next for this research and OncoHost.

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CancerNetwork® spoke with Emily Smith, MD, of the Ellis Fishchel Cancer Center, University of Missouri, about a patient case published in the December issue of the journal ONCOLOGY titled, “Metastatic Basal Cell Carcinoma Arising From a Primary Cutaneous Carcinosarcoma.” Smith and colleagues detailed a case regarding a 56-year-old man who the team of care providers diagnosed with metastatic basal cell carcinoma arising from a carcinosarcoma.

In the conversation, Smith talked about what makes this patient case unique, the timeline of this specific patient’s disease and treatment, the rarity of basal cell carcinoma arising from a carcinosarcoma, and plenty more.

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CancerNetwork spoke with Matthew Allaway, DO, founder and CEO of Perineologic, about a new prostate cancer biopsy technique that uses the transperineal approach to detect cancer in harder to reach areas of the prostate.

Allaway touched on the American Cancer Society’s annual report that shows the rate of advanced-stage prostate cancer cases are increasing in recent years. He also detailed a companion study to that report, and walked through the specific details and benefits of this biopsy technique.

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This week, CancerNetwork closed the book on the year that was 2021. CancerNetwork spoke with Amy Comander, MD, co-medical director and director of breast oncology and cancer survivorship at Mass General Cancer Center, about some of the key developments and data to emerge from 2021 for patients with breast cancer, with a specific focus on the 2021 San Antonio Breast Cancer Symposium (SABCS).

Not only did Comander detail important information from 2021 in the field of breast cancer, but she also touched on how the field is continuously evolving and shared her thoughts on what’s in store for patients in 2022.

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As part of its Between the Lines™ video series, CancerNetwork® spoke with Lyudmila Bazhenova, MD, a professor of medicine at the University of California San Diego Health, and Federico Albrecht, MD, an oncologist/hematologist at Miami Cancer Institute, Baptist Health South Florida, about when and how to use real-world evidence when making treatment decisions for patients with EGFR-mutated non–small cell lung cancer (NSCLC).

In the video series, Bazhenova and Albrecht discussed the following:

· Presentation: Benefits and Limitations of RWE: Lessons From EGFR Mutation-Positive NSCLC

· EGFR-Mutant NSCLC: Addressing Gaps When Collecting Data

· Experts in Treating EGFR-Positive NSCLC Compare Randomized Trials and Real-World Studies

· EGFR-Mutant NSCLC: Incorporating RWE Into Treatment Decisions

· Referring to Real-World Evidence When Managing EGFR-Mutant NSCLC

· Using Various Sources of Information to Guide Management of EGFR-Mutated NSCLC

· Increasing Rates of Real-World Studies in EGFR-Mutated NSCLC

To watch more videos in CancerNetwork®’s Between the Lines™ series, visit cancernetwork.com/between-the-lines.

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This week, CancerNetwork spoke with Don Dizon, MD, about certain unique challenges LGBTQ+ patients face when navigating through their cancer journey, and how providers can improve these experiences. The director of women’s cancers at the Lifespan Cancer Institute, director of medical oncology at Rhode Island Hospital, and professor of medicine at the Warren Alpert Medical School of Brown University in Providence, touched on overcoming barriers in clinical cancer research, creating a gender-affirming environment for patients, and other important topics for treating LGBTQ+ patients with cancer.

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The final episode of CancerNetwork’s 4-part series on small cell lung cancer (SCLC) welcomes back Wade Iams, MD, a thoracic medical oncologist at the Vanderbilt University Medical Center. In this conversation, Iams looks to the future of SCLC treatments, touching on topics including extending response durations for patients, emerging therapies for extensive stage SCLC, exciting research on the horizon, and more.

Don’t forget to subscribe to the "Oncology Peer Review On-The-Go" podcast on Apple Podcasts, Spotify, or anywhere podcasts are available.

Check out the previous podcast episodes in this series: · Episode 1: First-Line Therapeutic Options in Small Cell Lung Cancer

· Episode 2: Treatment Options for Relapsed/Refractory Small Cell Lung Cancer

· Episode 3: Practical Considerations for Small Cell Lung Cancer Therapeutic Options

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Jun Gong, MD, discussed his perspective piece from the October issue of the journal ONCOLOGY, titled “An Evolving Relationship Between Medical Oncologists and Genetic Counselors in Prostate Cancer.” Gong, a practicing medical oncologist who specializes in the treatment of genitourinary cancers at Cedars-Sinai Medical Center, commented on a review article previously examined on this podcast with Alexandra Sokolova, MD, titled “Germline Testing in Prostate Cancer: When and Who to Test.”

The review article focuses on the treatment implications of germline testing and how this type of testing is becoming more commonplace. Gong’s perspective applauds Sokolova and her colleagues for their work and expands on the necessary relationship between medical oncologists and genetic counselors to effectively treat patients with prostate cancer.

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In the third part of a 4-part series on small cell lung cancer (SCLC), CancerNetwork spoke with Wade Iams, MD, a thoracic medical oncologist at the Vanderbilt University Medical Center. The conversation focused on the toxicities of treatment options, quality of life for patients, and how Iams suggests managing and mitigating those events for individuals with SCLC. Some of the agents and regimens discussed include lurbinectedin and trilaciclib, as well as chemotherapy and immunotherapy.

Don’t forget to subscribe to the "Oncology Peer Review On-The-Go" podcast on Apple Podcasts, Spotify, or anywhere podcasts are available.

Check out the previous podcast episodes in this series: · Episode 1: First-Line Therapeutic Options in Small Cell Lung Cancer

· Episode 2: Treatment Options for Relapsed/Refractory Small Cell Lung Cancer

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This week’s conversation focuses on TrialJectory, a digital health company that utilizes artificial intelligence to inform patients with cancer on their treatment journey. CancerNetwork spoke with Tzvia Bader, CEO and co-founder of TrialJectory, and Karine Perreault, who recently was diagnosed with breast cancer and is on the TrialJectory platform.

The conversation touches on the perceived disconnect between the pharmaceutical industry and patients, the need to remove barriers to access testing, and the action items they thinks need to be prioritized to improve access for women with cancer.

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In the second part of a 4-part series on small cell lung cancer, CancerNetwork continued its conversation with Wade Iams, MD, a thoracic medical oncologist at the Vanderbilt University Medical Center. Iams turned the attention to different treatment options for patients with relapsed/refractory small cell lung cancer. Among others, Iams touched on lurbinectedin, topotecan, and some of the crucial clinical trials associated with treatment options for small cell lung cancer, including a phase 2 basket trial and phase 3 ATLANTIS trial examining lurbinectedin.

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Check out the first episode of this series on first-line therapeutic options in small cell lung cancer.

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CancerNetwork looks at research from the October issue of the journal ONCOLOGY, titled “Value of Geriatric Assessment in Patients With Genitourinary Carcinoma.” Lead author, Quirin Zangl, MD, from the Department of Neuroanesthesia, at the Christian Doppler Hospital in Salzburg, Austria, spoke in detail about the manuscript.

The research featured 111 patients with urogenital carcinomas with the goal of evaluating comprehensive geriatric assessment tools to better guide these individuals. Patients were divided into 2 groups, which were prostate cancer (n = 88) and distal urinary tract cancer (n = 29). Overall, the relationships between comprehensive geriatric assessment tools and complications, hospital duration, death rate, and baseline characteristics were analyzed.

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This week, CancerNetwork looks at an article from the October issue of the journal ONCOLOGY, titled “Germline Testing in Prostate Cancer: When and Who to Test.” CancerNetwork spoke with one of the authors of this article, Alexandra Sokolova, MD, an assistant professor at Oregon Health & Science University.

Sokolova detailed the article, which summarizes germline testing recommendations for prostate cancer, specifically looking at the recently updated NCCN guidelines, as well as describing care models for providing counsel and testing for patients.

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In this special episode of the "Oncology Peer Review On-The-Go" podcast, CancerNetwork spoke with Wade Iams, MD, a thoracic medical oncologist at the Vanderbilt University Medical Center, about therapeutic advances for small cell lung cancer. Iams discussed the current first-line therapies for small cell lung cancer, the IMpower133 and CASPIAN trials, and the factors considered for treating patients in the first-line setting.

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As part of its OncView video series, CancerNetwork spoke with Connie Batlevi, MD, PhD, a medical oncologist at Memorial Sloan Kettering Cancer Center, about recent updates in therapies for relapsed or refractory follicular lymphoma. Batlevi discussed the current treatment options for this disease, as well as third-line therapies, tazemetostat, and sequencing changes.

In the video series, Batlevi discussed the following:

· Current Treatment Options and Considerations for Relapsed/Refractory Follicular Lymphoma

· Third-Line Therapies in R/R FL

· Use of Tazemetostat in R/R FL

· Sequencing Changes in R/R FL Therapies

To watch more videos in CancerNetwork®’s OncView™ series, visit cancernetwork.com/oncview.

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This week, CancerNetwork spoke with Debra Patt, MD, PhD, MBA, FASCO, Executive Vice President at Texas Oncology. Patt discussed the rise of telehealth during the COVID-19 pandemic, how clinicians can use these tools to help treat patients with cancer, and the role of telemedicine moving forward.

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As part of CancerNetwork’s Between the Lines video series, Brian Helfand, MD, PhD, Chief of the Division of Urology and the Ronald L. Chez Family and Richard Melman Family Endowed Chair at NorthShore University HealthSystem, and Steven Finkelstein, MD, FACRO, a radiation oncologist with Florida Cancer Affiliates US Oncology Network in Panama City, Florida, examined the results and clinical implications of the phase 2/3 EMPIRE-1 trial in prostate cancer. The trial compares 18F-fluciclovine PET/CT imaging versus conventional imaging to guide postprostatectomy salvage radiotherapy.

To watch more videos in CancerNetwork’s Between the Lines series, visit cancernetwork.com.

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This episode features an examination of an article from the September issue of the journal ONCOLOGY, titled “Plasma Glutamine as a Prognostic Biomarker in Localized Prostate Cancer: Comparison of Conventional Variables in Risk Stratification.” CancerNetwork spoke with one of the authors of this research, Jun Gong, MD, a practicing medical oncologist with an emphasis in GU cancers at Cedars-Sinai Medical Center.

Gong detailed PSA’s role in prostate cancer, and other potential complementary biomarkers. He also discussed some of the significant findings from his research on plasma glutamine, which featured a cohort of over 100 patients with localized prostate cancer.

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This week, CancerNetwork spoke with Josh Ludwig, Global Director of Commercial Operations at ScaleReady, about how this joint venture between industry leaders launched in January, is uniquely positioned to make cell and gene therapy practical and viable.

Ludwig elaborated on how ScaleReady can support the entire industry, now and into the future, with a manufacturing platform that delivers a high throughput and efficient use of space. He also discussed G-Rex closed-system bioreactors, important processes for successful commercialization of cell and gene therapy, and what’s next for ScaleReady.

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CancerNetwork spoke with Quita Highsmith, Vice President and Chief Diversity Officer for Genentech, and Monica Baskin, PhD, a professor of preventive medicine and associate director for Community Outreach and Engagement for the O’Neal Comprehensive Cancer Center in Birmingham, Alabama. The conversation focused on the Advancing Inclusive Research Site Alliance, which is a coalition of clinical research sites partnering with Genentech to advance representation of diverse patient populations in oncology clinical trials.

Results from clinical trials without diverse patient cohorts are rarely generalizable to the entire population, and this initiative works to educate and inform the clinicians and researchers to ultimately make clinical trials more accessible and eliminate these disparities.

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For the final installment of a 3-part relapsed/refractory DLBCL series, CancerNetwork heard from Gilles Salles, MD, PhD, Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center in New York, and Kami Maddocks, MD, an associate professor of clinical internal medicine in the Division of Hematology at The Ohio State University Wexner Medical Center.

These lymphoma experts spoke about their thoughts on data from the L-MIND trial, when to implement CAR-T cell therapies for patients, the role of Selinexor in treating patients, and a host of other important ideas.

Don’t forget to subscribe to the Oncology Peer Review On-The-Go podcast on Apple Podcasts, Spotify or anywhere podcasts are available. Be sure to check out the 2 other installments of this 3-part DLBCL series on rituximab rechallenging and different treatment regimens.

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As part of its OncView™ video series, CancerNetwork® spoke with Javier Munoz, MD, MS, FACP, from the Mayo Clinic in Phoenix, Arizona, about updates in therapies of relapsed/refractory follicular lymphoma.

In the video series, Javier Munoz, MD, MS, FACP, discussed the following:

· Current Treatment Options for Relapsed/Refractory Follicular Lymphoma

· Factors in Choosing R/R FL Treatments

· Treatment Options for Third-Line R/R FL

· Use of Tazemetostat for R/R FL

· Changes in Sequencing of R/R FL Therapies

To watch more videos in CancerNetwork®’s OncView™ series, visit cancernetwork.com/oncview.

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As part of its OncView™ video series, CancerNetwork® spoke with Lee Schwartzberg, MD, FACP, of the West Cancer Center and Research Institute in Germantown, Tennessee, about updates to the National Comprehensive Cancer Network (NCCN) guidelines regarding hormone receptor (HR)–positive breast cancer.

In the video series, Lee Schwartzberg, MD, FACP, discussed the following:

· Extended Adjuvant Therapy for HR+ Breast Cancer

· Molecular Biomarkers for HR+ Breast Cancer

· Role of Genomic Testing in HR Positive Breast Cancer

· Appropriateness for Genomic Testing in HR+ Breast Cancer

· Integration of Genomic Testing into NCCN Guidelines

· Current Recommendations for Genomic Testing in HR+ Breast Cancer

· Treatment Limitations in HR+ Breast Cancer

To watch more videos in CancerNetwork®’s OncView™ series, visit cancernetwork.com/oncview.

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This week's podcast focuses on a review article published in the June issue of the journal ONCOLOGY titled, “Routine Breast Cancer Screening in Average-Risk Women Younger Than 50 Years: Current Paradigms Based on National Guidelines.” CancerNetwork spoke with Anath Ravi, PhD, co-founder and chief science and clinical officer of MOLLI Surgical, and Randy Miles, MD, MPH, an assistant professor in the Department of Radiology and clinical service chief in the Division of Breast Imaging at Massachusetts General Hospital, about their work with breast cancer screenings for women under the age of 50.

The conversation focused on the current breast cancer screening guidelines, the risks and benefits of screening for women between the ages of 40 and 49, the different imaging techniques and what roles they play, as well as the future direction of breast cancer screening.

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This week, CancerNetwork review an article published in the July issue of the journal ONCOLOGY titled, “Level of Scientific Evidence Underlying the National Comprehensive Cancer Network Clinical Practice Guidelines for Hematologic Malignancies.” CancerNetwork spoke with Thejaswi Poonacha, MD, MBA, a staff physician and hospitalist in the department of internal medicine at the University of Minnesota Medical Center, regarding the research from him and his colleagues.

The conversation focused on the scientific evidence behind the NCCN guidelines for hematologic malignancies, how each category corresponds with different levels of evidence, and the main findings from this study. Poonacha shared exactly what this means, and why this research was so significant for this group of authors.

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CancerNetwork spoke with Kami Maddocks MD, an associate professor of clinical internal medicine in the Division of Hematology at The Ohio State University, about CD-19 directed agents, avoiding rechallenging with rituximab, and second-line outcomes for transplant-ineligible patients with diffuse large B-cell lymphoma (DLBCL).

Visit cancernetwork.com to check out the first episode of this 3-part series here.

Don’t forget to subscribe to the "Oncology Peer Review On-The-Go" podcast on Apple Podcasts, Spotify or anywhere podcasts are available.

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This week, CancerNetwork® examined an article from the June issue of the journal ONCOLOGY® titled “Second-Line Therapies in the Changing Landscape of First-Line Therapies for Metastatic Clear Cell Renal Cell Cancer” by speaking with one of the authors, Robert A. Figlin, MD. Figlin, who is a professor of medicine and biomedical sciences, Steven Spielberg Family Chair in Hematology-Oncology, and deputy director of Cedars-Sinai Cancer at the Cedars-Sinai Medical Center in Los Angeles, California, spoke about the evolving treatment paradigm of metastatic clear cell renal cell carcinoma, specifically how the shifting landscape of first-line therapies has impacted second-line therapeutic strategies. He discussed standard therapeutic strategies in this space, such as the use of immunotherapy and tyrosine kinase inhibitors, and how new data affect where these agents fit in to patient care. Don’t forget to subscribe to the “Oncology Peer Review On-The-Go” podcast on Apple Podcasts, Spotify, or anywhere podcasts are available.

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As part of its OncView™ video series, CancerNetwork® spoke with Benjamin Levy, MD, of the John Hopkins Sidney Kimmel Comprehensive Cancer Center, to discuss frontline management of extensive-stage small cell lung cancer (SCLC) and the recent updates in the field. In the video series, Levy discussed the following: · Small Cell Lung Cancer: Risk and Prognosis

· Small Cell Lung Cancer: Standard of Care

· Extensive-Stage Small Cell Lung Cancer: Gaps in Treatment

· Immunotherapy for First-Line Extensive-Stage SCLC

· First-Line I-O Plus Chemotherapy for Extensive-Stage SCLC

· Significance of the IMpower133 Trial in Extensive-Stage SCLC

To watch more videos in CancerNetwork®’s OncView™ series, visit cancernetwork.com/oncview. Don’t forget to subscribe to the "Oncology Peer Review On-The-Go" podcast wherever you get your podcasts.

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In this episode, CancerNetwork spoke with 2 experts on the topic of biosimilars, Howard Hochster, MD, FACP, Associate Director for Clinical Research at the Rutgers Cancer Institute of New Jersey and Distinguished Professor of Medicine at the Rutgers School of Medicine, and Michael Kane, RPh, BCOP, Executive Director of Oncology Pharmacy Services for RWJBarnabas Health and Director of Pharmacy Services and the Research Pharmacy at the Rutgers Cancer Institute of New Jersey.

The episode dives into the background of biosimilars, including the Biologics Price Competition and Innovation Act (BPCIA) passed by the United States Congress in 2009 and subsequent 4-letter suffix rule used to identify biologics products without confusion. The conversation also analyzed some of the unintended consequences of these actions regarding biosimilars, and what Hochster and Kane would do to improve the system that’s currently in place.

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In this episode, CancerNetwork spoke with Gilles Salles, MD, PhD, Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center in New York, about recently approved and emerging treatment regimens for transplant-ineligible diffuse large B-cell lymphoma (DLBCL).

Salles discussed some of the available treatment options including tafasitamab, CAR T-cell therapies, selinexor, and antibody drug conjugates (ADCs). He also looked ahead at some of the upcoming research on the horizon, including the B-MIND trial investigating tafasitamab or rituximab plus bendamustine.

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As part of the OncView video series, CancerNetwork spoke with Mark Socinski, MD, of the AdventHealth Cancer Institute in Orlando, Florida about updates in the management of extensive-stage small cell lung cancer (ES-SCLC). Socinski touched on a number of important aspects of treating this disease, including the existing standards of care, treatment challenges, immunotherapy, IMpower 133 trial, and more.

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This week, "Oncology Peer Review On-The-Go" discussed an article from the May issue of the journal ONCOLOGY titled “Molecular Profiling Practices in Pancreatic Adenocarcinoma: Academic vs Community Physicians.” CancerNetwork spoke with Christine Chung, DO, from the HCA Swedish Medical Center in Englewood, Colorado, about the molecular profiling patterns she and her colleagues observed in this retrospective review. The authors found that both academic and community physicians ordered profiling about 50% of the time, which was contrary to previous reports that suggest academic centers perform molecular profiling more often.

The perspective for this article comes from Roman Groisberg, MD, a medical oncologist and director of the Sarcoma Medical Oncology Program at the Rutgers Cancer Institute. Groisberg discussed the role of profiling in pancreatic adenocarcinoma, his thoughts on the retrospective review, and the future of profiling for this cohort of patients.

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As part of its OncView™ video series, CancerNetwork® spoke with Sameh Gaballa, MD, of the Moffit Cancer Center, about current and future treatment options, and considerations for patients with relapsed/refractory follicular lymphoma. In the video series, Gaballa discussed the following: · Treatment Options in Relapsed/Refractory Follicular Lymphoma

· Considerations for Treatment Selection in R/R FL

· Third-Line Therapy in Follicular Lymphoma

· Tazemetostat for Relapsed/Refractory Follicular Lymphoma

· R/R FL: The Role of PI3K Inhibitors

· Unmet Needs and Looking Ahead in Follicular Lymphoma

To watch more videos in CancerNetwork®’s OncView™ series, visit cancernetwork.com/oncview.

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The May issue of the journal ONCOLOGY featured a review article titled “Primary Focal Therapy for Localized Prostate Cancer: A Review of the Literature.” Sudhir Isharwal, MD, an assistant professor in the Department of Urology at Oregon Health & Science University in Portland, Oregon, discussed the emergence of focal therapies in the last few years for the treatment of patients with localized prostate cancer. This literature review investigated some of the advantages and drawbacks of various therapeutic models in this space.

The perspective for this article was written by Thomas Polascik, MD, a professor of Surgery/Urology and director of Focal Therapy at the Duke Cancer Center, Duke Medical Center in Durham, North Carolina. Polascik discussed the response he wrote to this article, titled “Prostate Cancer Focal Therapy Has Made Great Strides and the Future Remains Bright.” He touched on all aspects of focal therapy, including history, potential hurdles, and patient selection and surveillance, among other things.

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The feature article for this episode comes from the April issue of the Journal ONCOLOGY titled “Treatment Considerations for Transplant-Ineligible Multiple Myeloma.” Sarah Holstein, MD, an associate professor of internal medicine in the Division of Oncology & Hematology at University of Nebraska Medical Center in Omaha, Nebraska, spoke about the need for further research into treatment options for the older and more frail patient population of multiple myeloma.

Holstein also explained the importance of understanding results from multiple myeloma clinical trials through the lens of how they apply to this specific transplant-ineligible population.

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As part of its OncView video series, CancerNetwork spoke with Reshma L. Mahtani, DO, Sylvester Comprehensive Cancer Center, about the current role of genomic testing in HR-positive breast cancer and guidance on the use of genomic assays to individualize therapy in the extended adjuvant setting. In the video series, Gadi discussed the following: · Extended Adjuvant Therapy for HR+ Breast Cancer

· NCCN Updates to Genomic Testing in HR+ Breast Cancer

· Genomic Testing for HR+ Breast Cancer: Best Practices

· Utilization of The Breast Cancer Index for HR+ Breast Cancer

· Optimizing Treatment Outcomes in HR+ Breast Cancer

To watch more videos in CancerNetwork’s OncView series, visit cancernetwork.com.

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As part of its OncView video series, CancerNetwork spoke with Vijayakrishna (VK) Gadi, MD, PhD, University of Illinois College of Medicine, about the current role of genomic testing in HR-positive breast cancer and guidance on the use of genomic assays to individualize therapy in the extended adjuvant setting. In the video series, Gadi discussed the following: · Adjuvant Vs Extended Adjuvant Therapy in HR+ Breast Cancer

· Predictive and Prognostic Factors in HR+ Breast Cancer

· Role of Genomic Testing in HR+ Breast Cancer

· NCCN Guideline Updates for the Use of Genomic Assays in HR+ Breast Cancer

· Identifying Patients for Extended Adjuvant Therapy With the Breast Cancer Index in HR+ Breast Cancer

· Improving the Management of HR+ Breast Cancer: Next Steps

To watch more videos in CancerNetwork’s OncView series, visit cancernetwork.com.

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This episode features an article published in the April issue of the Journal ONCOLOGY titled “Focus on Transitional Disease: A Critical Interval to Delay Progression of Prostate Cancer.” The lead author of the research, E. David Crawford, MD, a urologic oncologist, and professor of urology at the University of California San Diego, explained their research into prostate cancer disease states. Among other things, Crawford and the research team talked about next-generation imaging, biomarkers, and redefined prostate cancer disease states to introduce transitional disease into that equation.

The response perspective for this article comes from Rana McKay, MD, an associate professor of medicine and urology at the University of California San Diego. McKay provided some of her thoughts on the idea of redefining prostate cancer disease states and really emphasized the need for clinical research to validate treatment options and current practices.

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This episode features an article published in the Journal ONCOLOGY titled “Integrating PARP Inhibitors Into Advanced Prostate Cancer Therapeutics.”

CancerNetwork spoke with the corresponding author, Jun Gong, a medical oncologist at Cedars-Sinai Medical Center, to discuss the 4 PARP inhibitors that have undergone significant investigation for the treatment of patients with metastatic castrate-resistant prostate cancer. While elaborating on these PARP inhibitors, Gong also discussed the importance and potential value of successfully integrating these agents into prostate cancer practice.

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In this episode, CancerNetwork sat down for a conversation with David Johnson, chairman and CEO of Enveric Biosciences. Johnson gave a thorough background of the biosciences company, and detailed the endocannabinoid products Enveric is developing to positively impact the quality of life for patients with glioblastoma.

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This episode of the "Oncology Peer Review On-The-Go" podcast centers around an article publishing in the April issue of the Journal ONCOLOGY, titled “Messenger RNA Vaccines-Beckoning of a New Era in Cancer Immunotherapy.” The article touches on the recent development of mRNA vaccines approved to combat COVID-19, and how this development offers optimism for the future of mRNA to treat patients with cancer. The author, Mehmet Sitki Copur, MD, of the University of Nebraska Medical Center, broke down the basics of mRNA, its history, challenges and potential opportunities around this relatively new class of vaccine.

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In this episode, CancerNetwork examines an article from the March issue of the Journal ONCOLOGY titled “Factors Associated With Treatment Refusal and Impact of Treatment Refusal on Survival of Patients With Small Cell Lung Cancer.” The original research article found that treatment refusal among patients with small cell lung cancer was associated with worse survival, and strategies to increase patient acceptance of the recommended treatment need to be studied further. CancerNetwork spoke with one of the authors, KM Monirul Islam, MD, of the Georgia Medical Center, to learn more about this research.

For the response perspective, CancerNetwork spoke with Jennifer Carlisle, MD, an assistant professor of hematology and medical oncology at Winship Cancer Institute of Emory University. Carlisle spoke about small cell lung cancer, how treatment refusal impacts treatment of a patient, and plenty more regarding this original research.

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This week, CancerNetwork sat down for a 1-on-1 conversation with former Chief Medical Officer and Executive Vice President of ASCO, Richard Schilsky, MD, to discuss ASCO’s 2021 "Advance of the Year," molecular profiling driving progress in gastrointestinal cancers.

Schilsky discussed the progress being made in this field and the top research contributing to the momentum in gastrointestinal cancers, while also elaborating on health equity in cancer research, ASCO’s top research priorities moving forward, and more.

He also explained the changes forced on clinical trials due to the coronavirus disease 2019 (COVID-19) pandemic, and how he anticipates trials can leverage these adjustments moving forward in a post-COVID world.

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This week, CancerNetwork examined a review article published in the February issue of the Journal ONCOLOGY titled “Utility of the 21-Gene Recurrence Score in Node-Positive Breast Cancer.” The piece highlights the existing literature regarding the prognostic and predictive capabilities of the 21-gene recurrence score in patients with node-positive breast cancer, focusing on current practice patterns and emerging applications from the surrounding literature. For the summary, CancerNetwork spoke with 2 authors of the review, Alison Laws, MD, an associate surgeon at the Brigham and Women’s Hospital and Philip Poorvu, MD, a medical oncologist at the Dana Farber Cancer Institute. Laws and Poorvu provided valuable information on the process, focus and main takeaways of this review. For the article’s response perspective, CancerNetwork spoke with Sara Hurvitz, MD, a professor of medicine at the UCLA Johnson Comprehensive Cancer Center. Hurvitz detailed a number of studies analyzed by the review article, putting into perspective the findings from various pieces of literature. She expanded on the team’s work, and looked toward the future for treating patients with node-positive breast cancer.

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This week, CancerNetwork spoke with Justin Gregg, MD, about a study published in Cancer titled “Adherence to the Mediterranean diet and grade group progression in localized prostate cancer: An active surveillance cohort.” Gregg, an assistant professor of urology at The University of Texas MD Anderson Cancer Center and the lead author of the study, explained that the Mediterranean diet was associated with a lower risk of Gleason Grade group progression among men with localized prostate cancer on active surveillance. Larger follow-up studies are still necessary to verify the patient- and cancer-specific effects of adherence to the Mediterranean diet.

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In this episode, CancerNetwork speaks with Ashwatha Narayana, MD, a professor and chairman of radiation oncology at Northern West Chester Hospital. Narayana co-authored a review article titled “Guidelines for Palliative Treatment of Spinal Metastases: Choosing Between Stereotactic Body Radiation Therapy and Conventional Fractionation.” The article published in the January issue of the Journal ONCOLOGY and discusses the surrounding literature regarding palliative radiation therapy for spinal metastases. More, the team provides recommendations algorithmically to best select patients with metastatic disease for palliative spinal SBRT.

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In the first episode of 2021, CancerNetwork spoke with Che-Kai Tsao, MD, a medical oncologist at Mount Sinai. Tsao discussed smoking cessation, its relation to cancer, and screenings for patients. More, he went into detail regarding the National Cancer Institute-funded smoking cessation program, a program Mount Sinai has been a part of for a number of years.

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In this episode of "Oncology Peer Review On-The-Go", CancerNetwork takes a look at an article publishing in early 2021 for the Journal ONCOLOGY, titled “Patient-Reported Outcomes of Pain and Related Symptoms in Integrative Oncology Practice and Clinical Research: Evidence and Recommendations.”

The piece summarizes current and validated patient-reported outcomes (PROs) specific to cancer-related pain. The piece also recommends commonly used PROs to be standardized to aid integrative oncology clinicians and researchers in both patient care and study design. For the first of 2 interviews regarding this piece, CancerNetwork spoke with 3 authors of the article, W. Iris Zhi, MD, PhD, and Ting Bao, MD, DABMA, MS, from the Memorial Sloan Kettering Cancer Center, and Xin Shelley Wang, MD, MPH, of the MD Anderson Cancer Center.

For this week’s response perspective, CancerNetwork spoke with Linda Carlson, PhD, of the Cumming School of Medicine at the University of Calgary. Carlson expanded on the work done by Zhi and her colleagues, emphasizing the importance of understanding reliability and validity. Carlson focused on the importance of the research topic, and the impact properly validated PROs can have on patients for the cancer care team.

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In this edition of "Oncology Peer Review On-The-Go," CancerNetwork spoke with Zuri Murrell, MD, for a conversation regarding the rising rates of colorectal cancer for younger individuals, as well as the significantly higher incidence and death rates for black patients of this cancer type. Murrell, a colorectal surgeon and cancer specialist at Cedars-Sinai, explained that obesity, diabetes, smoking, and a family history of colorectal cancer may all play a role in the increasing rate.

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This latest episode of "Oncology Peer Review On-The-Go" looks at an article published in the November issue of the journal ONCOLOGY, titled “Supporting Decision-Making on Fertility Preservation Among Adolescent and Young Adult Women With Cancer.” The piece examines oncofertility, unexpected cancer diagnoses and the decision-making process for young adult patients. For a breakdown of the article, CancerNetwork spoke with co-author of the review article, Jackelyn Payne, MPH, MA, a doctoral student in the department of psychology at Stony Brook University.

For the response perspective, CancerNetwork spoke with Elizabeth Constance, MD, who is an associate professor at the University of Nebraska Medical Center. Constance wrote a perspective piece published in the journal ONCOLOGY titled “Opening Doors: Fertility Preservation for Adolescents and Young Adults Facing Gonadotoxic Therapy.” The piece highlights the evolving decision-making process for patients, the potential for multi-disciplinary treatment teams and more.

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This episode of "Oncology Peer Review On-The-Go" examines an article published in the October issue of the journal ONCOLOGY, titled “Barriers to Clinical Trial Enrollment in Patients With Pancreatic Adenocarcinoma Who Are Eligible for Early-Phase Clinical Trials.” The piece was written by Rachael Galvin, DO, MPH, Christine Chung, DO, Ella Achenbach, Oliwier Dziadkowiec, PhD, and Shiraj Sen, MD, PhD, and focuses on what keeps patients of this aggressive form of pancreatic cancer from pursuing enrollment in clinical trials. For a summary of the article, CancerNetwork spoke with lead author of the study, Rachael Galvin, DO, MPH, from the Swedish Medical Center in Englewood, Colorado. For the article’s response perspective, CancerNetwork spoke with Michael Lee, MD, of the MD Anderson Cancer Center. Lee discussed his perspective piece published on CancerNetwork titled “Barriers to Pancreatic Cancer Clinical Trials Enrollment.” The piece examines Galvin’s work and clinical trial enrollment for the disease as a whole.

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This episode of “Oncology Peer Review On-The-Go” examines an article published in the October issue of the journal ONCOLOGY, titled “Considerations for the Management of Oncology Patients During the COVID-19 Pandemic.” The piece focuses on the management of the coronavirus pandemic and best practices to effectively manage patients with cancer. For detailed information regarding the article, CancerNetwork spoke with two authors of the study, Jeffrey Schneider, MD, and Marc Braunstein, MD, PhD, from the NYU Winthrop Hospital. Don’t forget to subscribe to the “Oncology Peer Review On-The-Go” podcast on Apple Podcasts, Spotify or anywhere podcasts are available.

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This episode of "Oncology Peer Review On-The-Go" features an article published in the September issue of the journal ONCOLOGY. The article is titled “Screening for Phase 1 Clinical Trials: An Opportunity to Evaluate Psychological States and Re-educate Patients on Prognosis?” It was written by Sarah Moreland, MD, and Shiraj Sen, MD, PhD, and focuses on physician-patient communication and the psychosocial impact of cancer diagnoses on patients. For more information regarding the article, CancerNetwork spoke with Dr. Moreland from the Medical Center of Aurora.

For the article’s response perspective, CancerNetwork spoke with Daniel McFarland, DO, of the Memorial Sloan Kettering Cancer Center about the physician-patient relationship and the importance of clear communication throughout the clinical trial process.

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This episode of "Oncology Peer Review On-The-Go" examines a review article published in the September issue of the journal ONCOLOGY. The article, “Molecular Profiling in Metastatic Colorectal Cancer,” was written by Samantha Armstrong, MD, Rita Malley, MS, and Benjamin Weinberg, MD. The piece discusses the epidemiology, tumor location, and mutational landscape of metastatic colorectal cancer. For an in-depth evaluation of that piece, CancerNetwork spoke with Armstrong and Weinberg from the Georgetown Lombardi Comprehensive Cancer Center.

For the article’s response perspective, CancerNetwork spoke with John Marshall, MD, of the Georgetown Lombardi Comprehensive Cancer Center. Dr. Marshall discussed the cost, quality of care, accessibility and more regarding molecular profiling and precision medicine.

Don’t forget to subscribe to the Oncology Peer Review On-The-Go podcast on Apple Podcasts, Spotify or anywhere podcasts are available.

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CancerNetwork speaks with Michael Randell, MD, FACOG, of OBGYN Atlanta to learn more about the new cervical cancer screening guidelines released by the American Cancer Society. In the interview, Randell expresses his concerns with the updated guidelines, and details what he recommends to patients.

Don’t forget to subscribe to the Oncology Peer Review On-The-Go podcast on Apple Podcasts, Spotify or anywhere podcasts are available.

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In the latest episode of "Oncology Peer Review On-The-Go," CancerNetwork examines a Q&A piece in the August issue of the journal ONCOLOGY discussing next-generation sequencing for gastrointestinal cancers. The article is titled “Ushering in the Era of Precision Medicine” and it focuses on a conversation with Tanios Bekaii-Saab, MD, of the Mayo Clinic in Phoenix, Arizona. For a responding perspective, CancerNetwork spoke with Howard Hochster, MD, of the Rutgers Cancer Institute of New Jersey. Dr. Hochster discussed his feelings regarding next-generation sequencing, and suggests alternative ways to treat patients with GI cancers.

Don’t forget to subscribe to the "Oncology Peer Review On-The-Go" podcast on Apple Podcasts, Spotify or anywhere podcasts are available.

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In this week’s episode, CancerNetwork speaks with Christopher McNair, PhD, of the Sidney Kimmel Cancer Center – Jefferson Health for an in-depth discussion on how the COVID-19 pandemic has impacted cancer screenings. Then, CancerNetwork speaks with Lisa Berry Edwards, managing director of external affairs for the PreventCancer Foundation, to talk about their “Back on the Books” initiative working to get cancer screenings and regular appointments rescheduled during the pandemic.

Don’t forget to subscribe to the Oncology Peer Review On-The-Go podcast on Apple Podcasts, Spotify or anywhere podcasts are available, or listen online at www.cancernetwork.com.

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On this week's episode of Oncology Peer Review On-The-Go, CancerNetwork examines an article from the July issue of the journal ONCOLOGY entitled “Oncology Clinical Trials During the COVID-19 Pandemic.” The article was written by Aline Lara, MD, Denis Jardim, MD, PhD, and Diogo Bastos, MD. CancerNetwork spoke with Dr. Lara and Dr. Bastos for an overview of the review article.

Then, CancerNetwork speaks with Mehmet Copur, MD, of the Morrison Cancer Center for a peer reviewed perspective. Dr. Copur discussed how to navigate clinical trials during the pandemic and the need to improve the clinical trial system in the United States.

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In this episode of Oncology Peer Review On-The-Go, CancerNetwork speaks 1-on-1 with Xu Ji, PhD, MSPH, of the Winship Cancer Institute regarding her research entitled "Mental Health Among Nonelderly Adult Cancer Survivors: A National Estimate."

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CancerNetwork talks with Christopher Flowers, MD, of the MD Anderson Cancer Center regarding "Strategies for Overcoming Disparities for Patients With Hematologic Malignancies and for Improving Enrollment on Clinical Trials" from the journal ONCOLOGY.

Then, Julie Vose, MD, of the University of Nebraska Medical Center gives her perspective on the factors leading to cancer care disparities and the significance of representative enrollment in clinical trials.

Oncology Peer Review On-The-Go: Recent Episodes

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