Around the Practice

Panelists discuss how CAR T-cell therapy in relapsed/refractory multiple myeloma is supported by strong trial and real-world outcomes, and how optimizing patient selection and sequencing—while proactively addressing referral, logistical, toxicity, and insurance/financial barriers—can expand timely access and improve care delivery.

This program, recorded live from the San Antonio Breast Cancer Symposium, convened leading breast medical oncologists. Dr. McArthur, Dr. Gradishar, Dr. Rao, Dr. Sammons, and Dr. Traina, to discuss the latest advances in the treatment of advanced or metastatic breast cancer. The panel covered evolving genomic testing strategies, the integration of new targeted therapies, interpretation of clinical trial data, and implications for clinical practice. Key trials and recent FDA approvals were highlighted, with insights into optimizing sequencing and combination of therapies for hormone receptor-positive, HER2-positive, and triple negative breast cancer. The conversation emphasized the growing complexity and promise in the field, as well as the challenges in personalizing care for diverse patient populations.

This Around the Practice discussion series, BCMA Bispecific Antibodies in Relapsed/Refractory Multiple Myeloma: Real-World Integration and Patient-Centered Management, brings together leading experts Sundar Jagannath, MBBS, Icahn School of Medicine at Mount Sinai Hospital; Ajay Nooka, MD, MPH, FACP and Nisha Joseph, MD (Winship Cancer Institute of Emory University); Mohan Krishnamachary, MD (Suburban Hematology Oncology Associates); and Donna Catamero, MSN, ANP-BC, OCN, CBCN (Icahn School of Medicine at Mount Sinai Hospital), for a focused conversation recorded at ASH 2025. Through deep dives into pivotal data, agent comparisons, and a complex real-world case, the panel examines how BCMA bispecific antibodies—particularly linvoseltamab, teclistamab, and elranatamab—are being integrated alongside CAR T-cell therapy, with attention to toxicity mitigation, infection prophylaxis, and duration of therapy. The dialogue emphasizes practical strategies for transitioning care from academic to community settings, optimizing outpatient management, and ensuring that high-risk, heavily pretreated patients can safely access these potentially life-prolonging—and, in some cases, potentially curative—therapies.

This program focuses on optimizing the use of oral hypomethylating agents (HMAs) in myeloid malignancies, primarily high-risk myelodysplastic syndromes (MDS) and chronic myelomonocytic leukemia (CMML). A multidisciplinary panel of hematologists, transplant specialists, and an oncology nurse practitioner discusses real-world cases involving TP53-mutated MDS and proliferative CMML, both complicated by cytopenias, comorbidities, logistical challenges, and patient preferences. Panelists review evidence supporting oral decitabine/cedazuridine as a practical and clinically effective therapy comparable to intravenous HMAs. They also discuss transplant candidacy, timing, and the emerging role of combination therapies such as venetoclax with oral HMAs. Across the program, speakers emphasize individualized patient-centered care, balancing disease control with quality of life, treatment burden, telemedicine integration, and realistic expectations. The experts conclude that oral HMA therapy will lead to broader community-based treatment, greater patient autonomy, and future expansion of combination regimens and clinical trials.

This program provides an in-depth discussion on the evolving treatment strategies for patients with EGFR-mutant metastatic non-small cell lung cancer (mNSCLC), emphasizing the role of combination therapies to improve survival outcomes. Experts review recent clinical trial data, particularly focusing on central nervous system (CNS)-active regimens such as amivantamab plus lazertinib and osimertinib combinations. They highlight patient selection, emphasizing high-risk populations with CNS metastases or high tumor burden, and discuss the clinical rationale for early, aggressive therapy versus de-escalation approaches. Safety, tolerability, and patient-centered care are emphasized, including management of adverse events and considerations for quality of life. The program also addresses long-term treatment planning, highlighting the “marathon” nature of therapy and the importance of optimizing first-line interventions to maximize overall survival. Finally, emerging innovations, including subcutaneous formulations of amivantamab, are explored as ways to improve convenience and adherence, demonstrating the potential for both efficacy and improved patient experience in routine clinical practice.

This Around the Practice program brings together a multidisciplinary panel to examine evolving perioperative strategies for resectable gastroesophageal and gastric cancers, with a particular focus on integrating systemic therapy, immunotherapy, and surgical planning. Panelists review emerging data from key studies, including the DFLOT regimen evaluated in the MATTERHORN trial, and discuss how these findings may influence real world care once regulatory decisions are finalized. Throughout the program, the experts highlight the importance of accurate staging, appropriate patient selection, and careful assessment of treatment tolerance when approaching complex early stage disease. The discussion incorporates practical considerations faced in both academic and community settings, including nutrition support, feeding access, performance status preservation, germline testing, and the coordination required for patients living at a distance from major centers. Two detailed patient cases illustrate decision making around PD L1 status, locally advanced tumor biology, and multidisciplinary management. The program concludes with reflections on future directions in biomarker driven perioperative therapy and the expanding role of collaborative care teams.

This Around the Practice discussion series, Evolving Strategies in EGFR-Mutated NSCLC: Optimizing CNS Control and Managing Treatment-Related Toxicities, brings together leading experts Misako Nagasaka, MD, PhD; Luis Raez, MD; Edgardo Santos, MD, FACP, FASCO; and Jun Zhang, MD, PhD, to explore the newest data and clinical approaches in treating EGFR-mutated non–small cell lung cancer. Through real-world cases, the panel examines how dual EGFR-MET pathway inhibition, exemplified by amivantamab plus lazertinib, is reshaping frontline therapy, central nervous system management, and sequencing beyond progression. The dialogue emphasizes proactive toxicity prevention, multidisciplinary care, and individualized strategies to improve patient outcomes, long-term survival, and quality of life

Panelists discuss how bispecific antibody therapies are revolutionizing multiple myeloma treatment by providing highly effective, accessible options for heavily pretreated patients while addressing key implementation challenges including patient selection, sequencing strategies, safety management protocols, and the transition from academic centers to community-based care delivery.

Jan Drappatz MD; Elizabeth Maher, MD, PhD; Alexandra M. Miller, MD, PhD; and David Reardon, MD discuss how the 2021 WHO classification emphasizing molecular markers like IDH mutations has transformed glioma treatment from a histology-based approach to personalized therapy, with IDH inhibitors offering new first-line options that can defer radiation and chemotherapy while maintaining quality of life for patients with IDH-mutant gliomas.

Samuel Rosner, MD, discusses how the treatment landscape for EGFR-mutated non-small cell lung cancer has evolved from first-generation targeted therapies to osimertinib as the current standard of care, while exploring emerging options like fourth-generation TKIs, antibody-drug conjugates, and bispecific therapies to overcome resistance mechanisms.

Ajai Chari, MD; Ajay Nooka, MD, MPH, FACP; Muhamed Baljevic, MD; Gurbakhash Kaur, MD; and Anupama Kumar, MD, discuss how recent advances in multiple myeloma (MM) treatment, including quadruplet therapy regimens, CAR T-cell therapies in earlier lines, and emerging bispecific antibodies and trispecific agents, are transforming the treatment landscape with the potential to cure rather than just manage the disease, while addressing optimal sequencing strategies and management of adverse events across newly diagnosed and relapsed/refractory (R/R) settings.

Panelists discuss the evolving role of chimeric antigen receptor (CAR) T-cell therapy in multiple myeloma (MM), highlighting its transformative impact on patient outcomes across diverse real-world settings, the importance of individualized treatment decisions based on comparative efficacy and toxicity of available therapies, innovative approaches like bridging with bispecific antibodies, strategic sequencing with other B-cell maturation antigen–targeted agents, early integration in the treatment pathway, proactive management of neurotoxicity and infections, expanding access to high-risk populations, and the critical need for collaboration between specialized centers and community providers to optimize patient care and maximize durable responses.

Panelists highlighted evolving personalized treatment strategies in HER2-positive metastatic breast cancer—spanning maintenance therapy innovations, frontline and later-line sequencing with agents like trastuzumab deruxtecan and tucatinib, management of CNS metastases and toxicities such as interstitial lung disease, and the critical role of multidisciplinary care and clinical trials in optimizing patient outcomes and quality of life throughout complex, prolonged disease courses.

Leslie Randall, MD; Marion E. Cole, MD; Asim Farooq, MD, and Mallorie Haba, FNP, discuss how antibody-drug conjugates are transforming treatment strategies in recurrent ovarian cancer by offering new options for patients with platinum-resistant disease, emphasizing molecular testing, treatment sequencing, side effect management—particularly ocular toxicities—and the importance of patient-centered care.

Leading oncology experts come together for an in-depth virtual roundtable on immunotherapy strategies in advanced or metastatic melanoma. Moderated by Dr. Douglas B. Johnson of Vanderbilt University Medical Center, and joined by distinguished panelists Dr. Ahmad Tarhini (Moffitt Cancer Center) and Dr. Yana G. Najjar (University of Pittsburgh Medical Center), the series explores the evolving treatment landscape with a focus on real-world application, efficacy, and patient safety.

Panelists discuss the current treatment landscape of ES-SCLC, review recent clinical trials, and how they prepare their sites for tarlatamab administration, patient monitoring and management of adverse events

Panelists discuss how enhancing diagnostic accuracy, optimizing multidisciplinary care, and advancing treatment strategies—including targeted therapies—can improve outcomes and decision-making in patients with advanced epithelioid sarcoma (ES).

Panelists discuss how the evolving treatment landscape in relapsed/refractory follicular lymphoma, particularly in the third-line setting and beyond, is shaping clinical decision-making through patient-centered strategies that balance efficacy, tolerability, and individualized care.

Jason Efstathiou, MD, DPhil, FASTRO, FACRO; Brandon Mancini, MD, MBA, FACRO; Comron Hassanzadeh, MD, MPH; and Bridget Koontz, MD, FASTRO, discuss the evolving role of PSMA PET imaging in prostate cancer, examining its impact on diagnosis, disease staging, treatment decisions, and posttreatment assessment. They also review key clinical trial data, current guideline recommendations, and real-world applications of PSMA PET imaging in practice.

Krish Patel, MD; Saurabh Dahiya, MD, FACP​; Nathan Denlinger, DO, MS; Mohamed M. Hegazi, MD​, and Samuel Yamshon, MD discuss how, the DLBCL treatment landscape has evolved with CAR-T therapies transforming outcomes in R/R cases. Key considerations include risk stratification, optimal sequencing, and real-world efficacy vs. trial data. Future advances may refine patient selection, enhance manufacturing, and integrate novel therapies for improved durability and safety.

Panelists discuss how a patient-centered approach, shared decision-making, and clear communication between physicians, patients, and caregivers are essential in improving care, treatment adherence, and long-term management for individuals with paroxysmal nocturnal hemoglobinuria (PNH).

This program was made possible with support from Novartis Pharmaceuticals.

Panelists discuss how evolving treatment options, including T-DXd and tucatinib-based regimens, are reshaping the management of HER2+ metastatic breast cancer in later-line settings, emphasizing the importance of personalized therapy and proactive toxicity management.

Panelists discuss how the CAR-T referral process for relapsed/refractory multiple myeloma involves careful patient selection, bridging therapy, and coordination between community and academic centers to optimize treatment outcomes.

Cristina Gasparetto, MD; Amandeep Godara, MBBS; Ken Shain, MD, PhD; and Mansi Shah, MD, examine evolving treatment paradigms in newly diagnosed multiple myeloma (NDMM), highlighting the increasing role of daratumumab-based regimens across the care spectrum—from induction through maintenance—supported by landmark trials like PERSEUS, CASSIOPEIA, and AURIGA that demonstrate improved outcomes with these approaches while considering patient-specific factors in treatment selection.

Al-Ola Abdallah, MD; Muhammad Umair Mushtaq, MD; Jeries Kort, MD; and Zahra Mahmoudjafari examine the evolving landscape of chimeric antigen receptor (CAR) T-cell therapy in earlier lines of treatment for relapsed/refractory multiple myeloma, exploring institutional challenges around patient selection, slot availability, referral processes, and decision-making frameworks while considering both clinical and practical factors that influence treatment sequencing and access.

Panelists discuss how emerging treatment strategies, including novel induction therapies, maintenance regimens, and bispecific antibodies, are reshaping the management of newly diagnosed and relapsed/refractory multiple myeloma, with insights from ASH 2024 data and ongoing trials.

Panelists discuss how the evolving landscape of targeted therapies for PIK3CA-mutated HR+ HER2- breast cancer, including the approval of inavolisib and the growing importance of biomarker testing, is reshaping treatment strategies, patient care, and adverse event management.

Alfred Garfall, MD; Omar Nadeem, MD; Naresh Bumma, MD; and Surbhi Sidana, MD,explore the evolving therapeutic landscape of relapsed/refractory multiple myeloma, including bispecific antibodies, real-world outcomes across treatment settings, optimal sequencing strategies after CAR T progression, and long-term efficacy data from key clinical trials like MajesTEC-1.

Saad Usmani, MD, MBA; Carlyn Rose Tan, MD; Sham Mailankody, MBBS, and Sridevi Rajeeve, MD, examine evolving chimeric antigen receptor (CAR) T-cell therapy in multiple myeloma, discussing recent clinical trial data for cilta-cel and ide-cel, comparing study outcomes, evaluating institutional implementation factors, and assessing patient eligibility criteria for optimal therapy selection in earlier treatment lines.