Expert Interviews

Panelists discuss ongoing clinical trials and how the treatment landscape for HR positive (HR+)/ HER2 negative (HER2-) breast cancer is evolving with novel targeted therapies and combination strategies, with Dr Isaacs highlighting the most exciting aspects of these trials and their potential impact on the future of precision medicine in this patient population.

Panelists discuss how to optimize luspatercept dosing strategies by evaluating the benefits and risks of starting at maximum dose with downward titration vs initiating at lower doses with upward adjustments.

Panelists discuss practical insights and learning opportunities through interactive examination of a patient case.

Panelists discuss how the AURIGA trial demonstrates superior outcomes with daratumumab plus lenalidomide maintenance compared with lenalidomide alone after autologous stem cell transplantation (ASCT) in newly diagnosed multiple myeloma while examining key subgroup analyses that inform treatment decisions regarding posttransplant maintenance therapy selection.

Panelists discuss how while daratumumab-based quadruplet regimens are increasingly becoming the standard of care for patients with transplant-eligible newly diagnosed multiple myeloma (TE NDMM) due to superior efficacy data, certain factors like frailty, comorbidities, and cost considerations may still warrant triplet therapy in select cases.

Various kidney cancer trials have combined agents such as A2a receptor inhibitors with immunotherapy backbones to potentially improve treatment outcomes.

Panelists discuss how, when considering earlier lines of CAR T-cell therapy for relapsed/refractory multiple myeloma, key institutional factors include patient fitness/age, cytogenetic risk status, prior therapy response duration, and BCMA expression levels. Manufacturing timelines, financial considerations, and center-specific outcomes data also influence timing decisions. For patients receiving early-line CAR T therapy, subsequent treatment options typically focus on novel agent combinations or clinical trials exploring additional cellular therapies, with choices guided by response duration to CAR T and the patient’s individual disease characteristics and treatment goals.

Panelists discuss how, for second-line treatment of relapsed/refractory multiple myeloma (R/R MM), patients suitable for CAR T-cell (cilta-cel vs ide-cel) therapy typically have a poor prognosis with limited response to prior therapies. Institutional guidelines focus on factors such as prior lines of therapy, organ function, and cytogenetics. Non-medical factors, such as geographic access and financial constraints, also influence CAR T-cell therapy referral eligibility.

Panelists discuss how a third-line approach for a 54-year-old patient treated with a tucatinib-based regimen involves careful consideration of prior treatment responses, comorbidities, and the potential benefits of combining tucatinib with capecitabine and trastuzumab to improve outcomes in HER2+ metastatic breast cancer.

Leveraging novel agents, innovative clinical trial designs, and correlative studies may improve the treatment of patients with kidney cancer.

Panelists discuss how patient selection criteria for second-line chimeric antigen receptor T-cell therapy in relapsed/refractory multiple myeloma encompass both clinical eligibility guidelines and practical considerations, including geographical and financial factors.

Panelists discuss how institutional decisions to implement early-line chimeric antigen receptor T-cell therapy for relapsed/refractory multiple myeloma are influenced by patient characteristics, logistical capabilities, cost considerations, and subsequent treatment strategies.

Panelists explain how CAR-T cell therapy works and describe the treatment process, discussing whether CAR -T is considered a complex procedure at their institution or if the logistics have been streamlined into clinical workflows, and they also detail their institution's approach to bridging therapy for patients awaiting CAR-T manufacturing and infusion, including whether patients are managed in-house or sent back to community centers.

Panelists discuss which patients are considered for CAR-T therapy in second-line treatment for relapsed/refractory multiple myeloma (R/R MM) (cilta-cel vs ide-cel), describe the specific criteria and institutional guidelines used to determine patient eligibility, and explore how non-medical factors like such as location and financial considerations impact patient selection, while also outlining the typical CAR-T referral process from community physician outreach to patient evaluation and selection.

Panelists discuss the broader treatment landscape for advanced clear cell renal cell carcinoma (RCC), outlining the current standards of care, how treatment approaches vary for aggressive versus benign or indolent tumors, and the approach to shared decision-making with patients, including counseling and educating them on different treatment options.

Panelists discuss the multidisciplinary team’'s role in supporting patients through a renal cell carcinoma n( RCC) diagnosis, addressing informational gaps as patients process their diagnosis, offering supportive strategies and resources, and highlighting the unique challenges faced by patients with clear cell RCC compared to with those with non–-clear cell RCC.

Panelists discuss how the Phase phase 3 CLEAR trial evaluates organ-specific progression patterns in advanced renal cell carcinoma to better understand the efficacy of lenvatinib plus pembrolizumab compared to with sunitinib and guide subsequent treatment strategies.

Panelists discuss how clinical decision-making with TKI-IO combinations for advanced renal cell carcinoma involves evaluating factors such as efficacy, safety, patient characteristics, and the management of treatment-related toxicities to optimize patient outcomes.

Panelists note that while both teclistamab and elranatamab are weekly doses, elranatamab is a flat dose, and physicians have seen quick and positive responses to elranatamab treatment and physicians have seen…treatment and have been able to pull back patients from doses earlier to prevent an increase in adverse effects from infection.

Panelists discuss how patient 3 is a 61-year-old man with R-ISS stage III IgG-L double-hit myeloma/plasma cell leukemia and extramedullary plasmacytoma diagnosed in 2023 s/p radiation, now with a CNS relapse on elranatamab.