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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 

. Fingeret is the founder of Fingeret Psychology Services and specializes in body image and cancer.

Daniel C. McFarland, DO, and Michelle Fingeret, PhD, discuss the issue of body image in patients with cancer. 

Beyond the Tumor: Addressing Body Image in Oncology

 discussion with Manojkumar Bupathi, MD, MS, executive cochair of the Genitourinary Cancer Research Executive Committee at Sarah Cannon Research Institute (SCRI) and medical oncologist with Rocky Mountain Cancer Centers specializing in solid tumors and genitourinary cancers, and Benjamin Garmezy, MD, associate director of genitourinary research and executive cochair of the Genitourinary Cancer Research Executive Committee at SCRI and medical oncologist at SCRI Oncology Partners specializing in genitourinary cancers, dissects the current management of metastatic urothelial carcinoma, with a focus on treatment strategies beyond standard first-line therapies. The conversation highlights the recent paradigm shift with the approval of enfortumab vedotin-ejfv (Padcev) in combination with pembrolizumab (Keytruda). This combination’s efficacy, as demonstrated in the phase 3 EV-302 trial (NCT04223856), has positioned it as a new standard of care for many patients. The alternative, gemcitabine plus cisplatin with nivolumab (Opdivo), supported by the phase 3 CheckMate 901 trial (NCT03036098), remains a crucial first-line option, particularly for patients who are cisplatin-eligible.

The hosts delve into the nuances of second-line therapy, which has become a more complex and critical area. For patients who progress on enfortumab vedotin/pembrolizumab, the discussion covers options such as platinum-based chemotherapy with gemcitabine/cisplatin or carboplatin. The importance of biomarker-driven therapy is also emphasized, particularly the role of molecular testing for 

 inhibitor erdafitinib (Balversa) is highlighted as a viable option for patients with susceptible genetic alterations. Furthermore, the discussion touches on the evolving role of HER2-targeted agents and other novel early-phase assets that are being developed to address the unmet need in this patient population.

Management of toxicities is also a significant theme. The clinicians share insights on mitigating adverse effects such as peripheral neuropathy from enfortumab vedotin, and the challenges of managing hyperglycemia and skin toxicities. The need for more data-driven guidance on treatment duration and maintenance therapy is also underscored, with the observation that treatment discontinuation is a common clinical challenge lacking clear guidelines.

FDA approves enfortumab vedotin-ejfv with pembrolizumab for locally advanced or metastatic urothelial cancer. News release. FDA. December 15, 2023. Accessed August 13, 2025. https://tinyurl.com/45wkm3bd

The latest in first- and second-line therapies for bladder cancer, including trial data, AE management, and the role of molecular testing, were discussed in the latest Oncology Decoded podcast. 

Navigating the Evolving Second-Line Landscape of Metastatic Urothelial Carcinoma

 at the 2025 National Immune Cell Effector Therapy 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 chimeric antigen receptor (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.

Al Sagheer T. Mastering the management of adverse effects from cellular therapies in lymphoma. Presented at: 2025 National Immune Cell Effector Therapy Conference; July 26, 2025; Orlando, FL.

Gonzalez R. Navigating the challenges: managing adverse effects of cellular therapies in ALL. Presented at: 2025 National Immune Cell Effector Therapy Conference; July 26, 2025; Orlando, FL.

Kareem SS. Management of adverse events of CAR-T and T-cell engagers in myeloma. Presented at: 2025 National Immune Cell Effector Therapy Conference; July 26, 2025; Orlando, FL.

A panel of clinical pharmacists discussed strategies for mitigating toxicities across different multiple myeloma, lymphoma, and leukemia populations.

Navigating AE Management for Cellular Therapy Across Hematologic Cancers

®, 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)

phase 3 TROPION-Lung01 trial (NCT04656652)

accelerated approval of datopotamab deruxtecan-dlnk

mutant metastatic NSCLC in June 2025, discussed safety and efficacy considerations for the agent’s use.

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 

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, 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.

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.

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. 

. 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. 

. 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). 

. 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

Jacob Sands, MD, discussed considerations for EGFR-mutant non–small cell lung cancer following the approval of dato-DXd in this disease.

Integrating Dato-DXd Into Early-Line EGFR-Mutant NSCLC Management

 focuses on a discussion between hosts Manojkumar Bupathi, MD, MS, executive cochair of the Genitourinary Cancer Research Executive Committee at Sarah Cannon Research Institute (SCRI) and medical oncologist with Rocky Mountain Cancer Centers specializing in solid tumors and genitourinary cancers, and Benjamin Garmezy, MD, associate director of genitourinary research and executive cochair of the Genitourinary Cancer Research Executive Committee at SCRI and medical oncologist at SCRI Oncology Partners specializing in genitourinary cancers, in a recent live session with US Oncology Network and the Pathways Task Force, discussing the evolving landscape of second-line and beyond therapy for urothelial carcinoma, particularly in the context of recent advancements in first-line treatment.

The current standard of care for frontline metastatic urothelial carcinoma is enfortumab vedotin-ejfv (Padcev) in combination with pembrolizumab (Keytruda). Recent data from the phase EV-302 trial (NCT04223856) presented at the 2025 American Society of Clinical Oncology (ASCO) highlighted the remarkable durability of responses with this combination, showing a 2-year durability in a significant proportion of responders, including 75% of complete responders.

 While this combination is favored for most patients, the hosts acknowledged a subgroup for whom it may not be suitable due to unique toxicities such as neuropathy, skin toxicity, and hyperglycemia.

The phase 3 Checkmate901 trial (NCT03036098), evaluating cisplatin/gemcitabine with nivolumab (Opdivo), is also mentioned as a prior standard of care, though generally superseded by enfortumab vedotin/pembrolizumab. For patients with lymph-node-only disease, both cisplatin/gemcitabine and nivolumab or enfortumab vedotin/pembrolizumab show comparable high response rates, necessitating shared decision-making.

For patients progressing on enfortumab vedotin/pembrolizumab, the subsequent treatment landscape becomes more complex. Platinum-based chemotherapy doublets (cisplatin/gemcitabine or carboplatin/gemcitabine) are considered, though their efficacy in this heavily pretreated setting is limited and associated with significant toxicity.

 alterations is crucial, as erdafitinib (Balversa) offers a targeted option with a 40% response rate in patients who are 

-positive. Managing erdafitinib toxicities, including nail changes, skin reactions, and phosphate level elevations, requires close monitoring and patient education. The potential role of HER2-targeted antibody-drug conjugates is also discussed, particularly for HER2 3+ expression, though data in urothelial carcinoma are limited.

For patients without actionable biomarkers, single-agent taxanes (docetaxel, paclitaxel) have historically shown dismal response rates (~15-17%). Sacituzumab govitecan-hziy (Trodelvy), despite its accelerated approval withdrawal due to the confirmatory phase 2 TROPHY-U-01 trial (NCT03547973) not meeting statistical significance against single-agent chemotherapy, is still utilized by the speakers. They emphasize that with appropriate growth factor support, sacituzumab govitecan can be less toxic and equally efficacious as carboplatin/gemcitabine in select patients.

Bedke J, Powles TB, Valderrama BP, et al. EV-302: long-term subgroup analysis from the phase 3 global study of enfortumab vedotin in combination with pembrolizumab (EV+P) vs chemotherapy (chemo) in previously untreated locally advanced or metastatic urothelial carcinoma (la/mUC). 

. 2025;43(suppl 16):4571. doi:10.1200/JCO.2025.43.16_suppl.4571

Van der Heijden M, Galsky M, Powles T, et al. Nivolumab plus ipilimumab (NIVO+IPI) vs gemcitabine-carboplatin (gem-carbo) chemotherapy for previously untreated unresectable or metastatic urothelial carcinoma (mUC): Final results for cisplatin-ineligible patients from the CheckMate 901 trial. 

. 2025;43(suppl 17):4500. doi:10.1200/JCO.2025.43.16_suppl.4500

Gilead provides update on U.S. Indication for Trodelvy in metastatic urothelial cancer. News release. Gilead Sciences, Inc. October 18, 2024. Accessed July 30, 2025. https://tinyurl.com/2aku377j

Manojkumar Bupathi, MD, MS, and Benjamin Garmezy, MD, focus on treatment options for patients with urothelial carcinoma.

Navigating Second-Line Treatment Options in Urothelial Carcinoma

 hosted 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 

), 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

 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: 

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.

Experts share their perspectives on updated clinical trial results, personalized cancer vaccine research, and other notable developments in kidney cancer.

Key Advances Across Kidney Cancer Research and Management at KCRS 2025

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 

 International Congress on the Future of Breast Cancer® (IBC) East in New York, New York.

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 high-risk, early-stage estrogen receptor (ER)–positive 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.

McArthur expressed further excitement for ADC-based combinations for triple-negative disease as well as 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.

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 

2025 American Society of Clinical Oncology Annual Meeting

 Specifically, findings showed that vepdegestrant, an oral proteolysis-targeting chimera, exhibited an efficacy advantage over fulvestrant (Faslodex) in patients with 

-mutant ER-positive, HER2-negative advanced or metastatic disease. Moreover, she highlighted data from the 

 trial of T-DXd in various combinations for patients with HER2-positive metastatic breast cancer.

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, director of the Women’s Cancer Program, and professor in the Department of Medical Oncology & 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 Cancer 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.

 He concluded by discussing future considerations for combining multiple ADCs.

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. 

 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. 

. 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. 

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. 

. 2025;43(suppl 17):LBA109. doi:10.1200/JCO.2025.43.17_suppl.LBA109

Leading experts in the breast cancer field highlight the use of CDK4/6 inhibitors, antibody-drug conjugates, and other treatment modalities.

Advancements and Evolving Strategies in Breast Cancer Treatment at IBC East

 (Ibtrozi) for patients with locally advanced or metastatic 

According to Jorge Nieva, MD, taletrectinib may be a primary frontline therapy option for those with ROS1-positive non–small cell lung cancer.

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