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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 

 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.

 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.

Advances in next-generation sequencing and gene expression are reshaping T-cell lymphoma classification and the use of targeted therapies.

Highlighting Advancements in Personalized T-Cell Lymphoma Treatment

 and the American Society for Transplantation and Cellular Therapy (ASTCT) program 

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 β-thalassemia. They spoke in the context of a study that Gibson presented at the 

 which evaluated patients who received commercial beti-cel in a single-center cohort following 

Gibson 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 noncurative therapies such as 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,” Gibson said. “These therapies have been 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.”

Gibson NM, Friedman DF, Elgarten CW, et al. Post-approval, real-world experience with betibeglogene autotemcel for transfusion-dependent beta thalassemia. 

 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

Therapies such as betibeglogene autotemcel have been “life-changing” for patients with β-thalassemia, according to Nora M. Gibson, MD, MSCE.

Reviewing Real-World Use of Beti-Cel in Transfusion-Dependent β-Thalassemia

Manojkumar Bupathi, MD, MS; and Benjamin Garmezy, MD, dove into the complexities of adjuvant therapy for kidney cancer, providing valuable insights for oncology clinicians in the latest episode of 

. The discussion began with a fundamental overview of adjuvant therapy, which aims to eradicate residual microscopic disease and mitigate the risk of cancer recurrence.

Bupathi, 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 Garmezy, associate director of genitourinary research and executive cochair of the Genitourinary Cancer Research Executive Committee at SCRIand medical oncologist at SCRI Oncology Partners specializing in genitourinary cancers, underscored the curative potential of adjuvant therapy in kidney cancer.

The discussion also focused on 2 primary modalities of adjuvant therapy: targeted therapies and immunotherapy. Targeted therapies, particularly VEGF tyrosine kinase inhibitors, were discussed in the context of clear cell kidney cancer, the predominant subtype, where they inhibit the VEGF signaling pathway to impede cancer cell growth.

Bupathi and Garmezy spoke about results from the phase 3 KEYNOTE-564 trial (NCT03142334), which led to the FDA approval of pembrolizumab (Keytruda) for high-risk clear cell kidney cancer.

 The positive results from this trial are superior to those from others that explored different immunotherapy agents and regimens, none of which demonstrated a similar benefit. It was noted that there are differences in interpretations, heterogeneity in study designs, and patient populations for each trial.

Regarding risk stratification in the postnephrectomy setting, the hosts gave a critical evaluation of the role of nomograms in predicting recurrence. The benefits of adjuvant therapy against the potential for treatment-related toxicities were weighed, with an emphasis on the importance of individualized patient counseling.

Finally, they highlighted the management of disease progression following adjuvant pembrolizumab, with a focus on treatment sequencing and the role of second-line therapies. The relevance of extrapolating data from metastatic trials to the adjuvant setting was discussed, with a pragmatic approach to clinical decision-making.

Choueiri TK, Tomczak P, Park SH, et al; KEYNOTE-564 Investigators. Overall survival with adjuvant pembrolizumab in renal-cell carcinoma. 

. 2024;390(15):1359-1371. doi:10.1056/NEJMoa2312695

FDA approves pembrolizumab for adjuvant treatment of renal cell carcinoma. News release. FDA. November 17, 2021. Accessed April 24, 2025. https://tinyurl.com/yzxcjetz

Oncology Decoded hosts discuss adjuvant therapy in kidney cancer, including research, treatment strategies, and management of recurrence.

Beyond Surgery: The Evolving Landscape of Adjuvant Therapy in Kidney Cancer

In an interview with CancerNetwork®, William Kennedy, MD, a neuroradiation 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 such as 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 provides 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.

“Despite 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.”

A dedicated, well-trained, and expert staff at the Ivy Brain Tumor Center enables the facility to be at the forefront of cutting-edge radiosurgery treatment.

Elucidating Noninvasive Radiosurgery Advancements in CNS Tumors

, 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.

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

Findings highlight a need to incorporate diverse populations when developing guideline-concordant breast cancer care to achieve efficacy for all patients.

Eliminating Racial Disparities in Guideline-Concordant Breast Cancer Care

Audio content above is prompted by the following: 

Prolaris Genomic Testing: Clinical Implications for Prostate Cancer Management

Prolaris represents a significant advancement in prostate cancer genomic biomarker platforms, offering unique capabilities in:

Quantitative assessment of cancer aggressiveness through cell-cycle progression gene expression analysis

Precise prediction of absolute benefit from androgen deprivation therapy (ADT) when combined with radiation therapy

Providing actionable clinical information that goes beyond traditional risk stratification methods

Clinical Utility and Practice-Changing Insights

Patients with intermediate-risk prostate cancer considering radiation therapy

Patients with uncertainties about additional treatment necessities

Cases where traditional risk stratification methods provide insufficient guidance

Offers a more nuanced approach to treatment decision-making

Enables personalized treatment strategies by accurately quantifying individual cancer progression risk

Supports more targeted use of ADT, potentially reducing overtreatment

Continued refinement of genomic testing methodologies

Increasing integration of molecular insights into treatment algorithms

Potential for more precise, individualized treatment planning

Stay informed about latest genomic testing advancements

Understand the specific molecular mechanisms underlying Prolaris testing

Integrate genomic insights with traditional clinical parameters

Maintain a patient-centered approach to treatment decision-making

Incorporate Prolaris testing as a complementary tool in prostate cancer management, particularly for patients in intermediate-risk categories where treatment decisions require additional precision.

Steven E. Finkelstein, MD, DABR, FACRO discuses how Prolaris distinguishes itself from other genomic biomarker platforms by providing uniquely actionable clinical information that quantifies the absolute benefit of androgen deprivation therapy when added to radiation therapy, offering clinicians a more precise tool for personalizing prostate cancer treatment strategies.

Prolaris in Practice: Guiding ADT Benefits, Clinical Application, and Expert Insights From ACRO 2025

Clinical Cell-Cycle Risk Score: Evolving Prostate Cancer Risk Stratification

The clinical cell-cycle risk (CCR) score represents a significant paradigm shift in prostate cancer risk assessment, moving beyond traditional NCCN risk groups by providing:

More nuanced molecular-level risk evaluation

Personalized treatment stratification based on cellular proliferation characteristics

Enhanced precision in predicting metastatic potential

Radiation Therapy and Androgen Deprivation Therapy (ADT)

May not significantly benefit patients with CCR scores below the multimodal threshold

Challenges traditional combination therapy approaches

Enables more targeted treatment intensification strategies

When evaluating Prolaris reports, clinicians should:

Carefully assess absolute risk reduction metrics

Consider individual patient priorities and potential ADT adverse effects

Establish personalized clinical thresholds for treatment escalation

Balance potential survival benefits against quality-of-life implications

Future Outlook: Genomic Testing Developments

Anticipated advancements in the next 5 years include:

More sophisticated genetic and genomic testing methodologies

Enhanced molecular markers for precise risk stratification

Increased integration of molecular profiling into standard clinical decision-making

Stay current with emerging genomic research

Develop expertise in interpreting molecular risk scores

Integrate comprehensive patient-specific factors beyond traditional risk groups

Maintain flexibility in treatment approach based on evolving molecular insights

Alvaro Martinez, MD discusses how emerging genomic risk stratification tools such as the clinical cell-cycle risk (CCR) score are transforming personalized prostate cancer treatment by enabling more nuanced assessments of metastasis risk and treatment intensification strategies beyond traditional NCCN risk groupings.

CCR Scores and Beyond: Precision Strategies for Treatment Intensification in Prostate Cancer

Genomic Testing in Prostate Cancer Active Surveillance

Traditional clinical parameters are now augmented by genomic testing, providing a more nuanced approach to active surveillance patient selection. Genomic panels such as Prolaris offer critical insights that extend beyond conventional risk factors, allowing for:

When genomic testing results differ from conventional clinical parameters:

Prioritize comprehensive molecular risk assessment

Establish clear genomic score thresholds for surveillance confidence

Conduct thorough patient counseling about potential risks and benefits

Consider additional diagnostic information (repeat biopsy, advanced imaging)

Utilize molecular markers to refine risk stratification

Look beyond traditional Gleason scores and prostate-specific antigen levels

Daniel Kim, MD, MBA discusses how genomic testing has revolutionized patient selection for active surveillance by integrating molecular insights that transcend traditional clinical parameters, enabling more nuanced risk stratification and personalized management of intermediate-risk prostate cancer.

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