Videos

Panelists discuss how their key takeaways emphasize the importance of communication and collaboration between academic centers and community practices to ensure equitable access to bispecific therapies, highlighting that it’s an exciting time in myeloma treatment with patient-friendly options that can be administered closer to home, and concluding that virtually no patient should be denied exposure to bispecific therapy before discontinuing treatment, while anticipating that de-escalated Q4 weekly schedules and trispecific agents will transform current practice patterns in the coming years.

Oncology Decoded provides the current management of metastatic bladder cancer, recent advancements in systemic therapy, patient selection, and AE mitigation.

Ronald Bleday, MD, stated that before standardizing a stepwise approach to treating surgical pain, providers might have overtreated patients with opioids.

Panelists discuss how comprehensive supportive care strategies for GPRC5D bispecifics like talquetamab involve managing unique toxicities including taste and smell changes, skin and nail effects, and gastrointestinal issues, with one patient emphasizing her philosophy of addressing adverse effects as they arise rather than anticipating them, while highlighting the importance of continued research funding for innovative treatments that have extended her survival beyond initial prognosis.

Panelists discuss how shared clinical decision-making in chimeric antigen receptor (CAR) T-cell therapy involves seamless coordination between physicians and nurse coordinators who streamline the referral process for patients after first-line therapy failure, with coordinators managing logistics like condensing multiple appointments, arranging travel and lodging benefits through CAR T companies for out-of-state patients, providing clear communication in “nurse talk” rather than medical jargon, and emphasizing that the referral process is straightforward—encouraging oncologists not to wait but to send patients immediately after 1 line of therapy so the team can handle insurance approval and T-cell collection while patients return home during the 4- to 8-week manufacturing period.

Panelists discuss how patients with relapsed/refractory (R/R) multiple myeloma experience the challenging process of confirming disease recurrence through bone marrow biopsies and PET scans, often struggling with difficult treatment regimens like immunotherapy and daily lenalidomide (Revlimid) that cause severe illness, leading patients to advocate for themselves by researching alternative therapies like chimeric antigen receptor (CAR) T-cell therapy through educational materials and videos, ultimately seeking second-line treatments that offer the appeal of “one and done” therapy with less ongoing chemotherapy compared with traditional lifelong treatment approaches.

“It’s a treatment for those patients who don’t have any other effective treatments available,” said Muhammad Umair Mushtaq, MD, on lifileucel in melanoma.

Panelists discuss how the step-up dosing strategy for talquetamab involves graduated dose escalation from 0.01 to 0.06 mg/kg before reaching therapeutic levels to minimize severe cytokine release syndrome, with real-world data showing 85% to 86% of patients can safely receive outpatient step-up dosing, though one patient’s inpatient experience was chosen due to her drug allergies and travel distance considerations.

Conducting trials safely within a community setting lies at the heart of a successful collaboration between Northwell Health and START.

“There is margin to improve on these treatments, but this is a real hope for patients with melanoma,” said Mushtaq on TIL therapies.

Experts at the 2025 National ICE-T Conference discussed the need for improved management of toxicities in patients with leukemia.

The expertise of START's network may streamline the availability of clinical trial enrollment and novel treatment options among patients with cancer.

An expert explains that teclistamab has proven to be a highly effective and well-tolerated therapy for relapsed/refractory multiple myeloma in real-world settings, with outcomes mirroring clinical trials and improved infection management strategies enhancing its safety and accessibility for a broader range of patients.

“Every patient [with multiple myeloma] should be offered CAR T before they’re offered a bispecific, with some rare exceptions,” said Barry Paul, MD.

A new START center in New York may give patients with advanced malignancies an opportunity to access novel therapies in the community setting.

Barry Paul, MD, listed cilta-cel, anito-cel, and arlo-cel as 3 of the CAR T-cell therapies with the most promising efficacy in patients with multiple myeloma.

START is the largest early-phase oncology network in the community-based setting, according to Geraldine O’Sullivan Coyne, MD, PhD, MRCPI.

Jose Sandoval Sus, MD, discussed standard CAR T-cell therapies in patients across multiple high-risk lymphoma indications.

Panelists discuss evolving treatment strategies for metastatic melanoma with asymptomatic brain metastases, highlighting the superiority of PD-1 plus CTLA-4 combination therapy for durable intracranial responses, while noting that newer immunotherapy combinations like PD-1 plus LAG-3 show promise but require further evidence before altering current standards of care.

Panelists discuss the current standard of care for metastatic melanoma with asymptomatic brain metastases, emphasizing the durability of CTLA-4 plus PD-1 immunotherapy, the emerging but unproven role of newer combinations like PD-1 plus LAG-3, and the importance of multidisciplinary coordination, patient education, and timely intervention in managing both asymptomatic and symptomatic brain involvement.

Panelists discuss how a woman aged 69 years with standard-risk relapsed/refractory multiple myeloma (R/R MM), significant comorbidities including chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD), and history of respiratory infections would be a reasonable candidate for talquetamab despite infection concerns, citing that GPRC5D-targeting agents show much lower infection rates (less than 10%) compared with B-cell maturation antigen (BCMA) bispecifics (around 50%) due to preferential expression on malignant cells rather than normal B cells, with no requirement for prophylaxis and evidence of preserved humoral immunity including COVID-19 vaccine responses.

Panelists discuss how early use of IDH inhibitors maximizes therapeutic benefit and address resistance mechanisms, noting that tumors typically develop bypass pathways rather than losing the IDH mutation itself.

Panelists discuss how dose modifications for ALK inhibitors can significantly improve quality of life issues like brain fog and weight gain while maintaining disease control, emphasizing the importance of multidisciplinary team support including palliative care from diagnosis.

Panelists discuss how the INDIGO trial's compelling results led to early FDA approval of vorasidenib for progressive IDH-mutant gliomas, and how they counsel patients on sequencing IDH inhibitors vs traditional radiation and chemotherapy while considering long-term quality of life implications.

Panelists discuss how managing a high-risk patient aged 64 years who progressed after 11 months on talquetamab with decreased B-cell maturation antigen (BCMA) surface expression presents challenging options, including switching to GPRC5D-targeting agents like talquetamab, pursuing clinical trials, or potentially using sequential bispecifics despite T-cell exhaustion concerns, while noting that the MonumenTAL-1 trial’s prior BCMA-directed therapy cohort showed promising 12-month progression-free survival, although the data are confounded by intervening therapies between treatments.

Elucidating nonresponses to bispecific T-cell engagers may be an important research consideration in the multiple myeloma field.

Barriers to access and financial toxicities are challenges that must be addressed for CAR T-cell therapies in LBCL, according to Jose Sandoval Sus, MD.

While there is no clear and cut way to transition patients from pediatric to adult care, Maria C. Velez, MD, has established a helpful network of willing clinicians.

Fixed treatment durations with bispecific antibodies followed by observation may help in mitigating infection-related AEs, according to Shebli Atrash, MD.

Panelists discuss how patients educate themselves about multiple myeloma through hospital pamphlets and magazines, online research, and positive attitude books about cancer while emphasizing the critical importance of peer support and mentorship programs where patients can meet with others who have successfully undergone treatments like stem cell transplants, creating comforting group meetings that help alleviate fear and provide hope by seeing healthy survivors share their stories and demonstrate that recovery is possible.