Expert Interviews

Jeffrey V. Matous, MD, discusses how to counsel patients on chronic, low-grade toxicities to support adherence to ramantamig.

This episode applies the discussion to two patients with HER2-mutant non–small cell lung cancer.

The panel applies the treatment framework to clinical scenarios involving patients with hormone receptor-positive, HER2-negative metastatic breast cancer (HR+/HER2− mBC) after progression on first-line CDK4/6 inhibitor plus endocrine therapy.

Melody Rasouli, MD, MBA, FACOG, explained how random-start ovarian stimulation and rapid sperm banking fit fertility preservation into cancer care.

The panel focuses on multidisciplinary monitoring and proactive toxicity management for patients with hormone receptor-positive, HER2-negative metastatic breast cancer (HR+/HER2− mBC), particularly as treatment moves into later-line targeted therapy.

This episode maps the early weeks of oral zongertinib and the real-world factors that threaten them.

Veronika Bachanova, MD, PhD, discussed how the favorable safety profile of CAR natural killer cell therapies may come with trade-offs in persistence and response durability.

Dan Costin, MD, discusses where personalized mRNA vaccines could fit into lung cancer care within 5 to 10 years.

Wade T. Iams, MD, of Tennessee Oncology, reviews early COPERNICUS safety data, in which patients receiving subcutaneous amivantamab plus lazertinib also received intensive skin prophylaxis.

Luis E. Raez, MD, of Miami Cancer Institute, reviews baseline characteristics from the early safety analysis of COPERNICUS, which tested subcutaneous amivantamab plus lazertinib in epidermal growth factor receptor–mutated lung cancer.

Melody Rasouli, MD, MBA, FACOG, discussed the system breakdowns that delay fertility referrals and how EHR triggers can automate the process.

In this closing segment, Elizabeth Bohannon reflects on what continues to give her hope while living with relapsed/refractory multiple myeloma.

Dan Costin, MD, describes counseling his first patient on a personalized mRNA vaccine vs observation in the INTerpath-014 trial.

Jan Kitajewski, PhD, discussed how pooled expertise, pilot funding, and investigator support help move bench discoveries toward multicenter trials.

Neil Iyengar, MD, presents a second case: a 61-year-old woman with HER2-low metastatic breast cancer who progressed after 22 months on first-line palbociclib and letrozole and 8 months of subsequent endocrine therapy, now with an ESR1 and PIK3CA H1047R co-mutation.

Neil Iyengar, MD, presents a case of a 52-year-old woman with bone-only, hormone receptor-positive, HER2-negative metastatic breast cancer on first-line ribociclib and letrozole who has stable imaging at 12 months but a new ESR1 Y537S mutation on ctDNA with mild bone pain.

Carol Tweed, MD, tells community oncologists that camizestrant's cardiac and ocular effects do not require routine referral to cardiology or ophthalmology, calling asymptomatic bradycardia and photopsia a non-issue that does not impair patient function and tends to resolve over time.

Rebecca Shatsky, MD, reviews the safety profile of camizestrant based on her experience in the CAMBRIA adjuvant trials, highlighting photopsia, brief flashes of light in peripheral vision with no associated eye damage, and bradycardia, which she calls the Apple Watch effect after patients notice low heart rates on wearable devices overnight.

Rebecca Shatsky, MD, describes telling a patient with a clean scan but a new ESR1 mutation on ctDNA that treatment needs to change, saying she sets that expectation from the start of testing rather than presenting it as a surprise.

Carol Tweed, MD, unpacks how to interpret the progression-free survival benefit in the SERENA-6 trial, explaining that a second progression-free survival analysis, counted after patients on the standard arm crossed over to a subsequent therapy, still favored the camizestrant switch group.

Rebecca Shatsky, MD, walks through the design of the phase 3 SERENA-6 trial, led by Francois Bedard, who also designed the earlier PADA-1 trial using fulvestrant.

Rebecca Shatsky, MD, says her approach to co-mutations depends on the specific patient in front of her, citing a steep drop-off in response across oral selective estrogen receptor degraders that leaves a significant portion of patients without benefit.

Carol Tweed, MD, and Neil Iyengar, MD, discuss how co-occurring mutations such as PIK3CA, AKT1, and TP53 complicate treatment decisions once an ESR1 mutation emerges in hormone receptor-positive, HER2-negative metastatic breast cancer.

Rebecca Shatsky, MD, describes discussing ESR1 mutation results with patients, walking them through ctDNA clonal expansion data on a Guardant360 report and explaining why treatment needs to change before disease progresses.

Natalie S. Callander, MD, discussed the rationale for combining selinexor, carfilzomib, subcutaneous isatuximab, and dexamethasone in relapsed/refractory myeloma.

Melody Rasouli, MD, MBA, FACOG, explained why male fertility preservation information trails female content online and how cancer centers can fix it.

Dan Costin, MD, explains the rationale for testing a personalized mRNA vaccine after resection of high-risk stage I NSCLC.

Paul Rubinstein, MD, discussed how cooperative groups are expanding CAR T and bispecific antibody research for patients with HIV-associated lymphoma.

Nitin Ohri, MD, MS, discusses how his team manages toxicity and treatment tolerance as combination regimens grow more complex.

Estelamari Rodriguez, MD, MPH, of Sylvester Comprehensive Cancer Center contrasts central nervous system (CNS) imaging in the phase 3 MARIPOSA and FLAURA2 studies of epidermal growth factor receptor (EGFR)-mutated advanced non–small cell lung cancer (NSCLC), noting that one scanned every patient on a set schedule while the other continued imaging mainly in patients with baseline brain metastases.