Expert Interviews

Dwight H. Owen, MBBCh, MS, discussed why severe immune-related toxicities remain hard to predict as immunotherapy combinations expand in lung cancer.

Mingjia Li, MD, discussed the limitations of current biomarkers in selecting patients with resectable NSCLC for neoadjuvant chemoimmunotherapy.

Black women die from breast cancer at rates 40% higher than white women — and are still missing from the trials that could help. Dr. Coral Omene on why.

Dirk Schadendorf, MD, reviewed final STARBOARD data for encorafenib, binimetinib, and pembrolizumab in first-line BRAF V600–mutant melanoma.

Zev A. Wainberg, MD, MSc, discussed why neither the first-line regimen nor the second-line chemotherapy comparator altered the benefit seen with daraxonrasib in RASolute 302.

The faculty consider how to apply belantamab mafodotin in community practice, where clinicians typically see fewer patients with myeloma and want clear guidance and quick decisions. They discuss the therapy options available to patients and how access and distance from an academic center may shape the choice. They note that antibody-drug conjugates are familiar from other cancers, such as solid tumors and lymphomas, and proceed to describe an approach of assessing response and eye side effects after the first doses and then delaying or spacing doses as needed if the patient is responding to treatment.

Matthew Lee, MD, shares his key takeaway from the first disclosure of BG-C477 data in advanced NSCLC.

Matthew Lee, MD, discusses how confident he is that CEACAM5 expression will hold up as a biomarker for BG-C477 in NSCLC.

The panelists discuss how a beta blocker for atrial fibrillation affects baseline cardiac assessment, stressing the QTcF and frequent EKGs when starting revumenib.

One panelist reassures a responding patient whose dose is held that benefit does not depend on every-3-week dosing and that the eye has the ability to heal on its own, noting that patients at longer intervals in the study maintained benefit, some doing better by staying on treatment longer.

The moderator and the panelists then discuss how to prepare the patient for the first cycles.

Wade T. Iams, MD, of Tennessee Oncology, says the stability of skin toxicity rates across 8.3 months of COPERNICUS follow-up, with 86% of participants still on study, gives him the most confidence in subcutaneous amivantamab plus lazertinib, and the near elimination of infusion reactions carries the most weight.

The moderator presents Clinical Scenario 2, a 34-year-old woman with relapsed KMT2A-rearranged AML who has controlled paroxysmal atrial fibrillation, takes posaconazole, and has small children at home.

Data from the real-world CEMI-LUNG evaluating cemiplimab in advanced NSCLC were consistent with reports from the EMPOWER-Lung1 study.

At Big Ten CRC, Patricia A. Robinson, MD, discussed institutional and cooperative group strategies that have improved representation in oncology clinical trials.

Jesus Corral Jaime, MD, reviews real-world survival and response data for cemiplimab monotherapy from the CEMI-LUNG study.

At the Big Ten CRC Summit, VK Gadi, MD, PhD, explained why functional drug testing and genomic profiling should be used together in oncology.

Moshe C. Ornstein, MD, MA, of Cleveland Clinic says clinicians cannot yet predict which patient with advanced renal cell carcinoma (RCC) will respond better to dual immune checkpoint blockade or to immunotherapy plus a tyrosine kinase inhibitor (TKI), in a discussion moderated by Elizabeth R. Plimack, MD, MS, of Fox Chase Cancer Center.

Dr. Saad Usmani and Dr. Shaji Kumar conclude the discussion by considering how the CEPHEUS findings may be applied to individual patients with newly diagnosed multiple myeloma.

Siddhartha Devarakonda, MD, of Providence Swedish Cancer Institute says he tries not to push patients with asymptomatic brain metastases from epidermal growth factor receptor (EGFR)-mutated advanced non–small cell lung cancer (NSCLC) toward local therapy, calling whole brain radiation the wrong step for this patient and noting that another consultation costs the patient time.

Dr. Saad Usmani and Dr. Shaji Kumar discuss how sustained MRD negativity and long-term progression-free survival may inform future treatment strategies for patients with newly diagnosed multiple myeloma.

Estelamari Rodriguez, MD, MPH, of Sylvester Comprehensive Cancer Center presents a 68-year-old woman with newly diagnosed metastatic lung adenocarcinoma, an epidermal growth factor receptor (EGFR) exon 19 deletion with a concurrent TP53 co-mutation, multiple small asymptomatic brain metastases on staging magnetic resonance imaging, disease confined to lung and brain, and good performance status with support at home.

Elizabeth R. Plimack, MD, MS, of Fox Chase Cancer Center opens this CancerNetwork Training Academy discussion on first-line treatment decisions in advanced renal cell carcinoma (RCC) with Terence W. Friedlander, MD, of UCSF Helen Diller Family Comprehensive Cancer Center, and Moshe C. Ornstein, MD, MA, of Cleveland Clinic.

Pope Leo XIV’s lung adenocarcinoma diagnosis may increase awareness and combat stigma surrounding lung cancer screening.

Helena A. Yu, MD, discusses the background of REZILIENT3 and her key takeaways on zipalertinib in EGFR exon 20-mutated NSCLC.

Oana Danciu, MD, explained why phase 1 breast cancer trials are moving earlier in the treatment course and how disease stability guides patient selection.

The faculty turn to the safety and practical aspects of using belantamab mafodotin, drawing on earlier experience with the drug. They discuss how lines of therapy are defined and whether the definition needs refinement, and how efficacy endpoints translate into clinical relevance. Health-related quality of life is reviewed, with the view that good disease control is a driver of better quality of life. The panel describes holding the drug for eye symptoms, restarting at a lower dose, and adjusting dosing frequency to keep responding patients on therapy. They also note the overall response rate and MRD negativity in the study and discuss their interpretation of the data.

The panelists describe the first 6 weeks for this patient, including twice-weekly labs, weekly EKGs early on, and which checks can be done locally vs at the academic center.

The moderator asks whether any of the patient’s baseline comorbidities from the clinical scenario in the previous episode are a concern.

Luis E. Raez, MD, of Miami Cancer Institute, reports that with extended COPERNICUS follow-up, rash in the first 4 months of subcutaneous amivantamab plus lazertinib was lower than in MARIPOSA, similar across age groups, and less often grade 2 or higher, with lower cumulative incidence by 1 year.