Expert Interviews

Bruce Haffty, MD, and Mutlay Sayan, MD, on building radiation oncology at Rutgers, the future of the field, and a remarkable journey from eastern Turkey to Harvard faculty.

Marcio A. Fagundes, MD, discussed disease control by risk group among 404 patients with prostate cancer treated with intensity-modulated proton therapy.

Community physicians must be “smart” when it comes to initiating outpatient care with agents like ramantamig for multiple myeloma, according to Jeffrey V. Matous, MD.

William A. Hall, MD, reviews resection rates, surgical complications, and SBRT target volumes from the SOFT Preop study in pancreatic cancer.

Andy Liao, MD, discusses the distribution of KRAS mutations in biliary tract cancer and the different classes of KRAS inhibitors in development.

William A. Hall, MD, explains how fewer visits, no concurrent chemotherapy, and adaptive MRI guidance may have preserved quality of life with SBRT.

William A. Hall, MD, discussed how preoperative SBRT may serve as a platform for novel systemic therapies in pancreatic adenocarcinoma.

The panel discusses the clinical and practical considerations surrounding the introduction of gedatolisib for patients with hormone receptor-positive, HER2-negative metastatic breast cancer (HR+/HER2− mBC), with particular emphasis on its mechanism, toxicity profile, intravenous administration, and patient education.

This episode addresses central nervous system metastases, which the panel notes may affect nearly half of patients with HER2-mutant non–small cell lung cancer.

The panel examines the VIKTORIA-1 study and its implications for treatment selection in hormone receptor-positive, HER2-negative metastatic breast cancer (HR+/HER2− mBC) after CDK4/6 inhibitor therapy.

This episode focuses on the safety profile of zongertinib and what it takes to keep patients on therapy.

Chih-Yi “Andy” Liao, MD, discusses early clinical data for KRAS G12C and G12D inhibitors in cholangiocarcinoma, noting that trials are just getting started.

Closing the program, Surbhi Sidana, MD, asks each panelist what has changed most in her practice this year.

Surbhi Sidana, MD, presents 2 practical scenarios: a patient 6 to 7 weeks post-infusion who develops a fever at a local emergency department 4 hours from the treating center, and a patient around 7 to 8 weeks post-infusion who develops facial droop, drooling, and behavioral changes noticed by a spouse.

Surbhi Sidana, MD, asks about 2 less common but important delayed toxicities: delayed neurotoxicity and immune effector cell enterocolitis.

Doris Hansen, MD, and Prerna Mewawalla, MD, discuss long-term monitoring, infection prophylaxis, and vaccination after ciltacabtagene autoleucel (cilta-cel) therapy for patients with multiple myeloma.

Day 28 after ciltacabtagene autoleucel (cilta-cel) infusion marks an important transition for patients with multiple myeloma from center-led care to shared care with the community oncology team.

Timing referral for chimeric antigen receptor (CAR) T-cell therapy is critical when patients with multiple myeloma experience relapse or progressive disease.

Effective community referral pathways can improve access to chimeric antigen receptor (CAR) T-cell therapy for patients with multiple myeloma.

Doris Hansen, MD, and Prerna Mewawalla, MD, discuss ciltacabtagene autoleucel manufacturing, disease debulking, and bridging therapy before CAR T-cell infusion in patients with multiple myeloma.

Referral barriers can limit access to chimeric antigen receptor (CAR) T-cell therapy for patients with multiple myeloma.

Dr. Joshua Richter reviews the EXCALIBER-RRMM study evaluating iberdomide in combination with daratumumab and dexamethasone in patients with relapsed/refractory multiple myeloma.

The faculty consider what level of follow-up they consider meaningful for a one-time therapy, pointing to the International Myeloma Working Group consensus benchmark of sustained minimal residual disease (MRD) negativity with imaging negativity.

Cancer Network’s FACE-OFF introduces the evolving role of cereblon E3 ligase modulators, or CELMoDs, in relapsed/refractory multiple myeloma.

The program opens with panelist introductions and an overview of ciltacabtagene autoleucel (ciltacel), a BCMA-directed autologous CAR T-cell therapy given as a single infusion and approved for adults with relapsed or refractory multiple myeloma who have received at least 1 prior line of therapy, including a proteasome inhibitor and an immunomodulatory agent, and are refractory to lenalidomide.

Dr. Thomas Martin presents the final and most challenging case: an older patient being evaluated for BCMA-directed therapy after progression on prior anti-CD38 therapy, with baseline neuropathy, mild gait instability, recurrent infections, and significant caregiver concern about neurologic toxicity, infection, and logistics.

Dr. Thomas Martin presents the second case: a younger, fit, lenalidomide-refractory patient with biochemical and radiologic progression after frontline therapy who is relatively asymptomatic with controlled disease burden and is an appropriate candidate for either CAR T-cell or bispecific therapy, with no urgency to treat.

Dr. Thomas Martin introduces the third section, a rapid case-based discussion applying the program's themes to real-world scenarios, and presents the first case: a fit, transplant-exposed patient progressing on lenalidomide maintenance with rapidly progressive, symptomatic, high-risk disease requiring prompt intervention.

The face-off debate continues with the second and third questions, moderated by Dr. Thomas Martin.

Dr. Thomas Martin opens the second section, the face-off debate, and introduces the first debate question on how clinicians should approach treatment selection between CAR T-cell therapy and bispecific antibody-based approaches in second-line disease.