Here’s a practical guide on how biomarkers can guide treatment and cut costs for your breast cancer patients. In this episode of the BackTable Tumor Board Podcast, Dr. Lindsay Peterson and Dr. Jessica Trevino Jones review the role of precision medicine and biomarkers in early-stage and metastatic disease, specifically in breast cancer.

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https://www.backtable.com/app

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Timestamps

00:00 - Introduction
05:30 - Genomic Testing in the Metastatic Setting
11:47 - Liquid vs Tissue Biopsy
17:51 - Testing and Treatment for Triple Negative Metastatic Breast Cancer
21:20 - Precision Medicine and Patient Education
27:01 - Path CR and Residual Disease: Clinical Trials
37:01 - Neratinib in Triple Positive Breast Cancer and Brain Metastasis
39:55 - Genomic Tests: Oncotype and MammaPrint
43:45 - Importance of Clinical Trials and Wellness Support

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More about this episode

Dr. Peterson and Dr. Trevino Jones discuss the optimal timing for tumor genomic testing in ER-positive/HER2-negative and triple-negative metastatic breast cancer, and examine the decision-making process between liquid biopsy and tissue biopsy for biomarker analysis. The conversation also highlights how these technological advances can expand treatment options and help reduce financial toxicity for patients. Additionally, the doctors emphasize the importance of patient education about clinical trials, address common misconceptions, and discuss the integration of prevention, nutrition, exercise, and wellness support into comprehensive cancer care.

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Resources

OFSET Clinical Trial
https://clinicaltrials.gov/study/NCT05879926

SWOG 2206 Clinical Trial
https://www.swog.org/clinical-trials/s2206

Pembrolizumab vs. Observation in People With Triple-negative Breast Cancer Who Had a Path CR
https://clinicaltrials.gov/study/NCT05812807

KETNOTE-522 Clinical Trial
https://clinicaltrials.gov/study/NCT03036488
https://www.nejm.org/doi/full/10.1056/NEJMoa1910549

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BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

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How will the newest colorectal cancer trial results discussed at the 2026 ASCO GI Cancers Symposium in San Francisco impact patient care and therapeutic strategies? Medical oncologists Dr. Shruti Patel and Dr. Jun Gong dissect evidence from multiple practice-changing studies, translating complex data into practical recommendations.

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Timestamps

00:00 - Introduction
01:50 - BREAKWATER Trial for Metastatic CRC
11:31 - COMMIT Trial for Metastatic CRC dMMR
17:34 - STELLAR-303 Trial for Refractory CRC
26:03 - ALASCCA Trial on Adjuvant Low Dose Aspirin in CRC
31:29 - CHALLENGE Trial on Structured Exercise Programs
38:48 - ATOMIC Trial on Adjuvant Immunotherapy
44:34 - The Role of GLP-1s in CRC Prevention

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More about this episode

Dr. Patel and Dr. Gong cover key findings and takeaways from recent colorectal cancer studies, including BREAKWATER, COMMIT, STELLAR-303, ALASCCA, CHALLENGE, and ATOMIC.

BREAKWATER evaluates first-line targeted therapy combinations in BRAF V600E–mutant metastatic CRC, demonstrating improved response rates and progression-free survival with the addition of encorafenib-based regimens.

COMMIT investigates the role of immunotherapy with or without chemotherapy in dMMR metastatic CRC, helping clarify whether upfront chemotherapy adds benefit to checkpoint blockade in this population.
STELLAR-303 examines a novel therapeutic option in refractory CRC, comparing a new agent against standard therapies and showing modest survival benefit in heavily pretreated patients.

ALASCCA assesses the impact of adjuvant low-dose aspirin in biomarker-selected CRC patients, suggesting improved disease-free survival in patients with PI3K pathway alterations.

CHALLENGE evaluates structured exercise interventions in the post-treatment setting, demonstrating that increased physical activity is associated with improved disease-free survival and overall outcomes.
ATOMIC explores the addition of immunotherapy to standard adjuvant chemotherapy in resected dMMR CRC, supporting a potential shift toward incorporating checkpoint inhibitors in earlier-stage disease.

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Resources

BREAKWATER Trial Cohort 3 Study
https://ascopubs.org/doi/10.1200/JCO.2026.44.2_suppl.13

COMMIT Phase 3 Trial
https://ascopubs.org/doi/10.1200/JCO.2026.44.2_suppl.14

STELLAR-303 Phase 3 Trial
https://pubmed.ncbi.nlm.nih.gov/41130252/

Immunotherapy Efficacy in Mismatch Repair-Proficient Colorectal Cancer Patients With and Without Liver Metastases
https://ascopubs.org/doi/10.1200/JCO-25-01044

ALASCCA Trial
https://clinicaltrials.gov/study/NCT02647099?tab=study
CHALLENGE Phase 3 Trial

https://ascopubs.org/doi/10.1200/JCO.2025.43.17_suppl.LBA3510
Regular Physical Activity Can Help Manage CRC-Related Fatigue
https://dailynews.ascopubs.org/do/regular-physical-activity-can-help-manage-crc-related-fatigue

ATOMIC Phase 3 Trial
https://ascopubs.org/doi/10.1200/JCO.2025.43.17_suppl.LBA1

GLP-1 Receptor Agonist vs Aspiring for Primary Prevention of Colorectal Cancer
https://ascopubs.org/doi/10.1200/JCO.2026.44.2_suppl.18

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BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Don’t miss the “curative window”! This episode takes a closer look at how evolving perioperative strategies and biomarker integration are changing bladder cancer care, with a focus on preserving opportunities for cure. Jun Gong hosts Tyler Stewart to review key bladder cancer updates from ASCO Genitourinary Cancers Symposium 2026.

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Timestamps

00:00 - Introduction
01:50 - KEYNOTE-905 Overview
07:09 - Practice-Changing Takeaways
13:28 - Bladder Preservation Trials
16:06 - ctDNA Biomarker Updates
21:16 - Using ctDNA in Clinic
28:48 - Metastatic ADC Data
33:36 - Wrap-Up

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More about this episode

The discussion begins with KEYNOTE-905/EV-303 in cisplatin-ineligible muscle-invasive bladder cancer, where perioperative enfortumab vedotin plus pembrolizumab demonstrated improvements in event-free and overall survival. This is followed by KEYNOTE-B15, which compares perioperative EVP with gemcitabine/cisplatin and identifies EVP as the first non-platinum regimen to outperform cisplatin-based therapy. Implications for clinical adoption are considered, including the potential for EVP to extend across cisplatin eligibility groups, unresolved questions regarding perioperative duration and adjuvant use, and the need to avoid premature de-escalation outside of trial settings.
The latter portion of the episode focuses on biomarker-driven decision-making. Data from RETAIN-2 highlight the prognostic value of post-neoadjuvant ctDNA positivity for systemic relapse risk, while underscoring its limitations in detecting intravesical recurrence. Complementary findings from NIAGARA suggest that urine tumor DNA may more accurately reflect local disease burden and pathologic complete response. Together, these studies frame an evolving role for circulating and urine-based biomarkers in guiding surveillance, treatment selection, and timing—central considerations in maintaining the curative window.

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Resources

KEYNOTE-B15
https://ascopubs.org/doi/10.1200/JCO.2026.44.7_suppl.LBA630

KEYNOTE-905
https://www.nejm.org/doi/abs/10.1056/NEJMoa2511674

EV-302 Clinical Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2312117

When to test, how to prevent, and what you need to know about hereditary gynecologic cancer syndromes. Two USC gynecologic oncologists, Dr. Mona Guo and Dr. Marcia Ciccone, go in-depth in this BackTable OBGYN x Tumor Board crossover episode.

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Timestamps

00:00 - Introduction
01:37 - Why Hereditary Cancer Matters
04:51 - Family History Red Flags
09:01 - Who Should Order Genetic Testing
11:32 - Variants and Counseling Pitfalls
13:30 - Access and Remote Testing Options
19:27 - BRCA1 Positive Patient Walkthrough
24:52 - Risk-Reducing Surgeries
29:11 - Prevention and Screening Limits
32:38 - Why Ovarian Cancer Is Hard
34:04 - Combining Breast and Gyn Surgery
35:41 - Preop Ultrasound and CA-125
36:27 - BRCA Timing and HRT Nuance
42:32 - Nonhormonal Menopause Options
47:14 - Lynch Syndrome Screening Basics
54:22 - Endometrial Biopsy Debate
56:43 - Insurance and Coverage Pitfalls
59:00 - Fertility Preservation and REI
01:01:41 - Cascade Testing
01:02:45 - Conclusion

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More about this episode

Dr. Guo and Dr. Ciccone discuss how careful family history can identify patients who may benefit from genetic evaluation and highlight key red flags, including a family history of ovarian cancer, breast cancer at age 50 or younger, and metastatic prostate cancer. They explain the role of genetic counseling, including pre- and post-test discussions and how to approach variants of uncertain significance. They then cover BRCA counseling and risk-reduction strategies, including the timing of risk-reducing bilateral salpingo-oophorectomy, ongoing salpingectomy trials, and considerations for hysterectomy. Additionally, they touch on pathology protocols, breast cancer screening, and the potential protective effect of hormonal contraception.

The doctors address the limitations of ovarian cancer screening and outline patterns suggestive of Lynch syndrome, such as endometrial cancer occurring alongside gastrointestinal or urinary tract cancers. They review the Lynch workup, including tumor mismatch repair immunohistochemistry and MLH1 hypermethylation testing. Finally, they discuss practical considerations like barriers to access, Medicare coverage challenges, fertility preservation referrals, menopause management, and cascade testing in families, including the timing of testing in children.

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Resources

NCCN Guidelines: Detection, Prevention, and Risk Reduction
https://www.nccn.org/guidelines/category_2

Antibody-drug conjugates (ADCs) are expanding treatment options in breast cancer, but their use requires careful attention to toxicity. In this episode of the BackTable Tumor Board Podcast, Dr. Kate Baker and Dr. Sara Nunnery review the role of ADCs in HER2-positive disease and their growing application in HER2-low and HER2-ultralow metastatic settings.

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Timestamps

00:00 - Introduction
01:46 - How ADCs Work
08:40 - ILD Risk and Monitoring
13:46 - Next-Generation HER2 ADCs
24:14 - HER2-Low and Ultralow Disease
29:56 - Sequencing After Endocrine Therapy
33:42 - Future Targets and Bispecifics
38:08 - Wrap Up

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More about this episode

The discussion outlines ADC mechanisms and recent trial-driven shifts in clinical practice, with emphasis on interstitial lung disease (ILD) risk, monitoring, and patient counseling. They address practical considerations including patient selection, sequencing after endocrine therapy, and potential maintenance approaches. Additional topics include evolving pathology reporting, considerations for earlier-stage use in high-risk patients, and the development of next-generation HER2- and HER3-targeted ADCs, as well as bispecific therapies.

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Resources

DESTINY Breast 09
https://www.nejm.org/doi/full/10.1056/NEJMoa2508668

DESTINY Breast 05
https://www.nejm.org/doi/full/10.1056/NEJMoa2514661

DESTINY Breast 06
https://www.nejm.org/doi/abs/10.1056/NEJMoa2407086

When standard-of-care checkpoint blockade fails in metastatic melanoma, how can oncologists and interventional radiologists join forces to turn around patient outcomes? In this episode of the BackTable Podcast, medical oncologist Dr. Jennifer McQuade and interventional radiologist Dr. Rahul Sheth join host Dr. Tyler Sandow to discuss the growing evidence for intratumoral oncolytics as a therapeutic strategy for frontline immunotherapy-refractory melanoma and the interdisciplinary work that is required for successful implementation in practice.

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This podcast is supported by:
Replimune
https://www.replimune.com/

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SYNPOSIS

The physicians review how engineered viral vectors, particularly RP1, complement checkpoint blockade through direct tumor lysis and immune activation, and summarize the IGNYTE trial data supporting their use in patients with metastatic melanoma refractory to anti-PD-1 and anti-CTLA-4 agents. The discussion then shifts to practical administration, highlighting the central role of interventional radiology in delivering these therapies to visceral and deep-seated lesions under image guidance. The doctors go on to address the nuances of patient and lesion selection, injection technique, and response assessment, including the importance of recognizing pseudo-progression. They place particular emphasis on the need for multidisciplinary collaboration and stakeholder buy-in efforts on the part of IRs seeking to integrate intratumoral oncolytic injections into their scope of practice. The episode concludes with a forward-looking discussion on the potential for expansion of oncolytic platforms into other solid tumors, underscoring this field as a growing, IR-forward frontier in cancer treatment.

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TIMESTAMPS

00:00 - Introduction
02:28 - Immunotherapy Basics
06:51 - How Oncolytic Viruses Work
11:01 - IGNYTE Trials and Why IR Matters
18:14 - T-VEC vs RP1 Indications and Logistics
21:57 - Physician Communication and Multidisciplinary Treatment
23:06 - RP1 Protocol and Administration Techniques
30:28 - RP1 Safety Profile
32:46 - Follow-Up Imaging and Response Assessment
35:44 - Future Applications Beyond Melanoma
41:42 - Final Thoughts and Closing Remarks

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RESOURCES

Wong MK, et al. RP1 Combined With Nivolumab in Advance Anti-PD-1-Failed Melanoma (IGNYTE). J Clin Oncol. 2025;43(33):3589-3599.
https://doi.org/10.1200/jco-25-01346

IGNYTE-3 Trial
https://clinicaltrials.gov/study/NCT06264180

Though relatively new, there is a rapidly growing interest in the field of therapeutic radiopharmaceuticals and their potential to play a significant role in cancer treatment. This episode of BackTable Tumor Board covers recent developments in radiopharmaceutical therapies with radiation oncologists Dr. Dustin Boothe and Dr. Ryan Funk, where they discuss efficacy, side effects, and better tolerability of modern radiopharmaceuticals compared to older ones.

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This podcast is supported by:

Siemens Healthineers

https://cancercare.siemens-healthineers.com/products/software/digital-oncology/aria-core-for-theranostics

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SYNPOSIS

Dr. Boothe and Dr. Funk cover the roles of radiation oncologists in treating patients and collaborating with different specialists, the challenges in starting a radiopharmaceutical program, and the importance of having an authorized user and radioactive materials license. They also delve into the promising future of radiopharmaceuticals, emphasizing potential advancements such as personalized dosimetry, new indications, and combination therapies.

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TIMESTAMPS

00:00 - Introduction
02:54 - Understanding Radiopharmaceutical Terminology
04:40 - The Evolution of Radiopharmaceuticals
07:07 - The Rise of Targeted Radiopharmaceutical Therapies
12:35 - Radiation Oncologists’ Role in Systemic Therapy
23:55 - Challenges and Strategies in Practice Development
30:33 - Starting Up a Radiopharmaceutical Practice: Challenges, Authorized Users & RAM Licensing
37:47 - Advancing Practices with Clinical Trials and Dosimetry
44:48 - Future of Radiopharmaceutical Therapy
52:39 - Final Thoughts

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RESOURCES

Siemens Healthineers: ARIA CORE for Theranostics
https://cancercare.siemens-healthineers.com/products/software/digital-oncology/aria-core-for-theranostics

PREEMPT Trial (NRG-CC014)
https://clinicaltrials.gov/study/NCT06745024#collaborators-and-investigators

Community Theranostics
https://www.communitytheranostics.com/

Inflammatory breast cancer (IBC) is rare but highly aggressive, and often hides in plain sight. Rather than presenting as the distinct lump, IBC typically appears as redness or swelling in the breast and skin changes that can mimic mastitis or infection, leading to dangerous delays in diagnosis. In this episode of BackTable Tumor Board, breast medical oncologists Dr. Lindsay Peterson and Dr. Bora Lim break down how to recognize IBC’s typical and atypical presentations, approach diagnostic workup, and tailor treatment across subtypes.

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SYNPOSIS

Dr. Peterson and Dr. Lim explore evolving neoadjuvant strategies, emerging clinical trials, combination therapies, IBC vaccine development, and the growing role of AI and MRI pattern recognition in predicting recurrence and guiding surveillance. The discussion highlights the importance of multidisciplinary expertise and calls for broader clinician awareness–especially in primary care, dermatology, and urgent care–so that persistent “infection-like” breast changes prompt timely evaluation and treatment for IBC.

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TIMESTAMPS

0:00 - Introduction
3:26 - Typical Presentations of Inflammatory Breast Cancer (IBC)
8:30 - Atypical Presentations of IBC
11:48 - Routine Diagnostic Workup
16:06 - Treatments for Different Subtypes of IBC
19:49 - Clinical Trials
22:53 - Surveillance for Different Stages of IBC
25:59 - Current Clinical Trials for Best Treatments
29:18 - Central Nervous System Recurrence and Other Relapse Patterns in IBC
33:29 - Novel Neoadjuvant Therapy
37:27 - Centers Dedicated to Treating IBC
42:13 - Final Thoughts

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RESOURCES

Atezolizumab, Cobimetinib, and Eribulin in Treating Patients With Chemotherapy Resistant Metastatic Inflammatory Breast Cancer
https://clinicaltrials.gov/study/NCT03202316?tab=researcher#study-record-dates

Dana-Farber Cancer Institute
https://www.dana-farber.org/cancer-care/treatment/breast-oncology/programs/inflammatory-breast-cancer

MD Anderson Inflammatory Breast Cancer Clinic
https://www.mdanderson.org/patients-family/diagnosis-treatment/care-centers-clinics/breast-center/inflammatory-breast-cancer-clinic.html

In a patient with metastatic HER2-positive breast cancer, what should guide the next decision: trial data, toxicity, or durability of response? In this episode of BackTable Tumor Board, Dr. Lindsay Peterson (Washington University) sits down with Dr. Erica Hamilton (Sarah Cannon Research Institute) to examine how next-generation HER2-directed therapies are reshaping the management of metastatic disease. As treatment options expand beyond trastuzumab-based regimens to agents such as trastuzumab deruxtecan and tucatinib, clinical decision-making increasingly hinges on sequencing strategy, interpretation of evolving trial data, and thoughtful toxicity management.

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SYNPOSIS

The discussion integrates findings from pivotal studies including DESTINY-Breast09 and PATINA, highlighting how these data influence frontline and maintenance approaches. Dr. Hamilton outlines practical considerations in balancing depth and durability of response with quality-of-life concerns, and how she approaches therapy transitions in real-world practice. The episode also explores the management of CNS involvement within the broader systemic treatment landscape and considers whether current advances meaningfully shift long-term outcomes for patients with HER2-positive metastatic breast cancer.

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TIMESTAMPS

00:00 - Introduction
01:16 - Metastatic HER2-Positive Breast Cancer
06:46 - Treatment Strategies and Patient Management
11:57 - Maintenance Therapy Options
16:28 - HER2-Positive Breast Cancer Trials
20:13 - Brain Metastases and Systemic Therapy
27:38 - Future Directions in HER2-Positive Breast Cancer

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RESOURCES

DESTINY-Breast09 Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2508668

PATINA Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2511218

HER2CLIMB Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1914609

Bispecific antibodies are emerging as an important therapeutic class in non-small cell lung cancer (NSCLC); but how do they work, where do they fit in clinical practice, and what should oncologists be thinking about next? In this episode of Back Table Tumor Board, Dr. Kate Baker and Dr. Wade Iams from Tennessee Oncology answer these questions and more.

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SYNPOSIS

Dr. Baker and Dr. Iams discuss the evolving role of bispecific antibodies in NSCLC, covering the clinical data behind amivantamab, the practical benefits of subcutaneous vs IV administration, and key considerations for managing unique bispecific-related toxicities in real-world practice. This episode also explores emerging data in NSCLC, highlighting tarlatamab and its promising results in various treatment scenarios, including potential earlier-stage applications.

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TIMESTAMPS

00:00 - Introduction
01:14 - Recent Developments in Bispecific Antibodies
03:24 - Real-World Application of MARIPOSA Trial Data
04:28 - Managing Toxicities and Side Effects
06:28 - CNS Disease and Efficacy of Combination Therapy
08:26 - Counseling Patients on Prognosis and Treatment Options
12:45 - Challenges in Rolling Out New Treatments in Rural Areas
18:21- Future Directions in Non-Small Cell Lung Cancer
20:57 - BiTE Therapies in Small Cell Lung Cancer
35:00 - Final Thoughts

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RESOURCES

MARIPOSA Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2503001

FLAURA2 Trial
http://pubmed.ncbi.nlm.nih.gov/37937763/

COPERNICUS Trial
https://clinicaltrials.gov/study/NCT06667076

DeLLphi-304 Trial
https://clinicaltrials.gov/study/NCT05740566?tab=results