OncLive® On Air

Two Onc Docs, hosted by Samantha A. Armstrong, MD, and Karine Tawagi, MD, is a podcast dedicated to providing current and future oncologists and hematologists with the knowledge they need to ace their boards and deliver quality patient care. Dr Armstrong is a hematologist/oncologist and assistant professor of clinical medicine at Indiana University Health in Indianapolis. Dr Tawagi is a hematologist/oncologist and assistant professor of clinical medicine at the University of Illinois in Chicago.

In this episode, OncLive On Air® partnered with Two Onc Docs to provide a comprehensive review of metastatic urothelial carcinoma management, contrasting historical standards with the rapidly evolving frontline paradigm. As the field transitions into a new era of care, Drs Armstrong and Tawagi emphasized the importance of understanding trial data and toxicity management for both board preparation and clinical practice.

The discussion began with details about the historical treatment paradigm, which relied on platinum-based chemotherapy followed by maintenance avelumab for patients who did not progress. However, the experts noted that the current SOC has shifted dramatically following findings from the landmark EV-302 trial, which evaluated the combination of enfortumab vedotin and pembrolizumab.

They also explained that the toxicities associated with enfortumab vedotin plus pembrolizumab are highly testable and clinically relevant. Key adverse effects include skin toxicity and peripheral neuropathy, they said. Additionally, the hosts highlighted hyperglycemia and the risk of diabetic ketoacidosis, and emphasized that ocular toxicities, specifically dry eyes, also necessitate referrals to ophthalmology.

In the second-line setting following enfortumab vedotin plus pembrolizumab, Drs Armstrong and Tawagi noted that the paradigm unclear, though treatment options include platinum-based chemotherapy or targeted agents. They recommended testing for FGFR mutations to determine patient eligibility for erdafitinib, as well as testing for HER2 expression to determine eligibility for trastuzumab deruxtecan.

They also reported that for localized high-grade upper tract urothelial carcinoma, treatment options include neoadjuvant split-dose gemcitabine/cisplatin or upfront surgery followed by adjuvant chemotherapy. In the metastatic setting, they noted that rare disease variants like small cell carcinoma are treated with platinum doublets and immunotherapy, whereas adenocarcinoma management may require FOLFOX.

Highlights from the PER® CME activity "Show Me the Data®: From Mutation to Action—KRAS as a Therapeutic Target in PDAC" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.

In this podcast, experts E. Gabriela Chiorean, MD; Tanios S. Bekaii-Saab, MD; Mitesh Borad, MD; and Christopher Lieu, MD, discuss the evolving role of KRAS-targeted therapies in pancreatic cancer, including underlying biology, emerging clinical data, and real-world challenges in treatment selection and trial access.

Earn CME credit by completing the full accredited activity (available through May 1, 2027):
https://www.gotoper.com/sogo26pdac-activity

This podcast, including the narration, was developed by PER® (Physicians’ Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by an educational grant from Revolution Medicines.

This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

In today’s episode, we spoke with Alissa Cooper, MD. Dr Cooper is a physician at Dana-Farber Cancer Institute and an instructor in medicine at Harvard Medical School in Boston, Massachusetts. 

In our exclusive interview, Dr Cooper discussed recent advances that have reshaped the treatment paradigm for small cell lung cancer (SCLC), particularly in the relapsed setting. She highlighted the FDA approval of tarlatamab-dlle (Imdelltra), a DLL3-targeting T-cell engager, as one of the most impactful developments in recent years. Despite this progress, Cooper emphasized that the frontline standard of care has remained largely unchanged, continuing to rely on platinum-based chemotherapy in combination with immunotherapy. She noted that, although ongoing clinical trials are exploring biomarker-driven strategies and novel combinations, a more personalized first-line approach has yet to be established.

The conversation also explored real-world treatment sequencing and decision-making at the point of relapse. Cooper explained that, whenever feasible, oncologists aim to enroll patients in clinical trials or initiate treatment with tarlatamab. However, logistical barriers, including trial screening requirements and the need for monitored administration of T-cell engagers, can delay care. In cases of rapidly progressing disease, oncologists may instead turn to cytotoxic therapies such as lurbinectedin (Zepzelca) or use localized approaches like radiation to achieve faster disease control.

The importance of multidisciplinary coordination was another key theme. Cooper underscored that SCLC management requires rapid collaboration among medical oncologists, radiation oncologists, pulmonologists, pathologists, and supportive care teams. Early involvement of palliative care is also critical, given the aggressive nature of the disease and high symptom burden.

Additionally, she highlighted the essential role of oncology pharmacists, nursing teams, and structured patient education. Clear toxicity management protocols, dose-modification guidelines, and comprehensive patient education visits help ensure safe treatment delivery and empower patients to manage adverse effects.

Looking ahead, Cooper described an “embarrassment of riches” in emerging therapies and targets under investigation. Beyond DLL3, novel approaches targeting markers such as SEZ6 and B7-H3, as well as next-generation antibody-drug conjugates and trispecific T-cell engagers, are showing early promise. However, key questions remain regarding biomarker selection, treatment sequencing, and real-world effectiveness, particularly for patients who would not meet clinical trial eligibility criteria.

Finally, she emphasized that improving coordination between community and academic centers is essential to ensuring timely access to innovative therapies and clinical trials. Strengthening communication pathways and referral processes may help bridge gaps in care and improve outcomes for patients with this aggressive disease.

Highlights from the PER® CME activity "Cases and Conversations: Translating ctDNA Into Clinical Decisions in Breast Cancer" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.

In this podcast, experts Neil Iyengar, MD; Kelly Elizabeth McCann, MD, PhD; and Wassim Mchayleh, MD, MBA, FACP, discuss the clinical applications and current evidence for using circulating tumor DNA (ctDNA) testing in early-stage and metastatic breast cancer.

Earn CME credit by completing the full accredited activity (available through April 30, 2027):
https://www.gotoper.com/courses/cases-and-conversations-translating-ctdna-into-clinical-decisions-in-breast-cancer-62sc

This podcast, including the narration, was developed by PER® (Physicians’ Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by an educational grant from Natera, Inc.

This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

Breast Cancer Briefing, hosted by Sara Nunnery, MD, MSCI, a breast medical oncologist and the director of Breast Cancer Research at Tennessee Oncology in Nashville, is a podcast series that breaks down the latest news in breast cancer research, one conversation at a time.

In part 2 of this conversation, filmed live onsite at the 43rd Annual Miami Breast Cancer Conference, Dr Nunnery sat down with Irene Morae Kang, MD, an assistant professor in the Department of Medical Oncology & Therapeutics Research and the medical director of Women’s Health Medical Oncology at City of Hope Orange County in Irvine, California.

Their discussion focuses on the rapidly evolving treatment paradigm for first-line metastatic triple-negative breast cancer (TNBC), including the emergence of new data that is shifting standards of care. Dr Kang explained that TNBC is defined by the absence of estrogen, progesterone, and HER2 receptors, which historically restricted treatment options to non-targeted chemotherapy. A primary focus of the conversation was the role of PD-L1 expression and the use of immunotherapy. Dr Kang described PD-L1 as a checkpoint inhibitor protein on cancer cells that shuts off the immune system. By blocking this protein, oncologists can keep the body’s T-cells vigilant to fight the cancer. However, she noted that immunotherapy is typically reserved for the approximately 40% of patients who express PD-L1 and may be contraindicated for those with active autoimmune diseases or a history of severe immune-related toxicities.

The dialogue transitioned into the use of antibody-drug conjugates (ADCs). Dr Kang reviewed data from major trials using TROP2-targeting ADCs in the first-line setting. Dr Kang emphasized the importance of using these highly effective agents early, as many patients with TNBC do not survive to receive a second line of therapy.

Finally, Dr Kang highlighted the distinct toxicity profiles and administration schedules that guide clinical decision-making. Although sacituzumab govitecan-hziy (Trodelvy) is frequently associated with neutropenia and alopecia, the primary toxicities associated with datopotamab deruxtecan-dlnk (Dato-DXd; Datroway) are stomatitis and ocular adverse effects like dry eye. Using Dato-DXd in practice requires a rigorous prophylactic regimen, including steroid mouthwash and lubricating eye drops. Ultimately, Dr Kang noted that because efficacy appears similar between the 2 ADCs, the choice often rests on the patient’s lifestyle, their ability to adhere to preventative AE protocols, and infusion schedule preference.

Highlights from the PER® CME activity "Medical Crossfire® — From Diagnostic Dilemmas to Potential Treatment Breakthroughs: Exploring Novel Targets for Extrapulmonary Neuroendocrine Carcinomas" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.

In this podcast, experts David S. Klimstra, MD; Danielle A. Hutchings, MD; Nancy M. Joseph, MD, PhD; and Jonathan Strosberg, MD; discuss how neuroendocrine neoplasms are defined, diagnosed, and treated and why distinguishing between tumor types is critical for prognosis and therapies.

Earn CME credit by completing the full accredited activity (available through April 29, 2027):
https://www.gotoper.com/mc26epnces-activity

This podcast, including the narration, was developed by PER® (Physicians’ Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by an educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.

This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

Breast Cancer Briefing, hosted by Sara Nunnery, MD, MSCI, a breast medical oncologist and the director of Breast Cancer Research at Tennessee Oncology in Nashville, is a podcast series that breaks down the latest news in breast cancer research, one conversation at a time.

In part 2 of this conversation, filmed live onsite at the 43rd Annual Miami Breast Cancer Conference, Dr Nunnery sat down with Neil M. Iyengar, MD, an associate professor and co-director of Breast Medical Oncology in the Department of Hematology and Medical Oncology at the Emory University School of Medicine, as well as the director of Survivorship Services at the Winship Cancer Institute of Emory University in Atlanta, Georgia.

Their conversation highlighted the evolving integration of GLP-1 agonists into the breast cancer treatment armamentarium.

Two Onc Docs, hosted by Samantha A. Armstrong, MD, and Karine Tawagi, MD, is a podcast dedicated to providing current and future oncologists and hematologists with the knowledge they need to ace their boards and deliver quality patient care. Dr Armstrong is a hematologist/oncologist and assistant professor of clinical medicine at Indiana University Health in Indianapolis. Dr Tawagi is a hematologist/oncologist and assistant professor of clinical medicine at the University of Illinois in Chicago.

In this episode, OncLive On Air® partnered with Two Onc Docs to provide a comprehensive review of localized bladder cancer, covering everything from initial histology to the rapidly evolving treatment paradigms for muscle-invasive disease. Drs Armstrong and Tawagi emphasized that although urothelial carcinoma remains the most common bladder cancer histology, recognizing variants like squamous, adenocarcinoma, and small cell is vital, as they often require surgery-first approaches or specialized chemotherapy. A critical diagnostic pearl highlighted for oncology boards was the necessity of muscularis propria in the transurethral resection of the bladder tumor (TURBT) specimen. If muscle is absent, a repeat TURBT is mandatory to ensure the cancer is not under-staged. For non–muscle-invasive bladder cancer, the treatment goal is preventing recurrence and progression. Patients with high-risk disease should receive BCG induction and maintenance. For those who are BCG unresponsive, Drs Armstrong and Tawagi discussed several novel intravesical therapy options that may be preferred over systemic pembrolizumab to avoid toxicity.

The management of muscle-invasive bladder cancer (MIBC) is primarily dictated by cisplatin eligibility, which is determined by performance status, renal function, and the absence of neuropathy or hearing loss. In cisplatin-eligible patients, the phase 3 NIAGARA trial (NCT03732677) results led to a new standard of care (SOC), which is the addition of durvalumab (Imfinzi) to a gemcitabine/cisplatin backbone. Furthermore, the phase 3 KEYNOTE-B15 trial (NCT04700124) data demonstrated that neoadjuvant enfortumab vedotin-ejfv (Padcev) plus pembrolizumab (Keytruda) significantly improved overall survival compared with standard chemotherapy, though this combination is not yet the board-tested standard. For cisplatin-ineligible patients, the phase 3 EV-303 trial (NCT03924895) established neoadjuvant enfortumab vedotin plus pembrolizumab as a new SOC, replacing the previous approach of upfront cystectomy followed by adjuvant nivolumab (Opdivo).

Finally, Drs Armstrong and Tawagi discussed trimodal therapy as a bladder-sparing treatment approach. Ideal candidates for this approach must have small tumors, a complete TURBT, no hydronephrosis, and must commit to lifelong cystoscopic surveillance.