OncLive® On Air

In today’s episode, we spoke with Anthony Chi, MD, a staff pathologist; Monica Peravali, MD, a medical oncologist; and Archana Jadhav, MD, a medical oncologist, all faculty at the Mid-Atlantic Permanente Medical Group in Maryland. 

In our exclusive interview, Drs Chi, Peravali, and Jadhav discussed the practical advantages and clinical implications of implementing in-house next-generation sequencing (NGS) testing for patients with non–small cell lung cancer (NSCLC). The conversation focused on how internal molecular testing platforms can improve turnaround times, optimize tissue stewardship, reduce costs, and enhance quality control across the diagnostic and treatment continuums.

Chi explained that performing NGS internally eliminates delays associated with specimen transportation and external laboratory accessioning, significantly shortening turnaround times. He also highlighted Kaiser Permanente’s decision to implement a molecular platform distinct from those commonly used by outside vendors, allowing for reduced tissue input requirements and faster processing times. According to Chi, internal testing also gives pathology teams greater oversight of specimen use, enabling more strategic tissue conservation for future immunohistochemical (IHC) staining, repeat molecular analyses, or additional biomarker testing.

The panel emphasized the importance of close coordination between pathology and oncology teams in maximizing tissue adequacy, particularly in small biopsies and cytology specimens. Chi described educational initiatives implemented within pathology departments to encourage judicious use of IHC stains and preserve tissue for downstream molecular testing. He also outlined specimen-handling workflows in which tissue is divided into separate cassettes to prioritize molecular analysis and still supporting diagnostic evaluation.

Jadhav discussed the oncologist’s role in ensuring adequate tissue acquisition, emphasizing proactive communication with pathologists and interventional radiologists. She noted that when clinicians anticipate limited tissue yield, such as in pleural fluid cytology specimens, they often promptly arrange additional biopsies to avoid delays in treatment initiation and ensure comprehensive genomic profiling can be completed efficiently.

The discussion also addressed optimal timing for comprehensive genomic profiling in NSCLC. Peravali explained that Kaiser Permanente routinely performs NGS across all disease stages, including early-stage disease, due to increasing use of neoadjuvant chemoimmunotherapy approaches and the need to identify actionable biomarkers that may influence treatment selection. Although in-house testing serves as the primary platform, she noted that send-out testing remains important in select situations, including cancers of unknown primary origin, clinical trial enrollment, and discordant or clinically suspicious cases requiring additional confirmation.

As molecular reports become increasingly complex, the panel highlighted the importance of interpreting co-mutations, variants of unknown significance, and emerging biomarkers within a broader clinical context. Peravali explained that although variants without current therapeutic relevance may not immediately affect treatment decisions, repeat biopsies and serial NGS at disease progression can reveal newly actionable alterations as therapeutic options evolve.

Chi further emphasized the growing importance of newly approved biomarkers, including HER2 and c-MET alterations, in NSCLC. He described how pathology teams actively monitor FDA approvals and National Comprehensive Cancer Network (NCCN) guideline updates to identify new therapeutic opportunities for previously profiled patients. In some cases, archived tumor specimens are revisited for additional IHC testing when emerging therapies become clinically relevant.

The conversation also highlighted the value of multidisciplinary collaboration and tumor board discussions in complex diagnostic scenarios. The speakers described how integrated molecular analysis can help distinguish separate primary lung tumors from metastatic disease, resolve diagnostically challenging cases involving uncommon metastatic presentations, and support more confident staging and treatment decisions.

Finally, the panel underscored that successful implementation of precision oncology workflows depends on seamless collaboration among pulmonologists, pathologists, oncologists, interventional radiologists, and molecular laboratories. Early test ordering, centralized communication systems, and multidisciplinary case review were identified as key components of efficient, patient-centered care that can accelerate diagnosis and improve treatment planning for patients with lung cancer.

From Discovery to Delivery: Charting Progress in Gynecologic Oncology, hosted by Ursula A. Matulonis, MD, brings expert insights into the most recent breakthroughs, evolving standards, and emerging therapies across gynecologic cancers. Dr Matulonis is chief of the Division of Gynecologic Oncology and the Brock-Wilson Family Chair at the Dana-Farber Cancer Institute, as well as a professor of medicine at Harvard Medical School, both in Boston, Massachusetts.

In this episode, Dr Matulonis was joined by Meghan E. Shea, MD, an attending medical oncologist and ambulatory medical director and disease program leader for medical oncology at Beth Israel Deaconess Medical Center in Boston. Together, they explored the current landscape of cervical cancer, from the urgent need for expanded vaccination and screening to the evolving role of immunotherapy and antibody-drug conjugates (ADCs) across disease settings.

Dr Shea opened by addressing the epidemiology of cervical cancer, noting that despite decades of progress, rates are now plateauing and rising among women under 50 years of age. She identified 3 interrelated drivers of this trend: declining rates of routine gynecologic screening, inconsistent uptake of human papillomavirus (HPV) vaccination, and persistent high-risk HPV infections, particularly HPV 16 and 18, which are responsible for most cases. 

The conversation then turned to the effect of immunotherapy on cervical cancer treatment. Dr Shea traced the evolution of pembrolizumab (Keytruda) from its initial 2018 approval as a single agent in recurrent/metastatic disease to its more recent integration into the frontline setting. The phase 3 KEYNOTE-A18 trial (NCT04221945) demonstrated that adding pembrolizumab to standard weekly cisplatin-based chemoradiation significantly improved outcomes for patients with locally advanced disease. Although responses to immunotherapy, when they occur, are often durable, Dr Shea acknowledged that response rates remain lower than anticipated for a virally driven malignancy, underscoring the need for novel combinations and a deeper understanding of resistance mechanisms. Drs Matulonis and Shea both agreed that immunotherapy combined with ADCs represents one of the most compelling directions for the field, with phase 2 data for sacituzumab tirumotecan plus pembrolizumab generating interest ahead of anticipated phase 3 results.

On the ADC front, Dr Shea reviewed the 2 agents in this class that are currently FDA-approved for cervical cancer. Tisotumab vedotin-tftv (Tivdak) offers the advantage of biomarker-independent use, though its requirement for ophthalmologic monitoring at every treatment visit creates real-world access challenges outside major academic centers. Trastuzumab deruxtecan-nxki (Enhertu), approved in the HER2 immunohistochemistry 3+ setting based in part on the results of the phase 2 DESTINY-PanTumor02 trial (NCT04482309), has generated robust response rates but is most likely to benefit patients with adenocarcinoma. Dr Shea also highlighted additional targets under investigation, including Trop-2, Nectin-4, and B7-H4, with multiple phase 3 trials ongoing in both the frontline and recurrent settings.

The discussion closed with a look at the locally advanced disease landscape, where the NRG Oncology cooperative group is conducting a phase 3 trial to evaluate whether integrating the neoadjuvant carboplatin/paclitaxel regimen from the INTERLACE trial (NCT01566240) with the pembrolizumab-based regimen from KEYNOTE-A18 can further improve outcomes and reduce the morbidity associated with brachytherapy. Dr Shea expressed optimism about this question, citing preliminary experience suggesting that neoadjuvant chemotherapy may reduce the need for invasive radiation techniques.

In today’s episode, we spoke with Jacob Sands, MD. Dr Sands is the associate chief of the Lowe Center for Thoracic Oncology, Oncology Medical Director of the International Patient Center, and physician at Dana-Farber Cancer Institute, as well as an assistant professor at Harvard Medical School in Boston, Massachusetts. 

In our exclusive interview, Dr Sands discussed the rapidly evolving treatment landscape for small cell lung cancer (SCLC), emphasizing both the progress made with immunotherapy and the ongoing challenges associated with this aggressive disease. He noted that outcomes now vary widely, with some patients experiencing long-term durable disease control following checkpoint inhibitor therapy, while others continue to have limited benefit from currently available treatments.

A major focus of the discussion centered on tarlatamab-dlle (Imdelltra), the DLL3-targeting bispecific T-cell engager approved for relapsed SCLC. Sands described tarlatamab as a “new paradigm” therapy, highlighting results from the phase 3 DeLLphi-304 trial (NCT05740566) showing superiority in progression-free survival, overall survival, symptom improvement, and toxicity outcomes vs chemotherapy in the second-line setting. He also reviewed the evolution of DLL3 as a therapeutic target, explaining how earlier efforts with rovalpituzumab tesirine (Rova-T) helped establish the foundation for newer, more effective DLL3-directed approaches. 

The conversation also explored the growing role of molecular subtyping in SCLC, including emerging data involving ASCL1, NEUROD1, and POU2F3 transcription factor subsets. Although Sands cautioned that these findings remain investigational, he noted that subtype-driven treatment selection may eventually help personalize therapy in SCLC.

Sands also addressed real-world experience with tarlatamab, including higher observed rates of cytokine release syndrome and neurologic toxicities among patients who would not have qualified for clinical trials. Despite these risks, he emphasized that many heavily pretreated patients with poor performance status or brain metastases have still achieved meaningful and durable clinical benefit.

Finally, the discussion covered recent updates to National Comprehensive Cancer Network guidelines, including the establishment of tarlatamab as a preferred second-line standard of care regardless of chemotherapy-free interval. Looking ahead, Sands highlighted the growing pipeline of investigational therapies in SCLC, including CAR T-cell therapies, antibody-drug conjugates, radioligand therapies, and additional T-cell engagers, stressing the importance of clinical trial referral and collaboration between academic and community oncology centers.

In today’s episode, we spoke with Michael J. Mauro, MD, an attending physician at Memorial Sloan Kettering Cancer Center in New York, New York.

In our exclusive interview, Dr Mauro discussed the vast assortment of TKIs available for the treatment of patients with chronic myeloid leukemia (CML). In addition to breaking down numerous different TKIs that he turns to in clinical practice and their accompanying data, Mauro also dissected the November 2025 FDA approval of generic dasatinib (Phyrago) tablets for patients with CML and acute lymphoblastic leukemia. More specifically, Mauro outlined what this approval means for patients who need concomitant gastric acid–reducing agents like proton pump inhibitors.

In today’s episode, we welcomed Pedram Razavi, MD, PhD, and Dara S. Ross, MD. Dr Razavi is a breast medical oncologist and director of Liquid Biopsy & Genomics at Memorial Sloan Kettering Cancer Center in New York, New York. Dr Ross is an associate attending pathologist at Memorial Sloan Kettering Cancer Center.

In our exclusive interview, Drs Razavi and Ross discussed the evolution of ESR1 mutation–directed breast cancer management, emphasizing the role of comprehensive genomic testing at metastatic recurrence, including liquid biopsy and tissue sequencing. They highlighted that ESR1 mutations can develop in patients receiving aromatase inhibitors and that the detection of these mutations is crucial for treatment decisions. They also highlighted findings from the phase 3 SERENA-6 trial (NCT04964934), which tested switching to camizestrant upon the emergence of an ESR1 mutation during treatment with an aromatase inhibitor and a CDK4/6 inhibitor ahead of radiographic disease progression in patients with hormone receptor–positive, HER2-negative metastatic breast cancer. Despite concerns from the FDA's Oncologic Drugs Advisory Committee (ODAC) about SERENA-6’s design and overall survival outcomes, the experts praised the trial's innovative approach to personalizing breast cancer management based on biomarkers and noted ways that the ODAC decision may affect future clinical research in this field.

Welcome to OncLive On Air®! I’m your host today, Riley Kandel.

OncLive On Air is a podcast from OncLive®, which provides oncology professionals with the resources and information they need to provide the best patient care. In both digital and print formats, OncLive covers every angle of oncology practice, from new technology to treatment advances to important regulatory decisions.

During Esophageal Cancer Awareness Month, OncLive® sat down with Peter Enzinger, MD, to discuss evolving standards and ongoing areas of uncertainty in the diagnosis and management of esophageal cancer. 

In the exclusive interview, Enzinger highlighted common diagnostic and staging pitfalls in newly diagnosed disease; outlined the evolving role of surgery, chemoradiation, and multidisciplinary care; and reviewed emerging targeted therapeutic strategies shaping treatment decisions in esophageal and gastroesophageal cancers. He also discussed ongoing clinical trials of interest, including studies evaluating zanidatamab-hrii (Ziihera), pembrolizumab (Keytruda)–based nonoperative approaches, and novel combinations incorporating Claudin 18.2–targeted therapy.

Enzinger serves as director of the Center for Esophageal and Gastric Cancer, institute physician, and medical oncologist at Dana-Farber Cancer Institute, as well as an associate professor of medicine at Harvard Medical School in Boston, Massachusetts. 
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That’s all we have for today! Thank you for listening to this episode of OncLive On Air. Check back throughout the week for exclusive interviews with leading experts in the oncology field.

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In today’s episode, we welcomed Luhua (Michael) Wang, MD, to discuss the implications of the full FDA approval of brexucabtagene autoleucel (Tecartus; brexu-cel) for the treatment of adult patients with relapsed/refractory mantle cell lymphoma (MCL). Dr Wang is a professor in the Department of Lymphoma/Myeloma in the Division of Cancer Medicine, as well as a professor in the Department of Stem Cell Transplantation at The University of Texas MD Anderson Cancer Center in Houston.

On April 2, 2026, the FDA granted traditional approval to brexu-cel based on data from the phase 2 ZUMA-2 trial (cohorts 1 and 2, NCT02601313; cohort 3, NCT04880434), with confirmatory data from cohort 3 showing that patients naive to a BTK inhibitor experienced an overall response rate (ORR) of 91% (95% CI, 82.5%-95.9%), a complete response (CR) rate of 79% (95% CI, 69.0%-87.1%), and a median duration of response (DOR) that was not reached (NR; 95% CI, 26.2 months-not evaluable).

Dr Wang detailed the evolution of therapies in the MCL treatment paradigm, leading up to the approval of brexu-cel and the integration of CAR T-cell therapy. Along with highlighting the evolution of MCL management, Dr Wang explained how data from cohort 3 of ZUMA-2 add further context to the role of CAR T-cell therapy in the treatment paradigm and how it may affect treatment sequencing considerations.

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 this episode, Nunnery sat down with Annie Bond, a breast cancer survivor and patient advocate.

Diagnosed with breast cancer at age 26, Bond shared how her initial concerns about a breast lump were repeatedly dismissed by medical professionals who cited her youth and lack of a family history of breast cancer. It took months of persistence before she received a diagnosis, at which point the cancer had already spread to her liver.

Bond emphasizes the necessity of self-advocacy and the value of seeking second or third medical opinions. Regarding fertility preservation, her first oncologist discouraged her from freezing her eggs, but her third oncologist provided a more personalized approach, using CDK4/6 inhibitors rather than immediate chemotherapy based on her luminal A disease subtype.

A significant portion of the conversation focused on the mental health toll of cancer. Bond discusses the "warrior" stereotype, the guilt and shame she felt, and her struggle with post-traumatic stress disorder. She says she found critical support in community and support groups, which helped normalize her feelings and provided a sense of belonging.

Regarding physical adverse effects, Bond detailed the challenges of medical menopause, including "menopause brain" and joint pain, which she manages through walking and stretching. She expressed frustration with health education that focuses on diet or alcohol as "blame" factors, noting that cancer can often develop regardless of lifestyle.

Bond explained how she advocates for metastatic breast cancer research funding and the use of artificial intelligence risk assessment models to account for factors like breast density. Her mission is to increase early detection and ensure patients with metastatic disease are viewed with hope.

Welcome to OncLive On Air®! I’m your host today, Courtney Flaherty.

OncLive On Air is a podcast from OncLive®, which provides oncology professionals with the resources and information they need to provide the best patient care. In both digital and print formats, OncLive covers every angle of oncology practice, from new technology to treatment advances to important regulatory decisions. 

In today’s episode, Michael J. Pishvaian, MD, PhD, sat down to discuss the evolving role of biomarker-directed strategies in gastrointestinal (GI) oncology, as well as the importance of early comprehensive testing to identify molecular drivers and resistance mechanisms when approaching frontline treatment selection and sequencing. 

Pishvaian serves as director of the Gastrointestinal, Developmental Therapeutics, and Clinical Research Programs for the Johns Hopkins Kimmel Cancer Center in the National Capital Region.

Pishvaian began the discussion by highlighting the shift from a disease-site-specific approach to a molecularly defined paradigm, noting that microsatellite instability–high status and NTRK fusions now dictate therapy regardless of tumor origin. He reviewed the transformational data from the phase 3 HERIZON-GE-01 trial (NCT04276493), positing that zanidatamab (Ziihera) could become the new standard of care for HER2-positive upper GI cancers due to unprecedented survival outcomes. He also emphasized the emergence of Claudin 18.2-directed therapies, noting that data from the phase 2 ILUSTRO study (NCT03505320) demonstrates remarkable progression-free survival when adding zolbetuximab (Vyloy) to mFOLFOX6 and nivolumab (Opdivo) for high-expressing subgroups.

The conversation then shifted to colorectal cancer, where Dr. Pishvaian detailed how data from the phase 3 BREAKWATER trial (NCT03845036) has "locked in" a paradigm requiring frontline testing for BRAF V600E mutations to guide the use of encorafenib (Braftovi) plus cetuximab (Erbitux). He also discussed the "care revolution" in KRAS inhibition, spotlighting the significant survival benefits seen with daraxonrasib in pancreatic cancer and the potential for novel allele-specific inhibitors to combat disease resistance.

Finally, Pishvaian addressed the practicalities of implementation, noting that testing rates in the community remain low. He advocated for prioritizing testing, including liquid biopsies and ctDNA, at the time of initial diagnosis to ensure no patient is left behind.

This content is a production of OncLive; this OncLive On Air podcast episode is supported by funding, however, content is produced and independently developed by OncLive.

Highlights from the PER® CME activity "Cases and Conversations™: Next-Generation Pathology Advances and Considerations for Precision Care in Non–Small Cell Lung 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 Sanja Dacic, MD, PhD; Isabel Preeshagul, DO, MBS; and Soo-Ryum (Stewart) Yang, MD, discuss cases of patients with non–small cell lung cancer harboring actionable alterations.

Earn CME credit by completing the full accredited activity (available through May 6, 2027):
https://www.gotoper.com/pathology26nsclc-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 educational grants from Lilly, Nuvation Bio, and 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.