Oncology On The Go

In a cobranded episode between Oncology On the Go, hosted by CancerNetwork®, and the American Society for Transplantation and Cellular Therapy’s (ASTCT) program ASTCT Talks, Terri Lynn Shigle, PharmD, BCOP, hosted Vinita Pai, PharmD, MS, BCPPS, who spoke about the use of CAR T-cell therapy for pediatric patients, focusing on acute lymphoblastic leukemia (ALL). After a brief overview of progress in the cellular therapy field and pediatrics’ first and only FDA-approved CAR-T product since 2017, their discussion explored the following:

·      Review of real-world practice and outcomes in ALL

·      Pediatric practical challenges including logistics, leukapheresis and lymphodepletion chemotherapy

·      Strategies for managing cell therapy toxicities in pediatric patients

·      Considerations for survivorship and long-term toxicities

·      Gaps in pediatric care and future directions

The discussion highlighted the unique challenges of treating pediatric patients, paucity of data, and need for continued exploration of cellular therapy treatment not only in ALL, but other underlying diagnoses. 

Shigle is a clinical pharmacy specialist in the Stem Cell Transplantation & Cellular Therapy Department at The University of Texas MD Anderson Cancer Center. Pai is an associate clinical professor in the Division of Pharmacy Practice and Science at The Ohio State University.

Reference

O'Leary MC, Lu X, Huang Y, et al. FDA approval summary: tisagenlecleucel for treatment of patients with relapsed or refractory B-cell precursor acute lymphoblastic leukemia. Clin Cancer Res. 2019;25(4):1142-1146. doi:10.1158/1078-0432.CCR-18-2035

In the newest edition of Oncology On the Go, Joshua Richter, MD, and Marco Davila, MD, PhD, spoke about the current multiple myeloma treatment landscape and highlighted practical considerations for administering CAR T-cell therapy to patients. Their discussion touched upon several critical subtopics ranging from optimizing operational and referral workflows to dismantling barriers to treatment access in rural settings.

When it comes to navigating the multiple myeloma treatment algorithm, both hosts emphasized early evaluation to determine patient suitability for CAR T-cell therapy, which may help identify those who are most likely to experience the greatest responses with minimal toxicity. Regarding the question of sequencing different modalities, Richter pointed to data demonstrating the utility of administering CAR T-cell therapies prior to bispecific antibodies.

Acknowledging that the average patient enrolled on a clinical trial may not align with what is typically seen in real-world practice, the hosts discussed “reassuring” data that those who do not meet certain eligibility criteria may nevertheless benefit from CAR T-cell therapy. Additionally, on the topic of maintaining an effective referral relationship between community oncologists and CAR-T centers, Davila noted that academic cell therapy clinicians may have an incumbent responsibility to consider how to improve access to treatment and make it easier for others to refer patients to care.

“CAR T-cell therapy is now deeply entrenched in the world of relapsed multiple myeloma [and] soon to be likely entrenched in the newly diagnosed world. These are therapies that I think we're all going to need to embrace whether it's from an academic standpoint or a community standpoint,” Richter concluded. “Having that ongoing communication back and forth, especially as the field is moving so quickly, is absolutely key in providing optimal care for our patients.”

Richter is an associate professor of Medicine in the Division of Hematology and Medical Oncology at The Tisch Cancer Institute, as well as the director of Multiple Myeloma at the Blavatnik Family - Chelsea Medical Center at Mount Sinai. Davila is the senior vice president and associate director for Translational Research, a professor of Oncology, chief of Lymphoma/Multiple Myeloma Service, and Rustum Family Endowed Chair in Translational Research at Roswell Park Comprehensive Cancer Center.

At the 2026 National ICE-T Conference in Orlando, CancerNetwork® sat down with a variety of expert researchers and clinicians to discuss the latest developments in immune effector therapy across different hematologic oncology populations. Sessions at the meeting covered practical considerations for integrating CAR T-cell therapies, bispecific antibodies, and other modalities into the treatment of those with multiple myeloma, lymphoma, and other hematologic malignancies.

First, Benjamin Diamond, MD, an assistant professor of Clinical Medicine, a member of the Sylvester Myeloma Institute, and a member of the Myeloma Genomic Lab at the University of Miami Miller School of Medicine, spoke about his presentation reviewing bispecific antibodies for the management of multiple myeloma. In his session, Diamond stated that bispecific T-cell engagers are altering the landscape of multiple myeloma care and will eventually become an option in the frontline setting. With many products to choose from, Diamond emphasized sequencing these novel therapies wisely and stressed aggressive infection prophylaxis as a mandatory facet of care.

Next, Tiba Al Sagheer, PharmD, BCOP, BCACP, a pharmacy quality improvement coordinator for transplant and cellular therapy at Miami Cancer Institute of Baptist Health South Florida discussed her presentation focused on defining new thresholds for monitoring and mitigating toxicities associated with CAR T-cell therapy. She described considerations for balancing early toxicity intervention against the risk of blunting efficacy depending on the specific CAR T-cell product used during treatment. Ultimately, she noted that that there is still no definitive answer or threshold for initiating prophylaxis for toxicity associated with CAR T, and that differentiating between immune effector cell (IEC)–associated hemophagocytic lymphohistiocytosis (HLH)–like syndrome (IEC-HS) and cytokine release syndrome (CRS) represents an ongoing challenge in the field.

Finally, Nikesh N. Shah, MD, and Carlos Silva Rondon, MD, shared their perspectives on a debate regarding the roles of bispecific antibodies and CAR T-cell therapies in relapsed/refractory follicular lymphoma. In his presentation, Shah, a hematologist-oncologist at Tampa General Hospital who specializes in hematologic malignancies, including aggressive lymphomas and acute lymphoblastic leukemia, took the position that bispecific antibodies should be used prior to CAR T-cell therapy for most patients, although both treatments have utility in the field. Silva Rondon, a hematologist, oncologist, and bone marrow transplant specialist at Moffitt Malignant Hematology and Cellular Therapy at Memorial Healthcare System/Memorial Cancer Institute in Pembroke Pines, advocated for CAR T-cell therapy during the debate but acknowledged that both modalities can make up a complementary strategy for overcoming relapsed/refractory follicular lymphoma.

References

Following the FDA approval of allogeneic regulatory T cell–containing immunotherapy with hematopoietic stem and progenitor cell (HSPC) and T cells-vldq (Tregzi; Orca-T), CancerNetwork® spoke with Wendy Stock, MD, about what this decision means for the treatment of patients undergoing hematopoietic stem cell transplantation for different hematologic malignancies. Additionally, she discussed how this option fits into the treatment landscape alongside other options like posttransplant cyclophosphamide (PTCy) and other next steps for improving outcomes associated with matched donor transplants.

Stock reviewed findings from the phase 3 Precision-T trial (NCT05316701) that supported the approval of Orca-T, noting that the data appeared to be “effective across all populations” for patients with acute myeloid leukemia, acute lymphoblastic leukemia, high-risk myelodysplastic syndrome (MDS), and mixed-phenotype acute leukemia. Furthermore, she detailed what adoption of Orca-T might look like on an operational level, described the agent’s ability to reduce the risk of graft-versus-host disease, and emphasized referring patients early to transplantation.

The approval, Stock said, marks the beginning of potentially allowing “higher-risk populations to move forward with the knowledge that it is possible to undergo transplant safely.” She noted that the FDA’s decision may inspire the field of transplant graft engineering to look more carefully at other options that might further improve transplantation outcomes.

“Over the last 10 years, we have had incredibly exciting, still-to-be-tweaked methods for improving outcomes for patients undergoing transplant, which is such an important procedure for curing or [achieving] long-term survival for patients with acute leukemias and high-risk myelodysplastic syndromes,” Stock said. “This is a big advance, and it needs to be studied further, including comparisons with other major improvements in the world of transplant, such as PTCy.”

Stock is the Anjuli Seth Nayak Professor of Medicine, cochair of the Leukemia Committee for the National Cancer Institute–supported Alliance for Clinical Trials in Oncology, and coleader of the Clinical and Experimental Therapeutics Research Program at the University of Chicago Medicine Comprehensive Cancer Center.

References

Experts discuss diagnosing and treating insomnia in patients with cancer through methods like sleep hygiene, CBT-I, and pharmacotherapy.

Insomnia is one of the most common symptoms oncologists are asked to manage, yet it’s often treated reactively with medication rather than through a structured, history-driven approach. In this episode of Oncology On the Go, Daniel C. McFarland, DO, sat down with psychiatrist and psycho-oncologist Virginia C. O’Brien, MD, to unpack how clinicians can more effectively evaluate and treat insomnia in patients with cancer.

The conversation opened with a foundational distinction: primary vs secondary insomnia, and why secondary insomnia—driven by anxiety, depression, pain, or cancer treatment itself—is far more common in oncology populations. O’Brien emphasized that the most frequent clinical mistake is jumping straight to a prescription instead of taking a thorough sleep history, including which phase of sleep is disrupted (falling asleep, staying asleep, or early waking) and whether the problem is affecting daytime functioning.

From there, the discussion moved through practical sleep hygiene strategies clinicians can share with patients, such as limiting caffeine and screens, managing pets and partners in the bedroom, and setting a consistent nighttime routine. Then, they dove into cognitive behavioral therapy for insomnia (CBT-I), the first-line recommended treatment. O’Brien explained how sleep restriction works, why it’s often impractical during active chemotherapy, and how free digital tools like CBT-i Coach can help fill access gaps.

The latter part of the discussion tackled pharmacologic management in detail: when medications are appropriate for acute insomnia; how to sequence options from least to most habit-forming; and specific guidance on trazodone (Desyrel), ramelteon (Rozerem), zolpidem (Ambien; including FDA dosing warnings for women), benzodiazepines, and newer orexin receptor antagonists. Special attention was given to older patients, those with a fall risk, and patients with a history of substance use disorder.

The experts closed with guidance on when to refer to a sleep medicine specialist, including STOP-BANG screening for obstructive sleep apnea and red flags for parasomnias like REM sleep behavior disorder.

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being a psycho-oncology editorial advisory board member for the journal ONCOLOGY®. O’Brien is system director of Ambulatory Psychiatry at the Carilion Clinic. 

In this episode of Oncology On the Go, CancerNetwork® spoke with Kim Stravers, an International End-of-Life Doula Association (INELDA)–certified end-of-life doula, educator, and trainer based in the Phoenix Valley, to explore how death doulas support patients with cancer and their families across all stages of the disease trajectory.

Stravers opened by defining the scope of end-of-life doula work, clarifying that doulas provide nonmedical emotional, practical, and relational support to people confronting their mortality and those who care for them. She distinguished the role from hospice nursing and palliative care by emphasizing that doulas never act in a clinical capacity; they instead function as neutral companions who facilitate difficult conversations, help patients clarify their values and wishes, and advocate for individual autonomy across medical and personal decision-making. She also discussed her volunteer work within an interdisciplinary hospice team in Phoenix and described her invitation to speak at Grand Rounds for the Palliative Care Department at Mayo Clinic Arizona to introduce the role to clinical providers.

When addressing cancer-specific experiences, Stravers noted that patients often come to her late in their trajectory, frequently within the 6-month hospice eligibility window, and described nonpharmacological techniques she uses to support breakthrough pain and existential distress, including body scans and guided visualization. She also shared a detailed patient case involving a woman with pancreatic cancer and Lynch syndrome whose daughter previously died of the same disease, describing how the shared diagnosis intensified the patient's anticipatory anxiety and how weekly doula visits helped provide periods of calm.

Additional topics included the credentialing landscape for end-of-life doulas, which currently lacks a national licensure body, with organizations such as INELDA offering varied training and certification pathways. Stravers also addressed the portrayal of a death doula in the television drama The Pitt, affirming elements she found accurate while flagging several areas she viewed as outside the appropriate scope of doula practice. 

Stravers holds certification through INELDA, where she also serves as an educator and trainer, as well as proficiency through the National End-Of-Life Doula Alliance (NEDA).

Experts discuss the evolving frontline CML treatment landscape, the impact of asciminib, and clinical strategies for achieving treatment-free remission.

Once considered a terminal diagnosis, chronic myeloid leukemia (CML) in chronic phase has been fundamentally rewritten as a highly manageable chronic condition. In this episode of Oncology on the Go, Joshua Zeidner, MD, and Jorge E. Cortes, MD, sat down to explore the rapidly shifting therapeutic paradigm of frontline CML management. 

The discussion tracked the monumental evolution of treatment from early bone marrow transplants to the introduction of imatinib (Gleevec) and subsequent generations of tyrosine kinase inhibitors (TKIs). The experts dove deep into the practice-changing data from the phase 3 ASC4FIRST trial (NCT04971226), analyzing how the newly introduced STAMP inhibitor, asciminib (Scemblix), is challenging traditional treatment sequencing due to its superior efficacy and highly favorable toxicity profile.

In the ASC4FIRST trial, the major molecular response (MMR) rate was 74.1% with asciminib vs 52.0% with other investigator-selected TKIs. The MMR rate at week 96 was consistently higher with asciminib vs other investigator-selected TKIs and imatinib across all assessed demographic and prognostic subgroups. Overall, investigators concluded that asciminib demonstrated a favorable risk-benefit profile compared with other standard therapies and presented a “valuable frontline option” for patients with CML in chronic phase.

Zeidner and Cortes also shared practical clinical insights on:

Zeider is professor of medicine, chief of Leukemia Research, and director of Clinical Cancer Research Commercial Integration at the University of North Caroline-Chapel Hill Cancer Therapeutics Research Program. Cortes is associate director for Translation at the University of Alabama O’Neal Cancer Center. 

To watch the full discussion, visit: https://www.cancernetwork.com/between-the-lines/oncology-on-the-go-frontline-chronic-myeloid-leukemia-in-chronic-phase-optimizing-treatment

Reference

Cortes JE, Hughes TP, Wang J, et al. Asciminib demonstrates superior efficacy and safety in newly diagnosed chronic myeloid leukemia in the ASC4FIRST trial. Blood. 2026;147(3):1433-1446. doi:10.1182/blood.2025029210

In this episode of Oncology On the Go, CancerNetwork® joined Matthew Matasar, MD, chief of the Division of Blood Disorders at Rutgers Cancer Institute/Jack & Sheryl Morris Cancer Center, and professor of medicine at Rutgers Robert Wood Johnson Medical School, as he dove into the practice-changing data reshaping the management of aggressive and indolent B-cell lymphomas. Fresh off the presentations at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting and the 2026 European Hematology Association (EHA) Congress, Matasar broke down the most talked-about datasets in the field.  

Matasar began by sharing his expert clinical perspectives on the phase 3 frontMIND trial (NCT04824092) evaluating tafasitamab (Monjuvi) plus lenalidomide (Revlimid) and rituximab (Rituxan) with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in newly diagnosed high-risk diffuse large B-cell lymphoma (DLBCL), which were concurrently published in The Lancet.1,2 He assessed how to balance the regimen’s progression-free survival benefit against incremental toxicities and scheduling demands. Furthermore, the conversation explored encouraging data regarding bispecific antibody combinations for older or frail patient populations, as well as innovative engineering strategies aimed at overcoming the challenging "fratricide" phenomenon in cellular therapies for relapsed T-cell lymphoma.

“In terms of how we move from putative success with these studies into wider deployment, I am encouraged by the pace of community adoption of bispecific antibodies not just in lymphoma—where we have seen a very nice uptake over the last year—but in other disease states, including solid tumor malignancies,” Matasar said regarding the growth of bispecific antibodies in the field. “As the clear need to deploy these agents in a broader range of patients grows, the lymphoma community is going to benefit from that work, and we’ll see our community partners become increasingly capable of delivering these treatments. My expectation is that by the time these studies read out positively in the years to come, we will have an oncology community that is ready to meet those data where they are and deploy them in the best service of our patients.”

References

1. Lenz, G, Trněný M, Burke JM, et al. frontMIND: phase 3 study of tafasitamab (Tafa) plus lenalidomide (Len) and R-CHOP for patients (pts) with newly diagnosed diffuse large B-cell lymphoma (DLBCL). J Clin Oncol. 2026;44(suppl 17):LBA7000. doi:10.1200/JCO.2026.44.17_suppl.LBA7000

2. Lenz, G, Trněný M, Burke JM, et al. Tafasitamab plus lenalidomide and R-CHOP versus R-CHOP for first-line treatment of patients with high-risk diffuse large B-cell lymphoma (frontMIND): a global, phase 3, randomised, double-blind, placebo-controlled trial. Lancet. 2026;407(10547):P2528-2541. doi:10.1016/S0140-6736(26)00866-4

In a special edition of Oncology On the Go, Chinmay Jani, MD, joined CancerNetwork® in the studio to speak about different research initiatives he is involved with across precision oncology. He discussed ongoing work dedicated to validating and applying artificial intelligence (AI)–based tools in clinical work as well as overcoming immunotherapy resistance among patients with lung cancer.

Jani, chief fellow in Hematology and Oncology at University of Miami Sylvester Comprehensive Cancer Center, first detailed findings from a study he presented at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting evaluating AI decision support in the context of EGFR-mutated non–small cell lung cancer (NSCLC). Although AI systems aligned with expert decision-making in frontline treatment, significant divergence was observed in second-line care, highlighting a need for more rigorous validation and clinical safeguards when integrating AI into oncologic decision-making. Improving documentation and using tools more ethically, Jani said, will also be critical for future applications of AI in field.

Jani also spoke about the rapidly evolving thoracic oncology field based on research he and colleagues are leading at the University of Miami. Different investigations are exploring potential advancements in precision medicine, overcoming immunotherapy resistance, and early cancer detection to help elevate outcomes among patients with lung cancer. Looking ahead, Jani emphasized how novel therapeutics like tarlatamab-dlle (Imdelltra) and the incorporation of liquid biopsy may assist with the goal of turning lung cancer into “a chronic disease” where patients can survive not just for a few month or years but for decades.

According to Jani, other key concerns in the field include the evolving landscape surrounding adolescent and young adult (AYA) patients, who may require different types of molecular testing and therapeutic needs compared with adult populations. Being able to detect more fusions and alterations that may inform therapeutic strategies via circulating tumor DNA plus circulating tumor RNA or through wider minimal residual disease testing, he said, represents another ongoing goal in terms of precision medicine.

Reference

Jani C, Pérez-Granado J, Kalucha A, et al. Evaluating AI decision support in a rapidly evolving therapeutic landscape: EGFR-mutant metastatic NSCLC. J Clin Oncol. 2026;44(suppl 16):1630. doi:10.1200/JCO.2026.44.16_suppl.1630

Cancer is never convenient, and it never arrives when a patient is truly prepared, according to Daniel C. McFarland, DO, who began the most recent episode of Oncology On the Go with this sentiment. When individuals enter the high-stakes, highly coordinated world of oncology, they do so under extreme duress, often presenting the versions of themselves that are most under stress. In this environment, clinical teams frequently encounter behaviors that get unfairly lumped into the vague and pejorative category of the “difficult patient.” What happens when these challenges stem from an underlying personality disorder rather than just temporary situational anxiety? 

In this episode, McFarland was joined by psycho-oncology expert Kaleena Chilcote, MD, to unpack the inner workings of personality styles and disorders within oncologic science. Together, they explored the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) diagnostic framework, spanning the eccentric, dramatic, and anxious categories. They discussed how these enduring, pervasive traits impact a patient’s health care journey. 

Shifting the conversation away from the stigma of labels, McFarland and Chilcote delivered actionable, real-world advice for oncology teams. They discussed how to utilize objective, descriptive charting; initiate a pause to check your own provider emotions; and build highly consistent, structured boundaries. From managing frequent phone calls to intentionally scheduling short, high-frequency touchpoints, the pair provided a roadmap for turning interpersonal conflict into therapeutic collaboration, proving that underneath the defense mechanisms, every patient has a uniquely valuable strength to connect with. 

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being a psycho-oncology editorial advisory board member for the journal ONCOLOGY®. Chilcote is director of Psycho-Oncology in the Department of Palliative and Supportive Care at the Taussig Cancer Center, part of the Cleveland Clinic.