Targeted Talks

A single label can hide a lot. In this episode of Targeted Talks, two researchers look at what broad racial and ethnic categories obscure in breast cancer research, and what it would take to see more clearly.

First, Scarlett Lin Gomez, professor of epidemiology and biostatistics at the University of California, San Francisco, discusses a large study of survival among Asian American women with breast cancer. Her team confirmed that most of the larger Asian American ethnic groups had better survival than non-Hispanic white women. They then adjusted for clinical, treatment, lifestyle, and neighborhood factors, and the advantage persisted. She explains why the group is far from uniform, with some 30 ethnic groups and about 100 languages and dialects, and why patterns by birthplace differed from group to group. The results are not ready to change practice guidelines, she says, but clinicians should know the variation exists.

Next, Evanthia Roussos Torres, MD, PhD, assistant professor of medicine in the Division of Oncology at the University of Southern California, explains why Hispanic patients are rarely enrolled in breast cancer trials, and what that leaves unanswered. She describes how researchers can define the group beyond self-reported ethnicity, using ancestry genome arrays alongside surveys of where patients and their families come from. She also outlines her lab’s work on suppressive myeloid cells in breast tumors, why breast cancer has responded only modestly to checkpoint inhibitors, and her biggest open question: how much of that suppression must be overcome. Whether ancestry shapes immune response is still unknown, she stresses, and answering it will take time and more patients taking part in research.

Both guests make the same point from different angles: better questions require better data, and better data requires the patients to be seen. Listen for what each researcher would change next.

Valsamo “Elsa” Anagnostou, MD, PhD, of Johns Hopkins University School of Medicine, joins Targeted Talks to discuss a study on landmark circulating tumor DNA (ctDNA) molecular response in patients with metastatic non–small cell lung cancer (NSCLC) treated with immunotherapy.

Radiographic imaging, the current gold standard, can be slow and imprecise at capturing immunotherapy response. Anagnostou explains why a rapid molecular readout is needed to tailor treatment. In the prospective study of 109 patients, undetectable ctDNA 3 to 9 weeks after starting anti–PD-(L)1 therapy, alone or in combination, signaled clinical benefit. Persistent ctDNA signaled molecular disease progression.

A single on-treatment measurement predicted outcomes as well as the traditional 2-time point approach, which compares ctDNA at baseline with a later time point. That matters for patients who miss a baseline draw or have no detectable ctDNA at baseline. Clearing ctDNA even once in the window predicted outcome, regardless of variability in readouts within the window.

Anagnostou also covers:

On this episode of Targeted Talks, Lyudmila Bazhenova, MD, discusses the FDA’s expanded label approval of taletrectinib (Ibtrozi) for ROS1-positive non–small cell lung cancer (NSCLC). She explains that the approval is based on data already presented at the 2026 AACR Annual Meeting, which showed efficacy in both TKI-naive and TKI-pretreated patients with longer follow-up. In TKI-naive patients, pooled analysis showed an intracranial overall response rate of 76.5%, a median duration of response of 49.7 months, and a median progression-free survival of 46.1 months, with no new safety signals. Bazhenova also reviews 2 new subset analyses from the 2026 World Conference on Lung Cancer: efficacy was similar in patients with and without prior chemotherapy, and it did not differ by ROS1 fusion partner (CD74 vs non-CD74). She shares her approach to managing side effects, including monitoring liver function tests and proactively managing diarrhea, and discusses the ongoing adjuvant trial in resected early-stage ROS1-positive NSCLC.

In this episode of Targeted Talks, recorded for Hispanic Heritage Month, Narjust Florez, MD, of Dana-Farber Cancer Institute, explains what oncologists should know about lung cancer in Hispanic and Latinx patients, one of the fastest-growing patient populations in the United States.

Florez describes how risk factors in this population often extend beyond tobacco, including radon exposure, occupational and indoor air pollution such as cooking fumes, and a history of tuberculosis. She discusses the higher frequency of adenocarcinoma and driver alterations, including EGFR, KRAS, and ALK, in the Hispanic and Latinx population, and why biomarker testing is essential for every patient with nonsquamous non–small cell lung cancer. She also explains why treating Hispanic and Latinx patients as a single risk group can obscure differences in ancestry, migration patterns, and health care experience.

The conversation also covers barriers to clinical trial enrollment, including consent forms that aren’t translated, unconscious bias, and mistrust of the health care system, along with practical steps clinicians can take, such as “going beyond the no” when a patient declines a trial. Florez closes by describing the EQUAL study which is evaluating a blood test to help detect EGFR-mutated lung cancer earlier.

Learn more about the EQUAL study: https://equalstudy.dana-farber.org/

In this episode of Targeted Talks, Benjamin Herzberg, MD, discusses the evolving treatment landscape for KRAS-mutant non–small cell lung cancer (NSCLC). He explains why KRAS matters to all oncologists, since these mutations drive roughly 30% of NSCLC cases, and reviews why chemoimmunotherapy remains the first-line standard of care for now. He also covers how central nervous system metastases affect treatment planning and why close collaboration with pathology and upfront biomarker testing are essential. Herzberg then turns to the pan-RAS inhibitor daraxonrasib (Rasonque), recently approved in pancreatic cancer, and explains why lung cancer clinicians should pay attention. He discusses its published lung cancer data, which show response rates and durability similar to those in pancreatic cancer, as well as the ongoing phase 3 trial vs docetaxel. He also discusses zoldonrasib, a G12D-specific inhibitor with a favorable tolerability profile, and the idea of a "RAS toolkit" of pan-RAS and allele-specific agents. He closes with the biggest unmet needs, including driver-negative disease and resistance to targeted therapy, and what excites him most: molecular glues and other novel drug modalities, including MTAP/PRMT5 inhibitors.

00:00 Introduction to KRAS-Mutant Lung Cancer
00:40 Prevalence and Variants of KRAS Mutations
01:41 First-Line Chemoimmunotherapy for KRAS NSCLC
03:15 Managing CNS Metastases in Lung Cancer
05:11 Upfront Biomarker Testing and Collaboration
08:05 Adagrasib's Role in KRAS-Mutant Lung Cancer
10:22 Unmet Needs and Resistance Mechanisms
12:31 Future of RAS Inhibitors and the RAS Toolkit

Ahead of the 2026 ASTRO Annual Meeting, Dr Raj Singh of Baptist Health joins the podcast to break down the studies he's watching most closely. The conversation opens with a pooled analysis of 3 phase 2 trials using FMISO PET imaging to identify hypoxic tumor regions and select patients with HPV-positive head and neck cancer who may safely de-escalate radiation dose, and Singh discusses what it would take to move this biomarker-driven approach beyond a single high-volume academic center. He then turns to updated C-POST data on the timing of cemiplimab initiation after radiotherapy in high-risk cutaneous squamous cell carcinoma, and to Alliance A071801, a phase 3 trial comparing single-fraction vs fractionated stereotactic radiosurgery to the resection cavity after brain metastasis surgery, including why patient-reported cognitive and emotional well-being end points matter alongside recurrence-free survival.

The discussion moves to two practice-shaping trials in small cell lung cancer: MAVERICK, which found no overall survival benefit for prophylactic cranial irradiation over MRI surveillance alone in limited-stage disease, and NRG CC009, comparing radiosurgery with hippocampal-avoidance whole brain radiotherapy plus memantine for patients with limited brain metastatic disease. Singh explains how these results may accelerate an already-underway shift away from whole brain radiotherapy. The episode closes with a look at TRIDENT, a tumor-treating fields trial in newly diagnosed glioblastoma that missed its primary end point, and what subgroup data might still reveal—plus Singh's broader take on radiation oncology's shift toward patient-reported, quality-of-life-focused outcomes.

HER2 has long been synonymous with breast cancer, but a growing body of evidence shows it's expressed, at some level, across nearly every solid tumor type. In this episode of Targeted Talks, host Sabrina Serani sits down with Dr Aditya Shreenivas (City of Hope National Medical Center) and Dr Razelle Kurzrock (Medical College of Wisconsin Cancer Center) to unpack their new real-world analysis, published in ESMO Open, using data made available by Caris Life Sciences, examining HER2 immunohistochemistry (IHC) expression and ERBB2 alterations across more than 200,000 tumors.

The conversation traces how HER2 evolved from a breast cancer biomarker to a tumor-agnostic target, following the accelerated approval of fam-trastuzumab deruxtecan (T-DXd; Enhertu) for HER2 IHC 3+ solid tumors. Drs Shreenivas and Kurzrock walk through the study's key findings: how ERBB2 amplification and mutation status each relate to HER2 IHC expression, why that relationship is more complex—and more clinically important—for mutations than for amplifications, and what it means when the biomarkers disagree. They also dig into overall survival data showing that the prognostic benefit of high HER2 expression is largely concentrated in breast and gastric cancers, where HER2-targeted therapies are already standard of care, vs rarer tumor types like salivary gland and endometrial cancer, where the picture looks different.

Listeners will come away with a clearer sense of why HER2 should be treated as a continuous variable rather than a binary positive/negative result, why routine HER2 IHC testing matters for every patient with unresectable or metastatic disease, and where the open questions remain, including discordant cases where amplification and IHC don't line up.

A must-listen for oncologists, pathologists, and researchers working across breast, GI, gynecologic, and rare solid tumors who want a real-world, pan-cancer view of the evolving HER2 landscape.

In this episode of Targeted Talks, Sabrina Serani speaks with Dr Ryan Funk, chief radiation oncology officer at The US Oncology Network and a radiation oncologist with Minnesota Oncology, about the financial pressures reshaping radiation oncology in 2026. While CMS's overhaul of treatment delivery codes into complexity-based tiers has drawn attention, Dr. Funk argues that commercial payer contracts—not Medicare—are the bigger driver of instability, since commercial reimbursement typically funds the margin practices need to reinvest in costly, aging equipment.

Dr Funk discusses how practices are responding: tightening collections on contracted payments, delaying staffing cuts, and increasingly facing hard choices about whether to replace linear accelerators at all. He warns that the most visible effect won't be lower-quality care at existing centers, but outright closures, especially among freestanding and rural facilities, which have already seen disproportionate losses over the past decade. Since about half of all patients with cancer require radiation, and access is especially critical for patients traveling daily for treatment, he stresses that this is a multidisciplinary concern, not just a radiation oncology one.

The conversation also covers the role of patient advocacy groups, employers, and professional societies like ASTRO and ACRO in applying pressure at both the national and local contract levels, and Dr Funk's advice for physicians to engage more directly with the business side of their practices.