Targeted Talks

In this episode of the Treating Together podcast, host Dr Pallav Mehta, medical oncologist at MD Anderson Cancer Center at Cooper, assistant professor of medicine at Cooper Medical School, and medical director of Reimagine Care,
sits down with Jorge Garcia, PharmD, founder of Patagonia Healthcare, for an in-depth conversation about the rapidly evolving landscape of advanced cancer therapies, from CAR-T cells and bispecific antibodies to gene therapies.

Together, they explore what makes these treatments fundamentally different from traditional chemotherapy and immunotherapy, and why the systems built to deliver them must evolve just as quickly. The discussion covers the operational, financial, and clinical challenges facing health systems looking to bring bispecific therapies into community and outpatient settings — including reimbursement models, toxicity monitoring, caregiver education, and the critical role of oncology pharmacists. Dr Mehta and Dr Garcia also look ahead to the growing promise of technology, AI, and virtual care in enabling safer patient monitoring outside of hospital walls, and share their vision for a future where more patients can receive these transformative treatments closer to home.

Whether you're a clinician, administrator, pharmacist, or healthcare innovator, this conversation offers a grounded and forward-looking perspective on what it will take to make cutting-edge cancer care accessible to all patients—not just those near major academic centers.

In this minisode, we break down the latest update to ASCO's living guideline for stage IV non–small cell lung cancer (NSCLC) without driver mutations — and what it means for clinicians on the front lines of care.

We're drawing on a conversation with Dr. Joshua Reuss, thoracic medical oncologist at Georgetown University and co-chair of ASCO's Living Guidance Committee, who helped explain the key changes, the remaining uncertainties, and where the field is heading.

What changed — and why now? This was a scheduled comprehensive review, not triggered by a single trial or approval. The committee revisited existing recommendations and incorporated emerging data, even when it didn't clear the bar for a formal change in recommendation level.

Why this guideline is especially complex Unlike driver-positive NSCLC, where a mutation points clearly to a targeted therapy, the driver mutation–negative guideline must address a wide, heterogeneous population — split by histology (nonsquamous vs. squamous) and three PD-L1 tiers, resulting in six distinct patient subsets, each with its own evidence base.

Molecular testing moves to the top A key structural change: comprehensive molecular testing is now front and center in the guideline, reinforcing that confirming the absence of a driver mutation is just as critical as finding one. Starting immunotherapy before results return can create serious problems — if a driver mutation surfaces later, switching to targeted therapy may carry significant toxicity risks.

New in the toolkit: Teliso-V Telisotuzumab vedotin (Teliso-V), a MET-targeted antibody-drug conjugate, has been added to the guideline following its accelerated FDA approval for patients with high MET protein overexpression. It joins trastuzumab deruxtecan (T-DXd) in the subsequent-line ADC space — and its inclusion further underscores the need for thorough molecular and protein expression testing.

What we still don't know The honest answer to "which frontline regimen is best for my patient?" is: we don't know yet. Ongoing trials like INSIGNA are tackling whether chemo is necessary in high PD-L1 expressers. Co-mutations like STK11 and KEAP1 are being explored as biomarkers for dual checkpoint blockade strategies, though a recent prospective study (NIPPON) added caution — increased toxicity without a clear efficacy signal.

One to watch: ivonescimab This bispecific antibody co-targeting PD-1 and VEGF is generating buzz, with data from China suggesting it may outperform pembrolizumab alone. Dr. Reuss calls it potentially practice-changing — if the global data hold up.

The takeaway The guideline won't hand you one answer. It's designed to give clinicians the evidence they need to make the best decision for the individual patient in front of them.

🔗 Full guideline: ascopubs.org/doi/10.1200/JCO-25-02825

In this episode of Treating Together, host Pallav Mehta, MD, medical oncologist and director of Integrative Oncology at Cooper University Health Care and medical director of Reimagine Care, is joined by Debra Patt, MD, PhD, MBA, oncologist and executive vice president at Texas Oncology. Patt also serves as the president of the Community Oncology Alliance (COA). Their discussion focuses on the rapid transformation of community oncology and the growing pressures shaping its future.

Themes and Key Discussion Points

The episode focuses on the central role of community oncology in preserving local, quality care. Highlights include:

In this episode of Treating Together, host Marc Braunstein, MD, an associate professor of medicine at the Perlmutter Cancer Center, NYU Grossman School of Medicine, is joined by John Burke, MD, from Rocky Mountain Cancer Centers. Both specialists bring their extensive experience in lymphoma and multiple myeloma to a deep-dive discussion on the rapidly evolving treatment landscape of chronic lymphocytic leukemia (CLL).

Key Discussion Points
The episode focuses on the refinement of CLL therapy, moving away from traditional chemoimmunotherapy toward targeted approaches. Highlights include:

Looking Toward the Future
As the experts look ahead into 2026, they discuss the promising emergence of BTK degraders, which have shown high response rates in heavily pretreated patients and are moving toward potential market availability in the coming years.

This episode of Treating Together, hosted by Chandler Park, MD, featuring guests Benjamin Garmezy, MD, and Manoj Bupathi, MD,  centers on the intersection of clinical research and community oncology, specifically within the field of genitourinary (GU) oncology.

Core Themes and Discussion Points