Oncology On The Go

• S1 Ep152: Oncologists Reflect on Pandemic's Lasting Impact on Cancer Care

  In a recent episode of Oncology on the Go, several oncologists discussed the impact of the COVID-19 pandemic on oncology care, 5 years later. Each doctor discussed a different aspect of multidisciplinary care, including medical oncology, radiation oncology, and epidemiology. CancerNetwork® spoke with leading clinicians including:  ·      Aditya Bardia, MD, MPH, FSCO, professor in the Department of Medicine, Division of Hematology/Oncology, and director of Translational Research Integration at the University of California Los Angeles Health Jonsson Comprehensive Cancer Center; ·      Ritu Salani, MD, director of Gynecologic Oncology at the University of California Los Angeles, and ONCOLOGY® editorial advisory board member; ·      Scarlett Lin Gomez, PhD, MPH, a professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco (UCSF), and co-leader of the Cancer Control Program at UCSF Helen Diller Family Comprehensive Cancer Center ·      Marwan F. Fakih, MD, professor in the Department of Medical Oncology & Therapeutics Research, associate director for Clinical Sciences, medical director of the Briskin Center for Clinical Research, division chief of GI Medical Oncology, and co-director of the Gastrointestinal Cancer Program at City of Hope Comprehensive Cancer Center; ·      Elizabeth Zhang-Velten, MD, a radiation oncologist at Keck Medicine of University of Southern California;  ·      Frances Elain Chow, MD, neuro-oncologist at the University of Southern California (USC) Norris Comprehensive Cancer Center ·      James Yu, MD, MHS, FASTRO, assistant professor adjunct, Department of Radiation Oncology, Smilow Cancer Hospital at Saint Francis Hospital, and ONCOLOGY® editorial advisory board member.  The COVID-19 pandemic disrupted routine cancer care in a number of ways. Many patients were unable to receive timely screening, diagnosis, and treatment, Fakih noted. Additionally, Bardia stated that the pandemic led to a decrease in the number of patients participating in clinical trials. One of the most significant changes in oncology care, according to Salani, has been the increased use of telehealth. Telehealth has allowed patients to receive care from the comfort of their own homes, which has been especially beneficial for patients who live in rural areas or who have difficulty traveling. Telehealth has also made it easier for patients to connect with their doctors and to receive support from other members of their care team.  For Gomez, the COVID-19 pandemic also highlighted the importance of addressing the structural and social drivers of health. These are the conditions in which people are born, grow, live, work, and age that can affect their health. For example, people who live in poverty or who lack access to healthy food are more likely to develop cancer. The pandemic has led to a renewed focus on addressing these disparities. Overall, the COVID-19 pandemic has had a profound impact on oncology care. However, it has also led to a number of positive changes, such as the increased use of telehealth and the focus on addressing the structural and social drivers of health. In the years to come, it will be important to continue to build on these changes in order to improve the lives of patients with cancer.

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• S1 Ep151: Key CAR T and Transplantation Presentations From The 2025 Tandem Meeting

  CancerNetwork®, in collaboration with The American Society for Transplantation and Cellular Therapy (ASTCT), organized an X Space hosted by Rahul Banerjee, MD, FACP, an assistant Professor in the Clinical Research Division at the Fred Hutchinson Cancer Center in Seattle, Washington, and Shernan Holtan, MD, the chief of Blood and Marrow Transplantation and professor of Medicine at Roswell Park Comprehensive Cancer Center.  The conversation took place during the 2025 Tandem Meeting and highlighted many significant presentations and posters on CAR T-cell therapies and transplantation, Banerjee’s and Holtan’s respective areas of expertise. The following trials were discussed: LBA1 - Phase II Multicenter Trial of Idecabtagene Vicleucel (Ide-cel) Followed By Lenalidomide Maintenance for Multiple Myeloma Patients with Sub-Optimal Response after an Upfront Autologous Hematopoietic Cell Transplantation: Top Line Results from the BMT CTN 1902 Clinical Trial1 “This [study] is nice because it merges 2 worlds. It's like a tandem—but not really a tandem—because you're not doing 2 transplants back-to-back. You're doing a transplant followed by CAR T-cell therapy,” said Banerjee. Abstract 50 - CAR T Cell Therapy in Early Relapsed/Refractory Large B-Cell Lymphoma: Real World Analysis from the Cell Therapy Consortium2 “In a relatively small cohort, [investigators] found no difference in 9-month survival whether someone got their [CAR T cells] in second-line therapy vs third-line therapy from a statistical perspective. If you look at the curves, it looks like there is a potential benefit to second-line therapy, but there was not enough statistical power to determine a difference,” said Holtan. Poster 340 - CD83 Expression By Human Breast Cancer Mediates Effective Killing By CAR T3 “If there's a way to do [the therapy] armored and have a paracrine delivered in real time—and not given to the whole body—[so] the patient [would] have all the adverse effects and cytokine release syndrome release on their own…that would be awesome,” stated Banerjee.  Poster 317 - Risk Factors for Immune Effector Cell-Associated Enterocolitis (IEC-colitis) in Patients with Relapsed Myeloma Treated with Ciltacabtagene Autoleucel (cilta-cel)4 “From the best that we can tell, ironically, corticosteroids aren't the fix that we want them to be [for immune effector cell-associated colitis]…We were like ‘Diarrhea, whatever. Let's give some steroids and treat it like gut graft-versus-host-disease,’ but these patients [didn’t] respond as well [to that],” said Banerjee. Poster 572 - Post-CAR-T Driving Restrictions Appear Unnecessary after Week 4: Data from the US Multiple Myeloma Immunotherapy Consortium5 “Patients and their caregivers [who have] put their life aside for 4 weeks just to get through CAR T-cell therapy and the Risk Evaluation and Mitigation Strategies requirements are now being told ‘You're free to go, but you can't drive for 4 weeks, which means you can't get your own groceries or…go to doctor's appointments by yourself.’ Basically, we argue…that this [requirement] is not evidence-based,” stated Banerjee.  Presentation 58 - Physical Function Measures Identify Non-Hodgkin Lymphoma Patients at High Risk of Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) and 1-Year Mortality after Chimeric Antigen Receptor T (CAR-T) Cell Therapy6 “This [presentation] highlights that even within a high [CAR-HEMATOTOX group], those patients were at extraordinarily high risk of not benefitting from CAR T-cell therapy, and these tests are so simple to do. It’s going to be interesting to see if others can reproduce this,” said Holtan. Poster 618 - Comparison of Outcomes after Hematopoietic STEM Cell Transplantation (HCT) for Myelodysplastic Syndrome (MDS) Patients Older or Younger THAN 65 YEARS Old. a Retrospective Analysis of the Latin America Registry7 “My personal hope for this space is that our field can come up with more novel conditioning regimens such that we can ablate the marrow without causing those gastrointestinal toxicities or other organ toxicities [while] doing that so effectively that we don't even need maintenance therapies for a lot of conditions,” stated Holtan. Presentation 39 - Determinants of Immune Suppression Discontinuation in the Modern Era: A CIBMTR Analysis of 18,642 Subjects8 “I’m going to make a provocative prediction for the next paper [approximately 10 years from now]. I predict that steroids won’t be the first-line therapy for acute or chronic graft-versus-host-disease,” Holtan said. Poster 516 - Patient Experiences with Chronic Graft-Versus-Host Disease and Its Treatment in the United States: A Retrospective Social Media Listening Study9 “We can still work together to make life as good as we possibly can [for patients], to improve physical function, to take away some of this mental distress, and then work together for advocacy too. [We can] help with peer support, help with resources, and help relieve some of that misunderstanding in the community,” stated Holtan. References 1.        Garfall AL, Pasquini MC, Bai L, et al. Phase II multicenter trial of idecabtagene vicleucel (ide-cel) followed by lenalidomide maintenance for multiple myeloma patients with sub-optimal response after an upfront autologous hematopoietic cell transplantation: top line results from the BMT CTN 1902 clinical trial. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Abstract LBA-1. 2.        Rojek AE, Ahmed N, Gomez-Llobell M, et al. CAR T cell therapy in early relapsed/refractory large B-cell lymphoma: real world analysis from the cell therapy consortium. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Abstract 50. 3.        Betts BC, Davilla ML, Linden AM, et al. CD83 expression by human breast cancer mediates effective killing by CAR T. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 340. 4.        Chang Lim KJ, Chhabra S, Corraes ADMS, et al. Risk factors for immune effector cell-associated enterocolitis (IEC-colitis) in patients with relapsed myeloma treated with ciltacabtagene autoleucel (cilta-cel). Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 317. 5.        Banerjee R, Richards A, Khouri J, et al. Post-CAR-T driving restrictions appear unnecessary after week 4: data from the US multiple myeloma immunotherapy consortium. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 572. 6.        Herr M, McCarthy P, Jacobsen H, et al. Physical function measures identify non-Hodgkin lymphoma patients at high risk of immune effector cell-associated neurotoxicity syndrome (ICANS) and 1-year mortality after chimeric antigen receptor T (CAR-T) cell therapy. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Presentation ID 58. 7.        Duarte FB, Garcia YDO, Funke VAM, et al. Comparison of outcomes after hematopoietic STEM cell transplantation (HCT) for myelodysplastic syndrome (MDS) patients older or younger THAN 65 YEARS Old. A retrospective analysis of the Latin America registry. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 618. 8.        Pidala J, DeFlilipp Z, DeVos J, et al. Determinants of immune suppression discontinuation in the modern era: a CIBMTR analysis of 18,642 subjects. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Presentation ID 39. 9.        Cowden M, Derrien-Connors C, Holtan S, et al. Patient experiences with chronic graft-versus-host disease and its treatment in the United States: A retrospective social media listening study. Presented at: 2025 Transplant and Cellular Therapy Meetings; February 12-15, 2025; Honolulu, HI. Poster ID 516.

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• S1 Ep150: Sotorasib Combo Approval May Address Novel Therapy Need in KRAS G12C+ CRC

  In a conversation with CancerNetwork®, Marwan G. Fakih, MD, spoke about the FDA approval of sotorasib (Lumakras) plus panitumumab (Vectibix), and how it may affect the treatment paradigm for patients with KRAS G12C-mutant metastatic colorectal cancer (CRC). Fakih is a professor in the Department of Medical Oncology & Therapeutics Research, associate director for Clinical Sciences, medical director of the Briskin Center for Clinical Research, division chief of GI Medical Oncology, and co-director of the Gastrointestinal Cancer Program at City of Hope Comprehensive Cancer Center in Duarte, California. According to Fakih, the approval of this combination regimen is a “welcome step” for those with metastatic CRC harboring KRAS G12C mutations. Based on supporting data from the phase 3 CodeBreaK 300 trial (NCT05198934), sotorasib/panitumumab may prolong progression-free survival (PFS) and reduce disease burden in patients while offering improvements in other outcomes vs prior standards of care (SOC) like trifluridine/tipiracil (Lonsurf) and regorafenib (Stivarga). Topline data at the time of the approval showed a median PFS of 5.6 months (95% CI, 4.2-6.3) with sotorasib at 960 mg plus panitumumab vs 2.0 months (95% CI, 1.9-3.9) in the SOC arm, in which patients were assigned to receive trifluridine/tipiracil or regorafenib (HR, 0.48; 95% CI, 0.30-0.78; P = .005). Additionally, the overall response rate was 26% (95% CI, 15%-40%) vs 0% (95% CI, 0%-7%) in each respective arm. Looking ahead, Fakih highlighted the potential next steps for research associated with the sotorasib combination as well as other novel therapeutic strategies in the gastrointestinal cancer space. For example, he described the phase 3 CodeBreaK 301 study (NCT06252649), which will evaluate sotorasib/panitumumab as frontline therapy when administered in combination with folinic acid, fluorouracil, and irinotecan (FOLFIRI) vs FOLFIRI plus bevacizumab (Avastin) in metastatic KRAS G12C-mutant CRC. Other novel agents under development in the space include RAS inhibitors and immunotherapy regimens combining CTLA-4 inhibitors with anti–PD-L1 agents. References 1. FDA approves sotorasib with panitumumab for KRAS G12C-mutated colorectal cancer. News release. FDA. January 16, 2025. Accessed February 12, 2025. https://shorturl.at/1WviB 2. Kim TW, Price T, Grasselli J, et al. A phase 3 study of first-line sotorasib, panitumumab, and FOLFIRI versus FOLFIRI with or without bevacizumab-awwb for patients with KRAS G12C–mutated metastatic colorectal cancer (CodeBreaK 301). J Clin Oncol. 2025;43(suppl 4):TPS326. doi:10.1200/JCO.2025.43.4_suppl.TPS326

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• S1 Ep149: Highlighting Insights From the Marginal Zone Lymphoma Workshop

  Following the 2024 Marginal Zone Lymphoma (MZL) Workshop, CancerNetwork® spoke with multiple attending clinicians about insights they shared regarding the disease state, covering the significance of the workshop and its contribution to advancing research in areas such as prognostic factors and managing adverse events (AEs) related to the disease. Thomas Habermann, MD, professor of Medicine at the Mayo Clinic in Rochester, Minnesota, member of the Lymphoma Research Foundation’s Scientific Advisory Board, and MZL Workshop co-chair, spoke about the significance of the MZL Workshop. He highlighted the complexity of these types of diseases, which he believed warranted the establishment of the group. According to Habermann, MZL is a “heterogenous group of disorders” that most contemporaries in the field “don’t quite appreciate.” Next, Julie M. Vose, MD, MBA, George and Peggy Payne chair in oncology and chief of Hematology and Oncology at the University of Nebraska Medical Center, and co-editor-in-chief of ONCOLOGY®, spoke about how the MZL Workshop contributes to advancing research and improving outcomes for patients with MZL. She emphasized a need to be more inclusive when enrolling patients with MZL in clinical trials. Then, James R. Cerhan, MD, PhD, professor of Epidemiology at the Mayo Clinic College of Medicine and Science, and Ralph S. and Beverly Caulkins Professor of Cancer Research, spoke about addressing research questions in MZL epidemiology to further disease understanding. He emphasized a need to further study newly identified risk factors of the disease, as well as identifying new treatment targets for patients with MZL. Additionally, Alexandar Tzankov, MD, surgical pathologist and head of the Department of Histopathology and Autopsy at the Institute of Medical Genetics and Pathology at University Hospital Basel, and chair for the European Bone Marrow Working Group, discussed how prognostic factors for MZL may influence treatment. He described how the limited number of studies done with relatively small subsets of patients makes prognoses challenging, as prognostic factors have not been sufficiently explored. Finally, Andrew D. Zelenetz, MD, PhD, medical director of Quality Informatics at Memorial Sloan Kettering Cancer Center, outlined challenges related to AE management of treatments for MZL. He emphasized that safety management practices for MZL are comparable with other B-cell lymphomas, suggesting that use of bridging therapy for CAR T cells and step-up dosing for bispecific antibodies may help with mitigating AEs.

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• S1 Ep148: Navigating Management and Dosing Considerations for Amivantamab in NSCLC

  In the first edition of a special 3-part podcast series, CancerNetwork® spoke with Daniel Morgensztern, MD; Mary Ellen Flanagan, NP; and Janelle Mann, PharmD, BCOP, about best practices for implementing recently approved bispecific antibodies into cancer care. Their initial discussion focused on the clinical trial results, administration protocols, and toxicity management strategies related to the use of amivantamab-vmjw (Rybrevant) for patients with EGFR-mutated non–small cell lung cancer (NSCLC). Morgensztern is a professor of Medicine and clinical director of Thoracic Oncology in the Division of Oncology at Washington University School of Medicine in St. Louis. Flanagan is a nurse practitioner in the Division of Thoracic Oncology at Washington University in St. Louis. Mann is a clinical oncology pharmacist at Siteman Cancer Center of Washington University School of Medicine in St. Louis and manager of Clinical Pharmacy Services at Barnes-Jewish Hospital. Morgensztern began by giving an overview of amivantamab’s mechanism of action and highlighting supporting data for the agent when administered alone or in combination with other agents.  The FDA initially approved amivantamab monotherapy for patients with EGFR exon 20 insertion–mutant NSCLC in May 2021 based on data from the phase 1 CHRYSALIS trial (NCT02609776). Furthermore, the agency approved amivantamab/chemotherapy as frontline treatment for patients with NSCLC harboring EGFR exon 20 insertion mutations in March 2024 based on data from the phase 3 PAPILLON trial (NCT04538664). Findings from the phase 3 MARIPOSA trial (NCT04487080) also supported the FDA approval of amivantamab plus lazertinib (Lazcluze) for those with EGFR-mutant NSCLC in August 2024. Additionally, Mann reviewed key dosing considerations as patients receive amivantamab via intravenous infusion. She detailed the use of premedication such as diphenhydramine (Benadryl) to supplement amivantamab while monitoring for toxicities during the initial infusion period, which may necessitate additional dosing adjustments. Flanagan added to the conversation surrounding infusion-related reactions by describing strategies for mitigating the risk of venous thromboembolism, cutaneous toxicities, and other adverse effects. References 1. RYBREVANTTM (amivantamab-vmjw) receives FDA approval as the first targeted treatment for patients with non-small cell lung cancer with EGFR exon 20 insertion mutations. News release. The Janssen Pharmaceutical Companies of Johnson & Johnson. May 21, 2021. Accessed January 29, 2025. https://tinyurl.com/3d8wtu4m 2. FDA approves amivantamab-vmjw for EGFR exon 20 insertion-mutated non-small cell lung cancer indications. News release. FDA. March 1, 2024. Accessed January 29, 2025. https://tinyurl.com/msw4u5yk 3. RYBREVANT® (amivantamab-vmjw) plus LAZCLUZE™ (lazertinib) approved in the U.S. as a first-line chemotherapy-free treatment for patients with EGFR-mutated advanced lung cancer. News release. Johnson & Johnson. August 20, 2024. Accessed January 29, 2025. https://tinyurl.com/yxc8u8t4

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