Oncology News Central Peer-Spectives

The prospective randomized NHS-Galleri multicancer early detection trial didn’t meet its primary endpoint, but it did uncover a lot more early-stage cancers than predicted. Eric Klein, MD, and Robert Figlin, MD, talk about what the data reveal about cancer biology and for screening programs.

Data presented at the 2026 American Society of Clinical Oncology Annual Meeting add to the “ever-shifting and chaotic space” that is CLL care, says Matthew Lunning, DO. He discusses how new findings are affecting practice with Robert A. Figlin, MD.

New treatments for patients with microsatellite instability–high colorectal cancer are drastically changing outcomes. Nicholas James Hornstein, MD, PhD, discusses recent advances and key findings from the 2026 American Society of Clinical Oncology Annual Meeting with Carolina Bernabe Ramirez, MD

In the wake of recent key data about ESR1-mutated metastatic breast cancer, treatment decisions have become more complicated. “In current clinical practice, this is not a straightforward decision,”Marla Lipsyc-Sharf, MD, explains to Robert A. Figlin, MD.
 

“In breast cancer now, all of our treatment for hormone receptor–positive metastaticdisease is a bit of a moving target because of new therapies that are available,”explains Hope S. Rugo, MD, division chief of breast medical oncology and the Women’sCancers Program director at the City of Hope Comprehensive Cancer Center in Duarte,California. She discusses the “ever-changing” landscape involving the PI3kinase/AKT/mTOR pathway with Robert A. Figlin, MD, the Steven Spielberg FamilyChair in Hematology-Oncology at Cedars-Sinai Cancer in Los Angeles. Dr. Rugo detailskey considerations that she uses for decision making in practice. “And I think we justwant to be cautious about toxicity for these patients and really know that we’rebenefiting them, rather than using up treatments,” she explains.
 

As the management of patients with ESR1-mutated metastatic breast cancer evolves,various questions have emerged in clinical practice. “It's a complex situation,” explainsHope S. Rugo, MD, division chief of breast medical oncology and the Women's CancersProgram director at the City of Hope Comprehensive Cancer Center in Duarte,California. She discusses how recent advances have changed treatment decisions withRobert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology atCedars-Sinai Cancer in Los Angeles. “I think it's important to keep in mind that today wejust have single-agent oral SERDs, and people like to give combinations,” Dr. Rugonotes. But what combinations to give and when remains unclear. “I think how we'regoing to decide is that we're going to wait and see what's approved and then look atpatients to try and figure out what to do,” she offers.
 

How are oncologists currently approaching the care of patients with ESR1-mutated advanced breast cancer in practice? Erin Frances Cobain, MD, associate professor at the University of Michigan Rogel Cancer Center in Ann Arbor, speaks with Wassim Mchayleh, MD, MBA, the clinical program director of the breast cancer program at AdventHealth Cancer Institute and associate professor of medicine at the University of Central Florida in Orlando, about how to best use oral selective estrogen receptor degraders. “And the big question is ‘Can we use SERDs in combination, or are SERDs effective in patients without an ESR1 mutation?’ Can we go outside the current approved guidelines? And I think that’s the biggest question that everyone is asking today,” notes Dr. Mchayleh.

Combination regimens improve survival in advanced EGFR-mutated NSCLC, but they also increase toxicity. Jorge Nieva, MD, shares how he talks with patients about potential adverse events. Hedescribes the options available for prophylaxis and how he treats the toxicities that do arise.

Tackling central nervous system (CNS) disease in EGFR-mutated non-small cell lung cancer “is a huge problem, both from a quality-of-life perspective for patients and also from a longevity perspective,” explains Sid Devarakonda, MD, director of thoracic medical oncology at Swedish Cancer Institute in Seattle and clinical associate professor at Washington State University. He speaks with Aakash Desai, MD, MPH, associate director of the Phase 1 and Precision Oncology program at the University of Alabama at Birmingham, about how CNS metastases inform choices between regimens. Dr. Devarakonda also discusses how the recent U.S. Food and Drug Administration approval of subcutaneous amivantamab (Rybrevant Faspro) may change his approach. “[Y]ou still need to be comfortable managing some of the toxicities that still persist, even with the subcutaneous formulation, but it's terribly convenient from a practical perspective,” he notes.
Dr. Desai and Dr. Devarakonda reported various financial relationships.

With multiple regimens available for advanced EGFRm NSCLC, selecting the best regimen for an individual patient is key. Jorge Nieva, MD, tells host Aakash Desai, MD, MPH, that the questionshouldn’t be about who needs more efficacy, but rather understanding a patient’s personality and goals.