Oncology News Central Peer-Spectives

Treatment options are expanding quickly in early non-small cell lung cancer. Listen as Heather Wakelee, MD, division chief of Medical Oncology at Stanford University and president of the  International Association for the Study of Lung Cancer, describes how she’s using new agents and incorporating trial findings into practice. She and host Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology Oncology at Cedars-Sinai Cancer, explore the growing roles for neo- and adjuvant therapy and how to select patients for each therapeutic approach.

After a decade of limited gains in metastatic pancreatic cancer, Zev Wainberg, MD, professor of medicine and co-director of the GI oncology program at the University of California, Los Angeles, presented the results of the NAPOLI-3 trial at the ASCO Gastrointestinal Cancers Symposium last month. The data showed an improvement in overall survival and usher in a new standard for the hard-to-treat disease. Listen as Dr. Wainberg talks with Bob Figlin, MD,Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer, and host of OBR’s Peer-Spectives podcast, about those data and which patients should receive the regimen. They also talk about what advances might be coming next in the metastatic setting and in earlier disease, and what factors influence Dr. Wainberg’s treatment choices.    

The landscape for breast cancer treatment is shifting quickly, with an ever-increasingemphasis on targeted and hormonal therapies. Listen as Virginia Kaklamani,MD, professor of medicine in the division of hematology oncology at UT Health San Antonio, and medical directorof the breast oncologyprogram at UT Health San Antonio, MD Anderson Cancer Center,talks with Bob Figlin, MD, Steven Spielberg Family Chair in Hematology-OncologyatCedars-Sinai Cancer,about key findings coming out of the 2022 San Antonio Breast Cancer Symposium. She shares how she’ll use elacestrant following updated results from the EMERALD trial, how to select patients for ovarian suppression, and the expanding role of CDK4/6 inhibitors. “[T]here's no role for combination chemotherapy in first-line [estrogen receptor]-positive metastatic breast cancer anymore –even in patients that are deemed to have visceral crisis,”she said.    

Listen as Gabriela Hobbs, MD, clinical director of the leukemia atMass General, talks with Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology Oncology at Cedars-Sinai Cancer in Los Angeles, about the latest progress in the treatment of myelofibrosisand how she both assesses new patients and plans their treatment. New agents, including JAK2 inhibitors,are not curative but can have substantial effects on patients and open up further treatment options. Dr. Hobbs also talks about new drug classes on the horizon and what to expect at the upcoming ASH meeting.

Melissa Johnson, MD,a medical oncologist with Tennessee Oncology and Director of Lung Cancer Research at Sarah Cannon Research Institute in Nashville,joins host Robert Figlin, MD, Steven Spielberg Family Chair in HematologyOncologyat Cedars-Sinai Cancer, to talk about KRAS G12C inhibition in non-small cell lung cancer (NSCLC)treatment. She talks about how she uses sotorasib (Lumakras), which is U.S. Food and Drug Administration (FDA)approved for second-line treatment, why plasma-based genetic testing is so important, and how she explains to patients that even though she can’t start them off with this drug in the first-line, having it in reserve is a good plan.    

The key steps to launching a successful and professionally fulfilling hematology/oncology fellowship is to “reflect, project, and adapt,” according to Gerald Hsu, MD, PhD, associate clinical professor of medicine and director of the Hematology/Oncology Fellowship Program at UCSF. Dr. Hsu spoke with Robert Figlin, MD, to discuss how new fellows can best navigate the opportunities they’re presented with. Dr. Hsu recommends reflecting on your areas of passion and interest, projecting what you’ll need 10 years down the road, and adapting your goals as your priorities and interests evolve.

Tejas Patil, MD, assistant professor of medical oncology at the University of Colorado Cancer Center, talks with Robert A. Figlin, MD, about new targeted therapies for non-small cell lung cancer (NSCLC), particularly tepotinib (Tepmetko) for MET exon 14 and sotorasib (Lumakras) for KRAS G12C. The MET exon 14 skip mutation has attracted renewed attention because tepotinib and capmatinib (Tabrecta), which both target this mutation, recently received FDA approvals. But MET can be disrupted in other ways, as well. Listen as Dr. Patil discusses the different types of MET alterations, how to identify MET activation in patients, and best practices for using tepotinib to treat MET activation that arises as a resistance mechanism to the EGFR inhibitor osimertinib (Tagrisso).

  Jonathan Cohen, MD, MS, Associate Professor, Hematology and Medical Oncology, Emory University School of Medicine, , joins OBR Editor-in-Chief Robert Figlin, MD, to talk about mantle cell lymphoma. Dr. Cohen describes the key to making a correct diagnosis and what the best frontline treatment approaches are for different patient groups. He also talks about how BTK inhibitors and CAR T-cell therapy are shifting the treatment landscape and what he’s anticipating will be presented at upcoming conferences. “One of the things I know I've learned about mantle cell lymphoma is that if you wait six months, something new will come down the come down the pipeline,” Dr Cohen said.

Bob Figlin, MD, and Toni Choueiri, MD, the director of the Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute, discuss the early results from the COSMIC-313 trial, which Dr. Choueiri presented at ESMO 2022. The trial enrolled previously untreated patients with metastatic clear cell renal cell cancer who were classified as intermediate- to poor-risk. Standard of care doublet therapy, nivolumab (nivo) plus ipilimumab (ipi), was compared with triplet therapy, consisting of nivo-ipi plus cabozantinib. Triplet therapy improved progression-free survival compared with doublet therapy, specifically in the intermediate-risk group. Dr. Choueiri also discussed the complicated landscape in RCC and how practicing oncologists can evaluate patients for appropriate treatments as well as how to communicate effectively with patients about the factors that contribute to that decision.

Bob Figlin, MD, and Jamie Von Roenn, MD, discuss strategies for learning about the oncology specialty earlier in the training pipeline, particularly for under-represented groups. They also look at opportunities for oncology fellows to build skills in different career areas.