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In a cobranded episode between Oncology On the Go, hosted by CancerNetwork®, and the American Society for Transplantation and Cellular Therapy (ASTCT)’s program ASTCT Talks, an expert panel explored when early antibiotic de-escalation may be feasible for pediatric populations who undergo hematopoietic cell transplantation. The panel was hosted by Diego R. Hijano, MD, MSc, who was joined by his colleagues Gabriela Marón, MD, MSc, and Fareed Khawaja, MBBS. Marón began by contextualizing the traditional practice of continuing antibiotic therapy until neutrophil recovery, which was based on host defense physiology instead of clinical trial data. Prolonged antibiotic use, she said, may correspond with resistant pathogens, bloodstream infections, and increased intensive care unit mortality across pediatric populations. Additionally, a limited pipeline for new antibiotic agents, especially for pediatric patients, makes the prevention of resistance critical during patient care. Khawaja continued the discussion by highlighting recent literature and randomized clinical trials supporting the de-escalation of gram-negative coverage within 48 to 72 hours if no infection source is identified. He referenced new guidelines from the European Conference on Infections in Leukaemia, which support de-escalating antibiotics at 40 to 72 hours if no clear source of fever appears. Another study published in 2023 showed that decreased antibiotic days resulted in similar rates of successful treatment, subsequent fever, and 30-day mortality. Additionally, advances such as improved blood culture incubation and PET scans may bolster the ability of clinicians to safely de-escalate treatment. Future directions in the field, Khawaja said, may include investigating how aggressive stewardship impacts long-term outcomes while learning how to implement quality improvement programs. Marón also identified a need for more prospective pediatric trials and data on how the microbiome changes following prolonged antibiotic exposure. Hijano is medical director of Occupational Health and director of the Infectious Disease, Bone Marrow Transplant, and Cellular Therapy Division at St. Jude Children’s Research Hospital. Marón is a pediatric infectious disease specialist who works with patients who undergo transplant at St. Jude Children’s Research Hospital. Khawaja is an associate professor of Infectious Diseases, Infection Control and Employee Health, and Internal Medicine at The University of Texas MD Anderson Cancer Center. References Averbuch D, Vanbiervliet Y, Baccelli F, et al. Empirical and targeted antimicrobial therapy in patients with febrile neutropenia and haematological malignancy or after haematopoietic cell transplantation: recommendations from the 10th European Conference on Infections in Leukaemia. Lancet Infect Dis. 2026;26(6):e232-e247. doi: 10.1016/S1473-3099(25)00619-X Patel PA, Teherani MF, Xiang Y, et al. Short-course empiric antibiotics in children undergoing allogeneic hematopoietic cell transplantation. Transplant Cell Ther. 2023;29(12):778.e1-778.e6. doi:10.1016/j.jtct.2023.09.011

In September 2026, the FDA granted accelerated approval to sevabertinib (Hyrnuo) as a frontline treatment option for patients with locally advanced or metastatic nonsquamous non–small cell lung cancer (NSCLC) harboring HER2 tyrosine kinase domain (TKD)–activating mutations. The decision expanded sevabertinib’s indication from its accelerated approval in November 2025 as a therapy for patients who received prior systemic treatment. To better understand the potential clinical implications of this expanded approval for sevabertinib, CancerNetwork® spoke with Xiuning Le, MD, PhD, about the findings supporting the agent’s clinical benefit and how it fits alongside other available options in the NSCLC space. Le, an associate professor in the department of Thoracic/Head and Neck Medical Oncology at UT MD Anderson Cancer Center, was the lead investigator of the phase 1/2 SOHO-01 trial (NCT05099172), which led to both of sevabertinib’s accelerated approvals. Regarding sevabertinib’s label, Le highlighted the importance of mindfully interpreting the differences between TKD-activating mutations or insertions vs amplification, as precision oncology begins with the careful testing, detection, and interpretation of patient reports. She also described how the approval supplements the rapid evolution of HER2-directed therapy in lung cancer, as sevabertinib is now an option to consider alongside zongertinib (Hernexeos) and trastuzumab deruxtecan (Enhertu) across different treatment settings.  Given sevabertinib’s accelerated approval status, Le outlined the next steps for affirming the agent’s benefit in the phase 3 SOHO-02 trial (NCT06452277), which is randomly assigning patients with treatment-naive, HER2 mutation-positive NSCLC to receive sevabertinib or chemoimmunotherapy. Le concluded by emphasizing the value of testing and identifying patients with actionable markers who may benefit from treatment with sevabertinib and other targeted agents. “What I want to tell my peer oncologists is that HER2 is still a very new target. Make sure that you sequence all the [patients with] lung cancer to identify the HER2 mutation, as we're all learning how to use these medications,” Le said. “The first, most important part is to identify those patients. Once we identify those patients, then we can discuss which frontline [option] is the most appropriate. Testing still is the key.” References FDA grants accelerated approval to sevabertinib for locally advanced or metastatic non-squamous non-small cell lung cancer. News release. FDA. September 9, 2026. Accessed October 2, 2026. https://tinyurl.com/mwsay6jf FDA grants accelerated approval to sevabertinib for non-squamous non-small cell lung cancer. News release. FDA. November 19, 2025. Accessed October 2, 2026. https://tinyurl.com/mt455knh A study to learn more about how well sevabertinib works and how safe it is compared with standard treatment, in participants who have advanced non-small cell lung cancer (NSCLC) with mutations of the human epidermal growth factor receptor 2 (HER2) (SOHO-02). ClinicalTrials.gov. Updated September 23, 2026. Accessed October 2, 2026. https://tinyurl.com/2k32z6wu

In this episode of Oncology On the Go, Daniel C. McFarland, DO, spoke with Yesne Alici, MD, who oversees Memorial Sloan Kettering Cancer Center (MSKCC)’s medical aid in dying (MAID) program. Together, they explored what MAID means for oncology practice now that it is legal in New York State. Alici defined MAID as the legal practice in which a terminally ill, capacitated adult with a life expectancy of less than 6 months may request a prescription that they self-administer to hasten death. Self-administration, she noted, is the main distinction between MAID and euthanasia, which is not legal anywhere in the US. MAID is currently legal in 14 states and Washington, DC, giving roughly 1 in 3 US adults access, according to Alici. Even so, it accounts for less than 1% of all deaths in states where it is legal, and not every patient who inquires goes on to pursue it. Drawing on MSKCC’s experience fielding inquiries from patients in New Jersey since 2019, Alici described a population that was mostly older and predominantly female, with about one-third of patients having early-stage cancer when they asked and most still receiving treatment. Nationally, the top reasons patients inquire are loss of dignity, loss of control, and loss of ability to enjoy activities, rather than physical symptoms like pain or shortness of breath. The conversation also walked through New York’s safeguards, including multiple requests, 2 neutral adult witnesses, a decision-making capacity assessment, and a mandatory psychiatrist or psychologist evaluation, a requirement shared only with Hawaii. Alici argued that these assessments should be psycho-oncology informed and stressed the importance of approaching each request with neutrality, cautioning that conflating MAID with suicidal ideation risks alienating patients. McFarland shared a challenging case involving voluntarily stopping eating and drinking, reflecting on clinicians’ own moral discomfort and on broader philosophical concerns about the romanticization of death. The pair also discussed the need for more research, the role of palliative care, and conscientious objection. Alici closed by urging oncologists who object to MAID to ensure that patients still have a path to discuss their inquiry, noting that New York law mandates offering a palliative care referral. McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being the psycho-oncology editorial advisory board member for the journal ONCOLOGY®. Alici is vice chair of clinical operations in the Department of Psychiatry and Behavioral Services, clinical director, associate attending psychiatrist, and medical director of the Biobehavioral Health Clinic at MSKCC.

At the 2026 Society of Hematologic Oncology (SOHO) Annual Meeting, CancerNetwork® sat down with a variety of experts to discuss the latest data and emerging trends surrounding the management of different hematologic malignancies. Speakers and presentations covered everything from second primary malignancy risks to novel clinical trial findings across lymphoma, myelodysplastic syndrome (MDS), leukemia, and other patient patients. First, Jasmine M, Zain, MD, an attending physician in the Lymphoma Service at Memorial Sloan Kettering Cancer Center, highlighted key takeaways from her presentation exploring the risk of secondary lymphoma malignancies following CAR T-cell therapy. In addition to discussing the incidence, mechanisms, and possible risk factors of these second malignancies, she detailed how to clinically differentiate between malignancies directly driven by retroviral or lentiviral insertional mutagenesis compared with those arising from cumulative genotoxic stress. Additionally, David Sallman, MD, an associate member in the Department of Malignant Hematology at Moffitt Cancer Center in Tampa, Florida, reviewed findings from the phase 2a HT-6184-MDS-001 trial (NCT07052006). In this study, Sallman and colleagues assessed ofirnoflast (HT-6184), a first-in-class oral allosteric NEK7 inhibitor designed to block NLRP3 inflammasome activation, in patients with lower-risk MDS who were refractory to, intolerant of, or ineligible for erythropoiesis-stimulating agents. Sallman discussed the platelet and neutrophil responses observed with ofirnoflast and how its intermittent, oral dosing schedule may protect long-term quality of life, especially among older patients with comorbidities. Finally, Julie M. Vose, MD, MBA, the George and Peggy Payne Distinguished Chair of Oncology, professor in the Division of Hematology, and director of the Lymphoma Research Group at the University of Nebraska Medical Center, and co–editor in chief of ONCOLOGY®, spoke about general developments relating to the ever-evolving chronic lymphocytic leukemia (CLL) field. She detailed how minimal residual disease (MRD) testing may serve as an informative clinical decision-making tool, outlined strategies for community practices to keep up to date with the latest happenings in the space, and identified time-limited therapies as a key theme from the meeting. References Zain JM. Understanding the risk of second malignancies after CAR T therapies. Presented at: Society of Hematologic Oncology Annual Meeting; September 9-12, 2026; Houston, TX. Sallman D, Bafna V, Nath UK, et al. Ofirnoflast (HT-6184), a first-in-class allosteric NEK7 inhibitor, achieves durable transfusion independence (TI) and hematological improvement-erythroid (HI-E) in ESA-refractory lower-risk myelodysplastic syndrome (LR-MDS): phase 2 final results. Presented at: 2026 SOHO Annual Meeting; September 9-12, 2026; Houston, TX.

The treatment paradigm for non–muscle invasive bladder cancer (NMIBC) has shifted considerably since the FDA established a formal definition of Bacillus Calmette-Guérin (BCG)–unresponsive disease, opening the door to a wave of new intravesical and gene therapies, according to Saum Ghodoussipour, MD. In a conversation with CancerNetwork® on the Oncology On the Go podcast, Ghodoussipour, director of the Bladder and Urothelial Cancer Program at Rutgers Cancer Institute and associate professor of surgery at Robert Wood Johnson Medical School, discussed the distinction between real-world “BCG-exposed” disease and the FDA’s stricter, trial-oriented definition of BCG unresponsiveness. The agency’s definition accounts for persistent papillary disease, carcinoma in situ, or stage progression within specific timeframes following adequate BCG induction and maintenance. Ghodoussipour walked through how the bladder-sparing armamentarium has expanded since 2020, when pembrolizumab (Keytruda) became the first novel agent approved for BCG-unresponsive disease. He detailed how nadofaragene firadenovec (Adstiladrin), nogapendekin alfa inbakicept-pmln (Anktiva), and TAR-200 (Inlexzo) have since given patients and clinicians a broader menu of options beyond radical cystectomy, each with distinct dosing schedules, response rates, and durability data drawn from single-arm trials. He also addressed how a persistent global BCG shortage is reshaping treatment decisions, noting that some centers, including his own, have adopted third-dose maintenance schedules rather than full-dose, 3-year courses, informed by EORTC data showing no difference in progression or overall survival despite a modest reduction in recurrence prevention. Ghodoussipour further discussed how emerging comparative trials, such as the ECOG-led EA8212/BRIDGE trial (NCT05538663) evaluating BCG against gemcitabine/docetaxel combination therapy, may help resolve open questions around sequencing and allocation.1 On the surgical side, Ghodoussipour emphasized that radical cystectomy remains a guideline-recommended option for BCG-unresponsive disease and pointed to data from the CISTO trial (NCT03933826) suggesting that patient-reported quality of life may actually improve after cystectomy compared with prolonged bladder-sparing attempts.2 Still, he noted that improving risk stratification, using biomarkers such as circulating tumor DNA and the AI-driven Vesta Bladder test, may help identify which patients are the best candidates for continued bladder preservation. “[NMIBC] has been booming the last few years,” Ghodoussipour said. “I'm fortunate to have been in such an exciting space because…it's getting better for our patients. But in order for us to reach the point where we can confidently and consistently cure these patients, we really got to get down to tumor biology.” Throughout the conversation, Ghodoussipour underscored the importance of multidisciplinary collaboration among urologists, medical oncologists, and radiation oncologists as systemic therapies and checkpoint inhibitor combinations, including regimens studied in the phase 3 CREST (NCT04165317) and POTOMAC trials (NCT03528694), increasingly enter the BCG-naive and BCG-unresponsive settings.3,4 He also stressed that shared decision-making, better patient-reported outcome data, and continued discovery work into tumor biology will be essential to bring greater consistency to treatment sequencing in the years ahead. References1. Intravesical BCG vs GEMDOCE in NMIBC (BRIDGE). Clinicaltrials.gov. Updated July 17, 2026. Accessed September 9, 2026. https://tinyurl.com/w9axbzks 2. Gore JL, Wolff EM, Nash MG, et al. Twelve-month results from the CISTO study comparing radical cystectomy versus bladder-sparing therapy for recurrent high-grade non-muscle-invasive bladder cancer. J Clin Oncol. 2025;44(4):274-285. doi:10.1200/JCO-25-01324 3. Powles T, Shore N, Galsky M, et al. Sasanlimab in combination with bacillus Calmette-Guérin (BCG) in BCG-naive, high-risk non–muscle-invasive bladder cancer (NMIBC): Event-free survival (EFS) subgroup analyses based on disease stage from the CREST study. J Clin Oncol. 2025;43(suppl 17):4517. doi:10.1200/JCO.2025.43.16_suppl.4517 4. De Santis M, Redorta J, Nishiyama H, et al. Durvalumab in combination with BCG for BCG-naive, high-risk, non-muscle-invasive bladder cancer (POTOMAC): final analysis of a randomised, open-label, phase 3 trial. The Lancet. 2025;406(10516):2221-2234. doi:10.1016/S0140-6736(25)01897-5

In August 2026, the FDA granted accelerated approval to iberdomide (Zenbexus) in combination with daratumumab and hyaluronidase-fihj (Darzalex Faspro) and dexamethasone for patients with relapsed/refractory multiple myeloma. The agency’s decision represents the first approval of a CELMoD, a more potent, target-specific successor to immunomodulatory drugs (IMiDs), according to Surbhi Sidana, MD. In a conversation with CancerNetwork®, Sidana, an associate professor of medicine at Stanford University, where she leads the myeloma cellular immunotherapy program and chairs the American Society of Hematology (ASH) Committee on Communications, discussed how this regulatory decision may impact the multiple myeloma paradigm. Additionally, she spoke about the potential next steps for the CELMoD class across different treatment lines and settings. Considering iberdomide’s approval, Sidana described how clinicians have “an option that suits every patient,” although deciding on specific therapeutic strategies represents a different challenge. She detailed how iberdomide will fit alongside modalities like CAR T-cell therapies and bispecific antibodies by serving as a convenient option for patients who are older, frailer, or unable to travel to a center that offers immunotherapy. She also highlighted the potential to combine the CELMoD with other therapies as part of a “sandwich approach.” Speaking about CELMoDs more broadly, Sidana discussed how the drug class will serve as a complement to CAR T-cell therapy and bispecifics as bridging therapy, maintenance therapy, and even as a post-relapse option. Looking ahead, she foresees CELMoDs gradually moving to the frontline setting, with ongoing trials assessing them in combination regimens for patients with newly diagnosed disease. “This approval is a landmark approval for several reasons,” Sidana said. “Having [iberdomide] as an option, which is an oral drug and easy to give, is tremendous for our patients. Iberdomide is a CELMoD, which…I think of as IMiDs 2.0. They’re oral, they have a REMS program…and they’re given on a very similar schedule, but they’re more targeted…[with fewer] adverse effects.” Sidana also highlighted an initiative from ASH named Fight4Hematology, in which members and hematologists from the organization are advocating to legislators and educating the public on the importance of continuing to fund blood disorder and hematology research. References FDA grants accelerated approval to iberdomide with daratumumab and hyaluronidase-fihj and dexamethasone for multiple myeloma. News release. FDA. August 13, 2026. Accessed August 31, 2026. https://tinyurl.com/38258auk #Fight4Hematology Action Hub. American Society of Hematology. Accessed August 31, 2026. https://tinyurl.com/ms94frk9

Wellness and burnout are often treated as 2 ends of the same seesaw: add enough yoga, sleep, and time off, and the scale tips back toward balance. In this conversation, Daniel C. McFarland, DO, and Xiomara Rocha-Cadman, MD, argue that this framing misses what actually drives distress in oncology. Drawing on years of clinical and mentorship experience tracing back to Memorial Sloan Kettering Cancer Center, the 2 physicians distinguish wellness, an active, ongoing practice, from well-being, the broader emotional and psychological state it supports. They contend that oncology-specific stressors, repeated exposure to uncertainty, suffering, and death within close patient relationships, are qualitatively different from generalized workplace burnout and do not respond well to generic stress-reduction advice alone. Both describe personal experiences in which psychological defenses masked their own accumulating grief until it surfaced unexpectedly: Rocha-Cadman’s composure gave way after a patient’s death near the holidays, and McFarland noticed an uncharacteristic uptick in humor during his first year as an attending. Their shared conclusion is that engagement with patients, not emotional withdrawal, is the more durable protection against burnout. The discussion also touches on mentorship, including Rocha-Cadman’s influence on McFarland’s own career, the difficulty of sustaining reflective practices like Balint-style process groups without institutional buy-in, lingering stigma around physicians seeking mental health care, and the value of peer awareness and stable interdisciplinary care teams. They point to a well-documented but under-discussed pattern in which rates of burnout run higher among physicians than in many comparable professions, often because clinicians hesitate to ask each other the same sensitive questions they would ask patients. Both physicians close by framing compassion for colleagues as inseparable from compassion for patients, arguing that clinicians must look out for one another because no institution or government will do it for them. McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being the psycho-oncology editorial advisory board member for the journal ONCOLOGY®. Rocha-Cadman is associate professor and chief of the Division of Psychiatry in the Department of Supportive Care Medicine at City of Hope.

In this episode of Oncology On the Go, CancerNetwork® spoke with Frank McCormick, PhD, about the arc of KRAS-targeted drug development over his 40-year career. He explained why KRAS was long considered “undruggable.” He walked through the origins of the National Cancer Institute’s RAS Initiative, which he helped lead starting in 2013, and how that effort produced several of the drugs now advancing through clinical trials for pancreatic cancer. A central moment of the conversation centers on the phase 3 RASolute-302 trial (NCT06625320) data, which showed that daraxonrasib nearly doubled overall survival compared with standard of care in pancreatic cancer. McCormick described this as a turning point that transformed pancreatic cancer from a historically difficult indication into one now seeing a wave of new drug development. McCormick also discussed his vision for cancer prevention. He described a roughly 20-year window between initiating KRAS mutations and clinical disease, and outlined a future in which a safe, well-tolerated KRAS inhibitor could be taken periodically to eliminate precancerous lesions before they progress, potentially preventing KRAS-driven cancers from developing at all. Additionally, he addressed practical considerations for treating clinicians: the feasibility of moving RAS inhibitors into earlier lines of therapy, and the biology oncologists, pharmacists, and genetic counselors should understand about differing KRAS allele subtypes. McCormick is a professor in the Helen Diller Family Comprehensive Cancer Center and holds the David A. Wood Distinguished Professorship of Tumor Biology and Cancer Research at the University of California, San Francisco (UCSF). He has researched KRAS for 40 years and helped lead the NCI RAS Initiative. He was recently named the inaugural recipient of the Stephenson Global Prize from the Stephenson Global Pancreatic Cancer Research Institute. ReferenceDaraxonrasib demonstrates unprecedented overall survival benefit in pivotal phase 3 RASolute 302 clinical trial in patients with metastatic pancreatic cancer. News release. Revolution Medicines Inc. April 13, 2026. Accessed August 19, 2026. https://tinyurl.com/44t5vh5d

In this second installment of their conversation on depression in oncology, Daniel C. McFarland, DO, and Boris Kiselev, MD, moved from diagnosis, covered in Part 1, into treatment. The discussion opened with the differential diagnoses that need to be ruled out before starting therapy: delirium, bipolar disorder, medical conditions such as endocrinopathies and severe anemia, and neurocognitive issues stemming from central nervous system involvement or dementia. McFarland and Kiselev outlined the specific red flags that should prompt an oncologist to bring in a mental health specialist rather than manage treatment alone, including suicidality, psychosis, and complex psychiatric histories. From there, the conversation turned to how depression is categorized by severity using the PHQ-9 scale, and how that severity, along with patient preference and access to care, should guide the choice between lifestyle modification, psychotherapy, and pharmacotherapy. Kiselev introduced a simplified 4-drug toolkit for oncologists: 1 selective serotonin reuptake inhibitor, 1 serotonin and norepinephrine reuptake inhibitor, mirtazapine (Remeron), and bupropion, explaining how to match each option to a patient’s specific symptoms and adverse effect (AE) concerns. The back half of their discussion served as a practical walkthrough for starting a patient on medication. They covered how to frame the conversation to reduce stigma, what to say about timelines for benefit, and specific dosing and titration guidance for each of the 4 core drugs. McFarland and Kiselev closed by highlighting the most common AEs to flag upfront, a real-world case illustrating why dose titration matters, and general guidance on how long patients typically stay on treatment. McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being the psycho-oncology editorial advisory board member for the journal ONCOLOGY. Kiselev is a consult liaison psychiatrist at Atrium Health Carolinas Medical Center, an assistant professor in the Psycho-oncology Program in the Department of Supportive Oncology at Atrium Health Levine Cancer Institute, and an assistant professor in internal medicine. 00:02-02:24: Recap of the prior episode and framing for treatment 02:24-11:17: Ruling out other causes: delirium, bipolar disorder, medical conditions, and neurocognitive issues 11:49-15:17: Deciding when an oncologist can treat directly vs when to refer to a mental health specialist 15:45-23:01: Categorizing depression severity with the PHQ-9 and matching it to lifestyle, psychotherapy, or medication 23:46-26:05: Choosing between non-pharmacologic and pharmacologic treatment based on severity and access 26:05-35:49: Selecting a medication from a core 4-drug toolkit and preparing the patient to start it 37:30-48:30: Drug-specific dosing, titration strategy, and managing common adverse effects 50:37-51:59: How long patients typically stay on treatment and closing thoughts

In a cobranded episode between Oncology On the Go, hosted by CancerNetwork®, and the American Society for Transplantation and Cellular Therapy’s (ASTCT) program ASTCT Talks, Terri Lynn Shigle, PharmD, BCOP, hosted Vinita Pai, PharmD, MS, BCPPS, who spoke about the use of CAR T-cell therapy for pediatric patients, focusing on acute lymphoblastic leukemia (ALL). After a brief overview of progress in the cellular therapy field and pediatrics’ first and only FDA-approved CAR-T product since 2017, their discussion explored the following: ·      Review of real-world practice and outcomes in ALL ·      Pediatric practical challenges including logistics, leukapheresis and lymphodepletion chemotherapy ·      Strategies for managing cell therapy toxicities in pediatric patients ·      Considerations for survivorship and long-term toxicities ·      Gaps in pediatric care and future directions The discussion highlighted the unique challenges of treating pediatric patients, paucity of data, and need for continued exploration of cellular therapy treatment not only in ALL, but other underlying diagnoses.  Shigle is a clinical pharmacy specialist in the Stem Cell Transplantation & Cellular Therapy Department at The University of Texas MD Anderson Cancer Center. Pai is an associate clinical professor in the Division of Pharmacy Practice and Science at The Ohio State University. ReferenceO'Leary MC, Lu X, Huang Y, et al. FDA approval summary: tisagenlecleucel for treatment of patients with relapsed or refractory B-cell precursor acute lymphoblastic leukemia. Clin Cancer Res. 2019;25(4):1142-1146. doi:10.1158/1078-0432.CCR-18-2035

In the newest edition of Oncology On the Go, Joshua Richter, MD, and Marco Davila, MD, PhD, spoke about the current multiple myeloma treatment landscape and highlighted practical considerations for administering CAR T-cell therapy to patients. Their discussion touched upon several critical subtopics ranging from optimizing operational and referral workflows to dismantling barriers to treatment access in rural settings. When it comes to navigating the multiple myeloma treatment algorithm, both hosts emphasized early evaluation to determine patient suitability for CAR T-cell therapy, which may help identify those who are most likely to experience the greatest responses with minimal toxicity. Regarding the question of sequencing different modalities, Richter pointed to data demonstrating the utility of administering CAR T-cell therapies prior to bispecific antibodies. Acknowledging that the average patient enrolled on a clinical trial may not align with what is typically seen in real-world practice, the hosts discussed “reassuring” data that those who do not meet certain eligibility criteria may nevertheless benefit from CAR T-cell therapy. Additionally, on the topic of maintaining an effective referral relationship between community oncologists and CAR-T centers, Davila noted that academic cell therapy clinicians may have an incumbent responsibility to consider how to improve access to treatment and make it easier for others to refer patients to care. “CAR T-cell therapy is now deeply entrenched in the world of relapsed multiple myeloma [and] soon to be likely entrenched in the newly diagnosed world. These are therapies that I think we're all going to need to embrace whether it's from an academic standpoint or a community standpoint,” Richter concluded. “Having that ongoing communication back and forth, especially as the field is moving so quickly, is absolutely key in providing optimal care for our patients.” Richter is an associate professor of Medicine in the Division of Hematology and Medical Oncology at The Tisch Cancer Institute, as well as the director of Multiple Myeloma at the Blavatnik Family - Chelsea Medical Center at Mount Sinai. Davila is the senior vice president and associate director for Translational Research, a professor of Oncology, chief of Lymphoma/Multiple Myeloma Service, and Rustum Family Endowed Chair in Translational Research at Roswell Park Comprehensive Cancer Center.

At the 2026 National ICE-T Conference in Orlando, CancerNetwork® sat down with a variety of expert researchers and clinicians to discuss the latest developments in immune effector therapy across different hematologic oncology populations. Sessions at the meeting covered practical considerations for integrating CAR T-cell therapies, bispecific antibodies, and other modalities into the treatment of those with multiple myeloma, lymphoma, and other hematologic malignancies. First, Benjamin Diamond, MD, an assistant professor of Clinical Medicine, a member of the Sylvester Myeloma Institute, and a member of the Myeloma Genomic Lab at the University of Miami Miller School of Medicine, spoke about his presentation reviewing bispecific antibodies for the management of multiple myeloma. In his session, Diamond stated that bispecific T-cell engagers are altering the landscape of multiple myeloma care and will eventually become an option in the frontline setting. With many products to choose from, Diamond emphasized sequencing these novel therapies wisely and stressed aggressive infection prophylaxis as a mandatory facet of care. Next, Tiba Al Sagheer, PharmD, BCOP, BCACP, a pharmacy quality improvement coordinator for transplant and cellular therapy at Miami Cancer Institute of Baptist Health South Florida discussed her presentation focused on defining new thresholds for monitoring and mitigating toxicities associated with CAR T-cell therapy. She described considerations for balancing early toxicity intervention against the risk of blunting efficacy depending on the specific CAR T-cell product used during treatment. Ultimately, she noted that that there is still no definitive answer or threshold for initiating prophylaxis for toxicity associated with CAR T, and that differentiating between immune effector cell (IEC)–associated hemophagocytic lymphohistiocytosis (HLH)–like syndrome (IEC-HS) and cytokine release syndrome (CRS) represents an ongoing challenge in the field. Finally, Nikesh N. Shah, MD, and Carlos Silva Rondon, MD, shared their perspectives on a debate regarding the roles of bispecific antibodies and CAR T-cell therapies in relapsed/refractory follicular lymphoma. In his presentation, Shah, a hematologist-oncologist at Tampa General Hospital who specializes in hematologic malignancies, including aggressive lymphomas and acute lymphoblastic leukemia, took the position that bispecific antibodies should be used prior to CAR T-cell therapy for most patients, although both treatments have utility in the field. Silva Rondon, a hematologist, oncologist, and bone marrow transplant specialist at Moffitt Malignant Hematology and Cellular Therapy at Memorial Healthcare System/Memorial Cancer Institute in Pembroke Pines, advocated for CAR T-cell therapy during the debate but acknowledged that both modalities can make up a complementary strategy for overcoming relapsed/refractory follicular lymphoma. References Diamond B. Bispecific antibodies for the management of multiple myeloma. Presented at the 2026 National ICE-T Conference; July 18, 2026; Orlando, FL. Sagheer TA. Thresholds and therapeutics: a precision approach to CAR T toxicity management. Presented at the 2026 National ICE-T Conference; July 18, 2026; Orlando, FL. Shah N. Debate: bispecific antibodies vs CAR-T in follicular lymphoma. Presented at the 2026 National ICE-T Conference; July 18, 2026; Orlando, FL. Silva C. CAR-T cell therapy for relapsed follicular lymphoma. Presented at the 2026 National ICE-T Conference; July 18, 2026; Orlando, FL.

Following the FDA approval of allogeneic regulatory T cell–containing immunotherapy with hematopoietic stem and progenitor cell (HSPC) and T cells-vldq (Tregzi; Orca-T), CancerNetwork® spoke with Wendy Stock, MD, about what this decision means for the treatment of patients undergoing hematopoietic stem cell transplantation for different hematologic malignancies. Additionally, she discussed how this option fits into the treatment landscape alongside other options like posttransplant cyclophosphamide (PTCy) and other next steps for improving outcomes associated with matched donor transplants. Stock reviewed findings from the phase 3 Precision-T trial (NCT05316701) that supported the approval of Orca-T, noting that the data appeared to be “effective across all populations” for patients with acute myeloid leukemia, acute lymphoblastic leukemia, high-risk myelodysplastic syndrome (MDS), and mixed-phenotype acute leukemia. Furthermore, she detailed what adoption of Orca-T might look like on an operational level, described the agent’s ability to reduce the risk of graft-versus-host disease, and emphasized referring patients early to transplantation. The approval, Stock said, marks the beginning of potentially allowing “higher-risk populations to move forward with the knowledge that it is possible to undergo transplant safely.” She noted that the FDA’s decision may inspire the field of transplant graft engineering to look more carefully at other options that might further improve transplantation outcomes. “Over the last 10 years, we have had incredibly exciting, still-to-be-tweaked methods for improving outcomes for patients undergoing transplant, which is such an important procedure for curing or [achieving] long-term survival for patients with acute leukemias and high-risk myelodysplastic syndromes,” Stock said. “This is a big advance, and it needs to be studied further, including comparisons with other major improvements in the world of transplant, such as PTCy.” Stock is the Anjuli Seth Nayak Professor of Medicine, cochair of the Leukemia Committee for the National Cancer Institute–supported Alliance for Clinical Trials in Oncology, and coleader of the Clinical and Experimental Therapeutics Research Program at the University of Chicago Medicine Comprehensive Cancer Center. References FDA approves allogeneic regulatory T cell-based immunotherapy with HSPC and T cells-vldq for use in matched donor hematopoietic stem cell transplantation for adults with hematologic malignancies. News release. FDA. June 30, 2026. Accessed July 15, 2026. https://tinyurl.com/38s3wznr Meyer EH, Salhotra A, Gandhi AP, et al. Orca-T vs allogeneic hematopoietic stem cell transplantation (Precision-T): a multicenter, randomized phase 3 trial. Blood. 2026;147(11):1168-1177. doi:10.1182/blood.2025031313

Experts discuss diagnosing and treating insomnia in patients with cancer through methods like sleep hygiene, CBT-I, and pharmacotherapy. Insomnia is one of the most common symptoms oncologists are asked to manage, yet it’s often treated reactively with medication rather than through a structured, history-driven approach. In this episode of Oncology On the Go, Daniel C. McFarland, DO, sat down with psychiatrist and psycho-oncologist Virginia C. O’Brien, MD, to unpack how clinicians can more effectively evaluate and treat insomnia in patients with cancer. The conversation opened with a foundational distinction: primary vs secondary insomnia, and why secondary insomnia—driven by anxiety, depression, pain, or cancer treatment itself—is far more common in oncology populations. O’Brien emphasized that the most frequent clinical mistake is jumping straight to a prescription instead of taking a thorough sleep history, including which phase of sleep is disrupted (falling asleep, staying asleep, or early waking) and whether the problem is affecting daytime functioning. From there, the discussion moved through practical sleep hygiene strategies clinicians can share with patients, such as limiting caffeine and screens, managing pets and partners in the bedroom, and setting a consistent nighttime routine. Then, they dove into cognitive behavioral therapy for insomnia (CBT-I), the first-line recommended treatment. O’Brien explained how sleep restriction works, why it’s often impractical during active chemotherapy, and how free digital tools like CBT-i Coach can help fill access gaps. The latter part of the discussion tackled pharmacologic management in detail: when medications are appropriate for acute insomnia; how to sequence options from least to most habit-forming; and specific guidance on trazodone (Desyrel), ramelteon (Rozerem), zolpidem (Ambien; including FDA dosing warnings for women), benzodiazepines, and newer orexin receptor antagonists. Special attention was given to older patients, those with a fall risk, and patients with a history of substance use disorder. The experts closed with guidance on when to refer to a sleep medicine specialist, including STOP-BANG screening for obstructive sleep apnea and red flags for parasomnias like REM sleep behavior disorder. McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being a psycho-oncology editorial advisory board member for the journal ONCOLOGY®. O’Brien is system director of Ambulatory Psychiatry at the Carilion Clinic.

In this episode of Oncology On the Go, CancerNetwork® spoke with Kim Stravers, an International End-of-Life Doula Association (INELDA)–certified end-of-life doula, educator, and trainer based in the Phoenix Valley, to explore how death doulas support patients with cancer and their families across all stages of the disease trajectory. Stravers opened by defining the scope of end-of-life doula work, clarifying that doulas provide nonmedical emotional, practical, and relational support to people confronting their mortality and those who care for them. She distinguished the role from hospice nursing and palliative care by emphasizing that doulas never act in a clinical capacity; they instead function as neutral companions who facilitate difficult conversations, help patients clarify their values and wishes, and advocate for individual autonomy across medical and personal decision-making. She also discussed her volunteer work within an interdisciplinary hospice team in Phoenix and described her invitation to speak at Grand Rounds for the Palliative Care Department at Mayo Clinic Arizona to introduce the role to clinical providers. When addressing cancer-specific experiences, Stravers noted that patients often come to her late in their trajectory, frequently within the 6-month hospice eligibility window, and described nonpharmacological techniques she uses to support breakthrough pain and existential distress, including body scans and guided visualization. She also shared a detailed patient case involving a woman with pancreatic cancer and Lynch syndrome whose daughter previously died of the same disease, describing how the shared diagnosis intensified the patient's anticipatory anxiety and how weekly doula visits helped provide periods of calm. Additional topics included the credentialing landscape for end-of-life doulas, which currently lacks a national licensure body, with organizations such as INELDA offering varied training and certification pathways. Stravers also addressed the portrayal of a death doula in the television drama The Pitt, affirming elements she found accurate while flagging several areas she viewed as outside the appropriate scope of doula practice.  Stravers holds certification through INELDA, where she also serves as an educator and trainer, as well as proficiency through the National End-Of-Life Doula Alliance (NEDA).