Panelists discuss how future directions in chronic lymphocytic leukemia (CLL) treatment include promising developments with Bruton tyrosine kinase (BTK) degraders, noncovalent BTK inhibitors, alternative BCL2 inhibitors like sonrotoclax, bispecific antibodies for consolidation strategies, and addressing remaining gaps such as Richter transformation risk, infection susceptibility, and secondary malignancy surveillance in this rapidly evolving therapeutic landscape.
Panelists discuss how real-world evidence studies from databases like Flatiron demonstrate that second-generation Bruton tyrosine kinase (BTK) inhibitors perform better than first-generation agents in clinical practice, providing hypothesis-generating data that support clinical observations about treatment tolerability and infection rates, although these retrospective analyses should complement rather than replace randomized controlled trial evidence.
Panelists discuss how emerging combination strategies like acalabrutinib-venetoclax (AMPLIFY) and zanubrutinib-venetoclax (SEQUOIA Arm D) are expanding time-limited treatment options beyond the traditional venetoclax-obinutuzumab approach. However, they emphasize the need for longer follow-up data before widespread adoption and careful patient selection based on individual preferences and risk profiles.
Panelists discuss how to effectively mitigate Bruton tyrosine kinase (BTK) inhibitor toxicities through careful patient risk stratification, collaboration with cardio-oncologists, routine monitoring for arrhythmias and hypertension, appropriate use of dose reductions and drug holidays for chronic toxicities, and consideration of time-limited strategies to reduce long-term adverse effect exposure while maintaining treatment efficacy.
Panelists discuss how measurable residual disease (MRD) testing should be used primarily for prognostic information rather than routine treatment decision-making, with current guidelines recommending against using MRD results to alter therapy duration or change treatments. They question whether MRD negativity represents a sufficient surrogate end point for drug approvals, given the lack of cure potential and variable kinetics of MRD conversion.
Panelists discuss how obinutuzumab combinations with acalabrutinib (ELEVATE-TN data) and venetoclax (CLL14 data) provide compelling treatment options. The former shows continued progression-free survival benefits and curve separation over time, whereas the latter offers outstanding fixed-duration results even for high-risk patients. Both require careful consideration of intravenous (IV) vs oral preferences and long-term safety profiles.
Panelists discuss how the updated SEQUOIA Arm C data demonstrate that zanubrutinib monotherapy achieves a remarkable 72% progression-free survival at 5 years for high-risk patients with deletion 17p, showing similar outcomes to TP53 wild-type patients and establishing continuous monotherapy as an excellent option for these highest-risk patients.
Panelists discuss how to select among available Bruton tyrosine kinase (BTK) inhibitor treatment regimens for continuous vs fixed-duration strategies. They weigh the benefits of oral-only regimens against combination therapies that include intravenous (IV) infusions, while acknowledging the limited retreatment data for newer oral doublets.
Panelists discuss how the treatment landscape for treatment-naive patients with chronic lymphocytic leukemia (CLL) is rapidly evolving with new guideline updates every 6 to 12 months. They categorize approaches into fixed-duration vs continuous treatment strategies while emphasizing the need to study different molecular subtypes of CLL separately in future clinical trials.
An expert discusses emerging real-world strategies for managing adverse effects of antibody-drug conjugates (ADCs) in metastatic triple-negative breast cancer (mTNBC), emphasizing the importance of patient education about toxicities such as alopecia while highlighting the potential of ADCs to improve progression-free survival and quality of life.
An expert discusses the importance of managing adverse effects of antibody-drug conjugates (ADCs) in metastatic triple-negative breast cancer (mTNBC), highlighting strategies such as prophylactic growth factor support and emerging genetic screening for UGT1A1 polymorphisms to personalize and optimize patient care.
An expert discusses the multifaceted nature of CAR T-cell therapy for relapsed/refractory (R/R) large B-cell lymphoma (LBCL), emphasizing the need for early multidisciplinary coordination to address clinical, logistical, financial, and psychosocial challenges, ensuring patients are supported throughout the complex treatment journey.
An expert discusses the evolving management of relapsed/refractory (R/R) large B-cell lymphoma (LBCL), illustrating how CAR T-cell therapy has transformed third-line treatment from palliative to potentially curative, and emphasizing the importance of timely referral, reassessing eligibility, and individualizing care to optimize patient outcomes.
An expert discusses how optimal sequencing of therapies remains unclear in lower-risk MDS, with emerging combination strategies and ongoing trials that may help define the best treatment approaches.
An expert discusses how real-world evidence and patient-reported outcomes support luspatercept’s clinical benefits, while highlighting the high failure rates of ESA therapy in community practice.
Panelists discuss how implementing combination immunotherapy in clinical practice faces institutional barriers, including formulary approval for retifanlimab and payer authorization challenges. They maintain that published dosing schedules should be followed rather than modifying treatment intervals to address patient access barriers.
Panelists discuss how biomarker development in anal cancer remains limited with PD-L1 status not influencing treatment decisions, although rare targets like HER2, PIK3CA aberrations, and RAS wild-type status for EGFR inhibitors may warrant next-generation sequencing testing for research purposes, while emphasizing honest discussions about palliative treatment goals and quality-of-life balance.
An expert discusses that while CAR T-cell therapy has transformed the treatment landscape for primary refractory diffuse large B-cell lymphoma by outperforming traditional transplant approaches in the second-line setting, timely referral to specialized centers is critical, as misjudged eligibility and nonclinical barriers like geography, caregiver support, and insurance can delay or prevent access to this potentially curative therapy—challenges best addressed through proactive, multidisciplinary coordination.
An expert discusses that this case of a 60-year-old man with primary refractory diffuse large B-cell lymphoma highlights the urgent need for a shift in therapeutic strategy following early relapse after R-CHOP, with CAR T-cell therapy emerging as a preferred option given the poor prognosis of chemo-refractory disease, the patient’s eligibility for intensive treatment, and the critical role of timely referral, coordinated care, and transparent communication to optimize outcomes in high-risk lymphoma.
An expert discusses the importance of timely biomarker testing and emerging challenges in treatment sequencing for metastatic triple-negative breast cancer (mTNBC), as first-line use of antibody-drug conjugates (ADCs) raises concerns about cross-resistance and the need for strategic postprogression planning.
An expert discusses the evolving role of biomarker testing in first-line metastatic triple-negative breast cancer (mTNBC), highlighting how PD-L1, BRCA status, and emerging markers such as Trop-2 expression are shaping personalized treatment approaches and guiding the integration of antibody-drug conjugates (ADCs) and immunotherapy.
An expert discusses how long-term follow-up data from the COMMANDS trial demonstrated sustained superiority of luspatercept over ESAs, with an intriguing trend toward improved overall survival that warrants further investigation.
An expert discusses how the EPO-PRETAR trial results showed no significant difference in transfusion dependence between early and late ESA initiation, emphasizing that treatment timing remains an individualized decision.
An expert discusses how radiopharmaceuticals such as radium-223 offer a valuable different mechanism of action in treating advanced prostate cancer, requiring careful patient selection, safety monitoring including complete blood count (CBC) tracking, and practical management of adverse effects such as fatigue and nausea while following radiation safety protocols.
Panelists discuss how treatment selection between combination immunotherapy (IO) and chemotherapy alone should favor the FDA-approved carboplatin-paclitaxel-retifanlimab regimen for most patients with metastatic anal cancer, while avoiding checkpoint inhibitors in solid organ transplant recipients and maintaining that different checkpoint inhibitors are not necessarily interchangeable without specific trial data.
Panelists discuss how the PODIUM-303 study demonstrated improved progression-free survival (9.3 vs 7.4 months) and response rates (56% vs 44%) when adding retifanlimab to carboplatin-paclitaxel in first-line metastatic anal cancer, leading to FDA approval despite nonsignificant overall survival results due to 45% crossover in the interim analysis.
An expert discusses how emerging trial data, particularly from ASCENT-04, are reshaping first-line treatment strategies for PD-L1–positive metastatic triple-negative breast cancer (mTNBC) by demonstrating the potential superiority of antibody-drug conjugates (ADCs) combined with immunotherapy over standard chemotherapy regimens.
An expert discusses how recent clinical advancements and biomarker-driven strategies are reshaping first-line treatment decisions in metastatic triple-negative breast cancer (mTNBC), emphasizing the critical need for early, optimized therapy to improve outcomes in this aggressive disease.
A panelist notes that while new treatments like luspatercept and imetelstat offer hope beyond traditional erythropoiesis-stimulating agents—which fail in many patients and provide limited response duration—variability in patient response, influenced by factors such as mutation burden, underscores the need for personalized therapies and continued development of agents that can modify disease progression and improve survival in low-risk myelodysplastic syndrome.
A panelist highlights that after initial hemoglobin decline despite dose escalation, further increasing luspatercept dosing led to transfusion independence and hemoglobin improvement, underscoring the critical role of regular monitoring and timely dose adjustments to optimize anemia management in low-risk myelodysplastic syndrome.