An expert discusses how the PEACE III combination of radium-223 and enzalutamide represents an effective treatment option for the limited population of patients who reach first-line metastatic castration-resistant prostate cancer (mCRPC) without prior androgen receptor pathway inhibitor exposure, while other combinations such as radium-223 plus olaparib showed mixed results with concerning toxicity profiles.
A panelist emphasizes that recent real-world retrospective data from 103 first-line luspatercept-treated patients closely align with, and even slightly exceed, COMMANDS trial results—demonstrating significant hemoglobin improvements and transfusion independence—thereby reinforcing luspatercept’s effectiveness and practical value in routine clinical care for erythropoiesis-stimulating agent–naïve, low-risk patients with myelodysplastic syndrome.
An expert discusses how CT scans and bone scans remain the standard imaging approach for most patients with metastatic castration-resistant prostate cancer (mCRPC), whereas prostate-specific membrane antigen (PSMA) PET scans are primarily reserved for selecting patients for specific treatments such as lutetium Lu 177 vipivotide tetraxetan (Pluvicto), though they may offer better sensitivity for detecting soft tissue disease in radium-223 candidates.
A panelist highlights that updated COMMANDS trial data demonstrate luspatercept’s robust efficacy in erythropoiesis-stimulating agent–naive patients with low-risk myelodysplastic syndrome—achieving high rates of durable transfusion independence and hemoglobin improvement across subgroups—with emerging evidence suggesting potential long-term survival benefits and a favorable safety profile.
Panelists discuss how current NCCN guidelines for metastatic anal cancer recommend carboplatin-paclitaxel as preferred first-line therapy, with the recent addition of carboplatin-paclitaxel plus retifanlimab as category 2B evidence following FDA approval, while noting that induction chemotherapy for bulky disease remains case-specific without randomized data support.
Panelists discuss how a woman aged 55 years with T3N1M0 locally advanced squamous cell carcinoma represents a typical case for definitive chemoradiation therapy over surgical resection, emphasizing the importance of supportive care measures, including pain management, hydration monitoring, and patient education, to optimize treatment completion rates and minimize toxicity.
An expert discusses how the treatment landscape for lower-risk MDS has evolved with multiple new options including luspatercept, imetelstat, and lenalidomide based on specific patient characteristics like ring sideroblast status and EPO levels.
An expert discusses how a 67-year-old woman with symptomatic anemia was diagnosed with lower-risk MDS and treated with luspatercept as first-line therapy.
A panelist emphasizes that treatment decisions for anemia in low-risk myelodysplastic syndrome should be guided by symptoms and functional status rather than strict hemoglobin thresholds, with erythropoiesis-stimulating agents or luspatercept often initiated before transfusion dependence to improve quality of life and potentially delay disease progression.
Panelists discuss how the future treatment landscape for myeloproliferative neoplasms is evolving with many promising therapies in development, including calreticulin antibodies, selective JAK2 inhibitors, and novel agents targeting various pathways.
A panelist explains how the distinct mechanisms of erythropoiesis-stimulating agents (ESAs), luspatercept, and imetelstat offer tailored treatment options for anemia in lower-risk ESAs, enabling clinicians to address different stages of erythropoiesis and disease biology to optimize patient outcomes.
Panelists discuss how rusfertide, a hepcidin mimetic peptide, shows promise in polycythemia vera by reducing phlebotomy requirements and potentially improving symptoms by altering iron homeostasis.
Panelists discuss how the evolution of anal cancer treatment began with the 1974 Nigro regimen combining 5-fluorouracil and mitomycin with radiation, which remains the preferred treatment approach despite alternative options like capecitabine, with modifications including day 28 mitomycin based on subsequent studies showing improved colostomy-free survival.
Panelists discuss how successful treatment of locally advanced anal cancer requires a multidisciplinary approach involving colorectal surgeons, radiation oncologists, pathologists, medical oncologists, and physician assistants. They emphasize the importance of proper histological classification to distinguish squamous cell carcinoma from adenocarcinoma.
Panelists discuss the rapidly evolving endocrine treatment landscape in oncology, emphasizing the shift toward personalized therapy guided by tumor biomarkers such as ESR1, PI3K, and HER2-low, with excitement about new targeted agents and combination strategies expected over the next 5 years; they highlight challenges in treatment sequencing and resistance but remain optimistic that ongoing research and emerging data will enable more effective, tailored care that improves survival, delays toxicity, and potentially enhances cure rates.
Panelists discuss recent phase 3 trials of novel endocrine agents in advanced breast cancer, highlighting benefits—especially in patients with ESR1 mutations—from proteolysis-targeting chimeras (PROTACs) and oral selective estrogen receptor degraders (SERDs), including early switching based on molecular monitoring and combination strategies with CDK4/6 inhibitors; they emphasize the favorable safety profiles and the promise of personalized regimens, while also looking ahead to ongoing studies evaluating these agents earlier in treatment to improve cure rates and reduce recurrence in hormone receptor–positive breast cancer.
Panelists discuss the ELEVATE trial’s ongoing evaluation of elacestrant combined with targeted agents such as ribociclib, capivasertib, and everolimus, emphasizing the importance of optimizing dosing—such as the ribociclib reduction to 400 mg on a 3-weeks-on, 1-week-off schedule—to balance efficacy and tolerability, and highlighting the trial’s role in advancing precision combination therapies that may reshape treatment sequences in hormone receptor–positive breast cancer.
Panelists discuss the EMBER-3 trial, which evaluated single-agent oral selective estrogen receptor degrader (SERD) imlunestrant vs standard endocrine therapy and the combination of imlunestrant with abemaciclib beyond progression, highlighting enhanced progression-free survival with the combination regardless of ESR1 mutation status, underscoring the promise of dual blockade strategies to overcome resistance while emphasizing the need to balance efficacy, safety, and biomarker use as treatment paradigms evolve.
Panelists discuss the SERENA-6 trial evaluating camizestrant, which uniquely enrolled patients with molecularly detected ESR1 mutations before clinical progression, showing that early switching to this oral selective estrogen receptor degrader (SERD) improved progression-free survival and quality of life compared with continuing standard therapy, while highlighting ongoing questions about long-term benefits, optimal timing, and the practical challenges of frequent circulating tumor DNA (ctDNA) monitoring in clinical practice.
Panelists discuss recent phase 3 trials introducing novel endocrine agents such as proteolysis-targeting chimeras (PROTACs) that target estrogen receptors through new mechanisms, highlighting modest progression-free survival benefits—especially in patients with ESR1-mutated disease—and generally favorable tolerability profiles, while underscoring the importance of monitoring unique adverse effects and the potential for these therapies to advance treatment of endocrine-resistant metastatic breast cancer.
Panelists discuss the expanding array of treatment options for metastatic hormone receptor–positive breast cancer, emphasizing the critical role of molecular testing—both tissue biopsy and circulating tumor DNA (ctDNA)—in identifying targets and guiding therapy selection, with serial ctDNA testing enabling dynamic monitoring of tumor evolution and timely adjustments to personalized treatment plans.
Panelists discuss that although the use of everolimus has declined with newer targeted therapies, it remains an important option for patients without ESR1 mutations or PI3K/AKT pathway alterations, improving outcomes when endocrine therapy alone is ineffective and serving as a valuable alternative in later treatment lines when other targeted agents are unsuitable.
Panelists highlight that oral endocrine therapies for hormone receptor-positive breast cancer are generally well tolerated with manageable mild adverse effects, whereas PI3K/AKT/mTOR inhibitors often cause more challenging toxicities such as hyperglycemia and diarrhea, leading many clinicians to prioritize better-tolerated endocrine agents initially to balance efficacy with patient quality of life.
Panelists discuss that for patients with both ESR1 and PIK3CA mutations after progression on CDK4/6 inhibitors, single-agent elacestrant shows meaningful clinical activity and is often favored in the second line due to its efficacy and tolerability, with more toxic combination regimens typically reserved for later treatment lines.
Panelists discuss that, based on EMERALD trial data, elacestrant provides consistent clinical benefit in metastatic breast cancer regardless of ESR1 mutation allele frequency, supporting the use of any detectable ESR1 mutation—regardless of variant allele frequency (VAF)—as a valid criterion for treatment selection.
Panelists discuss how real-world evidence has reinforced the clinical effectiveness of oral selective estrogen receptor degraders observed in the EMERALD trial, showing consistent benefit—even in more heavily pretreated and diverse patient populations—thereby validating the drug’s utility and expanding its role in routine care for ESR1-mutated metastatic breast cancer.
A panelist discusses the evolving role of luspatercept in low-risk myelodysplastic syndrome, highlighting its broad efficacy beyond SF3B1 mutations, its advantage in reducing transfusions and improving quality of life, and the shift toward treatment decisions based on clinical presentation and lifestyle factors rather than genetic profiles alone.
A panelist discusses a typical lower-risk myelodysplastic syndrome case managed with luspatercept over erythropoiesis-stimulating agents due to its convenient every-3-week dosing and favorable early response, emphasizing how treatment decisions should align with patient lifestyle, anemia severity, and goals of improving hemoglobin levels, minimizing transfusions, and enhancing quality of life.
An expert highlights that the future of metastatic castration-resistant prostate cancer (mCRPC) treatment is advancing with novel drug classes such as radioligand therapies, proteolysis-targeting chimeras (PROTACs), T-cell engagers, and antibody-drug conjugates, all aimed at enhancing precision medicine through tumor sequencing to enable personalized, effective, and better-tolerated combination regimens that extend survival while preserving quality of life and patient independence.
An expert discusses how the PEACE III trial demonstrated that combining radium-223 with enzalutamide significantly improved radiographic progression-free survival and overall survival compared with enzalutamide alone in patients with metastatic castration-resistant prostate cancer (mCRPC) who had bone metastases and limited prior treatment exposure.