Oncology On The Go

In this episode recorded at the 2026 American Psychosocial Oncology Society (APOS) annual meeting, Daniel C. McFarland, DO, sat down with Kelly Irwin, MD, to address one of the most challenging topics in oncology: suicide risk. The conversation aimed to equip oncologists with the tools and confidence to navigate the emotional complexities of cancer care.Key Discussion Points: Understanding the Risk: Patients with cancer experience more than double the risk of completed suicide compared with the general population. The risk is highest during the first month following a diagnosis—a 12-fold increase in some studies—and remains elevated for the first year. Identifying High-Risk Factors: Beyond a prior suicide attempt (the No.1 risk factor), specific contributors include advanced-stage disease, financial distress, and cancers that impact core identity or physical function, such as head and neck or pancreatic cancers. The Power of Asking: Both experts emphasized that a clinician asking about suicide does not increase the risk. Irwin advises clinicians to trust their instincts and use a continuum of questioning, starting with general feelings of hopelessness and moving toward specific plans and access to "means" (such as firearms or medication). The "Don’t Worry Alone" Rule: Irwin urged clinicians never to handle these concerns in isolation. She recommended involving social workers, nurses, and family members, noting that in life-threatening situations, clinician-patient confidentiality (HIPAA) can be "broken" to ensure safety. Relieving Suffering and Building Connection: The primary goal is to make the "unbearable bearable". Irwin highlighted that even small, non-transactional gestures—like a "thinking of you" message—can significantly decrease suicide risk by reinforcing a patient's sense of belonging and mattering. Available Resources:· National Mental Health Hotline: Call or text 988· Connect with a crisis counselor: Text HOME to 741741· Samaritans Hotline and Website: (877)870-4673; https://samaritanshope.org/our-services/24-7-helpline/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®. Irwin is an instructor in psychiatry at Harvard Medical School and a faculty psychiatrist at the Massachusetts General Hospital (MGH) Cancer Center and MGH Schizophrenia Program, where she founded the Cancer Prevention Program.

In a conversation with CancerNetwork®, Julian Hong, MD, MS, discussed considerations for optimizing care among patients with mental health disorders (MHDs) who are undergoing treatment for cancer. He spoke in the context of a study he and coauthors published in Cancer, which showed that patients with cancer and a mental health condition experience an increased risk of all-cause mortality.Specifically, findings from the study demonstrated that early MHDs conferred a heightened all-cause mortality risk in the initial 12 to 35 months of cancer diagnosis (HR, 1.51; 95% CI, 1.47-1.56). This trend diminished over time, with gradually reduced risks observed from 36 to 59 months (HR, 1.17; 95% CI, 1.11-1.24) and from 60 to 120 months after that initial period (HR, 0.95; 95% CI, 0.89-1.01). Furthermore, the risk of all-cause mortality was even higher for patients with an early MHD and receipt of psychotropic medications at 12 to 36 months (HR, 2.67; 95% CI, 2.52-2.83), 36 to 60 months (HR, 1.25; 95% CI, 1.07-1.46), and 60 to 120 months (HR, 1.01; 95% CI, 0.82-1.25).“We’re…trying to combine different types of data to identify earlier mental health diagnoses. Even what can feel like small amounts of time—weeks and months—can make a huge difference for people who are going through these conditions,” Hong stated regarding the next steps for research in the field. “It’s one thing to help identify some of these issues and some of these implications of different conditions, but at the end of the day, the goal is to intervene on these things and do a better job of taking care of patients.”Hong is an associate professor of radiation oncology in the Baker Computational Health Sciences Institute at the University of California, San Francisco (UCSF), and head of Artificial Intelligence at UCSF Helen Diller Family Comprehensive Cancer Center.ReferenceGanjouei AA, Zack T, Friesner I, et al. Association of mental health disorders and all-cause mortality for patients with cancer: large-scale analysis of University of California Health System data. Cancer. 2026;132(5):e70254. doi:10.1002/cncr.70254

In this episode of Oncology on The Go, created in collaboration with the American Psychosocial Oncology Society, Daniel C. McFarland, DO, and Ilana M. Braun, MD, dove into the complexities of cannabis use within the oncology landscape. They explored the tension between rising public popularity and the need for rigorous scientific scrutiny in symptom management.Key Discussion Points: The 2024 ASCO Guidelines: Braun highlighted the first-of-its-kind clinical guidelines from the American Society of Clinical Oncology, which acknowledge medicinal utility for chemotherapy-induced nausea, vomiting (as an adjunct), and non-cancer pain. Routes of Administration: McFarland and Braun compared oral, combusted, and vaporized methods, noting that while oncologists favor oral routes, they are subject to "first-pass metabolism," which can delay relief. Safety and Clinical Concerns: There are potential negative impacts on outcomes for patients using immune checkpoint inhibitors. Risks may impact patients with a personal or family history of psychosis when using THC-predominant products. There are possible dangers linked to e-cigarette or vaping use-associated lung injury (EVALI) from informally sourced products. Addressing "Cancer-Directed" Claims: The pair addressed the misconception that cannabis treats the cancer itself, noting that ASCO explicitly discourages using it as a replacement for conventional treatments like chemotherapy or surgery. The Future of Research: The discussion concluded with the potential impact of reclassifying cannabis to Schedule III, which could reduce red tape and enable high-quality comparative efficacy trials for sleep, anxiety, and depression. The conversation emphasized a "harm reduction" approach, urging oncologists to provide stigma-free, evidence-based education while respecting patient autonomy.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. Braun is an associate professor of psychiatry at Harvard Medical School and senior physician at Dana-Farber Cancer Institute. ReferenceBraun IM, Bohlke K, Abrams DI, et al. Cannabis and cannabinoids in adults with cancer: ASCO guideline. J Clin Oncol. 2024;42(13):1575-1593. doi:10.1200/JCO.23.02596

During a visit to Columbia University Irving Cancer Research Center, experts across hematologic oncology shared their perspectives on key trends and developments in their respective fields. These conversations explored novel therapeutic approaches and translational research that may advance the paradigm across different leukemia, multiple myeloma, and lymphoma populations.First, Nicole Lamanna, MD, an associate clinical professor of medicine in the Hematologic Malignancies Section of the Hematology/Oncology Division at Irving Medical Center, discussed relevant advancements in the management of chronic lymphocytic leukemia (CLL). She described how the FDA approval of fixed-duration acalabrutinib (Calquence) plus venetoclax (Venclexta) may affirm a shift away from standard chemoimmunotherapy in the field. Her discussion also emphasized evaluating the adverse effects and benefit/risk profiles of drug classes such as BTK inhibitors and BCL-2 inhibitors during the treatment decision-making process.Next, Rajshekhar Chakraborty, MD, an assistant professor of medicine in the Division of Hematology/Oncology at Irving Medical Center, touched upon critical themes related to the use of bispecific antibodies for patients with multiple myeloma and other plasma cell disorders. Educating providers on the utility of bispecific antibodies in earlier treatment settings, he noted, is one of the important challenges that the field must address to expand usage of these therapies in community practices. He also highlighted findings from the phase 3 MajesTEC-3 trial (NCT05083169) and how they support the clinical utility of teclistamab-cqyv (Tecvayli) plus daratumumab and hyaluronidase-fihj (Darzalex Faspro) for patients with relapsed/refractory disease.Finally, Hua-Jay “Jeff” Cherng, MD, an assistant professor of medicine in the Lymphoma Program in the Division of Hematology and Oncology at Irving Medical Center, detailed translational work that may shape clinical practice in the lymphoma space. He spoke about research aiming to move markers like ctDNA and minimal residual disease from “the bench to the bedside” as part of clinical decision-making for patients with diffuse large B-cell lymphoma (DLBCL). Other future focuses, Cherng said, include leveraging molecular genotyping to improve outcomes for higher-risk subgroups or even replacing chemotherapy with less toxic targeted agents.References CALQUENCE® plus venetoclax approved in the US as first all-oral, fixed-duration combination for patients with chronic lymphocytic leukemia in the 1st-line setting. News release. AstraZeneca. February 20, 2026. Accessed March 11, 2026. https://tinyurl.com/38zbx96s Mateos MV, Bahlis N, Perrot A, et al. Phase 3 randomized study of teclistamab plus daratumumab versus investigator’s choice of daratumumab and dexamethasone with either pomalidomide or bortezomib (DPd/DVd) in patients (pts) with relapsed refractory multiple myeloma (RRMM): results of MajesTEC-3. Blood. 2025;146(suppl 2):LBA-6. doi:10.1182/blood-2025-LBA-6

In a conversation with CancerNetwork®, Sagar Lonial, MD, FACP, FASCO, discussed the potential implications of the FDA approving iberdomide plus daratumumab (Darzalex) and dexamethasone for patients with relapsed/refractory multiple myeloma. He spoke in context of the FDA accepting a new drug application for the iberdomide regimen based on data from the phase 3 EXCALIBER-RRMM trial (NCT04975997).Lonial discussed the potential benefits that iberdomide could offer based on its properties as a CELMoD. He noted how the potency, safety profile, and targeting capabilities of this drug class may differentiate it from previous standards such as immunomodulatory drugs.Regarding the supporting findings from the EXCALIBER-RRMM trial, Lonial stated that the study was the “first test case” for using minimal residual disease (MRD) as an early end point for approval. In September 2025, investigators announced that iberdomide-based therapy showed a significant improvement in MRD-negative status vs daratumumab, bortezomib (Velcade), and dexamethasone.The potential approval of iberdomide in this multiple myeloma population, Lonial said, would open the door for using the agent in combination with other immunotherapies. Noting that T-cell engagers are “perfect partners” for the CELMoD class, Lonial emphasized the utility of combination regimens across the field.“Recognizing that we have agents that can reset or augment immunity and partnering them [are important]. People always want to say it's a black and white world; you're either going to use this, or you're going to use this. To me, it's about combination therapy,” Lonial stated. “Having this tool belt with many drugs and putting them together in combinations is how we get to [a] cure.”Lonial is a professor and chair of the Department of Hematology and Medical Oncology and the Anne and Bernard Gray Family Chair in Cancer at Emory University School of Medicine, and the chief medical officer at Winship Cancer Institute of Emory University. He is also a member of the International Myeloma Foundation scientific board.References U.S. Food and Drug Administration accepts Bristol Myers Squibb's new drug application for iberdomide in patients with relapsed or refractory multiple myeloma. News release. Bristol Myers Squibb. February 17, 2026. Accessed March 5, 2026. https://tinyurl.com/4c8mb6ex Bristol Myers Squibb announces phase 3 EXCALIBER-RRMM study evaluating iberdomide in combination with standard therapies demonstrated a significant improvement in minimal residual disease negativity rates in relapsed or refractory multiple myeloma. News release. Bristol Myers Squibb. September 23, 2025. Accessed March 5, 2026. https://tinyurl.com/5n9768k5

Daniel C. McFarland, DO, and Boris Kiselev, MD, highlighted the need for oncologists to recognize and address depression for patients with cancer. In a new episode of Oncology on the Go created in collaboration with the American Psychosocial Oncology Society, host Daniel C. McFarland, DO, spoke with Boris Kiselev, MD. Together, they explored the complex intersection of oncology and psychiatry. The conversation challenged the oversimplification of “cancer-related sadness” to provide clinicians with a framework for distinguishing between normative grief and clinical Major Depressive Disorder (MDD).The conversation focused on: The Diagnostic Continuum: Depression exists on a spectrum ranging from normative sadness—encompassing a healthy, waxing-and-waning response to trauma—to pathological MDD. Differentiating Grief vs Depression: Grief/Normative Sadness: Often occurs in waves, improves over time, and does not typically affect a patient’s functional ability. It is often a response to the loss of one’s “pre-cancer self”. Clinical Depression: Marked by anhedonia (loss of pleasure), persistent feelings of guilt or worthlessness, and a fundamental change in identity where the patient no longer “feels like themselves”. The “Quantum” Observation Effect: Patients often present differently to oncologists than they do to mental health professionals. In the oncology clinic, patients may unconsciously “shield” their distress to ensure that their treatment plan remains unchanged. The Power of the Story: The experts emphasized that the oncologist-patient relationship is therapeutic. Allowing patients to “tell their story” rather than jumping straight to clinical data builds trust with them and uncovers hidden psychological pressure points. 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.

Sarah Poland, MD, lead author of a recently published article in the journal ONCOLOGY titled Advances in Immunotherapy for Breast Cancer, highlighted key findings from her review in a conversation with CancerNetwork®.1 Throughout the discussion, she spoke about: Shifting Perspectives on Immunogenicity: Historically, breast cancer was considered a “cold,” poorly immunogenic tumor due to low tumor mutational burden (TMB) and few tumor-infiltrating lymphocytes (TILs). Poland highlighted how clinical research has shifted this perspective, particularly through the study of triple-negative breast cancer (TNBC), which often exhibits higher PD-L1 expression and immune infiltration.Key Clinical Milestones: The review highlighted foundational data that established immunotherapy as a standard of care: Early-Stage TNBC: The phase 3 KEYNOTE-522 trial (NCT03036488) established pembrolizumab (Keytruda) plus chemotherapy as a standard neoadjuvant treatment for stage II to III TNBC.2 Metastatic TNBC: The phase 3 KEYNOTE-355 trial (NCT02819518) demonstrated the benefit of pembrolizumab in PD-L1–positive metastatic disease.3 Managing Toxicity and Rechallenge: Poland addressed the feasibility of pembrolizumab rechallenge after an immune-related adverse effect (irAE), emphasizing that while possible, it requires a highly individualized approach based on the severity and timing of the initial toxicity.The Future Landscape: Beyond PD-1/PD-L1 inhibitors, the discussion covered emerging technologies that are poised to redefine treatment: Antibody-Drug Conjugates (ADCs): Exploration of novel combinations of ADCs with immunotherapy. Emerging Modalities: The potential role of bispecific antibodies and vaccine trials utilizing tumor antigens. Subtype Expansion: Emerging evidence supporting the efficacy of immunotherapy in hormone receptor–positive and HER2-positive subtypes, moving beyond the traditional focus on TNBC. Unmet Educational Needs: Poland emphasized the importance of resources that connect providers and patients, particularly in translating complex trial data into clinical practice and addressing patient concerns regarding the newest therapies and trials.Poland is from the Department of Medicine in the Section of Hematology/Oncology at The University of Chicago.References1. Poland S, de Oliveira Andrade M, Nanda R. Advances in immunotherapy for breast cancer. Oncology (Williston Park). 2026;40(1):8-15. doi:10.46883/2026.259210612. Schmid P, Cortes J, Pusztai L, et al. Pembrolizumab for early triple-negative breast cancer. N Engl J Med. 2020;382(9):810-821. doi:10.1056/NEJMoa19105493. Cortes J, Rugo HS, Cescon DW, et al. Pembrolizumab plus chemotherapy in advanced triple-negative breast cancer. N Engl J Med. 2022;387(3):217-226. doi:10.1056/NEJMoa2202809

At the 2026 Tandem Meetings, CancerNetwork® spoke with a variety of experts who presented on key developments and advancements across hematologic oncology. As part of different oral presentations and poster sessions, researchers and clinicians shared updated findings that may influence the management of myelodysplastic syndromes (MDS), leukemia, lymphoma, and other blood cancer types.First, Fernando Duarte, head of the Bone Marrow Transplant Service at Walter Cantídio University Hospital (HUWC), hematologist and professor at the Federal University of Ceará, and president of the Brazilian Society of Cell Therapy and Bone Marrow Transplant, highlighted his presentation analyzing trends associated with allogenic hematopoietic cell transplantation (allo-HCT) among patients with MDS or myeloproliferative neoplasms (MPN) and other types of MDS. Data from the Brazillian SBTMO and CIBMTR registry revealed that patients receiving allo-HCT for MDS/MPN were typically older with worse performance statuses. Additionally, MDS/MPN independently predicted worse overall survival (OS) and relapse-free survival outcomes.Next, Alfonso Molina, MD, MPH, a third-year Hematology and Medical Oncology fellow at Stanford University, detailed results from a phase 1 trial (NCT05507827) assessing Orca-T, an investigational allogeneic T-cell immunotherapy, among those with high-risk B-cell acute lymphoblastic leukemia (B-ALL). Treatment with Orca-T yielded disease-free survival and OS in all (100%) 18 evaluable patients after a median follow-up of 14 months (range, 3-35), which occurred without graft failure, significant graft-versus-host-disease, or severe CAR-mediated toxicity.Finally, Irtiza N. Sheikh, DO, an assistant professor in the Department of Pediatrics - Patient Care, Stem Cell Transplantation and Cellular Therapy Section of the Division of Pediatrics at The University of Texas MD Anderson Cancer Center, discussed his presentation exploring differences in outcomes with lisocabtagene maraleucel (Breyanzi; liso-cel) across various treatment settings and patient populations with large B-cell lymphoma. Data demonstrated that among patients younger than 50 years old, liso-cel produced enduring responses across real-world and clinical trial settings, which were comparable to outcomes in overall populations. References Duarte FB, Garcia YDO, Hamerschlak N, et al. Comparative outcomes of allogeneic hematopoietic cell transplantation in myelodysplastic/myeloproliferative neoplasms and other myelodysplastic syndromes: Brazilian Sbtmo/CIBMTR registry analysis. Presented at: 2026 Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR; February 4-7, 2026; Salt Lake City, UT. Presentation 63. Molina A, Shiraz A, Kanegai A, et al. Mature outcomes from the phase I trial of Orca-T and allogeneic CD19/CD22 CAR-T cells for adults with high-risk B-ALL. Presented at: 2026 Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR; February 4-7, 2026; Salt Lake City, UT. Presentation 31. Sheikh IN, Patel K, Perales MA, et al. Clinical outcomes of lisocabtagene maraleucel (liso-cel) in YOUNGER PATIENTS (Pts) with relapsed or refractory (R/R) large B-cell lymphoma (LBCL). Presented at: 2026 Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR; February 4-7, 2026; Salt Lake City, UT. Poster 210.