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.

In a conversation with CancerNetwork®, Manoj Bhasin, PhD, MS, spoke about findings from a study in which he and colleagues developed a single-cell atlas characterizing the dysregulation of the bone marrow immune microenvironment in newly diagnosed multiple myeloma. Findings published in Nature Cancer showed that the immune system has a broad, treatment-independent influence on outcomes in newly diagnosed multiple myeloma.Bhasin began by detailing the background and methodology of his study, in which an Immune Atlas of multiple myeloma helped generate profiles of 1,397,272 single cells from the bone marrow of 337 patients with newly diagnosed disease to characterize immune and hematopoietic cell populations. He also broke down specific analyses of certain aspects of the immune microenvironment, such as signaling evaluations demonstrating active intercellular communication involving a proliferation-inducing ligand and B cell maturation antigen potentially associated with tumor growth and survival.Looking ahead, Bhasin described a need to research additional factors, including those beyond the bone marrow, which may help clinicians further optimize therapeutic strategies for patients with multiple myeloma.“Maybe the biggest thing we want to say from this study is that the immune system is a critical player in the outcome of multiple myeloma, its emergence, and its therapeutic response. It is not a byproduct; it is a major driver of the outcomes,” Bhasin stated. “[Not] all high-risk multiple myeloma lesions are the same. We should look at the immune imprints of them, further comprehensively study them, and then help in designing immune therapies that fix the immune dysregulation that is associated with each cytogenetic alteration [instead of] thinking that all high-risk cytogenetic lesions of myeloma are all the same.”Bhasin is a professor in the Department of Pediatrics and in the Department of Biomedical Informatics at Emory University School of Medicine, and director of Genomics, Proteomics, Bioinformatics and Systems Biology and the Aflac Director of the Single Cell Biology Program at Children’s Healthcare of Atlanta.ReferencePilcher WC, Yao L, Gonzalez-Kozlova E, et al. A single-cell atlas characterizes dysregulation of the bone marrow immune microenvironment associated with outcomes in multiple myeloma. Nat Cancer. 2026;7:224-246. doi:10.1038/s43018-025-01072-4

In a conversation with CancerNetwork®, Ram Prakash Thirugnanasambandam, MBBS, discussed the evolving roles that artificial intelligence (AI)–based tools may play in palliative care and the management of different hematologic malignancies. He spoke in the context of a publication he authored, The Role of Artificial Intelligence in Palliative Oncology: Zeroing in on Hematologic Malignancies,which was featured in the November/December 2025 issue of the journal ONCOLOGY®.Thirugnanasambandam, a fellow of Internal Medicine, Hospice and Palliative Medicine, and Geriatric Medicine at the University of Miami, outlined the paper’s aim to explore how AI can assist with patient-centric goals of care like symptom management as well as decision-making support among clinicians. In the context of palliative medicine, AI has demonstrated utility as a supportive tool that can help with marking patients who may benefit from a palliative care conversation. Such tools have also assisted with identifying symptoms such as pain, dyspnea, anxiety, or psychosocial distress, allowing providers to form a more proactive approach to patient care.According to Thirugnanasambandam, implementing AI into one’s workflow may help accurately predict disease subtypes and burdens among patients with leukemia, lymphoma, or multiple myeloma. He noted that predictive analytic capabilities may also facilitate effective management of cytopenias, transplant-related needs, infections, and other treatment-related toxicities.Thirugnanasambandam also discussed some of the ethical considerations surrounding the growth of AI-based tools, highlighting information privacy concerns and potentially biased datasets as notable issues with these platforms. Although AI may assist with decision-making, Thirugnanasambandam stated that it ultimately cannot replace a human’s nuanced clinical judgment and empathy.“I want readers to take away a sense of balance,” Thirugnanasambandam said regarding his publication. “We’ve done the article to help clinicians be more comfortable in engaging with AI. We need to apply it critically, not as replacing judgment or decision-making skills, but more as an adjunct.”

Emphasizing the evidence-based nature of medicine, Nathan Goodyear, MD, explained that integrative oncology uses many of the same parameters and key clinical thresholds among patients undergoing treatment for a diagnosis of cancer that his conventional oncologist colleagues use.In this episode of Oncology on the Go, Goodyear, an integrative medicine physician at the Williams Cancer Institute, discussed key clinical efficacy and safety thresholds that integrative oncologists use for flagship integrative therapies, emerging localized and combinatory immunotherapy options in this clinical landscape, and a focus on reestablishing trust through patient-doctor relationships.Regarding clinical thresholds, he explained that integrative care uses guidelines such as the CTCAE to follow adverse effects (AEs). RECIST criteria are also employed to ascertain clinical outcomes and utilize imaging to gauge responses in a way that is not arbitrary but translatable.Next, Goodyear discussed combinatory regimens with immunotherapy backbones, such as pulsed electric fields (PEF) with intratumoral immunotherapy, as well as anti-CD40/CpG immunotherapies, to help generate an intratumoral response prior to resection, particularly in “immune desert” tumors. He noted how these strategies may also mitigate the possibility of postoperative recurrence.Finally, he touched upon the evolving role of doctors as collaborators with their patients as opposed to a paternalistic and authoritative role over the course of their treatment. Driven by growing demands for a greater desire to preserve quality of life during care, Goodyear explained that his institution aims to “innovate, elevate, and empower” by bringing emergent innovative strategies to patients, elevating their immune system through immune responses, and empowering patients to undergo the healing process in tandem with a reduction of AEs.Goodyear concluded by reiterating the importance of patient-centric care, particularly as it pertains to the restoration of trust in medicine, as well as a return to a doctor’s intended rule as a healer.For more expert-level discussions across the oncology paradigm, check out the newest podcast series on CancerNetwork®, RadOnc on the Run. Join host and ONCOLOGY® editor-at-large Brandon Mancini, MD, MBA, FACRO, as he speaks with colleagues about the latest advancements and hottest research in the radiation oncology space.

In a conversation with CancerNetwork®, Kandace P. McGuire, MD, and Paschalia Mountziaris, MD, PhD, highlighted the use of L-Dex bioimpedance spectroscopy as a method for detecting lymphedema earlier in patients who undergo surgery for breast cancer. The experts discussed seamlessly integrating this novel modality into standard vitals workflows and detailed other considerations for improving long-term survivorship outcomes via proactive lymphatic care.McGuire began by breaking down why detection of lymphedema typically occurs later after its development, describing how a sentinel lymph node biopsy and additive radiation can cause lymphatic damage and obstruction that correspond with symptoms months to years down the road. At her institution, bioimpedance spectroscopy, the use of a small electrical signal measuring “bioimpedance”, is employed at various points before and after breast cancer surgery to easily determine the likelihood of developing lymphedema through a nursing visit. According to Mountziaris, having a noninvasive method like this provides a “valuable tool” for informing patients of their risks of experiencing lymphedema.The experts also discussed a need to develop a more nuanced method for detecting potential lymphedema among patients with a higher body mass index and spoke about fostering communication across the breast surgery oncology team, the plastic/reconstructive team, and physical rehabilitation specialists to monitor abnormal fluid changes in patients. Looking ahead, they emphasized making bioimpedance spectroscopy more accessible as a key goal in lymphedema care.“We are privileged that McGuire and I have a great team and that I have the equipment that we’re able to provide these things for our patients. From my standpoint, some of these patients appear—to me, by measurements, and everything else—to have been cured of their lymphedema after these interventions,” Mountziaris stated. “Getting an L-Dex score on them is just another way to demonstrate that we did bring them to stage 0 or no lymphedema.”McGuire is professor of surgery and chief of breast surgery at Virginia Commonwealth University (VCU) Massey Cancer Center. Mountziaris is assistant professor of surgery in the Division of Plastic and Reconstructive Surgery at VCU Massey Cancer Center.ReferenceVCU Massey now offers new technology for early detection of lymphedema. News release. December 8, 2025. Accessed January 14, 2026. https://tinyurl.com/2ktfzf5k

In a conversation with CancerNetwork®, Nathan Goodyear, MD, provided an overview of how to implement integrative modalities that may effectively supplement standard-of-care oncologic therapies. Beyond the use of intravenous vitamin C and other flagship strategies at his institution, Goodyear addressed potential misconceptions and biases surrounding integrative oncology and discussed how to re-engage patients back into evidence-based care.Goodyear, an integrative oncologist at the Williams Cancer Institute, described how conventional modalities like surgery and radiotherapy may damage the immune system during cancer treatment, and how integrative strategies aim to re-engage and stimulate areas like the gut microbiome to safeguard patient quality of life. He touched upon how practices such as fecal transplantation, fasting, and intratumoral pulsed electric field (PEF) therapy can convert unresponsive diseases into “hot” tumors that immunologically react to treatment.Looking across the medical field entirely, Goodyear described how certain “camps” may perceive integrative oncology as an “alternative” form of medicine. Citing an article published in JAMA Network Open showing how patient trust in US hospitals decreased from 71.5% in 2020 to 40.1% in 2024, Goodyear noted how such divisiveness among healthcare providers may have played a role in losing the support of patients. As part of mitigating the prejudicial, marginalizing attitudes towards integrative care as well as the infighting among physicians, Goodyear emphasized building bridges across holistic care, conventional oncology, and other fields to properly advance the treatment of patients. Having an open dialogue and debating the science behind new integrative modalities, he explained, will help in advocating for patients and establishing trust in their care teams.“We must re-engage with [patients] through the science, through public debate and discourse with other doctors; that will re-engage the patient,” Goodyear stated. “More importantly, I think that will re-engage the patient’s trust in doctors. When we restore a doctor-patient relationship, medicine is going to get better, and patients are going to get better.”ReferencePerlis RH, Ognyanova K, Uslu A, et al. Trust in physicians and hospitals during the COVID-19 pandemic in a 50-state survey of US adults. JAMA Netw Open. 2024;7(7):e2424984. doi:10.1001/jamanetworkopen.2024.24984

In a conversation with CancerNetwork®, Jose G. Trevino, II, MD, FACS, spoke about the current state of the pancreatic ductal adenocarcinoma (PDAC) paradigm as well as next steps for improving the prognosis of patients who present with this disease. Throughout the discussion, Trevino outlined the roles that surgical oncologists can play in disease management, the different demographic and socioeconomic drivers of disparate patient outcomes, and translational research focusing on factors like the tumor microenvironment.Trevino stressed the idea of pancreatic cancer care as a “team science,” rejecting a “silo mentality” that involves handing off a patient from one department to the next. Because surgical approaches by themselves have remained “limited” in pancreatic cancer for the past 20 to 30 years, he emphasized continued collaboration with medical oncologists, radiation oncologists, and translational scientists to enhance patient quality of life. Regarding disparities, Trevino noted the importance of recognizing various barriers to treatment access among those in rural communities as well as unequal outcomes across different racial and ethnic groups of patients, including worse survival among Black populations. Additionally, in the face of continuously rising PDAC incidence, he stressed additional training across the board on how to detect the red flags associated with disease.“…There has to be a ton of education for our patients and our physicians who see patients on a primary level to know what those red flags are when a patient comes to their clinic. Early detection of early lesions that could eventually turn into pancreatic adenocarcinoma is going to be the key to survival, ultimately. [If we] catch it before it becomes a cancer, we solve a huge problem,” Trevino stated. “Early detection of early lesions is key.”Trevino is chair of the Division of Surgical Oncology and an associate professor in the Department of Surgery at VCU School of Medicine as well as surgeon-in-chief and Walter Lawrence, Jr., Distinguished Professor of Oncology at VCU Massey Cancer Center.

After the 2025 American Society of Hematology (ASH) Annual Meeting had passed, the data were out, and the hematologist/oncologists of the world had time to digest the practice changes that awaited them upon their returns home. Rahul Banerjee, MD, FACP, and Brooke Adams, PharmD, BCOP, took part in an X Spaces discussion hosted by CancerNetwork® in collaboration with The American Society for Transplantation and Cellular Therapy (ASTCT) to highlight these potential changes.Adams and Banerjee discussed abstracts from the meeting, including the phase 3 MajesTEC-3 trial (NCT05083169), which evaluated teclistamab-cqyv (Tecvayli) plus daratumumab (Darzalex) in patients with relapsed/refractory multiple myeloma who progressed on at least 1 prior line of therapy.1 A significant progression-free survival benefit was observed with the experimental combination compared with standard of care in this population.They also discussed data from cohort A of the phase 2 IFM2021-01 trial (NCT05572229), which evaluated subcutaneous teclistamab in combination with subcutaneous daratumumab in patients with newly diagnosed multiple myeloma. Results demonstrated that the combination was effective and safe in the frontline treatment of patients who were ineligible for transplant.2The discussion also covered the broader treatment landscape, as the experts compared the use of bispecific antibodies with BCMA-directed CAR T-cell therapies. Frontline bispecific strategies for transplant-ineligible populations were also topics of conversation, as well as post-transplant consolidation with bispecifics. Ultimately, they stated that multiple myeloma care is undergoing a paradigm shift toward deeper minimal residual disease negativity, possible treatment de‑escalation, and even serious use of the word “cure” for the disease.Banerjee is an assistant professor in the Clinical Research Division at the Fred Hutchinson Cancer Center, and Adams is a clinical pharmacist in the Department of Stem Cell Transplant and Cellular Therapy and coordinator of the PGY-2 Oncology Residency at Orlando Health. Both are also members of the ASTCT content committee.References Mateos M-V, 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 Manier S, Lambert J, Marco M, et al. A phase 2 study of teclistamab in combination with daratumumab in elderly patients with newly diagnosed multiple myeloma: the IFM2021-01 teclille trial, cohort A. Blood. 2025;146(suppl 1):367. doi:10.1182/blood-2025-367