Oncology On The Go

In a special edition of Oncology On the Go, Chinmay Jani, MD, joined CancerNetwork® in the studio to speak about different research initiatives he is involved with across precision oncology. He discussed ongoing work dedicated to validating and applying artificial intelligence (AI)–based tools in clinical work as well as overcoming immunotherapy resistance among patients with lung cancer.Jani, chief fellow in Hematology and Oncology at University of Miami Sylvester Comprehensive Cancer Center, first detailed findings from a study he presented at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting evaluating AI decision support in the context of EGFR-mutated non–small cell lung cancer (NSCLC). Although AI systems aligned with expert decision-making in frontline treatment, significant divergence was observed in second-line care, highlighting a need for more rigorous validation and clinical safeguards when integrating AI into oncologic decision-making. Improving documentation and using tools more ethically, Jani said, will also be critical for future applications of AI in field.Jani also spoke about the rapidly evolving thoracic oncology field based on research he and colleagues are leading at the University of Miami. Different investigations are exploring potential advancements in precision medicine, overcoming immunotherapy resistance, and early cancer detection to help elevate outcomes among patients with lung cancer. Looking ahead, Jani emphasized how novel therapeutics like tarlatamab-dlle (Imdelltra) and the incorporation of liquid biopsy may assist with the goal of turning lung cancer into “a chronic disease” where patients can survive not just for a few month or years but for decades.According to Jani, other key concerns in the field include the evolving landscape surrounding adolescent and young adult (AYA) patients, who may require different types of molecular testing and therapeutic needs compared with adult populations. Being able to detect more fusions and alterations that may inform therapeutic strategies via circulating tumor DNA plus circulating tumor RNA or through wider minimal residual disease testing, he said, represents another ongoing goal in terms of precision medicine.ReferenceJani C, Pérez-Granado J, Kalucha A, et al. Evaluating AI decision support in a rapidly evolving therapeutic landscape: EGFR-mutant metastatic NSCLC. J Clin Oncol. 2026;44(suppl 16):1630. doi:10.1200/JCO.2026.44.16_suppl.1630

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 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

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

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

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

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®, 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