Oncology On The Go

In the newest edition of Oncology On the Go, Matthew J. Frigault, MD, joined Adam D. Cohen, MD, to discuss the evolving cellular therapy paradigm in multiple myeloma practice. They highlighted what the newest guidelines and long-term clinical trial data mean for patient care and how academic centers and community practices can collaborate more effectively.
The conversation opened with a look at how recent updates to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology for multiple myeloma position CAR T-cell therapy in early relapse. Frigault noted that the guidelines now support referral for CAR T-cell therapy as early as the second line in patients who are refractory to lenalidomide (Revlimid), emphasizing the utility of agents such as ciltacabtagene autoleucel (cilta-cel; Carvykti). 
The experts also touched upon the implications of updated findings from cohort A of the phase 2 CARTITUDE-2 trial (NCT04133636), in which investigators assessed cilta-cel in patients with lenalidomide-refractory disease following 1 to 3 prior lines of therapy. With all patients now beyond 5 years of follow-up, 10 of 20 were alive and showed no progression after a single infusion without any further therapy, although Cohen cautioned that the cohort is small and that long-term follow-up data from the phase 3 CARTITUDE-4 trial (NCT04181827) are needed to confirm these findings.
Early referral of patients for cellular therapy was also a key point, as Frigault described how less heavily pretreated populations experience better outcomes and that those with lower disease burden and better functional status have shown improved efficacy, fewer toxicities, and lower long-term mortality after CAR T-cell therapy. Looking toward the future of the field, Frigault and Cohen detailed how dual-targeting CAR T-cell products, first-line trials comparing CAR T-cell therapy with autologous stem cell transplant, and other novel modalities may continue to evolve the field and introduce even more therapeutic options.
Frigault is clinical director of the Cellular Immunotherapy Program at Mass General Brigham Cancer Institute. Cohen is director of Myeloma Immunotherapy and professor of medicine at the Hospital of the University of Pennsylvania.
References

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Multiple Myeloma. Version 2.2027. National Comprehensive Cancer Network. September 24, 2026. Accessed October 21, 2026. https://tinyurl.com/47x35wch

Cohen AD, Mateos M-V, Cohen YC, et al. Long-term (≥5-Year) remission and survival with ciltacabtagene autoleucel (Cilta-Cel) in relapsed/refractory multiple myeloma (RRMM) with 1-3 prior lines of therapy: CARTITUDE 2 Cohort A. Presented at: 23rd International Myeloma Society Annual Meeting; September 23-26, 2026; Glasgow, Scotland. Poster PA-288.

In this episode of Oncology On the Go, Daniel C. McFarland, DO, spoke with Ramy Sedhom, MD, about how to build a cancer practice where symptom management and emotional support are part of routine oncology care rather than an outside referral.
Sedhom traced his approach to mentorship from Thomas Smith, MD, during his oncology fellowship at Johns Hopkins and to his palliative care training at Memorial Sloan Kettering Cancer Center. Noting that most patients with cancer receive treatment in their local communities, he described a model in which medical oncologists share clinical space with palliative care and psycho-oncology teams. That proximity, he explained, improves access and normalizes supportive care as a standard part of treatment. Using the example of a young mother newly diagnosed with triple-negative breast cancer, he walked through how a real-time message through the electronic medical record can bring a psychologist into the room for a warm handoff before the patient leaves the visit, often leading to ongoing therapy such as cognitive behavioral therapy.
McFarland emphasized that therapeutic presence and the ongoing patient-clinician relationship are healing, even though they are difficult to measure or reimburse. He described the use of shared medical visits in his practice and the value of weekly team meetings that include therapists, chaplains, and other staff. Both clinicians discussed proactive distress screening at regular intervals, which Sedhom said can reveal concerns patients may not otherwise raise. They also highlighted the prognostic uncertainty and anticipatory distress faced by patients living for years with EGFR-mutated lung cancer on oral targeted therapy such as osimertinib (Tagrisso), as well as the confusion that can follow a “good prognosis” diagnosis.
The conversation also covered lessons psychiatry can offer oncologists, including reframing difficult patient behavior, loosening control of the visit agenda, building rapport before having honest conversations, and accepting ambiguity to help prevent burnout. The two closed by considering whether a broad supportive care umbrella could unite palliative care, psychiatry, psychology, and other disciplines, with McFarland urging clinicians to set aside silos and professional egos for the benefit of patients.
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®. co-lead of Geriatric Oncology at Penn Cancer Service Line; clinical director of Medical Oncology at Penn Medicine Princeton Health; associate director of Penn Center for Cancer Care Innovation; co-lead of Psychosocial Oncology Services at Penn Medicine Princeton Health; division chief in the Palliative Care Division of Medical Oncology; and a clinical associate professor of medicine (Hematology-Oncology).

In a cobranded episode between Oncology On the Go, hosted by CancerNetwork®, and the American Society for Transplantation and Cellular Therapy (ASTCT)’s program ASTCT Talks, an expert panel explored when early antibiotic de-escalation may be feasible for pediatric populations who undergo hematopoietic cell transplantation. The panel was hosted by Diego R. Hijano, MD, MSc, who was joined by his colleagues Gabriela Marón, MD, MSc, and Fareed Khawaja, MBBS.
Marón began by contextualizing the traditional practice of continuing antibiotic therapy until neutrophil recovery, which was based on host defense physiology instead of clinical trial data. Prolonged antibiotic use, she said, may correspond with resistant pathogens, bloodstream infections, and increased intensive care unit mortality across pediatric populations. Additionally, a limited pipeline for new antibiotic agents, especially for pediatric patients, makes the prevention of resistance critical during patient care.
Khawaja continued the discussion by highlighting recent literature and randomized clinical trials supporting the de-escalation of gram-negative coverage within 48 to 72 hours if no infection source is identified. He referenced new guidelines from the European Conference on Infections in Leukaemia, which support de-escalating antibiotics at 40 to 72 hours if no clear source of fever appears. Another study published in 2023 showed that decreased antibiotic days resulted in similar rates of successful treatment, subsequent fever, and 30-day mortality. Additionally, advances such as improved blood culture incubation and PET scans may bolster the ability of clinicians to safely de-escalate treatment.
Future directions in the field, Khawaja said, may include investigating how aggressive stewardship impacts long-term outcomes while learning how to implement quality improvement programs. Marón also identified a need for more prospective pediatric trials and data on how the microbiome changes following prolonged antibiotic exposure.
Hijano is medical director of Occupational Health and director of the Infectious Disease, Bone Marrow Transplant, and Cellular Therapy Division at St. Jude Children’s Research Hospital. Marón is a pediatric infectious disease specialist who works with patients who undergo transplant at St. Jude Children’s Research Hospital. Khawaja is an associate professor of Infectious Diseases, Infection Control and Employee Health, and Internal Medicine at The University of Texas MD Anderson Cancer Center.
References

Averbuch D, Vanbiervliet Y, Baccelli F, et al. Empirical and targeted antimicrobial therapy in patients with febrile neutropenia and haematological malignancy or after haematopoietic cell transplantation: recommendations from the 10th European Conference on Infections in Leukaemia. Lancet Infect Dis. 2026;26(6):e232-e247. doi: 10.1016/S1473-3099(25)00619-X

Patel PA, Teherani MF, Xiang Y, et al. Short-course empiric antibiotics in children undergoing allogeneic hematopoietic cell transplantation. Transplant Cell Ther. 2023;29(12):778.e1-778.e6. doi:10.1016/j.jtct.2023.09.011

In September 2026, the FDA granted accelerated approval to sevabertinib (Hyrnuo) as a frontline treatment option for patients with locally advanced or metastatic nonsquamous non–small cell lung cancer (NSCLC) harboring HER2 tyrosine kinase domain (TKD)–activating mutations. The decision expanded sevabertinib’s indication from its accelerated approval in November 2025 as a therapy for patients who received prior systemic treatment.
To better understand the potential clinical implications of this expanded approval for sevabertinib, CancerNetwork® spoke with Xiuning Le, MD, PhD, about the findings supporting the agent’s clinical benefit and how it fits alongside other available options in the NSCLC space. Le, an associate professor in the department of Thoracic/Head and Neck Medical Oncology at UT MD Anderson Cancer Center, was the lead investigator of the phase 1/2 SOHO-01 trial (NCT05099172), which led to both of sevabertinib’s accelerated approvals.
Regarding sevabertinib’s label, Le highlighted the importance of mindfully interpreting the differences between TKD-activating mutations or insertions vs amplification, as precision oncology begins with the careful testing, detection, and interpretation of patient reports. She also described how the approval supplements the rapid evolution of HER2-directed therapy in lung cancer, as sevabertinib is now an option to consider alongside zongertinib (Hernexeos) and trastuzumab deruxtecan (Enhertu) across different treatment settings. 
Given sevabertinib’s accelerated approval status, Le outlined the next steps for affirming the agent’s benefit in the phase 3 SOHO-02 trial (NCT06452277), which is randomly assigning patients with treatment-naive, HER2 mutation-positive NSCLC to receive sevabertinib or chemoimmunotherapy. Le concluded by emphasizing the value of testing and identifying patients with actionable markers who may benefit from treatment with sevabertinib and other targeted agents.
“What I want to tell my peer oncologists is that HER2 is still a very new target. Make sure that you sequence all the [patients with] lung cancer to identify the HER2 mutation, as we're all learning how to use these medications,” Le said. “The first, most important part is to identify those patients. Once we identify those patients, then we can discuss which frontline [option] is the most appropriate. Testing still is the key.”
References

FDA grants accelerated approval to sevabertinib for locally advanced or metastatic non-squamous non-small cell lung cancer. News release. FDA. September 9, 2026. Accessed October 2, 2026. https://tinyurl.com/mwsay6jf

FDA grants accelerated approval to sevabertinib for non-squamous non-small cell lung cancer. News release. FDA. November 19, 2025. Accessed October 2, 2026. https://tinyurl.com/mt455knh

A study to learn more about how well sevabertinib works and how safe it is compared with standard treatment, in participants who have advanced non-small cell lung cancer (NSCLC) with mutations of the human epidermal growth factor receptor 2 (HER2) (SOHO-02). ClinicalTrials.gov. Updated September 23, 2026. Accessed October 2, 2026. https://tinyurl.com/2k32z6wu

In this episode of Oncology On the Go, Daniel C. McFarland, DO, spoke with Yesne Alici, MD, who oversees Memorial Sloan Kettering Cancer Center (MSKCC)’s medical aid in dying (MAID) program. Together, they explored what MAID means for oncology practice now that it is legal in New York State.
Alici defined MAID as the legal practice in which a terminally ill, capacitated adult with a life expectancy of less than 6 months may request a prescription that they self-administer to hasten death. Self-administration, she noted, is the main distinction between MAID and euthanasia, which is not legal anywhere in the US. MAID is currently legal in 14 states and Washington, DC, giving roughly 1 in 3 US adults access, according to Alici. Even so, it accounts for less than 1% of all deaths in states where it is legal, and not every patient who inquires goes on to pursue it.
Drawing on MSKCC’s experience fielding inquiries from patients in New Jersey since 2019, Alici described a population that was mostly older and predominantly female, with about one-third of patients having early-stage cancer when they asked and most still receiving treatment. Nationally, the top reasons patients inquire are loss of dignity, loss of control, and loss of ability to enjoy activities, rather than physical symptoms like pain or shortness of breath.
The conversation also walked through New York’s safeguards, including multiple requests, 2 neutral adult witnesses, a decision-making capacity assessment, and a mandatory psychiatrist or psychologist evaluation, a requirement shared only with Hawaii. Alici argued that these assessments should be psycho-oncology informed and stressed the importance of approaching each request with neutrality, cautioning that conflating MAID with suicidal ideation risks alienating patients.
McFarland shared a challenging case involving voluntarily stopping eating and drinking, reflecting on clinicians’ own moral discomfort and on broader philosophical concerns about the romanticization of death. The pair also discussed the need for more research, the role of palliative care, and conscientious objection. Alici closed by urging oncologists who object to MAID to ensure that patients still have a path to discuss their inquiry, noting that New York law mandates offering a palliative care referral.
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®. Alici is vice chair of clinical operations in the Department of Psychiatry and Behavioral Services, clinical director, associate attending psychiatrist, and medical director of the Biobehavioral Health Clinic at MSKCC.