ASCO Guidelines

Drs. Zeina Nahleh and Maryam Lustberg join the podcast to discuss the updated ASCO guideline on breast cancer follow-up and surveillance after primary treatment. Drs. Nahleh and Lustberg explain the new risk-stratified approach, which personalizes surveillance intensity based on a patient's risk of recurrence, moving away from a one-size-fits-all model. They detail the recommendations for low, intermediate, and high-intensity surveillance groups, review the current role of blood-based biomarkers like ctDNA, and clarify the guideline's stance on supplemental imaging such as MRI and ultrasound. The co-chairs emphasize the importance of shared decision-making between clinicians and patients and discuss how these updated recommendations aim to improve quality of life and reduce unnecessary testing for breast cancer survivors.
Read the full guideline, "Breast Cancer Follow-up and Surveillance after Primary Treatment: ASCO Guideline Update," at www.ascopubs.org/topics/asco-guidelines/breast-cancer"
LINK TO FULL TRANSCRIPT

Drs. Jamie Lesnock and Sara Bouberhan join the podcast to discuss the first ASCO guideline on systemic treatment for recurrent ovarian cancer. They provide a comprehensive overview of the evidence-based recommendations for patients with both platinum-sensitive and platinum-resistant or platinum-refractory disease. The discussion covers systemic therapy options, the role of maintenance therapy with agents like bevacizumab, and the nuanced recommendations for secondary cytoreductive surgery based on mixed clinical trial results. Drs. Lesnock and Bouberhan emphasize the importance of an individualized, multidisciplinary approach to care. As this is a living guideline, they also look ahead to emerging evidence that will shape future updates.

Read the full living guideline, "Systemic Treatment of Ovarian Cancer Recurrence: ASCO Living Guideline, Version 2026.1.0," at www.ascopubs.org/guidelines/systemic-treatment-ovarian-cancer-recurrence"
LINK TO FULL TRANSCRIPT

Dr. Sonam Puri joins the podcast to share the update to the living guideline on stage IV NSCLC with driver alterations. Dr. Puri discusses the practice-changing evidence reviewed for both NTRK rearrangements, including the TRIDENT-1 trial, and HER2 activating mutations, including the Beamion LUNG-1 study. She shares how these results impacted the clinical practice guideline with the addition of repotrectinib and zongertinib, what these new TKIs mean for patients, and where the panel is waiting for additional randomized data to clarify the role of therapeutic options. Dr. Puri encourages listeners to stay tuned for future updates to the living guideline as new evidence is published.

Read the full living guideline "Therapy for Stage IV Non-Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2026.3.2" at www.ascopubs.org/guidelines/therapy-stage-iv-non-small-cell-lung-cancer-driver-alterations"
LINK TO FULL TRANSCRIPT

Dr. Rahul Banerjee joins the podcast to discuss the latest update to the living guideline on the treatment of multiple myeloma. He explains how sensational results from the MajesTEC-3 trial, which evaluated teclistamab plus daratumumab, prompted a major shift in the recommendations for patients with relapsed or refractory disease. Dr. Banerjee details why immunotherapies, specifically CAR T-cell therapy and bispecific antibodies, are now the preferred treatment options at first relapse over traditional triplets. He also provides context on evidence that did not lead to recommendation changes, the importance of individualized decision-making when choosing between immunotherapy options, and what future updates may be on the horizon, including data on CELMoDs.
Read the full living guideline, "Treatment of Multiple Myeloma: ASCO Living Guideline, Version 2026.1.1," at www.ascopubs.org/guidelines/treatment-multiple-myeloma-asco-living-guideline

Drs. Tina Lockwood and Stacy Gray share the newly released evidence-based guideline on circulating tumor DNA (ctDNA) testing from ASCO. They highlight recommendations on when ctDNA testing should be offered—including scenarios where tissue biopsies are challenging, unsafe, or unavailable in time to guide management—and explicitly outline situations where testing should not be utilized. They dive into the evidence evaluating ctDNA for treatment selection, molecular residual disease (MRD), and response monitoring across solid tumors and lymphoma. Drs. Lockwood and Gray explain the importance of balancing ctDNA's high specificity with its moderate sensitivity. They also touch on outstanding questions, including standardizing definitions for MRD, disease-specific applications, and the use of multi-cancer early detection (MCED) screening. 

Read the full guideline, "Circulating Tumor DNA Testing in Solid Tumors and Lymphoma: ASCO Guideline" at www.asco.org/molecular-testing-and-biomarkers-guidelines"
LINK TO FULL TRANSCRIPT