OncLive® On Air

In this episode of Oncology Unplugged, host Chandler Park, MD, MSc, FACP, a medical oncologist at Norton Cancer Institute in Louisville, Kentucky, was joined by Petros Grivas, MD, PhD, FASCO, the medical director of local/regional outreach and international program and a professor in the Clinical Research Division at Fred Hutch Cancer Center, as well as a professor in the Division of Hematology and Oncology at the University of Washington School of Medicine in Seattle.
Their discussion centered on key bladder cancer data presented at the 2026 ESMO Congress, highlighting the rapidly expanding landscape of perioperative, metastatic, and non–muscle-invasive disease management. Drs Park and Grivas first addressed findings from the phase 3 VOLGA trial (NCT04960709), which evaluated neoadjuvant durvalumab (Imfinzi) plus enfortumab vedotin-ejfv (Padcev), with or without tremelimumab (Imjudo), followed by cystectomy and adjuvant durvalumab in patients with cisplatin-ineligible or cisplatin-declining muscle-invasive bladder cancer. Dr Grivas noted that the durvalumab/enfortumab vedotin arm met both event-free survival (EFS) and overall survival (OS) end points, whereas the tremelimumab arm met the end point for EFS but not OS. He emphasized that the need for adjuvant enfortumab vedotin remains an open question.
The conversation then turned to the discordant results among trials in cisplatin-eligible patients. Dr Grivas contrasted the positive phase 3 NIAGARA trial (NCT03732677) data with the results of the phase 3 KEYNOTE-866 (NCT03924856) and ENERGIZE (NCT03661320) trials, which did not meet their EFS end points, and noted that all 3 enfortumab vedotin–based perioperative trials were positive. They also discussed exploratory circulating tumor DNA analyses from VOLGA and the phase 3 KEYNOTE-B15 study (NCT04700124), molecular subtype analysis findings from NIAGARA, and ongoing bladder-preservation trials.
Drs Park and Grivas also reviewed data in metastatic disease, including from cohort 7 of the phase 2 TROPHY-U-01 trial (NCT03547973), in which sacituzumab govitecan-hziy (Trodelvy) plus enfortumab vedotin and zimberelimab (AB122/GLS-010) yielded a high overall response rate. They also discussed data with sacituzumab tirumotecan (MK-2870/SKB264) plus pembrolizumab (Keytruda). In non–muscle-invasive disease, Dr Grivas discussed data from the phase 3 POTOMAC trial (NCT03528694) of durvalumab plus BCG and the role of shared decision-making in bladder cancer management. The experts concluded by highlighting developments in artificial intelligence, as well as the importance of patient advocacy and clinical trial participation.

In our exclusive interview, Dr Haddad discussed the importance of consistent daily adherence to oral TKIs for achieving deep responses, treatment-free remission, and long-term survival in patients with CML. Additionally, he broke down common barriers to TKI adherence, including busy schedules, travel, and under-recognized adverse effects (AEs), underscoring the use of dose reductions and therapy changes to manage AEs and keep patients on treatment. Finally, Haddad explored where liquid and orally disintegrating TKI formulations, such as imatinib oral solution (Imkeldi), may help patients who cannot swallow, those with advanced-phase CML or Philadelphia chromosome–positive acute lymphoblastic leukemia, and pediatric patients.

In today’s episode, we spoke with Nathan A. Boggs, MD, PhD, about the role the allergists play in the diagnosis and management of systemic mastocytosis. Dr Boggs is the director of the Allergy Division in the School of Medicine of Uniformed Services University of the Health Sciences in Bethesda, Maryland.
In our exclusive interview, Dr Boggs broke down how allergists/immunologists fit into the multidisciplinary diagnosis and treatment of patients with systemic mastocytosis. Additionally, Boggs highlighted key strategies for symptom management and how agents such as avapritinib (Ayvakit), bezuclastinib (CGT9486), and elenestinib (BLU-263) have and will continue to affect the treatment paradigm.

Two Onc Docs, hosted by Samantha A. Armstrong, MD, and Karine Tawagi, MD, is a podcast dedicated to providing current and future oncologists and hematologists with the knowledge they need to ace their boards and deliver quality patient care. Dr Armstrong is a hematologist/oncologist and assistant professor of clinical medicine at Indiana University Health in Indianapolis. Dr Tawagi is a hematologist/oncologist and assistant professor of clinical medicine at the University of Illinois in Chicago.
In this episode, OncLive On Air® partnered with Two Onc Docs to deliver a board exam preparation guide for the days leading up to the American Board of Internal Medicine hematology and oncology certification exams, offering test-day strategies and a rapid-fire review of high-yield topics.
The discussion began with exam logistics, noting back-to-back testing days on November 17 (hematology) and November 18 (oncology). Drs Armstrong and Tawagi encouraged examinees to use the exam blueprint to prioritize high-yield topics, such as gastrointestinal, breast, genitourinary, and lung cancers in oncology and neoplasms in hematology, and to prepare for the endurance required to read lengthy clinical vignettes.
Regarding oncology content, they reviewed topics to know regarding stage II and III non–small cell lung cancer, including staging, perioperative immunotherapy regimens, driver-directed adjuvant therapy, and the clinical implications of the phase 3 PACIFIC trial (NCT02125461). They then covered high-yield breast cancer topics, such as HER2-positive regimens, the 21-gene recurrence score assay cutoffs, triple-negative adjuvant strategies, and use of PARP inhibitors in patients with BRCA mutations.
For hematology, they emphasized the malignant hematologic conditions, hemoglobin electrophoresis, von Willebrand disease subtypes, and inherited bone marrow failure syndromes, including dyskeratosis congenita, Fanconi anemia, and Diamond-Blackfan anemia.
Drs Armstrong and Tawagi also highlighted other testable areas, including black box warnings, clinical research methodology, ethics, performance status–guided decision-making, and supportive care. They concluded with wellness advice, cautioning against last-minute cramming, and recommended revisiting their prior board review episodes.

In this episode of OncLive On Air, Aditya Juloori, MD, a radiation oncologist and associate professor at the University of Chicago in Illinois, was joined by David Carbone, MD, PhD, a thoracic medical oncologist and director of the Thoracic Oncology Center at The Ohio State University in Columbus. Together, they explored how factors beyond PD-L1 expression, including histology, co-occurring genomic alterations, brain metastases, and patient fitness, can inform first-line regimen selection for patients with driver-negative metastatic non–small cell lung cancer (NSCLC).
Dr Carbone began by explaining that immunotherapy has transformed the treatment landscape, with frontline regimens now producing an overall 5-year survival rate of approximately 20% and potentially curing a subset of patients. However, he noted that this benefit is not evenly distributed. Patients with PD-L1–negative disease tend to fare worse than those with PD-L1–positive tumors, and outcomes are particularly poor for patients with PD-L1–negative squamous disease. In the 5-year data from the phase 3 KEYNOTE-407 trial (NCT02775435), survival curves for this subgroup had fully converged with the control arm, and the 5-year survival rate among patients with PD-L1–negative nonsquamous disease in the phase 3 KEYNOTE-189 trial (NCT02578680) was below 10%.
Drs Carbone and Juloori emphasized that dual checkpoint inhibition has emerged as an important option for these higher-risk populations. Dr Carbone highlighted that the CheckMate 9LA regimen (NCT03215706) of nivolumab (Opdivo) plus ipilimumab (Yervoy) with 2 cycles of chemotherapy produced a 5-year survival rate exceeding 20% in PD-L1–negative and squamous subsets, making it his preferred approach for patients with PD-L1–negative squamous disease. For PD-L1–negative nonsquamous tumors, he weighs additional factors such as brain metastases and STK11 or KEAP1 alterations. Although dual immunotherapy carries a higher risk of immune-related adverse effects, he noted that outcomes in CheckMate 9LA remained favorable even among patients who discontinued a component of therapy, underscoring the effectiveness of proactive toxicity management. He added that the chemotherapy-free regimen evaluated in the phase 3 CheckMate 227 trial (NCT02477826) demonstrated similar efficacy, and that many patients value receiving only 2 cycles of chemotherapy.
The conversation also explored the management of patients with baseline brain metastases. Dr Juloori explained that in both CheckMate 227 and CheckMate 9LA, the benefit of dual immunotherapy was at least as large in patients with brain metastases as in those without. This may reflect the ability of CTLA-4 blockade to convert immunologically cold intracranial tumors, which tend to have fewer activated cytotoxic T cells and tertiary lymphoid structures, into more inflamed ones. He cited a phase 2 trial of ipilimumab, nivolumab, and chemotherapy that reported an intracranial response rate of approximately 50%. For patients with multiple asymptomatic brain metastases, Dr Juloori described starting the 9LA regimen with close monthly brain imaging to assess early intracranial response, an approach that can defer whole-brain radiation therapy and help preserve performance status and eligibility for subsequent therapies. He noted that some of his patients have avoided radiation for more than a year with sustained complete responses.
Turning to genomic modifiers, Dr Carbone described STK11 and KEAP1 alterations as markers of immunologically cold, often PD-L1–negative tumors that may require more than standard chemotherapy plus pembrolizumab (Keytruda). The prospective phase 2 TRITON trial (NCT06008093) of durvalumab (Imfinzi) plus tremelimumab-actl (Imjudo) in STK11-, KEAP1-, or KRAS-mutant disease was limited by low accrual, but multiple studies support dual immunotherapy activity in these subsets. He cautioned, however, that mutation status is an imperfect surrogate for STK11 function, noting that his laboratory has identified mutant tumors that retain function and wild-type tumors that have lost it. As a result, he would still favor single-agent immunotherapy for a patient with high PD-L1 expression and an isolated STK11 mutation.
Dr Carbone also addressed how to apply trial data to patients who are older, frail, or have reduced performance status. He suggested that limiting chemotherapy exposure may be particularly beneficial in these populations, while noting that patients with interstitial lung disease or active autoimmune conditions requiring aggressive immunosuppression may be poor candidates for dual immunotherapy. He added that age alone should not preclude more intensive treatment in patients with good performance status and organ function. Both experts expressed a preference for nivolumab plus ipilimumab over durvalumab plus tremelimumab, citing stronger supporting data, particularly in squamous disease.
Looking ahead, Dr Carbone noted that emerging tools, including serum proteomic assays and SMARCA4 status, may eventually be incorporated into treatment algorithms, though their role in the dual immunotherapy and PD-L1–negative settings remains undefined. Drs Carbone and Juloori concluded that while clinicians often must rely on incomplete data and cross-trial comparisons, decisions should remain grounded in the available evidence as the field works toward more precise tools for moving beyond PD-L1.