OncLive® On Air

Welcome to OncLive On Air®! I’m your host today, Courtney Flaherty.
OncLive On Air is a podcast from OncLive®, which provides oncology professionals with the resources and information they need to provide the best patient care. In both digital and print formats, OncLive covers every angle of oncology practice, from new technology to treatment advances to important regulatory decisions. 
In today’s episode, Michael J. Pishvaian, MD, PhD, sat down to discuss the evolving role of biomarker-directed strategies in gastrointestinal (GI) oncology, as well as the importance of early comprehensive testing to identify molecular drivers and resistance mechanisms when approaching frontline treatment selection and sequencing. 
Pishvaian serves as director of the Gastrointestinal, Developmental Therapeutics, and Clinical Research Programs for the Johns Hopkins Kimmel Cancer Center in the National Capital Region.
Pishvaian began the discussion by highlighting the shift from a disease-site-specific approach to a molecularly defined paradigm, noting that microsatellite instability–high status and NTRK fusions now dictate therapy regardless of tumor origin. He reviewed the transformational data from the phase 3 HERIZON-GE-01 trial (NCT04276493), positing that zanidatamab (Ziihera) could become the new standard of care for HER2-positive upper GI cancers due to unprecedented survival outcomes. He also emphasized the emergence of Claudin 18.2-directed therapies, noting that data from the phase 2 ILUSTRO study (NCT03505320) demonstrates remarkable progression-free survival when adding zolbetuximab (Vyloy) to mFOLFOX6 and nivolumab (Opdivo) for high-expressing subgroups.
The conversation then shifted to colorectal cancer, where Dr. Pishvaian detailed how data from the phase 3 BREAKWATER trial (NCT03845036) has "locked in" a paradigm requiring frontline testing for BRAF V600E mutations to guide the use of encorafenib (Braftovi) plus cetuximab (Erbitux). He also discussed the "care revolution" in KRAS inhibition, spotlighting the significant survival benefits seen with daraxonrasib in pancreatic cancer and the potential for novel allele-specific inhibitors to combat disease resistance.
Finally, Pishvaian addressed the practicalities of implementation, noting that testing rates in the community remain low. He advocated for prioritizing testing, including liquid biopsies and ctDNA, at the time of initial diagnosis to ensure no patient is left behind.
This content is a production of OncLive; this OncLive On Air podcast episode is supported by funding, however, content is produced and independently developed by OncLive.

In this podcast, experts Sanja Dacic, MD, PhD; Isabel Preeshagul, DO, MBS; and Soo-Ryum (Stewart) Yang, MD, discuss cases of patients with non–small cell lung cancer harboring actionable alterations.

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 provide a comprehensive review of metastatic urothelial carcinoma management, contrasting historical standards with the rapidly evolving frontline paradigm. As the field transitions into a new era of care, Drs Armstrong and Tawagi emphasized the importance of understanding trial data and toxicity management for both board preparation and clinical practice.
The discussion began with details about the historical treatment paradigm, which relied on platinum-based chemotherapy followed by maintenance avelumab for patients who did not progress. However, the experts noted that the current SOC has shifted dramatically following findings from the landmark EV-302 trial, which evaluated the combination of enfortumab vedotin and pembrolizumab.
They also explained that the toxicities associated with enfortumab vedotin plus pembrolizumab are highly testable and clinically relevant. Key adverse effects include skin toxicity and peripheral neuropathy, they said. Additionally, the hosts highlighted hyperglycemia and the risk of diabetic ketoacidosis, and emphasized that ocular toxicities, specifically dry eyes, also necessitate referrals to ophthalmology.
In the second-line setting following enfortumab vedotin plus pembrolizumab, Drs Armstrong and Tawagi noted that the paradigm unclear, though treatment options include platinum-based chemotherapy or targeted agents. They recommended testing for FGFR mutations to determine patient eligibility for erdafitinib, as well as testing for HER2 expression to determine eligibility for trastuzumab deruxtecan.
They also reported that for localized high-grade upper tract urothelial carcinoma, treatment options include neoadjuvant split-dose gemcitabine/cisplatin or upfront surgery followed by adjuvant chemotherapy. In the metastatic setting, they noted that rare disease variants like small cell carcinoma are treated with platinum doublets and immunotherapy, whereas adenocarcinoma management may require FOLFOX.

In this podcast, experts E. Gabriela Chiorean, MD; Tanios S. Bekaii-Saab, MD; Mitesh Borad, MD; and Christopher Lieu, MD, discuss the evolving role of KRAS-targeted therapies in pancreatic cancer, including underlying biology, emerging clinical data, and real-world challenges in treatment selection and trial access.

Dr Kruse discussed the evolving role of FES-PET/CT in breast cancer, particularly invasive lobular carcinoma. She explained that FES-PET/CT uses a radiotracer to map estrogen receptor–positive cancer sites, offering advantages over traditional imaging. FIndings from a study presented at the 2025 San Antonio Breast Cancer Symposium showed that many patients experienced treatment changes based on FES-PET/CT results. The National Comprehensive Cancer Network guidelines also now recommend FES-PET/CT for use in lobular breast cancer, enhancing its clinical utility. Dr Kruse concluded by emphasizing that future research is needed to explore its use in early-stage breast cancer and for monitoring endocrine therapy response.