Video Programs

Dr. Monty Pal concludes the program by discussing how the treatment landscape for advanced renal cell carcinoma (RCC) may evolve as new clinical evidence emerges.

Dr. Monty Pal concludes his discussion on treatment sequencing in advanced renal cell carcinoma (RCC) by summarizing how he applies current guideline recommendations alongside individualized clinical decision making in routine practice.

Dr. Monty Pal reviews emerging clinical evidence evaluating belzutifan-based treatment strategies in advanced renal cell carcinoma (RCC), with particular focus on the LITESPARK-011 trial comparing lenvatinib plus belzutifan with cabozantinib.

Dr. Monty Pal discusses the growing importance of quality of life and long-term tolerability when selecting subsequent therapies for advanced renal cell carcinoma (RCC).

Dr. Monty Pal discusses how patient- and disease-specific characteristics influence treatment sequencing decisions for advanced renal cell carcinoma (RCC) beyond the first-line setting.

Dr. Monty Pal discusses his approach to selecting second-line therapy for advanced renal cell carcinoma (RCC) based on the type of first-line immunotherapy regimen previously received.

Dr. Monty Pal begins the discussion on treatment sequencing in advanced renal cell carcinoma (RCC) by emphasizing the importance of optimizing first-line therapy, noting that many patients may not receive multiple subsequent lines of treatment.

Dr. Monty Pal summarizes his practical first-line treatment algorithm for advanced renal cell carcinoma (RCC), highlighting how he incorporates disease risk, clinical presentation, and treatment goals into routine decision making.

Dr. Monty Pal discusses how the increasing use of adjuvant immunotherapy has introduced new considerations for the management of advanced renal cell carcinoma (RCC).

The panel discusses the full multidisciplinary team required to optimize outcomes for patients with ROS1-positive advanced NSCLC: neuro-oncology for brain metastasis management, radiation oncology for CNS and bone disease, palliative care and symptom management specialists from diagnosis, physical therapy and nutrition, social work, and mental health services.

The panel addresses patients who received crizotinib or entrectinib in first line rather than lorlatinib, and who are now progressing.

The panel reinforces that oligo-progression management in ROS1-positive NSCLC requires careful distinction from strategies used in EGFR-mutated NSCLC.

For the patient with a G2032R resistance mutation and intracranial progression, the panel unanimously favors lorlatinib-based therapy in second line based on its known activity against solvent-front mutations and documented CNS penetrance, with median duration of response of approximately 7 to 8 months in this setting.

The second clinical case presents a patient with ROS1 fusion-positive advanced NSCLC who achieved partial response on frontline lorlatinib, maintained for 18 months, before symptomatic and radiographic progression: increasing primary tumor size, new contralateral pulmonary nodules, and brain MRI showing 3 new small intracranial lesions.

Given the patient's osseous disease, the panel discusses bone-directed therapy integration.

All panelists select lorlatinib at 600 mg for this patient based on response rates, duration of disease control, favorable tolerability, and its design intent to achieve superior CNS penetration compared to earlier-generation ROS1 inhibitors, which is particularly relevant given the patient's age, symptomatic disease burden, and risk of future CNS progression.

The first clinical case presents a 58-year-old female never-smoker with persistent cough, mild dyspnea, and new right-sided pleural effusion.

The panel addresses scenarios where patients arrive on treatments other than the panel's preferred agent.

Beyond efficacy, the panel identifies the key factors influencing agent selection: brain metastasis activity given the high prevalence of CNS involvement in younger ROS1-positive patients; toxicity profiles (earlier agents cause significant dizziness, taste changes, and neuropathic pain that are poorly tolerated chronically); frequency of clinic visits; and insurance access.

Dr. Monty Pal compares the available immunotherapy plus tyrosine kinase inhibitor (IO/TKI) combination regimens for the first-line treatment of advanced renal cell carcinoma (RCC) and explains the clinical rationale behind his preferred treatment approach.

Dr. Monty Pal reviews how current clinical guidelines support both immunotherapy plus tyrosine kinase inhibitor (IO/TKI) combinations and dual immunotherapy (IO/IO) as frontline treatment options for advanced renal cell carcinoma (RCC).

Misako Nagasaka, MD, PhD, describes how it is a “great time to be a thoracic oncologist” with the constantly expanding armamentarium in the field. She specifically discusses the available treatment options in frontline EGFR mutation–positive advanced non–small cell lung cancer and what particular clinical and lifestyle benefits are provided by the treatment regimen of subcutaneous amivantamab plus lazertinib.

Misako Nagasaka, MD, PhD, discusses practical considerations for oncologists implementing subcutaneous (SC) vs intravenous (IV) amivantamab plus lazertinib in the frontline setting for patients with EGFR-mutated advanced or metastatic non–small cell lung cancer. Nagasaka recommends the SC over the IV regimen in the frontline setting, particularly when focusing on convenience and patients’ quality of life.

Misako Nagasaka, MD, PhD, explains the use of prophylactic anticoagulation for preventing venous thromboembolism (VTE) when administering amivantamab plus lazertinib in patients with EGFR-mutated advanced non–small cell lung cancer. The prophylactic anticoagulation is particularly recommended for the first 4 months of treatment, when the risk of VTE is highest.

Misako Nagasaka, MD, PhD, discusses optimizing patient management when administering frontline SC amivantamab plus lazertinib in patients with EGFR-mutated advanced non–small cell lung cancer. She describes how the majority of adverse events (AEs) with the SC regimen in the PALOMA-2 trial occurred during first 4 months of treatment. According to Nagasaka, this highlights the importance of early patient counseling regarding expectations and reporting of AEs when starting the SC regimen.

Misako Nagasaka, MD, PhD, describes the tolerability results with subcutaneous (SC) amivantamab plus lazertinib in patients with treatment-naïve, EGFR-mutated advanced non–small cell lung cancer from the PALOMA-2 trial. She explains that the data thus far have shown comparable discontinuation rates related to adverse events for the SC regimen compared with what has been observed with intravenous amivantamab regimens in prior studies.

Misako Nagasaka, MD, PhD, discusses the overall response rate and duration of response with subcutaneous (SC) amivantamab plus lazertinib in patients with treatment-naïve, EGFR-mutated advanced non–small cell lung cancer, as reported from the PALOMA-2 trial. She explains the significance of the durability demonstrated by the SC regimen in the frontline setting for EGFR-mutated advanced NSCLC.

Dr. Monty Pal discusses the historical role of the International Metastatic Renal Cell Database Consortium (IMDC) risk criteria in guiding treatment decisions for advanced renal cell carcinoma (RCC) and explains why its influence has evolved in the current therapeutic landscape.

Dr. Monty Pal introduces the program by outlining the evolving treatment landscape for advanced renal cell carcinoma (RCC) and emphasizing the importance of translating clinical trial evidence and guideline recommendations into individualized patient care.

Daniel Ermann, MD, discusses his approach to treatment sequencing in patients with chronic lymphocytic leukemia who aged 80 years and older.