Alana Hippensteele, MA

Antibody-drug conjugates are rapidly reshaping the treatment landscape of non–small cell lung cancer (NSCLC), with advances in design, clinical efficacy, and regulatory approvals tempered by ongoing challenges in toxicity, resistance, and biomarker optimization.

Bispecific antibodies are emerging as a transformative class in advanced non–small cell lung cancer (NSCLC), with agents such as amivantamab and zenocutuzumab already demonstrating clinical benefit and a broad pipeline of investigational therapies showing promise in overcoming resistance.

National Comprehensive Cancer Network (NCCN), the European Society for Medical Oncology (ESMO), and the American College of Chest Physicians (CHEST) offer complementary yet distinct frameworks for lung cancer care, reflecting differences in evidence evaluation, regional adaptation, and policy integration.

Oranus Mohammadi, MD, outlines how antibody-drug conjugates are transforming breast cancer treatment across subtypes and discusses her approach to sequencing high-cost targeted therapies within payer and clinical practice constraints.

Oranus Mohammadi, MD, discusses the emerging applications of circulating tumor DNA (ctDNA) in breast cancer care and emphasizes the importance of clear communication to help patients navigate uncertain or anxiety-provoking biomarker test results.

Joanne Mortimer, MD, FACP, FASCO, discusses the practical applications and limitations of circulating tumor DNA (ctDNA) testing in breast cancer, highlighting its role in guiding targeted therapy, challenges in patient communication and payer coverage, and unique barriers for male patients.

Jorge Nieva, MD, explores the challenges of translating biomarker testing into treatment decisions for non–small cell lung cancer (NSCLC), the role of repeat testing in detecting resistance mutations, and the importance of equitable access to molecular diagnostics in value-based care settings.

Jorge Nieva, MD, highlights the critical role of molecular testing in non–small cell lung cancer (NSCLC) care, while addressing barriers such as limited tissue samples, delayed turnaround times, and the need for faster, more accessible diagnostic technologies.

Yale Podnos, MD, MPH, FACS, discusses strategies to address social determinants of health in oncology, improve clinical trial enrollment for underserved communities, and leverage value-based care models to reduce financial toxicity and ensure equitable cancer care.

Daniel Virnich, MD, highlights the need for proactive social determinants of health screening, language-inclusive clinical trial practices, value-based treatment decisions, and policy reforms to improve equitable access to cancer care.

Lauren Antrim, MD, of City of Hope Cancer Center Duarte, emphasized the need for more evidence to guide optimal immunotherapy duration and sequencing in in non–small cell lung cancer (NSCLC), highlighting ongoing trials and the potential role of ctDNA in tailoring treatment strategies.

Lauren Antrim, MD, emphasized the need to balance safety, efficacy, and financial considerations when managing immune checkpoint inhibitors in NSCLC, underscoring the importance of patient-centered discussions and ongoing trials to refine treatment duration strategies.

Jonathan Thompson, MD, MS, explains how financial, insurance, and socioeconomic barriers limit equitable access to biomarker testing and advanced therapies, underscoring the need for provider advocacy and systemic support.

In advanced non–small cell lung cancer (NSCLC), discontinuing immunotherapy after 2 years can maintain durable responses while reducing financial and toxicity burdens, with decisions guided by residual disease testing and shared decision-making, explained Jonathan Thompson, MD, MS.

Jonathan Thompson, MD, MS, explains that adjuvant immunotherapy benefits patients with early-stage lung cancer with incomplete neoadjuvant response, while treatment decisions in the adjuvant setting must weigh efficacy, toxicity, and limited evidence.

Jonathan Thompson, MD, MS, highlighted that reducing delays in molecular testing and treatment initiation is critical for improving lung cancer outcomes, and that clinical trial data suggest immunotherapy duration can often be safely de-escalated in patients who achieve a complete pathologic response.

Jenny Craven, PharmD, BCPS, outlines the strategies UC Davis Health has used to successfully navigate the complex challenges of implementing cell and gene therapies.

Health systems must prepare for the growing impact of cell and gene therapies by addressing their high costs, complex care pathways, and payer collaboration needs to ensure timely and sustainable patient access.

Jonathan Thompson, MD, MS, emphasized that broader molecular testing in early-stage non–small cell lung cancer (NSCLC) is essential to guide perioperative treatment decisions, while selective retesting at progression can identify resistance mutations or new targets to optimize value-based care.

Emilie Aschenbrenner, PharmD, BCOP, outlines how Froedtert Health and the Medical College of Wisconsin use outpatient-based care models, standardized protocols, and collaborative partnerships to improve cost-effectiveness, accessibility, and patient experience.

Jonathan Thompson, MD, MS, emphasized that comprehensive biomarker testing with next-generation sequencing and PD-L1 analysis—implemented as reflex testing at biopsy—is essential to guide precision therapy in lung cancer and to address persistent disparities in timely, equitable access to care.

Clayton Irvine, PharmD, MBA, MS, discusses how pharmacists are essential to advancing payer–provider collaboration in value-based care by shaping formularies, standardizing drug reviews, leveraging real-world evidence, and leading pilot programs to optimize patient outcomes and cost-effectiveness.

Emilie Aschenbrenner, PharmD, BCOP, highlights how measurable residual disease (MRD) testing can support value-based care in multiple myeloma by guiding personalized treatment intensity, potentially reducing costs and improving outcomes.

Clayton Irvine, PharmD, MBA, MS, emphasized that optimizing value-based access to cell and gene therapies requires standardized care protocols, coordinated transitions between care settings, careful evaluation of prior authorization and financial assistance options, and formulary decisions that balance clinical outcomes with both direct and indirect costs to patients and institutions.

Emilie Aschenbrenner, PharmD, BCOP, discusses how integrating CD38-targeted therapies into first-line treatment for transplant-ineligible multiple myeloma requires balancing clinical benefit, cost, and insurance coverage.

Jason Bergsbaken, PharmD, MBA, BCOP, explains the value of pharmacist involvement in precision molecular tumor boards and end-of-life care discussions, highlighting their role in ensuring evidence-based therapy selection, patient-specific recommendations, and shared decision-making that aligns treatment with individual goals.

Clayton Irvine, PharmD, MBA, MS, discusses strategies to address payer-driven biosimilar and prior authorization challenges through integrated digital solutions, while advocating for flexible, regularly reviewed treatment pathways supported by molecular tumor boards and artificial intelligence to balance standardization with personalized, biomarker-driven oncology care.

Clayton Irvine, PharmD, MBA, MS, explains that leveraging high-quality, real-world data; cross-institutional collaboration; standardized care pathways; advanced technologies; and integrated academic–community oncology partnerships can improve treatment decision-making, reduce financial toxicity, address drug shortages, and optimize infusion center efficiency.

Jason Bergsbaken, PharmD, MBA, BCOP, highlights the operational challenges of value-based oncology care while emphasizing the need to balance standardized treatment pathways with flexibility for personalized, biomarker-driven care.

Jason Bergsbaken, PharmD, MBA, BCOP, highlights the growing role of real-world data in validating or de-implementing therapies, the need for vigilant postapproval outcomes monitoring, and the value of academic–community oncology partnerships.