Peer Exchange

In this AJMC Peer Exchange series, expert panelists Kavita Nair, Anton Porsteinsson, and Alireza Atri discuss key updates and clinical insights related to Alzheimer's disease agitation. The discussion covers the clinical definition and diagnostic criteria for agitation, its emergence across the disease course, the multifactorial triggers that drive symptoms, and the critical role of primary care in early recognition. Additional topics include the burden agitation places on patients and caregivers, the foundational role of non-pharmacologic interventions, the limitations of traditional off-label therapies, and the mechanisms of action, clinical trial evidence, sequencing considerations, and payer access strategies for the two Food and Drug Administration (FDA)-approved therapies brexpiprazole and dextromethorphan-bupropion.

This AJMC Peer Exchange program explores how next-generation oral SERDs and ctDNA-based ESR1 mutation monitoring are reshaping the management of HR-positive, HER2-negative breast cancer, with a focus on earlier intervention, real-world implementation, treatment sequencing, and future clinical and access considerations.

In this AJMC Peer Exchange series, expert panelists Ryan Haumschild, PharmD, MBA; William Oh, MD; Aman Chauhan, MD; Namrata Vijayvergia, MD; and Sandy Kotiah, MD, discuss key updates and clinical insights related to extrapulmonary neuroendocrine carcinoma (epNEC). The discussion focuses on defining the epNEC disease landscape and its unmet needs, the multidisciplinary approach to diagnosis and care coordination, the challenges of underrecognition and delayed diagnosis, the clinical and humanistic burden on patients and caregivers, current treatment strategies and their limitations, the evolving biomarker testing infrastructure and associated access barriers, and the exciting pipeline of novel targeted therapies — including T-cell engaging bispecific antibodies, antibody-drug conjugates, and radiopharmaceuticals — that hold promise for transforming the future of epNEC care.

In this AJMC Peer Exchange series, Ryan Haumschild, Tiffany Richards, Jackson Gao, and Tyler Sandahl explore the rapidly evolving treatment landscape for multiple myeloma, from the broad adoption of quadruplet induction in newly diagnosed disease to the increasingly complex and crowded relapsed or refractory setting.

In this AJMC Peer Exchange series, a panel of psychiatrists examine the systemic, clinical, and administrative barriers that drive unmet needs in mental health care across major depressive disorder, bipolar depression, and schizophrenia. Across ten episodes, the panelists explore the compounding challenges of late diagnosis, provider shortages, treatment failure, payer barriers, and clinician burnout, offering evidence-based strategies for breaking the cycle and prioritizing patient-centered care.

In this AJMC Peer Exchange series, a panel of leading neurologists provides a masterclass on the current and future state of stroke management. From the foundational "Fab Five" risk factors and the nuances of hemorrhagic stroke mnemonics to the landmark OCEANIC-STROKE data and the 2026 treatment guidelines, this series offers an evidence-based roadmap for the modern clinician. The experts conclude with a vision of the next five years, where the convergence of novel anticoagulants, artificial intelligence, and expanded surgical windows promises to significantly reduce the global burden of stroke-related disability.

In this AJMC Peer Exchange series, expert panelists discuss key updates and clinical insights related to non-small cell lung cancer. The discussion focuses on the latest clinical updates in both resectable and metastatic non-small cell lung cancer, as well as intravenous and subcutaneous routes of administration for oncology patients.

This AJMC Peer Exchange series examines the rapidly evolving HER2‑mutant NSCLC landscape, underscoring the need for comprehensive molecular testing and the potential of new targeted therapies. Panelists discuss critical challenges—including testing and access disparities, optimal therapeutic sequencing, and toxicity management—to guide clinical integration.

This AJMC Peer Exchange program brings together multiple myeloma experts to discuss the rapidly evolving role of bispecific antibodies across treatment settings. Panelists examine emerging clinical data, real world evidence, safety considerations, and practical strategies for integrating these therapies alongside CAR T-cell therapy and antibody drug conjugates. The discussion also highlights ongoing studies evaluating the potential use of bispecifics earlier in the treatment landscape, as well as opportunities to improve access, optimize sequencing, and support effective transitions between academic and community care.

Panelists discuss how advanced practice providers are driving transformation in Alzheimer disease management through early detection, personalized treatment, and comprehensive patient and caregiver support. Across 17 videos, they highlight the growing leadership of advanced practice providers (APPs) in multidisciplinary collaboration, operational efficiency, and equitable access to care.

**One-Sentence Summary:** Panelists discuss how APPs are redefining Alzheimer care through leadership, coordination, and holistic patient engagement.

Panelists discuss how integrating metabolic, pharmacologic, and multidisciplinary strategies can bridge the obesity–MASH divide to improve early detection, treatment outcomes, and long-term public health impact.

This AJMC Peer Exchange® program, moderated by Ryan Haumschild, PharmD, MS, MBA, brings together clinical pharmacy specialists Shahrier Hossain, PharmD; Michael Singel, PharmD; and hematologist Naresh Bumma, MD, to explore how emerging therapies are reshaping care for relapsed/refractory multiple myeloma (RRMM). The panel reviews disease biology, conventional first-line and later-line options, and then dives into bispecific antibodies—including linvoseltamab, teclistamab, talquetamab, and elranatamab—covering mechanisms of action, pivotal approval data, dosing schedules, and toxicity management. They close by comparing operational considerations across bispecifics and CAR T therapies, emphasizing practical dosing, CRS/ICANS management, and the biggest unmet needs and future advances expected over the next 5 years.

Panelists discuss how policy, payer practices, and clinical evidence intersect to shape oncology access, innovation, and affordability. They explore how aligning coverage frameworks with evolving evidence, real-world data, and patient-centered values can improve outcomes and sustain innovation in a rapidly changing health care landscape.

Panel of experts will explore opportunities for diagnosing and treating desmoid tumors.

Panelists discuss how evolving schizophrenia care requires balancing early diagnosis, effective and safe treatment options, and equitable access to novel therapies to improve patient outcomes and quality of life.

Panel of experts will explore treatment of EGFR + NSCLC. Panelists discuss efficacy and safety data from recent studies and how these data are shaping EGFR+ NSCLC management in clinical practice. Panelists also talk about increasing interest in the use of subcutaneous formulations of NSCLC treatments and how this mode of administration can advance patient care in EGFR+ NSCLC.

Panelists discuss how evolving clinical evidence, real-world outcomes, and patient-reported data inform the selection, sequencing, and implementation of third-line therapies for metastatic colorectal cancer, highlighting the importance of individualized care, cross-setting collaboration, and strategies to enhance community adoption and patient quality of life.

Experts discuss the clinical benefits of topical therapies in managing pediatric atopic dermatitis (AD), strategies to delay biologic treatments, and how health economics and outcomes research (HEOR) informs cost-effective treatment choices and healthcare resource optimization.

Panelists discuss how acute myeloid leukemia treatment has evolved from a one-size-fits-all approach to personalized medicine incorporating genetic profiling, targeted therapies like venetoclax and IDH inhibitors, emerging oral regimens, and comprehensive patient assessments that consider not only traditional fitness criteria but also social determinants of health, quality of life factors, and the potential for curative versus palliative care in different patient populations.

Panelists discuss how heart failure management has evolved from limited treatment options to a comprehensive approach requiring multidisciplinary collaboration, early intervention strategies, and integration of multiple evidence-based therapies including SGLT2 inhibitors, ARNIs, and mineralocorticoid receptor antagonists to address the substantial clinical and economic burden of this condition affecting millions of Americans.

Ryan Haumschild, PharmD, MS, MBA, CPEL; Andrew Alexis, MD, MPH; April W. Armstrong, MD, MPH; Andrew M. Mastro, MS, PA-C; and Mark Makhinson, PharmD, discuss how atopic dermatitis is an immune-mediated disease with heterogeneous pathways that present differently across skin tones, requiring health care professionals to recognize diverse clinical manifestations, address educational gaps in understanding the complex immunopathogenesis, and ensure equitable access to targeted biologic therapies through improved training, clinical trial representation, and coordinated care teams.

Experts discuss the unmet clinical and economic needs in arrhythmia evaluation—particularly in patients with comorbidities—highlighting how early detection and predictive solutions can improve care and reduce costs, while integrated workflows support better outcomes and align with broader population health goals.

Panelists discuss the evolving disease burden and health equity challenges of hidradenitis suppurativa, recent therapeutic advancements, and the comprehensive economic impact, highlighting opportunities for improved clinical outcomes and cost-effective, equitable care.

Panelists describe the aggressive clinical and molecular features of KMT2A-rearranged acute myeloid leukemia (AML)—including its menin-dependent biology and poor response to standard chemotherapy—while evaluating current and emerging therapies like Menin inhibitors, and highlighting persistent challenges in early diagnosis, equitable access, and delivering specialized care across health care settings.

Zahra Mahmoudjafari, PharmD, MBA, BCOP, FHOPA; Ryan Haumschild, PharmD, MBA, MS; Faith Davies, MD; Shachar Peles, MD, and Sagar Lonial MD, FACP discuss how quadruple therapy regimens incorporating CD38 antibodies have become the standard of care for both transplant-eligible and transplant-ineligible multiple myeloma patients, with treatment decisions guided by patient risk stratification, minimal residual disease monitoring, and the balance between achieving deep responses and maintaining quality of life.

A panel of experts describes the impact of subcutaneous formulations on oncology workflows and discusses actionable strategies for oncology practice transformation to successfully integrate subcutaneous therapies into clinical workflows.

Nihar Desai, MD, MPH; Kenny J. Cole, MD, MS; Jacinda Mawson Nicklas, MD, MPH, MA; Esra Karslioglu French, MD, MBA, and Goutham Rao, MD, discuss how recent advances in GLP-1 receptor agonists and other therapies are transforming the treatment of type 2 diabetes and obesity by enabling a paradigm shift from reactive glucose management to proactive weight-focused care that addresses the root causes of cardiometabolic disease, while emphasizing the critical need for multidisciplinary teams, bias-free patient communication, and systematic healthcare delivery changes to overcome barriers like provider time constraints, medication access, and weight stigma.