Boston Experts Weigh Access, Sequencing, and Testing Across 4 Cancers

Policy talks preceded more typical clinical panels at an Institute for Value-Based Medicine^® event in Boston, Massachusetts, on August 19, 2026. Exchanges on the use of artificial intelligence (AI) and translating academic practices at the community level were highlights of the evening, with discussions on chronic lymphocytic leukemia (CLL), multiple myeloma, breast cancer, and use of biomarkers in lung cancer bringing it to a close. The event featured faculty from across the region amid institutional shifts in Boston’s health care landscape.¹

Academic Settings, Community Practice Both Face Access Challenges

Amir Fathi, MD, director of the leukemia program at Mass General Brigham Cancer Institute, led the discussion “Translating Excellence, Bringing Academic Best Practices to Community Settings,” which was especially relevant as novel therapies move into outpatient settings. Panelists were Sita Bhatt, PharmD, BCOP, of Boston Medical Center (BMC) and Boston University Chobanian & Avedisian School of Medicine; Michael Serzan, MD, of Dana-Farber Cancer Institute’s Lank Center for Genitourinary Oncology; and Julia Rotow, MD, of Dana-Farber’s Lowe Center for Thoracic Oncology.

Bhatt described BMC’s recent acquisition of community sites and the challenge of training general oncologists on rapidly evolving, disease-specific protocols without overburdening specialist staff. General oncologists train at BMC Main “to give them an overview of our guidelines and our processes that these community sites are going to start to adapt,” she said. “Having these guidelines that we’ve developed at BMC Main has allowed them to have that reference point…when they don’t have myself or an oncologist or a hematologist readily accessible.”

Serzan and Rotow discussed how Dana-Farber uses quarterly clinical pathways programs to disseminate FDA approvals, consensus treatment recommendations, and cost and toxicity considerations to satellite sites, while also linking open clinical trials directly to pathway recommendations. Both emphasized close relationships with satellite “champions” who join case conferences and help determine the optimal treatment regimen when newer, higher-toxicity therapies become choices. Serzan shared an example involving a patient treated with the radioligand therapy lutetium Lu 177 vipivotide tetraxetan (Pluvicto; Novartis) for prostate cancer, and Rotow discussed how this works for tarlatamab (Imdelltra; Amgen).

“That’s been a change for us in thinking about how do we interface with our regional networks to allow patients to have access to these agents safely and successfully,” Rotow said.

Clinical trial access was a focal point. Bhatt cited concerns about lack of diversity in trial enrollment and described BMC’s transportation support program for patients. Fathi highlighted the inherent tension in trying to create equitable access.

“The accessibility issue is an interesting conundrum for me sometimes, because there [are] the ethics of accessibility and the broad dissemination of what we think should be available for a wide swath of patient populations, regardless of social background or ethnicity,” Fathi said. “At the same time, you have to be careful about being promissory in terms of offering trials…. We have a hoteling program at Mass General. We have to be very careful about how we phrase that in our discussions with patients, because you don’t want to incentivize, in terms of just ethical considerations, clinical trial participation.”

Serzan and Rotow pointed to cooperative group and investigator-initiated trials as more feasible for community expansion than early-phase studies, whereas Rotow argued that outdated regulatory frameworks—designed around 1980s-era logistics—limit broader use of telemedicine and remote monitoring, particularly for rural patients.

The speakers also addressed home-based and outpatient administration of therapies, including subcutaneous checkpoint inhibitors and chimeric antigen receptor (CAR) T-cell and bispecific therapies. They described both the appeal of reduced infusion-center burden and the risk through loss of direct monitoring, especially for medically complex patients or those who do not speak English. Bhatt confirmed that BMC has CAR T-cell therapy, autologous transplant, and gene therapy infrastructure, although autoimmune-indication CAR T-cell treatment remains in early planning.

The discussion turned to palliative care access, with Rotow highlighting a shortage of palliative specialists. “There’s just not enough to see all the patients who could benefit from that level of care,” she said. “A trend that I have seen that I like is oncology programs beginning to offer double boarding in oncology and palliative care.”

Serzan noted the value of rapid germline genetic testing programs for closing gaps in community-based genetic counseling access.

Many Nuances in CLL When Selecting Among BTK Inhibitors

Moderator Nathalie Javidi-Sharifi, MD, PhD, of Dana-Farber, led the panel “In CLL, Navigating Treatment Options With BTK Inhibitors,” featuring Jacob Soumerai, MD, of Mass General Brigham Cancer Institute; and Christine Ryan, MD, and Amy Bessnow, MD, MPH, both of Dana-Farber. The panel covered treatment sequencing in CLL, framed around the shift from continuous covalent Bruton tyrosine kinase (BTK) inhibitors to a broader menu of finite, combination, and noncovalent options following the 2026 approval of acalabrutinib (Calquence; AstraZeneca) plus venetoclax (Venclexta; AV; Genentech/AbbVie) based on the AMPLIFY study (NCT02796677).²

Soumerai outlined frontline options: continuous covalent BTK inhibitors, with second-generation acalabrutinib and zanubrutinib (Brukinsa; BeOne Medicines) preferred over first-generation ibrutinib (Imbruvica; Johnson & Johnson); fixed-duration venetoclax-obinutuzumab (Gazyva; VO; Genentech) or AV/AVO; and minimal residual disease (MRD)–guided approaches supported by the Dana-Farber AVO (NCT03580928) and SEQUOIA Arm D (NCT03336333) studies.^3,4 Bessnow discussed patient-specific selection factors—age, comorbidities, infusion logistics, and insurance—noting zanubrutinib's simpler dosing and noncovalent pirtobrutinib’s (Jaypirca; Eli Lilly) favorable cardiovascular safety profile. Ryan emphasized that treatment decisions increasingly hinge on nuanced discussions about pill-vs-infusion logistics and family support. Panelists agreed that TP53-aberrant and IGHV-unmutated disease still meaningfully influence regimen choice, with VO favored in patients with IGHV-mutated disease, given the progression-free survival (PFS) data from the CLL14 trial (NCT02242942).⁵

On MRD, the panelists stressed that no randomized data yet show MRD-guided treatment duration improves outcomes. “We need to [randomly assign] patients to the MRD-guided treatment decision or not, and that’s being done in the CLL18 study [NCT03580928⁶],” Soumerai said. “That data are very welcome and are going to really inform how we apply MRD. We still don’t really know whether use of MRD to determine treatment duration is the right thing to do.”

Bessnow raised the practical barrier of needing a baseline peripheral blood sample for clonoSEQ testing⁷ in community settings. “Do you send it [for] anybody you’re thinking might get a time-limited [regimen] so that you have a specimen to use, or do you think that MRD flow is good enough, which can be done by anybody at any time?” Bessnow asked.

“It’s a really important question,” Ryan replied. “I try to send it on any patient before I start treatment.”

Discussion of the relapsed/refractory setting covered BTK inhibitor intolerance vs resistance: switching between covalent agents for idiosyncratic intolerance, mutation testing at progression to guide use of pirtobrutinib, and the choice between venetoclax-based regimens and pirtobrutinib-venetoclax-rituximab informed by new phase 3 data.⁸ Panelists also discussed practical management of transitioning between regimens, including overlapping BTK inhibitor therapy during venetoclax ramp-up to reduce rebound risk. Looking ahead, the panel highlighted excitement around BTK degraders and the new BCL2 inhibitor, sonrotoclax (Beqalzi; BeOne Medicines) as next-generation options, particularly for younger patients with high-risk TP53-mutated disease.

An audience question on drug costs—covalent BTK inhibitors run roughly $200,000 annually,⁹ with noncovalent agents even higher—prompted discussion of Medicare Part D’s $2000 out-of-pocket cap under the Inflation Reduction Act, financial toxicity, and the cost of molecular testing, with a Mass General Brigham molecular diagnostics representative noting CLL is among the most frequently denied indications for expanded genomic panels under Medicare.

Innovation That Focuses on the Individual in Multiple Myeloma

Selection, sequencing, and therapy tailored to the individual were all part of the session “Patient-Centered Innovation in Multiple Myeloma Therapy.” Moderator Andreas Klein, MD, of Tufts Medical Center, led panelists Noopur Raje, MD, of the Center for Multiple Myeloma at Mass General Brigham; Jan Cerny, MD, PhD, of UMass Chan Medical School; and Clifton Mo, MD, of Dana-Farber, in a discussion of an increasingly individualized myeloma landscape.

Panelists agreed that quadruplet therapy—a CD38 antibody, an immunomodulatory drug, a proteasome inhibitor, and dexamethasone—has become standard for most newly diagnosed patients, a shift from just 5 years ago when quad therapies were reserved for transplant-eligible patients. Raje predicted immunotherapies will move further into the frontline setting, potentially limiting most patients to 2 or 3 lines of treatment, given the depth of MRD-negative responses now achievable with CAR T-cell and bispecific therapies. Mo cautioned that whether T-cell–engaging therapies will fit into frontline sequencing or follow quad therapy remains an open question among investigators, citing ongoing trials such as DETERMINATION 2 (NCT07624513).¹⁰

“Within the class of what we call BCMA [B-cell maturation antigen]–directed therapies, we have the antibody-drug conjugate [ADC] belantamab mafodotin (Blenrep; GSK) that’s also being studied in the first line,”¹¹ Mo said. “I think we’re all confident these therapies are going to be in the first line. They’re going to be given to patients who were previously untreated before the time of first relapse.” He added that he was unsure “exactly how they’re going to fall into first-line therapy,” but perhaps these drugs could supplant older ones or be given after several cycles of quad therapy to deepen responses.

Community access barriers remain for both CAR T-cell and bispecific therapies, the panelists said. Mo described persistent challenges, including unfamiliarity with cytokine release syndrome (CRS) management, hospitalization requirements, and geographic burden for rural patients. Raje explained that Mass General Brigham’s BOSS protocol (bispecific outpatient safe step-up)¹² is designed to be prescriptive enough for community oncologists to adopt, and noted the health system keeps all approved BCMA-directed products on formulary specifically to support whichever drug a patient’s home practice already uses. Cerny emphasized ongoing education efforts—grand rounds, shared clinical guidelines, and direct availability to community colleagues—as essential to safe decentralization, including educating emergency physicians to recognize CRS rather than mistake it for sepsis.

The panel also debated the future role of autologous stem cell transplant, with Mo noting it may become a shrinking share of first- and second-line care as CAR T cells, bispecifics, and a new class of cereblon E3 ligase modulatory drugs known as CELMoDs make their mark. The first approval for this class, iberdomide (Zenbexus; Bristol Myers Squibb), came on August 13, 2026,¹³ with encouraging data for a more powerful drug, mezigdomide, having been presented in June 2026 at the American Society of Clinical Oncology Annual Meeting.¹⁴

As these data mature, however, Mo cautioned that infection risk and toxicity from immunotherapies mean transplant and multiple drug classes will remain necessary for some patients, particularly older or frailer ones. Raje highlighted a newly approved subcutaneous on-body injector formulation of isatuximab (Sarclisa Escena; Sanofi) as a potential shift toward home-based maintenance therapy, reducing infusion-center burden.¹⁵

“I do think that is going to change how we practice medicine. Maybe the US is going to be behind Europe here, but this is a very easy way of giving the treatment,” she said. “It’s literally slapped onto somebody’s belly and the drug goes in, so you do not need a nurse injecting.”

Cerny identified prevention of secondary malignancies as a key unmet need despite the retreat from chemotherapy-based regimens.

An audience question on in vivo CAR T-cell therapy, in which CAR T cells are manufactured inside a patient rather than through ex vivo processing, prompted Mo and Raje to describe early but promising data, including MRD-negative responses in an initial cohort, while emphasizing that long-term safety and durability remain unknown.

So Many New Targeted Options in Breast Cancer: News in Every Subtype

Moderator Paolo Tarantino, MD, PhD, of Dana-Farber, led panelists Heather Benjamin, MD, of Mass General Brigham Cancer Institute in Danvers, and Anasuya Gunturi, MD, PhD, of Lowell General Hospital, Tufts Medicine, through “Targeted Success: Operationalizing Therapies in Breast Cancer.” This subtype-by-subtype discussion covered how rapidly evolving data are reshaping breast cancer treatment sequencing.

Regarding HER2-positive disease, the panel discussed how the DESTINY-Breast11 (NCT05113251) and DESTINY-Breast05 (NCT04622319) trials, both presented at the 2025 European Society for Medical Oncology meeting,^16,17 have shifted use of trastuzumab deruxtecan (T-DXd; Enhertu; AstraZeneca) into curative-intent settings. Benjamin noted that the clearest impact has been adjuvant use for residual nodal disease after neoadjuvant therapy, whereas the TCHP combination (docetaxel, carboplatin, trastuzumab [Herceptin; Genentech], and pertuzumab [Perjeta; Genentech]) remains her comparator of choice in the neoadjuvant setting pending stronger data linking pathologic complete response to long-term outcomes.

Tarantino described an emerging, trial-unsupported practice at Dana-Farber of starting with THP and escalating to T-DXd only in nonresponders to avoid anthracycline exposure. Gunturi said she is awaiting more data before adopting this in the community. The group also discussed newly complex metastatic HER2-positive options—DESTINY-Breast09 (NCT04784715),¹⁸ PATINA (NCT02947685),¹⁹ and HER2CLIMB-05 (NCT05132582)²⁰—with Gunturi noting the shift from the single standard regimen, THP, toward decisions balancing efficacy, toxicity, and quality of life, particularly given competing options such as tucatinib (Tukysa; Pfizer) addition earlier in sequencing.

The discussion moved to triple-negative breast cancer, where TROP2-targeted ADCs sacituzumab govitecan (Trodelvy; Gilead) and datopotamab deruxtecan (dato-DXd; Datroway; AstraZeneca) are replacing chemotherapy in first-line metastatic treatment based on data from the ASCENT-03 (NCT05382299),²¹ ASCENT-04 (NCT05382286),²² and TROPION-Breast02 (NCT05374512) trials.²³ Panelists said selection is largely case-by-case based on toxicity profile and patient ability to manage prophylactic requirements, which include eye drops and mouthwash for dato-DXd, vs neutropenia/diarrhea management for sacituzumab.

What drives therapy selection? “A lot of times it is the patient,” Benjamin said. Individual safety profiles are a chief consideration, she added, along with what will offer the most durable benefit.

“Right now, I don’t necessarily see one as being better than the other. [One has] a bit more neutropenia, diarrhea, but something that we’re very comfortable with, vs dato-DXd, which has more of the needing the eye drops and trying to make sure that we have a patient who can be [adherent to] that,” she said.

Benjamin described using growth factor support reactively after a first cycle rather than universally upfront. On sequencing after ADC progression, Benjamin said she prefers inserting conventional chemotherapy between ADCs given emerging evidence of cross-resistance, rather than moving directly from one ADC to another.

Tarantino noted, “We’re seeing more and more real-world data suggesting that there is cross-resistance between ADCs. They’re super helpful, but we’re realizing most of the activity comes from the first ADC, and so I think choosing the most effective option as early as possible, now in the first line, can really impact outcomes.”

For estrogen receptor–positive (ER+) disease, Benjamin described changing her practice to send the Prosigna assay (PAM50 Classifier) instead of Oncotype DX for premenopausal patients with node-positive disease, citing concerns that the RxPONDER trial (NCT01272037) may have overstated chemotherapy’s benefit due to suboptimal endocrine therapy (tamoxifen alone) in the comparator arm.²⁴ Regarding adjuvant CDK4/6 inhibitors, Gunturi described a structured workflow using dedicated nurse practitioners for patient education and toxicity monitoring, which she believes improves treatment completion rates. Benjamin noted that convincing lower-risk patients with node-negative disease to accept added monitoring burden for an approximate 3% to 5% invasive disease-free survival benefit with ribociclib (Kisqali; Novartis), per updated NATALEE data (NCT03701334), remains a difficult conversation.²⁵

For metastatic ER+ disease, Gunturi said elacestrant (Orserdu; Stemline) remains the most commonly used oral selective estrogen receptor degrader in community practice due to familiarity, with newer agents, such as imlunestrant (Inluriyo; Eli Lilly) or vepdegestrant (Veppanu; Rigel), not yet adopted due to administrative and formulary barriers. Benjamin reported strong personal experience with gedatolisib (Revtorpyk; Celcuity) plus fulvestrant (Faslodex; AstraZeneca), with or without palbociclib (Ibrance; Pfizer), in both PIK3CA-mutant and wild-type disease in the VIKTORIA-1 trial (NCT05501886),²⁶ noting durable responses despite the inconvenience of intravenous infusion, and suggesting it may suit motivated, higher-risk patients living near treatment centers.

Precision in Practice: Implementing Biomarker Testing in Lung Cancer

Lynette Sholl, MD, chief of thoracic pathology at Brigham and Women’s Hospital, served as moderator for the final session, “Precision in Practice: Implementing Biomarker Testing in Lung Cancer.” The session featured panelists Karl D’Silva, MD, of Beth Israel Lahey Health; Jennifer Marks, MD, of Dana-Farber; and Konstantin Dragnev, MD, of Dartmouth Health, in a discussion of biomarker testing gaps and workflow in lung cancer.

D’Silva opened by noting that approximately 35% of lung adenocarcinomas now harbor an actionable mutation, with 12 to 14 biomarkers identified since his fellowship, and yet, testing remains inconsistent, particularly in community settings shifting toward in-house panels. Marks highlighted durable long-term outcomes with ALK-targeted therapy, with 7-year data with median PFS not yet reached from the phase 3 CROWN trial (NCT03052608),²⁷ and described sending both tissue and circulating tumor DNA simultaneously in the metastatic setting to ensure a complete biomarker profile despite turnaround-time trade-offs.

“The lesson is that if you don’t test, you’re usually depriving the patient from a highly effective treatment,” Dragnev said. “Maybe we delude ourselves—of course, everybody tests. But we see studies that show that up to 30% of patients don’t get tested,²⁸ which I cannot understand how this is happening. But these are [the] data.”

He discussed the expanding challenge of reflexive testing in the early-stage/adjuvant setting, where approved targeted therapies such as osimertinib (Tagrisso; AstraZeneca), taletrectinib (Ibtrozi; Nuvation Bio), and selpercatinib (Retevmo; Eli Lilly) require panels to keep pace, often triggering payer denials.

The panelists agreed that tissue remains the gold standard for early-stage testing, as liquid biopsy carries the risk of false negatives or clonal hematopoiesis artifacts, whereas metastatic testing increasingly combines DNA and RNA sequencing via both tissue and liquid approaches.

“You definitely need to do tissue and not liquid biopsy,” D’Silva said. Otherwise, “you are not going to detect some of the mutations. So, I think you need to do the tissue testing because the management is going to change with some of the actionable mutations.”

He and Dragnev described recurring reimbursement friction, including denials tied to prior authorization gaps for molecular pathology and cases where payers required documentation of a negative (wild-type) result. Sholl explained the pathology lab’s operational tension between a single broad hybrid-capture panel with a 2-week turnaround and smaller, faster targeted assays better suited to time-sensitive neoadjuvant/adjuvant decisions.

“We will often get denied testing reimbursement because we have not obtained prior [authorization],” Sholl said. “Whereas, of course, there’s prior auth in place for imaging or surgical procedures, etc, but this is not necessarily something that we’ve got in existence in pathology,” and it falls to oncologists to place the phone calls, she added.

On emerging biomarkers, the group discussed MET and HER2 overexpression testing via immunohistochemistry, weighed against tissue conservation concerns. Sholl noted mutations, such as HER2 exon 20 insertions, are more reliably actionable than overexpression, which is more heterogeneous and subjective to interpret, as well as dynamic under treatment pressure. She cited the emergence of HER2 amplification as a resistance mechanism not present at baseline. D’Silva and Marks discussed sequencing decisions around HER2, MET, and post-EGFR resistance testing, such as emerging savolitinib-osimertinib data.

Throughout, the need for adequate tissue was a constant theme. “I do worry about exhausting tissue, especially if I don’t have the full molecular panel with DNA- and RNA-based sequencing at the time I’m seeing the patient,” Marks said. “So, discussing [this] with my pathology colleagues is helpful in that regard, making sure we can at least prioritize some tests over others.”

Asked about AI, the panelists described limited current use. D’Silva was skeptical of predictive algorithmic tools such as Tempus AI beyond specific applications such as TROP2 computational pathology. Dragnev and Marks described mainly using large language models, such as OpenEvidence, to check literature on unusual mutations. Sholl, responding to an audience question about AI eventually replacing pathologists, said pathology and radiology face meaningful disruption risk given how much of their data are already digitized, but she argued that AI’s greatest value lies in distilling complex biological information into actionable clinical variables.

Closing remarks centered on the need for universal testing guidelines across the National Comprehensive Cancer Network, the American Society of Clinical Oncology, and the International Association for the Study of Lung Cancer. Panelists called for increased advocacy for Medicare coverage of molecular testing, which they identified as the primary barrier to closing persistent testing gaps.

References

1. Saltzman J. ‘Like an earthquake': Mass General Brigham fumbled hospital merger, former executive says. Boston Globe. July 28, 2026. Accessed September 10, 2026. https://www.bostonglobe.com/2026/07/28/business/mass-general-brigham-merger/
2. Brown JR, Seymour JF, Jurczak W, et al; AMPLIFY investigators. Fixed-duration acalabrutinib combinations in untreated chronic lymphocytic leukemia. N Engl J Med. 2025;392(8):748-762. doi:10.1056/NEJMoa2409804
3. Davids MS, Ryan CE, Lampson BL, et al. Phase II study of acalabrutinib, venetoclax, and obinutuzumab in a treatment-naïve chronic lymphocytic leukemia population enriched for high-risk disease. J Clin Oncol. 2025;43(7):788-799. doi:10.1200/JCO-24-02503
4. Shadman M, Munir T, Ma S, et al. Zanubrutinib and venetoclax for patients with treatment-naïve chronic lymphocytic leukemia/small lymphocytic lymphoma with and without del(17p)/TP53 mutation: SEQUOIA arm D results. J Clin Oncol. 2025;43(21):2409-2417. doi:10.1200/JCO-25-00758
5. Al-Sawaf O, Robrecht S, Zhang C, et al. Venetoclax-obinutuzumab for previously untreated chronic lymphocytic leukemia: 6-year results of the randomized phase 3 CLL14 study. Blood. 2024;144(18):1924-1935. doi:10.1182/blood.2024024631
6. Mazot L, Görgen E, Robrecht S, et al. CLL-984: CLL18/MOIRAI international phase 3 trial: aiming to establish measurement of individual residual disease for adjustment of treatment duration to improve outcomes in first-line treatment of CLL/SLL. Clin Lymphoma Myeloma Leuk. 2025;25(suppl 1):S534-S535. doi:10.1016/S2152-2650(25)01874-9
7. Holstein SA, Hillengass J, McCarthy PL. Is peripheral blood MRD assessment ready to replace bone marrow testing in multiple myeloma? ASCO Daily News. March 29, 2023. Accessed September 10, 2026. https://dailynews.ascopubs.org/do/peripheral-blood-mrd-assessment-ready-replace-bone-marrow-testing-multiple-myeloma
8. Davids MS, Eyre TA, Woyach JA, et al. Fixed-duration pirtobrutinib plus venetoclax-rituximab versus venetoclax-rituximab for patients with previously treated chronic lymphocytic leukaemia or small lymphocytic lymphoma (BRUIN CLL-322): an open-label, multicentre, randomised, controlled, phase 3 trial. Lancet. 2026;408(10553):453-470. doi:10.1016/S0140-6736(26)01204-3
9. Kittai AS, Patel DA, Shafrin J, et al. Cost-offset analysis performed utilizing covalent Bruton's tyrosine kinase inhibitors safety profiles among Medicare patients with chronic lymphocytic leukemia. Blood. 2024;144(suppl 1):5031. doi:10.1182/blood-2024-201039
10. Determination 2 - isatuximab, iberdomide, bortezomib and dexamethasone induction followed by risk- and response-adapted consolidation and maintenance therapy, in transplant-eligible patients with newly diagnosed multiple myeloma. Dana-Farber Cancer Institute. Accessed September 11, 2026. https://www.dana-farber.org/clinical-trials/25-900
11. Usmani SZ, Mielnik M, Alonso A, et al. DREAMM-9 final analysis: belantamab mafodotin (belamaf), bortezomib, lenalidomide, and dexamethasone (BVRd) for transplant-ineligible (TI) newly diagnosed multiple myeloma (NDMM). J Clin Oncol. 2026;44(suppl 16):7503. doi:10.1200/JCO.2026.44.16_suppl.7503
12. Cirstea D, Kim B, O’Neill S, et al. Implementing the bispecific outpatient safe step-up (BOSS) program for elranatamab in ambulatory treatment of multiple myeloma. J Clin Oncol. 2025;43(suppl 16):e19507(2025) doi:10.1200/JCO.2025.43.16_suppl.e19507
13. Shaw ML. FDA approves novel iberdomide regimen in RRMM. AJMC. August 13, 2026. Accessed September 11, 2026. https://www.ajmc.com/view/fda-approves-novel-iberdomide-regimen-in-rrmm
14. Caffrey M. Adding powerful CELMoD to carfilzomib backbone cuts risk of disease progression or death 52% in R/R multiple myeloma. Am J Manag Care. 2026;32(spec 8):SP395.
15. Caffrey M. FDA approves isatuximab on-body injector, raising anti-CD38 competition in myeloma. Am J Manag Care. 2026;32(spec 9):SP498.
16. Harbeck N, Modi S, Pusztai L, et al; DESTINY-Breast11 Trial Investigators. Neoadjuvant trastuzumab deruxtecan alone or followed by paclitaxel, trastuzumab, and pertuzumab for high-risk HER2-positive early breast cancer (DESTINY-Breast11): a randomised, open-label, multicentre, phase III trial. Ann Oncol. 2026;37(2):166-179. doi:10.1016/j.annonc.2025.10.019
17. Loibl S, Park YH, Shao Z, et al; DESTINY-Breast05 Trial Investigators. Trastuzumab deruxtecan in residual HER2-positive early breast cancer. N Engl J Med. 2026;394(9):845-857. doi:10.1056/NEJMoa2514661
18. Tolaney SM, Jiang Z, Zhang Q, et al; DESTINY-Breast09 Trial Investigators. Trastuzumab deruxtecan plus pertuzumab for HER2-positive metastatic breast cancer. N Engl J Med. 2026;394(6):551-562. doi:10.1056/NEJMoa2508668
19. Metzger O, Mandrekar S, Goel S, et al. Palbociclib for hormone-receptor-positive, HER2-positive advanced breast cancer. N Engl J Med. 2026;394(5):451-462. doi:10.1056/NEJMoa2511218
20. Diéras V, Curigliano G, Martin M, et al; HER2CLIMB-05 Investigators. HER2CLIMB-05: a phase III study of tucatinib versus placebo in combination with trastuzumab and pertuzumab as first-line maintenance therapy for HER2+ metastatic breast cancer. J Clin Oncol. 2026;44(17):1597-1607. doi:10.1200/JCO-25-02600
21. Cortés J, Punie K, Barrios C, et al; ASCENT-03 Clinical Trial Investigators. Sacituzumab govitecan in untreated, advanced triple-negative breast cancer. N Engl J Med. 2025;393(19):1912-1925. doi:10.1056/NEJMoa2511734
22. Tolaney SM, de Azambuja E, Kalinsky K, et al; ASCENT-04/KEYNOTE-D19 Clinical Trial Investigators. Sacituzumab govitecan plus pembrolizumab for advanced triple-negative breast cancer. N Engl J Med. 2026;394(4):354-366. doi:10.1056/NEJMoa2508959
23. Dent R, Shao Z, Schmid P, et al; TROPION-Breast02 investigators. Datopotamab deruxtecan in patients with untreated, advanced triple-negative breast cancer (TROPION-Breast02): a randomised, open-label, international, phase III trial. Ann Oncol. 2026;37(8):1066-1080. doi:10.1016/j.annonc.2026.03.008
24. Zeng C, Zhang J. A narrative review of five multigenetic assays in breast cancer. Transl Cancer Res. 2022;11(4):897-907. doi:10.21037/tcr-21-1920
25. Crown J, Stroyakovskii D, Yardley DA, et al. Adjuvant ribociclib plus nonsteroidal aromatase inhibitor therapy in patients with HR-positive/HER2-negative early breast cancer: 5-year follow-up of NATALEE efficacy outcomes and updated overall survival. ESMO Open. 2025;10(11):105858. doi:10.1016/j.esmoop.2025.105858
26. Hurvitz SA, Layman RM, Curigliano G, et al; VIKTORIA-1 Study Group. VIKTORIA-1 trial of gedatolisib plus fulvestrant with or without palbociclib in hormone receptor-positive/HER2-/PIK3CA wild-type advanced breast cancer. J Clin Oncol. 2026;44(12):1108-1119. doi:10.1200/JCO-25-02643
27. Shaw AT, Solomon BJ, Felip E. Lorlatinib versus crizotinib as first-line treatment for advanced ALK-positive non-small-cell lung cancer: 7-year update from the phase III CROWN study. Ann Oncol. 2026;37(9):1242-1252. doi:10.1016/j.annonc.2026.05.692
28. Roberts TJ, Kehl KL, Brooks GA, et al. Practice-level variation in molecular testing and use of targeted therapy for patients with non-small cell lung cancer and colorectal cancer. JAMA Netw Open. 2023;6(4):e2310809. doi:10.1001/jamanetworkopen.2023.10809