Five Under 5: Top Oncology Videos for the Week of 7/27

Welcome to The Five Under 5, your go-to roundup of the top 5 videos of the week.

These short videos are designed for busy oncologists to view on the go, and feature expert insights on breaking news, regulatory updates, practice-changing data shared at medical meetings, and other key topics in the realm of oncology.

Here’s what you may have missed:

Cost Analysis of Osimertinib/Chemo vs Amivantamab/Lazertinib in EGFR+ NSCLC: Gilberto Lopes, MD

Gilberto Lopes, MD, MBA, FAMS, of Sylvester Comprehensive Cancer Center, commented on a recent cost-effectiveness analysis comparing first-line osimertinib (Tagrisso) plus chemotherapy with amivantamab (Rybrevant) plus lazertinib (Lazcluze) for patients with EGFR-mutated advanced non–small cell lung cancer. He noted that the higher overall cost of the amivantamab/lazertinib regimen was expected, given the need for intensive adverse effect (AE) management and the use of two branded agents. In contrast, the osimertinib-based regimen incorporated mostly generic chemotherapy agents and a TKI likely to come off patent soon. Lopes emphasized that although clinical outcomes remain the priority, the rising concern around financial toxicity in the United States highlights the importance of factoring in cost and treatment burden during shared decision-making.

Importance of Establishing Consensus Within the Evolving Lung Cancer Treatment Landscape: Narjust Florez, MD

Narjust Florez, MD, of Dana-Farber Cancer Institute, highlighted the critical role of the Bridging the Gaps in Lung Cancer meeting in addressing unresolved questions in thoracic oncology. Now in its third year, the forum is structured to rapidly adapt to new data and generate expert-driven consensus on evolving issues such as optimal adjuvant therapy duration and management of complete pathologic responses post–chemoimmunotherapy. Florez emphasized that the consensus reached is dynamic—revised annually based on emerging trial results—and serves as a practical, globally relevant guide for oncologists navigating areas where definitive clinical evidence remains limited.

Key Considerations for Clinical Trial Enrollment in Myelofibrosis: John Mascarenhas, MD

John O. Mascarenhas, MD, of the Icahn School of Medicine at Mount Sinai, emphasized the need for personalized, goal-oriented care in myelofibrosis, particularly when considering clinical trial enrollment. He stressed the importance of timely referral, as patients with declining performance status may miss opportunities to participate in trials like the phase 3 IMpact-MF study (NCT04576156). Treatment decisions, including the use of investigational agents such as imetelstat (Rytelo), must weigh disease biology, patient comorbidities, and therapeutic goals, ranging from symptom relief to potential disease modification or transplant eligibility.

Biomarker-Driven Therapies of Interest for Second-Line SCLC: Ravi Salgia, MD, PhD

Ravi Salgia, MD, PhD, of City of Hope, highlighted DLL3, B7-H3, and mitochondrial function as emerging therapeutic targets in small cell lung cancer (SCLC), noting their relevance to biomarker-informed strategies discussed at the 2025 Bridging the Gaps in Lung Cancer meeting. He emphasized that targeting mitochondrial biology, alongside surface markers like DLL3 and B7-H3, may open new avenues for personalized second-line treatment approaches. Combining agents such as lurbinectedin (Zepzelca) with immunotherapies or mitochondrial inhibitors could play a key role in evolving treatment paradigms, particularly as molecular subtyping and biomarkers like SLFN11 guide therapy selection.

Optimizing Patient Monitoring After Liso-Cel in MCL: Manali Kamdar, MD

Manali Kamdar, MD, of the University of Colorado Anschutz Medical Campus, emphasized that although CD19-directed CAR T-cell therapies like lisocabtagene maraleucel (liso-cel; Breyanzi) have transformed outcomes in B-cell malignancies, their unique AEs such as cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome necessitate careful monitoring and post-infusion management. Speaking on the importance of optimizing care following liso-cel treatment, Kamdar noted that although these toxicities are typically manageable, the current requirement for patients to remain within close proximity to treatment centers for 4 weeks presents socioeconomic and logistical barriers to access. With FDA approvals for liso-cel expanding, including in mantle cell lymphoma as of May 2024, Kamdar stressed the need to develop individualized monitoring strategies that maintain safety while improving feasibility and access.