ASCO Guidelines

Dr. Sonam Puri joins the podcast to share the update to the living guideline on stage IV NSCLC with driver alterations. Dr. Puri discusses the practice-changing evidence reviewed for both NTRK rearrangements, including the TRIDENT-1 trial, and HER2 activating mutations, including the Beamion LUNG-1 study. She shares how these results impacted the clinical practice guideline with the addition of repotrectinib and zongertinib, what these new TKIs mean for patients, and where the panel is waiting for additional randomized data to clarify the role of therapeutic options. Dr. Puri encourages listeners to stay tuned for future updates to the living guideline as new evidence is published.

Read the full living guideline "Therapy for Stage IV Non-Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2026.3.2" at www.ascopubs.org/guidelines/therapy-stage-iv-non-small-cell-lung-cancer-driver-alterations"
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Dr. Rahul Banerjee joins the podcast to discuss the latest update to the living guideline on the treatment of multiple myeloma. He explains how sensational results from the MajesTEC-3 trial, which evaluated teclistamab plus daratumumab, prompted a major shift in the recommendations for patients with relapsed or refractory disease. Dr. Banerjee details why immunotherapies, specifically CAR T-cell therapy and bispecific antibodies, are now the preferred treatment options at first relapse over traditional triplets. He also provides context on evidence that did not lead to recommendation changes, the importance of individualized decision-making when choosing between immunotherapy options, and what future updates may be on the horizon, including data on CELMoDs.
Read the full living guideline, "Treatment of Multiple Myeloma: ASCO Living Guideline, Version 2026.1.1," at www.ascopubs.org/guidelines/treatment-multiple-myeloma-asco-living-guideline

Drs. Tina Lockwood and Stacy Gray share the newly released evidence-based guideline on circulating tumor DNA (ctDNA) testing from ASCO. They highlight recommendations on when ctDNA testing should be offered—including scenarios where tissue biopsies are challenging, unsafe, or unavailable in time to guide management—and explicitly outline situations where testing should not be utilized. They dive into the evidence evaluating ctDNA for treatment selection, molecular residual disease (MRD), and response monitoring across solid tumors and lymphoma. Drs. Lockwood and Gray explain the importance of balancing ctDNA's high specificity with its moderate sensitivity. They also touch on outstanding questions, including standardizing definitions for MRD, disease-specific applications, and the use of multi-cancer early detection (MCED) screening. 

Read the full guideline, "Circulating Tumor DNA Testing in Solid Tumors and Lymphoma: ASCO Guideline" at www.asco.org/molecular-testing-and-biomarkers-guidelines"
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Dr. Joshua Reuss returns to the podcast to discuss the update to the living guideline on stage IV NSCLC with driver alterations. The conversation focuses on new cancer treatment strategies for patients with advanced NSCLC and EGFR mutations, including classical EGFR alterations (exon 19 deletions, exon 21 L858R substitution) and rarer alterations (exon 20 insertion mutations). Dr. Reuss discusses results from clinical trials, including MARIPOSA and CHRYSALIS-2 and how these impacted first-line and subsequent line treatment recommendations. He looks to the future on what new evidence and potential updates are in the pipeline for this living guideline.
Read the full living guideline "Therapy for Stage IV Non-Small Cell Lung Cancer with Driver Alterations, ASCO Living Guideline Version 2026.3.1" 
LINK TO FULL TRANSCRIPT

Dr. Lyudmila Bazhenova joins the podcast to share the update to the living guideline on stage IV NSCLC without driver alterations. Dr. Bazhenova discusses the evidence reviewed for both non-squamous NSCLC, including the POD1IM-304 and BAP BRAIN trials, and squamous cell NSCLC, including the HARMONi-6 trial. She shares how these results impacted the clinical practice guideline, what they mean for patients receiving immunotherapy and chemotherapy, and where the panel is waiting for additional evidence to clarify the role of therapeutic options. Dr. Bazhenova encourages listeners to stay tuned for future updates to the living guideline after publication of data from the 2026 ASCO Annual Meeting.

Read the full living guideline "Therapy for Stage IV Non-Small Cell Lung Cancer without Driver Alterations, ASCO Living Guideline Version 2026.3.1"
LINK TO FULL TRANSCRIPT