Raajit K. Rampal, MD, PhD, on Managing Anemia and Thrombocytopenia in Patients With Myelofibrosis
Thematic Newsreels
Raajit K. Rampal, MD, PhD, Director of the Center for Hematologic Malignancies and the Myeloproliferative Neoplasms Program at Memorial Sloan Kettering Cancer Center, discusses management strategies for these two conditions often associated with myelofibrosis. He discusses the role of Janus kinase inhibitors; using older therapies in novel ways; how stem cell transplantation is considered; and more.
References
- Marrone M, Morere L, Oladapo A, et al: Hematologic improvement experienced by pacritinib-treated patients with myelofibrosis in real-world clinical settings. Blood 144 (suppl 1):3814, 2024.
- Rampal RK, Verstovsek S, Devlin SM, et al: Safety and efficacy of combined ruxolitinib and thalidomide in patients with myelofibrosis: A phase II study. Blood 134 (suppl 1):4163, 2019.
The ASCO Post Staff
Circulating tumor DNA has many roles in cancer treatment: early diagnosis, tumor profiling, determining response to therapy, and tracking clinical dynamics. In this video, Arvind N. Dasari, MD, MS, of The University of Texas MD Anderson Cancer Center, focuses on it as a marker for measurable residual disease (MRD), which can help to determine risk of disease recurrence in patients with cancer. Dr. Dasari reviews the development of assays for MRD, both tumor-informed and tumor-agnostic, and provides top-level data from several clinical trials on the topic that have informed the role of MRD testing in both the colorectal cancer and general solid tumor space.
References
- Tie J, Wang Y, Lo SN, et al: Circulating tumor DNA analysis guiding adjuvant therapy in stage II colon cancer: Overall survival and updated 5-year results from the randomized DYNAMIC trial. 2024 ASCO Annual Meeting. Abstract 108.
- Lieu CH, Yu G, Kopetz S, et al: NRG-GI008: Colon adjuvant chemotherapy based on evaluation of residual disease (CIRCULATE-NORTH AMERICA). 2024 ASCO Gastrointestinal Cancers Symposium. Abstract TPS243.
- Tie J, Wang Y, Loree J, et al: ctDNA-guided adjuvant chemotherapy escalation in stage III colon cancer: Primary analysis of the ctDNA-positive cohort from the randomized AGITG dynamic-III trial (intergroup study of AGITG and CCTG). 2025 ASCO Annual Meeting. Abstract 3505.
- Lumish MA, Jayakumaran G, Fox M, et al: Frequency of minimal residual disease as measured by ctDNA in mismatch repair deficient tumors following curative resection. 2021 ASCO Annual Meeting. Abstract e14520.
- Kotani D, Oki E, Nakamura Y, et al: Molecular residual disease and efficacy of adjuvant chemotherapy in patients with colorectal cancer. Nature Medicine 29:127-134, 2023.
- Kasi PM, Aushev VN, Ensor J, et al: Circulating tumor DNA (ctDNA) for informing adjuvant chemotherapy (ACT) in stage II/III colorectal cancer (CRC): Interim analysis of BESPOKE CRC study. 2024 ASCO Gastrointestinal Cancers Symposium. Abstract 9.
- Maddalena G, Pellatt AJ, Eluri M, et al: INTERCEPT Program of circulating tumor DNA (ctDNA) testing for minimal residual disease (MRD) in colorectal cancer (CRC): Results from a prospective clinical cohort. 2024 ASCO Gastrointestinal Cancers Symposium. Abstract 27.
- Meyerhardt JA, Shi Q, Fuchs CS, et al: Effect of celecoxib vs placebo added to standard adjuvant therapy on disease-free survival among patients with stage III colon cancer. JAMA 13:1277-1286, 2021.
- Nowak JA, Shi Q, Twombly T, et al: Prognostic and predictive role of circulating tumor DNA (ctDNA) in stage III colon cancer treated with celecoxib: Findings from CALGB (Alliance)/SWOG 80702. 2025 ASCO Gastrointestinal Cancers Symposium. Abstract LBA14.
The ASCO Post Staff
Nikhil Khushalani, MD, Vice Chair for the Department of Cutaneous Oncology at Moffitt Cancer Center, reviews advances in the adjuvant and neoadjuvant treatment of cutaneous squamous cell carcinoma (CSCC). He discusses the possibility of de-escalating therapy for patients who respond positively to presurgical agents; how to best select postoperative regimens; and ongoing trials in both spaces.
References
- Gross ND, Miller DM, Khushalani NI, et al: Neoadjuvant cemiplimab for stage II to IV cutaneous squamous-cell carcinoma. N Eng J Med 387:1557-1568, 2022.
- Gross ND, Miller DM, Khushalani NI, et al: Neoadjuvant cemiplimab and surgery for stage II-IV cutaneous squamous-cell carcinoma: Follow-up and survival outcomes of a single-arm, multicentre, phase 2 study. Lancet Oncol 11:1196-1205, 2023.
- Breukers SE, Traets JJH, van Dijk SW, et al: Neoadjuvant ipilimumab and nivolumab in resectable cutaneous squamous cell carcinoma: A randomized phase 2 trial. Nature Medicine. October 8, 2025 (early release online).
- Ladwa R, Lee JH, McGrath M, et al: Response-adapted surgical and radiotherapy de-escalation in resectable cutaneous squamous cell cancer using pembrolizumab: The De-Squamate study. J Clin Oncol 26:2888-2986, 2025.
- Porceddu SV, Bressel M, Poulsen MG, et al: Postoperative concurrent chemoradiotherapy versus postoperative radiotherapy in high-risk cutaneous squamous cell carcinoma of the head and neck: The randomized phase III TROG 05.01 trial. J Clin Oncol 13:1275-1283, 2018.
- Rischin D, Porceddu S, Day F, et al: Adjuvant cemiplimab or placebo in high-risk cutaneous squamous-cell carcinoma. N Eng J Med 393:774-785, 2025.
- Koyfman SA, Lee JHJ, Mortier L, et al: Phase 3 randomized trial (KEYNOTE-630) of adjuvant pembrolizumab versus placebo for high-risk locally advanced cutaneous squamous cell carcinoma following surgery and radiation. 2025 ASCO Annual Meeting. Abstract 6000. Presented May 31, 2025.
Access to second-line chimeric antigen receptor (CAR) T-cell therapy remains suboptimal in relapsed/refractory diffuse large B-cell lymphoma (DLBCL). Matthew Lunning, DO, FACP, of the University of Nebraska Medical Center, explains that prior tafasitamab exposure may theoretically affect CD19 detection or antigen persistence, but clinical evidence demonstrating impaired subsequent CAR T-cell efficacy is lacking. Real-world data have not established CD19 loss, supporting continued consideration of CAR T-cell therapy following tafasitamab-based treatment.
In hormone receptor–positive, HER2-negative metastatic breast cancer, co-occurring ESR1 and PIK3CA mutations create therapeutic complexity. Oral SERDs, including elacestrant, retain activity despite PIK3CA co-mutation and may offer an efficacy–toxicity balance compared with PI3K/AKT pathway inhibitors. Treatment selection should incorporate molecular profile, anticipated efficacy, toxicity, and shared decision-making, states Neil M. Iyengar, MD.
The phase III frontMIND trial demonstrated improved outcomes vs R-CHOP in high-risk patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL), paralleling the POLARIX trial. Despite efficacy, tafasitamab/lenalidomide/R-CHOP has not achieved comparable guideline adoption. Uncertainty regarding overall survival benefit, limited follow-up, cross-trial comparisons, and implementation complexity may contribute to the underutilization of this regimen despite its manageable toxicity.
