Five Under 5: Top Oncology Videos for the Week of 12/28

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:

Real-World Outcomes Following Treatment With Obe-Cel and Brexu-Cel in R/R ALL: Yannis K. Valtis, MD

Yannis K. Valtis, MD, of Memorial Sloan Kettering Cancer Center, discusses real-world outcomes with obecabtagene autoleucel (obe-cel; Aucatzyl) and brexucabtagene autoleucel (brexu-cel; Tecartus) for patients with relapsed/refractory acute lymphoblastic leukemia using data from the ROCCA registry. Presented at the 2025 ASH Annual Meeting, the analysis showed comparable early efficacy, with minimal residual disease (MRD)–negative complete response (CR)/CR with incomplete hematologic recovery rates of 81% with obe-cel and 80% with brexu-cel at day 28. These data reinforced previous trial findings supporting both CAR T-cell products as highly active therapies in heavily pretreated patients. However, Valtis emphasized that key unanswered questions remain regarding the durability of remission and whether either product is more likely to be curative, as follow-up from ROCCA is still limited.

Challenges in the Diagnosis and Management of LEMS in SCLC: Jacob Sands, MD

Jacob Sands, MD, of Dana-Farber Cancer Institute and Harvard Medical School, discusses the challenges of diagnosing and managing Lambert-Eaton myasthenic syndrome (LEMS) in patients with small cell lung cancer (SCLC). He explained that hallmark symptoms like proximal muscle weakness and autonomic dysfunction often overlap with treatment-associated toxicities or cancer-related fatigue, leading to underrecognition. Sands stressed that vague or unexplained neurologic symptoms in patients with SCLC should raise suspicion for paraneoplastic syndromes, including LEMS. He advocated for a low threshold to pursue paraneoplastic antibody testing and early neurology involvement to avoid missed diagnoses.

Where CELMoDs Could Fit in the Myeloma Treatment Paradigm: Joshua Richter, MD

Joshua Richter, MD, of the Blavatnik Family Chelsea Medical Center at Mount Sinai, discusses evolving roles for the CELMoDs iberdomide (CC-220) and mezigdomide (CC-92480) in multiple myeloma. He highlighted findings from the phase 2 EMN 26 trial (NCT04564703), in which iberdomide led to MRD-negativity conversion rates of 30% to 50% post–autologous stem cell transplant, exceeding historical lenalidomide benchmarks. Richter also cited strong activity for iberdomide combinations, including with elranatamab-bcmm (Elrexfio) in MagnetisMM-30 (NCT06215118). In contrast, he positioned mezigdomide as a more potent option for high-risk diseases such as extramedullary myeloma, where early studies have demonstrated deep remissions.

Updated Efficacy Data for Avapritinib in Indolent Systemic Mastocytosis: Tsewang Tashi, MD

Tsewang Tashi, MD, of the University of Utah, discusses long-term efficacy findings for avapritinib (Ayvakit) in indolent systemic mastocytosis from part 3 of the phase 2 PIONEER trial (NCT03731260). With follow-up extending to 3 years, avapritinib led to deep and sustained improvements in total symptom score, consistent with earlier data from part 2. Quality-of-life benefits also remained durable at both 2 and 3 years. Importantly, Tashi noted that no new safety signals emerged with longer-term treatment at either the 25-mg or 50-mg doses.

Factors Informing Frontline Chemotherapy Selection in Pancreatic Cancer: Dong Kim, MD

Dong Kim, MD, of Maryland Oncology Hematology, discusses contemporary decision-making for frontline chemotherapy selection in metastatic pancreatic cancer. He explained that although age and performance status remain relevant, treatment decisions should increasingly focus on the likelihood of platinum sensitivity rather than chronological age alone. Kim emphasized that fit older patients should not be automatically excluded from platinum-based regimens such as FOLFIRINOX (leucovorin, 5-fluorouracil [5-FU], irinotecan, and oxaliplatin) or NALIRIFOX (liposomal irinotecan [Onivyde], oxaliplatin, 5-FU, and leucovorin), alongside gemcitabine/nab-paclitaxel (Abraxane). He also highlighted the importance of balancing timely treatment initiation with next-generation sequencing information and aligning therapy choices with patient goals and disease biology.