Real-world data suggests that using one antibody-drug conjugate (ADC) immediately after another is often ineffective. A potential strategy to overcome this resistance is to administer a different class of chemotherapy before starting the second ADC.

Clinicians are concerned about the overuse of Stereotactic Body Radiation Therapy (SBRT) for oligoprogressive disease, a practice dubbed 'Pokemon' (gotta catch 'em all). This approach of sequentially radiating new lesions can delay the start of more effective systemic therapies and is not considered a standard of care.

Unlike traditional chemotherapy, radioligand therapy's toxicity may be inversely correlated with tumor volume. In low-burden disease, fewer cancer cells act as a 'sink' for the drug, potentially leading to higher radiation exposure and side effects in healthy, PSMA-expressing tissues like salivary glands.

Radioligand therapy has a unique toxicity profile, described as 'the gift that keeps on giving,' where side effects can worsen even after the treatment course is complete. This contrasts with chemotherapy like docetaxel, where a patient's quality of life often rebounds and improves once the drug is stopped.

In follicular lymphoma, the treatment goal is durable remission with manageable toxicity, not necessarily a cure. Therefore, clinicians frequently prefer using a bispecific antibody first, reserving the more complex and toxic CAR-T cell therapy for transformed disease or after a bispecific fails.

A leading hypothesis for why adding immunotherapy to chemoradiation failed is that radiation, particularly for central tumors, destroys the very lymphocytes immunotherapy aims to activate. This biological mechanism suggests the radiation essentially canceled out the drug's intended effect.

In survivors over 50, an increased risk of secondary cancers is specifically associated with prior radiation treatment received 30+ years ago. The study found no similar association with chemotherapy exposures, highlighting the exceptionally long-term and distinct risks of radiation. This underscores the importance of modern efforts to reduce or eliminate its use.

Using a BCMA bispecific antibody first can exhaust a patient's T-cells or cause tumors to lose the BCMA target, rendering a subsequent BCMA-targeted CAR-T therapy ineffective. The optimal sequence is CAR-T first, which preserves T-cell function and BCMA expression, leaving bispecifics as a viable later-line option.

CLL-associated immunosuppression dramatically increases the risk and aggressiveness of skin cancers. This risk is not mitigated by novel therapies, and in some cases, the secondary skin malignancy can become a greater threat to a patient's life than their underlying CLL.