Artificial intelligence (AI) has slammed into the elements of everyday life in some fashion, and the oncology profession has not been excluded. Scout, an AI-powered assistant developed to streamline access to expert clinical insight and research-based commentary, launched in May 2025 and is accessible on the desktop and mobile versions of OncLive.com, CancerNetwork.com, and TargetedOncology.com.
But what is Scout truly capable of? After real-world clinical scenarios were posted into Scout, oncology leaders reviewed the AI platform’s responses, weighed their validity and quality, and touched on how Scout can best complement their clinical practice.
CLINICAL SCENARIO
What is the best treatment for a symptomatic 65-year-old [man] with stage IVA mantle cell lymphoma (MCL) and a TP53 mutation?
SCOUT RESPONSE
For a symptomatic 65-year-old [man] with stage IVA MCL and a TP53 mutation, the current evidence-based recommendations emphasize the use of novel, chemotherapy-free regimens due to the poor outcomes associated with standard chemoimmunotherapy in this high-risk group.
Key aspects and recommendations [include the following]:
- Impact of TP53 mutation:TP53-mutant MCL is considered high-risk and is associated with poor survival and low response rates to conventional chemoimmunotherapy, including intensive regimens and autologous stem cell transplant.
- Best current treatment option: The most promising regimen is the BOVen combination: zanubrutinib (Brukinsa; a [Bruton tyrosine kinase] inhibitor), obinutuzumab (Gazyva; an anti-CD20 antibody), and venetoclax (Venclexta; a BCL-2 inhibitor).
- In a recent phase 2 trial, this regimen achieved a 2-year progression-free survival (PFS) rate of 72% and a 2-year overall survival rate of 75% in [patients with] previously untreated, TP53-mutant MCL. The overall response rate was 96%, with an 88% complete metabolic response rate.
- The regimen is outpatient-based, well-tolerated, and uses a minimal residual disease (MRD)–driven approach to adapt therapy duration and intensity.
- Safety and tolerability: The BOVen regimen was generally well-tolerated. The most common adverse effects (AEs) were diarrhea, neutropenia, and infusion reactions, with manageable rates of serious AEs. Tumor lysis syndrome risk was mitigated by careful venetoclax ramp-up.
- Clinical trial and guideline updates: The BOVen regimen is the first to show such promising results specifically in TP53-mutant MCL, outperforming historical controls (eg, 2-year PFS rate of 20% with intensive chemoimmunotherapy and 55% with ibrutinib [Imbruvica]-based regimens).
- There is a growing consensus among experts and guidelines to prioritize novel agent-based, chemotherapy-free regimens for TP53-mutant MCL, and to consider clinical trial enrollment whenever possible.
- Additional considerations: MRD assessment is increasingly used to guide treatment adaptation and de-escalation, aiming to minimize toxicity while maintaining efficacy.
- For relapsed/refractory cases or those not responding to novel agents, CAR [chimeric antigen receptor] T-cell therapy and bispecific antibodies are under investigation and may be considered in select patients.
In summary, for a symptomatic 65-year-old [man] with stage IVA TP53-mutant MCL, the BOVen regimen is currently the most evidence-based and promising frontline option, with strong support from recent clinical trials and expert recommendations, as highlighted by Anita Kumar [MD, of Memorial Sloan Kettering Cancer Center] and other leading investigators.
Julie M. Vose, MD, MBA
George and Peggy Payne Distinguished Chair of Oncology
Chief, Oncology & Hematology
Professor, Oncology & Hematology
University of Nebraska Medical Center
Co-editor in chief, ONCOLOGY
“I tried it out with a couple of clinical cases, and it came up with what I would consider the correct answer,” Vose said in response to the above prompt and reply. “It did seem to take a bit longer to generate the answers than ChatGPT, for example. It says references 1 to 3, but it did not actually give me the references. That would be my only bad comment.”
CLINICAL SCENARIO
Thomas Chen is a 62-year-old [man] presenting with a 3-month history of unexplained weight loss, fatigue, and new-onset, mild upper abdominal pain radiating to his back. His medical history is notable for well-controlled hypertension and type 2 diabetes. He has no history of smoking or heavy alcohol use.
A recent abdominal ultrasound revealed a pancreatic head mass. This was followed by a multiphasic CT scan of the abdomen and pelvis with a dedicated pancreatic protocol. The scan showed a 3.5 cm hypodense mass in the head of the pancreas with clear involvement of the superior mesenteric vein (SMV), specifically showing tumor contact of more than 180 degrees, but without evidence of distant metastases. This imaging finding classifies his disease as borderline resectable pancreatic cancer (BRPC).
His laboratory results are as follows:
CA [carbohydrate antigen] 19-9: 950 U/mL (significantly elevated)
Hemoglobin [level]: 12.8 g/dL
Liver function tests: Mildly elevated bilirubin and alkaline phosphatase [levels] (suggesting some degree of biliary obstruction)
Glucose [level]: Elevated, requiring medication adjustment.
An endoscopic ultrasound (EUS) with fine-needle aspiration was performed, which confirmed pancreatic ductal adenocarcinoma. A biliary stent was also placed during the EUS to relieve the obstruction. Chen’s performance status is ECOG 1.
What is the optimal treatment strategy, and why is this a multidisciplinary discussion?
SCOUT RESPONSE
The optimal treatment strategy for a 62-year-old [man] with BRPC involving the SMV, [with] ECOG 1, elevated CA 19-9, and biliary obstruction relieved by stenting is a multidisciplinary, evidence-based approach centered on neoadjuvant systemic therapy, followed by reassessment for surgical resection.
Key Aspects and Evidence-Based Recommendations
Neoadjuvant therapy as standard of care: For BRPC, initial systemic chemotherapy is recommended to downstage the tumor, address micrometastatic disease, and improve the likelihood of achieving an R0 resection (margin-negative surgery). This is especially important when there is vascular involvement (eg, SMV) and elevated CA 19-9, which are associated with [a] higher risk of occult metastasis and recurrence. Paul Oberstein [MD, of NYU Langone Health] and colleagues emphasize that systemic chemotherapy is the first-line approach in such cases, with regimens [such as] modified FOLFIRINOX or gemcitabine/nab-paclitaxel [Abraxane] commonly used for patients with good performance status (ECOG 1).
Role of multidisciplinary team: A multidisciplinary tumor board is essential for optimal management. As stated by Rohit Gosain [MD, of Roswell Park Comprehensive Cancer Center], this approach ensures coordinated care involving surgical oncologists, medical oncologists, radiation oncologists, gastroenterologists, radiologists, and supportive care specialists. The complexity of BRPC—especially with vascular involvement and the need for precise surgical planning—requires input from all these disciplines to determine resectability, select the best neoadjuvant regimen, and time surgery appropriately.
Supportive and nutritional care: Addressing biliary obstruction with stenting is a critical first step, as it allows for safe administration of chemotherapy and improves patient symptoms. Nutritional support is also vital, as malnutrition can compromise treatment tolerance and outcomes. Recent American Society of Clinical Oncology 2025 updates highlight the importance of integrating nutrition and supportive care early in the treatment plan to enable optimal chemotherapy delivery and maintain quality of life.
Reassessment and surgery: After completion of neoadjuvant therapy, restaging with high-quality imaging is necessary to evaluate response and determine if the tumor has become resectable. The [multidisciplinary care team] then reassesses surgical candidacy, considering both anatomical and biological factors (eg, CA 19-9 response, absence of progression).
Genetic and molecular testing: Germline and somatic testing should be offered to all patients with pancreatic cancer, as recommended by Gosain, to identify actionable mutations (eg, BRCA1/2) that may influence therapy and have implications for family members.
Why Multidisciplinary Care Is Essential
BRPC management is complex, requiring expertise in advanced imaging, surgical techniques (including vascular reconstruction), systemic therapy, and supportive care. The [multidisciplinary care team] ensures that all aspects—oncologic, surgical, nutritional, and psychosocial—are addressed, maximizing the chance for cure and minimizing complications. This collaborative approach is supported by consensus guidelines and is now standard in high-volume centers.
Summary:
- Start with neoadjuvant chemotherapy (eg, FOLFIRINOX or gemcitabine/nab-paclitaxel).
- Relieve biliary obstruction and provide nutritional support.
- Conduct germline and somatic testing.
- Reassess for surgery after systemic therapy.
- [Make] all decisions in a multidisciplinary setting to optimize outcomes and personalize care.
Shubham Pant, MD
Professor
Department of Gastrointestinal Medical Oncology
Department of Investigational Cancer Therapeutics (Phase I Center)
The University of Texas MD Anderson Cancer Center
“It’s a good thing in summarizing,” Pant said. “The only [cautionary] thing is that [some of it is] based on opinion [rather] than data you can quote from some source, from a reference. The information was fine, actually—it was good. Normally, in the community, you look at [NCCN] guidelines, but they could supplement this by kind of understanding a little bit [more from Scout]. You just have to be sure that all the information that is on the online platform is good—sometimes people give their opinions. If you’re pulling from that, it might not be the most updated information.”
CLINICAL SCENARIO
Robert Jones is a 68-year-old [man] with an 8-year history of IgG [immunoglobulin G]-κ multiple myeloma, initially diagnosed in 2017. His initial workup revealed International Staging System (ISS) stage 3, Revised-ISS stage 3 disease with high-risk cytogenetics (t(4;14), del(17p)). He was initially treated with bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (VRd), followed by an autologous stem cell transplant. He achieved a very good partial response and was maintained on lenalidomide, but relapsed 2 years later.
He has since received multiple lines of therapy, including daratumumab (Darzalex)-pomalidomide (Pomalyst)-dexamethasone (DPd), isatuximab-irfc (Sarclisa)-carfilzomib (Kyprolis)-dexamethasone (IsaKd), and, most recently, a clinical trial with a B-cell maturation antigen (BCMA)–targeted bispecific antibody. Despite these treatments, his disease has progressed, with his M [monoclonal]-spike rising from 0.8 g/dL to 2.5 g/dL over the past 3 months.
His recent labs show [the following]:
- Hemoglobin [level]: 9.2 g/dL (down from 11.5 g/dL)
- Creatinine [level]: 1.8 mg/dL (up from 1.2 mg/dL)
- Corrected calcium [level]: 10.8 mg/dL
- Serum β2-microglobulin [level]: 6.2 mg/L
- M-spike: 2.5 g/dL
- Free light chain ratio: 105 (κ: 450 mg/L; λ: 4.3 mg/L)
- Bone marrow biopsy: 40% clonal plasma cells
- PET/CT scan: Multiple new lytic bone lesions in the spine and pelvis, with a focal lesion in the left humerus.
Jones’ performance status is ECOG 2 due to increasing fatigue and bone pain. He has an extensive history of neuropathy from previous bortezomib and requires careful management of his renal function. What is the next best course of treatment for this patient?
SCOUT’S RESPONSE
For a 68-year-old [man] with high-risk, relapsed/refractory IgG-κ multiple myeloma (t(4;14), del(17p)), who has progressed after VRd, ASCT, lenalidomide maintenance, DPd, IsaKd, and a BCMA-targeted bispecific antibody, and now presents with worsening cytopenias, renal dysfunction, new bone lesions, ECOG 2, significant neuropathy, and renal impairment, the next best evidence-based treatment options should consider both disease biology and comorbidities:
- GPRC5D-Targeted Bispecific Antibody (eg, talquetamab [Talvey])
After failure of BCMA-targeted therapy, switching to a GPRC5D-targeted bispecific antibody such as talquetamab is supported by current expert consensus. Ajay Nooka [MD, of Emory Winship Cancer Institute] and colleagues highlight that talquetamab is particularly suitable for patients with poor organ function, cytopenias, and high infection risk, as it is associated with a lower rate of severe infections compared with BCMA bispecifics (grade 3 infections less than 10% vs greater than 50% for BCMA bispecifics) and does not require pneumocystis jirovecii pneumonia prophylaxis as monotherapy. This makes it a strong option for patients with significant comorbidities, including renal dysfunction and cytopenias, as in your case.
- CELMoDs (eg, iberdomide, mezigdomide)
For heavily pretreated, high-risk patients, CELMoDs (cereblon E3 ligase modulators) are emerging as potential options, especially if not previously used. Compassionate use or clinical trial enrollment may be considered, as discussed by Ajai Chari [MD, of the University of California, San Francisco] and colleagues. These agents can be combined with other drugs the patient has previously tolerated, but careful consideration of cytopenias and renal function is needed.
- CAR T-Cell Therapy (ciltacabtagene autoleucel [Carvykti] or idecabtagene vicleucel [Abecma])
CAR T-cell therapy remains an option for fit patients, even in later lines. However, Surbhi Sidana [MD, of Stanford Medicine] and panelists emphasize that frailty, organ dysfunction, and performance status are critical in decision-making. For patients with ECOG 2, significant neuropathy, and renal impairment, the risks of CAR T (including severe infections, neurotoxicity, and nonrelapse mortality) must be weighed against potential benefits. Bridging therapy and frailty assessment are essential, and some centers may still consider CAR T for high-risk, functional patients if comorbidities are manageable.
Key considerations for your patient [include the following]:
- GPRC5D bispecifics (talquetamab) are preferred due to lower infection risk and better tolerability in the context of cytopenias and renal dysfunction.
- CELMoDs may be considered if available and if the patient’s cytopenias are manageable.
- CAR T-cell therapy is an option if the patient’s performance status and comorbidities allow but may not be ideal given current frailty and organ dysfunction.
In summary, the most evidence-based and practical next step is to pursue a GPRC5D-targeted bispecific antibody, such as talquetamab, with supportive care for cytopenias and renal dysfunction, and consider CELMoDs or CAR T-cell therapy only if the patient’s performance status and comorbidities improve or are manageable.
Joshua Richter, MD
Associate Professor of Medicine
The Tisch Cancer Institute
Division of Hematology and Medical Oncology
Director of Multiple Myeloma, Blavatnik Family-Chelsea Medical Center
Mount Sinai
“CELMoDs are not FDA approved and won’t be until 2026/2027,” Richter said, emphasizing the current investigational use of this class of agents. “Talquetamab is my recommendation for treatment, but there are other options, including selinexor [Xpovio]-based therapy.”
