It’s been a while since my last post. That’s not for lack of news. These past several months have been some of the fullest of my life: clinic, program building, my directorship, speaking, consulting, the businesses my wife and I run together, and most importantly, being a husband and a dad to four kids. Writing kept sliding to “next week.” So I’m writing this one from Madrid, where ESMO 2026 opens today.
Getting here
The trip started the way a lot of physician travel does. I worked a full clinic day, went home to pack, and caught the overnight flight from Orlando. I don’t sleep on red-eyes, and this one was no exception. After landing, I went straight into a research meeting to present a protocol for a trial on a new approach to severe immune-related colitis and hepatitis. These are among the hardest complications we manage with immunotherapy. Then I joined our melanoma tumor board from across the Atlantic. Cancer doesn’t pause for jet lag, and neither does the team.
Almost a year in…
In a few weeks, I’ll mark one year at AdventHealth Orlando. Many of my patients have been told somewhere along the way that their options are running out. Here in Central Florida, that answer is increasingly changing. Here’s where things stand.
Liver-directed therapy: a first, done. We completed our first percutaneous hepatic perfusion procedure with HEPZATO, and it went smoothly. Behind that one procedure were months of screening protocols and coordination across interventional radiology, anesthesia, pharmacy, and nursing. The Delcath team has been a tremendous partner throughout. I’ll share more in a separate post.
Cellular therapy: first TIL patients ready. Our TIL program with Iovance is up and running, and our first patients are cleared and scheduled for admission for their infusions. We’re also exploring TIL in non-small cell lung cancer through investigator-initiated research. Solid tumor cellular therapy has been my niche for more than a decade. It’s a privilege to build it again with a team this committed. A lot of credit to Karin Donaldson who’s been working with me in TILs for more than a decade and my good friend Dr Peter Peng our lead TIL Surgical Oncologist who knows TIL better than me as he came highly experienced from the NCI!
Treating tumors where they live. In August, the FDA granted accelerated approval to vusolimogene oderparepvec (Tudriqev, formerly RP1) with nivolumab for melanoma that has progressed on PD-1 therapy. Our clinical pathway is now finalized, and we’re completing the treatment orders in our electronic health record. That’s the unglamorous step that makes safe, consistent delivery possible. Engaging with our interventional radiology team and the Replimune team, we’ll be able to reach deeper lesions, including in the liver and lung, when it’s safe and feasible. Only few institutions will be able to do this unique therapy.
Partnering with industry. One part of this work I genuinely enjoy is partnering with industry on education. New options for patients with cutaneous cancers are arriving faster than ever. Those therapies only help if physicians, nurses, and patients understand how and when to use them. This year I’ve had the chance to speak with Iovance on cellular therapy, join advisory boards, and spend a fun day on a video shoot with the team at Sun Pharma focused on care for patients with cutaneous malignancies. I’m also excited about the progress of individualized adjuvant mRNA vaccines in melanoma. I look forward to engaging with Merck/Moderna in the near future, and to seeing the latest data here at ESMO. When industry and clinicians work together on education, patients are the ones who benefit.
Moderating and teaching beyond the clinic. I also had the honor of moderating the oncology symposium for CAPI, an organization of physicians of Indian origin. It was a great afternoon of clinical discussion with colleagues who share both a profession and a heritage. Next week, I’ll moderate a cutaneous malignancy program with Dermatology Times, bringing oncologists and dermatologists into the same conversation. That collaboration matters, because so many of these cancers are first spotted in a dermatologist’s office. Moderating is one of my favorite roles. My job is to ask the questions that help the experts in the room turn new data into practical guidance for patients.
Clinical trials: now enrolling. We’re enrolling in several cellular therapy studies, including Immatics’ Phase 3 SUPRAME trial of IMA203. IMA203 is a PRAME-targeted TCR-T cell therapy for previously treated advanced melanoma. PRAME is found in the vast majority of melanomas, which is why so much of the field is focused on it. We’ve also opened a first-line PRAME-targeted Phase 3 Immunocore bispecific in combination with checkpoint inhibitors study, Obsidian TIL protocols for refractory melanoma, and TIL and cellular therapy trials beyond melanoma.
Building the program. Our Advent Health Melanoma/Sarcoma program is now formalized. Medical, surgical, radiation, head and neck, orthopedic oncology, and plastic surgery come together around every complex case at dedicated multidisciplinary tumor boards. No single specialist has all the answers for these patients, but a room full of the right ones usually does. And I’m especially excited about our new collaboration with Dana-Farber Cancer Institute.
The other half of my world: sarcoma. This update leans heavily on melanoma, but half of my practice is soft tissue and bone sarcoma. These cancers are rare, varied, and unforgiving of fragmented care. One of the real joys of this year has been partnering with Dr. Ryan Durfee, our orthopedic oncologist, who leads surgical care for our sarcoma patients. Sarcoma care depends on surgery, systemic therapy, radiation, and pathology working as one team from the very first visit. Having a surgical partner I trust completely means our patients get a coordinated plan from day one, close to home. It has also been a lot of fun, and I learn something from every case we share. Sarcoma is seeing exciting progress of its own, including new therapies and new interventional approaches, and I’ll dedicate future posts to it.
Training the next generation. As one of the core faculty and partner with our directors of HemOnc Fellowship Dr Parkins and Dr Tejani, I helped interview and welcome the first class of our new hematology/oncology fellowship. The therapies we’re building only matter long term if we train the physicians who will carry them forward.
This week at ESMO
Over the next few days I’ll post daily recaps from Madrid, focused on melanoma and sarcoma. I’ll cover what’s new, what’s practice-changing, and what it means for patients.
None of this is a solo effort. Every “first” above took a team working through details most patients will never see. Each one also means a patient can get cutting-edge therapy close to home instead of across the country.
More from Madrid tomorrow. Pictures from this past year!
Dr. Sajeve Thomas is a distinguished medical professional and a compassionate guide in the field of oncology. With over a decade of dedicated experience as a board-certified medical oncologist/internal medicine specialist, Dr. Thomas has become a trusted expert in the treatment of melanoma, sarcoma, and gastrointestinal conditions. He brings a wealth of expertise to the complex and challenging world of oncology.
Disclosures:
Dr. Thomas serves as a speaker for BMS, Merck, Ipsen, Natera, Immunocore, Pfizer, Sun Pharma, SpringWorks. He also receives industry grants in support of numerous clinical trials.
Patient cases described in this post are composites and have been altered — including but not limited to diagnosis specifics, demographics, timeline, and clinical details — to protect patient privacy and confidentiality. No case represents an actual, identifiable patient, and any resemblance to a specific individual is coincidental. Clinical scenarios involving other providers have similarly been altered and are presented for educational purposes only, not as a representation of any specific person’s practice. This post is for general educational purposes and does not constitute medical advice; it should not be used to guide individual treatment decisions. This article is for education and general information only. It is written about an anonymized case, shared with permission, and it is not personal medical advice. The individual described is not a patient of the author, is not treated in the United States or at the author’s institution, and no doctor–patient relationship is created by reading this. Statistics and treatment options are summarized from the current oncology literature and evolve quickly; specific percentages are approximate. Any real medical decisions should be made with a qualified treating team that can evaluate the patient directly.
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