Gynecologic Cancers   

Specifically, are there strategies you use to 1) empower patients to participate in decision-making and 2) reassure patients who may be skeptical?

How do you "have the talk" in a way that is straightforward without emotionally crushing the patient?

Patient has tolerated combination therapy well to date.

Given recent approval of niraparib (Zejula) for the maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube, or prima...

Patient is 34yo and G0 referred from surgical oncology. Laparoscopic specimens of myoma and what appeared to be adhesions were significant for maligna...

If patient meets high intermediate risk criteria, would you consider chemotherapy in addition to radiation?

Does not technically meet high intermediate risk criteria.

There are mixed recommendations about re-testing vs simply waiting for a quarantine period prior to resuming therapy. 

Would you consider adjuvant chemotherapy, radiation therapy, hormone therapy, or surveillance?

The patient has a history of pelvic radiation and progressed through first line carboplatin/taxol. She has had a partial response to pembro/lenvatinib...

Based on recent PAOLA-1

After optimizing symptoms and reversible factors, and attempting cognitive-behavioral interventions and exercise, do you recommend pharmacologic agent...

This case involves an impressive ‘high volume’ vaginal recurrence and patient was not originally planned for adjuvant therapy. Concerned t...

Does residual grade 1-2 neuropathy from Taxol/ carbo 10 years ago affect your recommendation?

Ie for patients who are inoperable due to comorbidities?

Since no data exists or is pending, and the two disease processes are similar, should we consider PARP inhibition in this setting? This is assumi...

E.g. a patient with progression of their primary cancer but still is testing COVID19+ over a month after infection?

I am considering every 6 week pembrolizumab dosing in patients >70 years old in whom I want to reduce clinic visits for, especially in the context ...

This is not the standard of care in the USA.

This has been a common practice in the community. Is there a benefit for certain patients?

How would you approach a patient who is receiving chemoRT but has confirmed COVID-19 with minor symptoms, as breaking treatment for 2 weeks quarantine...

When a physical exam is important and telehealth is not a good option, should we be proactive and reschedule or should we continue to see them as sche...

 No adjuvant treatment was given upfront

SOLO1 trial studied stage 3/4 patients.

Would you be more or less likely to use a cisplatin-containing regimen if a patient had previously responded to chemoradiation with concurrent cisplat...

https://www.nejm.org/doi/full/10.1056/NEJMoa1813181

Does the phase II KN-158 provide sufficient evidence to change management?

Should this be done at the time of recurrence or after failure of 1st line therapy for recurrence?

The NCCN recommends either systemic therapy + brachytherapy or pelvic RT + brachy or brachy alone or observation. How do you decide among these option...

Given the recent press release regarding the update on the phase 3 soft tissue sarcoma study of LARTRUVO (olaratumab) showing no benefit to the combin...

Should this be the new standard of care based on the results from the recently published SOLO-1 trial?

Two new phase 2 studies this year with apatinib/oral etoposide (AEROC) and sorafenib/topotecan (TRIAS) were released, and NCCN also lists many single ...

Or do you wait for platinum resistance?

Certainly ovarian cancer will respond to carboplatin and paclitaxel and it sounds like a reasonable chemotherapy to give to a stage IV NSCLC, however ...

Is it reasonable to use single agent carboplatin for elderly patients?

In a patient who underwent laparoscopy for endometriosis and was found to have a 1mm focus of neuroendocrine tumor, would you recommend further surger...

She has metastatic disease beyond the pelvis (lungs).

Would you approach this situation as synchronous primaries (eg. FIGO IA in both) or as a locally advanced endometrial cancer (FIGO IIIA)? What adjuva...

Would you add chemotherapy if there was gross residual disease, pN+ and/or ECE?

Can the classic indications for post-hysterectomy radiation (eg. "Sedlis" and "Peter's" criteria) be applied? Does the histology change radiation dose...

How many cycles do you prefer before and after? How long do you tend to wait before starting radiation after initial chemo and after radiation to resu...

Do you try to keep Hb> 10 or 12? Or somewhere in between?