Medical Oncology


Questions discussed in this category

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 ...

What if the patient has a history of confirmed COVID-19 but has since recovered?

How do you prescribe a steroid taper? If it is grade 2, would you keep them on low dose prednisone while continuing? When do you feel comfortable re-c...

Do the results of the unplanned subset analysis of the PACIFIC trial showing no OS benefit in this population lean you away from consolidation?

In patients who have a mixed response or progression and are poor candidates for other systemic agents, would you consider consolidating the chest? Wo...

Do you re-challenge with nivolumab alone, change from nivo 1/ipi 3 to nivo 3/ipi 1 upon re-challenge, or stop immunotherapy altogether if grade 3?&nbs...

For instance, not chronic autoimmune diseases (eg RA, IBD) that may relapse/remit but events like Guillan Barre syndrome that is not likely to recur b...

Particularly if steroids are used for non-immunotherapy toxicities (COPD exacerbation, brain edema, autoimmune diseases to name a few) -- when do you ...

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

Rate of pneumonitis was low in the PACIFIC trial but does it mirror the real world setting? We are seeing increased pneumonitis in our practice.

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

With increasing utility of immunotherapy across cancer types, patients with history of solid organ transplants may face need for cancer IO. How do you...

The FDA has approved the new dosing schedule of Nivolumab 480 mg every 4 weeks for multiple disease sites (melanoma, RCC, urothelial carcinoma, SCC of...

Would starting with chemotherapy be preferred in this situation and consider concurrent radiation, then switch over to Pembrolizumab once some control...

There are now five PD-1/PDL-1 inhibitors approved for metastatic bladder CA, one (Atezolizumab) as first-line therapy in cisplatin-ineligible patients...

I recently saw a patient who had been treated with concurrent pembrolizumab-RT elsewhere. Is this an acceptable practice outside the setting of a clin...

These patients have been largely excluded from these trials.  What if the infection is well controlled?

Would you ever considering re-starting immunotherapy before completing the taper? According to the new guildelines on managing immunotherapy related ...

How do the different assays compare when choosing a specific immunotherapy, and does this change for first vs second (or beyond) line of therapy?

What immunosuppressive agents are used and in what order?  Does your approach differ depending on the organ involved, e.g. colitis vs. pneumoniti...

Does the extent/duration of systemic disease control (complete response vs. stable disease, for example) influence your decision?  What about whe...

Does the risk of severe inflammation of the liver lead you to choose other therapies in in this population?  What about in patients with mild liv...

If not what radiation fractionation regimen is preferred for otherwise good KPS patient? 

For patients who remain fit and interested in treatment, but for whom a clinical trial is not an option, what systemic therapy do you reach for in thi...

Based on recently published data from CheckMate 032, do you now offer nivolumab to small cell patients who have progressed after first-line chemothera...

Does the type of autoimmune disease (ex IBD, rheumatoid arthritis, interstitial lung disease) matter?

If so, how do you sequence this with other therapies?  In addition, in the absence of an effect on radiographic PFS or serum PSA, how do you asse...

In the IMvigor 210 trial, increased PD-L1 expression in patients’ tumors was associated with response to atezolizumab, but some patients whose t...

Is there any consensus regarding the optimal RT dose, fractionation, and timing to the best abscopal response? What is the optimal metastatic site to ...

For example, should nivolumab be considered standard second-line therapy for adenocarcinoma patients?   Can it be considered for first-line thera...

Papers discussed in this category

The New England journal of medicine, 2015-10-22

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-11-01

The Lancet. Oncology, 2016-07

Cancer Treat. Rev., 2016-04-01

Immunotherapy, 2016-10

J Thorac Oncol, 2017-02-01

JAMA oncology, 2017-08-01

N Engl J Med, 2015 May 31

Lancet (London, England), 2017-01-07

The New England journal of medicine, 2017-03-16

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-06-10

JCO Precision Oncology, 2017 Sep 29


Nature, 2017-04-26

The New England journal of medicine, 2016-11-10

N Engl J Med, 2017 Nov 16

The New England journal of medicine, 2017-06-22

Radiat Oncol, 2015 Apr 26

The New England journal of medicine, 2017-12-28

Nature, 2013-07-11

The Lancet. Oncology, 2017-07

International journal of radiation oncology, biology, physics, 2017-06-01

JAMA oncology, 2018-01-11

The New England journal of medicine, 2018-12-13

Future Oncol, 2019 Apr 25

Clinical cancer research : an official journal of the American Association for Cancer Research, 2015-12-15

The Lancet. Oncology, 2016-07

J Thorac Oncol, 2019 Feb 16

Int. J. Radiat. Oncol. Biol. Phys., 2019 Aug 31

Lung Cancer, 2019 Jan 15

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-04-01

The New England journal of medicine, 2018-08-23

JAMA oncology, 2017-06-01

Neuro-oncology, 2019-02-23

Semin. Cancer Biol., 2019 Jul 19

J Natl Compr Canc Netw,

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-06-10

J Immunother Cancer, 2019 Aug 22

Journal for immunotherapy of cancer, 2017-11-21

Cancer management and research, 2017

Lancet Oncol., 2020 Mar 03

Lancet, 2020 Feb 07

Ann. Rheum. Dis., 2019 Sep 20