Medical Oncology

Sarcoma   

Questions discussed in this category



Should treatment be based on current histology (rhabdomyosarcoma) or origin (germ cell)?

Would you consider using recently approved agent for symptomatic / unresectable PN, Selumetinib prior to Systemic Chemotherapy in this setting?

For example, would you consider switching to an outpatient regimen in lieu of AIM for metastatic soft tissue sarcoma?

For example, gastric GIST, < 5 mitoses/hpf and size > 5 cm but < 10 cm is intermediate by NIH criteria but low by NCCN/CAP criteria.  Th...

Would you consider regorafenib based on the REGOBONE trial? Or would you consider other agents knowing that we do not have positive survival data with...

Tumor 13 cm on back with retiform and kaposiform features; all margins negative except one abuts inked margin; atypical cells with 4 mitosis/HPF. Add...

How do you choose between single-agent or combination chemotherapy versus newer treatment strategies such as palbociclib?

For example, if a biopsy reads: lesion comprised of spindle cells arranged in a fascicular pattern, elongated, hyperchromatic nuclei, focally positive...

Would your recommendations change in the neoadjuvant versus adjuvant or metastatic setting?

i.e. doxorubicin, ifosfamide + RT. Do you worry about decreased locoregional control or increased toxicities with the use of G-CSF in combination with...

Is there an age limit you use to consider MAP? Would you consider using AIM instead?

How do you choose between local therapy (surgical debulking or ablation) v. 2nd line systemic therapy? Would you consider immunotherapy?

Given metastatic disease and not a trial candidate, how would you approach this scenario? How does an underlying diagnosis of NF1 affect your decision...

When, if ever, do you utilize adjuvant RT or chemotherapy?

NCCN suggests to consider continuation of imatinib from some single/multi institution non-randomized trials for ~2 years, but does not suggest what fa...

How would you treat metastatic, unresectable, solitary fibrous tumor in a patient with mild hemophilia A? Each anti-VEGF medication comes with a warni...

How does grade or performance status affect your treatment decisions?

Does anatomic location (eg retroperitoneal or thoracic) affect your treatment decision?

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...

I have seen favorable clinical trial reports on dasatinib for metastatic disease, but no data on possible adjuvant use.  NCCN guidelines suggest ...

What other pathologic features may you use to guide therapy decisions (eg mitoses/grade or NGS)?  If you decide on adjuvant therapy, what regimen...

Is there any data to suggest delayed initiation of adjuvant treatment would be beneficial? Or would close surveillance be reasonable? Patient is asymp...

CIC-DUX4 fusion sarcoma is a rare entity, the aggressiveness of which is comparable to Ewing's sarcoma. A major dilemma is whether to treat these pati...

Do you offer neoadjuvant RT with resection and node dissection vs. definitive radiation?  How extensive does the nodal disease have to be for you...

Tumor involves stomach, liver, and lymph nodes. Pathology is suspicious for sarcomatoid carcinoma, possibly sarcomatoid cholangiocarcinoma.


Papers discussed in this category


JAMA Oncol,

Clin. Cancer Res.,

The Lancet. Oncology, 2009-11

Ann. Surg. Oncol., 2015 Feb 05

Oral Oncol., 2013 Nov 15

Int. J. Radiat. Oncol. Biol. Phys.,

Cancer,

Eur. J. Cancer,

Clinical cancer research : an official journal of the American Association for Cancer Research, 2018-04-15

Cancer,

Cancer medicine, 2019-01

Tumori,

Thromb. Haemost.,

World J. Gastroenterol.,

Ann Surg Oncol, 2014 Aug

American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting, 2018-05-23

Acta Oncol, 2017 Apr 21

Lancet Oncol., 2017 Sep 04

Lancet Oncol., 2012 Sep 04

European journal of cancer (Oxford, England : 1990), 2012-06

The New England journal of medicine, 2018-12-20

Ann. Oncol., 2012 Feb 13

Cancer, 2011-11-01

Case reports in oncology, 2017

BMC Cancer, 2015 Oct 15

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 1997-06

Lancet Oncol., 2018 Nov 23

Ann. Oncol., 2011 Apr 28

Lancet Oncol., 2020 Feb 17

Sarcoma, 2020 Jan 30