Medical Oncology
Physician insights on cancer treatment protocols, immunotherapy, targeted therapies, and clinical trial updates.
Recent Discussions
How do you approach ILD monitoring when selecting Dato-DXd in frontline TNBC treatment?
ILD rates were very low in TROPION-Breast02, with less than 1% Gr3 or higher. I would follow recommendations per the FDA label and have an awareness of rare potential risk and counsel patients to alert clinical teams should they have symptoms of ILD.
Does the recent publication of EPCORE FL-1 (Epcoritamab + R2) change your preferred 2L SOC for R/R FL?
The approval of the combination of epcoritamab + R2 for relapsed/refractory FL based on the data from the EPCORE FL-1 study has provided an additional effective option for the treatment of patients with relapsed/refractory FL, and I have incorporated it into my practice for patients in the 2L settin...
Does the recent publication of EPCORE FL-1 (Epcoritamab + R2) change your preferred 2L SOC for R/R FL?
The approval of the combination of epcoritamab + R2 for relapsed/refractory FL based on the data from the EPCORE FL-1 study has provided an additional effective option for the treatment of patients with relapsed/refractory FL, and I have incorporated it into my practice for patients in the 2L settin...
Is there any role for early stem cell mobilization and collection during the SMM phase?
Prolonged exposure to lenalidomide can affect the ability to mobilize and collect stem cells, though this is less of an issue with increasing use of plerixafor (Giralt et al., 2009). If you are going to treat with an IMD, it is important to collect stem cells after 4-6 months of therapy, similar to ...
What are your top takeaways in Cutaneous Malignancies from ASCO 2026?
I presented a phase II trial of neoadjuvant cemiplimab immunotherapy and response-adapted radiotherapy for patients with locally advanced, unresectable cutaneous squamous cell carcinoma. Historically, the 2-year progression-free survival (PFS) rate in this situation with radiotherapy with or without...
For muscle invasive bladder cancer, after neoadjuvant chemotherapy with cis/gem and surgery with residual tumor and lymph node involvement, would you consider adjuvant avelumab as an extrapolation base on the JAVELIN 100 results?
I would not use adjuvant avelumab following radical cystectomy finding residual high risk disease after neoadjuvant chemotherapy. Biologically, this group has disease resistant to neoadjuvant chemotherapy, and is not akin to those with stable or responding disease following platinum therapy included...
How do you approach and counsel women with high risk, early stage breast cancer requiring chemotherapy for whom fertility preservation is a major concern?
Fertility preservation is a major issue in survivorship for younger cancer patients. Discussion with a specialist regarding banking eggs or embryos as early as possible is important. Proven techniques such as embryo cryopreservation may not be available due to financial constraints or other issues. ...
Do you perform PDL1 and molecular testing for patients with stages I-III NSCLC?
Do you order PDL1 and molecular testing for patients with stages I-III NSCLC?When I answered this question about two years ago, I said no, primarily because there was no Level 1 efficacy data to support an improvement in outcomes for these patients. This has since changed... although in some ways, n...
Are there still clinical situations in which you deliberately treat patients with a DOAC besides apixaban?
Thank you for your question. Apixaban has been my preferred agent for a long time for patients requiring therapeutic anticoagulation. Apixaban’s lower bleeding risk was shown prior to and now has additional evidence to support this with the COBRRA trial. The risk is also ameliorated by the safety in...
Is pembrolizumab considered standard of care in the 2nd line treatment of recurrent cervical cancer?
The phase II Keynote-158 indication is based on objective response of 14% in patients with PD-L1+ tumors. The US FDA approval is accelerated approval meaning that there needs to be a confirmatory trial - this is Keynote 826 which is ongoing.