Medical Oncology
Physician insights on cancer treatment protocols, immunotherapy, targeted therapies, and clinical trial updates.
Recent Discussions
How do you select first-line therapy for PD-L1-positive metastatic TNBC?
At this point, we only have mature data on pembro and SG, and this is the regimen I would use.
Does anyone utilize P2Y12 assays to determine if clopidogrel may be ineffective when used for DAPT?
Yes, I use P2Y12 assays in two distinct settings. Medical management: If a patient on clopidogrel mono/dual therapy has disease progression with ICAD or experiences a recurrent ischemic event, I obtain a P2Y12 assay to assess responsiveness. This helps guide the decision to switch to ticagrelor and ...
How would you advise a younger patient with residual/recurrent optic nerve meningioma, proceeding with radiotherapy, about the risks of malignant transformation or induction of other brain malignancies because of radiation?
The risk of malignant transformation of an optic nerve sheath meningioma (ONSM) after RT appears to be remarkably low, much lower than the risk of blindness from an untreated, progressive ONSM. In a younger patient, I would lean toward RT for patients with imaging progression or early visual loss, ...
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...
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...
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...