Medical Oncology
Physician insights on cancer treatment protocols, immunotherapy, targeted therapies, and clinical trial updates.
Recent Discussions
What are your top takeaways in Hematologic Malignancies from ASH 2025?
The PARADIGM study is a very important one that may result in a paradigm change for the treatment of AML. The study showed that outcomes are equal or better with AZA + VEN among patients with AML suitable for intensive chemotherapy. The efficacy was superior in response rate and EFS (but not overall...
In patients with advanced endometrial cancer who you plan to treat with chemotherapy + immunotherapy (per GY018 or RUBY), how and when do you utilize adjuvant EBRT and/or brachytherapy?
Reading the question at face value - does advanced endometrial cancer mean stage IVB? III/IVA? If IVB, there is not routinely a role of 'adjuvant' EBRT or BT.Given the discussion of adjuvant therapy, I presume the question is asking for the small fraction of RUBY and GY-018 patients who were stage I...
How do you manage sexual dysfunction in women receiving ovarian suppression for breast cancer?
Asking questions about sexual dysfunction during routine follow ups is important. Many women may feel uncomfortable bringing up the issue. Next important to evaluate contributors such as physical complaints of dryness, dyspareunia, or libido issues, body image concerns, or relationship concerns. Phy...
Do you routinely stop ESA when starting myelofibrosis patients on JAK inhibitor therapy?
The management of myelofibrosis with anemia is becoming increasingly nuanced, given the several JAK inhibitors available to us and the potential for add-on therapies! An excellent resource to consider regarding decision-making is Jain et al., PMID 39808793. Regarding this specific question at hand, ...
Do you routinely stop ESA when starting myelofibrosis patients on JAK inhibitor therapy?
The management of myelofibrosis with anemia is becoming increasingly nuanced, given the several JAK inhibitors available to us and the potential for add-on therapies! An excellent resource to consider regarding decision-making is Jain et al., PMID 39808793. Regarding this specific question at hand, ...
How do you approach the outpatient management of bispecific antibody therapy for hematologic malignancies?
Multiple bispecific antibodies (BsAbs) targeting CD20 on lymphoma cells and CD3 on T-cells are now available in follicular and large B-cell lymphoma. A multi-disciplinary team with knowledge of the different BsAb indications and possible toxicities is an important aspect of safely administering thes...
How do you approach the outpatient management of bispecific antibody therapy for hematologic malignancies?
Multiple bispecific antibodies (BsAbs) targeting CD20 on lymphoma cells and CD3 on T-cells are now available in follicular and large B-cell lymphoma. A multi-disciplinary team with knowledge of the different BsAb indications and possible toxicities is an important aspect of safely administering thes...
What duration androgen deprivation do you recommend with salvage pelvic radiotherapy for pelvic node relapse after prostatectomy?
6 months ADT, 2 years ADT, 2 years ADT + abiraterone/prednisone seems reasonable depending on the circumstances. For example, early pelvic node recurrence for pT3b Gleason 4+5 would be a higher risk than a very late recurrence of pT2 Gleason 3+3.
How do you determine the timeline for healing after craniotomy prior to starting chemotherapy and radiation?
I typically wait at least 10-14 days post-op, always after neurosurgery has re-evaluated the craniotomy site for appropriate healing and has already removed staples or sutures.
In a patient with de novo metastatic RCC s/p Ipi/Nivo with partial response and residual viable RCC on cytoreductive nephrectomy, would you add cabozantinib or other TKI prior to disease progression?
Cytoreductive nephrectomy in asymptomatic patients is a controversial topic. There is some data suggesting clinical benefit to patients, but prospective data in the present checkpoint inhibitor era are needed. Fortunately, there are ongoing prospective clinical trials to provide this much-needed dat...