Medical Oncology
Physician insights on cancer treatment protocols, immunotherapy, targeted therapies, and clinical trial updates.
Recent Discussions
Is there any role for elacestrant in patient who have received prior fulvestrant if they have ESR1 mutation?
The short answer is Yes!! The pivotal EMERALD trial that led to the approval of Elacestrant (oral Selective Estrogen Receptor Degrader) did enroll patients who previously received Fulvestrant (Faslodex). In a pre-planned subgroup analysis of EMERALD data, benefit of Elacestrant was seen even in subg...
What supportive care measures do you prioritize to manage or prevent toxicity in patients receiving Dato-DXd?
My supportive care approach is centered around early identification and management of interstitial lung disease (ILD) and mucositis, both of which were observed in the TROPION-Breast01 trial. Twelve patients (3.3%) in the Dato-DXd arm had adjudicated drug-related ILD/pneumonitis. I routinely obtain ...
Can AMPLIFY data be extrapolated to use of other BTKi's in combination with venetoclax or would you only ever use acalabrutinib/venetoclax in first line?
I think the main question here is whether AV can be extrapolated to ZV, since there is already phase 3 data with IV, and I do not think it would be appropriate to extrapolate to a non-covalent BTKi. I think it is very likely that ZV is as effective as AV, but there are not many clinical scenarios wh...
Can AMPLIFY data be extrapolated to use of other BTKi's in combination with venetoclax or would you only ever use acalabrutinib/venetoclax in first line?
I think the main question here is whether AV can be extrapolated to ZV, since there is already phase 3 data with IV, and I do not think it would be appropriate to extrapolate to a non-covalent BTKi. I think it is very likely that ZV is as effective as AV, but there are not many clinical scenarios wh...
How will you utilize the PARADIGM study results from ASH 2025, comparing azacitidine/venetoclax to intensive induction chemotherapy for fit patients with newly diagnosed AML?
It was very exciting to see PARADIGM presented as a plenary at ASH, and I look forward to the manuscript! Interpreting the findings in the context of the enrolled patients is very important. The median age of enrolled patients was approximately 65 years in both arms, and ~75% of enrolled patients ha...
How will you utilize the PARADIGM study results from ASH 2025, comparing azacitidine/venetoclax to intensive induction chemotherapy for fit patients with newly diagnosed AML?
It was very exciting to see PARADIGM presented as a plenary at ASH, and I look forward to the manuscript! Interpreting the findings in the context of the enrolled patients is very important. The median age of enrolled patients was approximately 65 years in both arms, and ~75% of enrolled patients ha...
Does the presence of paraneoplastic pemphigus influence your treatment options in CLL?
Paraneoplastic pemphigus is often difficult to treat, and if traditional measures do not control it, I often will use continuous therapy for CLL to both eliminate the disease and continue suppressing the autoimmune source of this paraneoplastic complication.
Does the presence of paraneoplastic pemphigus influence your treatment options in CLL?
Paraneoplastic pemphigus is often difficult to treat, and if traditional measures do not control it, I often will use continuous therapy for CLL to both eliminate the disease and continue suppressing the autoimmune source of this paraneoplastic complication.
How do you counsel patients on imaging findings after liver SBRT for HCC, particularly with regard to expectations on timing to tumor resolution?
My experience has been that the more successful the treatment, the sooner the patients want the good news. In reality, a well-designed and executed SBRT treatment to an ablative dose should result in 85 to 95% tumor control (mostly size independent) at 2 years with very little local progression afte...
Would you still offer durvalumab after chemoradiation in patients with stage III NSCLC whose treatment was delayed due to prolonged recovery from chemoradiation?
The PACIFIC study, which evaluated the use of durvalamab after completion of chemotherapy and radiation (both sequential and concurrent) is a landmark trial demonstrating improved survival for those receiving immunotherapy. The design of the study required that durvalamab commence within 42 days of ...