Medical Oncology
Physician insights on cancer treatment protocols, immunotherapy, targeted therapies, and clinical trial updates.
Recent Discussions
How do you treat a patient who develops metastatic prostate CA while on enzalutamide or apalutamide for originally M0 CRPC?
Most patients in this setting actually have mCRPC but very low volume disease. Occasionally this can be local/regional only but most PET imaging studies suggest that M0 CRPC is comprised of metastatic disease below the limits of detection of conventional CT and bone scan imaging. Thus I manage these...
Would you consider delaying radiation to wait for OncoType results to guide adjuvant chemotherapy for early stage HR+ node negative breast cancer?
I would definitely recommend obtaining the information from a predictive genomic signature, independent of the timing of radiation consultation.While the standard approach is to administer chemotherapy (if indicated) prior to radiation therapy, there is a paucity of evidence based studies to clearly...
What adjuvant therapy do you give after surgery to patients with gastric CA who undergo 3 cycles of FLOT with no tumor effect on pathology and maintain good PS?
I know I'm not a medical oncologist in a question (and disease site) geared towards med-oncs, but I would caution against such definitive statements about RT (agree with @Dr. First Last on ECF) when subset analyses of the CRITICS trial evaluating the role of TRG (along with other factors, such as no...
What systemic therapy would you suggest for metastatic odontogenic clear cell carcinoma with no actionable mutations on NGS?
With the FDA approval of third line pembrolizumab for patients with SCLC, how would you select a candidate for pembrolizumab or nivolumab in the third line management of SCLC?
Would you consider lenvatinib plus everolimus as first line treatment for a patient with tuberous sclerosis and metastatic renal cell carcinoma?
What would be the preferred chemotherapy regimen in elderly patients with advanced stage classical Hodgkin Lymphoma and contraindication to doxorubicin and bleomycin?
First, I’d seek clarification as to what contraindications were present. Contraindications to either can be absolute or more relative. A Hgb-adj DLCO of less than 50% in the presence of known lung disease is an absolute contraindication to bleo, whereas a DLCO of 65 perhaps contributed to by HL itse...
What therapy would you offer a young BRAF wild type patient with metastatic melanoma, who progressed on single agent pembrolizumab?
Given that response to anti-PD-1 therapy is one of the strongest biomakers for outcome in patients with metastatic melanoma, prognosis for these patients is poor. Therefore, clinical trial should be strongly considered, if available. If no clinical trial is available, standard options for these pati...
Would you consider HER2-directed therapy in a patient with pretreated metastatic right sided colon adenocarcinoma progressed on FOLFOX-bevacizumab if they are both HER2-neu amplified and have a HER2-neu exon 19 mutation?
Would you use CTS5 to help you decide whether to offer prolonged adjuvant ET to HR+ breast cancer?
I would