Medical Oncology
Physician insights on cancer treatment protocols, immunotherapy, targeted therapies, and clinical trial updates.
Recent Discussions
Would you consider utilizing pembrolizumab/enfortumab as a bladder preservation approach in patients with MIBC?
Yes, I think that this is a viable approach. Data from perioperative trials, including KN-905 and EV-304, suggest very high rates of pathologic complete responses in almost two-thirds of all patients at the time of radical cystectomy. Many of these patients may not need radical cystectomy for an opt...
Do you utilize D-dimer to inform anticoagulation duration in the treatment of VTE?
I had developed a policy during my last eight or ten years of practice evaluating how long patients should be treated after a thrombosis and I'd like to share some impressions over these years as well as conclusions that I reached. These conclusions formed the basis of my approach to this problem. I...
Do you utilize D-dimer to inform anticoagulation duration in the treatment of VTE?
I had developed a policy during my last eight or ten years of practice evaluating how long patients should be treated after a thrombosis and I'd like to share some impressions over these years as well as conclusions that I reached. These conclusions formed the basis of my approach to this problem. I...
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...
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...
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, ...
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.
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...