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How would you manage tucatinib-associated grade 2 indirect hyperbilirubinemia in a patient with metastatic HER2-positive breast cancer involving the CNS is receiving trastuzumab + capecitabine + tucatinib?

Patient is young. Bilirubin normalizes when tucatinib is held, but again increases to grade 2 when it is restarted. Evaluation for hemolysis was negat...

How do you approach adjuvant therapy for resected lung adenocarcinoma that was found unexpectedly postop to be N2?

Do you routinely offer post-operative adjuvant radiation in addition to chemotherapy? Are the results of the recently published negative phase ...

9 Answers available

Do you offer adjuvant bisphosphonates to high-risk premenopausal women on ovarian suppression for early-stage breast cancer who would want to consider pregnancy in the future?

Which agents would you select and for how long would you treat them?

What is your approach to chemoprevention for HR+ DCIS in the ipsilateral breast in a patient who already completed 7 years of an AI for a prior HR+ invasive breast cancer?

Patient underwent mastectomy for DCIS in the setting of previous lumpectomy and adjuvant radiation for the invasive breast cancer.

In which cases would you use adjuvant abemaciclib for a patient with extensive residual disease that is triple-positive (ER+PR+HER2+) following neoadjuvant TCHP?

Patient is ypT2N1

Would you consider adjuvant nivolumab to be the standard of care in stage II/III esophageal/GE junction cancer after completion of neoadjuvant chemoradiotherapy and surgery?

Based on CheckMate 577?Is DFS endpoint sufficient to establish SOC or is OS benefit needed?

4 Answers available

When do you add an adjuvant bone-modifying agent in patients with history of localized breast cancer?

Is there any role for denosumab? How do you counsel patients regarding the benefit of bisphosphonates on breast cancer outcomes?

What is the role for adjuvant chemotherapy and/or radiation in ampullary carcinoma?

Ampullary carcinoma is not in the NCCN guidelines. Please address not only the role for therapy but the optimal regimen (i.e. Gem based, vs mFOLFIRINO...

Are there circumstances where you would recommend every 6 week dosing schedule for pembrolizumab monotherapy?

I am considering every 6 week pembrolizumab dosing in patients >70 years old in whom I want to reduce clinic visits for, especially in the context ...

What is your approach to patients with malignant breast adenomyoepithelioma?

Is adjuvant radiation and/or adjuvant chemotherapy indicated?

Which systemic therapy do you recommend for a patient with esophageal squamous cell carcinoma undergoing definitive chemoradiation alone?

In a patient who is not a surgical candidate, do you offer concurrent carbo/taxol rather than 5FU/oxaliplatin?

0 Answers available

What is your adjuvant treatment approach to patients with strongly hormone-receptor positive breast cancer who have minimal response to neoadjuvant chemotherapy?

How do you decide what induction chemotherapy regimen to use for a patient with locally advanced rectal cancer (cT4N1) receiving total neoadjuvant therapy?

Would you use FOLFIRINOX as in Prodige 23 or FOLFOX as in RAPIDO?

When do you add chemotherapy to post-operative RT for thymomas after a R2 resection?

How might you alter treatment for a breast cancer patient receiving standard taxane-based adjuvant therapy who develops an adverse reaction to the taxane (e.g. severe pneumonitis) after completion of ddAC?

For a patient with high risk disease and a severe enough reaction that additional taxane-based therapy is contraindicated, do you consider alternate c...

What is your approach to oligometastatic HER2 positive breast cancer, particularly after excellent clinical response in all sites of disease to trastuzumab, pertuzumab, and a taxane?

Would you assume a diagnosis of metastatic recurrence and initiate therapy for a patient with history of locally advanced NSCLC treated with definitive chemoradiation who develops multiple enlarging lung nodules that are too small to biopsy?

Is there an advantage to early diagnosis and intervention versus observation until the nodules are amenable to percutaneous biopsy?

How has COVID-19 altered your recommendations for invasive mediastinal staging for NSCLC?

Should staging and treatment decisions be made based on imaging alone?

Should we consider deferring adjuvant chemotherapy for resected early-stage NSCLC in light of COVID-19?

If so, how long is too long to wait?

How do you approach treatment for solitary fibrous tumor with a multifocal pleural-based metastatic recurrence that is surgically inoperable in a patient with good performance status?

How, if any, do you utilize genomic testing to guide systemic therapy?

Is there a role for incorporating local therapy into the management of oligometastatic EGFR-mutant NSCLC with curative intent?

If so, what is your approach to sequencing and timing of targeted therapy and local therapy?

In what circumstances, if any, do you administer concurrent capecitabine with radiation therapy in the treatment of breast cancer?

For patients with EGFR-mutant NSCLC who progress on osimertinib, do you repeat tumor molecular profiling?

If so do you favor repeat tumor biopsy or cfDNA?

Would you extrapolate data from PACIFIC trial for unresectable disease to consider consolidation therapy with durvalumab for Stage III NSCLC with single-station N2 disease amenable to lobectomy?

4 Answers available

In a premenopausal woman with low risk, early stage HR-positive breast cancer who is unable to discontinue a strong CYP2D6 inhibitor, do you use still utilize tamoxifen versus an AI with ovarian suppression?

Is there a role for checkpoint inhibition in patients with advanced, high PD-L1 expressing, chemotherapy-refractory thymoma?

What if the patient has thymoma-associated myasthenia gravis?

What is your systemic therapy approach to women with isolated local recurrences of hormone-receptor positive breast cancer?

How does the timing of recurrence play into your decision?

Do you use gene expression profiling for premenopausal women with hormone receptor positive breast cancer with 1-3 positive lymph nodes?

Do you ever consider local therapy to oligometastatic hormone-receptor positive breast cancer?

What is your approach to women with early-stage hormone responsive breast cancer intolerant of AI's who want to remain on endocrine therapy but have contraindications to tamoxifen?

How do you decide on the sequence of systemic and local therapy for patients with oligometastatic NSCLC?

When would you favor delivering local therapy (e.g. SBRT) prior to systemic therapy?

What is your approach to young healthy women with locally advanced breast cancer and biopsy-proven low cervical lymph nodes?

Would you treat this as a locally advanced breast cancer and offer surgery, radiation, and systemic therapy? Does your management change depending on ...

Would you treat a patient with HIV or hepatitis C with an anti-PD-1 agent?

These patients have been largely excluded from these trials. What if the infection is well controlled?

Would you offer adjuvant TKI to patients with Stage III, EGFR-mutant NSCLC after standard chemoradiation?

Would you offer adjuvant TKI following ADAURA data? Or proceed with durvalumab based on PACIFIC data?

What is the best management for a local recurrence for a stage I NSCLC treated previously with SBRT?

Should fractionated EBRT be administered or can repeat SBRT be used?