Does being on maintenance pembrolizumab change how you manage patients with partial metabolic response on PET/CT 3 months after chemoradiation for cervical cancer?
On the one hand, the addition of immunotherapy should increase a patient's likelihood of treatment response, so perhaps persistent disease in this setting is an even worse prognostic factor. However, the patient will be continuing on systemic therapy far beyond completion of radiation, so do you have a higher "tolerance" for residual disease in this setting and are perhaps less likely to re-biopsy?
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Has the addition of immunotherapy to chemoradiation for locally advanced cervical cancer changed how you monitor patients post-treatment?
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2 Answers
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Gynecologic Oncology · BayCare Medical Group
Answered on · Updated on
No, a good percentage of patients will not have a complete response by 3 months. Six months seems to be a reasonable cutoff. Persistent disease at 3 months does not seem to be a worse prognostic factor than completion at 6 months. At the 3-month mark, I would not manage differently. At 6 months, I w...
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
I would still add MRI with DWI sequence to decide the next step. If negative, continue the same but if positive, consider biopsy and plan salvage accordingly.
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