Medical Oncology
Physician insights on cancer treatment protocols, immunotherapy, targeted therapies, and clinical trial updates.
Recent Discussions
How do you choose which LHRH agonist or antagonist to prescribe for ADT in patients with prostate cancer?
The choice of LHRH agonist or antagonist depends on patient factors. Most patients receive some form of leuprolide or goserelin since these allow longer intervals between injections (as compared to degarelix). Goserelin is used more for those on anticoagulation or with bleeding disorders since it is...
Would you radiate the thoracic duct for bilateral chylothorax in a hematologic malignancy with no discrete adenopathy?
We have done for adenopathy, which relieves obstruction and thus helps with drainage, but we don’t know how it would help in this situation.
Would you radiate the thoracic duct for bilateral chylothorax in a hematologic malignancy with no discrete adenopathy?
We have done for adenopathy, which relieves obstruction and thus helps with drainage, but we don’t know how it would help in this situation.
Do you offer enasidenib with azacitadine in AML with an IDH2 mutation for patients ineligible for intensive induction chemotherapy?
I typically do not give enasidenib with azacitidine upfront for patients with AML with IDH2 mutation and ineligible for intensive induction chemotherapy. Based on the results of the VIALE-A study (DiNardo et al, NEJM 2020), I usually give venetoclax with azacitidine to those patients. In addition to...
Do you offer enasidenib with azacitadine in AML with an IDH2 mutation for patients ineligible for intensive induction chemotherapy?
I typically do not give enasidenib with azacitidine upfront for patients with AML with IDH2 mutation and ineligible for intensive induction chemotherapy. Based on the results of the VIALE-A study (DiNardo et al, NEJM 2020), I usually give venetoclax with azacitidine to those patients. In addition to...
For muscle invasive bladder cancer, after neoadjuvant chemotherapy with cis/gem and surgery with residual tumor and lymph node involvement, would you consider adjuvant avelumab as an extrapolation base on the JAVELIN 100 results?
I would not use adjuvant avelumab following radical cystectomy finding residual high risk disease after neoadjuvant chemotherapy. Biologically, this group has disease resistant to neoadjuvant chemotherapy, and is not akin to those with stable or responding disease following platinum therapy included...
Is there a correlation with severity of rash as an adverse event and response rate with capivasertib?
While it is tempting to hope that patients with significant side effects on targeted therapies might be more likely to demonstrate an antitumor response to that treatment, and there is limited data to suggest a possible correlation between immune-related adverse events and response to immunotherapy,...
When, if ever, would you recommend risk reducing BSO in patients with moderate penetrance breast cancer germline mutations?
RAD51C, RAD51D, and BRIP1 are all associated with significant risks of ovarian cancer and are appropriate for consideration of prophylactic oophorectomy, albeit perhaps at a slightly later age than BRCA1 and BRCA2. ATM and PALB2 may be associated with ovarian cancer risks that are similar to that of...
What approaches can we take to initiate therapy and improve survival rates in patients with HLH?
At our institution, we have comprised a multidisciplinary team to help treat these patients. The team or "HLH task force" as we like to call ourselves is comprised of a clinical immunologist, rheumatologist, dermatologist, critical care physician, hepatologist, BMT attending/hematologist, infectious...
How are you approaching patient selection and timing of RNA-based NGS, in light of the approval of zenocutuzumab for NRG1 fusion–positive advanced cholangiocarcinoma?
My standard has been to do all DNA, RNA, and IHC through a single vendor. I test all newly diagnosed patients with cholangiocarcinoma. I always do tissue and liquid biopsy NGS. If tissue biopsy is not feasible because of sample quantity/quality, then another biopsy will be the way to go to obtain, e...