Medical Oncology
Physician insights on cancer treatment protocols, immunotherapy, targeted therapies, and clinical trial updates.
Recent Discussions
What is the recommended approach for systemic therapy in a patient with metastatic cutaneous squamous cell carcinoma with active autoimmune disease (dermatomyositis)?
Dermatomyositis can occur with myositis/myasthenia gravis (overlap syndrome). At the Ohio State University Comprehensive Cancer Center, we have established an Immunotoxicity Clinic headed by a rheumatologist, Dr. @Dr. First Last. I would recommend engaging with a rheumatologist who is familiar with ...
For inoperable cholangiocarcinoma, do you recommend up-front chemotherapy prior to offering SBRT or combination chemoradiation?
For inoperable cholangiocarcinoma, there are many factors to consider. First, does the patient have any metastatic disease? If no, then how large is the primary and are there any nodes? Finally, is the patient suffering from biliary obstruction - causing hyperbilirubinemia and persistent/recurrent c...
What are the indications for anticoagulation in splenic infarctions?
A great reminder that splenic infarct relates to ARTERIAL thromboembolism and not to VENOUS VTE. Too often, I see massive, blind thrombophilia work-up for (incidentally) detected splenic infarcts.
What are the indications for anticoagulation in splenic infarctions?
A great reminder that splenic infarct relates to ARTERIAL thromboembolism and not to VENOUS VTE. Too often, I see massive, blind thrombophilia work-up for (incidentally) detected splenic infarcts.
How do you approach evaluation for underlying rheumatologic disease in patients with chronic asymptomatic thrombocytopenia?
APL testing as well as evaluation for SLE and Sjogrens with complement, urine, antibody testing, not just an ANA.
How do you reconcile the lack of OS benefit in the CLEAR trial comparing Lenvatinib + Pembrolizumab to Sunitinib, to the very impressive ORR and mPFS benefit seen?
At the primary analysis point of the phase III open-label, CLEAR study (Study 307/KEYNOTE-581), with a median survival follow-up of 26.6 months, lenvatinib plus pembrolizumab showed superior efficacy versus sunitinib in the first-line treatment of patients with advanced renal cell carcinoma. (Motzer...
What can prostate patients do for sexual function while on ADT?
While libido drops for most men on ADT, sexual function is still an important component for many, and educating on what to expect will help prevent disappointment or confusion. First, some men can get an erection with testosterone suppressed, but it is less common and not as firm an erection as wha...
How do you approach treatment for patients with ALK+ mNSCLC who have multifocal or leptomeningeal CNS progression while on first-line targeted therapy?
Leptomeningeal disease is one of the more challenging scenarios to manage in a patient with ALK rearranged lung cancer. One must work carefully with the radiation oncologist and factor in imaging findings as well as patient symptomatology to make the best decision moving forward. Radiation options i...
How often should you screen for lymphoma in patients with primary Sjogren's syndrome?
Depends on index of suspicion, I don't have a set schedule. In addition to assessing the initial "phenotype" and disease activity of SjD, I want to know baseline status of quantitative Ig's and if a monoclonal is present. I reassess based on clinical scenario over time. Some colleagues will recommen...
Would you offer consolidative durvalumab after chemoRT for an isolated mediastinal recurrence of NSCLC that occurred during adjuvant pembrolizumab given for the initial lung cancer?
No, I would not