Medical Oncology
Physician insights on cancer treatment protocols, immunotherapy, targeted therapies, and clinical trial updates.
Recent Discussions
What systemic therapy would you suggest for metastatic odontogenic clear cell carcinoma with no actionable mutations on NGS?
With the FDA approval of third line pembrolizumab for patients with SCLC, how would you select a candidate for pembrolizumab or nivolumab in the third line management of SCLC?
Would you consider lenvatinib plus everolimus as first line treatment for a patient with tuberous sclerosis and metastatic renal cell carcinoma?
What would be the preferred chemotherapy regimen in elderly patients with advanced stage classical Hodgkin Lymphoma and contraindication to doxorubicin and bleomycin?
First, I’d seek clarification as to what contraindications were present. Contraindications to either can be absolute or more relative. A Hgb-adj DLCO of less than 50% in the presence of known lung disease is an absolute contraindication to bleo, whereas a DLCO of 65 perhaps contributed to by HL itse...
What therapy would you offer a young BRAF wild type patient with metastatic melanoma, who progressed on single agent pembrolizumab?
Given that response to anti-PD-1 therapy is one of the strongest biomakers for outcome in patients with metastatic melanoma, prognosis for these patients is poor. Therefore, clinical trial should be strongly considered, if available. If no clinical trial is available, standard options for these pati...
Would you consider HER2-directed therapy in a patient with pretreated metastatic right sided colon adenocarcinoma progressed on FOLFOX-bevacizumab if they are both HER2-neu amplified and have a HER2-neu exon 19 mutation?
Would you use CTS5 to help you decide whether to offer prolonged adjuvant ET to HR+ breast cancer?
I would
Would you recommend Radium-223 for extensive bone disease in a prostate cancer patient with adenopathy >3cm?
I think that there are several nuances to this question. One, Xofigo is a calcium mimetic which has shown both overall survival advantage as well as improvement in symptomatic skeletal events for men who progressed on docetaxel or refused chemotherapy in the ALSYMPCA trial. Patients experienced less...
Would you consider a PARP inhibitor in a patient who harbors a germline BRCA mutation who has metastatic HER2 negative gastric cancer?
Would you consider cystectomy in a patient who acheived radiologic and cystoscopic CR from chemo-radiation for oligometastatic urothelial carcinoma originating in the bladder if remains disease free > 6 months?
For this patient, I would currently recommend 4-6 cycles of cisplatin based chemotherapy followed by avelumab switch maintenance therapy. I would strongly consider radiation or chemoradiation after the combination chemo directed at the bladder and lymph node, followed soon after by avelumab. I think...