Neurology   

Can you explain when would you consider light chain amyloidosis work up with fat pad biopsy?

E.g., patients with small CNS mets without vasogenic edema or symptoms. Epidural disease without epidural spinal cord compression or asymptomatic low-...

If so, how long do you continue medication and when do you discontinue? Does treatment with surgical resection versus radiation alone change your mana...

How would you counsel the patient given the drug interactions present?

Do you treat this similarly to IDH-Wildtype GBM with the STUPP regimen? Is there any role of less-intensive paradigms, such as 59.4 Gy/33 fx?

Is there a role for adjuvant chemotherapy or radiation?

Do you recommend adjuvant chemotherapy after radiation treatment?

With the recent publication in IJROBP showing a greater than 50% response rate, have you started integrating this into your practice? 

Would you continue KEYNOTE-522 neoadjuvant therapy? The patient has a PMH of sarcoidosis with no stroke risk factors. No residual deficits. 

Do you utilize rituximab or any other specific management strategies?

Are there any instances where you would prefer a biosimilar rather than the reference product? 

Is your approach different than that to a primary essential tremor?

Regimen currently 25 mg lenalidomide D1-21 of D28 day cycles, Daratumumab 16 mg/kg every 2 weeks.

History of 4th ventricle choroid plexus papilloma s/p GTR, now with recurrent disease in the 4th ventricle and the left lateral ventricle (7 nodules i...

Are there any protocols in place? Aside from telling patients to use ice packs or bags or immerse hands/feet in ice water baths from 15" before to 15"...

What is your preferred dose/fractionation following a previous course of radiotherapy?

What would be your next treatment for a young adult patient with medulloblastoma refractory to repeat resection, craniospinal irradiation, and initial...

Would the checkpoint inhibitor still work if blocking only that portion of the inflammatory cascade as opposed to more global blockade with steroids?

Based on this review (Melamed and Lee, PMID 31998289), patients with MS on several DMTs may be at higher risk for certain cancers. How does this play ...

Do you prophylactically start all patients on B12, B-complex, and/or omega-3? If so, what dose? What about ice mittens and booties?

Do you ever add prophylactic Keppra (levetiracetam) for glioblastoma patients without a seizure history based on data such as this study (nature.com) ...

How often are you scanning the brain and what is your trigger to treat?

If so, what would you consider ordering?

Is there role for IVIG? Would you alter the dose or time course of steroid therapy?

In the setting of no personal or family history and no other risk factors for thrombosis, is systemic anticoagulation warranted if local treatments (e...

NCCN lists PCV as category 1 (and now with analysis in Abstract 2002 from ASCO 2019 showing benefit in IDH mutated), and temozolomide as 2B, yet temoz...

Are there contraindications to drugs like oxaliplatin or abraxane? Does chronicity or severity of the patient's underlying symptoms play a role in yo...

e.g. DITP from eptifibatide after a cardiac intervention

For medical oncologists, would you offer a PD-1/L1 inhibitor? For other subspecialties, how would you counsel the oncologist regarding the risk of usi...

For stroke-like migraine attacks after radiation therapy (SMART syndrome), does your management of these patient's change with recurrent episodes? How...

Can intrathecal methotrexate be continued with close neurologic observation vs switch in treatment now due to findings?

If so, when do you consider this? 

Can you expand on this by sharing exactly what this routine workup should include? What additional tests outside of evaluating for POEMS and amyloidos...

Presuming that work-up for cardioembolic sources is negative, how would you proceed?

Do you consider the small, but statistically significant, improvement in OS to outweigh the side effects of treatment?

Length of temozolomide course when given with adjuvant radiotherapy

If not, how often do you repeat pelvic imaging?

Patients can develop sensory and motor symptoms such as paresthesias, jaw/facial pain and stiffness, cramping and twitching, ptosis and vision changes...