Medical Oncology

University of Wisconsin

Questions discussed in this category

Would you offer definitive local therapy to a patient with ER/PR+, Her2 neg breast cancer with oligometastatic disease that responded well to CDK 4/6 inhibitor +AI, despite NRG-BR002 results?

Young healthy patient, ER/PR positive HER2 negative right breast cancer with a synchronous single site of oligometastatic disease in the right 4th rib...

2 Answers available

Would you recommend axillary lymph node dissection in a pre-menopausal woman with ER+ PR+ HER2- IDC, s/p lumpectomy and SLN with pT1c pN1 cM0 disease, where 2 sentinel nodes are positive for macrometastasis and 1 SN is positive for micrometastasis?

1 Answer available

In patients who have received neoadjuvant endocrine therapy for localized ER/PR+, HER2 negative breast cancer, how do you decide which patients to offer adjuvant chemotherapy to?

What type of adjuvant chemotherapy would you offer? Would clinically positive lymph nodes or residual disease at the time of surgery change your decis...

1 Answer available

Will you recommend abemaciclib in combination with standard adjuvant endocrine therapy in patients with high risk hormone receptor positive, HER2- early breast cancer?

With the recent announcement that the phase 3 MonarchE trial met its primary endpoint.

3 Answers available

Would you consider neoadjuvant endocrine therapy in a postmenopausal patient with ER + locally advanced breast cancer with nodal disease who wants to avoid chemotherapy?

3 Answers available

Would you consider giving FLOT entirely in the neoadjuvant setting for resectable gastric cancer?

If so, how many cycles would you give? Both the MAGIC and FLOT trials showed difficulty with administering adjuvant chemotherapy.

2 Answers available

What adjuvant systemic therapy would you recommend for a woman s/p ALND for a nodal recurrence of ER-/HER2+ breast cancer 1 year after completing adjuvant therapy with paclitaxel/trastuzumab for her initial disease?

At initial diagnosis she had T1cN0 disease treated with lumpectomy and SLNB followed by 12 weeks of paclitaxel with 1 year of trastuzumab.

4 Answers available

How would you approach a young patient with oligometastatic inflammatory triple negative breast cancer with bone only metastases?

Would you consider definitive local therapy (surgery, radiation?) if she achieved a good response to initial systemic therapy?

3 Answers available

What is your preferred adjuvant therapy for a patient with triple negative breast cancer and has a BRCA germline mutation who had minimal to no response to neoadjuvant chemotherapy?

Young patient, germline BRCA carrier with cT1cN0 to ypT2N0 disease after docetaxel/ cyclophosphamide x 4.

2 Answers available

In patients with HCC and asymptomatic but endoscopically visible varices, how long do you wait to start bevacizumab after banding?

1 Answer available

In which situations do you offer neoadjuvant chemotherapy for a nodal recurrence alone of ER/PR positive, HER2 negative breast cancer?

Patient is young and reoccurrence is one year after initial diagnosis of T1cN0 ER/PR positive, HER2-negative breast cancer treated with mastectomy, bu...

1 Answer available

How would you approach systemic therapy for a pre-menopausal woman with ER+/PR+/HER2 positive breast cancer who had a local recurrence 6 months after completing adjuvant TCH and a year of trastuzumab + tamoxifen?

Would you consider neoadjuvant or adjuvant treatment and if so, which therapies? Patient initially had pT2N0 disease and recurrent disease is also ER+...

1 Answer available

Would you offer adjuvant abemaciclib + an aromatase inhibitor to a patient with a local HR+HER- breast cancer reoccurrence while on tamoxifen that meets high-risk criteria?

High-risk criteria meaning >4 positive nodes and Ki67 >20%

3 Answers available

For locally advanced rectal cancer, would you consider utilizing the RAPIDO trial approach of short course radiation followed by neoadjuvant chemotherapy prior to surgery?

Colleagues in surgery have raised concerns about post radiation effects in the pelvis with the ordering of short course RT->chemo ->surgery.

5 Answers available

For patients with metastatic triple negative breast cancer on nab-paclitaxel + atezolizumab who have an ongoing response, are you continuing immunotherapy after the FDA withdrawal of atezolizumab?

1 Answer available

How will you counsel patients with breast cancer receiving adjuvant chemotherapy regarding COVID-19 vaccine administration?

For example, will you recommend a certain vaccination timing in relationship to their treatment? Any concerns for reduced immune response or risks of ...

1 Answer available

How would you approach adjuvant systemic therapy for a patient with a history of localized triple negative breast cancer 7 years prior for which she received adjuvant AC-T, now presenting with another ipsilateral T1cN0 triple negative breast cancer?

Given the data from KEYNOTE-522, would you try to incorporate chemotherapy in the treatment regimen?

2 Answers available

For a metastatic neuroendocrine tumor patient who has experienced prolonged progression free survival, how would you approach surgical debulking?

Does the advent of more effective therapies like peptide receptor radioligand therapy (PRRT) and capecitabine and temozolomide (CAPTEM) dampen enthusi...

1 Answer available

What is the maximum cumulative anthracycline dose you would administer in a patient with metastatic breast cancer who is asymptomatic with good disease control on liposomal doxorubicin?

2 Answers available

In patients with inflammatory bowel disease with low rectal cancer with planned proctocolectomy, would you consider creation of a pouch?

1 Answer available

In very rapidly progressive/poorly differentiated hepatocellular cancer, would you use the targeted options (sorafenib/lenvatinib) or would you try a traditional cytotoxic regimen?

1 Answer available

Would you offer adjuvant therapy to a patient who underwent bilateral mastectomies for DCIS and was found to have isolated tumor cells on sentinel node biopsy?

She had had 4 prior biopsies. Would the fact that she received 2 months of neoadjuvant tamoxifen due to COVID change your approach?

1 Answer available

How do you choose first or second-line systemic therapy for fibrolamellar hepatocellular carcinoma?

What are there most evidence-based options?

1 Answer available

What is your strategy for a patient who develops an enlarging ipsilateral axillary lymph node shortly after undergoing mastectomy and ALND for a pT2N3 ER+/HER2+ right breast cancer?

This patient underwent mastectomy and ALND (10/28 positive lymph nodes). Immediately following axillary LN dissection (and prior to radiation) imaging...

1 Answer available

Would you recommend adjuvant chemotherapy for a stage IIB triple negative apocrine carcinoma?

What chemotherapy regimen would you recommend?

2 Answers available

Do you consider neoadjuvant pertuzumab for node negative multifocal HER2+/ER+ IDC without any single focus >2 cm?

2 Answers available

How should our selection for neoadjuvant chemotherapy for breast cancer change in light of COVID-19?

2 Answers available

How would differing breast cancer receptors between biopsy and surgery affect your treatment recommendations?

For example, if you had a triple positive breast cancer found on breast biopsy and repeat ER/PR/HER2 testing at the time of surgical resection showed ...

1 Answer available

Do you recommend chemoradiation following neoadjuvant FOLFIRINOX for resectable pancreatic cancer?

4 Answers available

How would you approach a patient with a new axillary skin lesion with pathology suspecting a metastatic breast cancer, and no other sites of disease noted on PET imaging?

Would you treat this differently than someone who only presents with axillary nodal disease?

1 Answer available

What neoadjuvant strategies do you utilize for initially unresectable biliary tract cancer?

In your experience, what approach has been successful to bridge to surgery?

2 Answers available

Would you offer additional therapy for a patient with HR+ breast cancer on AI+OS who is found to have a focus of ovarian metastasis at the time of elective BSO?

Additionally, would the finding of any mutations, such as ESR1, change your recommendation?

2 Answers available

How do you proceed if a breast cancer patient has imaging concerning for pulmonary lymphangitic carcinomatosis but no other evidence of metastatic disease?

1 Answer available

How long do you give neoadjuvant therapy in resectable/borderline resectable pancreatic cancer, when you are considering chemoradiotherapy as part of your neoadjuvant strategy?

I have seen anywhere from 4-6 months utilized. Is there any data to guide your strategy?

1 Answer available

What is the preferred clinical management of hyperglycemia related to alpelisib?

1 Answer available

When do you consider total neoadjuvant therapy (chemotherapy and chemoradiation) for rectal cancer?

1 Answer available

Which patients with metastatic breast cancer should have mastectomy?

1 Answer available

What is the preferred treatment approach for patients with metastatic phyllodes tumor?

1 Answer available

How will the findings from the study of adjuvant capecitabine in TNBC presented at SABCS 2018 (CIBOMA/2004-01_GEICAM/2003-11) affect standard of care?

1 Answer available

Should atezolizumab and nab-paclitaxel now be used in first line therapy for metastatic, triple negative breast cancer?

Have the results from IMpassion130 changed the standard of care?

2 Answers available

Would you add HER2 targeted therapy to adjuvant chemotherapy for a patient with initial breast biopsy showing a ER/PR positive, HER2 negative invasive ductal carcinoma but mastectomy sample showing equivocal Her2 by FISH on initial assay with an alternative probe testing positive?

(HER2/CEP17 ratio <2.0, copy number >4.0 and <6.0 signals/cell)

1 Answer available

How would you treat a patient with a history of ER+ breast cancer over 10 years ago, now presenting with an ER+ loco-regional recurrence while still on Tamoxifen?

In a patient treated over 10 years ago with mastectomy and chemo now with recurrence in the ipislateral axilla, would you offer additional with chemot...

1 Answer available

What is your approach to adjuvant HER-2 directed therapy in a patient who developed cardiotoxicity following neoadjuvant TC-HP?

Can these patients be re-challenged with Herceptin?

6 Answers available