AYA&nbsp;&nbsp;&nbsp;

How would you treat a patient with Hodgkin lymphoma who has an isolated relapse within the CNS?

How would you approach breast cancer screening in an adolescent patient with a CDH1 mutation?

Is there a concern for the potential of future congenital malformations in offspring when preservation of eggs and sperm is done AFTER cyclophosphamide treatment given that it is an alkylating agent?

When is a bone marrow biopsy indicated in the up-front evaluation of an AYA patient with Ewing sarcoma?

Do you routinely recommend completion hysterectomy with contralateral salpingo-oophorectomy for patients with a history of fertility-sparing staging for borderline tumor of the ovary who have since completed childbearing?

Do you recommend the HPV vaccination for your young patients with HPV-associated cancers or pre-cancers who have not yet been vaccinated?

Assuming patient is <45 years old with cervical, vulvar, vaginal, anal, or head/neck cancers, or with CIN/VIN/VaIN/AIN/oropharyngeal precancerous l...

Do you provide prophylactic radiotherapy for heterotopic ossification in young patients?

In young adults (20-30), would you provide perioperative radiotherapy f if they have actually developed HO?

Would you consider a cycle of EP in a patient with good risk stage IIIB seminoma on BEP but with bleomycin omitted for cycle 3?

Bleomycin omitted due to asymptomatic decline in DLCO

Is there any scenario where you would consider treating a relapsed AYA patient with Hodgkin Lymphoma without consolidative auto transplant?

If so, what treatment regimen would you recommend?

How do you mitigate 6-MP-induced GI toxicity in pediatric and AYA patients with leukemia?

For T cell ALL treated in CR (without transplant), how often do you do BM biopsies as part of surveillance, and for how long?

What would you want community oncologists to know when following these patients? Are there any other special issues to follow especially in AYA?

How do you decide between RPLND vs. chemotherapy in patients with Stage IIA mixed germ cell tumor as primary treatment?

Would you recommend adding a TKI to a pediatric regimen for a AYA B-ALL patient with IKZF1 mutation?

How would you approach a sarcoma that was initially diagnosed as UPS of the distal femur with groin lymph node spread, resected, and found to have an EWSR1-FLI1 fusion diagnostic of Ewing's on NGS?

What is your treatment approach for a pediatric patient with uterine embryonal rhabdomyosarcoma found after removal of a prolapsing uterine mass, with no evidence of distant metastasis on imaging?

In a patient with HR B ALL and severe pancreatitis due to peg-asparaginase, how do you assess the impact of peg discontinuation on risk of relapse?

For patients not on study, would you consider replacing missed doses of peg with a non-asparaginase based chemotherapy?

Would you consider using DOACs in a young patient with SLE and Libman-Sacks endocarditis, who is negative for APS?

How do you approach hormone replacement therapy for premenopausal patients following pelvic radiation therapy?

How is your approach different from or similar to those who undergo surgical menopause?

How would you approach an adolescent patient with stage IIIC serous borderline tumor, s/p fertility sparing surgical staging with unilateral salpingo-oophorectromy, who presents with an enlarging contralateral ovarian mass and additional pelvic disease on imaging?

What are your recommendations for a male patient who was recently started on imatinib and wants to conceive?

What is the benefit of cytoreduction with Hydroxyurea for patients with newly diagnosed chronic phase CML with a WBC count >100 prior to the initiation of a TKI?

Which, if any, young/fit intermediate-risk AML patients would you not offer allogeneic transplant to in MRD- CR1?

What criteria is needed in relapsed/refractory B-cell ALL to choose CAR-T therapy over conventional stem cell transplant as destination therapy?

Is there any benefit to transplant patients with Ph+ ALL who have achieved MRD-negativity?

What is your approach to pediatric or AYA patients with B-cell ALL who relapse after CD-19 CAR-T?

In a patient with stage 1 mixed germ cell tumor who cleared tumor markers post-orchiectomy but with subsequent rise to borderline abnormal within 6 weeks, would you treat with 3 cycles BEP as for S1 disease?

If serum markers were normal, how strongly do you consider 1 cycle of BEP for embryonal predominant pathology?

For a young male with Stage III intermediate risk NSGCT with active 1 ppd smoking history but normal PFTs and DLCO results, would you still consider use of BEP x 4?

VIP can be considered, but given complex psychosocial issues and limited community cancer treatment resources, this question is being asked.

Do you treat stage 1 non-seminoma differently if there is a component of embryonal carcinoma?

Do you routinely check Pulmonary function testing prior to each cycle of BEP for young patients with testicular cancer with no pulmonary risk factors?

NCCN guidelines state check at baseline and then as clinically indicated. Some other sources state, can check prior to each cycle of BEP? What ...

How would you treat a pediatric or AYA patient with Ph-like ALL with induction failure?

How do you approach therapy for a patient with stage IIIA NSGCT who received 4 cycles of EP followed by RPLND which revealed residual mixed teratoma and embryonal carcinoma?

Given persistent embryonal histology on RPLND, do you favor observation or TIP/VIP? What do you use to guide your decision?

How would you treat a young patient with classical intermediate-risk Hodgkin lymphoma who has an underlying DNA repair-deficiency disorder, such as congenital mismatch repair disorder or ataxia telangiectasia?

How does your treatment approach vary depending on the underlying predisposition?

When do you offer adjuvant radiation therapy for high grade non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) in a skeletally mature teenager or young adult?

Individuals often cite ARST0332 to justify radiation omission in high grade R0 resections, but R0 was defined as > 5 mm margins.

Do you recommend menstrual suppression for post-menarchal adolescents and young adults receiving myelosuppressive chemotherapy?

If yes, by what mechanism?

How do you approach treatment of metastatic hepatocellular carcinoma in an adolescent?

Would you offer liver transplant in the setting of metastatic disease?

What is the role of upfront addition of an ALK inhibitor in an ALK positive mature B Cell lymphoma in an AYA patient?

What is the preferred treatment regimen for an adolescent or young adult patient with treatment-related AML?

How long should patients treated with frontline therapy for Hodgkin lymphoma wait before attempting to conceive a child?

Do your recommendations differ between those who receive ABVD and escalated BEACOPP? Do you recommend consultation with fertility specialists for all...

How do you approach treatment of a glioblastoma in pregnancy?

How would you manage metastatic alveolar soft part sarcoma in an young patient failing TKI?

How do you incorporate PD-L1 blockade?

Under what circumstances would you consider anticoagulation in a young female patient with persistently elevated factor XI activity?

While this is a known risk factor for venous [Meijers et al NEJM 2000] and potentially arterial [Yang et al, Am J Clin Pathol 2006] thrombosis, it is ...

What is the preferred regimen for AYA patients with T-Cell Lymphoblastic Lymphoma?

What strategies have you found to be most effective in engaging PCPs in a primary-care or shared-care model of survivorship for pediatric and AYA patients who will receive ongoing care in their communities away from their primary oncology treatment site?

In follow up to @Jacqueline Casillas presentation at ASCO 2021 regarding models of survivorship care delivery for AYA patients.

How is pediatric and young adult primary bone lymphoma risk stratified?

NCCN guideline V4.2021 DLBCL page BCEL-3 states stage I-II, bulky >= 7.5cm should be treated with 6 cycles of RCHOP, but most bone lymphoma studies...

How do you approach contraception and pregnancy counseling in women of childbearing age with Desmoid tumors who may be contemplating future pregnancy?

Since desmoid tumors are associated with high estrogen states, is there an optimal contraception approach? Is there an optimal time for pregnancy? How...

Should targeted therapies such as Brentuximab or Crizotinib be used in the upfront management of anaplastic large cell lymphoma in a pediatric or AYA patient?

Would you recommend hematopoietic stem cell transplant for AYAs with Ph-like ALL?

How would you counsel a young female patient who refuses to use contraception during radiotherapy?

Would your counseling change if she reported a history of unplanned pregnancy? Is there any wording or waiver you might be able to use warning her of ...

What additional testing, if any, should be performed for an adolescent patient with heavy menstrual bleeding and a negative von Willebrand disease evaluation?

What is your approach for salvage therapy in a patient with Relapsed/Refractory Primary Mediastinal B-Cell Lymphoma that has received a Rituximab-containing upfront regimen?

Should end-of-therapy echocardiograms be obtained for AYA patients with sarcomas who have received high-dose anthracyclines?

At what frequency and for how long should echos be monitored?

Is dexrazoxane recommended for cardioprotection in AYA patients with Hodgkin lymphoma who are receiving anthracyclines as part of their upfront therapy?

Is there utility in metronomic chemotherapy in adolescent and young adult patients with refractory sarcoma?

Can an AYA patient with newly diagnosed AML safely sperm bank after starting cytoreduction with hydroxyurea or cytarabine?

How would you modify Ewing sarcoma chemotherapy and timing of dialysis for a dialysis-dependent patient?

How would you treat an adolescent or young adult with newly diagnosed hepatosplenic T-cell lymphoma?

How would you incorporate whole abdomen radiation therapy after cytoreduction in an AYA patient with desmoplastic small round cell tumor?

What if the patient had also received HIPEC prior?

How do you approach the pharmacologic management of cancer-related fatigue?

After optimizing symptoms and reversible factors, and attempting cognitive-behavioral interventions and exercise, do you recommend pharmacologic agent...

How would you approach therapy for a young, fit patient with alveolar rhabdomyosarcoma involving the anterior nasal vault/sinuses in the absence of available clinical trials?

Presented with mass projecting into right/left anterior ethmoid complex

How would you approach treatment in an otherwise young, fit patient with transformed AML currently in remission with a plan for transplant and was found to have an invasive fungal infection not amenable to resection upon recovery from induction?

Would you consider “bridging” therapy with something like an HMA?

What are the options of induction treatment of young AML patients who are on CRRT, continuous renal replacement therapy ?

For pre-menopausal female patients who present with acute leukemia in need of urgent anti-neoplastic therapy, what is your preferred approach in effort to preserve fertility?

Does acute leukemia sub-type affect your decision?

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

What are there most evidence-based options?

How would you treat a stage 1a Sertoli-Leydig cell tumor with heterologous elements?

Would you recommend prophylactic cranial irradiation (PCI) for a teenager with a T cell acute lymphoblastic leukemia in remission?

If so, what dose would you recommend?

How do you determine whether to treat a young adult with stage IA Hodgkin Lymphoma with the adult or pediatric treatment paradigm?

At what age would you treat an early stage hodgkins lymphoma patient with ABVD + RT (adult treatment) vs OEPA x 2 or AV-PC x 3 (pediatric paradigm)?&n...

Do you offer fertility preservation to patients prior to CAR-T therapy?

Do you limit it to post-pubertal patients? Do you offer it only if they will proceed with bone marrow transplantation after CAR-T?

How do you treat a patient with a history of clinical stage IIb cN2, mixed germ cell embryonal carcinoma treated with BEP and RPLND five years ago, who now has signet ring cell adenocarcinoma with abdominal carcinomatosis with an unknown primary?

GI work up negative. NGS cancer type and isochromosome 12p ordered and pending. Pathology at RPLND was negative for cancer.

What techniques do you use to address fertility preservation in young female patients being treated with chemoradiation therapy for cancer in the pelvis?

How do you prevent early menopause in women? Please comment on freezing of eggs, oophopexy, supine vs prone position, vaginal dialator.

Do you have preferred regimens for young patients (<30 y/o) with early stage DLBCL?

Guidelines indicate RCHOPx3 +RT as category I and RCHOP x 6 below that; long term f/u for SWOG 8736 showed similar PFS and OS. Do you have and approac...

How does the management of nasopharyngeal cancer in kids/young adults differ from adult patients?

-The data on induction for adult H&N ca has been mixed (excluded NPX) but recent data suggest a benefit for adult NPX. -Given that this is standa...

Is there a subset of breast cancer patients who may benefit more from GnRH analogs for fertility preservation compared to others?

How do you approach and counsel women with high risk, early stage breast cancer requiring chemotherapy for whom fertility preservation is a major concern?

When treating younger men with anal cancer do you consider dose to the prostate?

Given risk of secondary malignancies do you make an effort to avoid/spare the prostate or give any specific dose constraints when treating young men w...

What rates of radiation-induced secondary malignancies do you typically quote to patients in their 30s-40s?

It seems that we have increasingly been seeing younger patients with breast and rectal cancers. What rates of radiation-caused secondary maligna...

What are your indications for treating a pelvic desmoid tumor in a young woman concerned with fertility?

When do you suggest ovarian suppression for fertility preservation in premenopausal women receiving neo/adjuvant chemotherapy?

Do you reserve this approach for only women with triple negative breast cancer or all-comers?

Would especially young age (eg 20's) influence your recommendation for breast conservation vs mastectomy in an early stage breast cancer?