Liver Tumors   

For what duration and is there a preferred anticoagulation agent?

Would you treat as cholangiocarcinoma with a gemcitabine/platinum regimen or would you use a more HCC regimen like atezo/bev or durva/trem?

The Mayo Clinic protocol recommends initial fields -1.5 Gy BID initially to 45 Gy followed by a Brachytherapy boost. If HDR /LDR is not available, wha...

Are there factors which would make you more likely to use atezo/bev vs durva/treme vs TKI?

If so, what regimen? At what point is it safe to start chemo in a freshly transplanted liver?

From NCCN (Rectal MS-33): SBRT is a reasonable option for patients who cannot be resected or ablated. What is the role of SBRT versus microwave ablat...

Is liquid biopsy helpful? Would you treat if this shows somatic mutation?

Will the results of the recently published randomized comparison of proton beam therapy (PBT) vs. transarterial chemoembolization (TACE) change the wa...

If the patient had PSC and baseline atrophy preventing brachytherapy boost (received SBRT boost instead), would this change your threshold for stentin...

No evidence of distant disease elsewhere. Surgical resection is not possible. Would you recommend metastasis direct therapy to the liver (i.e. SBRT or...

What contraindications or concerns do you have in this scenario beyond assessing the Child Pugh Score?

If borderline resectable, can the TOPAZ regimen be considered for downstaging effects?

How would you balance the OS benefit from TOPAZ-1 with the risks of immunotherapy in this or other high-risk populations?

How do you sequence systemic treatment options for in patients with Child's Pugh B (or greater) in context of IMbrave150 and HIMALAYA? When do you in...

Previously untreated

Would the etiology of HCC affect your decision, e.g. non-viral hepatitis since less benefit was shown for this group in IMbrave150?

What factors make you more likely to offer or omit chemotherapy?

Biopsy of other sites is more consistent with carcinoid tumor.

Would you try atezolizumab/bevacizumab or switch to a TKI?

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

i.e. EGD surveillance for varices?

What parameters do you use to decide to treat beyond progression? Is there any efficacy data from this specific study subgroup in IMbrave150?

In light of the SIRveNIB trial results and now IMbrave150, what is the role of intra-arterial therapy now?

Do you screen even asymptomatic patients?

What are there most evidence-based options?

Would you consider single agent IO such as Nivolumab, given data are not strong (Checkmate 459)?

Is there a "best" way to approach treatment of the viral infection i.e concurrently with therapy, prior to therapy, delayed or post therapy? Does this...

Would you alter your SBRT dose? How long would you hold the VEGF inhibitor before and after? Does the primary matter (e.g. NSCLC vs. colorectal)?

A number of phase 2 trials support various combinations (e.g. gem/ox, cape/cis, cape/ox, 5-FU based) -- how do you decide either between these regimen...

Does the Child Pugh score factor in your treatment decision, i.e. Child Pugh score C?

Currently, nivolumab is approved as a second line systemic therapy for patients with metastatic HCC with Child-Pugh (CP) A-B7 based on results fr...

Do you offer chemotherapy upfront in all patients or only if borderline resectable/unresectable?  If you treat, what regimen do you use and how l...

Is there data for switching from nivolumab/ipilimumab to pembrolizumab if a patient develops significant pneumonitis but also had a significant radiog...

If so, how would HIV/Hepatitis status affect you decision?

What immunosuppressive agents are used and in what order?  Does your approach differ depending on the organ involved, e.g. colitis vs. pneumoniti...

How do you weigh the recently presented/published data from the NETTER-1 and RADIANT-4 trials in your decision making?

Is salvage liver resection considered the next step in treatment for patients who may have resectable tumors after TACE?  If so, do specific tumo...

Does the risk of severe inflammation of the liver lead you to choose other therapies in in this population?  What about in patients with mild liv...