Small cell lung cancer   

Is there objective evidence demonstrating a benefit of consolidative durvalumab or prophylactic cranial irradiation in patients with stage I small cel...

Would you consider it for a patient who had bulky thoracic disease, with limited extrathoracic disease at diagnosis and achieved a CR after induction ...

What clinical factors do you take into consideration? Would you recommend chemo-immunotherapy regimens for a fit patient who relapses at 6 mos post-t...

Does tumor size, age, or performance status play a role in your decision-making?

This has become standard practice at our institution for patients with a good performance status, with whole brain radiotherapy given after the comple...

Would the timing of the relapse (eg within 6 months) impact your decision making?

In elderly patients (>70-75) with a good performance status, does the risk of neurocognitive decline outweigh the benefit of PCI?

If yes, do you recommend it be given concurrently with chemotherapy or sequentially? What is your target volume and dose?

Would you offer topotecan, lurbinectedin, or another agent given the CNS progression as well? 

Given that prophylactic cranial irradiation (PCI) has been shown to decrease the incidence of symptomatic brain metastases in patients with extensive ...

Patient is <60 years old 

Are you routinely performing molecular sequencing? Would you modify your treatment approach in first or later lines based on PDL1 status?

If so, do you allow a period of "washout" between immunotherapy and radiation?

How do you decide between supportive care v. chemoimmunotherapy? Is there a threshold of disease burden that would push you towards recommending hospi...

Would you differentiate between patients with measurable disease vs NED?  Are there specific data to guide us?

E.g. chemo/durvalumab vs chemo/atezolizumab?  

What are the risks of infection with COVID-19 if using immunotherapy?  

If you are using a standard 30/10 fractionation, is there a benefit to keeping chemo on board for radio-sensitization?

Would you consider adding atezolizumab to a cisplatin/irinotecan regimen, or cisplatin instead of carboplatin?

Does your practice differ based on limited or extensive stage disease?

Has the publication of IMpower133 changed standard of care?

Would you repeat PET or is it adequate to change to CT surveillance? Although surveillance PET/CT is not recommended by NCCN guidelines, these are oft...

Or would you wait to start coincident with the start of cycle 2? If a shorter time from the start of any therapy to the end of radiation (SER) is sign...