Medical Oncology

UCSF

Questions discussed in this category

For muscle-invasive bladder cancer with predominant (>90%) squamous differentiation, would you consider cisplatin-based neoadjuvant chemotherapy prior to radical cystectomy or upfront surgery?

Would a PET avid pelvic lymph node without distant metastatic disease change your management?

1 Answer available

How would you approach therapy for a patient with smoldering multiple myeloma whose light chain ratio has increased to greater than 100 over several years in the absence of any other myeloma-defining events?

Does a progressing kappa/lambda ratio > 100 at any point in time warrant treatment, or does one wait to treat patients in the setting of a slowly i...

2 Answers available

For patients with mild CKD, how do you decide between zoledronic acid and denosumab for bone protection in patients with multiple myeloma?

For pts w/ eGFR between 30-60

1 Answer available

How do you approach patients with recurrent grade 3+ neutropenia on IMiD-containing regimens (e.g., VRd or KRd) beyond dose reductions?

For example: shorten IMiD duration each cycle, add scheduled G-CSF, add antibacterial prophylaxis, etc.

1 Answer available

What treatment would you consider for small cell neuroendocrine carcinoma of the bladder with a metastatic recurrence within 3 months of neoadjuvant cisplatin/etoposide followed by radical cystectomy (ypT0N0)?

NGS of TURBT specimen had high TMB (18 Muts/Mb).

2 Answers available

What is the optimal prophylaxis regimen to use prior to a selinexor based regimen in the treatment of multiple myeloma for nausea and electrolyte abnormalities?

2 Answers available

How would you manage metastatic small cell/neuroendocrine bladder cancer after response to 6 cycles of platinum/etoposide?

If any clinical benefit (ie. CR, PR or SD) would you consider switch maintenance avelumab, surveillance until progression, or an alternate regimen?

1 Answer available

What treatment would you consider for metastatic urachal carcinoma following progression on FOLFOX and FOLFIRI?

Molecular profiling revealed no targetable alterations, however tumor mutational burden was >10 mut/Mb.

1 Answer available

What is your preferred regimen for metastatic clear cell RCC following progression on IO/TKI?

Patient has progression of liver metastases while on pembrolzumab/axitinib. ECOG PS 1 and limited comorbidities.

3 Answers available

Would you move to a venetoclax-based regimen for a patient with pentarefractory MM and t(11;14) translocation, previously treated with bortezomib and carfilzomib?

If so, venetoclax/dexamethasone by itself or do you include a PI?

2 Answers available

Would you give adjuvant therapy for a urothelial carcinoma T2 on TURBT but pTis at margins on cystectomy?

Patient has not had any prior systemic treatment and is cisplatin-eligible.

1 Answer available

What is the preferred adjuvant therapy for high-risk non-clear cell RCC?

1 Answer available

Would you consider radical prostatectomy for a young male with unfavorable intermediate risk cT3a prostate cancer and PSMA PET concerning for regional lymph nodes involvement but negative conventional imaging?

Gleason 4+3=7 and PSA 4

3 Answers available

In a patient with metastatic clear cell RCC who achieved a prolonged PR with first line nivolumab/ipilimumab, discontinued due to IRAEs, would you consider a TKI/checkpoint inhibitor combination regimen?

In this case, nivo/ipi discontinued for immune-related arthralgias requiring steroids and an anti-TNFa agent, now off all immunosuppression.

1 Answer available

When would you recommend adjuvant therapy for a patient with urethral adenocarcinoma after partial urethrectomy?

What clinicopathological features would need to be present for you to recommend adjuvant chemotherapy? Would you treat pT3 disease? Any specific histo...

2 Answers available

For persistent PSA elevation after prostatectomy, would you recommend salvage radiation if pathologically negative nodes, but regional and non-regional lymphadenopathy on PSMA PET?

Specifically, would you offer salvage radiation to a patient who underwent a prostatectomy with PLND and had a post-op PSA of 12 with pathology reveal...

2 Answers available

For a patient on dialysis with metastatic clear cell renal cancer, what regimen would you use after front line immunotherapy?

1 Answer available

Would you use maintenance avelumab for a patient with metastatic urothelial carcinoma who progressed on first-line pembrolizumab, then had stable disease after at least four cycles of second-line carboplatin plus gemcitabine?

Would it change your decision if they had progressed on a first-line trial with cisplatin followed by pembrolizumab plus enfortumab vedotin maintenanc...

1 Answer available