How would you approach a patient with well controlled metastatic lung cancer who develops a new primary P16 positive oropharyngeal squamous cell carcinoma?
Is it reasonable to dose de-escalate since survival will likely depend on the metastatic lung cancer?
Answer from: Medical Oncologist at Community Practice
Multiple primaries are not uncommon. Given tremendous advances in treatments of advanced lung cancer and consequent improvement in overall survival, it is important to focus on screening, early detection, and curative-intent of other cancers whenever applicable. This seems to be one such situation.
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Answer from: Medical Oncologist at Academic Institution
Treatment of this patient's p16+ oropharynx primary would depend on a few factors. One, how well is this patient's lung cancer controlled? Moreover, if the cancer has a prolonged PF interval due to a response induced by a checkpoint inhibitor or perhaps a RET targeted therapy? If so, then I may cons...