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Would you consider a treatment holiday in a patient with HR+ oligometastatic breast cancer who is in a prolonged remission?
The patient initially received definitive therapy with AC-T and RT to the breast as well as RT to a solitary bone lesion. She has been on AI for the last 20 years with no evidence of disease. What is the optimal duration of endocrine therapy?
Answer from: Medical Oncologist at Academic Institution
Obviously, we have little data to guide our approach here. However, I would feel a bit uncomfortable holding the patient's AI but would consider it in certain situations, such as the patient having toxicities that are difficult to tolerate. In that situation, I would consider an alternative endocrin...
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Answer from: Medical Oncologist at Community Practice
I agree with the fact that there is little evidence to guide medical decision making in this particular case. This would constitute an ideal case whereby circulating tumor DNA could potentially inform medical decision-making.The dichotomy between metastatic versus nonmetastatic disease is seriously ...
Answer from: Medical Oncologist at Community Practice
If she is tolerating treatment and has no complications from it, I would continue. If she has significant side effects and wanted to stop, I think that would be completely reasonable.
I do agree with @Christos Vaklavas that sometimes getting surveillance imaging covered in these cases can be challe...