Medical Oncology

Gynecologic Cancers   

Questions discussed in this category


The patient has a history of pelvic radiation and progressed through first line carboplatin/taxol. She has had a partial response to pembro/lenvatinib...

How do you "have the talk" in a way that is straightforward without emotionally crushing the patient?

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice? ...

How does the presence of specific mutations affect your adjuvant treatment planning or patient counseling?

Given data from metastatic breast cancer trials that show benefit with continuing trastuzumab despite progression.

What is the impact among patients and providers? Has your documentation been adjusted now that patients can readily review?

Do you include pembrolizumab with platinum-taxane + bevacizumab or reserve it as a second line option?

Do you try to keep Hb> 10 or 12? Or somewhere in between? 

Do you prophylactically start all patients on B12, B-complex, and/or omega-3? If so, what dose? What about ice mittens and booties?

Genes such as ATM, CHEK2, PALB2, RAD51C/D, BRIP1 seem to show some potential increased risk of ovarian cancer. Should these patients under prophylacti...

History of CDH1 mutation and prophylactic gastrectomy in 2017 - no other primary site found beyond vagina at diagnosis. Vaginal tumor completely resp...

How do you manage the initial event, including length of steroid taper and the role of pancreatic enzyme monitoring? What is your experience of subse...

Previously received pelvic EBRT and intracavitary brachytherapy. IORT was administered to the node-positive side wall at the time of exenteration.

Initially treated with definitive chemoRT but recurred with distant mets. Completed 6 cycles carb/tax/bev with minimal toxicity. Excellent performance...

Recurrence was 2cm and PET confirmed local. Excision with positive margins. Current plan for salvage whole pelvic RT and vaginal cuff brachytherapy +/...

s/p optimal debulking. If this was an early-stage cancer would it change your adjuvant therapy recommendations?

Recurrence picked up incidentally on CT. No germ line mutations, somatic tumor testing of node resulted negative. PET confirmed isolated recurrence

What non-pharmacological interventions do you recommend? Do you routinely prescribe prophylactic laxatives to patients initiating opioids? How do you ...

Does your practice vary based on risk status (low vs high risk) or specific mutation status (BRCA+ vs HRD+) given PAOLA subset analyses? 

I am considering every 6 week pembrolizumab dosing in patients >70 years old in whom I want to reduce clinic visits for, especially in the context ...

What specific platforms for determining somatic BRCA and HRD status do you use for a patient who does not carry a germline BRCA mutation?

How many cycles do you prefer before and after? How long do you tend to wait before starting radiation after initial chemo and after radiation to resu...

Specifically, are there strategies you use to 1) empower patients to participate in decision-making and 2) reassure patients who may be skeptical?

Do you use specific tools or take into account certain factors when considering treatment options for older adults?

Given recent approval of niraparib (Zejula) for the maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube, or prima...

Patient is 34yo and G0 referred from surgical oncology. Laparoscopic specimens of myoma and what appeared to be adhesions were significant for maligna...

There are mixed recommendations about re-testing vs simply waiting for a quarantine period prior to resuming therapy. 

Would you consider adjuvant chemotherapy, radiation therapy, hormone therapy, or surveillance?

After optimizing symptoms and reversible factors, and attempting cognitive-behavioral interventions and exercise, do you recommend pharmacologic agent...

This case involves an impressive ‘high volume’ vaginal recurrence and patient was not originally planned for adjuvant therapy. Concerned t...

Since no data exists or is pending, and the two disease processes are similar, should we consider PARP inhibition in this setting? This is assumi...

I care deeply about clinical trials but have always struggled on how to approach this topic. I would really appreciate tips from those of you who have...

This has been a common practice in the community. Is there a benefit for certain patients?

Can it be prevented? How do you evaluate patients? What non-pharmacologic or pharmacologic interventions do you use for treatment?

Obviously, patient and caregiver preferences are paramount. But, what factors do you consider? Does expanded hospice (e.g., Medicare Care Choices) inf...

How would you approach a patient who is receiving chemoRT but has confirmed COVID-19 with minor symptoms, as breaking treatment for 2 weeks quarantine...

When a physical exam is important and telehealth is not a good option, should we be proactive and reschedule or should we continue to see them as sche...

When, if ever, do you utilize adjuvant RT or chemotherapy?

Would you be more or less likely to use a cisplatin-containing regimen if a patient had previously responded to chemoradiation with concurrent cisplat...

Should this be done at the time of recurrence or after failure of 1st line therapy for recurrence?

The NCCN recommends either systemic therapy + brachytherapy or pelvic RT + brachy or brachy alone or observation. How do you decide among these option...

Given the recent press release regarding the update on the phase 3 soft tissue sarcoma study of LARTRUVO (olaratumab) showing no benefit to the combin...

Two new phase 2 studies this year with apatinib/oral etoposide (AEROC) and sorafenib/topotecan (TRIAS) were released, and NCCN also lists many single ...

Certainly ovarian cancer will respond to carboplatin and paclitaxel and it sounds like a reasonable chemotherapy to give to a stage IV NSCLC, however ...

In a patient who underwent laparoscopy for endometriosis and was found to have a 1mm focus of neuroendocrine tumor, would you recommend further surger...

Would you approach this situation as synchronous primaries (eg. FIGO IA in both) or as a locally advanced endometrial cancer (FIGO IIIA)? What adjuva...

Would you add chemotherapy if there was gross residual disease, pN+ and/or ECE?

Can the classic indications for post-hysterectomy radiation (eg. "Sedlis" and "Peter's" criteria) be applied? Does the histology change radiation dose...

My patient’s family has asked that I don’t tell her that she has metastatic cancer because it will devastate her. I am planning on palliat...


Papers discussed in this category


Gynecol Oncol, 2019 Aug 16

JAMA,

JAMA Netw Open, 2021 Apr 01

Gynecologic oncology, 2010-03

The New England journal of medicine, 2019-06-13

Lancet Oncol., 2019 Jul 22

Gynecol Oncol, 2019 Sep

Gynecologic oncology, 2004-04

American journal of obstetrics and gynecology, 2010-10

Obstetrics and gynecology, 1988-01

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2014-11

Gynecologic oncology, 2015-06

The Lancet. Oncology, 2017-09

Cancer, 1987-10-15

Gynecologic oncology, 2015-09

Curr Oncol Rep,

Adv Anat Pathol,

Gynecologic oncology, 2014-11

N Engl J Med, 2016 Feb 25

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-06-01

The New England journal of medicine, 2011-12-29

N Engl J Med, 2011 Dec 29

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-09-10

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-06-10

Lancet Oncol, 2017 Jun

Lancet (London, England), 2017-10-28

The New England journal of medicine, 2016-12-01

The New England journal of medicine, 2012-04-12

J. Clin. Oncol.,

J Clin Oncol, 2014 May 1

Int J Gynecol Cancer, 2018 Mar

Br. J. Cancer,

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2015-02

The New England journal of medicine, 2018-12-27

Gynecologic oncology, 2018-10

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-07-10

International journal of radiation oncology, biology, physics, 1994-06-15

International journal of radiation oncology, biology, physics, 2010-12-01

Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2010-06

Clinical cancer research : an official journal of the American Association for Cancer Research, 2015-12-15

N. Engl. J. Med., 2019 Sep 28

N Engl J Med, 2019 Dec 19

Science (New York, N.Y.), 2017-07-28

The New England journal of medicine, 2018-05-31

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-12-20

The New England journal of medicine, 2006-01-05

Lancet Oncol, 2013 Sep

J. Clin. Oncol., 2019 Apr 19

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-01-01

Lancet Oncol., 2014-06-01

Clinical cancer research : an official journal of the American Association for Cancer Research, 2017-02-01

Ann Surg Oncol, 2014 Aug

Cancer,

American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting, 2018-05-23

Acta Oncol, 2017 Apr 21

Lancet Oncol., 2017 Sep 04

Lancet Oncol., 2012 Sep 04

Cancer management and research, 2017

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-06-10

Br. J. Cancer, 2009 Feb 17

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2011-05

Lancet Oncol., 2020 Mar 03

Lancet, 2020 Feb 07

Lancet Oncol., 2020 Feb 14

Ann. Oncol., 2020 Mar 26

Current treatment options in oncology, 2018-11-15

Gynecol. Oncol., 2019 Oct 17

J Oncol Pharm Pract, 2020 Jan 06

Gynecologic oncology, 2007-05

Gynecol Oncol Rep, 2016 Dec 18

Gynecol Oncol,

BMC Cancer, 2019 Mar 11

Clin Cancer Res, 2017 Sep 27

Oncogene, 2020 Mar 02

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2000-01

Lancet, 2019 Nov 29

Lancet Oncol., 2014 Feb 28

Lancet,

Gynecologic oncology, 2009-08

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-04-01

Lancet Oncol.,

Br. J. Cancer, 2018 Oct 24

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011-04-10

Cancer journal (Sudbury, Mass.), 2007

The journal of supportive oncology, 2003

J Clin Oncol,

Breast Cancer (Dove Med Press), 2017 Jan 23

J. Clin. Oncol., 2011 Mar 28

BMC Cancer, 2017 Apr 28

Clinical cancer research : an official journal of the American Association for Cancer Research, 2018-02-15

N Engl J Med, 2019 Dec 19

J Clin Oncol, 2020 Apr 10

Nature, 2013-05-02

Gynecologic oncology, 2019-09

F1000Res, 2019 Jun 12

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013-09-01

Journal of the National Cancer Institute, 2013-08-21

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2010-02

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-07-20

Lancet Oncol., 2018 Feb 12

Ann. Rheum. Dis., 2019 Sep 20

Blood, 2008-05-15

The New England journal of medicine, 2019-02-21

J Thromb Haemost, 2019 Jul 28

N Engl J Med, 2018 Dec 04

Obstet Gynecol,

JAMA,

Cancer Prev Res (Phila), 2019 Aug 16

Lancet, 2010-03-06

Lancet,

Gynecol Oncol Rep, 2020 Jan 30

World J Surg Oncol, 2017 Jan 10

The New England journal of medicine, 2018-07-12

Breast J, 2019 Jul 04

Lancet Oncol, 2021 Mar 18

Lancet Oncol, 2015 Jun 23

N. Engl. J. Med.,

Lancet (London, England), 2017-10-07

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-06-10

J Clin Oncol, 2019 Nov 04

Lancet Oncol, 2021 Apr 09

Gynecologic oncology, 2016-01

Gynecol Oncol, 2020 Jul 9

Gynecol Oncol, 2020 Jul 25

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2000-04

Gynecologic oncology, 1998-08

EMBO Mol Med, 2020 Apr 29

J Oncol, 2020 Jun 24

Journal for immunotherapy of cancer, 2017-11-21

J Immunother Cancer, 2021 Feb

J Natl Compr Canc Netw,

Ann Oncol,

J Immunother Cancer,

J Immunother Cancer,

J Clin Oncol, 2021 Dec 20

Gynecologic oncology, 2019-06

Gynecol Oncol, 2021 Mar 05

Ann Oncol, 2021 Mar 18

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014-06-20

The Lancet. Oncology, 2014-02

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2004-06-01

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2004

Cochrane Database Syst Rev, 2011 Jun 15

Arch Gynecol Obstet, 2009 Mar 21

Strahlenther Onkol, 2011 Nov 17

Gynecol Oncol Res Pract, 2016 Jun 17

Gynecologic oncology, 2011-07

BMC Cancer, 2018 May 04

Gynecol Oncol, 2017 Sep 24

JAMA oncology, 2019-03-01

N Engl J Med, 2021 Sep 18

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2011-10

Journal of oncology practice, 2019-01

Support Care Cancer, 2021 Aug 16

Arthritis Rheumatol, 2021 Apr 01

Int J Gynecol Cancer, 2020 Dec 18

N Engl J Med, 2022 Jan 19

Gynecol Oncol, 2020 Nov 05

Cancer Cell, 2020 Oct 08

J Gen Intern Med, 2021 Feb 02

JAMA Netw Open, 2020 Jun 01

Practical radiation oncology, 2019-03

The Lancet. Oncology, 2019-05

Nat Commun, 2021 May 03

Blood Adv, 2017 Jun 22

Cancer medicine, 2018-06

Gynecologic oncology, 2015-03

Gynecologic oncology, 1999-02

Gynecol Oncol, 2017 May 19

N Engl J Med, 2009 Jun 10

Cancer Res, 2020 Jul 08

J Clin Oncol, 2022 Jun 06

Journal of hospital medicine, 2018-08-01

Gynecologic oncology, 2017-02

Lancet Oncol, 2014 Sep 28

Lancet Oncol, 2012 Nov 16

Lancet Oncol,

Arthritis care & research, 2018-10