Lung | Age 50 | R/R

50yo man with metastatic ALK+ adenocarcinoma of the lung who progressed on crizotinib (was on this for two years) and alectinib (was on this for 4 years). He is now on lorlatinib and wanted to ask about prognosis. We found some studies that suggested a 9 month progression free survival for lorlatinib, but is there more helpful information you may know?

AML | Age 38 | New Dx

38 y/o F with favorable risk AML, biallelic CEBPA and RAD21 E148, normal karyotype, who I inherited post-induction (FLAG-IDA-VEN) from another institution due to insurance issues. Achieved a CR. I am planning HiDAC consolidation. Would you consider adding gemtuzumab even though she did not receive it with induction?

CLL | New Dx

73 yo man with recent diagnosis of CLL who has received 3 doses of obinituzumab with robust cytoreduction, WBC dropped from 250 to 5. He still have bulky lymphadenopathy in axilla and inguinal area. I wanted to start venetoclax or BTKi but any oral therapy is cost prohibitive. What IV therapy would you recommend?

Heme | Age 71

Refractory ITP 71-year-old male Afib, PAD, on methotrexate golimumab for psoriatic arthritis presented with thrombocytopenia, IPF fraction was high, thrombocytopenia determined to be in setting of ITP. Tried steroids and IVIG. Next my plan was to have him start rituximab from next week, however hepatitis surface antibody and core antibody positive. Would you recommend starting him on rituximab or Romiplostin next?

NHL

Could you guide me with the management of mucositis? I know it is a step-up approach and we usually start up with topical solutions such as Maalox Benadryl lidocaine. Then there is role of oral suctioning and oral hygiene. My patient is having gag reflex with all of these. Are there any other topical options we could consider?

GYN | Age 77 | New Dx

Patient with 2cm FIGO Grade 1 endometrioid adenocarcinoma with tumor invading > 50% of myometrial depth. Cervical stromal invasion and extensive (>3 vessel) lymphovascular invasion were seen. Negative margins. pT2Nx FIGO stage II. Molecular markers with pMMR, wild type p53, POLE testing pending, ER 91-100%, PR 71-80%, HER2 0+. Would you consider completion lymphadenectomy or move on to adjuvant EBRT?