NHL | 71 | New Dx

71yo fairly healthy M (ECOG 1) who presented with unintentional weight loss, fatigue, and progressive swelling of left neck and shoulder.PET with extensive bulky conglomerate FDG-avidity throughout right neck, supraclavicular region, right shoulder including scapula with a pathological fracture, upper arm, with additional hypermetabolic adenopathy of left neck. Spleen enlarged to 15.5cm but without hypermetabolism.Biopsy of R neck mass with CD5-/CD10- small B-cell lymphoma. No large cell component seen. Cyclin D1 and BCL 6 negative. LPL vs MZL. MYD88 negative.

Heme | 45 | New Dx

Middle-aged man with idiopathic HES (negative workup including bone marrow studies, gene testing). No PDGFR mutation though has NF1 mutation, and there are case reports of an association. Regardless, I started mepolizumab with minimal response (WBC 23, eos 22%->WBC 25, eos 10%). No improvement with Hydrea 500 mg twice daily, unable to tolerate higher doses, and now unable to tolerate imatinib 400 mg daily. Any ideas of what else I should try?

H&N | 46 | New Dx

46 year old male with left parotid salivary gland tumor s/p left total parotidectomy and radical neck dissection. Final path: high grade MEC with mets to 5/9 LN, +margins, pathological staging is pT4a pN3b, no distant mets on PET. Patient is being referred for consideration of adjuvant chemoRT. While there is clear data supporting adjuvant RT, i am less clear on the benefit of adding chemo and NCCN lists this as category 2B. What are your thoughts? Although young and fit patient with many high risk features, there is limited data if any outlining benefit of adding platinum chemo hence Im looking for some guidance.

Esophagus | 65

65yr female with metastatic poorly diff esophageal adeno who is progressing after 3 months of FOLFOX/nivo with overt intra-abd disease. Caris- MET amplified, PDL1 60%, Her2 0, ARID1A and RHOA mutated. What would you offer next? Excellent PS.

CLL | R/R

Pt with CLL for many years, not on treatment, asymptomatic, with counts between 100k-150k that doubled in a day to 300k

CRC | Age 68 | New Dx

68-year-old female with High Risk Stage II Colon Cancer - Right Sided - p MMR intact pT3pN0 s/p Right colectomy earlier this year with only LVI as high risk feature