MPN | Age 77 | R/R

77 yo M patient with history of JAK2 positive myelofibrosis diagnosed in 2014. Recent bone marrow biopsy showed progression of myelofibrosis with JAK2, ASX1, and TET2 mutations. Karyotype interestingly showed a 9;22 translocation. Can MF obtain this mutation or has new CML developed?

GU Cancer | Age 76 | R/R

What would be your first line of systemic therapy for a 76YM with locally recurrent urothelial carcinoma of the bladder/ureter post-cystectomy and does not appear to be a cisplatin candidate?

Breast Cancer | Age 60 | New Dx

60 year old breast cancer patient. We are considering introducing pembrolizumab (her PD-L1 (22C3) CPS is 40) but are concerned about her history of myocarditis. Of note, she also has PALB2 mutation. Wondering what your thoughts would be regarding adjuvant pembrolizumab vs PARPi.

Multiple Myeloma | Age 54 | R/R

54 yo female with clinically aggressive myeloma diagnosed in 2021 (FISH at diagnosis with gain 1q). Treated across a number of different therapies. Recently progressed with no organ failure so far and relatively OK performance status. What would you consider as the next therapeutic steps?

GI Cancer | Age 64 | New Dx

64 y/o male patient with metastatic pancreatic cancer, currently receiving palliative mFOLFIRINOX. He continues to have significant abdominal pain related to his cancer despite using his fentanyl patch, Oxycodone PRN, and gabapentin. I was considering palliative RT for relief of symptoms but have seen mixed opinions in literature. Would you recommend RT or another form of therapy (e.g. celiac nerve block?)?

MPN | Age 40 | New Dx

40 year old female with CML who has been on Imatinib for one year with CMR. She developed dyspnea recently and an echocardiogram showed a posterior focal pericardial effusion. She was seen by cardiology and started on prednisone and colchicine. I stopped imatinib now and it seems that most TKI have a risk for pericardial effusion. In this situation, you would consider trying pericardiocentesis and biopsy? What is the best way to deal with pericardial effusions from imatinib?