Stampede: RT for M1 PCA—> OS benefit

[Ray D. Ayshun]

Maybe talk to your urologists?

Seeing them is not the issue. More a matter of mixed messages. The medonc isn't convinced the side effects are worth the unclear benefit.

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[Palex80]

The medonc isn't convinced the side effects are worth the unclear benefit.

There are practically no side effects ...

 

[Ray D. Ayshun]

There are practically no side effects ...

That too...but I won't fault him for ignorance there. On the other hand, there seems to be good data supporting it. And it's recommended, rt to the primary that is, in a somewhat confusing manner by nccn.

 

[evilbooyaa]

The main push back I get about stampede is that not all patients received abi or enza which would now be SoC. I still try to push for it but try to explain we can't rerun trials with every new thing but rather more as a proof of concept.

 

[ramsesthenice]

Seeing them is not the issue. More a matter of mixed messages. The medonc isn't convinced the side effects are worth the unclear benefit.

Maybe remind the med onc if they live longer that is more time to charge for systemic therapy

On my end, I have the opposite issue. More often I end up saying I think they are pushing the envelope too far with who they want me to see. It’s a great problem to have.

 

[SneakyBooger]

And any GBM treatment is palliative, but then again, it‘s a matter of perception and how you call things.

A patient newly diagnosed with GBM asked me this summer what the chance is the tumor will not come back. I said „practically 0%“. What would you say?

Though I generally agree with your sentiment, 16 years ago I treated a gentleman for GBM with 3DCRT, 2 resections, and 2 courses of SRS. I lost him to followup and thought he was dead. His wife came in for consult the other day and there he was. He is still working as a contractor.

So you just never know.

 

[evilbooyaa]

Though I generally agree with your sentiment, 16 years ago I treated a gentleman for GBM with 3DCRT, 2 resections, and 2 courses of SRS. I lost him to followup and thought he was dead. His wife came in for consult the other day and there he was. He is still working as a contractor.

So you just never know.

Agreed. It is very poor prognosis but we cannot and should not call GBM chance of cure 0%.

 

[Burt Radnolds]

Though I generally agree with your sentiment, 16 years ago I treated a gentleman for GBM with 3DCRT, 2 resections, and 2 courses of SRS. I lost him to followup and thought he was dead. His wife came in for consult the other day and there he was. He is still working as a contractor.

So you just never know.

Have the path reviewed

 

[SneakyBooger]

Have the path reviewed

Both resections confirmed GBM including review at outside institutions.

 

[Palex80]

Both resections confirmed GBM including review at outside institutions.

The plot thickens!

Although I understand your point, I presume you have seen more than 100 GBM patients in your career. And this is the only example, you can think of, making the odds to survive a GBM <1%, which "practically" means 0%,

 

[Ray D. Ayshun]

Both resections confirmed GBM including review at outside institutions.

Has the patient ever had any other cancers?

 

[SneakyBooger]

Has the patient ever had any other cancers?

No

 

[Neuronix]

Pleomorphic xanthoastrocytoma is a more recently described GBM mimic that used to get confused frequently in the past. Could have been one of those.

 

[seper]

Every oncologist has a story about a miracle. Some are true, some are not. They keep us going