Discover and read the best of Twitter Threads about #ASCO22

Most recents (24)

1/ A THREAD on what $PVCT achieved in 2022. #event #discovery #milestone #milepost. #rosebengal #rosebengalsodium.
2/ $PVCT 2023 Stockholder Letter (released January 9th). . #rosebengal #rosebengalsodium.
3/ $PVCT #clinical and #research collaborators made 6 presentations at 5 medical conferences about PV-10 for different cancers. #ENETS22 #AACR22 #ASCO22 #ISOO2022 #melanomabridge. #presentations. #rosebengal #rosebengalsodium.
Read 50 tweets
@TumorBoardTues @HwakeleeMD @manalipatelmd @jillfeldman4 @JackWestMD Alright lets go!
1/18 #TumorBoardTuesday #LCSM #OncTwitter
63 yo 👩🏻
🚭 never smoker
C/O: shortness of breath presents in 2017
PMH: None
🫁 PET: shows a RLL mass and pleural effusion
ECOG PS: 0
🔬cT2, cN2, pM1a (Stage IVA) lung adenoCA

🤨What is the next step?
@TumorBoardTues @HwakeleeMD @manalipatelmd @jillfeldman4 @JackWestMD 2/18 #TumorBoardTuesday #LCSM
Case continued..
🦠 Tissue NGS and IHC was sent 🧬
🔬 NGS: EGFR p.A767_V769dup; c.2300_2308dupCCAGCGTGG (exon 20 ins)
🔬 PD-L1 negative

🤨 What treatment plan do you initiate next? @HemOncFellows @OncBrothers @OncoAlert @lcsmchat
@TumorBoardTues @HwakeleeMD @manalipatelmd @jillfeldman4 @JackWestMD @HemOncFellows @OncBrothers @OncoAlert @lcsmchat 3/15.. #TumorBoardTuesday #LCSM
👩🏽‍🏫Mini tweetorial 1 👨🏽‍🏫
🚩🚩 for EGFR mutations
Types of EGFR mutations
🚩Classic Activating EGFR Mut
▫️L858R, del19-Outside US
🚩Uncommon EGFR Muts
▫️G719X, L861Q, S768I
🚩EGFR Exon 20 Ins: bit.ly/3nGc8Yp
@NatRevClinOncol
Read 16 tweets
@TumorBoardTues @ASCO @JohnEbbenMDPhD @SushmaJonna @HeekeMd #TumorBoardTuesday
#ASCO22 Biomarker Recap

😀Don't know about you all - but I had a great time at the meeting this year!

👉I will🔦a few biomarker based studies that caught my👁️

😉Did you notice that TWO of the plenary abstracts were for biomarker based trials‼️ Image
@TumorBoardTues @ASCO @JohnEbbenMDPhD @SushmaJonna @HeekeMd @pashtoonkasi @KReissMD @DrR_DUNNE @FogacciJoao @AJacomeMD @OncBrothers @oncologician @DrSteveMartin @stolaney1 #TumorBoardTuesday
#1⃣
✅Dr. Yoshino🧑‍🏫the results of the Ph 3 PARADIGM trial
➡️FOLFOX-Pani vs. FOLFOX-Bev for RAS WT left CRC
👉823 Pts

👏OS>with Pani 36.2 vs. 31.3 months
👏ORR also > with Pani 75% vs. 67%

🤔BUT the curves don't separate until 26 months❓

🔎Abstract #LBA1 Image
@TumorBoardTues @ASCO @JohnEbbenMDPhD @SushmaJonna @HeekeMd @pashtoonkasi @KReissMD @DrR_DUNNE @FogacciJoao @AJacomeMD @OncBrothers @oncologician @DrSteveMartin @stolaney1 #TumorBoardTuesday
#2⃣

✅Dr. Modi🧑‍🏫the results of the Ph 3 DESTINY-Breast04 trial
➡️T-DXd vs. SOC for HER-2 low metBreast Ca
👉557 Pts

👏PFS>with T-DXd 10.1 vs. 5.4 months
👏OS also > with T-DXd 23.9 vs. 17.5 months

🔎Abstract #LBA3 Image
Read 17 tweets
1/8 IT’S #TumorBoardTuesday CASE WRAP UP TIME!

🫁@NarjustFlorezMD @ShrutiPatelMD taught us about EGFR mutated #NSCLC & adjuvant therapy–rapidly changing field. Summary below!

👉Don’t forget to grab🆓#CME (AMA/MOC) w 2 quick❓ CME eval & rationale🔗: integrityce.com/tbteval Image
2/8 #TumorBoardTuesday
Thurs Case🎀

Take🏠-pt 1
We discussed #NSCLC & EGFRm
✅EGFR mutations:
🔹Female>Male;
🔹Never smoker >> smoker
✅NEED‼️NGS data‼️BEFORE systemic tx. Order panel of common EGFR muts if limited time.

We captured much of chat:
P1: twitter.com/i/events/15369…
2.33 #TumorBoardTuesday
Thurs Case🎀
Take🏠msgs:
✅Osimertinib= EGFRi w demonstrated DFS⬆️in adj setting; waiting on OS data
✅Osi best TKI (Drake says so), diff strategies for diff mutations (i.e. ex20)
✅THINK about side FX, including fertility

P2: twitter.com/i/events/15372…
Read 15 tweets
I would like to do my 2nd deep dive post #ASCO22 analysis on #ctDNA guided adjuvant therapy for pts with stage II colon cancer‼️

✳️The DYNAMIC trial is certainly step forward (kudos) ‼️But doesn’t answer many questions❗️@OncoAlert @manjuggm @CrcChange @TheColonClub Why ?👇
1️⃣ Firstly, the whole point of ctDNA is identification of MRD so to give RIGHT chemotherapy to RIGHT patients❗️

✳️Not only reduce adjuvant tx, but offer it to patients who may potentially miss that opportunity (such as offering folfox to a patient with ctDNA (+)T3N0 disease)❗️
2️⃣The DYNAMIC suggests we get same DFS rate whether we use ctDNA or conventional risks for decision‼️
✳️Then one would rightfully wonder why to use ctDNA over conventional clinicopathological criteria if we get same outcomes anyway by using MORE oxaliplation❓just to reduce 5FU❓
Read 8 tweets
Bispecific antibodies are showing unprecedented single agent activity in relapsed/refractory MM. There are several phase I trials in this setting, let’s see at the data shared at #ASCO22 and #EHA2022 with Teclistamab , Elranatamab and REGN5458 targeting BCMA and…
….Talquetamab targeting GPRC5D. Here is a quick summary of the data #CARTSM #ASCO22_SZU #MedIQ22ASCO Strong work by #mmsm peeps!!
Teclistamab SC showed a response rate of 63%, MRD- 27% at 10-5 via NGS, CRS ~70% (grade 1/2), ICANS 3 % (grade 1/2),median PFS 11.3 months, median DoR 18.4 months, median follow-up 14 months. ascopubs.org/doi/abs/10.120… #CARTSM #ASCO22 #ASCO22_SZU #MedIQ22ASCO #EHA2022
Read 10 tweets
Passi in avanti anche per il tumore al polmone non a piccole cellule (NSCLC) da #ASCO22: quando i pazienti (stadio IB a IIIA) vengono trattati con nivolumab (immunoterapico anti PD-1)+chemio, ottengono una risposta patologica completa con una riduzione dell'80% di recidive. 1/n
Interessanti i risultati che derivano dallo studio CheckMate-816 di fase 3 con un totale di 358 pazienti che apre scenari importanti nel trattamento in fase precoce (neoadiuvante) in quanto potrebbero aumentare non solo le guarigioni 2/n
ma anche le persone che possono accedere all'intervento almeno per la malattia localmente avanzata. clinicaltrials.gov/ct2/show/NCT02… 3/n
Read 6 tweets
My thoughts on the DETERMINATION trial in myeloma presented in the Plenary session of #ASCO22 and published simultaneously in @NEJM #ASCO22VR

1) This is not a trial of transplant vs no transplant.

2) It's ~ the 5th RCT of early vs delayed transplant
3) As with prior RCTs it shows prolonged PFS with early transplant but similar overall survival. That's because transplant works, but the timing doesn't matter as far as survival is concerned.

You do the same trial many times of course you are going to get the same results.
4) The timing is however affected by other factors besides survival.

Patient preference - some want to get it over with. Some want to love current life and do it later. We need to respect this.

Feasibility - some places cannot collect and store stem cells forever
Read 25 tweets
#ASCO22
✳️Happy to say there is great progress for patients with CRC‼️
@OncoAlert @ASCO @manjuggm @CrcChange‼️
Here is summary of some key studies 👇
1️⃣ Immune checkpoint inhibitor monothetapy with dostarlimab for MMR-D is certainly practice changing❗️

✳️Although long term outcomes are needed, no need to reinvent the wheel‼️

✳️ Once a deep response achieved in MMR-D CRC it is very durable even in metastatic setting ‼️
2️⃣ #ctDNA study (DYNAMIC) was my second favorite study ❗️

✳️ We are certainly in the right pathway to use #ctDNA however we have to be careful for false negative results in high risk population: T4 disease ‼️

✳️We need more trials to get more data ❗️Enroll COBRA/CIRCULATE
Read 16 tweets
This should be interesting as I am running a trial in clear cell cancer with colleagues @BrownOncology
Presented by my fellow Matt Hadfield at #ASCO22
This should be interesting as I am running a trial in clear cell cancer with colleagues @BrownOncology
Presented by my fellow Matt Hadfield at #ASCO22
Retrospective study suggests bevacizumab + chemo improved survival in people with ovarian clear cell carcinoma. Hypothesis generating for sure.
This study was a larger retrospective in Japan before and after Bev was approved.
Read 9 tweets
Next up #gyncsm #ASCO22 Ruxolitinib
Ruxolitinib = JACK 1/2 inhibitor. The IL-6/JAK/STAT3 implicated in the survival of cancer stem like cells. Inhibition of this axis may improve the activity of chemotherapy.
SO... "dispositioned to neoadjuvant chemotherapy" seems really weird to say. These volunteers were recommended to NACT.
Read 7 tweets
Novità pazzesche per il tumore al seno metastatico con bassa espressione di HER2: nello studio di fase3 DESTINY-Breast04, trastuzumab deruxtecan ha dimostrato una sopravvivenza libera da progressione e sopravvivenza globale superiori e clinicamente significative vs chemio. 1/n 🧵
Nel 2020 sono stati diagnosticati più di due milioni di casi di carcinoma mammario, con quasi 685.000 decessi a livello globale. HER2 è un recettore di membrana tirosin-chinasico ed è espresso sulla superficie delle cellule di molti tipi di tumore, in particolare mammario. 2/n
L’espressione di HER2 è viene determinata da un test di immunoistochimica (IHC) che misura la quantità di proteina HER2 sulla superficie di una cellula tumorale, e/o da un test di ibridazione in situ (ISH), che conta le copie del gene HER2 nelle cellule tumorali. 3/n
Read 7 tweets
A thread of my #ASCO22 #ASCO2022 videos for @Plenary_Session

I aim to be educational & what discussant should have said

Suggestions accepted in replies

#1 SHINE - I-BR vs BR, Mantle Cell PFS
#2 DYNAMIC - CT DNA guided Adjuvant CRC
#3 DESTINY BREAST-04
DYNAMIC
Non-inferiority margin 8.5%!!
CT DNA in Stage II
Oxaliplatin vs 5 FU
Guarantee you will learn something from this video 👇👇
DETERMINATION
No OS gain
QoL not better
Should we recommend transplant in CR1?
Read 4 tweets
I could access the page for #ASCO22 survivorship posters. My favorites:
Prevalence of frailty for middle-aged and older adults starting a new line of systemic cancer treatment: Is age just a number? 1/4
Pergolotti Ab 12054 P300
patient reported Geriatric Assess similar frailty
2/4 Effects of scalp cooling on hair preservation/hair regrowth in breast cancer therapy Brunner P 339 #ASCO22
50% patients w/taxane monotherapy grade 1 alopecia compared to 17% patients w/ anthracycline-taxane
Drop-out: 13% in CAP / 5% in NCAP group
No sig effect in regrowth
3/4 #ASCO22 Yoga intervention on distress indicators among diverse women /gyn , gi, &thoracic cancers Hanvey AB 12129
Mindfulness-based yoga intervention was associated with sig reductions in depressive symptoms, anxiety, & psychological distress related to Fear of Recurrence
Read 4 tweets
The ATLAS trial presented at #ASCO22
-Given design (3 drugs maint, and PFS as endpoint), answer was obvious.
-Low power to detect any survival difference
-No quality of life presented, suspect would be worse if properly measured in KRd arm
-Please don’t adopt in practice! #mmsm
Other thoughts:
-induction suboptimal by US standards, suspect benefit would be even less if len was given. Remember- that len based consolidation helps if induction regimen did not contain len (emn02-h095), but does NOT help if induction regimen contains len (STAMINA trial)
Presenter described treatment as well tolerated. There was a treatment related death in KRd arm. After randomization, 5 patient in len arm withdrew due to “patient decision/other” but 16 withdrew in KRd arm.

That’s informative censoring.And likely because KRd was tough to handle
Read 4 tweets
#ASCO22

✳️The standard of care for MMR-D rectal cancer is changing/changed❗️
✳️We should do all we can to avoid surgery for patients with MMR-D rectal cancer ❗️
✳️Although data is early and it is highly promising enough to move forward ‼️@asco @OncoAlert @MoffittNews
👇
✳️Perhaps important to note that 100% clinical response is not complete pathological response ‼️

✳️However this is higher than we achieved with OPRA in MSS rectal cancer ‼️

✳️Also, all patients had BRAF WT which is expected (Lynch cause more MMR-D rectal than sporadic event)
✳️As next step we should consider adding anti-CTLA4 blockade after seeing long term outcomes, if needed ‼️
✳️Very exciting time for patients with MMR-D CRC and great to see this change in this field and happy for our patients ‼️
Read 4 tweets
#ASCO22
✳️DYNAMIC trial results are highly exciting and glad to see field is moving forward !

✳️Very encouraging findings that we are in right pathway to use #ctDNA for adjuvant tx‼️

However there are important points that we need to address 👇@ASCO @OncoAlert @MoffittNews ImageImageImageImage
✳️Firstly, I am categorically against putting T4 and T3 disease into same pocket (stage II is highly heterogeneous)❗️

✳️Risk of peritoneal recurrence for T4 and T3 is not same and not even close ‼️

✳️Peritoneal microscopic disease doesn’t shed CtDNA as much as liver MRD‼️
✳️Moreover, control group was a bit vague in this study, conventional risk factors are used for ad therapy which can offer you different approaches ‼️

✳️Currently there is not consensus for high risk stage II in NCCN and options include observation vs FP alone or doublet ‼️
Read 7 tweets
TROLLEYS & ONCOLOGY

Every Ethics 101 student wrestles with the trolley problem.

In this exercise, you are placed by train tracks watching a runaway trolley race towards 5 people who are going to be crushed unless you intercede.

THREAD/
If you pull a lever, the trolley will divert on a different track, where it is bound to kill one person.

In this situation, is it better to be passive or active?

Should you pull the lever or not?

2/
While not quite as dramatic a scenario, a similarly freighted decision between inaction and intervention plays out in oncology clinics multiple times every day as doctors weigh the risks & benefits of adjuvant chemotherapy.

3/
Read 12 tweets
🧵 A little vignette for #ASCO22 attendees & esp speakers/chairs. Today I spoke in an Ed session. E350 is small enough I could see faces. When we began, most were in 😷, but I counted 11 who weren’t. One had a drink. The rest didn’t appear to be eating/drinking. Importantly… 1/
a few people (not sure if in 😷 or not) were coughing. That’s something you always hear, but it takes on added significance in a #pandemic because #COVIDisAirborne & current #Covidvariants spread as easily as measles, the most contagious respiratory pathogen on earth. /2
Before I began my talk, I called attention to the fact that I would be continuing to #WearAMask while speaking. #Covid19 doesn’t care that I’m at the #ASCO22 podium. I said I was speaking masked to model the #OncTwitter behavior I hope to see. /3
Read 8 tweets
🧵#ASCO22 Sessions at a Glance for #OncTwitter

Friday June 3 Image
#ASCO22 Saturday June 4 Image
#ASCO22 Sunday June 5 Image
Read 5 tweets
📢In preparation for #ASCO22, I wanted to present my list for the #PancreaticCancer abstracts to👀for @ASCO

Again,🙏note - I went through a LOT of abstracts, and I definitely may have missed some‼️
👉And these are not in any particular order

✅But enjoy, RT, and reply😀
#ASCO22 #PancreaticCancer
🤔Is more better❓
✅Dr. Carrato🧑‍🏫a Rand trial
👉Gem-nab-pac➡️FOLFOX (sequenced Q6 wks)
vs.
👉Standard Gem-nab-pac
➡️mOS was 3.5mos⬆️with sequenced Tx
➡️Even though more standard pts got 2nd line Tx
🤯Really❓
🤔Interesting
🔎GI Can Oral Abst 4022
#ASCO22 #PancreaticCancer
🤔Is more better❓
✅Similarly, Dr. Portalesa🧑‍🏫a Rand Ph2 "Trial in Progress" comparing:
👉Sequential gem-nab-pac➡️FFX
vs.
👉Standard FFX alone
➡️Primary objective is OS
🤔But really, what will be critical will be the OS
🔎Abst TPS4190, Poster 160a
Read 11 tweets
#TumorBoardTuesday #ASCO2022

📢@ASCO is only a few days away & we really wanted to put out our top abstracts to👀for

🙏note - we viewed several thousand titles - so we definitely may have missed some‼️
👉And these are not in any particular order

✅But enjoy, RT, and reply😀
#TumorBoardTuesday #ASCO2022
"Emerging"🎯💊
✅Dr. Jones👨‍🏫the Ph2 FAKTION trial of fulv/capi vs fulv/placebo for Breast Ca
➡️Capi⬆️mOS by 6 mos
➡️This⬆️jumped to 19 ms if the tumor harbored PIK3CA or AKT1 activating OR PTEN inactivating🧬mutations
🔎Breast Ca Oral Abstract # 1005
#TumorBoardTuesday #ASCO2022
"Emerging"🎯💊
✅Dr. Rixe👨‍🏫PhI data4⃣OBT076, an ADC🎯the CD205/Ly75 Ag - a receptor⬆️on immunosuppressive dendritic cells
➡️1⃣PR & 6⃣SD out of 2⃣0⃣pts
➡️Near CR in 2⃣pts who then had pembro
🤔Why wasn't☝️more than a poster❓
🔎Abs 3028, Poster 20
Read 32 tweets
Myeloma FAQs for patients & clinicians. Please add additional questions.

1) Do you still recommend autologous stem cell transplant?

Yes. But for standard risk patients, delaying transplant is an option & gives similar survival (#ASH21 below). Look forward to #ASCO22 plenary.
2) What regimen do use for initial therapy?

VRd for most. Dara plus VRd for young high risk patients as pre transplant induction.

DRd is an alternative to VRd; but you need Dara plus Revlimid for many years. With VRd after 6-8 months it's only Revlimid. onlinelibrary.wiley.com/doi/abs/10.100…
3) What do you use for maintenance therapy?

Lenalidomide alone for standard risk. Lenalidomide plus bortezomib for high risk.
Read 20 tweets
As you read the #ASCO22 abstracts, here are some tips I offer to separate true & useful from all the rest

PS: The Amgen ad on the banner of the abstract page is emblematic of what you have to contend with
🧵
I. Let me start with observational/ uncontrolled studies. These can be useful to describe prognosis, identify risk factors, track time trends, establish activity, etc. but there are many caveats
1. An abstract shows survival improves by decade in a cancer - author claims it is due to better drugs

Possibly yes, but also possible the definition of the cancer is different (AHEM myeloma), we look for it more often, our CT/PET scan is more sensitive (stage migration), etc.
Read 32 tweets

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