Discover and read the best of Twitter Threads about #LungCancer
Most recents (24)
1/26 #TumorBoardTuesday #LungCancer #OncTwitter @DrSteveMartin
⛹🏻♀️Case 1⛹️♂️
80 yo 👵🏼 never 🚬
🩻 Imaging shows R lung mass
🦴 New hip pain found to have R femoral lytic lesion
⚒️Undergoes ORIF R femur
🔬R femur path: metastatic squamous cell carcinoma, TPS 1%
🤔What next?
⛹🏻♀️Case 1⛹️♂️
80 yo 👵🏼 never 🚬
🩻 Imaging shows R lung mass
🦴 New hip pain found to have R femoral lytic lesion
⚒️Undergoes ORIF R femur
🔬R femur path: metastatic squamous cell carcinoma, TPS 1%
🤔What next?
2/26 #TumorBoardTuesday #LCSM
🩸🧬Surprise, surprise - you send ctDNA!
➡️Results show MET Exon 14 skipping mutation (VAF 0.5%)
👵🏼started on MET TKI capmatinib 400mg BID
👍CTCAP 2 months later shows impressive response 🙌🏽
🩸🧬Surprise, surprise - you send ctDNA!
➡️Results show MET Exon 14 skipping mutation (VAF 0.5%)
👵🏼started on MET TKI capmatinib 400mg BID
👍CTCAP 2 months later shows impressive response 🙌🏽
3/26 #TumorBoardTuesday #LCSM
👨🏻🏫Mini tweetorial 1👩🏻🏫
⭐️~10.5% of pts w SCC have actionable alterations
🕵🏻♀️Consider NGS in nonadeno #NSCLC pts who
1⃣🚭or light 🚬hx (1-10 pack yrs)
2⃣young age (dx age <50)
bc potentially ⬆️ prevalence driver muts
📚@IASLC jto.org/article/S1556-…
👨🏻🏫Mini tweetorial 1👩🏻🏫
⭐️~10.5% of pts w SCC have actionable alterations
🕵🏻♀️Consider NGS in nonadeno #NSCLC pts who
1⃣🚭or light 🚬hx (1-10 pack yrs)
2⃣young age (dx age <50)
bc potentially ⬆️ prevalence driver muts
📚@IASLC jto.org/article/S1556-…
@TumorBoardTues @NarjustFlorezMD 1/23 #TumorBoardTuesday #LungCancer #OncTwitter
64y 👱🏼♂️with no 🚬hx
Presents w/chest pain
PMH: diabetes
☢️: 8cm mass in RUL with peribronchial lymph nodes with adrenal metastasis
🧠Brain MRI: ❌mets
🔬Stage IVA (T4N1M1a) 🫁 Squamous Cell Ca
🤨What systemic tx would YOU give?
64y 👱🏼♂️with no 🚬hx
Presents w/chest pain
PMH: diabetes
☢️: 8cm mass in RUL with peribronchial lymph nodes with adrenal metastasis
🧠Brain MRI: ❌mets
🔬Stage IVA (T4N1M1a) 🫁 Squamous Cell Ca
🤨What systemic tx would YOU give?
@TumorBoardTues @NarjustFlorezMD 2/23 #TumorBoardTuesday #LungCancer
⏳ You await further testing
🔪 🫁biopsy tissue tested
🦠 IHC was sent 🧬
🔬 NGS: no actionable mutations
🔬 PD-L1 10%
🤨 Of the options below, what systemic tx would YOU give now?
⏳ You await further testing
🔪 🫁biopsy tissue tested
🦠 IHC was sent 🧬
🔬 NGS: no actionable mutations
🔬 PD-L1 10%
🤨 Of the options below, what systemic tx would YOU give now?
@TumorBoardTues @NarjustFlorezMD 3/23 #TumorBoardTuesday
SQUAMOUS NSCLC:
🫁 20-30% of all lung Ca, with declining incidence
🫁 associated with ⬇️survival vs nonsquamous #NSCLC
🫁 treatment decision-making relies on upfront PD-L1 expression testing
SQUAMOUS NSCLC:
🫁 20-30% of all lung Ca, with declining incidence
🫁 associated with ⬇️survival vs nonsquamous #NSCLC
🫁 treatment decision-making relies on upfront PD-L1 expression testing
"Doctor, the cancer has spread to the brain. Would he be alive for atleast 3-4months? There are so many things we want to do for him " 2 children enquiring about their elderly father brought in with seizures
Read on this miraculous story.
#CancerAwareness #oncology #MedTwitter
Read on this miraculous story.
#CancerAwareness #oncology #MedTwitter
An elderly patient who was diagnosed as #lungcancer 2 years back presented to the ER at 5 pm with multiple episodes of seizures. He couldnt speak, recognise his daughters and was having slurring of speech. His consciousness levels were low
#CancerAwareness #oncology #MedTwitter
#CancerAwareness #oncology #MedTwitter
A MRI of the brain done showed one of the most tragic sights-multiple areas of the brain affected by Cancer deposits. In the image you can see them as the fluffy white spots.
#lungcancer #MedTwitter #oncology
#lungcancer #MedTwitter #oncology
@TumorBoardTues @arkhaki @glovedoc @PGrivasMDPhD @rafee_talukder @MPishvaian @Uromigos 2/5 #TumorBoardTuesday
Case🎀
Take🏠
✅For plat ineligible, pembro=1L option
✅4 cycles of plat tx ➡️ IO maint equally efficacious to 6 cycles
✅Early prog predicts⬇️2L IO benefit
✅💔Myocarditis irAE needs aggressive mgmt
📚@arkhaki @glovedoc’s thread
threadreaderapp.com/thread/1625661…
Case🎀
Take🏠
✅For plat ineligible, pembro=1L option
✅4 cycles of plat tx ➡️ IO maint equally efficacious to 6 cycles
✅Early prog predicts⬇️2L IO benefit
✅💔Myocarditis irAE needs aggressive mgmt
📚@arkhaki @glovedoc’s thread
threadreaderapp.com/thread/1625661…
@TumorBoardTues @arkhaki @glovedoc @PGrivasMDPhD @rafee_talukder @MPishvaian @Uromigos 2.5/5 #TumorBoardTuesday
Bonus: @PGrivasMDPhD & @rafee_talukder recently discussed platinum eligibility & tx options- take a look here:
threadreaderapp.com/thread/1612977…
Bonus: @PGrivasMDPhD & @rafee_talukder recently discussed platinum eligibility & tx options- take a look here:
threadreaderapp.com/thread/1612977…
@TumorBoardTues @arkhaki @glovedoc @PGrivasMDPhD @rafee_talukder @MPishvaian @Uromigos 3/5 #TumorBoardTuesday
Thurs Case🎀
🎥 TBT in video
Pembro= 1L option for pts not eligible for plat tx.
☑️4 cycles plat doublet AS GOOD as 6 in plat eligible
💔ICI myocarditis is rare, but serious- we discuss tx
Quick video summary covering major pts in just over 2 mins!
Thurs Case🎀
🎥 TBT in video
Pembro= 1L option for pts not eligible for plat tx.
☑️4 cycles plat doublet AS GOOD as 6 in plat eligible
💔ICI myocarditis is rare, but serious- we discuss tx
Quick video summary covering major pts in just over 2 mins!
@TumorBoardTues 1/17 #TumorBoardTuesday #LungCancer #OncTwitter
42yo 👨🏽💼
PMH: never smoker
persistent cough
🩻PET/CT: 3.5 cm mass LLL & bulky, coalescing LNs in L hilum & mediastinum (AP 🪟, subcarinal, bilat paratracheal, supraclav)
Axillary LNs
🦴multi bony mets
🫀small pericardial effusion
42yo 👨🏽💼
PMH: never smoker
persistent cough
🩻PET/CT: 3.5 cm mass LLL & bulky, coalescing LNs in L hilum & mediastinum (AP 🪟, subcarinal, bilat paratracheal, supraclav)
Axillary LNs
🦴multi bony mets
🫀small pericardial effusion
@TumorBoardTues 2/17 #TumorBoardTuesday #LungCancer #NSCLC
🫁🎥Mediastinoscopy shows adenocarcinoma with signet rings.
🔬 ALK IHC positive
🐟 FISH positive
🧬 PDL1 = 0
🤨What’s your recommended initial therapy:
🫁🎥Mediastinoscopy shows adenocarcinoma with signet rings.
🔬 ALK IHC positive
🐟 FISH positive
🧬 PDL1 = 0
🤨What’s your recommended initial therapy:
@TumorBoardTues 3/17 #TumorBoardTuesday #LCSM
🧲MRI: Brain shows 4 CNS mets in frontal lobes & cerebellum
📏 = 13, 10, 8 and 4 mm
💧No edema
🧠 no neuro symptoms
🤨 Does the presence of CNS mets change your 1st line recommendation?
A = alectinib
B = brigatinib
L = lorlatinib
🧲MRI: Brain shows 4 CNS mets in frontal lobes & cerebellum
📏 = 13, 10, 8 and 4 mm
💧No edema
🧠 no neuro symptoms
🤨 Does the presence of CNS mets change your 1st line recommendation?
A = alectinib
B = brigatinib
L = lorlatinib
@TumorBoardTues @drteplinsky @MPishvaian @PTarantinoMD @DFCI_BreastOnc @KariWisinski_MD @JaniceTNBCmets @her2bc 2/4 #TumorBoardTuesday
Thurs Case🎀
Take🏠messages:
#HER2+ #BreastCancer
✅Localized, early ➡️neoadj tx w chemo + anti-HER2
✅⬆️DFS w T-DM1 for residual disease
✅Future role for T-DXd?
📚We captured @drteplinsky’s discussion in this moment: twitter.com/i/events/15831…
Thurs Case🎀
Take🏠messages:
#HER2+ #BreastCancer
✅Localized, early ➡️neoadj tx w chemo + anti-HER2
✅⬆️DFS w T-DM1 for residual disease
✅Future role for T-DXd?
📚We captured @drteplinsky’s discussion in this moment: twitter.com/i/events/15831…
@TumorBoardTues @drteplinsky @MPishvaian @PTarantinoMD @DFCI_BreastOnc @KariWisinski_MD @JaniceTNBCmets @her2bc 3/4 #TumorBoardTuesday
Thursday Case🎀
📷 TBT in an image: Take a 👀at a (simplified) guide to treatment of early stage HER2+, localized #BreastCancer!
We review KATHERINE and use of ADCs to improve OS with residual disease. Is there an evolving role for T-DXd?
Thursday Case🎀
📷 TBT in an image: Take a 👀at a (simplified) guide to treatment of early stage HER2+, localized #BreastCancer!
We review KATHERINE and use of ADCs to improve OS with residual disease. Is there an evolving role for T-DXd?
@TumorBoardTues @drteplinsky @MPishvaian @PTarantinoMD @DFCI_BreastOnc @KariWisinski_MD @JaniceTNBCmets @her2bc @dradityabardia @EricaMarieRomn1 @jacobadashek @esinghimd @BreastCaupdates 4/4 #TumorBoardTuesday
Thurs Case🎀
🙏 Anti-HER2+ tx in neoadj setting improves pCR. T-DM1 improves OS when residual disease is present.
🤔 Role for other ADCs or even neoadj setting?
➡️Be sure to join us 11.01.22 when @LeciaSequist presents a case of ALK+ #NSCLC #LungCancer
Thurs Case🎀
🙏 Anti-HER2+ tx in neoadj setting improves pCR. T-DM1 improves OS when residual disease is present.
🤔 Role for other ADCs or even neoadj setting?
➡️Be sure to join us 11.01.22 when @LeciaSequist presents a case of ALK+ #NSCLC #LungCancer
#LungCancer is the leading cause of cancer death in Australia, and it has the lowest survival of the top five most common cancers. No national screening program exists. A/Prof Gavin Wright @Clavikul discussed how we implement life-saving lung #cancer policy at a national level.
2/ It also represents stark inequities. Indigenous Australians are twice as likely to be diagnosed with lung cancer, and twice as likely to die from it as their non-Indigenous counterparts. More women die from lung cancer than breast, uterine and ovarian cancer combined.
3/ Lung cancer remains a source of shame and stigma, with the well-documented transfer of blame from Big Tobacco to individual patients still wreaking havoc; lung cancer results in the most distress/anxiety/depression of the top five cancers.
#KRAS alert! Over the past 4 years, a multi-disciplinary team from @hopkinskimmel @VUMC_Cancer @DanaFarber @MSKCancerCenter & @Amgen has been studying the distribution and co-mutations of KRAS, NRAS and HRAS mutant #cancers under the auspices of @AACR project #GENIE. Read the 🧵
Our work is now published online at @CR_AACR and represents the largest study of RAS genomic architecture to date, leveraging #NGS data from >600,000 mutations and >66,000 tumors across 51 #cancer types.
Full text here
aacrjournals.org/cancerres/arti….
Full text here
aacrjournals.org/cancerres/arti….
Our findings provide insights in the genomic architecture of RAS mutant cancers and may serve as a blueprint for mapping therapeutic vulnerabilities for mut RAS. Given the vast array of findings we have put together a shiny app for interactive #dataviz:
ras-hallmarks.jhmi.edu
ras-hallmarks.jhmi.edu
@TumorBoardTues 1/17 #TumorBoardTuesday #LungCancer #OncTwitter
72y 👩🏻with 58 pk-yr 🚬hx
Chest pain
PMH: diabetes
CT: 3 cm LLL nodule & left pleural effusion with 5mm nodule in LUL
PET: GGO in LLL SUV 4.5
💉thora with cytology
🔬Stage IVA (T4N0M1a) 🫁 adenoCa
🤨What systemic tx would YOU give?
72y 👩🏻with 58 pk-yr 🚬hx
Chest pain
PMH: diabetes
CT: 3 cm LLL nodule & left pleural effusion with 5mm nodule in LUL
PET: GGO in LLL SUV 4.5
💉thora with cytology
🔬Stage IVA (T4N0M1a) 🫁 adenoCa
🤨What systemic tx would YOU give?
@TumorBoardTues 2/17 #TumorBoardTuesday #LungCancer
🔪 🫁 tissue tested
🦠 Tissue NGS and IHC was sent 🧬
🔬 NGS: no actionable mutations
🔬 PD-L1 62%
🔪 🫁 tissue tested
🦠 Tissue NGS and IHC was sent 🧬
🔬 NGS: no actionable mutations
🔬 PD-L1 62%
@TumorBoardTues 3/17 #TumorBoardTuesday #LungCancer
👩🏽🏫Mini tweetorial 1👩🏽🏫
@NCCN based guideline for #NSCLC biomarker negative, PDL1 >50% ⤵️
CATEGORY 1 RECOMMENDATIONS:
📍 Pembro, atezo, and cemiplimab
📍 ipi/nivo considered in certain circumstances
👩🏽🏫Mini tweetorial 1👩🏽🏫
@NCCN based guideline for #NSCLC biomarker negative, PDL1 >50% ⤵️
CATEGORY 1 RECOMMENDATIONS:
📍 Pembro, atezo, and cemiplimab
📍 ipi/nivo considered in certain circumstances
@TumorBoardTues @MPishvaian @JohnEbbenMDPhD @ASCO @JCO_ASCO @MLJohnsonMD2 @BurrisSkip @RielyMD @JustinGainor @ChiFuJeffYang @ECarcereny @anguspratt @KRASKickers @thenasheffect @ALKpositiveINT @EgidiusLambrech @EugeneManley @ipreeshagul @JoelNealMD @HwakeleeMD @GlopesMd @jmsuga #TumorBoardTuesday
Some of tonight’s conversation will be discussing of multiple treatments of stage 3 #NSCLC.
My COI: I’m a consultant with @AstraZeneca, but thoughts are my own.
Some of tonight’s conversation will be discussing of multiple treatments of stage 3 #NSCLC.
My COI: I’m a consultant with @AstraZeneca, but thoughts are my own.
@TumorBoardTues @MPishvaian @JohnEbbenMDPhD @ASCO @JCO_ASCO @MLJohnsonMD2 @BurrisSkip @RielyMD @JustinGainor @ChiFuJeffYang @ECarcereny @anguspratt @KRASKickers @thenasheffect @ALKpositiveINT @EgidiusLambrech @EugeneManley @ipreeshagul @JoelNealMD @HwakeleeMD @GlopesMd @jmsuga @AstraZeneca 1/13 #TumorBoardTuesday #NSCLC #OncTwitter
65yo 🧔🏽, former 🚬, pmhx🫀 MI with stents
🩻CT: 🫁 right middle lobe mass & adenopathy
EBUS confirms adenocarcinoma level 7, 4R and the mass
🔬Molecular test: KRAS G12C & STK11 mutations, TMB 10, PD-L1 40% by 22C3.
Final stage T3N2M0
65yo 🧔🏽, former 🚬, pmhx🫀 MI with stents
🩻CT: 🫁 right middle lobe mass & adenopathy
EBUS confirms adenocarcinoma level 7, 4R and the mass
🔬Molecular test: KRAS G12C & STK11 mutations, TMB 10, PD-L1 40% by 22C3.
Final stage T3N2M0
@TumorBoardTues @MPishvaian @JohnEbbenMDPhD @ASCO @JCO_ASCO @MLJohnsonMD2 @BurrisSkip @RielyMD @JustinGainor @ChiFuJeffYang @ECarcereny @anguspratt @KRASKickers @thenasheffect @ALKpositiveINT @EgidiusLambrech @EugeneManley @ipreeshagul @JoelNealMD @HwakeleeMD @GlopesMd @jmsuga @AstraZeneca 2/13 #TumorBoardTuesday #LCSM #NSCLC
Multi-D Tumor Board discussion about 👆🏽patient.
🧐 Is an STK11 mutation taken into consideration?
🤨 What would you recommend as a treatment option?
Multi-D Tumor Board discussion about 👆🏽patient.
🧐 Is an STK11 mutation taken into consideration?
🤨 What would you recommend as a treatment option?
Major update for small cell #lung cancer! #LCSM
With @juliensage + @FoundationATCG, our paper now on @bioRxiv:
►Genomic analysis of *3,600* pts with SCLC; largest SCLC study to date!
►Multiple interesting findings discussed in this 🧵
biorxiv.org/content/10.110…
With @juliensage + @FoundationATCG, our paper now on @bioRxiv:
►Genomic analysis of *3,600* pts with SCLC; largest SCLC study to date!
►Multiple interesting findings discussed in this 🧵
biorxiv.org/content/10.110…
🧵2
This study is unique in many ways:
> The #SCLC cohort studied came mostly from community sites --> representing a more typical “real-world” cohort of SCLC.
> The genomic data are tied to clinical data + outcomes.
#LCSM
This study is unique in many ways:
> The #SCLC cohort studied came mostly from community sites --> representing a more typical “real-world” cohort of SCLC.
> The genomic data are tied to clinical data + outcomes.
#LCSM
🧵3
To the best of our knowledge, our study analyzes the largest number of SCLC tumors from African ancestry to date:
> n=256 AFR cases
> 7.1% of the entire cohort
#Diversity in clinical studies is critical!!
See tweet 🧵9 for more details.
To the best of our knowledge, our study analyzes the largest number of SCLC tumors from African ancestry to date:
> n=256 AFR cases
> 7.1% of the entire cohort
#Diversity in clinical studies is critical!!
See tweet 🧵9 for more details.
1/n) ICMR released Standard Treatment Workflows (STWs) volume 3 which contains 11 specialties with 52 diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App.
@MoHFW_INDIA @DeptHealthRes #STW
@MoHFW_INDIA @DeptHealthRes #STW
2/n) Standard Treatment Workflows (STWs) on #𝐃𝐞𝐫𝐦𝐚𝐭𝐨𝐥𝐨𝐠𝐲 containing 14 major diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App. @MoHFW_INDIA @DeptHealthRes
3/n) Standard Treatment Workflows (STWs) on #Endocrinology containing 06 major diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App. @MoHFW_INDIA @AyushmanNHA @WHOSEARO #diabetes
@TumorBoardTues @CharuAggarwalMD @ADesaiMD @Latinamd @PTarantinoMD @LealTiciana @NarjustFlorezMD 1/8 #TumorBoardTuesday
🔬🧬@CharuAggrawalMD @ADesaiMD taught us about EGFR mutations in #LungCancer–specifically, new 2L strategies for EGFRexon20m.
➡️Here's this week's Thursday Case🎀
Pick up your 🆓#CME
ALL CME 🔗: integrityce.com/tbt
CME eval🔗: integrityce.com/tbteval
🔬🧬@CharuAggrawalMD @ADesaiMD taught us about EGFR mutations in #LungCancer–specifically, new 2L strategies for EGFRexon20m.
➡️Here's this week's Thursday Case🎀
Pick up your 🆓#CME
ALL CME 🔗: integrityce.com/tbt
CME eval🔗: integrityce.com/tbteval
@TumorBoardTues @CharuAggarwalMD @ADesaiMD @Latinamd @PTarantinoMD @LealTiciana @NarjustFlorezMD 2/8 #TumorBoardTuesday
Thurs Case🎀
Take🏠messages:
We discussed #EGFR mutations in #LungCancer
✅Not all EGFR mutations are the same!
✅Osimertinib=tx for most activating EGFR mutations
✅…but exon20insmut more resistant to TKIs
✅Amivantamab, mobocertinib= 2L strategies
Thurs Case🎀
Take🏠messages:
We discussed #EGFR mutations in #LungCancer
✅Not all EGFR mutations are the same!
✅Osimertinib=tx for most activating EGFR mutations
✅…but exon20insmut more resistant to TKIs
✅Amivantamab, mobocertinib= 2L strategies
@TumorBoardTues @CharuAggarwalMD @ADesaiMD @Latinamd @PTarantinoMD @LealTiciana @NarjustFlorezMD 2.5 / 8 #TumorBoardTuesday
📚We captured as much of @CharuAggrawalMD @ADesaiMD’s discussion as we could in this moment: twitter.com/i/events/15463…
CRITICAL point: if you don’t look, you won’t know! RNA based NGS recommended for 🫁cancer cases to identify actionable mut
📚We captured as much of @CharuAggrawalMD @ADesaiMD’s discussion as we could in this moment: twitter.com/i/events/15463…
CRITICAL point: if you don’t look, you won’t know! RNA based NGS recommended for 🫁cancer cases to identify actionable mut
@TumorBoardTues @Dr_RShatsky @PTarantinoMD @ErikaHamilton9 @UCSDCancer @KariWisinski_MD @marina_sharifi @JPoteralaMD @LaurenBzak @benjiwal @drteplinsky @MarkRobsonMD 2/11 #TumorBoardTuesday
Thurs Case🎀
Take🏠:
#TNBC &neoadjuvant tx
✅KEYNOTE-522= new standard of care
– Pembro+chemo in neoadj= BEST pCR so far
– Caveat: only for T2+ TNBC
✅Adding pembro may have ⬆️benefit in RCB II
📚We captured much of chat:
p1: twitter.com/i/events/15423…
Thurs Case🎀
Take🏠:
#TNBC &neoadjuvant tx
✅KEYNOTE-522= new standard of care
– Pembro+chemo in neoadj= BEST pCR so far
– Caveat: only for T2+ TNBC
✅Adding pembro may have ⬆️benefit in RCB II
📚We captured much of chat:
p1: twitter.com/i/events/15423…
@TumorBoardTues @Dr_RShatsky @PTarantinoMD @ErikaHamilton9 @UCSDCancer @KariWisinski_MD @marina_sharifi @JPoteralaMD @LaurenBzak @benjiwal @drteplinsky @MarkRobsonMD 3/11 #TumorBoardTuesday
Thurs Case🎀
Take🏠msgs (cont’d):
✅IO NOT shown to add benefit in metastatic dz
– Atezolizumab approval in mTNBC withdrawn
✅Standard of care – multi-d team
✅No current evidence to hold IO pre-op
P2: twitter.com/i/events/15425…
Thurs Case🎀
Take🏠msgs (cont’d):
✅IO NOT shown to add benefit in metastatic dz
– Atezolizumab approval in mTNBC withdrawn
✅Standard of care – multi-d team
✅No current evidence to hold IO pre-op
P2: twitter.com/i/events/15425…
@TumorBoardTues @Dr_RShatsky @PTarantinoMD @ErikaHamilton9 @UCSDCancer @KariWisinski_MD @marina_sharifi @JPoteralaMD @LaurenBzak @benjiwal @drteplinsky @MarkRobsonMD 4/11 #TumorBoardTuesday
Thurs Case🎀
Take🏠messages (cont’d):
✅THINK about side FX, including fertility
— Ovarian suppression may preserve fertility while undergoing neoadj tx
✅Patient voice is MOST important- pts define “acceptable tox,” not 🩺
Thurs Case🎀
Take🏠messages (cont’d):
✅THINK about side FX, including fertility
— Ovarian suppression may preserve fertility while undergoing neoadj tx
✅Patient voice is MOST important- pts define “acceptable tox,” not 🩺
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
🫁@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
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…
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…
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…
@TumorBoardTues 1/16 #TumorBoardTuesday #LungCancer #OncTwitter
38yo 👩🏻with remote 8 pk-yr 🚬hx
CP & diarrhea
PMH: None
🩻: 2 cm focal consolidations in the LLL
PET: GGO in LLL SUV 4.5
🔪+ mediastinal staging
🔬pT2a, pN1 (Stage IIB) lung adenoCa
🤨What adjuvant systemic tx would YOU give next?
38yo 👩🏻with remote 8 pk-yr 🚬hx
CP & diarrhea
PMH: None
🩻: 2 cm focal consolidations in the LLL
PET: GGO in LLL SUV 4.5
🔪+ mediastinal staging
🔬pT2a, pN1 (Stage IIB) lung adenoCa
🤨What adjuvant systemic tx would YOU give next?
@TumorBoardTues 2/16 #TumorBoardTuesday #LCSM #LungCancer
🧪 Resected 🫁 tissue tested
🦠 Tissue NGS and IHC was sent 🧬
🔬 NGS: EGFR exon 19 deleted
🔬 PD-L1 52%
🤨 What adjuvant treatment plan do you initiate next?
🧪 Resected 🫁 tissue tested
🦠 Tissue NGS and IHC was sent 🧬
🔬 NGS: EGFR exon 19 deleted
🔬 PD-L1 52%
🤨 What adjuvant treatment plan do you initiate next?
@TumorBoardTues 3/16 #TumorBoardTuesday #LungCancer
👩🏽🏫Mini tweetorial 1 👩🏽🏫
🚩🚩🚩 for EGFR mutations
🚩 Asian >> Western - 47.9% vs 19.2% according to metaA
🚩 Higher in NEVER smoker 🚭
🚩 More prevalent in females
🚩 Pathologic Subtype (adeno>>SCC)
👩🏽🏫Mini tweetorial 1 👩🏽🏫
🚩🚩🚩 for EGFR mutations
🚩 Asian >> Western - 47.9% vs 19.2% according to metaA
🚩 Higher in NEVER smoker 🚭
🚩 More prevalent in females
🚩 Pathologic Subtype (adeno>>SCC)
@TumorBoardTues @MPishvaian @SushmaJonna @Latinamd @GDutcherMD @Empoweringpts9 @ADesaiMD @JackWestMD @DrSteveMartin @esinghimd @GO2Foundation 1/13 #TumorBoardTuesday #LCSM
➡️Here’s this week's Thursday Case🎀!
🧬@Latinamd @GDutcherMD took us through METex14 skipping in older pts with 🫁#NSCLC.
👉Get 🆓#CME credit with quick❓
CME eval 🔗: integrityce.com/tbteval
@SylvesterCancer
➡️Here’s this week's Thursday Case🎀!
🧬@Latinamd @GDutcherMD took us through METex14 skipping in older pts with 🫁#NSCLC.
👉Get 🆓#CME credit with quick❓
CME eval 🔗: integrityce.com/tbteval
@SylvesterCancer
@TumorBoardTues @MPishvaian @SushmaJonna @Latinamd @GDutcherMD @Empoweringpts9 @ADesaiMD @JackWestMD @DrSteveMartin @esinghimd @GO2Foundation @SylvesterCancer 2/13 #TumorBoardTuesday
Thurs Case🎀
Take🏠points:
#LungCancer= molecular disease
✅IDEAL=wait for NGS before tx
✅Send tissue NGS & ct🧬
✅MET mut= RTK driver- rare!
🔷MET exon 14 skipping best detected w RNAseq
🔷Capmatinib/tepotinib= FDA👍🏽
✅METi side effects: 🤨EDEMA
Thurs Case🎀
Take🏠points:
#LungCancer= molecular disease
✅IDEAL=wait for NGS before tx
✅Send tissue NGS & ct🧬
✅MET mut= RTK driver- rare!
🔷MET exon 14 skipping best detected w RNAseq
🔷Capmatinib/tepotinib= FDA👍🏽
✅METi side effects: 🤨EDEMA
@TumorBoardTues @MPishvaian @SushmaJonna @Latinamd @GDutcherMD @Empoweringpts9 @ADesaiMD @JackWestMD @DrSteveMartin @esinghimd @GO2Foundation @SylvesterCancer 3/13 #TumorBoardTuesday
Thurs Case🎀
Take🏠points (cont’d):
✅🎯tx preferred in 1L >> IO
🗝️ IO first 👉🏽TKI (osi) 👉🏽⬆️irAE
✅Older pts may need dose adjustment of TKI d/t tox
✅MET bispecifics (amivantamab) & ADCs coming!
Thurs Case🎀
Take🏠points (cont’d):
✅🎯tx preferred in 1L >> IO
🗝️ IO first 👉🏽TKI (osi) 👉🏽⬆️irAE
✅Older pts may need dose adjustment of TKI d/t tox
✅MET bispecifics (amivantamab) & ADCs coming!
1/15 #TumorBoardTuesday #LungCancer #OncTwitter
83 yo👩🏽 remote 🚬 with good PS presents with SOB
PMhx: Afib, mild cognitive dysfunction
🩻: RML 6x3cm mass & pleural effusion
🫁: Stage IV lung adenocarcinoma
PDL1 90%
🎂Does age impact tx decision?
📊How would you Tx this pt?
83 yo👩🏽 remote 🚬 with good PS presents with SOB
PMhx: Afib, mild cognitive dysfunction
🩻: RML 6x3cm mass & pleural effusion
🫁: Stage IV lung adenocarcinoma
PDL1 90%
🎂Does age impact tx decision?
📊How would you Tx this pt?
@DrSteveMartin @glopesmd @NarjustDumaMD
@AnaVManana @COlazagasti @StephenVLiu @chulkimMD @LudaBazhenovaMD @benlevylungdoc @luisraez1 @edgardo_ny @GlopesMd
@AnaVManana @COlazagasti @StephenVLiu @chulkimMD @LudaBazhenovaMD @benlevylungdoc @luisraez1 @edgardo_ny @GlopesMd
2/15 #TumorBoardTuesday
✅ Tissue NGS and💧liquid biopsy ordered
🔬Liquid biopsy comes with MET Ex 14 skip mutation
✅Confirmed with tissue NGS based assay (🧬RNA and 🧬DNA sequencing)
👉🏽Do you start 1L immunotherapy or 🎯therapy?
✅ Tissue NGS and💧liquid biopsy ordered
🔬Liquid biopsy comes with MET Ex 14 skip mutation
✅Confirmed with tissue NGS based assay (🧬RNA and 🧬DNA sequencing)
👉🏽Do you start 1L immunotherapy or 🎯therapy?
1/
🚨Delighted to do a quick #tweetorial on our short report in the💚#GreenJournal @RadiotherapyOn1
☢️Heterogeneous immunogenicity of SARS-CoV-2 vaccines in #cancer patients receiving
#radiotherapy💉
➡️thegreenjournal.com/article/S0167-…
#radonc #COVID19 #CovidVaccine #lcsm
#OncoAlert
🚨Delighted to do a quick #tweetorial on our short report in the💚#GreenJournal @RadiotherapyOn1
☢️Heterogeneous immunogenicity of SARS-CoV-2 vaccines in #cancer patients receiving
#radiotherapy💉
➡️thegreenjournal.com/article/S0167-…
#radonc #COVID19 #CovidVaccine #lcsm
#OncoAlert
2/
Inspired by:
[Our patients]
Doctor, is the #radiotherapy I am getting affecting how well my #CovidVaccine works?
[Us]
🤷
Inspired by:
[Our patients]
Doctor, is the #radiotherapy I am getting affecting how well my #CovidVaccine works?
[Us]
🤷
3/
There is large heterogeneity when looking at immunogenicity of #COVID19 vaccines in #cancer patients & esp #lungcancer patients shown by @vivek_naranbhai & team in @JCO_ASCO
Chemo may suppress antibody levels somewhat.
What about #radiotherapy?
➡️ascopubs.org/doi/pdf/10.120…
There is large heterogeneity when looking at immunogenicity of #COVID19 vaccines in #cancer patients & esp #lungcancer patients shown by @vivek_naranbhai & team in @JCO_ASCO
Chemo may suppress antibody levels somewhat.
What about #radiotherapy?
➡️ascopubs.org/doi/pdf/10.120…
Oggi vi parlo di cosa studiamo in laboratorio. Da oltre cinque anni in @operapadrepio con il team della dott.ssa Muscarella lavoriamo alle lesioni molecolari nel tumore polmonare di un gene chiamato #NRG1. Mi scuso in anticipo per alcuni tecnicismi che troverete. 1/18
#lungcancer
#lungcancer
Intro. In particolar modo il focus è sulle fusioni geniche che interessano riarrangiamenti a carico delle Neureguline (NRG1-4) recentemente descritti nel carcinoma polmonare non a piccole cellule (NSCLC). Ma andiamo per ordine, partendo dalle basi. 2/18
Le basi/1. Per fusione genica si intende un’alterazione in cui due geni si fondono andando a formare un gene “anomalo”, il più delle volte originatosi dalla prima metà di un gene e dalla seconda metà del secondo. 3/18
Very happy to present our #proteomics analysis of #lungcancer published today @NatureCancer!🙂
Here’s a walk-through: #MassSpec analysis covering almost 14k proteins in 141 NSCLC tumors revealed 6 proteome subtypes with distinct biology. 1/6
rdcu.be/cBOtU
Here’s a walk-through: #MassSpec analysis covering almost 14k proteins in 141 NSCLC tumors revealed 6 proteome subtypes with distinct biology. 1/6
rdcu.be/cBOtU
#NSCLC proteome subtypes are driven by histology, growth pattern, immune cell infiltration, driver mutations, oncogenic pathways, and cell types, suggesting potential clinical value for treatment stratification and #PrecisionMedicine. 2/6
Unexpectedly, #proteogenomics analysis revealed that high neoantigen burden was linked to global hypomethylation, and that complex neoantigens mapping to genomic regions normally not active in lung were produced in immune-cold subtypes. 3/6
1/ 🙏 patients, investigators and funders for
@TROGfightcancer 13.01 SAFRON II trial at #ESTRO21. n=90 pts with 133 pulmonary oligometastases, across 13 centers in 🇳🇿+🇦🇺. Median F/U = 3 years, randomization for single (SF) 28Gy vs 48Gy in 4fx (MF). #radonc #LCSM @PeterMacCC
@TROGfightcancer 13.01 SAFRON II trial at #ESTRO21. n=90 pts with 133 pulmonary oligometastases, across 13 centers in 🇳🇿+🇦🇺. Median F/U = 3 years, randomization for single (SF) 28Gy vs 48Gy in 4fx (MF). #radonc #LCSM @PeterMacCC
2/ No difference in SF vs MF. Both were safe (G3+ AEs were 5% MF v 3% SF), and effective - 2yr OS 85% MF v 88% SF (p=0.44), LC 83% MF v 73% SF (p=0.13). No diff. in DFS (median 13.2 MF v 14.3 SF, p=0.99). Mean time to systemic treatment ~29mo. SABR did not impact QoL measures
3/ Both SF and MF arms drove systemic immune activation
- ⬆️%CD4+FoxP3+ Tregs, ⬆️ %CTLA-4 and %PD-1 expressing CD4+, CD8+ and/or CD4-CD8- T cell subsets
- modestly ⬆️ % change of CD4+ T cell and CD8+ T cell subsets expressing PD-1 or TIGIT in the SF arm as compared to MF arm
- ⬆️%CD4+FoxP3+ Tregs, ⬆️ %CTLA-4 and %PD-1 expressing CD4+, CD8+ and/or CD4-CD8- T cell subsets
- modestly ⬆️ % change of CD4+ T cell and CD8+ T cell subsets expressing PD-1 or TIGIT in the SF arm as compared to MF arm
@ShimaghavimiMD @TumorBoardTues #TumorBoardTuesday
Case 08/03/21
74 yo♂️presents with RUQ pain and fatigue, 30# weight loss, PS=2
CT scan demonstrates a large panc mass and diffuse liver metastases
Liver core biopsy confirms an acinar cell #PancreaticCancer
➡️What would be your treatment recommendation❓
Case 08/03/21
74 yo♂️presents with RUQ pain and fatigue, 30# weight loss, PS=2
CT scan demonstrates a large panc mass and diffuse liver metastases
Liver core biopsy confirms an acinar cell #PancreaticCancer
➡️What would be your treatment recommendation❓
@ShimaghavimiMD @TumorBoardTues #TumorBoardTuesday
08/03/21
He was treated with every other week Gem-nab-pac
🙏@GIcancerDoc
➡️Had rapid symptomatic improvement
➡️Now essentially normal PS
➡️Nice response to treatment for 9 months🙂
But then disease progression❗️
What would be your 2nd line therapy choice❓
08/03/21
He was treated with every other week Gem-nab-pac
🙏@GIcancerDoc
➡️Had rapid symptomatic improvement
➡️Now essentially normal PS
➡️Nice response to treatment for 9 months🙂
But then disease progression❗️
What would be your 2nd line therapy choice❓
@ShimaghavimiMD @TumorBoardTues @GIcancerDoc #TumorBoardTuesday
08/03/21
Germline NGS🧬testing did not reveal any inherited alterations
☝️Somatic (tumor) NGS🧬testing revealed a
💥BRAFV600E mutation💥
✅And no KRAS mutation
➡️Done while on 1st line therapy
Would the results alter your treatment choice now?
08/03/21
Germline NGS🧬testing did not reveal any inherited alterations
☝️Somatic (tumor) NGS🧬testing revealed a
💥BRAFV600E mutation💥
✅And no KRAS mutation
➡️Done while on 1st line therapy
Would the results alter your treatment choice now?
#WorldLungCancerDay 🎗
#lungcancerawareness
ఊపిరితిత్తుల క్యాన్సర్ (ఆంగ్లం: #lungcancer #cancer, లేదా lung carcinoma) ఊపిరితిత్తుల్లోని కణాలు విపరీతంగా పెరిగిపోవడం వల్ల వచ్చే క్యాన్సర్.ఈ పెరుగుదల మెటాస్టాసిస్ అనే ప్రక్రియ ద్వారా కేవలం ఊపిరితిత్తులతోనే ఆగిపోకుండా చుట్టూ ఉన్న
#lungcancerawareness
ఊపిరితిత్తుల క్యాన్సర్ (ఆంగ్లం: #lungcancer #cancer, లేదా lung carcinoma) ఊపిరితిత్తుల్లోని కణాలు విపరీతంగా పెరిగిపోవడం వల్ల వచ్చే క్యాన్సర్.ఈ పెరుగుదల మెటాస్టాసిస్ అనే ప్రక్రియ ద్వారా కేవలం ఊపిరితిత్తులతోనే ఆగిపోకుండా చుట్టూ ఉన్న
అవయువాలకు కూడా వ్యాపించే అవకాశం ఉంది. సాధారణంగా ఊపిరితిత్తుల్లో ప్రారంభమయ్యే ప్రాథమిక ఊపిరితిత్తుల క్యాన్సర్ (primary lung #cancers) లు కార్సినోమాలు (#carcinomas) ఈ క్యాన్సర్లలో అధిక భాగం (సుమారు 85 శాతం) దీర్ఘకాలం పాటు పొగాకు సేవించే వారిలో కనిపిస్తాయి.
10–15% కేసుల్లో బాధితులు ఎప్పుడూ ధూమపానం చేయలేదు.
2012 గణాంకాల ప్రకారం ప్రపంచవ్యాప్తంగా 18 లక్షల మంది ఈ వ్యాధి బారిన పడగా అందులో సుమారు 16 లక్షలమంది మరణించారు. మగవారిలో కాన్సర్ మరణాలలో ఈ వ్యాధి మొదటి స్థానంలో ఉండగా, ఆడవారిలో రొమ్ము కాన్సర్ తర్వాత ఎక్కువ మంది ఈ వ్యాధి వలననే
2012 గణాంకాల ప్రకారం ప్రపంచవ్యాప్తంగా 18 లక్షల మంది ఈ వ్యాధి బారిన పడగా అందులో సుమారు 16 లక్షలమంది మరణించారు. మగవారిలో కాన్సర్ మరణాలలో ఈ వ్యాధి మొదటి స్థానంలో ఉండగా, ఆడవారిలో రొమ్ము కాన్సర్ తర్వాత ఎక్కువ మంది ఈ వ్యాధి వలననే
