Discover and read the best of Twitter Threads about #Lungcancer
Most recents (24)
You can join the livestream for this workshop being organized by @HEIresearch @EuroRespSoc & @ISEE_global
bit.ly/3BL46nY
#CleanAir4EU
bit.ly/3BL46nY
#CleanAir4EU
@DrMariaNeira joins the meetings from the #WHA76 urges the #AirQuality community to work closely with climate change.
She also notes that EU should take the lead and be the first to use the ambitious @WHO air quality guidelines.
#CleanAir4EU
She also notes that EU should take the lead and be the first to use the ambitious @WHO air quality guidelines.
#CleanAir4EU
@TumorBoardTues @LealTiciana 1/21 #TumorBoardTuesday #LungCancer #OncTwitter
47yo 👨🏽💼🚭
No significant PMHx
Incidental 📏 2.8cm cavitary RLL nodule on coronary calcium scan in 2020
FDG 💥on PET with hilar LN 💥
🫁🎥 Mediastinoscopy shows adenocarcinoma, + subcarinal LN (stage IIIA)
🤨 How would you treat?
47yo 👨🏽💼🚭
No significant PMHx
Incidental 📏 2.8cm cavitary RLL nodule on coronary calcium scan in 2020
FDG 💥on PET with hilar LN 💥
🫁🎥 Mediastinoscopy shows adenocarcinoma, + subcarinal LN (stage IIIA)
🤨 How would you treat?
@TumorBoardTues @LealTiciana 2/21 #TumorBoardTuesday
Due to findings👆🏽
👨🏽💼Began Neoadjuvant cisplatin/pemetrexed x 4
✂️lobectomy in 2020
ChemoIO was not SOC in 2020.
✨Checkmate 816
📍patients excluded if they had EGFR and ALK alterations:
📚@FordePatrick @DrMarkAwad @JulieBrahmer nejm.org/doi/full/10.10…
Due to findings👆🏽
👨🏽💼Began Neoadjuvant cisplatin/pemetrexed x 4
✂️lobectomy in 2020
ChemoIO was not SOC in 2020.
✨Checkmate 816
📍patients excluded if they had EGFR and ALK alterations:
📚@FordePatrick @DrMarkAwad @JulieBrahmer nejm.org/doi/full/10.10…
@TumorBoardTues @LealTiciana @FordePatrick @DrMarkAwad @JulieBrahmer @TonyMok9 @FordePatrick @RamalingamMD @RachelSanbornMD @KarenReckampMD @DrMarkAwad @JulieBrahmer @AnaVManana @DevikaDasMD @JSabari @Exon20Group @CharuAggarwalMD @tehfem @ElizSMcKenna @JineshGheeya @ShrutiPatelMD @NarjustFlorezMD @HosseinBorghaei @ThanksCancer @IASLC @IbiayiMD
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
