Discover and read the best of Twitter Threads about #OncTwitter
Most recents (24)
@TumorBoardTues 1/15 #TumorBoardTuesday #BCSM #BreastCancer #OncTwitter @drteplinsky
🎯45 yo premenopausal 👩🦰
❌relevant medical history.
FHx: Mom 👩🦳 with breast cancer at 48y
Screening mammogram normal for the last few years.
Now with microcalcifications 📏3mm in the UOQ of the R breast.
🎯45 yo premenopausal 👩🦰
❌relevant medical history.
FHx: Mom 👩🦳 with breast cancer at 48y
Screening mammogram normal for the last few years.
Now with microcalcifications 📏3mm in the UOQ of the R breast.
@TumorBoardTues @drteplinsky 2/15 #TumorBoardTuesday #BreastCancer #OncTwitter @MPishvaian @JohnEbbenMDPhD
👩🦰Underwent a biopsy
🔬Surgical pathology: Atypical ductal hyperplasia
✂️Underwent a lumpectomy confirming diagnosis and no additional findings
🤔Which of the following would you recommend for her?
👩🦰Underwent a biopsy
🔬Surgical pathology: Atypical ductal hyperplasia
✂️Underwent a lumpectomy confirming diagnosis and no additional findings
🤔Which of the following would you recommend for her?
@TumorBoardTues @drteplinsky @MPishvaian @JohnEbbenMDPhD @drRTee @masreya_dr @mabelonc @KadrinWilfong @TammyMarcotte11 @maur_jmp @eccarville @JAMouabbi @VaniaGodo @katsuki_arima @CPratilasMD @DrAmyComander @antoinedardenn1 @KoontzOncology @AMJohnston1315 @JaniceTNBCmets @Martha__Carlson @CCortiMD @ehgkulow @khewittmd @csjeanmd
🌻This Tuesday 05.16.23 at 8pm ET @drteplinsky @prarthnavb join #TumorBoardTuesday to take us through using baby Tam for high risk lesions & in #BreastCancer
💬Join us!
🧠While we finalize the case, collect FREE #CME
👉🏽integrityce.com/tbt 2023👈🏼#OncTwitter #BCSM
💬Join us!
🧠While we finalize the case, collect FREE #CME
👉🏽integrityce.com/tbt 2023👈🏼#OncTwitter #BCSM
@drteplinsky @prarthnavb @MPishvaian @JohnEbbenMDPhD @Dr_RShatsky @hmcarthur @DrSGraff @DrTimothyErick @MdVarvaras @sardesai_sagar @ZainabFatima100 @AnupamaN20 #TumorBoardTuesday
What to recommend for your patients who are high risk #BreastCancer?
👉🏽Join @drteplinsky @prarthnavb Tues 05/16/23 at 8PM ET
📊Respond to polls
Weigh in & bring citations🧾
Retweet & tag your colleagues
🏆Earn FREE CME: integrityce.com/TBT2023
What to recommend for your patients who are high risk #BreastCancer?
👉🏽Join @drteplinsky @prarthnavb Tues 05/16/23 at 8PM ET
📊Respond to polls
Weigh in & bring citations🧾
Retweet & tag your colleagues
🏆Earn FREE CME: integrityce.com/TBT2023
#TumorBoardTuesday
B4⃣ the #BreastCancer case, help us guide the discussion and tell us your connection to🩺 cases like these.
🧐Where you are in your 🩺 journey?
👇
B4⃣ the #BreastCancer case, help us guide the discussion and tell us your connection to🩺 cases like these.
🧐Where you are in your 🩺 journey?
👇
In May 2019, Dr. @rschilsky & I co-chaired the #AAADV19 Workshop Plenary Session "Decentralized #ClinicalTrials: The Future is Now." An incredible group of panelists from academia, industry, govt, & patient #advocacy 👇discussed the rationale, challenges, & opportunities of DCTs.
No one knew yet that the #COVID19 #pandemic was just around the corner. In Mar 2020, FDA released a guidance on conduct of #clinicaltrials during the pandemic: fda.gov/media/136238/d…, & colleagues wrote about the impact on #OncTwitter trials: ncbi.nlm.nih.gov/pmc/articles/P…. /2
FDA has now released a draft guidance on decentralized #clinicaltrials for drugs, biological products, & devices covering #telehealth, remote assessments, consent, shipping of IP, & more: fda.gov/media/167696/d…. #MedTwitter #regulatory #drugdevelopment
@TumorBoardTues @PGrivasMDPhD 1/17 #TumorBoardTuesday #UrothelialCancer #OncTwitter @PGrivasMDPhD
73yo 👴🏼
PMH: HTN, CKD stage 3 (GFR 40), hearing loss
2 month hx flank pain, urinary hesitancy, & hematuria
🩻CT chest abd/pelvis: focal mass-like thickening of anterior bladder wall; no LN-pathy or other mets
73yo 👴🏼
PMH: HTN, CKD stage 3 (GFR 40), hearing loss
2 month hx flank pain, urinary hesitancy, & hematuria
🩻CT chest abd/pelvis: focal mass-like thickening of anterior bladder wall; no LN-pathy or other mets
@TumorBoardTues @PGrivasMDPhD 2/17 #TumorBoardTuesday #UrothelialCancer #BladderCancer @MPishvaian @JohnEbbenMDPhD @OncoAlert @BCMCancerCenter
👴🏼 underwent TURBT
🔬biopsy: high grade urothelial carcinoma, micropapillary variant (100%) with involvement of muscularis propria
🧐 What would you do for this pt?
👴🏼 underwent TURBT
🔬biopsy: high grade urothelial carcinoma, micropapillary variant (100%) with involvement of muscularis propria
🧐 What would you do for this pt?
@TumorBoardTues @PGrivasMDPhD @MPishvaian @JohnEbbenMDPhD @OncoAlert @BCMCancerCenter @Daniel_J_George @BlkBoiScientist @SimaPorten @dawood_findakly @mtsiatas @TomJayram @arnabguonc @KidneyCancerDoc @HHammersMD @arihakimi @AmandaNizamMD @montypal @brian_rini @shilpaonc @DrYukselUrun @TiansterZhang @fuatbcr @UROncDoc @KNJobanputra @minaseconomides @DrRosenbergMSK
@TumorBoardTues 1/15 #TumorBoardTuesday #PanCan #OncTwitter
46yo 👩🏻 asymptomatic
no comorb
🌀Screening abd US: liver nodules + pancreatic mass (body/tail)
🔬Liver bx + NET G2 Ki67 12%
🩻PET-Ga + uptake in pancreas & liver (SUVs>20)
💉1L: Lanreotide SC - DP liver after 1y (⬆️volume)
🤨What 2L tx?
46yo 👩🏻 asymptomatic
no comorb
🌀Screening abd US: liver nodules + pancreatic mass (body/tail)
🔬Liver bx + NET G2 Ki67 12%
🩻PET-Ga + uptake in pancreas & liver (SUVs>20)
💉1L: Lanreotide SC - DP liver after 1y (⬆️volume)
🤨What 2L tx?
@TumorBoardTues 2/15 #TumorBoardTuesday
👩🏻 starts 2L CAPTEM: major partial response🙏🏼
🔪Pancreatectomy + R0 liver resections
🔬Path: NET G3 Ki67 90%
🗓️2 mo later
back pain + weight loss: large retroperitoneal LN
💉3L: rechallenge CAPTEM ➡️ poor clinical control 🔀 Cisplatin + Etoposide
👩🏻 starts 2L CAPTEM: major partial response🙏🏼
🔪Pancreatectomy + R0 liver resections
🔬Path: NET G3 Ki67 90%
🗓️2 mo later
back pain + weight loss: large retroperitoneal LN
💉3L: rechallenge CAPTEM ➡️ poor clinical control 🔀 Cisplatin + Etoposide
@TumorBoardTues 3/15 #TumorBoardTuesday #NETCancer @RachelRiechelm2 @MPishvaian @JohnEbbenMDPhD
👩🏻 DP mediastinal LN after 6 mo
💉4L: FOLFIRINOX with partial response/severe toxicity
📑NGS (Foundation One): very high TMB 97 MSS
🧐What 5L tx would you pick?
👩🏻 DP mediastinal LN after 6 mo
💉4L: FOLFIRINOX with partial response/severe toxicity
📑NGS (Foundation One): very high TMB 97 MSS
🧐What 5L tx would you pick?
@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
@TumorBoardTues @JenniferLitton 1/18 #TumorBoardTuesday #BreastCancer #OncTwitter
32 yo 👩🏽
4 months post-partum
🚫comorbidities
FHx paternal uncle with #PanCan
🔬Bx: L breast mass - IDC, G3, ER 50%, PR 30%, HER2 0, Ki67 30%
Clinically node+; FNA confirms LN involvement
🚫 e/o metastatic dz
🤔Do all EXCEPT?
32 yo 👩🏽
4 months post-partum
🚫comorbidities
FHx paternal uncle with #PanCan
🔬Bx: L breast mass - IDC, G3, ER 50%, PR 30%, HER2 0, Ki67 30%
Clinically node+; FNA confirms LN involvement
🚫 e/o metastatic dz
🤔Do all EXCEPT?
@TumorBoardTues @JenniferLitton 2/18 #TumorBoardTuesday #BCSM @JenniferLitton
🧬 testing returns with BRCA2 path variant
✂️ L mastectomy and ALND
Right risk ⬇️ mastectomy
Found to have 8+/15 LNs
Undergoes adjuvant AC/T
🤔After referring to ☢️ XRT, you discuss which of these treatments?
ET= AI+OS vs Tamoxifen
🧬 testing returns with BRCA2 path variant
✂️ L mastectomy and ALND
Right risk ⬇️ mastectomy
Found to have 8+/15 LNs
Undergoes adjuvant AC/T
🤔After referring to ☢️ XRT, you discuss which of these treatments?
ET= AI+OS vs Tamoxifen
@TumorBoardTues @JenniferLitton @JasmineSukumar @Dr_RShatsky @awolff @jane_meisel @sardesai_sagar @andMORand @MassimoDiMaio75 @MLambouras @melindatelli @IBCradiation @TJH0828 @naborala @MuozMateu @FadwaARahman @emrekocamd @spinmaplered @LeandroJonatad1 @crisonco @adrianakahnmd @MamMa_mimumemo @LauBuisseret
@TumorBoardTues 1/15 #TumorBoardTuesday #BladderCancer #OncTwitter
75yo👴🏽
HTN: Amlodipine
T2DM: Metformin, Insulin
6 mo: haematuria & weight loss
CTCAP: thickened bladder wall with L side hydronephrosis & borderline paraaortic LNS. No distant mets
TURBT: G3 PT2N1M0 bladder TCC
CrCl: 75ml/min
75yo👴🏽
HTN: Amlodipine
T2DM: Metformin, Insulin
6 mo: haematuria & weight loss
CTCAP: thickened bladder wall with L side hydronephrosis & borderline paraaortic LNS. No distant mets
TURBT: G3 PT2N1M0 bladder TCC
CrCl: 75ml/min
@TumorBoardTues 2/15 #TumorBoardTuesday #BladderCancer @tompowles1 @MPishvaian @JohnEbbenMDPhD
👴🏽 Patient opts for cystectomy.
🤔 Should we do a PET scan prior to surgery? Why or why not?
👴🏽 Patient opts for cystectomy.
🤔 Should we do a PET scan prior to surgery? Why or why not?
@TumorBoardTues @tompowles1 @MPishvaian @JohnEbbenMDPhD 3/15 #TumorBoardTuesday #BladderCancer
❌PET scan prior to✂️
🩻PET lacks sensitivity in MIBC (70% in prior study n=43)
📚@adamkibel_uro pubmed.ncbi.nlm.nih.gov/19652070/
clinically negative CT + bone scan, PET/CT had SNS of 70% in MIBC
🧑🏻⚕️🤝👴🏽 #SharedDecision 4 cycles neoadju gem+cis
❌PET scan prior to✂️
🩻PET lacks sensitivity in MIBC (70% in prior study n=43)
📚@adamkibel_uro pubmed.ncbi.nlm.nih.gov/19652070/
clinically negative CT + bone scan, PET/CT had SNS of 70% in MIBC
🧑🏻⚕️🤝👴🏽 #SharedDecision 4 cycles neoadju gem+cis
No monkeying around!
👨🏻⚕️@tompowles1 @drfrankiejs👩🏼⚕️may be in UK, but they’re leading #TumorBoardTuesday on Tuesday!
📅03.28.23 at 8pm ET/12am BT
📰1L pembro or Nivo+Cabo?
🐵While case is finalized, collect FREE #CME (AMA & MOC)
🐒integrityce.com/tbt🙊#OncTwitter #RenalCancer
👨🏻⚕️@tompowles1 @drfrankiejs👩🏼⚕️may be in UK, but they’re leading #TumorBoardTuesday on Tuesday!
📅03.28.23 at 8pm ET/12am BT
📰1L pembro or Nivo+Cabo?
🐵While case is finalized, collect FREE #CME (AMA & MOC)
🐒integrityce.com/tbt🙊#OncTwitter #RenalCancer
@tompowles1 @drfrankiejs @MPishvaian @minaseconomides @JohnEbbenMDPhD @JineshGheeya @niklas_kluemper @EHeath4100 @Heer_Lab @MariaChiaraMCS @ReisLO @PGrivasMDPhD A tad bit of 🙊monkeying around in #TumorBoardTuesday land by attaching a sneak peak into @JohnEbbenMDPhD's wrap up image. 😉
The info is the same!
📅Tues 03/28/23
🕰️8pm ET/12am BT
☕️Cuppa with🇬🇧@tompowles1 👨🏻⚕️👩🏼⚕️@drfrankiejs
🗞️1L tx decision for #RenalCancer
#Urology @Uromigos
The info is the same!
📅Tues 03/28/23
🕰️8pm ET/12am BT
☕️Cuppa with🇬🇧@tompowles1 👨🏻⚕️👩🏼⚕️@drfrankiejs
🗞️1L tx decision for #RenalCancer
#Urology @Uromigos
Join us here on #TumorBoardTuesday for a UK-led #BladderCancer case from👨🏻⚕️ @tompowles1👩🏼⚕️ @drfrankiejs
📅Tues, 03/28/23 at🕗8PM ET / 12AM 🇬🇧
FREE #CME👉🏽integrityce.com/tbt 👈🏼
💬A way to gather input is with📊, so b4️⃣ their case, tell us where you are in your 🩺 journey
👇🏽
📅Tues, 03/28/23 at🕗8PM ET / 12AM 🇬🇧
FREE #CME👉🏽integrityce.com/tbt 👈🏼
💬A way to gather input is with📊, so b4️⃣ their case, tell us where you are in your 🩺 journey
👇🏽
@TumorBoardTues @MPishvaian @JohnEbbenMDPhD @CCAlliance 1/22 #TumorBoardTuesday #ColonCancerAwarenessMonth #OncTwitter @shafiarahman_
62 yo 👨🏼🦳 asymptomatic
🔦 Screening colonoscopy - sigmoid mass
🔬Biopsy + for pMMR/MSS adenocarcinoma
🩻Staging CT + for unresectable liver mets
🤨What first line systemic treatment would you choose?
62 yo 👨🏼🦳 asymptomatic
🔦 Screening colonoscopy - sigmoid mass
🔬Biopsy + for pMMR/MSS adenocarcinoma
🩻Staging CT + for unresectable liver mets
🤨What first line systemic treatment would you choose?
@TumorBoardTues @MPishvaian @JohnEbbenMDPhD @CCAlliance @shafiarahman_ 2/22 #TumorBoardTuesday @MPishvaian @JohnEbbenMDPhD #CRCAwarenessMonth
👨🏼🦳started on first line FOLFOX
🧪NGS testing
KRAS/BRAF WT
TMB low
ERBB2 negative
ATM mutation
👨🏼🦳started on first line FOLFOX
🧪NGS testing
KRAS/BRAF WT
TMB low
ERBB2 negative
ATM mutation
@TumorBoardTues @MPishvaian @JohnEbbenMDPhD @CCAlliance @shafiarahman_ 3/22 #TumorBoardTuesday #GI23 #CRCAwareness
👩🏻🏫Mini tweetorial 1👨🏻🏫
↩️Left side tumors more common:
BRAF WT
KRAS WT
HER2 amp
↪️Right side tumors enriched for
BRAF V600E mutation
KRAS Mut
MSI-H
📚@ASCO
👩🏻🏫Mini tweetorial 1👨🏻🏫
↩️Left side tumors more common:
BRAF WT
KRAS WT
HER2 amp
↪️Right side tumors enriched for
BRAF V600E mutation
KRAS Mut
MSI-H
📚@ASCO
@TumorBoardTues 1/17 #TumorBoardTuesday #RenalCancer #OncTwitter
68yo👨🏾
HTN
T2DM
Arthritis
✂️2022: L Radical Nephrectomy
🔬Clear cell #RenalCellCarcinoma
📏8.2 cm, Grade 2, extends into renal vein (T3a)
❓No lymph nodes sampled (NX)
❌No other dz sites
What would you pick for adj therapy?
68yo👨🏾
HTN
T2DM
Arthritis
✂️2022: L Radical Nephrectomy
🔬Clear cell #RenalCellCarcinoma
📏8.2 cm, Grade 2, extends into renal vein (T3a)
❓No lymph nodes sampled (NX)
❌No other dz sites
What would you pick for adj therapy?
@TumorBoardTues 2/17 #TumorBoardTuesday #RCC
🚨There’s significant relapse risk in ≥ Stage II RCC even after local tx✂️
🔢We use tools like Fox Chase’s ASSURE Prognostic nomogram to estimate disease free survival (DFS)
📈Example for our pt below
📚Correa, Andres F cancernomograms.com/nomograms/492
🚨There’s significant relapse risk in ≥ Stage II RCC even after local tx✂️
🔢We use tools like Fox Chase’s ASSURE Prognostic nomogram to estimate disease free survival (DFS)
📈Example for our pt below
📚Correa, Andres F cancernomograms.com/nomograms/492
@TumorBoardTues 3/17 #TumorBoardTuesday @brian_rini
⭐RCC Adjuvant Therapy⭐
⚖️Weighing recurrence risk with a long list 📜 of adj trial results?
💉Focusing on adju IO & review:
✨KEYNOTE-564: Pembro
✨CheckMate 914: Nivo/Ipi
✨IMmotion010: Atezo
✨PROSPER: Periop Nivo
⭐RCC Adjuvant Therapy⭐
⚖️Weighing recurrence risk with a long list 📜 of adj trial results?
💉Focusing on adju IO & review:
✨KEYNOTE-564: Pembro
✨CheckMate 914: Nivo/Ipi
✨IMmotion010: Atezo
✨PROSPER: Periop Nivo
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 @drsarahsam 1/24 #TumorBoardTuesday #BreastCancer #OncTwitter
54yo 👩🏻 post-menopausal
HTN
hypothyroidism
FH: aunt with late-onset BC
Germline genetic testing: negative
🔪Dec ‘10 Left lumpectomy + SLNB:
left IDC G2
ER 95%
PgR 10%
HER2-neg (IHC 1+)
Ki67 35%
stage pT2 (25 mm) pN0
Oncotype 32
54yo 👩🏻 post-menopausal
HTN
hypothyroidism
FH: aunt with late-onset BC
Germline genetic testing: negative
🔪Dec ‘10 Left lumpectomy + SLNB:
left IDC G2
ER 95%
PgR 10%
HER2-neg (IHC 1+)
Ki67 35%
stage pT2 (25 mm) pN0
Oncotype 32
@TumorBoardTues @drsarahsam 2/24 #TumorBoardTuesday #BCSM
☢️Jan ‘11: TC x 4 ➡️ XRT
Treatment well tolerated, apart from alopecia, G2 fatigue
Summer ‘11 – started letrozole
🔀 Fall ‘11 – switch to exemestane due to G3 arthralgias ➡️ improvement of symptoms
2016 completed 5 years of Aromatase Inhibitor
☢️Jan ‘11: TC x 4 ➡️ XRT
Treatment well tolerated, apart from alopecia, G2 fatigue
Summer ‘11 – started letrozole
🔀 Fall ‘11 – switch to exemestane due to G3 arthralgias ➡️ improvement of symptoms
2016 completed 5 years of Aromatase Inhibitor
@TumorBoardTues @drsarahsam 3/24 #TumorBoardTuesday #BCSM
Apr ‘21 – Mild abdo discomfort
🩻CT CAP scan:
liver: 5 lesions, max 15 mm
bone: spine & ribs
enlarged mediastinal lymph nodes
🩸: G1 anemia, normal LFTs, no other abnormality
🔬US-guided liver biopsy:
IDC, grade 2, ER 90%, PR 0%, HER2-0, Ki67 25%
Apr ‘21 – Mild abdo discomfort
🩻CT CAP scan:
liver: 5 lesions, max 15 mm
bone: spine & ribs
enlarged mediastinal lymph nodes
🩸: G1 anemia, normal LFTs, no other abnormality
🔬US-guided liver biopsy:
IDC, grade 2, ER 90%, PR 0%, HER2-0, Ki67 25%
@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
@TumorBoardTues @TomJayram @arnabguonc @UroCancerMD @vinay_onc @simon_p_kim @AlexAlvaro_PSC @AlyaShamsan @MichaelStaehler @DrOmarMian @kaydaustin @josiegarcia1 @LeeJonesMBA @mcricardoa @UroDocAsh @Uromigos @AJangMD @BenMironMD @ChrisSweens1 @Tanjin097 @NikiTripathi27 1/15 #TumorBoardTuesday #BladderCancer #OncTwitter
71 y/o 👨🏽🦳
Former 🚬
👨🏭Worked in various factories in 80s-00s
Recently diagnosed metastatic #UrothelialCancer (lymph nodes/lung)
🤨 What would you pick for your first line of therapy?
71 y/o 👨🏽🦳
Former 🚬
👨🏭Worked in various factories in 80s-00s
Recently diagnosed metastatic #UrothelialCancer (lymph nodes/lung)
🤨 What would you pick for your first line of therapy?
@TumorBoardTues @TomJayram @arnabguonc @UroCancerMD @vinay_onc @simon_p_kim @AlexAlvaro_PSC @AlyaShamsan @MichaelStaehler @DrOmarMian @kaydaustin @josiegarcia1 @LeeJonesMBA @mcricardoa @UroDocAsh @Uromigos @AJangMD @BenMironMD @ChrisSweens1 @Tanjin097 @NikiTripathi27 2/15 #TumorBoardTuesday
1L treatment for UC
📍cis eligible: SOC is gem/cis
📚pubmed.ncbi.nlm.nih.gov/11001674/
📍Frontline EV+P promising early phase results in cis-ineligible
📚ascopubs.org/doi/abs/10.120…
📍Ongoing ph3 trial: EV+pembro vs gem/cis (or carbo) clinicaltrials.gov/ct2/show/NCT04…
1L treatment for UC
📍cis eligible: SOC is gem/cis
📚pubmed.ncbi.nlm.nih.gov/11001674/
📍Frontline EV+P promising early phase results in cis-ineligible
📚ascopubs.org/doi/abs/10.120…
📍Ongoing ph3 trial: EV+pembro vs gem/cis (or carbo) clinicaltrials.gov/ct2/show/NCT04…
@TumorBoardTues @TomJayram @arnabguonc @UroCancerMD @vinay_onc @simon_p_kim @AlexAlvaro_PSC @AlyaShamsan @MichaelStaehler @DrOmarMian @kaydaustin @josiegarcia1 @LeeJonesMBA @mcricardoa @UroDocAsh @Uromigos @AJangMD @BenMironMD @ChrisSweens1 @Tanjin097 @NikiTripathi27 @PGrivasMDPhD @PauloBergerot @spsutkaMD @shilpaonc @montypal @tompowles1 @NazliDizman 3/15 #TumorBoardTuesday
Checkpoint☑️
✅Pembrolizumab: approved as single agent for those NOT eligible for platinum chemotherapy
📚thelancet.com/journals/lanon…
BUT
✨KEYNOTE-361: adding pembro to platinum based chemo did NOT result in PFS/OS improvement
📚thelancet.com/journals/lanon…
Checkpoint☑️
✅Pembrolizumab: approved as single agent for those NOT eligible for platinum chemotherapy
📚thelancet.com/journals/lanon…
BUT
✨KEYNOTE-361: adding pembro to platinum based chemo did NOT result in PFS/OS improvement
📚thelancet.com/journals/lanon…
1/22 #TumorBoardTuesday #OncTwitter
60yo 👩🏻
ER+/PR-/HER2 low met #BreastCancer
Since 2016: 3 lines of endocrine therapy including AI+CDK 4/6 inhibitor ➡️ Fulvestrant ➡️ Everolimus+exemestane
No actionable mutation
🤨 What would be your first chemotherapy choice:
60yo 👩🏻
ER+/PR-/HER2 low met #BreastCancer
Since 2016: 3 lines of endocrine therapy including AI+CDK 4/6 inhibitor ➡️ Fulvestrant ➡️ Everolimus+exemestane
No actionable mutation
🤨 What would be your first chemotherapy choice:
2/22 #TumorBoardTuesday @MPishvaian @JohnEbbenMDPhD #BreastCancer #BCSM
2021*: Started on capecitabine for 8 months until POD
2022: Switched to paclitaxel for 5 months ➡️ POD in the liver and pleura
🤨 What would be your next step?
2021*: Started on capecitabine for 8 months until POD
2022: Switched to paclitaxel for 5 months ➡️ POD in the liver and pleura
🤨 What would be your next step?
3/22 #TumorBoardTuesday
👩🏻🏫Mini tweetorial 1
📌What is HER2-low?
🔸Traditionally HER2-positive and HER2-negative were separate entities
🔸NOW, HER2-low is a separate entity 👉🏽 1+ or 2+ on IHC and ISH negative‼️
📚@PTarantinoMD @curijoey @stolaney1 aacrjournals.org/cancerdiscover…
👩🏻🏫Mini tweetorial 1
📌What is HER2-low?
🔸Traditionally HER2-positive and HER2-negative were separate entities
🔸NOW, HER2-low is a separate entity 👉🏽 1+ or 2+ on IHC and ISH negative‼️
📚@PTarantinoMD @curijoey @stolaney1 aacrjournals.org/cancerdiscover…
Some of the most challenging cases on the leukemia service were patients who seemed totally stable but wouldn't stop fevering!
#OncID is one of my favorite parts of cancer care.
Let's talk inpatient neutropenic fever!
- Thread -
#MedTwitter #MedED #FOAMed #OncTwitter
1/23
#OncID is one of my favorite parts of cancer care.
Let's talk inpatient neutropenic fever!
- Thread -
#MedTwitter #MedED #FOAMed #OncTwitter
1/23
Check out the neutropenic fever inpatient template @pointofcaremed
pointofcaremedicine.com/hematology-and…
Also, check out the podcast and a video with accompanying slides on our new YouTube channel!
spotifyanchor-web.app.link/e/lGRz5aFLNwb
2/23
pointofcaremedicine.com/hematology-and…
Also, check out the podcast and a video with accompanying slides on our new YouTube channel!
spotifyanchor-web.app.link/e/lGRz5aFLNwb
2/23
Interestingly, there are many different definitions of fever depending on the context.
A fever is technically any temperature above "normal."
The Merck Manual defines fever as an oral temp >37.8 C (>100.0 F) OR a rectal temp >38.2 C (>100.8 F)
3/23
A fever is technically any temperature above "normal."
The Merck Manual defines fever as an oral temp >37.8 C (>100.0 F) OR a rectal temp >38.2 C (>100.8 F)
3/23
💥#EndometrialCancer TKI/IO safety data & AE mgmt webinar 💥┈┈┈ w @DrMMurphy & @drteplinsky ┈┈┈🔹#CME info 👉 bit.ly/3Vqtabi 👈 @BonumCE ┈┈┈🔸Supported by edu grants from Eisai & @Merck 🔹#TumorBoardTuesday #gyncsm #OncTwitter twitter.com/i/broadcasts/1…
1/#TumorBoardTuesday #OncTwitter
#1:Answer #PreTest❓bit.ly/PreTest-AEs-EC
#2:Tell us who u are👇
#3:🔁Retweet & tag colleagues
🧧#CME ℹ️bit.ly/3Vqtabi
Supported by edu grants from Eisai & @Merck
🟢Where r u in your career?
#1:Answer #PreTest❓bit.ly/PreTest-AEs-EC
#2:Tell us who u are👇
#3:🔁Retweet & tag colleagues
🧧#CME ℹ️bit.ly/3Vqtabi
Supported by edu grants from Eisai & @Merck
🟢Where r u in your career?
2/#TumorBoardTuesday #BonumCE #OncTwitter #GynCSM #gynonc #EndometrialCancer
🟠Earn 🆓 #CME 🏆
🟠#CME ℹ️🔗bit.ly/3YRDkog
📸 Faculty disclosures & important CME info 👇
🟠Earn 🆓 #CME 🏆
🟠#CME ℹ️🔗bit.ly/3YRDkog
📸 Faculty disclosures & important CME info 👇
💥#EndometrialCancer TKI/IO safety data & AE mgmt webinar 💥┈┈┈ w @DrMMurphy & @drteplinsky ┈┈┈🔹#CME info 👉 bit.ly/3Vqtabi 👈 @BonumCE ┈┈┈🔸Supported by edu grants from Eisai & @Merck 🔹#TumorBoardTuesday #gyncsm #OncTwitter twitter.com/i/broadcasts/1…
1/#TumorBoardTuesday #OncTwitter
#1:Answer #PreTest❓🔗bit.ly/EC_AEs_TBTpre
#2:Tell us who u are👇
#3:🔁Retweet & tag colleagues
🧧#CME ℹ️bit.ly/3Vqtabi
Supported by edu grants from Eisai & @Merck
🟢Where r u in your career?
#1:Answer #PreTest❓🔗bit.ly/EC_AEs_TBTpre
#2:Tell us who u are👇
#3:🔁Retweet & tag colleagues
🧧#CME ℹ️bit.ly/3Vqtabi
Supported by edu grants from Eisai & @Merck
🟢Where r u in your career?
3/#TumorBoardTuesday #BonumCE #OncTwitter #GynCSM #gynonc #EndometrialCancer
🟠Earn 🆓 #CME 🏆
🟠#CME ℹ️🔗bit.ly/3YRDkog
📸 Faculty disclosures & important CME info 👇
🟠Earn 🆓 #CME 🏆
🟠#CME ℹ️🔗bit.ly/3YRDkog
📸 Faculty disclosures & important CME info 👇
1/#TumorBoardTuesday #OncTwitter
🗓️TODAY🗓 w @DrTeplinsky & @TumorBoardTues
🎥#EndometrialCancer - Mnging TKI/IO AEs
#CMEℹ️ bit.ly/3Vqtabi
Support by edu grants from Eisai & @Merck
🚨Be ready @ 8p ET/5p PT
✅Answer #PreTest👇
🔁RT & tag 🩺
🟢Where r u in your career?
🗓️TODAY🗓 w @DrTeplinsky & @TumorBoardTues
🎥#EndometrialCancer - Mnging TKI/IO AEs
#CMEℹ️ bit.ly/3Vqtabi
Support by edu grants from Eisai & @Merck
🚨Be ready @ 8p ET/5p PT
✅Answer #PreTest👇
🔁RT & tag 🩺
🟢Where r u in your career?
2/#TumorBoardTuesday #OncTwitter #GynCSM #gynonc
#CME🔗bit.ly/3YRDkog
🟢#PreTest Q 1️⃣
📊Diarrhea, nausea, & vomiting are common GI toxicities associated w pembro + lenvatinib combo therapy.
🟢Which other tox may occur if these GI toxicities are not effectively managed?
#CME🔗bit.ly/3YRDkog
🟢#PreTest Q 1️⃣
📊Diarrhea, nausea, & vomiting are common GI toxicities associated w pembro + lenvatinib combo therapy.
🟢Which other tox may occur if these GI toxicities are not effectively managed?
3/#TumorBoardTuesday #GynCSM #EndometrialCancer
#CME 🔗bit.ly/3YRDkog
🟢#PreTest Q 2️⃣
📊During tx w pembro + lenvatinib, pt develops grade 3 diarrhea
🛑Lenva held
💊Loperamide Rx
Grade 3 diarrhea persists
🟢Which is the appropriate next step for this pt?
#CME 🔗bit.ly/3YRDkog
🟢#PreTest Q 2️⃣
📊During tx w pembro + lenvatinib, pt develops grade 3 diarrhea
🛑Lenva held
💊Loperamide Rx
Grade 3 diarrhea persists
🟢Which is the appropriate next step for this pt?
1/#TumorBoardTuesday #OncTwitter
🗓️TODAY🗓 w @DrMMurphy & @DrTeplinsky
🎥#EndometrialCancer - Mnging TKI/IO AEs
#CMEℹ️ bit.ly/3Vqtabi
Support by edu grants from Eisai & @Merck
🚨Be ready @ 8p ET/5p PT
✅Answer #PreTest👇
🔁RT & tag 🩺
🟢Where r u in your career?
🗓️TODAY🗓 w @DrMMurphy & @DrTeplinsky
🎥#EndometrialCancer - Mnging TKI/IO AEs
#CMEℹ️ bit.ly/3Vqtabi
Support by edu grants from Eisai & @Merck
🚨Be ready @ 8p ET/5p PT
✅Answer #PreTest👇
🔁RT & tag 🩺
🟢Where r u in your career?
2/#TumorBoardTuesday #OncTwitter #GynCSM #gynonc
#CME🔗bit.ly/3YRDkog
🟢#PreTest Q 1️⃣
📊Diarrhea, nausea, & vomiting are common GI toxicities associated w pembro + lenvatinib combo therapy
🟢Which other tox may occur if these GI toxicities are not effectively managed?
#CME🔗bit.ly/3YRDkog
🟢#PreTest Q 1️⃣
📊Diarrhea, nausea, & vomiting are common GI toxicities associated w pembro + lenvatinib combo therapy
🟢Which other tox may occur if these GI toxicities are not effectively managed?
3/#TumorBoardTuesday #GynCSM #EndometrialCancer
#CME🔗bit.ly/3YRDkog
🟢#PreTest Q 2️⃣
📊During tx w pembro + lenvatinib, pt develops grade 3 diarrhea
🛑Lenva held
💊Loperamide Rx
Grade3️⃣diarrhea persists
🟢What is the next step for this pt?
(cs=corticosteroid)
#CME🔗bit.ly/3YRDkog
🟢#PreTest Q 2️⃣
📊During tx w pembro + lenvatinib, pt develops grade 3 diarrhea
🛑Lenva held
💊Loperamide Rx
Grade3️⃣diarrhea persists
🟢What is the next step for this pt?
(cs=corticosteroid)
1/#OncTwitter #TumorBoardTuesday #MedTweetorial 🧵
✅#EndometrialCancer AE deep dive🤿
🧪Trial results
🔬Tox for TKI-ICI
w @DrMMurphy @MeganLeigh127 & us!
🆓#CME @BonumCe🔗bit.ly/3VBGJEJ
Supported by edu grants from Eisai & @Merck
🟢What's your specialty?
✅#EndometrialCancer AE deep dive🤿
🧪Trial results
🔬Tox for TKI-ICI
w @DrMMurphy @MeganLeigh127 & us!
🆓#CME @BonumCe🔗bit.ly/3VBGJEJ
Supported by edu grants from Eisai & @Merck
🟢What's your specialty?
2/#TumorBoardTuesday #BonumCE #OncTwitter #gyncsm #gynonc #EndometrialCancer #MedTweetorial
🆓 CME > full info➕ref list🗒️& program archive
👉bit.ly/3VBGJEJ
🔑#CME info👇
🆓 CME > full info➕ref list🗒️& program archive
👉bit.ly/3VBGJEJ
🔑#CME info👇
3/#TumorBoardTuesday #BonumCE #OncTwitter #GynOnc #gyncsm #EndometrialCancer
🟢Which I/O +🎯tx combo is FDA approved for treatment of advanced or metastatic #EndometrialCarcinoma?
nivo = nivolumab
dostarlimab = dostarlimab-gxly
pembro = pembrolizumab
🟢Which I/O +🎯tx combo is FDA approved for treatment of advanced or metastatic #EndometrialCarcinoma?
nivo = nivolumab
dostarlimab = dostarlimab-gxly
pembro = pembrolizumab
@TumorBoardTues @PGrivasMDPhD @MPishvaian @JohnEbbenMDPhD 1/19 #TumorBoardTuesday #BladderCancer #OncTwitter
74 yo🧓🏼
HTN
DM2
2020: localized Rt upper tract urothelial carcinoma
2020: ✂️ radical nephroureterectomy
🧪Germline testing negative
Complicated by CKD stage 4 after ✂️ (creatinine clearance 25 ml/min)
🩻Restaging CT CAP 1 year
74 yo🧓🏼
HTN
DM2
2020: localized Rt upper tract urothelial carcinoma
2020: ✂️ radical nephroureterectomy
🧪Germline testing negative
Complicated by CKD stage 4 after ✂️ (creatinine clearance 25 ml/min)
🩻Restaging CT CAP 1 year
@TumorBoardTues @PGrivasMDPhD @MPishvaian @JohnEbbenMDPhD 🩻 NEW metastatic disease to spine, 🫁 and retroperitoneal lymph nodes
ECOG PS 2
🔬Biopsy of RP lymph node: Metastatic #UrothelialCarcinoma
🧪Molecular: FGFR3-TACC3 fusion, MTAP loss, CDKN2A loss
🤨 What 1L treatment would you pick for this patient?
ECOG PS 2
🔬Biopsy of RP lymph node: Metastatic #UrothelialCarcinoma
🧪Molecular: FGFR3-TACC3 fusion, MTAP loss, CDKN2A loss
🤨 What 1L treatment would you pick for this patient?
@TumorBoardTues @PGrivasMDPhD @MPishvaian @JohnEbbenMDPhD 3/19 #TumorBoardTuesday @PGrivasMDPhD @MPishvaian @JohnEbbenMDPhD #UrothelialCancer
🤔 Is the above 74yo 🧓🏼 patient a good candidate for platinum-based chemotherapy?
🤨 Poll: Which of these criteria would make this patient platinum-ineligible?
🤔 Is the above 74yo 🧓🏼 patient a good candidate for platinum-based chemotherapy?
🤨 Poll: Which of these criteria would make this patient platinum-ineligible?
🔥IMPORTANT! #MedTwitter & all workers: the @FTC is proposing to make noncompete clauses illegal. Employers would be prohibited from establishing them & forced to rescind existing ones, incl notifying past employees of the change! 👏👏 @MedicineForward nytimes.com/2023/01/05/bus…
~ 1/5 of US workers are currently under non-compete clauses. They harm workers in many sectors, incl #MedTwitter, e.g., by preventing them from taking a better position w/ another company unless they’re willing to move or travel a long way to work. 2/
#MedTwitter is often subject to noncompete clauses. Here’s why that is so important, even if you’re not a dr yourself: nytimes.com/2019/03/15/bus…
3/
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