Discover and read the best of Twitter Threads about #TumorBoardTuesday

Most recents (24)

@TumorBoardTues @JohnEbbenMDPhD #TumorBoardTuesday
📣Welcome as we summarize some of the incredible data from #ASCO23
👉There was SO much to take in, that even focusing on GI Cancers was a challenge
🙏As always, these were the🧑‍🏫that caught OUR interest, but this is not a judgement on those we do not highlight‼️
@TumorBoardTues @JohnEbbenMDPhD 1/21
🤔Speaking for myself, @knutjla ‘s data has shaken my practice the most (including twice last week)
👉He presented the NORPACT-1 trial of peri-operative FOLFIRINOX vs. upfront🔪for resectable #PancreaticCancer Image
@TumorBoardTues @JohnEbbenMDPhD @knutjla @MDAkhilChawla @FlavioRochaMD @NbmerchantMD @MadameSurgeon @NirajGusani @TsengJennifer 2/21
@knutjla🗣️a well designed, well run trial
✅The authors even hypothesized a 20%⬆️in mOS
➡️However, pre-operative chemotherapy led to a significant⬇️in 18 month mOS😲
👉Despite a much better R0 resection rate

🤔What are your thoughts💭❓ Image
Read 22 tweets
@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.
@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?
Read 19 tweets
🌻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

👉🏽 2023👈🏼#OncTwitter #BCSM Join us for a #TumorBoardTu...
@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: Join us for a #TumorBoardTu...

B4⃣ the #BreastCancer case, help us guide the discussion and tell us your connection to🩺 cases like these.

🧐Where you are in your 🩺 journey?

Read 5 tweets
1/6 #TumorBoardTuesday

🔬🧬@PGrivasMDPhD @rafee_talukder discussed variant histology #urothelialcarcinoma & cis-ineligible dz

➡️Thursday Case wrap up 🎀

🆓 #CME: answer 2 quick ❓
CME eval🔗: Image
2/6 #TumorBoardTuesday
Thurs Case🎀
✅Variant hist UC changes tx
⬇️resp to plat 👉surg first, clin trial
✅Cis inelig mUC- acc approval: Enfortumab Vedotin + pembro 1L
✅Trials: 1L SG + IO, others

📚Here’s @PGrivasMDPhD @rafee_talukder’s thread…
@PGrivasMDPhD @rafee_talukder 3/6 #TumorBoardTuesday
Thursday Case🎀
🎞️ TBT in a video

Here’s the highlight reel:
Dr. Talukder & Grivas talk about:
🔹new approaches for cis ineligible disease
🔹variant histology
🙌 what to look forward to at #ASCO2023.

Check out the next tweet for the Director’s 🎬 cut!
Read 10 tweets
@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
@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?
Read 20 tweets
1/5 #TumorBoardTuesday

🧬No more waiting! Here’s our summary of @RachelRiechelm2 @jessrzanotti’s talk re: hypermut #NET. Can biomarker become clinically actionable?

🆓#CME: 2 quick❓
CME eval🔗: #TumorBoardTuesday… Image
2/5 #TumorBoardTuesday

Take🏠 messages:
✅ Hypermut(TMB>10) RARE in NET
✅ Post-tx w alkylator (CAPE/TEM)
✅Mixed results w IO monotx; studying dual IO, combos
✅ Repeat NGS if NET becomes more aggressive; ID new targets, hypermut

📚The thread:…
3/5 #TumorBoardTuesday

🎥 TBT in a video
@RachelRiechelm2 shared key points:
✅NGS critical in NETs–change substantially over time!
✅Hypermut after CAPE/TEM more common than we think
✅Strategies that use dual IO are under active investigation- may be more effective!
Read 8 tweets
@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?
@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
@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?
Read 19 tweets

🔬🧬Tx of #EGFR Exon20 insertion has changed significantly. @LealTiciana @JennyCarlisleMD brought us up to speed at #TumorBoardtuesday

➡️Here’s the Thursday Case 🎀
🆓 #CME: 2 quick❓
CME eval🔗: Image
2/8 #TumorBoardTuesday
Thurs Case🎀
✅Next gen seq=ESSENTIAL. PCR misses EGFR exon20 ins!
✅CHRYSALIS: Amivantamab (EGFR/MET Bispecifc mAb) 2L
✅EXCLAIM: Mobocertinib (EGFR TKI) 2L
✅1L= Plat chemo; 2L= ami/mobo

📚 @LealTiciana @JennyCarlisleMD’s thread…
3/8 #TumorBoardTuesday
Thurs Case🎀
🎥 TBT in a video: Pt 1-
@LealTiciana takes us through importance of NGS–but not just any NGS.

🔹RNA/DNA based NGS>>> hotspot PCR, which may miss ex20 ins
🔹🩸ctDNA + tumor🧬= Make faster tx decision, ⬆️sens
🔹Identify trials, future options
Read 9 tweets
@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?
@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… Image
Read 24 tweets
@TumorBoardTues @JenniferLitton @marijasullivan @MPishvaian @MDAndersonNews @BreastCaupdates @BRCAUmbrella @hoperugo @Dr_RShatsky 2/5 #TumorBoardTuesday
✅ 🧬test 🗝️! Biomarkers 👉 best tx
✅ OlympiA: OS & IDFS⬆️w Olaparib- gBRCAm
✅ MonarchE: IDFS⬆️ w abema +ET- HR+
✅ Fertility pres & interrupting adj tx (if desired) for pregnancy
📚@JenniferLitton @marijasullivan’s thread…
@TumorBoardTues @JenniferLitton @marijasullivan @MPishvaian @MDAndersonNews @BreastCaupdates @BRCAUmbrella @hoperugo @Dr_RShatsky 3/5 #TumorBoardTuesday
Thursday Case🎀

🎥 TBT in a video
@marijasullivan summarizes adj tx based on biomarkers. How to approach pts w gBRCA1/2m & HR+? Need more data!

🔹gBRCAm👉 Olaparib x 1y
🔹 HR+👉 Abemaciclib + ET x 2y -> ET; data expected on other CDK4/6i soon (ribociclib)
@TumorBoardTues @JenniferLitton @marijasullivan @MPishvaian @MDAndersonNews @BreastCaupdates @BRCAUmbrella @hoperugo @Dr_RShatsky 4/5 #TumorBoardTuesday
📷 TBT in an image

In pts who desire pregnancy, data that adj tx can be interrupted & later resumed safely- waiting on long-term follow up @AnnPartridgeMD.

✅Pregnancy outcomes after #BreastCancer NOT worse. Fertility pres strat BEFORE tx 🗝️ if desired. Image
Read 8 tweets
@TumorBoardTues @JenniferLitton 1/18 #TumorBoardTuesday #BreastCancer #OncTwitter

32 yo 👩🏽
4 months post-partum
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
Read 23 tweets
@TumorBoardTues 1/15 #TumorBoardTuesday #BladderCancer #OncTwitter
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?
@TumorBoardTues @tompowles1 @MPishvaian @JohnEbbenMDPhD 3/15 #TumorBoardTuesday #BladderCancer

❌PET scan prior to✂️
🩻PET lacks sensitivity in MIBC (70% in prior study n=43)
clinically negative CT + bone scan, PET/CT had SNS of 70% in MIBC
🧑🏻‍⚕️🤝👴🏽 #SharedDecision 4 cycles neoadju gem+cis
Read 19 tweets
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)

🐒🙊#OncTwitter #RenalCancer Join us for a #TumorBoardTu...
@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 Join us for a #TumorBoardTu...
Join us here on #TumorBoardTuesday for a UK-led #BladderCancer case from👨🏻‍⚕️ @tompowles1👩🏼‍⚕️ @drfrankiejs

📅Tues, 03/28/23 at🕗8PM ET / 12AM 🇬🇧
FREE #CME👉🏽 👈🏼

💬A way to gather input is with📊, so b4️⃣ their case, tell us where you are in your 🩺 journey
Read 7 tweets
@TumorBoardTues @shafiarahman_ @RischZack @MPishvaian @ColonCancerCoal @colontown @coloncancermike @GlobalCRC 2/6 #TumorBoardTuesday
Thurs Case🎀

#mCRC & #EGFR tx:
✅Anti-EGFR useful in RAS/RAF WT; debate re: timing vs anti-VEGF
✅Pt centered discussion including SEs 🗝️
✅Emerging data: EGFR re-tx, using ctDNA to guide

📚@shafiarahman_ @RischZack’s thread:…
@TumorBoardTues @shafiarahman_ @RischZack @MPishvaian @ColonCancerCoal @colontown @coloncancermike @GlobalCRC 3/6 #TumorBoardTuesday
🎥 TBT in a vid- Part 1:

@shafiarahman_ 's approach: pt eligible for EGFR-directed tx in #metastatic #CRC
🔹RAS/RAF WT- more important than side
🔹Bev or pan 1L? Trend toward pan, but is 🗝️actually that pt gets anti-EGFR in tx, 🚫necessarily 1L?
@TumorBoardTues @shafiarahman_ @RischZack @MPishvaian @ColonCancerCoal @colontown @coloncancermike @GlobalCRC 4/6 #TumorBoardTuesday
🎥 TBT in a vid- Part 2:

@shafiarahman_ gives us a preview of what might be coming in #EGFR directed tx in #mCRC
🔹Re-challenge based on ctDNA clearance of resistant clones; pts w resistance to EGFRi benefit later as the tumor evolves again
🔹New combos!
Read 12 tweets
@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?
@TumorBoardTues @MPishvaian @JohnEbbenMDPhD @CCAlliance @shafiarahman_ 2/22 #TumorBoardTuesday @MPishvaian @JohnEbbenMDPhD #CRCAwarenessMonth

👨🏼‍🦳started on first line FOLFOX
🧪NGS testing
TMB low
ERBB2 negative
ATM mutation
@TumorBoardTues @MPishvaian @JohnEbbenMDPhD @CCAlliance @shafiarahman_ 3/22 #TumorBoardTuesday #GI23 #CRCAwareness
👩🏻‍🏫Mini tweetorial 1👨🏻‍🏫

↩️Left side tumors more common:
HER2 amp

↪️Right side tumors enriched for
BRAF V600E mutation
Read 29 tweets
@TumorBoardTues @brian_rini @JVentoMD @MPishvaian @Uromigos @JoshLangMD @renalandurology @UroDocAsh 2/5 #TumorBoardTuesday
Thurs Case🎀

✅ Pembro ONLY approved adj IO in RCC
✅ 3 recent trials w IO failure: nivo/ipi, atezo & periop nivo
✅ Must balance risks vs benefits- shared decision-making 🗝️

📚@brian_rini @JVentoMD’s thread:…
@TumorBoardTues @brian_rini @JVentoMD @MPishvaian @Uromigos @JoshLangMD @renalandurology @UroDocAsh 3/5 #TumorBoardTuesday
Thurs Case🎀

🎥 TBT in a video
High risk #RCC, pembro= DFS advantage, but w cost- Grade 3 AEs= 32%. High risk #RCC defined by:
🔹Stage II w sarcomatoid features
🔹Stage III+
🔹Regional LN+/M1 disease

Quick overview of adj IO decision making:
@TumorBoardTues @brian_rini @JVentoMD @MPishvaian @Uromigos @JoshLangMD @renalandurology @UroDocAsh 4/5 #TumorBoardTuesday
Thursday Case🎀

📷 TBT in an image
Nomograms, including ASSURE from @FoxChaseCancer can provide addtl context re: risk of recurrence–but remember:

⭐️Every patient is an individual!

Our guide to help lead discussions w pts re: risks/benefits of adj IO:
Read 9 tweets
@TumorBoardTues 1/17 #TumorBoardTuesday #RenalCancer #OncTwitter

✂️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
@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
Read 20 tweets
@TumorBoardTues @DrSteveMartin @DAielloMD @MPishvaian @NarjustFlorezMD @EGFRResisters @lcrf_org @ADesaiMD @GDutcherMD 2/5 #TumorBoardTuesday
Thurs Case🎀

✅ctDNA= both tx decision making & MRD in #NSCLC
✅Identify actionable muts in dz where a bx not possible
✅Pros (serum test) & cons ($, inability to multiplex with IHC- aka PD-L1 status)

📚The thread:…
@TumorBoardTues @DrSteveMartin @DAielloMD @MPishvaian @NarjustFlorezMD @EGFRResisters @lcrf_org @ADesaiMD @GDutcherMD 3/5 #TumorBoardTuesday
Thurs Case🎀

🎥 TBT in a video
ctDNA + tissue-based NGS= highest sensitivity (do NOT miss actionable mutations in #NSCLC).
ctDNA can be used to:
🔹Identify actionable mutations
🔹Track disease status (MRD)
🔹Adapt targeted therapies based on 2dary muts
@TumorBoardTues @DrSteveMartin @DAielloMD @MPishvaian @NarjustFlorezMD @EGFRResisters @lcrf_org @ADesaiMD @GDutcherMD 4/5 #TumorBoardTuesday
Thurs Case🎀

📷 TBT in an image

Also have to understand caveats!
1⃣ctDNA works best in higher volume dz.
2⃣Know when to suspect germline mut (variant allele fractions near 50%)
3⃣Clonal hematopoiesis of indeterminate potential muts that could mislead! Image
Read 11 tweets
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?
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 🙌🏽
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
Read 33 tweets
@TumorBoardTues @drsarahsam @PTarantinoMD @stolaney1 @MPishvaian @BreastCaupdates @BCRFcure @BCAction @LivingBeyondBC @RenoHemonc 2/5 #TumorBoardTuesday

✅CDK4/6i +endocrine tx= 1L HR+ mBC
✅Ribo =⬆️OS; select based on shared decision
✅After prog on CDK4/6i, eval muts (ESR1, PIK3CA)➡️SERD vs PIK3CAi
✅Benefit in adj- monarchE

📚Here’s @drsarahsam @PTarantinoMD’s thread…
@TumorBoardTues @drsarahsam @PTarantinoMD @stolaney1 @MPishvaian @BreastCaupdates @BCRFcure @BCAction @LivingBeyondBC @RenoHemonc 3/5 #TumorBoardTuesday

🎥 TBT in a video: HR+ #mBC tx has changed significantly, esp in 2L setting.

Check out this SHORT video w algorithm to approach tx after progression on CDK4/6i:

A bigger and bigger role for 🎯 medicine to select next best therapy!
@TumorBoardTues @drsarahsam @PTarantinoMD @stolaney1 @MPishvaian @BreastCaupdates @BCRFcure @BCAction @LivingBeyondBC @RenoHemonc 4/5 #TumorBoardTuesday

📷 TBT in an image: Selecting CDK4/6i involves shared decision making! Things to keep in mind:

🔹OS benefit seen with ribociclib, but not palbo.
🔹Different toxicity profiles
🔹Medication interactions (QTc prolongation w ribo+ tamoxifen!) Image
Read 10 tweets
@TumorBoardTues @drsarahsam 1/24 #TumorBoardTuesday #BreastCancer #OncTwitter
54yo 👩🏻 post-menopausal
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
@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%
Read 26 tweets
@TumorBoardTues @ShrutiPatelMD @NarjustFlorezMD @LungAssociation @DrSteveMartin @FawziAbuRous @esinghimd @RenoHemonc @HemOncFellows 2/5 #TumorBoardTuesday
Thurs Case🎀
✅Biomarker - sq cell #LC, chemoIO is the SOC
✅Pembro, cemi, ipi/nivo approved in 1L squamous cell lung cancer—must be paired with chemo if PD-L1 TPS < 50%
✅ irAEs can be very serious- early, multi-D mgmt is 🗝️

@TumorBoardTues @ShrutiPatelMD @NarjustFlorezMD @LungAssociation @DrSteveMartin @FawziAbuRous @esinghimd @RenoHemonc @HemOncFellows 3/5 #TumorBoardTuesday
Thurs Case🎀

📽️TBT video wrap up:

IO has fundamentally changed 🫁 cancer tx.
Choosing the right strategy in squamous cell lung ca largely based on PD-L1 status; we’re hoping for more, & better, biomarkers in the future.
@TumorBoardTues @ShrutiPatelMD @NarjustFlorezMD @LungAssociation @DrSteveMartin @FawziAbuRous @esinghimd @RenoHemonc @HemOncFellows 4/5 #TumorBoardTuesday
Thurs Case🎀

📷TBT in an image:

Check out this algo to help select IO vs chemoIO strat in #squamouscell #lcsm lung cancer 1L setting.
No head-to-head 👊data to define clear winner, but pembro, cemiplimab, and ipi/nivo approved based on OS benefit. Image
Read 18 tweets
@NarjustFlorezMD @TumorBoardTues @drRTee @ADesaiMD @esinghimd @FawziAbuRous @ALKpositiveINT @Rothangpuia5 @SamuelKareffMD @AlyaShamsan @LVaezi @n8pennell 4/23 #TumorBoardTuesday
👩🏽‍🏫Mini tweetorial 1👩🏽‍🏫

📚@NCCN based #NSCLC guide for biomarker neg, PDL1 <1% ⤵️

📍Pembro + carboplatin + paclitaxel
📍Pembro + carboplatin + nab-paclitaxel
📍Ipi/Nivo + carbo + paclitaxel
📍Cemiplimab + carbo + paclitaxel
@NarjustFlorezMD @TumorBoardTues @drRTee @ADesaiMD @esinghimd @FawziAbuRous @ALKpositiveINT @Rothangpuia5 @SamuelKareffMD @AlyaShamsan @LVaezi @n8pennell @NCCN 5/23 #TumorBoardTuesday
👩🏽‍🏫Mini tweetorial 2👩🏽‍🏫

♦️Phase III
♦️Untreated metastatic, squamous NSCLC
♦️Pts randomized 1:1 pembro+platinum-doublet vs plat doublet alone
♦️Median OS 15.9 mos vs 11.3 mos
♦️69.8% of grade 3+ AEs in pembro-combo vs 68.2% in placebo-combo
@NarjustFlorezMD @TumorBoardTues @drRTee @ADesaiMD @esinghimd @FawziAbuRous @ALKpositiveINT @Rothangpuia5 @SamuelKareffMD @AlyaShamsan @LVaezi @n8pennell @NCCN 6/23 #TumorBoardTuesday
👩🏽‍🏫Mini tweetorial 3👩🏽‍🏫

♦️ Phase III in untreated metastatic NSCLC
♦️ patients randomized 1:1 nivolumab+ipilimumab + 2 cycles chemo vs 4 cycles chemo

PFS KM Curves in Squamous Pts ⬇️
Read 22 tweets
@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?
@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?
@TumorBoardTues @NarjustFlorezMD 3/23 #TumorBoardTuesday


🫁 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
Read 3 tweets

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