Discover and read the best of Twitter Threads about #crcsm
Most recents (11)
Let's have a closer look 🧐at the PROSPECT trial after its presentation at #ASCO23 and publication in @NEJM bit.ly/43L83oI #radonc #crcsm 1/n
First of all, the study team is to be congratulated for successful recruitment and completion of the study. Almost 1200 patients randomized - everyone who has led a multicenter trial can appreciate how challenging it can be to keep recruitment up over time.
The study enrolled patients with locally advanced rectal cancer that had to meet some specific inclusion criteria.
🔹Tumor located 5-12 cm from anal verge
🔹Sphincter sparing surgery possible at baseline
🔹Distance from MRF min. 3 mm
🔹T2N1 or T3N- or T3 N1
Exclusion:
♦️T4
🔹Tumor located 5-12 cm from anal verge
🔹Sphincter sparing surgery possible at baseline
🔹Distance from MRF min. 3 mm
🔹T2N1 or T3N- or T3 N1
Exclusion:
♦️T4
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FDA has now released a draft guidance on decentralized #clinicaltrials for drugs, biological products, & devices covering #telehealth, remote assessments, consent, shipping of IP, & more: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
🥁🥁🥁Tweetorial
FOxTROT, the 1st ph 3 RCT of neoadjuvant chemo (NAC) in locally advanced colon cancer
We report that NAC is
✅deliverable and safe
✅led to statistically significant reduction in cancer recurrence than upfront surgery
A 🧵 (1/14)
#crcsm
ascopubs.org/doi/full/10.12…
FOxTROT, the 1st ph 3 RCT of neoadjuvant chemo (NAC) in locally advanced colon cancer
We report that NAC is
✅deliverable and safe
✅led to statistically significant reduction in cancer recurrence than upfront surgery
A 🧵 (1/14)
#crcsm
ascopubs.org/doi/full/10.12…
2/14 The trial:
⭕️moved 6 weeks of chemo ahead of surgery, vs standard treatment.
⭕️Same total duration of chemo in each arm (pre-IDEA so total duration 24 weeks)
⭕️ primary endpoint 2 year RFS
1053 pts from 85 centres in 3 countries
⭕️moved 6 weeks of chemo ahead of surgery, vs standard treatment.
⭕️Same total duration of chemo in each arm (pre-IDEA so total duration 24 weeks)
⭕️ primary endpoint 2 year RFS
1053 pts from 85 centres in 3 countries
3/14
🥁 Primary endpoint is met. 6 weeks of NAC led to:
✅ 28% relative reduction in 2 year recurrence
✅ 31% relative reduction in 3 year DFS
These data have strengthened since preliminary data presented and are final with mature follow up
🥁 Primary endpoint is met. 6 weeks of NAC led to:
✅ 28% relative reduction in 2 year recurrence
✅ 31% relative reduction in 3 year DFS
These data have strengthened since preliminary data presented and are final with mature follow up
Is there a role for Local Tx of the Primary Tumor for Patients with Metastatic Cancer?
🚫Many studies demonstrate no benefit.
📌We performed a MetaAnalysis to evaluate the average effect of Local Tx across various tumors.
A thread🧵#AMSM #PRIMETX
redjournal.org/article/S0360-…
1/25
🚫Many studies demonstrate no benefit.
📌We performed a MetaAnalysis to evaluate the average effect of Local Tx across various tumors.
A thread🧵#AMSM #PRIMETX
redjournal.org/article/S0360-…
1/25
Critics of Local Tx to the Primary Tumor
📌 Many providers think local control of the primary tumor in the setting of M1 dz is akin to “closing the barn door after the horse has bolted”
📌 Ian Tannock wrote a fantastic article on this back in 2000.
pubmed.ncbi.nlm.nih.gov/11759650/
2/
📌 Many providers think local control of the primary tumor in the setting of M1 dz is akin to “closing the barn door after the horse has bolted”
📌 Ian Tannock wrote a fantastic article on this back in 2000.
pubmed.ncbi.nlm.nih.gov/11759650/
2/
Supporters of Local Tx
📌Some support aggressive ablation of all sites due to the enhanced ability to detect occult disease with improved imaging technologies and 📉 toxicities with complete ablation.
pubmed.ncbi.nlm.nih.gov/35831494/
pubmed.ncbi.nlm.nih.gov/31182289/
pubmed.ncbi.nlm.nih.gov/34742582/
3/
📌Some support aggressive ablation of all sites due to the enhanced ability to detect occult disease with improved imaging technologies and 📉 toxicities with complete ablation.
pubmed.ncbi.nlm.nih.gov/35831494/
pubmed.ncbi.nlm.nih.gov/31182289/
pubmed.ncbi.nlm.nih.gov/34742582/
3/
TROLLEYS & ONCOLOGY
Every Ethics 101 student wrestles with the trolley problem.
In this exercise, you are placed by train tracks watching a runaway trolley race towards 5 people who are going to be crushed unless you intercede.
THREAD/
Every Ethics 101 student wrestles with the trolley problem.
In this exercise, you are placed by train tracks watching a runaway trolley race towards 5 people who are going to be crushed unless you intercede.
THREAD/
If you pull a lever, the trolley will divert on a different track, where it is bound to kill one person.
In this situation, is it better to be passive or active?
Should you pull the lever or not?
2/
In this situation, is it better to be passive or active?
Should you pull the lever or not?
2/
While not quite as dramatic a scenario, a similarly freighted decision between inaction and intervention plays out in oncology clinics multiple times every day as doctors weigh the risks & benefits of adjuvant chemotherapy.
3/
3/
Yesterday at #TargetedChat we talked about a challenging case of a young individual with recurrent UNRESECTABLE colon cancer after adjuvant.
Here’s a 🧵 on the questions/answers. No one right away. What would you do differently?👇🏾Read/reply along #ColorectalCancerAwarenessMonth
Here’s a 🧵 on the questions/answers. No one right away. What would you do differently?👇🏾Read/reply along #ColorectalCancerAwarenessMonth
It was interesting to see the distribution on the chemo backbone options.
TRIPLETS 🆚 DOUBLETS #TargetedChat #CRCSM
TRIPLETS 🆚 DOUBLETS #TargetedChat #CRCSM
👇🏾With the doublets and triplets discussion, a little bit of art 🖼 to the science 🧪
Have to see and individualize in each patient which tools 🛠 from the toolbox 🧰.
#TargetedChat #CRCSM #ColorectalCancer #ColorectalCancerAwarenessMonth
Have to see and individualize in each patient which tools 🛠 from the toolbox 🧰.
#TargetedChat #CRCSM #ColorectalCancer #ColorectalCancerAwarenessMonth
Welcome to #TumorBoardTuesday
Hello Everyone,
I’m Manju George, a stage 3b rectal cancer survivor
I was diagnosed in 2017 & I wasn’t yet 45 then
Are you excited to discuss #CtDNA testing?
Let's get started..
But first things 1st
Tell us about you
#PatientExperience #CRCSM
Hello Everyone,
I’m Manju George, a stage 3b rectal cancer survivor
I was diagnosed in 2017 & I wasn’t yet 45 then
Are you excited to discuss #CtDNA testing?
Let's get started..
But first things 1st
Tell us about you
#PatientExperience #CRCSM
My tumor
-In the upper rectum near the recto-sigmoid
Clean CAP CT scan & MRI pelvis
CEA 1.0 at dx
LAR sx 1st
Stage 3b rectal, MSS, BRAF WT
No chemo-RT
4 cycles of CAPOX
Clean scans at the end of treatment🎉🎉
What about you?
#TumorBoardTuesday #CRCSM #CtDNA #LiquidBiopsies
-In the upper rectum near the recto-sigmoid
Clean CAP CT scan & MRI pelvis
CEA 1.0 at dx
LAR sx 1st
Stage 3b rectal, MSS, BRAF WT
No chemo-RT
4 cycles of CAPOX
Clean scans at the end of treatment🎉🎉
What about you?
#TumorBoardTuesday #CRCSM #CtDNA #LiquidBiopsies
Survivorship--Different parts, very nice diagram from @CancerSurvSM
Great patient worksheet resource here--smhs.gwu.edu/cancercontrolt…
#TumorBoardTuesday #PatientExperience #CtDNA
Great patient worksheet resource here--smhs.gwu.edu/cancercontrolt…
#TumorBoardTuesday #PatientExperience #CtDNA
In no particular order, 5 abstracts that caught my eye as a GI oncologist preparing for #ASCO21
KEYNOTE-177:
meetinglibrary.asco.org/record/195775/…
#crcsm
1/
KEYNOTE-177:
meetinglibrary.asco.org/record/195775/…
#crcsm
1/
#TumorBoardTuesday
Thursday Case Wrap Up🎀
(Case from 02/02/21)
➡️In case you missed the fast moving conversation, follow this thread for our summary
➡️And also take a look at these Twitter Moments from the case!
Page 1
twitter.com/i/events/13501…
Page 2
twitter.com/i/events/13573…
Thursday Case Wrap Up🎀
(Case from 02/02/21)
➡️In case you missed the fast moving conversation, follow this thread for our summary
➡️And also take a look at these Twitter Moments from the case!
Page 1
twitter.com/i/events/13501…
Page 2
twitter.com/i/events/13573…
👏What a great #TumorBoardTuesday discussion on MSI-high, and NTRK-fusion+ #CRCSM led by @pashtoonkasi
Don't forget the 🏆🆓credit!!
✅2 Post-Test❓ integrityce.com/tbt2-2
⬇️⬇️Here is a breakdown of the participants⬇️⬇️
Don't forget the 🏆🆓credit!!
✅2 Post-Test❓ integrityce.com/tbt2-2
⬇️⬇️Here is a breakdown of the participants⬇️⬇️
#TumorBoardTuesday
Thursday Case Wrap Up🎀
(Case from 02/02/21)
We started with 2 pre-case poll questions⬇️
Thursday Case Wrap Up🎀
(Case from 02/02/21)
We started with 2 pre-case poll questions⬇️
Thank you @BilalMohammadMD @AmyOxentenkoMD for reigniting a convo ab #medtwitter #GITwitter, an important facet of the healthcare #SoMe landscape.
Let's review a few analyses we performed over the years on engagement + impact of GI #SoMe:
(Evidence to convince more to join?)
🧵
Let's review a few analyses we performed over the years on engagement + impact of GI #SoMe:
(Evidence to convince more to join?)
🧵
Q: Is there benefit to divisional social media presence for a healthcare dept/institution?
With @DrLorenGR @walterchanMD we demonstrated an ⬆️ in institutional social media presence predicted GI divisional #ranking improvement on @USNewsHealth
jmir.org/2019/9/e13345/ @jmirpub
With @DrLorenGR @walterchanMD we demonstrated an ⬆️ in institutional social media presence predicted GI divisional #ranking improvement on @USNewsHealth
jmir.org/2019/9/e13345/ @jmirpub
As mentioned, with @BrennanSpiegel @Doctor_V we created the GI hashtag ontology in 2016 to standardize GI discourse on Twitter with all GI societies/journals at the time, after a discussion w @subatomicdoc whose work in Heme/Onc inspired us. @symplur
journals.lww.com/ajg/Citation/2…
journals.lww.com/ajg/Citation/2…
Bird’s-eye view 👁 on what to look out for @WCGIC #WorldGI2020.
Opening remarks on important data 📺 @myESMO - by Dr. Eric Van Cutsem @UZLeuven.
🟩Good to see more #PrecisionMedicine🧬
🟥#Immunotherapy #Immuno-#oncology
🟦TNT & other chemo strategies
@Annals_Oncology #OncoAlert
Opening remarks on important data 📺 @myESMO - by Dr. Eric Van Cutsem @UZLeuven.
🟩Good to see more #PrecisionMedicine🧬
🟥#Immunotherapy #Immuno-#oncology
🟦TNT & other chemo strategies
@Annals_Oncology #OncoAlert
🆕#ctDNA #liquidbiopsies 🩸🧬
👀 👇🏾at the number of #clinicaltrials cropping up in this space‼️
🇦🇺DYNAMIC-II
🇦🇺DYNAMIC-III
🇺🇸COBRA @NRGonc
🇺🇸BESPOKE
🇺🇸@SU2C
🇯🇵 CIRCULATE
🌎COLUMBIA
🇮🇹🇪🇸PEGASYS
🇬🇧TRACC
🇩🇪CIRCULATE
🇫🇷crEATE
🇩🇰IMPROVE-IT
We have 2🇺🇸studies open. #CRCSM #WorldGI2020
👀 👇🏾at the number of #clinicaltrials cropping up in this space‼️
🇦🇺DYNAMIC-II
🇦🇺DYNAMIC-III
🇺🇸COBRA @NRGonc
🇺🇸BESPOKE
🇺🇸@SU2C
🇯🇵 CIRCULATE
🌎COLUMBIA
🇮🇹🇪🇸PEGASYS
🇬🇧TRACC
🇩🇪CIRCULATE
🇫🇷crEATE
🇩🇰IMPROVE-IT
We have 2🇺🇸studies open. #CRCSM #WorldGI2020
#WORLDGI2020 This is 🆒 ☢️ 32-P EUS-guided implantation in #pancreascancer #PANCSM @myESMO @WCGIC @Annals_Oncology.
Still miles to go. OS median of 16 months pointing again to the systemic nature of disease. Need to piggyback these local approaches to better systemic. #OncoAlert
Still miles to go. OS median of 16 months pointing again to the systemic nature of disease. Need to piggyback these local approaches to better systemic. #OncoAlert
