Discover and read the best of Twitter Threads about #ctDNA

Most recents (11)

I would like to do my 2nd deep dive post #ASCO22 analysis on #ctDNA guided adjuvant therapy for pts with stage II colon cancer‼️

✳️The DYNAMIC trial is certainly step forward (kudos) ‼️But doesn’t answer many questions❗️@OncoAlert @manjuggm @CrcChange @TheColonClub Why ?👇
1️⃣ Firstly, the whole point of ctDNA is identification of MRD so to give RIGHT chemotherapy to RIGHT patients❗️

✳️Not only reduce adjuvant tx, but offer it to patients who may potentially miss that opportunity (such as offering folfox to a patient with ctDNA (+)T3N0 disease)❗️
2️⃣The DYNAMIC suggests we get same DFS rate whether we use ctDNA or conventional risks for decision‼️
✳️Then one would rightfully wonder why to use ctDNA over conventional clinicopathological criteria if we get same outcomes anyway by using MORE oxaliplation❓just to reduce 5FU❓
Read 8 tweets
✳️Happy to say there is great progress for patients with CRC‼️
@OncoAlert @ASCO @manjuggm @CrcChange‼️
Here is summary of some key studies 👇
1️⃣ Immune checkpoint inhibitor monothetapy with dostarlimab for MMR-D is certainly practice changing❗️

✳️Although long term outcomes are needed, no need to reinvent the wheel‼️

✳️ Once a deep response achieved in MMR-D CRC it is very durable even in metastatic setting ‼️
2️⃣ #ctDNA study (DYNAMIC) was my second favorite study ❗️

✳️ We are certainly in the right pathway to use #ctDNA however we have to be careful for false negative results in high risk population: T4 disease ‼️

✳️We need more trials to get more data ❗️Enroll COBRA/CIRCULATE
Read 16 tweets
✳️DYNAMIC trial results are highly exciting and glad to see field is moving forward !

✳️Very encouraging findings that we are in right pathway to use #ctDNA for adjuvant tx‼️

However there are important points that we need to address 👇@ASCO @OncoAlert @MoffittNews ImageImageImageImage
✳️Firstly, I am categorically against putting T4 and T3 disease into same pocket (stage II is highly heterogeneous)❗️

✳️Risk of peritoneal recurrence for T4 and T3 is not same and not even close ‼️

✳️Peritoneal microscopic disease doesn’t shed CtDNA as much as liver MRD‼️
✳️Moreover, control group was a bit vague in this study, conventional risk factors are used for ad therapy which can offer you different approaches ‼️

✳️Currently there is not consensus for high risk stage II in NCCN and options include observation vs FP alone or doublet ‼️
Read 7 tweets
1/12 #TumorBoardTuesday #CCA
56y 🚭M w/ abd pain, 🚫🍻, 🚫Hx hepatitis

FHx - uncle (80) CRC, aunt (40) breast Ca
📷CT: 9cm liver mass with portal vein clot
🔦EGD/Colonoscopy unrevealing
🔬Bx: poorly diff adenoCa. pMMR, PD-L1 CPS 0%

Unresectable IHCC, PS 0, how would U Tx?
2/12 #TumorBoardTuesday

💊Tx with G/C for 4mo➡️SDz
✂️Still unresectable

🩺Outside tumor board discussion suggested switching Tx.
Tumor NGS
👉ARID1A S745fs

🤔What would you choose for next Tx?
3/12 #TumorBoardTuesday Mini-Tweetorial 1 👨‍🏫
#BiliaryTractCancer @curecc @CCA_Alliance
➡️ Other 1L Tx's

✅Ph2 high ORR for GCN @rachnatshroff
✅Ph3 SWOG 1815⌛️data…
✅TOPAZ-1: G/C+durva⬆️mOS, mPFS, RRvs. G/C… Image
Read 12 tweets
@MPishvaian @TumorBoardTues @SalemGIOncDoc @YJanjigianMD @DocCatenacci @rachnatshroff @gabe_a_brooks @sonbol_bassam @JoeChaoMD @JohnEbbenMDPhD 2/13 #TumorBoardTuesday

Starts on FLOT. C2 c/b😴, neutropenia, LFT ⬆️.
Unplanned CT with🙅🏼‍♂️👎response, hard to separate mass from liver capsule (not metastatic).

MDC feels risk of R1 resection, but resectable. MMR testing, complete PMS2 & MLH1 loss
Read 15 tweets
Pls join us in welcoming @JohnEbbenMDPhD to #TumorBoardTuesday!! 🎊

Dr Ebben is an onc fellow from WI, interested in🧬med & immunotherapy. He’ll also debate🧀curds & the best🍦custard in WI! He’ll be assisting with case wrap up🎀

We’re excited to have him!! #TBTFellow 1/17 White male with short brown...
2/17 #TumorBoardTuesday Thursday Case🎀(08/24/21)

Bringing #ctDNA to bear to improve pts🙌🏽 @pashtoonkasi shows us how we can♻️ 🎯therapies to extend survival.

We go deep -🔬molecular biology➡️clinical trials➡️pt case.

👉🏽Don’t forget🆓#CME credit:
3/17 #TumorBoardTuesday Thursday Case🎀(08/24/21)

📚We captured as much of @pashtoonkasi's discussion as we could in this moment:
#ColorectalCancer #CRC #OncTwitter…
Read 19 tweets
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
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
Survivorship--Different parts, very nice diagram from @CancerSurvSM
Great patient worksheet resource…
#TumorBoardTuesday #PatientExperience #CtDNA
Read 10 tweets
Delighted to share our new study… introducing PhasED-Seq out today @NatureBiotech.
A fantastic collaboration from @StanfordMedicine led by Dave_Kurtz & Joanne Soo with @max_diehn to help transform #cancer interception & monitoring by improving #LiquidBiopsy #ctDNA detection of #MRD.
For many cancers & nearly all currently available techniques, the impressive KM plots of #ctDNA #MRD immediately after definitive Rx w/ curative-intent unfortunately still miss ~50% of all events which occur in the MRD-negative subset, thus having modest NPV.
Read 21 tweets
#GI21 time for another #Tweetorial🧵 on


in a very 🎯 “Target-rich” disease

~3️⃣0️⃣% actionable findings

Interestingly we found more #FGFR🧬 fusions on liquid🩸than tissue 🔬. #OncoAlert
🧵2️⃣ #GI21
#Cholangiocarcinoma is the poster child of actionable aberrations & truly a 🎯“Target-rich” disease.

We focused on %numbers for aberrations for which there’s either an ✅approved drug, guideline endorsement, #clinicaltrials or even off-label reports/cases.👇🏾
🧵3️⃣ #GI21
We often don’t think of #ctDNA based platforms to be as sensitive for detecting fusions; when present it is real & an actionable finding.

Interestingly we found #FGFR🧬fusions
💭 maybe because of selection bias. #ctDNA filling the void. #OncoAlert
Read 12 tweets
JPM Healthcare Daily Roundup #JPM2021

The first day of the conference hasn't disappointed, especially if you're a fan of talking cubes. What is this mysterious object and what sorcery is inside?

See disclosures at the end.
The Tempus One, meant to be carried in a doctor's coat or sat at the bedside, is a physical manifestation of @TempusLabs' genomic and phenotypic data-lake. Oncologists can ask One all sorts of questions regarding their patients, though I'm unsure if it'll (...)
(...) just reflex you to a computer after a sufficiently difficult question. I'm sure we'll learn more soon. Has this sort of form-factor been tried before?

I'm just hoping it has adjustable humor/honesty settings like TARS from Interstellar.

Moving right along.
Read 15 tweets
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
🆕#ctDNA #liquidbiopsies 🩸🧬
👀 👇🏾at the number of #clinicaltrials cropping up in this space‼️
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
Read 55 tweets

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