Discover and read the best of Twitter Threads about #ctDNA

Most recents (15)

Excited to share our TRACERx nature publication on circulating tumor DNA (#ctDNA, #MRD) detection in resectable lung cancer led by @AbboshChris, @AFrankell, @juditkisistok, Thomas Harrison, Aaron Garnett, @nbirkbak and @NickyMcGranahan 👇👇👇 Tweetorial🧵…
🔬Circulating tumor DNA is a powerful biomarker that can guide and monitor treatment response in early-stage lung cancer patients. Technologies enabling ctDNA detection and characterization are advancing rapidly but we need to understand how to use them in the clinic…
👥 Through collaboration with scientists at @TheCrick and @uclcancer, @AstraZeneca and @Invitae, we developed and validated an anchored-multiplex PCR approach ctDNA detection in 197 patients who donated over 1000 plasma samples to TRACERx.
Read 22 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
Great idea: time for Elacestrant thread Tuesday! 🧵

But first a reminder: access to paywalled papers from @Annals_Oncology, @ESMO_Open & multiple other affiliated journals is free for @myESMO members, and I could not recommend more to become a member!
Endocrine treatment is among the most effective treatment strategies we have for breast cancer. 50 years ago, the approval of the SERD tamoxifen really revolutionized the field, & we still use the drug today.

Yet, no novel ET had been approved for the last 20 years. Until now
Multiple oral SERDs (selective estrogen receptor degraders) are being developed for patients with HR+ MBC. The first to achieve positive phase 3 results was elacestrant, tested in the #EMERALD trial vs. SoC ET (fulvestrant or AI). Primary endpoint -> PFS overall & in ESR1-mut

Read 9 tweets
Very excited to share our new study on determinants of resistance to anti-CD19 CAR T-cells (CART19) in large B-cell lymphomas (LBCLs)! Out today in @Cancer_Cell /1…
A fantastic collaboration from @StanfordMed and @StanfordCancer led by Brian Sworder, David Kurtz, @StefanAlig, and Matthew Frank with David Miklos & @max_diehn to help improve outcomes following CAR T-cell therapy in lymphomas & beyond /2
We serially profiled plasma & tumor samples from 138 r/rLBCL patients across 2 independent cohorts treated w/ SOC axicabtagene ciloleucel (#axicel #yescarta) @StanfordBMT_CT /3 Image
Read 12 tweets
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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