Discover and read the best of Twitter Threads about #esmo19
Most recents (14)
#OncoAlert Now online @Annals_Oncology is the phase III ETOP 9-15 trial (PROMISE-meso) of pembrolizumab vs chemotherapy for pretreated mesothelioma #MPM presented at #ESMO19 @myESMO @DrSanjayPopat @MdCurioni @GautschiOliver @NadalErnest @peters_solange
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#OncoAlert Randomized 144 patients with relapsed #MPM to pembrolizumab vs chemo (gemcitabine or vinorelbine), no PDL1 selection. No difference in BICR PFS noted (HR 1.06) though RR favored pembro (22% vs 6%). 
#OncoAlert In this trial, 63% of patients receiving chemotherapy crossed over and with 17.5m median follow up, no difference in survival noted (OS HR 1.12). No impact of PDL1 expression on the bottom line. Somewhat disappointing but fortunate to have 1L data for IO in #MPM now.
#ESMO19 Phase 3 ETOP 9-15 trial of pembrolizumab vs chemo (gem/vinorelbine) in previously treated #mesothelioma presented by @DrSanjayPopat - recall RR 20% (5/25) in KN-028 #OncoAlert
#ESMO19 Primary endpoint was PFS. This study did not meet its primary endpoint. PFS and OS curves overlap. RR higher with pembro but DOR poor. High crossover rates. No clear subgroup that benefits. #OncoAlert
#ESMO19 With pembrolizumab in mesothelioma, no PFS/OS benefit of 2+L pembrolizumab over chemo and PDL1 not discriminating. With monotherapy, need good biomarker and PDL1 not enough. Next step? CPS? Chemo combo? #OncoAlert
#ESMO19 Outcomes with pembro mono in patients with treated brain metastases from KN 001, -010, -024, -042 presenter by @AMansfieldMD. Some heterogeneity. Those with brain mets were younger, more nonsquamous, more EGFR, I suspect more other alterations too. #OncoAlert
#ESMO19 In patients with brain metastases and high PDL1, OS favors pembro. Trend also seen in PDL1+ and OS/PFS benefit similar between those with and without brain metastases. Remember that these studies required brain metastases be treated and stable for 4 weeks. #OncoAlert
#ESMO19 and same trends with response. Overall, I think this tells us that our IO approach applies to patients with and without brain metastases (treated). Not entirely surprising but reassuring. Now need more data for untreated asymptotic brain mets. #OncoAlert #LCSM
#ESMO19 Shirish Gadgeel presents #ALK cohort of BFAST. Global Phase II/III using blood based NGS to guide therapy. 10-20 mL of blood drawn, results within 10-14d, assigned treatment based on results (ALK, RET, ROS1, bTMB). Goal to show consistency using blood only. #OncoAlert
#ESMO19 Reports only for ALK cohort. Met accrual in 1 year. Screened 2219 patients and identified 119 ALK fusions. 5.4% prevalence similar to expected rates. Mostly EML4. #OncoAlert
#ESMO19 independent review showed RR 92% with alectinib (again, ALK+ by blood only) with 1y PFS 68%. Results very consistent with ALEX results. Safety profile similar. Unclear that this is exactly the same population but validates this general approach. #OncoAlert #LCSM
So @ANZUPtrials #ENZAMEt #PCSM results fro #HRQOL were presented today at #ESMO19, here are some of the headline outcomes 1/5 #InternationalCollaboration #RCT
@ANZUPtrials Acknowledgements usually come last but we can't do these studies without #patients. So our very sincere thanks to the 1125 men living with mHRPC #PCSM who volunteered to take part, have the treatment, & fill out #HRQOL questionnaires! #ENZAMET @anzupartners #ESMO19 2/5
@ANZUPtrials @anzupartners In the @ANZUPTrials #ENZAMET study we measured #HRQOL using @EORTC_QLG's #QLQC30 (global qol, social, physical, emotional, functional domains) & Prostate Cancer module #PR25 at weeks 0, 4, 12, then 12-weekly until clinical progression #PCSM #ESMO19 3/5
#ESMO19 OS results from FLAURA by @RamalingamMD - primary endpoint was PFS, this is a key secondary endpoint. #OncoAlert #LCSM
#ESMO19 OS results here. 7 month improvement in survival. HR 0.799 with impressive landmarks along the way. Control arm did extremely well with an zOs of 32 months. #OncoAlert #LCSM
#ESMO19 Even in this modern trial, 30% of patients did not receive second line therapy. Time on treatment better with osi. Safety favors osi despite longer time on treatment, more opportunity for toxicity. Reinforces current SOC! #OncoAlert #LCSM
#ESMO19 Final results from primary endpoint for CheckMate 227 presented by @peters_solange - building on excellent long term outcomes in RCC and melanoma.
#ESMO19 Study design here. In PDL1+ subset, with mature curves (and remember IO stopped at 2y), OS superior with nivo/ipi over chemo, HR 0.79 with good landmark survival rates. Dramatically better DOR. #OncoAlert #LCSM
#ESMO19 multiple comparisons from this million-arm trial. Describing contribution of ipi in PDL1+, outcomes in PDL1 high, nivo/ipi vs chemo in PDL1 neg (secondary endpoint), and negative results of nivo+chemo in PDL1 neg #OncoAlert #LCSM
AMG 510 via discussant T Arkenau #ESMO19 $AMGN $MRTX
Reminder of AMG 510 in NSCLC via T Arkenau #ESMO19 $AMGN $MRTX
AMG 510 study authors’ conclusions, and take-home message by discussant T Arkenau #ESMO19 $AMGN $MRTX
#ESMO19 Practice changing study presented by Antonio Gonzalez Martin. PRIMA study of niraparib in patients with ovarian cancer responding to 1L platinum based chemo. Primary endpoint of PFS in homologous repair deficient subset. #GYNSM #OncoAlert
#ESMO19 Look at these curves!Dramatic improvement in PFS with niraparib, HR 0.43 in HRD subset. In overall population, PFS HR 0.62. Benefit seen across subsets. #GYNSM #OncoAlert
#ESMO19 OS with niraparib not yet mature. Toxicity noted though. Simultaneous publication in @NEJM appropriately. A new standard of care. #OncoAlert #GYNSM
#ESMO19 Debate (“boxing”) on use of IO biomarkers in #NSCLC. @Alfdoc2 gives the pro position. Highlights KN024 and recent IMp110 using PDL1 and the important @IASLC Blueprint study with @fred_hirsch. Draws parallels with targeted therapy paradigms. #OncoAlert Nice job Alfredo!
#ESMO19 The contra position by Enriqueta Felip. KN024 great but note screen failures, maybe lack of generalizability. Chemo-immunotherapy combo very effective in PDL1 unknown. Utility of #TMB limited. Case made for IO in some form for everyone. #OncoAlert Also well done!
#ESMO19 Enjoyed the boxing format - discussion led by @peters_solange pushing @Alfdoc2 and @EFelipSEOM19 on what will the future hold. Great session chaired by @matteolambe - more lively way to present and discuss the state of the art. #OncoAlert
#ESMO19 Taking some time to cross pollinate by attending some non-lung sessions. Melanoma increasingly relevant for all of oncology. Also helps that the speaker is friend and @LombardiCancer colleague (and boss) Mike Atkins, my go-to expert for any immunotherapy question!
#ESMO19 Mike Atkins with throwbacks to IL-2 and the key advances of Allison and Honjo. Nivo beats chemo in melanoma and changes the field forever. We owe our progress throughout oncology to these early landmark studies. Curative therapy with long follow up.
#ESMO19 found this interesting. Who specifically benefits from CTLA4? In nivo/ipi vs nivo, groups that did better with addition of ipi were BRAF+, high LDH, high tumor burden (not mutational burden - disease burden). Parallels in lung cancer?
#ESMO19 David Spigel @dave6408 presents OS from IMpower 110, phase III analysis of atezolizumab monotherapy vs histology appropriate chemotherapy in PDL1+ #NSCLC #OncoAlert #LCSM
#ESMO19 IMpower 110 meets its primary endpoint of improving OS in PDL1 high NSCLC. Signal seen (to lesser degree) as PDL1 expression decreases. HR 0.59 in TC3/IC3 with median OS of 20.2 vs 13.1 months. #OncoAlert #LCSM
#ESMO19 Higher response rate in the PDL1 high subgroup. No new safety signals seen. Reassuring data. While we may have expected a positive trial, it’s not always the case (see CheckMate-026). Ongoing efforts to harmonize the PDL1 testing method (SP142 here). #OncoAlert
#ESMO19 Laura Chow presents ASCEND-7, examining scrutinize in #ALK NSCLC with brain metastases. Not a randomized study but an important patient subgroup given the high tropism for CNS in ALK+ cancer. #OncoAlert #LCSM
#ESMO19 PFS here encouraging but not surprising. Same with OS. Reassuring when medians are not reached. #OncoAlert
#ESMO19 Key results here. Particularly for Arm 4, where patients had no prior radiation. ORR 52%. Need to standardize our endpoints across studies. ORR, DOR, DCR - all measure slightly different things. #OncoAlert
#ESMO19 Timely review and discussion of novel therapies in #SCLC by @charlesrudin in a session chaired by @fblackhall Big challenge is unraveling the biology. Need to “subdivide and conquer” #OncoAlert #LCSM
#ESMO19 Subsets certainly exist in #SCLC and efforts to standardize nomenclature is an important first step. Think of some of these as markers, not necessarily drivers. Already implementing at @MSKPathology with sample report here to allow prospective analysis #OncoAlert
#ESMO19 need to translate these subtypes into guiding therapy and may allow us to revisit other “negative” trials which may have just lacked the right selection criteria. Key point. We need smarter studies, not necessarily larger studies. #OncoAlert
