Discover and read the best of Twitter Threads about #oncstewardship
Most recents (3)
For those of you who come across the few CPX-351 (Vyxeos) #ASCO2020 abstracts still trying to spin that data positively 🙄, let me save you some time - See our 3 part #tweetorial on why you shouldn’t use this drug 🚮:
#oncstewardship
cc: @AnthonyPerissi2 @Lydialbc
#oncstewardship
cc: @AnthonyPerissi2 @Lydialbc
Part 1️⃣ - sAML background
Part 2️⃣ - CPX-351 - flaws and comparisons
PART 3! If you’re not sold on moderately intensive chemo, outcomes with HMA +/- ven also rival outcomes with CPX-351 in sAML. One could argue the control group in the CPX-351 paper should have been hypomethylating agent-based regimens!
CR/CRi rates with 10-d decitabine are consistently >50%, irrespective of sAML, age, and cytogenetics. Median OS in Blum, PNAS 2010 ~13 months. pnas.org/content/107/16… 
Whether venetoclax adds anything to this remains to be seen. In the phase I/II study of HMA+ven, CR/CRi in elderly sAML was 67%, median OS NR. Wait for the phase III before you make any conclusions #oncstewardship #anothertweetorial? ncbi.nlm.nih.gov/pubmed/30361262
PART 1 - Background. Vyxeos is the “winner” of the first #oncstewardship #tweetorial! There are some serious flaws in the Vyxeos data. First let’s define Secondary AML (sAML)
sAML can be divided into AML that has evolved from an antecedent heme disorder (AHD), or therapy-related AML (tAML). Per WHO, AML with myelodysplasia-related changes (AML-MRC) also includes those with MDS-related cytogenetic abnormalities and those with multilineage dysplasia
Classic agents that lead to tAML are:
1⃣XRT/alkylating agents➡️longer time to AML development (5-7 yrs)➡️associated w/ MDS-like monosomal karyotypes (deletion 5 or 7)
2⃣Topo II inhibitors➡️shorter latency (1-3 yrs)➡️associated w/KMT2A rearrangements (MLL, 11q23)
#boardquestion
1⃣XRT/alkylating agents➡️longer time to AML development (5-7 yrs)➡️associated w/ MDS-like monosomal karyotypes (deletion 5 or 7)
2⃣Topo II inhibitors➡️shorter latency (1-3 yrs)➡️associated w/KMT2A rearrangements (MLL, 11q23)
#boardquestion
