Discover and read the best of Twitter Threads about #precisionmedicine

Most recents (24)

Hot but not bothered?🧠🔥 Our paper on human brain temperature is out today in Brain! @ONeill_Lab @MRC_LMB @Brain1878 #LMBResearch #BrainTemp #BrainTrauma doi.org/10.1093/brain/…
With thanks to our amazing participants, collaborators, and supporters @AriErcole @Etherjoe @ManuelCabeleira @CescaStats @EdinUniImaging @EdinUniNeuro @EdinUniBrainSci @CenterTBI @CellBiol_MRCLMB @RachelSEdgar and @The_MRC for funding
In a prospective analysis of healthy men and women, we found that brain temperature is higher than body temperature; brain temperature ranges from 36.1 to 40.9°C, with an average of 38.5C 🧠🔥.
Read 11 tweets
1/9 #TumorBoardTuesday Thursday Case Wrap Up🎀

⏰ for #TBT Case Wrap Up!

We looked at dx and tx of Carcinoma of Unknown Primary (#CUP), including how 🧬 can change tx.
There was a lot to learn–we captured what we could of the discussion here:

twitter.com/i/events/15089…
2/9 #TumorBoardTuesday Thurs Case🎀
Take🏠:
#CUP is complicated!
✅Comprehensive approach needed, including:
H&P,🔬, 🩻, 🧬
✅Overall inc of CUP is ⬇️–many liver CUP being recognized as cholangio
✅NGS can help augment the w/u
✅STK11= frequently mut in lung; ⬇️response to IO Image
3/9 #TumorBoardTuesday Thursday Case🎀

@LaurenBzak’s case: Pt p/w solitary 🧠 lesion ➡️ poorly diff adenocarcinoma. But–not a primary CNS malignancy. NOTHING outside 🧠on CT or PET.

🧐What should we do next?

👍Detailed H&P (smoking hx)
👍PATH CONSULT!
Read 12 tweets
@TumorBoardTues @JohnEbbenMDPhD 1/14 Case Presentation

63 👱‍♂️ p/w LUE & LLE weakness. CT 🧠 w/ R frontal mass.

Craniotomy and 🔪 resection ➡️ metastatic poorly-differentiated carcinoma. CT C/A/P normal.

❓What would you do next? 🧐

@NSethakorn @NarjustDumaMD @HamidEmamekhoo @KariWisinski_MD @HemOncFellows
@TumorBoardTues @JohnEbbenMDPhD @NSethakorn @NarjustDumaMD @HamidEmamekhoo @KariWisinski_MD @HemOncFellows 2/14 #TumorBoardTuesday #OncTwitter #CUP

This is cancer of unknown primary (CUP)! ☕️

Initial evaluation of CUP includes:
🔹 H&P
🔹 CBC, CMP 🧪
🔹 CT C/A/P 📷
🔹 IHC 🔬
🔹 Optional ➡️ tumor markers, endoscopy, mammogram, PET/CT

@SamLubner @loconte @uw_hemeoncpc @OncoAlert
@TumorBoardTues @JohnEbbenMDPhD @NSethakorn @NarjustDumaMD @HamidEmamekhoo @KariWisinski_MD @HemOncFellows @SamLubner @loconte @uw_hemeoncpc @OncoAlert 3/14 #TumorBoardTuesday

Other history ➡️ no other sxs, 🚬 30 pack-years, no family history of cancer

The patient’s IHC findings:
🔸 CAM5.2 ➕
🔸 CK7 ➕
🔸 CK20 ➖
🔸 All other markers ➖

❓What primary site are you most suspicious of? 🕵️

@UWiscPathology @erik_rannheim
Read 14 tweets
1/9 #TumorBoardTuesday Friday Case Wrap Up

🚨Special Friday Edition of #TBT🚨
This week, mgmt of #Pancreatic neuroendo tumors (pNET), led by @nanudasmd. We discussed SOC, role of IO, & brand🆕 💊. Buckle up! We captured the discussion in this moment:

twitter.com/i/events/14995…
2/9 #TumorBoardTuesday Friday Case🎀
Take🏠messages:
We discussed #pNET:
✅Well diff= sens to cape/tem; high% of MGMT methylation -but not predictive of response
✅Tx dictated by disease extent
✅NOT all NETs are ➕ on dotatate! If they are, ☢️PRRT option- but may use late line
2.5/9 #TumorBoardTuesday Friday Case🎀

Take 🏠 messages continued:

✅Mixed track record of IO, despite TMB increase s/p TMZ. Higher prolif rate = better IO response
✅New: belzutifan (HIF-2a inhibitor) w activity in pNET!
✅Each pt is different- 💊 customized to pt situation
Read 12 tweets
I am a recent but huge fan of @Freakonomics podcast. I've also been enjoying @DrBapuPod by @AnupamBJena

Episode today was about #ArtificialIntelligence in #medicine and I want to share my concerns about the discussion on racial disparities in knee pain (starting at 19:00)

A 🧵
#1 - The suggestion that only pain that can be explained by pathology seen on a knee xray is "real, organic, genuine" and other pain is "in someone's head" is hugely problematic and detrimental to patients seeking care for #Chronicpain and providers.

nature.com/articles/s4159…
This is not aligned with the role of nervous system sensitization, psychological factors, and other mechanisms underlying the chronic pain experience.
Imp to note that #machinelearning model from xrays explained only 16% of variability in pain overall

@NatureMedicine @oziadias
Read 16 tweets
1) Welcome to @cardiomet_CE's series on #lipid management! This is a 10-#tweetorial program, all #accredited, that will cover IT ALL. The expert author for this module is Robert Giugliano MD @ @rgiugliano, renowned #cardiologist from @BrighamWomens & @harvardmed ! Image
2) This #tweetorial, accredited for #CME/CE and intended for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists is supported by an educational grant from Esperion Therapeutics. See faculty disclosures at cardiometabolic-ce.com/disclosures/.
3) @rgiugliano is going to discuss care of patients taking #statins who still have residual atherosclerotic cardiovascular disease #ASCVD risk.
Read 48 tweets
Happy present our manuscript on targeting RTK and adaptive resistance in RTK-addicted sarcomas 🎯. @MLadanyi, Romel Somwar and amazing @sloan_kettering pediatrics team! @JGladeBender @MichaelVOrtiz #MSKkids #MolPath #Sarcoma @OncoAlert

cancerres.aacrjournals.org/content/early/…

🧵 🧵 🧵 (1/19) Image
Disclaimer #1: I have no conflicts of interest to disclose.
Disclaimer #2: Please note that this post does not constitute medical advice. Please consult your physician or other qualified health care provider. (2/19)
With the development and broader adaptation of NGS, we now know that a variety of soft tissue sarcomas harbor receptor tyrosine kinase (RTK) fusions. (3/19) Image
Read 19 tweets
Very happy to present our #proteomics analysis of #lungcancer published today @NatureCancer!🙂
Here’s a walk-through: #MassSpec analysis covering almost 14k proteins in 141 NSCLC tumors revealed 6 proteome subtypes with distinct biology. 1/6
rdcu.be/cBOtU
#NSCLC proteome subtypes are driven by histology, growth pattern, immune cell infiltration, driver mutations, oncogenic pathways, and cell types, suggesting potential clinical value for treatment stratification and #PrecisionMedicine. 2/6
Unexpectedly, #proteogenomics analysis revealed that high neoantigen burden was linked to global hypomethylation, and that complex neoantigens mapping to genomic regions normally not active in lung were produced in immune-cold subtypes. 3/6
Read 6 tweets
1/10 #TumorBoardTuesday

🔬A discussion focused on precision med in cervical cancer led by @GauravGangwan15
➡️Here's the Thursday Case🎀

👉 Don’t forget to pick up your 🆓 #CME credit- answer 2 quick❓here: bit.ly/3A6ipjH

ALL CME 🔗: integrityce.com/tbt
2/10 #TumorBoardTuesday
Case🎀
Take🏠msgs re: stage IV #CervicalCancer & 🎯med.
✅Cervical ca =4th leading cause of ca☠️ in♀️around the🌍
✅Screen &💉key; some spirited debate re: 💉roll out
✅AJCC revised- consider HPV, incorp addtl imaging in staging

3/10 #TumorBoardTuesday
Case🎀
Take🏠messages cont’d:
✅NGS can yield 🗝️tx, even when🎯🧬are rare in a dz
✅CRAF🎯 💊 paired with MEK 💊. Why?
✅RAF inhib➡️ ⬆️MEK activation

📚We captured as much of @GauravGangwan15’s discussion as we could: twitter.com/i/events/14455…
Read 12 tweets
1/10 #TumorBoardTuesday

🔬We reviewed RET mutations as an actionable🎯 in practice!
➡️Here’s this week's Thursday Case🎀

👉👉 Don’t forget to pick up your 🆓 #CME credit by answering 2 quick❓
Here’s the post-test🔗: bit.ly/2W7Acck
ALL CME 🔗: integrityce.com/tbt
2/10 #TumorBoardTuesday
Take🏠messages:
RET muts are ⬆️in medullary thyroid cancer
✅Sensitive to multikinase 💊
✅Gatekeeper resistance muts overcome by specific💊
✅RET is also seen in other cancers, including 🫁
2.5/10 #TumorBoardTuesday
9/28/2021 Case 🎀

✅Repeat NGS w progression is🗝️strategy to tx resistance

@VivekSubbiah is truly the “RET Master”!
Read 14 tweets
Recurrent Frameshift Neoantigen Vaccine Elicits Protective Immunity With Reduced Tumor Burden and Improved Overall Survival in a Lynch Syndrome Mouse Model #GITwitter
#PrecisionMedicine

gastrojournal.org/article/S0016-…
Read 10 tweets
Delighted to share our new study nature.com/articles/s4158… 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
Very excited to share our synthetic lethality based precision oncology approach via the tumor transcriptome (SELECT) @Cell
This effort is led by @joo_sang_lee @theNCI #PrecisionMedicine [1/n]
cell.com/cell/fulltext/…
Current precision oncology mainly targets actionable mutations & has limited patient coverage. We present the first precision oncology framework that systematically guides cancer treatment based on *synthetic lethal* vulnerabilities identified via the tumor transcriptome.
*Synthetic lethality* (SL) is an interaction between a pair of genes, where their individual inactivation has no phenotype, but their co-inactivation leads to cell death. We identified the SL pairs from analyzing a large collection of patient cohorts of 10k tumors.
Read 14 tweets
#GI21 time for another #Tweetorial🧵 on

#LiquidBiopsies
#CirculatingTumorDNA
#ctDNA

in a very 🎯 “Target-rich” disease
#Cholangiocarcinoma
#HPBCSM

~3️⃣0️⃣% actionable findings

Interestingly we found more #FGFR🧬 fusions on liquid🩸than tissue 🔬. #OncoAlert
@TempusLabs
🧵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
🩸LIQUID>>TISSUE🔬
💭 maybe because of selection bias. #ctDNA filling the void. #OncoAlert
Read 12 tweets
0/6
Background: Liquid biopsies have the potential to become an invaluable tool in the management of #cancer.
That’s why, it is important to generate solid evidence to define areas in which they can guide treatment decisions.

@OncoAlert 🚨 #LiquidBiopsies #PrecisionMedicine
1/6
Accordingly, this paper by @LizzySmyth1 & team in @myESMO @Annals_Oncology on the prognostic value of longitudinal ctDNA 🧬💉 assessment in #EsophagealCancer #esocsm addresses a very relevant question.
@OncoAlert 🚨 #PrecisionMedicine #LiquidBiopsies
annalsofoncology.org/article/S0923-…
2/6

✅ 97 patients that underwent neo-adjuvant chemotherapy & resection with a total of 245 available samples were identified in 🇬🇧 OCCAMS consortium dataset.

✅ Samples were analysed w a pan #cancer ctDNA panel

@OncoAlert 🚨
Read 7 tweets
Catch yourself when you say “risks vs. benefits” because you aren’t making a fair comparison.

In @JAMA_current ja.ma/336Lj4Y
& podcast ja.ma/2FAGKI2

@eliowa @drjohnm @d_spiegel @zeynep @VPrasadMDMPH

Why we say it and what we think is better below...
This building block of clinical decisions biases by framing uncertain harm vs. certain benefits and nudges towards treatment

Written with
@DKorenstein @ldscherer
(Over 2 years, i'm embarrassed to admit)
Clearly, the words physicians use have
a critical function in this communication

Referring to harms as “risks” emphasizes that
the unfavorable outcome may or may not happen,
whereas there is no parallel language that highlights
the equally probabilistic nature of “benefits.”
Read 8 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‼️
🇦🇺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
Read 55 tweets
🆕 We are proud to announce we’ve been awarded £38m from the @UKRI_News #StrengthInPlaces fund to create a #PrecisionMedicine Living Lab focussed on translating clinical innovation to create a global centre of excellence.

ow.ly/5gb730qTy7N

#WorldChangingGlasgow Image
The Living Lab — which will be on the UofG campus adjacent to the @NHSGGC QEUH — is made possible by further support from a consortium of industry partners, investment from the @GlasgowCityDeal & @GlasgowCC, and support from @gsc1.
The “game-changing” £91m-project will employ the Triple Helix of academia, industry & NHS to help Scotland lead the world in #PrecisionMedicine, translating research innovation into clinical practice for patient benefit, & transforming the area of Govan for economic growth.
Read 3 tweets
#Doctors and #Medicine need an #AI update.
Bold and convincing book.

@EricTopol
#ArtificialIntelligence has the ability to bring the fourth industrial revolution. Healthcare is deemed to be an industry which can get transformed the most.

#DeepMedicine
@EricTopol is a #cardiologist, historian of the present and a #MedicalFuturist.
He believes that the way we practice medicine now ( #ShallowMedicine ) relies too heavily on human inputs and is thus plagued by human biases and imperfections.

#DeepMedicine
Read 23 tweets
Meet Dr Yazad Irani, @Yaz_Sci, at @sahmriAU, the researcher paving the way to better outcomes in chronic myeloid #leukemia - by helping predict patient responses to #cancer therapy

A thread 👇

@AcademicChatter #chemotherapy #medicalresearch #precisionmedicine #CML #immunology Image
Our blood is composed of red blood cells, in charge of carrying oxygen; and white blood cells, whose main function is to help the immune response to fight infections and diseases.
Chronic myeloid leukemia (CML) is a blood cancer in which a subpopulation of white blood cells, known as granulocytes, grow out of control. Although new treatments have resulted in good patient outcomes for 80% of patients, the remaining 20% of patients do not respond to therapy.
Read 9 tweets
1/ Hot-off-the-press 🔥✍🏽🗣

Precision #CardioOncology: Systems-based Perspective on Tyrosine Kinase Inhibitors & Immune Checkpoint Inhibitors

#PrecisionCardioOnc @SpringerNature

Latest manuscript w/ @MayoClinicCV @mayocvonc & edited by @AnaBaracCardio

rdcu.be/b3q0Y
2/ 🔥✍🏽🗣

A broad spectrum of #CVD toxicities can be seen with targeted therapies or #ICIs

Toxicities of one or the other can include cardiomyopathy, HF, myocarditis, venous or arterial thrombosis, progression of atherosclerosis, QTc prolongation, or arrhythmias

#CardioOnc
3/ 🔥✍🏽🗣

An eminent need is optimal risk management, surveillance, detection, and prevention

The heterogeneities of patient populations, risks, and disease spectra have complicated clinical and translation efforts

#cvPrev #PrevCardioOnc #CardioOnc
Read 13 tweets
A New Year, New Therapies! An #IBD #medtwitter #tweetorial

As a late ring into the New Year, let’s explore Novel #IBD Agents coming to practice!

Our Aims:
1️⃣ Understand the Nomenclature
2️⃣ Revise Currently Available Drugs
3️⃣ Discuss Mechanisms & Adverse Events of Novel Agents
First, do we even know what are we treating ⁉️

Studies 🔬 within each one of these four key elements have unveiled pathways involved in #IBD pathogenesis.

Some of which are amendable for potential therapeutic intervention…
In summary...

It takes a genetically susceptible host 🧬 to be exposed to a specific environmental agent 🦠 that, through a weakened intestinal barrier ⚔️, will lead to an exaggerated Immune activation🔥, responsible for the phenotypes we see in clinical practice!
Read 25 tweets

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