Discover and read the best of Twitter Threads about #precisionmedicine

Most recents (19)

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
It's storytime.

She knocks on my door. Our research team’s statistician is at my door, with laptop in hand.

She says: “Do you have a couple minutes? I found something I think you’ll want to see.”

Of course I have time. This is what I live for.
She: "You remember that we exome sequenced 260 patients with aortic aneurysm, and 260 healthy controls, right?"

"And then sent all the genetic changes to the lab in Texas -- the top lab in the world to identify genetic changes that cause aortic dissection ....."
Me: "I sure do."

I fought to make sure we didn’t tell the other lab who had a dissection and who didn’t. I really wanted them to be blinded to case and control status when they decided which variants were disease-causing.
Read 29 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
#1 HOT OFF THE PRESS @CellCellPress Introducing MASTER OBSERVATIONAL TRIAL (MOT): A NEW class of Master Protocol to Advance #PrecisionMedicine cell.com/cell/fulltext/… MOT hybridizes power of molecularly based master interventional protocols with the breadth of #realworlddata
# 2The Master Observational Trial (MOT)-->Patients are broadly accepted into the trial along with diagnosis + staging info. Biomarker testing results (both positive and negative) are collected & classified using methods shown in Figures 1A and 1B.
# 3High-level outcomes are collected in connection with each line of therapy. All of the information is tied together in a prospective observational registry using standardized reporting methods and metrics. cell.com/cell/fulltext/…
Read 16 tweets
Engaging and inspiring grand rounds from @EMARIANOMD today @HSSAnesthesia about biggest threats to #anesthesiology —concerns and solutions- classic Ed. Too much good info to share so excuse the string 1/8
Loss of identity.
-anesthesia is safe. We have enabled remarkable surgeries to happen and make it look easy
-we are sometimes invisible. We have a “ambivalence toward recognition”
-loss of identity ➡️ #burnout 2/8
SOLUTION to loss of identity
- We need to consider our brand
- #anesthesiology can lead in #PrecisionMedicine
- Take a “victory lap” and talk to families after #anesthesia
- Know when to take the mask off. Lead committees, contribute to the hospital, community impact 3/8
Read 9 tweets
#WCLC19 Registrational results for LOXO-292, now Selpercatinib, presented by @alexdrilon. This is a highly selective RET inhibitor with preclinical CNS activity. Enrolled remarkably quickly: 253 RET+ #NSCLC enrolled since May 2017! #OncoAlert #LCSM ImageImageImageImage
#WCLC19 Selpercatinib patient demographics. Incredible waterfall plot! In previously treated ORR 68% and nearly all patients with some reduction. CNS ORR 91%. Even better in 1L: 85%! mPFS 18.4 months. Impressive results for #RET #NSCLC #OncoAlert ImageImageImageImage
#WCLC19 Illustrative examples of the depth of response possible. Safety profile very reassuring. Impressive results from Selpercatinib - now awaiting update from BLU-667. A great time for #RET targeting! #OncoAlert #LCSM #PrecisionMedicine ImageImageImageImage
Read 8 tweets
"Statistics at a Crossroads: Challenges and Opportunities in the Data Science Era" talks 2:00pm Monday #JSM2019 in CC-207 hub.ki/groups/statscr… hear from Bin Yu, David Banks, Dylan Small, Marianthi Markatou, David Madigan, Xuming He, and Michael Jordan @InstMathStat @CMU_Stats Image
@InstMathStat @CMU_Stats Irrespective of whether you can attend or not, grand challenge ideas and reflections on the draft report are solicited at docs.google.com/forms/d/e/1FAI…
@InstMathStat @CMU_Stats Here's a direct link to the report: hub.ki/files/MTRjZGIz…
Read 26 tweets
New at @nature - Efficacy of MEK inhibition in patients with histiocytosis. The culmination of an amazing 7-year collaboration @sloan_kettering with Eli Diamond @AbdelWahablab @ECDGA @Histiocytosis @Roche and many others! rdcu.be/bqSIq [1/x]
We stumbled into histiocytosis after Barret Rollins' lab discovered BRAF V600 mutations in ~50% of LCH, followed later by Julian Haroche making similar observations in ECD.
bloodjournal.org/content/116/11…
bloodjournal.org/content/120/13… [2/x]
At the time I had just opened the vemurafenib basket (VE-BASKET) study and the first patient we treated was a woman who had been neurologically devastated by ECD - 7 years later she remains healthy on drug! [3/x]
Read 8 tweets
Starting "Voices without Frontiers" #VoicesIWS
A program by @IWS_Network to promote awareness about the challenges & lessons learned by #Immigrant and #International #WomenInScience

I was born & raised in Chicoral, Colombia. A tiny town in the middle of the Andes Cordillera.
I attended Nuestra Señora del Rosario school, located in Espinal, 15Km away from Chicoral. Due to the high heat by noon, all schools start really early back home. This meant, I had to wake up at 5am to attend school every morning since I was 4 years old. #VoicesIWS
I did well in math and science in elementary and high school, so I chose to study clinical microbiology. Although coming from a low-middle income family, I was able to attend university, thanks to my parents’ effort to prioritize education over other commodities. #VoicesIWS
Read 40 tweets
There are a lot of misconceptions about sunscreen and whether or not dark-skinned people need to wear it to prevent skin cancer. This NPR piece does a POOR job presenting the actual evidence. I think a TWEETORIAL is in order.
Melanoma is a potentially deadly form of skin cancer that has been linked to over exposure to UV rays from the sun. Thus, the promotion of sunscreen as an effective intervention to prevent melanoma is a reasonable public health message.
While this may be true for fair-skinned patients, i.e. white people, this is NOT the case for dark-skinned people, i.e. most black and brown people.
Read 17 tweets
In 2005, Gregory Berns, a neuroscientist at Emory University, decided to conduct an experiment to demonstrate the power of conformity (this has relevance in oncology and medicine in general, so bear with me)
Berns and his team recruited volunteers and asked them to participitae in a game in which each group member was shown 2 different 3D objects on a computer screen and asked if the first object can be rotated to match the second
He then used fMRI scanning to evaluate the areas of volunteers brains as they conformed to or broke with group opinion. Berns came out with 2 interesting observations:
Read 11 tweets

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