Discover and read the best of Twitter Threads about #rcc

Most recents (13)

@TumorBoardTues @brian_rini @JVentoMD @MPishvaian @Uromigos @JoshLangMD @renalandurology @UroDocAsh 2/5 #TumorBoardTuesday
Thurs Case🎀

✅ Pembro ONLY approved adj IO in RCC
✅ 3 recent trials w IO failure: nivo/ipi, atezo & periop nivo
✅ Must balance risks vs benefits- shared decision-making 🗝️

📚@brian_rini @JVentoMD’s thread:…
@TumorBoardTues @brian_rini @JVentoMD @MPishvaian @Uromigos @JoshLangMD @renalandurology @UroDocAsh 3/5 #TumorBoardTuesday
Thurs Case🎀

🎥 TBT in a video
High risk #RCC, pembro= DFS advantage, but w cost- Grade 3 AEs= 32%. High risk #RCC defined by:
🔹Stage II w sarcomatoid features
🔹Stage III+
🔹Regional LN+/M1 disease

Quick overview of adj IO decision making:
@TumorBoardTues @brian_rini @JVentoMD @MPishvaian @Uromigos @JoshLangMD @renalandurology @UroDocAsh 4/5 #TumorBoardTuesday
Thursday Case🎀

📷 TBT in an image
Nomograms, including ASSURE from @FoxChaseCancer can provide addtl context re: risk of recurrence–but remember:

⭐️Every patient is an individual!

Our guide to help lead discussions w pts re: risks/benefits of adj IO:
Read 9 tweets
@TumorBoardTues 1/17 #TumorBoardTuesday #RenalCancer #OncTwitter

✂️2022: L Radical Nephrectomy
🔬Clear cell #RenalCellCarcinoma
📏8.2 cm, Grade 2, extends into renal vein (T3a)
❓No lymph nodes sampled (NX)
❌No other dz sites

What would you pick for adj therapy?
@TumorBoardTues 2/17 #TumorBoardTuesday #RCC
🚨There’s significant relapse risk in ≥ Stage II RCC even after local tx✂️

🔢We use tools like Fox Chase’s ASSURE Prognostic nomogram to estimate disease free survival (DFS)
📈Example for our pt below

📚Correa, Andres F
@TumorBoardTues 3/17 #TumorBoardTuesday @brian_rini

⭐RCC Adjuvant Therapy⭐

⚖️Weighing recurrence risk with a long list 📜 of adj trial results?

💉Focusing on adju IO & review:
✨KEYNOTE-564: Pembro
✨CheckMate 914: Nivo/Ipi
✨IMmotion010: Atezo
✨PROSPER: Periop Nivo
Read 20 tweets
@TumorBoardTues @DrSteveMartin @DAielloMD @MPishvaian @NarjustFlorezMD @EGFRResisters @lcrf_org @ADesaiMD @GDutcherMD 2/5 #TumorBoardTuesday
Thurs Case🎀

✅ctDNA= both tx decision making & MRD in #NSCLC
✅Identify actionable muts in dz where a bx not possible
✅Pros (serum test) & cons ($, inability to multiplex with IHC- aka PD-L1 status)

📚The thread:…
@TumorBoardTues @DrSteveMartin @DAielloMD @MPishvaian @NarjustFlorezMD @EGFRResisters @lcrf_org @ADesaiMD @GDutcherMD 3/5 #TumorBoardTuesday
Thurs Case🎀

🎥 TBT in a video
ctDNA + tissue-based NGS= highest sensitivity (do NOT miss actionable mutations in #NSCLC).
ctDNA can be used to:
🔹Identify actionable mutations
🔹Track disease status (MRD)
🔹Adapt targeted therapies based on 2dary muts
@TumorBoardTues @DrSteveMartin @DAielloMD @MPishvaian @NarjustFlorezMD @EGFRResisters @lcrf_org @ADesaiMD @GDutcherMD 4/5 #TumorBoardTuesday
Thurs Case🎀

📷 TBT in an image

Also have to understand caveats!
1⃣ctDNA works best in higher volume dz.
2⃣Know when to suspect germline mut (variant allele fractions near 50%)
3⃣Clonal hematopoiesis of indeterminate potential muts that could mislead! Image
Read 11 tweets
It is this time of the year again: TOP 10 GU Oncology clinical papers/trials in 2022:

Some negative, some positive, but we learned from all!

Feel free to add more & retweet & tag anyone involved

This is not an exhaustive list!

@OncoAlert @DanaFarber

#OnwardFor2023 Image
1/ #ARASENS phase 3 trial shows ⬆️OS with darolutamide in combination with docetaxel and ADT in #mHSPC (vs docetaxel + ADT alone) with similar AE profile, leading to @US_FDA approval.
#MatthewSmith @BertrandTOMBAL @MGHMedicine @NEJM… ImageImageImage
2/ In #PCa patients with detectable PSA after prostatectomy, lymph node RT + ADT+ PBRT⬆️freedom from progression compared to ADT+ PBRT and PBRT alone according to #SPPORT trial.
@_APollack @DrHowardSandler @TheLancet… ImageImage
Read 11 tweets
@TumorBoardTues @MPishvaian 1/18 #TumorBoardTuesday #RenalCancer #OncTwitter

60yo 👴🏽#RenalCell dx in 2022 tx with right radical nephrectomy
6mo f/u
Uses WC d/t DM2 - limited mobility & homebound

🤨 What would be your next step?
@TumorBoardTues @MPishvaian 2/18 #TumorBoardTuesday
🩻Lung nodules, mediastinal lymphadenopathy🫁
🔬: Bx returns as metastatic clear cell #RCC
➡️1st relapse at 6mo f/u

👴🏽 limited mobility and difficult time leaving the house.

🤨 What treatment would you select for this patient?
Read 22 tweets
#ESMO22 COSMIC-313 presented by @DrChoueiri Triplet therapy with cabo/nivo/ipi vs cabo/nivo for patients with advanced TN advanced intermediate or poor-risk #RCC. Primary EP: PFS; N=855 Image
#ESMO22 #COSMIC313: Longer PFS with triplet vs doublet. mPFS NR vs 11.3 mo with benefit seen in most predefined subgroups #RCC ImageImageImage
#ESMO22 #COSMIC313 ORR 43% vs 36% with 3% CR in both arms; mDOR not reached in either arm #RCC ImageImage
Read 6 tweets
@TumorBoardTues @brian_rini @DrChoueiri @RenoHemonc @tompowles1 @CParkMD @RCCadvocate @EricaMarieRomn1 @jacobadashek 2/5 #TumorBoardTuesday
Thursday Case🎀


✅High risk feat= consider adj tx
✅Sunitinib= FDA ☑️; can be hard to tolerate
✅Pembro= FDA ☑️ w DFS benefit
✅irAE mgmt - gr3+= steroids

📚We captured @brian_rini’s discussion in this moment:…
@TumorBoardTues @brian_rini @DrChoueiri @RenoHemonc @tompowles1 @CParkMD @RCCadvocate @EricaMarieRomn1 @jacobadashek 3/5 #TumorBoardTuesday
Thursday Case🎀

📷 TBT in an image: 👀out a clinical algorithm 📊for adj therapy in #RCC.

Some pearls re: irAE mgmt & addtl info to help choose a patient appropriate adjuvant regimen! Image
@TumorBoardTues @brian_rini @DrChoueiri @RenoHemonc @tompowles1 @CParkMD @RCCadvocate @EricaMarieRomn1 @jacobadashek @esinghimd @PaulCrispenMD @apolo_andrea @AmandaNizamMD 4/5 Thurs Case 🎀
#PostTest Q2️⃣ #CME #TumorBoardTuesday
CME eval🔗

Now that you’ve reviewed- try your hand at #CME:

🤨Which strategy would you use for a pt receiving pembrolizumab experiencing #IBD colitis (grade 3)?
Read 10 tweets
The latest @HaydnKissick lab paper is out! I am delighted to have worked w/ my mentor, friend, and role model @JennyCarlisleMD as co-first authors to share our latest work in @JITC, detailing features of patients' peripheral and intratumoral response to #ICB in #RCC.
In this study, we study a cohort of 36 #RCC patients receiving immunotherapy at @WinshipAtEmory, and we find that following #ICB, patients often have an identifiable burst of activated T cells in their blood, demonstrated by coexpression of the activation markers CD38 and HLADR.
What was more interesting, though, is that patients with a strong burst in activated T cells also had a positive clinical response to immune checkpoint blockade, shown here by %change in target lesion size and by PFS.
Read 11 tweets
@LiangGQu, Vaisnavi Thirugnanasundralingam, @damien_bolton, @UroOncMD & @lawrentschuk reviewed the role of tissue-based immunohistochemical markers for diagnosis and classification of #RCC in this 1st edition of #SIUJ!
#OpenAccess #UroSoMe…

1/n Image
#RCC presents various subtypes, classified according to anatomical, morphological, immunohistochemical (#IHC) & molecular features. Even after '16 reclassification, tissue biomarkers differentiate RCC subtypes & distinguish them from non-renal neoplasms or metastatic disease
2/n Image
Despite advances in #IHC staining, challenges are:
- Staining heterogeneity across and within tumors
- Variations in processing may = inconsistencies
- Revisions by @WHO & @ISUPorg = misinterpretation of older literature
- Smaller samples (biopsies) needing to be analyzed

Read 7 tweets
@myESMO #ESMO20 as a #trainee can be #overwhelming! So many good studies, some more #practicechanging then others, if you missed some and want to understand (albeit at a simplistic #trainee level), sit back, relax and enjoy as we go through some great data #ESMO20 @OncoAlert
1. #NSCLC: 2 major studies #ADAURA #CROWN for adjuvant #EGFRmNSCLC, and advanced #ALK+ experts can provide better perspective @JackWestMD @n8pennell @StephenVLiu @AMansfieldMD @CharuAggarwalMD @NarjustDumaMD @GlopesMd @DevikaDasMD @OncoAlert
1. A) #ADAURA: Stage IB-IIIA #resected #NSCLC with #EGFRm treated with #Osimertinib vs #placebo [SOC prior to this was adjuvant chemotherapy [cisplatin-based doublet based on #LACE metanalysis-] showed improvement in #DFS @NEJM…
Read 19 tweets
Why do some pts with renal cell carcinoma present w/ polycythemia🩸vs others w/anemia🤔?

1/ Erythropoietin (EPO)➡️glycoprotein that induces differentiation of erythrocytes in the bone marrow to promote RBC production➡️produced in the KIDNEY Image
In RCC➡️EPO is produced ectopically by RCC tumor cells causing abnormalities in RBC production

🧐In fact‼️ ectopic EPO occurs in 66% of RCC pts!

Despite high concentrations of EPO➡️Anemia (⬇️RBC) is common due to poor nutrition🍎, hematuria🩸 or ineffective erythropoiesis🛑
Polycythemia➡️less common in 1-5% of pts, most common in clear cell RCC is due to paraneoplastic production of EPO results in excess RBC and reduction in inhibitory proteins that haunt RBC production!

#twitterx #OTILT #renalcellcarinoma #rcc
Read 3 tweets
mañana lunes, 25 de mayo
🤎💛🧡💛🤎🌻🐝 Image
La @ColeFeminista estará repartiendo almuerzos en la Placita Barceló en Barrio Obrero. Exigiéndole al estado una reapertura responsable, que cumpla con unas garantías poniendo primero al pueblo.

#RCC #BrigadasPorLaVida Image
1. La expansión y aprobación rápida del Programa de Asistencia Nutricional, la apertura de los comedores escolares y congelación de los precios de alimentos.

#RCC #BrigadasPorLaVida Image
Read 7 tweets
Ya @wandavazquezg anunció la reapertura del sector económico. Una REAPERTURA APRESURADA sin pruebas suficientes, sin haberse controlado el ritmo de contagio y sin protocolos efectivos para el rastreo. #RCC Image
Una REAPERTURA PRESIONADA por el sector privado que está más pendiente de las pérdidas de ventas que de las pérdidas de vida bajo una pandemia. Una REAPERTURA IRRESPONSABLE que pretende lanzarnos a una normalidad ilusa, porque no se ha atendido las necesidades del país. #RCC
Entonces, nos preguntamos:¿REAPERTURA?¿CUÁNDO? ¿CÓMO?Nosotras tiramos nuestras condiciones para una reapertura que priorice y responsabilice a atender la vulnerabilidad creada por políticas públicas en servicio de la mal llamada productividad.¡Resistimos sus políticas de muerte! Image
Read 9 tweets

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