Discover and read the best of Twitter Threads about #tnbc
Most recents (11)
We are thrilled to share #Starfysh ⭐️ an auxiliary deep generative model for multi-modal analysis and integration of spatial transcriptomic (ST) datasets and histology images, and its application to heterogeneous #breastcancer tumors! 😃 tinyurl.com/hffdhvx7 1/ 
Incredibly fortunate to have a passionate, collaborative & talented team that didn't slow down with all the challenges of the past few years 🙏: @SiyuHe7 @YinuoJin6, @AchilleNazaret @shi_lingting and a fruitful and ongoing collaboration with @GeorgePlitas and Sasha Rudensky. 2/
Using ST, we wanted to find out if our previously observed continuous phenotypic expansion of intratumoral immune states (doi.org/10.1016/j.cell…) could be explained by the #spatialdynamics of immune cells and exposure to different environmental signals and nutrient supply? 🧐 3/
I got into a screaming match with a jerk oncologist who sold out by working for insurance companies to deny claims today. My whole office stopped and stared. But then they clapped after they realized why I was yelling. @premera is denying my patient’s Keytruda for her #TNBC
I asked the oncologist on the line why he was doing what he was doing and he had no answer. I then asked him if this was really the hill he wanted to die on, denying potentially life saving therapy for a young women with bad breast cancer. Again no answer. #MedTwitter #bcsm
He started with some nonsense about how the data wasn’t yet clear if patients really need adjuvant Keytruda and that if I had wanted adjuvant Keytuda she shouldn’t have been treated on the I-SPY2 trial in the neoadjuvant setting😡🤬. This man is not a breast oncologist.
@TumorBoardTues @DrSGraff @CharlesMilrod 1/18 #TumorBoardTuesday #OncTwitter
44 yo👩🏾
Stage 1 triple neg #BreastCancer #TNBC
✂️right lumpectomy
adj ACx4
radiation ☢️
8⃣🗓️months later
New R breast mass, ⬆️fatigue x3 mos
🩻CT many small 🫁 nodules & 4cm liver mass
🔬Breast & Liver ➡️ breast ca ER0% PR0% HER2 1+
Now?
44 yo👩🏾
Stage 1 triple neg #BreastCancer #TNBC
✂️right lumpectomy
adj ACx4
radiation ☢️
8⃣🗓️months later
New R breast mass, ⬆️fatigue x3 mos
🩻CT many small 🫁 nodules & 4cm liver mass
🔬Breast & Liver ➡️ breast ca ER0% PR0% HER2 1+
Now?
@TumorBoardTues @DrSGraff @CharlesMilrod 2/18 #TumorBoardTuesday
Closer look at the biopsies:
🔬Breast: Invasive Ductal Carcinoma w/dense lymphocytic infiltrate, G3, ER 0% PR 0% HER2 1+
🔬Liver: met carcinoma c/w breast primary, ER staining absent
❓What additional testing?
🤨Would it differ with ER+ #BreastCancer?
Closer look at the biopsies:
🔬Breast: Invasive Ductal Carcinoma w/dense lymphocytic infiltrate, G3, ER 0% PR 0% HER2 1+
🔬Liver: met carcinoma c/w breast primary, ER staining absent
❓What additional testing?
🤨Would it differ with ER+ #BreastCancer?
@TumorBoardTues @DrSGraff @CharlesMilrod 3/18 #TumorBoardTuesday #BreastCancer
📌For metastatic #TNBC
📍Germline BRCA1/2 (gBRCApv) and PD-L1 are 🔑 in early decision making📍
🤔What if she were 3L or beyond?
❓What factors–clinical, genomic–impact decisions?
📌For metastatic #TNBC
📍Germline BRCA1/2 (gBRCApv) and PD-L1 are 🔑 in early decision making📍
🤔What if she were 3L or beyond?
❓What factors–clinical, genomic–impact decisions?
Sponsored by @Roche,
I would like to share a Tweetorial about recent important advances in the management of advanced/metastatic triple negative breast cancer (mTNBC)
#Tweetorial #Oncology #Cancer #Diagnosis #TNBC #Immunotherapy #PDL1
I would like to share a Tweetorial about recent important advances in the management of advanced/metastatic triple negative breast cancer (mTNBC)
#Tweetorial #Oncology #Cancer #Diagnosis #TNBC #Immunotherapy #PDL1
TNBC is a challenging disease to treat due to its aggressive behavior, heterogeneity, and the lack of universal actionable targets. mTNBC is commonly diagnosed at a younger age than other BC subtypes and its prognosis is poor, with a median survival of <2 years.
Advanced TNBC can result from recurrence after treatment in the early-stage disease setting, or it may be diagnosed at initial (de novo) presentation
@TumorBoardTues @dradityabardia @ArielleMedford @Latinamd @EricaMarieRomn1 @HillStirSci @ErikaHamilton9 @stolaney1 @PTarantinoMD 2/5 #TumorBoardTuesday
Thurs Case🎀
Take🏠messages
✅BRCAm= 10-20% of TNBC!
✅PD-L1 CPS>10= PFS & OS benefit w/ IO in mTNBC
✅PARPi= PFS benefit
✅Biomarkers, side effects, pt pref key
📚We captured much of @dradityabardia @ariellemedford’s discussion: twitter.com/i/events/15548…
Thurs Case🎀
Take🏠messages
✅BRCAm= 10-20% of TNBC!
✅PD-L1 CPS>10= PFS & OS benefit w/ IO in mTNBC
✅PARPi= PFS benefit
✅Biomarkers, side effects, pt pref key
📚We captured much of @dradityabardia @ariellemedford’s discussion: twitter.com/i/events/15548…
@TumorBoardTues @dradityabardia @ArielleMedford @Latinamd @EricaMarieRomn1 @HillStirSci @ErikaHamilton9 @stolaney1 @PTarantinoMD 3/5 #TumorBoardTuesday
Thursday Case🎀
How do you choose IO vs PARPi in #TNBC w #BRCA mutation? Check out the summary and algorithm below!
Important to know there are more 2L options as well, including sacituzumab-gov & other ADCs. New trials evaluating IO+ PARPi–stay tuned!
Thursday Case🎀
How do you choose IO vs PARPi in #TNBC w #BRCA mutation? Check out the summary and algorithm below!
Important to know there are more 2L options as well, including sacituzumab-gov & other ADCs. New trials evaluating IO+ PARPi–stay tuned!
@TumorBoardTues @dradityabardia @ArielleMedford @Latinamd @EricaMarieRomn1 @HillStirSci @ErikaHamilton9 @stolaney1 @PTarantinoMD @DFCI_BreastOnc @oreganruth @marina_sharifi @JaniceTNBCmets @OncBrothers @Myshastry @BRCAUmbrella 4/5 #TumorBoardTuesday
Remember #TumorBoardTuesday offers AMA & now MOC credit for FREE! Don’t forget to answer the polls👇🏽
Then click this link to quickly request your credit!
CME eval🔗: integrityce.com/tbteval
ALL CME 🔗: integrityce.com/tbt
Remember #TumorBoardTuesday offers AMA & now MOC credit for FREE! Don’t forget to answer the polls👇🏽
Then click this link to quickly request your credit!
CME eval🔗: integrityce.com/tbteval
ALL CME 🔗: integrityce.com/tbt
@TumorBoardTues 1/19 #TumorBoardTuesday #BreastCancer #OncTwitter
45yo 👩🏼 non smoker 🚭 with 2 kids is diagnosed with T2N0 TNBC
Fmh: mother (78) HTN, grandmother BRCA+
🧪Genetic testing shows BRCA1 mutation
🤨How would you proceed?
45yo 👩🏼 non smoker 🚭 with 2 kids is diagnosed with T2N0 TNBC
Fmh: mother (78) HTN, grandmother BRCA+
🧪Genetic testing shows BRCA1 mutation
🤨How would you proceed?
@TumorBoardTues 2/19 #TumorBoardTuesday #TNBC
Rxed with Neoadj AC-T (IO not approved at time), followed by B/L mastectomy.
🔬Pathology showed 5mm residual disease.
IDC
ER 0%
PR 0%
HER2 0
Ki-67 90%
Stage ypT1aN0
She receives adjuvant capecitabine.
@dradityabardia @MPishvaian @JohnEbbenMDPhD
Rxed with Neoadj AC-T (IO not approved at time), followed by B/L mastectomy.
🔬Pathology showed 5mm residual disease.
IDC
ER 0%
PR 0%
HER2 0
Ki-67 90%
Stage ypT1aN0
She receives adjuvant capecitabine.
@dradityabardia @MPishvaian @JohnEbbenMDPhD
@TumorBoardTues @dradityabardia @MPishvaian @JohnEbbenMDPhD 3/19 #TumorBoardTuesday #BreastCancer #BCSM
🗓 Two years after completing capecitabine, she’s found to have liver metastases.
🔬 Bx: TNBC, PD-L1+
🤨 What would you do next?
🤨 Would your decision change if she had received neo/adjuvant pembrolizumab?
🗓 Two years after completing capecitabine, she’s found to have liver metastases.
🔬 Bx: TNBC, PD-L1+
🤨 What would you do next?
🤨 Would your decision change if she had received neo/adjuvant pembrolizumab?
@TumorBoardTues @PTarantinoMD @CaterinaSpo @ADesaiMD @silke4senate @DrLauraEsserman @BRCAUmbrella @hoperugo @SusanGKomen @ErikaHamilton9 @stolaney1 1/8 #TumorBoardTuesday
🔬🧬Discussion on 1L treatment for BRCA+ #MBC led by @PTarantinoMD @CaterinaSpo #BreastCancer
➡️Here’s the week's Thursday Case 🎀
👉Don’t forget your🆓 #CME credit by answering 1 quick❓
CME🔗: integrityce.com/tbt
CME eval🔗: integrityce.com/tbteval
🔬🧬Discussion on 1L treatment for BRCA+ #MBC led by @PTarantinoMD @CaterinaSpo #BreastCancer
➡️Here’s the week's Thursday Case 🎀
👉Don’t forget your🆓 #CME credit by answering 1 quick❓
CME🔗: integrityce.com/tbt
CME eval🔗: integrityce.com/tbteval
@TumorBoardTues @PTarantinoMD @CaterinaSpo @ADesaiMD @silke4senate @DrLauraEsserman @BRCAUmbrella @hoperugo @SusanGKomen @ErikaHamilton9 @stolaney1 2/8 #TumorBoardTuesday
Thursday Case🎀
Take🏠messages for germline #BRCAm & 2L tx in #BreastCancer
✅BRCAm fairly common - 10-20% of #TNBC
✅PARPi approved in met, BRCAm dz
✅Fast responses, with ORR > chemo
📚Much of @PTarantinoMD @CaterinaSpo’s chat👇🏽
twitter.com/i/events/15487…
Thursday Case🎀
Take🏠messages for germline #BRCAm & 2L tx in #BreastCancer
✅BRCAm fairly common - 10-20% of #TNBC
✅PARPi approved in met, BRCAm dz
✅Fast responses, with ORR > chemo
📚Much of @PTarantinoMD @CaterinaSpo’s chat👇🏽
twitter.com/i/events/15487…
@TumorBoardTues @PTarantinoMD @CaterinaSpo @ADesaiMD @silke4senate @DrLauraEsserman @BRCAUmbrella @hoperugo @SusanGKomen @ErikaHamilton9 @stolaney1 2.33/8 #TumorBoardTuesday
Thursday Case🎀
Take🏠messages (continued):
✅Toxicities for 🤢, myelosuppression- managed w ⬇️ reduction, tx holiday
‼️(remember 3-5% risk of MDS/AML)‼️
Thursday Case🎀
Take🏠messages (continued):
✅Toxicities for 🤢, myelosuppression- managed w ⬇️ reduction, tx holiday
‼️(remember 3-5% risk of MDS/AML)‼️
@TumorBoardTues @Dr_RShatsky @PTarantinoMD @ErikaHamilton9 @UCSDCancer @KariWisinski_MD @marina_sharifi @JPoteralaMD @LaurenBzak @benjiwal @drteplinsky @MarkRobsonMD 2/11 #TumorBoardTuesday
Thurs Case🎀
Take🏠:
#TNBC &neoadjuvant tx
✅KEYNOTE-522= new standard of care
– Pembro+chemo in neoadj= BEST pCR so far
– Caveat: only for T2+ TNBC
✅Adding pembro may have ⬆️benefit in RCB II
📚We captured much of chat:
p1: twitter.com/i/events/15423…
Thurs Case🎀
Take🏠:
#TNBC &neoadjuvant tx
✅KEYNOTE-522= new standard of care
– Pembro+chemo in neoadj= BEST pCR so far
– Caveat: only for T2+ TNBC
✅Adding pembro may have ⬆️benefit in RCB II
📚We captured much of chat:
p1: twitter.com/i/events/15423…
@TumorBoardTues @Dr_RShatsky @PTarantinoMD @ErikaHamilton9 @UCSDCancer @KariWisinski_MD @marina_sharifi @JPoteralaMD @LaurenBzak @benjiwal @drteplinsky @MarkRobsonMD 3/11 #TumorBoardTuesday
Thurs Case🎀
Take🏠msgs (cont’d):
✅IO NOT shown to add benefit in metastatic dz
– Atezolizumab approval in mTNBC withdrawn
✅Standard of care – multi-d team
✅No current evidence to hold IO pre-op
P2: twitter.com/i/events/15425…
Thurs Case🎀
Take🏠msgs (cont’d):
✅IO NOT shown to add benefit in metastatic dz
– Atezolizumab approval in mTNBC withdrawn
✅Standard of care – multi-d team
✅No current evidence to hold IO pre-op
P2: twitter.com/i/events/15425…
@TumorBoardTues @Dr_RShatsky @PTarantinoMD @ErikaHamilton9 @UCSDCancer @KariWisinski_MD @marina_sharifi @JPoteralaMD @LaurenBzak @benjiwal @drteplinsky @MarkRobsonMD 4/11 #TumorBoardTuesday
Thurs Case🎀
Take🏠messages (cont’d):
✅THINK about side FX, including fertility
— Ovarian suppression may preserve fertility while undergoing neoadj tx
✅Patient voice is MOST important- pts define “acceptable tox,” not 🩺
Thurs Case🎀
Take🏠messages (cont’d):
✅THINK about side FX, including fertility
— Ovarian suppression may preserve fertility while undergoing neoadj tx
✅Patient voice is MOST important- pts define “acceptable tox,” not 🩺
@DrAttai T2. Let’s talk now about radiation specifically for breast cancer. We’ll start w/ breast conserving therapy (BCT) – a term for breast conserving surgery w/radiation as a combined strategy with similar results to a mastectomy. #bcsm #radonc 1/
@DrAttai T2. Vera Peters, whose mother had breast cancer, was a radiation oncologist advocating for smaller surgery w/RT in the 1960s-1970s. Amazing researcher and helped push us toward BCT as an option thefoldingchairhistory.com/2018/03/23/dr-… #bcsm #radonc 2/
Folks! We return for #HOTrainees with the exciting #Day2 @myESMO #ESMO20 and some more #practice relevant studies in #breastcancer #ProstateCancer #lungcancer #GI, so sit back, relax and lets go through some data (#HO #trainee-style!) Shout out to @peters_solange @OncoAlert
1. #BreastCancer: We have #monarchE and #IMPassion031 hoping to hear from experts @ErikaHamilton9 @NicoleKuderer @DrSGraff @matteolambe @tmprowell @GeorgeSledge51 @VukovicPetra for more insights- please link to your discussions here for #trainees:
1. A) #monarchE: use of #abemiciclib in HR+, HER2-,high risk #EBC in addition to endocrine therapy.
Current #SOC: adjuvant ET (5-10 years)
#monarchE: #Abemaciclib + ET iDFS HR 0.747, here's a great summary by @ErikaHamilton9 for @OncoAlert :
Current #SOC: adjuvant ET (5-10 years)
#monarchE: #Abemaciclib + ET iDFS HR 0.747, here's a great summary by @ErikaHamilton9 for @OncoAlert :
@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- pubmed.ncbi.nlm.nih.gov/18506026/] showed improvement in #DFS @NEJM nejm.org/doi/full/10.10…
