Profile picture
Eli Van Allen @VanAllenLab
, 4 tweets, 2 min read Read on Twitter
Lots of discussion whether broad cancer NGS testing is good/bad given @JAMAOnc article below. Tbh I'm far more interested in some general issues it exposes re: prospectively testing the precision oncology hypothesis:

jamanetwork.com/journals/jama/… [1/4]
1) NGS testing w/o companion (early phase?) clinical trial network & mid-trial adjustments for when new approvals arise creates a ‘last mile’ problem that reduces potential impact. Can a precision oncology trial have experimental Rx access and be changed in real time? [2/4]
2) Dropping a complicated test of any kind on providers who have no prior training or expertise in its interpretation (when also paired with often…err…curious interpretations from vendors) will confound outcomes.

See also: academic.oup.com/jamia/article/… [3/4]
The good news is these are imminently solvable problems toward effectively assessing the impact of molecular profiling in the clinic! (Though, when talking about fundamentally changing the way clinical trials are accessed/distributed, will require a lot of teamwork) [4/4]
Missing some Tweet in this thread?
You can try to force a refresh.

Like this thread? Get email updates or save it to PDF!

Subscribe to Eli Van Allen
Profile picture

Get real-time email alerts when new unrolls are available from this author!

This content may be removed anytime!

Twitter may remove this content at anytime, convert it as a PDF, save and print for later use!

Try unrolling a thread yourself!

how to unroll video

1) Follow Thread Reader App on Twitter so you can easily mention us!

2) Go to a Twitter thread (series of Tweets by the same owner) and mention us with a keyword "unroll" @threadreaderapp unroll

You can practice here first or read more on our help page!

More from @VanAllenLab see all

Profile picture
Here, we partnered w/ cancer patients + friends @KDeutsch @adamhayden @CultPerfectMoms @CurrentIncurSci @stephanie_mul to liberate their cancer genomic data from clinical labs.

It was a struggle…

...but there’s hope & we have a plan! [1/n] @OSFramework osf.io/gupvq
(Updated my bio to have a disclosures link, including consulting for genomics labs which is relevant for this effort. Also pasting here: goo.gl/6kfq2E)
Patients have a right to their data, and HIPAA states that data (whether clinical, molecular, or anything in between) should come in a computable form.

hhs.gov/hipaa/for-prof… cc @EricTopol @TheLizArmy
Read 13 tweets
Profile picture
A thread on our latest look at cancer genomics + immune checkpoint blockade → congrats @diana_miao, Claire, @NIVokes et al!

Thx @SU2C @BroadIgnite @HHMINEWS @theNCI for supporting this & the ppl doing it @NatureGenet @DanaFarber @broadinstitute

rdcu.be/5iVz [1/n]
We analyzed every tumor-normal exome from patients getting immune checkpoint blockade (ICB) we could get & integrated w/ clinical outcomes for biological and clinical exploration → lots of technical pain here + open questions re: defining clinical benefit
For context, lots of ongoing biology re: mutations/neoantigens driving response to immune checkpoint blockade by many groups (including ours).

In parallel, lots of buzz about tumor mutational burden (TMB) as a *clinical* biomarker for cancer ICB...
Read 13 tweets
Profile picture
Reflecting on the recent/heated “hype vs. hope” precision oncology debates: It’s not “vs.” → real hope it engenders & current limitations are simultaneously true. This tension mirrors so much of oncology, as @Bob_Wachter elegantly points out here:
nytimes.com/2018/04/19/opi… [1/n]
Thankfully, @DHymanMD captured this critical point clearly, here:
A recent 'back of the envelope' study noted only ~15% (~95k) metastatic cancer patients may get genome-informed Rx in 2018, & less achieve clinical benefit:
jamanetwork.com/journals/jamao…

But that same study indicates steady progress (see below from sciencemag.org/news/2018/04/c…)
Read 6 tweets

Related threads

Profile picture
Lessons of my 20s

1. Your personality is not fixed

People can massively change over the years. They become entirely new people, mature, and truly do grow up

You cannot judge people off how they are when they are young,

People DO change
2. Attitude is everything

I play Little League baseball from 6 to 11. I always remember the coaches harping about "attitude, its all about attitude"

They were right.

I've not seen any pessimists do particularly well
Cynicism is acceptable when you're young, but if you never outgrow it,

its cancerous.

People with "good attitudes" do better in EVERYTHING,

which is another lesson
Read 63 tweets
Profile picture
1) Donald Trump’s press conference Wednesday, and the responses to it, are an important and perhaps historic moment, beyond the controversy. It made irrevocably clear that Trump intends to rule as an authoritarian, and his followers want that. Ridiculously long thread follows.
2) @ThePlumLine has already limned the authoritarian nature of the behavior of both Trump and his minions in searing detail. I urge everyone to read this thread so they can understand the dynamic at work here.

3) This is hardly the first time Trump has attempted to assert that his version of reality is the only legitimate one, and that all others are “fake.” It’s been a trademark of his tenure. He uses the gap as a wedge to drive his followers closer.

bit.ly/2JOX8Tb
Read 78 tweets
Profile picture
1/ My experience is that most pitches go sideways because the investor is lead to believe there is more maturity in a company than their is. And then they leave unsatisfied because there wasn't sufficient focus on the important metrics for the assumed stage.
2/ For example, a company claims to be raising a series B to scale sales, however there are few hard signs of product market fit and instead the pitch focuses on product vision and roadmap.
3/ In this thread, I try and outline how we view startup maturity, and what we look for in each stage, independent of the round label.
Read 18 tweets
Profile picture
A Jikook au where Jimin and Jungkook used to be together—it’s been years since they’ve seen each other, but when they end up as Yoongi and Hoseok’s best men for their wedding, their paths are bound to cross again.
I got this prompt from a cc anon and I couldn’t resist writing it! Notes:

-please quote/rt!!

-another interactive au, so there will be polls!

-angst and fluff, very likely nsfw 🔞

-if you enjoy it, please like or share!!!
When Hoseok asks Jimin to be his best man at his wedding, Jimin is ecstatic. Hoseok and Yoongi had been engaged for months, and honestly Jimin had started to get worried that Hoseok had someone else in mind, despite the fact that Jimin was his best friend.
Read 119 tweets
Profile picture
I'm one of a few million Americans awake when we should be sleeping because of the pain of #cancer or some other chronic illness.

Adding to our sleeplessness is knowing #healthcare is under threat. We may not be able to afford it due to the #GOP's actions.

It's terrorizing.
My parents were Civil Rights workers. My father was a Freedom Rider. As a small child I was taught the legacy of #MLK.
I watched people invoking MLK on Monday. Not in defense of #votingrights or in outrage over how the #SCOTUS ruled on two pivotal cases on gerrymandering.
2/
MLK wasn't being invoked for #votingrights but for Sarah Huckabee Sanders, who lies to America every day about policies that could very well kill me & others.

Policies that are hurting millions.

Policies that have kept me a citizen without equal rights in my own country.
3/
Read 17 tweets
Profile picture
THE WATCHMAN

[...] "The watchman’s task has always been a thankless one.
"There are treacherous fifth column elements, who are really working for the #defeat of the #nation, at the hands of its enemies.
"These subversive elements readily gain and hold the #public’s ear, because they soothingly tell the people what they want to hear. Go back to sleep, no danger can come, and there is nothing you can do.
Read 134 tweets

Trending hashtags

#trust #Breathe #anti #deceivers #rightwinger #warned #moral #GOTV #without #laws #MuslimBan #priests #evil #extreme #WorldCouncilofChurches #Sodom #Ezekiel #national #merchant #falsechoices #honeytrap #dictate #cousin #humanright #true

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just three indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member and get exclusive features!

Premium member ($3.00/month or $30.00/year)

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!