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Vincent Rajkumar
@VincentRK
, 8 tweets, 12 min read Read on Twitter
Here are my Top 5 #ASCO19 @ASCO myeloma abstracts. #ASCO19VR

I’ve listed them with links to the full abstract. @mtmdphd @myelomaMD @MyelomaTeacher @MayoMyeloma @NorthTxMSG @Mohty_EBMT @BldCancerDoc @DrAnasYounes @DrMiguelPerales @JohnPLeonardMD
See thread for countdown! 👇
#5 Isatuximab-Pom-Dex vs Pom-Dex in relapsed refractory myeloma. First phase III with this drug. May lead to FDA approval and provide alternative to Dara (?compete on cost) @DanaFarber @sanofi @mtmdphd @grpetersen1 #ASCO19 #ASCO19VR
abstracts.asco.org/239/AbstView_2…
#4 IMWG Risk stratification for Smoldering Myeloma. ~2000 patient study defines intermediate & high risk smoldering myeloma with simple parameters. Of importance: identifies candidates for early therapy. @mvmateos @myelomaMD @IMFmyeloma #ASCO19 #ASCO19VR
abstracts.asco.org/239/AbstView_2…
#3 CC-220 in relapsed refractory myeloma. First Phase I/II of this new drug, a #CELMoD, shows activity in advanced myeloma. One more new drug for this disease is always good news. @SagarLonialMD @WinshipAtEmory @Celgene @grpetersen1 #ASCO19 #ASCO19VR abstracts.asco.org/239/AbstView_2…
#2 Ph III trial of Lenalidomide vs Observation in Smoldering Myeloma: Early therapy delays end-organ damage. Coupled with Spanish trial showing overall survival benefit will lead to change in standard of care @SagarLonialMD @eaonc @theNCI #ASCO19 #ASCO19VR abstracts.asco.org/239/AbstView_2…
#1 Dara-VTd vs VTd in Newly Diagnosed Myeloma. #CASSIOPEA trial. First ph III testing addition of moAb to IMiD-PI triplet. Trend for OS benefit. Except for cost: we are headed to quadruplets for at least some patients. #IFM @JanssenUS #ASCO19 #ASCO19VR abstracts.asco.org/239/AbstView_2…
As in the past, I left out some great studies that were already presented or published before; or a similar study was already presented. I went for clinical relevance and impact. Since I was lead author on one study I got a second opinion from #ASCO19 #ASCO19VR @myelomaMD!
Here is a link to my Top 5 picks from last year @asco #ASCO18
2 have been published in @TheLancetOncol and one in @NEJM so far.
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More from @VincentRK see all

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Vincent Rajkumar
@VincentRK
1/ Cost of Myeloma Drugs—

Lenalidomide & pomalidomide are 150 times more expensive in USA than India; Why? A big reason is true free market competition: 12-18 companies make them

Bortezomib is 25 times cheaper; 25 companies make it.

@DavidP4AD @mtmdphd @myelomaMD @Mohty_EBMT
2/ Usually one generic doesn’t help. A wide open generic market (once patents end) is what really drives cost down. At least 4 plus generics are needed. @US_FDA @tmprowell

So FDA has to be more liberal. Emphasis on safety standards is good. But need to balance it with access
3/ The prices of myeloma drugs in India are driven lower and lower by a desire to compete on the lowest price when bidding for formulary contracts. No middlemen.

We have the opposite: higher list price is more desirable for PBMs coz it means more rebates to pocket. @DavidP4AD
Read 7 tweets
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Vincent Rajkumar
@VincentRK
You want to know why drug prices keep going up? Please read this convo which took place during a recent trip to India.

I asked a top executive at a leading generic company on why they can’t come into the US market & sell for $1000 a drug that sells for $15000 in the US
1/👇
He said: 3 PBMs control what’s on formulary in USA. When a generic is allowed entry, we place bids along with other generic companies. Bids are secret. If we price drug too low or don’t give the best rebate to the PBM we won’t be on formulary. A low price will hurt our chances 2/
In what kind of crazy system do middlemen who are supposed to look out for the best interest of the patient seek a HIGHER list price and a HIGHER rebate as a key determinant of which drug is on the formulary? Where the pressure is to keep price HIGH not low!! @aholdenj 3/
Read 5 tweets
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Vincent Rajkumar
@VincentRK
1/ During my Grand Rounds talk @MayoClinic on cost of drugs I had a question on #LEMS drug #Firdapse that was recently priced at a mindboggling price of $350,000 per year by @CatalystPharma - I answered it. What happened next was very very powerful and moving. Read on 👇
2/ Unknown to me, a patient with #LEMS was in the audience. She raised her hand and spoke up. She had received the drug almost for free from Jacobus Pharma for many years. But now because of @CatalystPharma this program was done. She had to buy Firdapse: at $3800/month co pay! 👇
3/ She had written to several Congressmen with no answers. She said she was on Medicare Part D and cannot afford the co pays. Her symptoms from this disease were well controlled for years. But not she must go without meds and suffer. There was no choice coz of @CatalystPharma 👇
Read 8 tweets

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Adam Draper 🔌 🛸 🌊
@AdamDraper
1/ For the last 5 years, the #VR builders and entrepreneurs have had to beg people to try their experiences.
2/ They had to lug 20 pounds of equipment to pitch meetings, unpack the computer, the sensors and the headset, set it up and then ask people to put a vizor on their heads.
3/ They had to sell a vision of their product, being built on a technology that was still unproven.
Read 11 tweets
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tipatat
@tipatat
Rant: Seven Reasons I know current VR/AR technology is succeeding for consumer and enterprise

3 Years of actual market data tells us that VR/AR are viable industries so let's stop with this VR/AR is dead or not going to work nonsense

retweet if you trust data over opinions! 1/9
First HMD sales: True consumer VR (6DOF) was off to a slow start, but year after year the market has grown and there is now an install base of over 7+M (3+M PSVR, 4+M PC VR) 2/9 Thanks @RtoVR for the nice graphic
True VR (6dof heads and hands) has until now been very user unfriendly: high cost, need of a tethered computer, complicated set up with external sensors, and a long time to vr from boot, especially with troubleshooting drivers and other issues. The @Oculus Quest solves all this!
Read 9 tweets
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Josh Russell
@josh_emerson
Twitter released the tweets of another 418 russian accounts on January 31.
I'm going to use this thread to take a look at the information they gave us about these accounts.
And talk about other bots and trolls you can find using this data.
blog.twitter.com/en_us/topics/c…
Of the 418 accounts 1 was a double, @CovfefeNationUS it was already included in the last batch of accounts.
One was not actually suspended until I reminded them.
2 of them had active backup accounts at the time of publication of the data.
around 320 of the accounts I had tweeted about a lot. So i'm not going to bother going back over them.
I found them right after NBC put out the 1st batch of tweets from the russian trolls.
They were bots, and most of the data about what they did is unavailable.
Read 45 tweets
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AliDS 🇺🇸 #WWG1WGA 🇺🇸 IFB PATRIOTS
@Becky56992880
Here I will outline the affect of homelessness and drug abuse in mostly Democratic run states. It is a crisis on the largest magnitude and these American citizens do matter! Here is the top homeless cities of the United States in order!

statista.com/chart/6949/the…
Remember 1 is the worse and 10 is the best. This list only shows 10 major cities.... here we go!
1. Andrew Coumo - Governor of New York - Democrat
As of 2018 New York City, NY has a staggering 78, 676 homeless people in New York City alone- ranking them at the top of the charts.
Read 16 tweets
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Molly McKew
@MollyMcKew
Here are our top questions for Facebook about data, privacy, info ops, and foreign actors for this week's congressional hearings.

(We'll also post a longer, comprehensive list of questions at end of thread)

Some areas in particular to explore: /1
What kind of support do Facebook employees embedded with "clients" provide?
Do they differentiate between types of campaigns -- for example, do they support obvious "black PR" campaigns?
Do they work for state actors? How? /2
What does Facebook know about the scale and efficacy of info ops/influence campaigns on its platform -- especially beyond regular "advertising"?

Who scraped data from Americans, and where is it now?

Why did FB change its API policies in 2015? /3
Read 9 tweets
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Jesse Damiani
@JesseDamiani
Just saw the @ReadyPlayerOne movie and want to know how it stacks up against the reality of virtual reality? This thread that breaks down what RP1 gets right, not-quite-right, and flat-out wrong about the future of #VR, immersion, & the metaverse.
We’ll also examine the tech #ReadyPlayerOne left out altogether. After all, the film is set in 2045, and given the exponential rate of technological advancement, 27 years will likely yield some dramatic changes in society.
There are a few articles that have pointed out some of the basics, but having worked in the industry for 4+ years, I want to paint a fuller picture of our impending reality, with RP1 as the jumping-off point.
Read 84 tweets

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