Thread by @TumorBoardTues

#TumorBoardTuesday
Thursday Case Wrap Up🎀
(Case from 02/02/21)

➡️In case you missed the fast moving conversation, follow this thread for our summary

➡️And also take a look at these Twitter Moments from the case!

Page 1
twitter.com/i/events/13501…

Page 2
twitter.com/i/events/13573…

👏What a great #TumorBoardTuesday discussion on MSI-high, and NTRK-fusion+ #CRCSM led by @pashtoonkasi

Don't forget the 🏆🆓credit!!
✅2 Post-Test❓ integrityce.com/tbt2-2

⬇️⬇️Here is a breakdown of the participants⬇️⬇️

#TumorBoardTuesday
Thursday Case Wrap Up🎀
(Case from 02/02/21)

We started with 2 pre-case poll questions⬇️

#TumorBoardTuesday
Thursday Case Wrap Up🎀
(Case from 02/02/21)

The case @pashtoonkasi presented generated a LOT of discussion

43 yo ♀️ with unresectable metastatic #CRCSM
Testing showed MSI⬆️/RAS/RAF-WT

How would you Rx this pt 1️⃣line?

#TumorBoardTuesday
Thursday Case Wrap Up🎀
(Case from 02/02/21)

Most chose pembro - based on Keynote-177
doi: 10.1056/NEJMoa2017699

15% chose nivo + ipi, based on the Phase II trial ⬇️
(This was the ASCO 2020 Poster)
Lenz H-J, et al, JCO 38: 2020 (suppl; abstr 4040)

#TumorBoardTuesday
Thursday Case Wrap Up🎀
(Case from 02/02/21)

A lot of discussion about:
➡️A.E. profile
➡️"Best" tx to render pts operable
➡️And if ctDNA could help in choosing Tx
➡️Can ipi after PD on a PD-1inh "rescue" response (Trial❓)
DOI: 10.1634/theoncologist.2018-0686

#TumorBoardTuesday
Thursday Case Wrap Up🎀
(Case from 02/02/21)

Then @pashtoonkasi challenged us with what to do next:
➡️The patient progressed on pembro

But testing revealed an TPR-NTRK-1 fusion😀
➡️Must test pts for these markers

No data on which is better (laro vs. entrect)

#TumorBoardTuesday
Thursday Case Wrap Up🎀
(Case from 02/02/21)

💡Interestingly, MSI⬆️#CRCSM is enriched in NTRK-fusions🧬

(Excellent review of NTRK/TRKinh by Cocco, Scaltriti, and @alexdrilon)
doi.org/10.1038/s41571…

These Txs have OUTSTANDING activity in NTRK-fusion+ cancers

#TumorBoardTuesday
Thursday Case Wrap Up🎀
(Case from 02/02/21)

Finally, 🙏to @StephenVLiu for💡on NEXT-GEN Trk inhibitors:
➡️3 next gen Txs in the clinic now
✅LOXO-195 ➡️45% ORR
✅Repotrectinib (TPX-005) - FDA breakthrough designation
✅Taletrectinib (DS-6051b) Ph I paper⬇️