Thread by @TumorBoardTues

#TumorBoardTuesday

🙏for joining &⚖️in on a robust🗣️ with A LOT of deep🔬on NRG-1 fusion+ #CRC led by @benweinbergmd

➡️Here is this week's Thursday Case🎀

👉👉Don't forget to pick up your🆓#CME credit by answering 2 quick❓

Here is the post-test🔗
bit.ly/3fFpTUe

#TumorBoardTuesday
Thursday Case🎀
(Case from 04/06/21)

We discussed #colorectalcancer and:
✅ChemoTx choices and sequencing
✅5FU cardiotox
✅KRAS and other🧬alterations
✅And of course all about NRG-1

We captured as much as we could in this moment:
twitter.com/i/events/13794…

#TumorBoardTuesday
Thursday Case🎀
(Case from 04/06/21)

@benweinbergmd presented a case of a patient with met #CRC

👍2-dary🗣️on:
➡️What chemo after metastasectomy
➡️💪evidence for FOLFOXIRI+mAb for metCRC

ncbi.nlm.nih.gov/pubmed/17470860
ncbi.nlm.nih.gov/pubmed/16508637
ncbi.nlm.nih.gov/pubmed/26338525

#TumorBoardTuesday
Thursday Case🎀
(Case from 04/06/21)

😱The patient has❤️vasospasm w/FOLFOX

🤔What to do now❓❓❓
💡Go with FLOX to avoid the CI5FU @pashtoonkasi
@anup_kasi @RenoHemonc @DrR_DUNNE et al

pubmed.ncbi.nlm.nih.gov/12860947/
clinical-colorectal-cancer.com/article/S1533-…
pubmed.ncbi.nlm.nih.gov/29299356/

#TumorBoardTuesday
Thursday Case🎀
(Case from 04/06/21)

The patient can't tolerate irinotecan, & needs surgery for new mets
➡️Now what❓❓

Well........it is @TumorBoardTues - so🧬NGS of course😉👍

💡And make sure your panel includes RNAseq for FUSIONS!

➡️🔬POMK-NRG1 fusion

#TumorBoardTuesday
Thursday Case🎀
(Case from 04/06/21)

Which led to @benweinbergmd 's mini-tweetorial about NRG-1 fusions:

Mini-tweetorial #1

https://twitter.com/benweinbergmd/status/1379594324476895232?s=20

#TumorBoardTuesday
Thursday Case🎀
(Case from 04/06/21)

Mini-tweetorial #2

https://twitter.com/benweinbergmd/status/1379594471806021638?s=20

#TumorBoardTuesday
Thursday Case🎀
(Case from 04/06/21)

Yes - these are UNCOMMON mutations
❌NOT rare
(EU definition of RARE is <1/2000)
ec.europa.eu/info/research-…

But finding that needle in the haystack can be so valuable to the patient!!

#TumorBoardTuesday
Thursday Case🎀
(Case from 04/06/21)

➡️And despite the fusion being uncommon, there are FOUR4⃣therapies💊(at least...probably more out there/more to come) targeting this driving 🧬molecular abnormality

Mini-tweetorial #3

https://twitter.com/benweinbergmd/status/1379594583282188291?s=20

#TumorBoardTuesday
Thursday Case🎀
(Case from 04/06/21)

@benweinbergmd then brought it all🏡:
➡️🧬Profiling can🔬targetable genetic alterations even in patients with known driver mutations
➡️NRG1 fusions are👀at low %s across tumor types
➡️Drugs🏹HER may act against NRG1+ tumors

#TumorBoardTuesday
Thursday Case🎀
(Case from 04/06/21)

Thank you all again for participating

And I hope you will join us 04/20/21 for a very special #TumorBoardTuesday with @drallysonocean and @letswinpc discussing #pancreaticcancer during #PancChat

#PostTest Q 1️⃣ #CME
#TumorBoardTuesday


🤔 What is the clinical significance of a tumor with an NRG1 fusion?🧬


👉🏼 Post test 🔗 to collect 🆓 CME: bit.ly/3fFpTUe

All 🏆CME 🔗: integrityce.com/tumorboardtues… #CRC #ColorectalCancer

#PostTest Q 2️⃣ #CME
#TumorBoardTuesday

🧐Approximately what percentage of solid tumors harbor NRG1 fusions?🧬


👉🏼 Post test 🔗 to collect 🆓 CME: bit.ly/3fFpTUe

All 🏆CME 🔗: integrityce.com/tumorboardtues… #CRC #ColorectalCancer