Thread by @TumorBoardTues

1/9 #TumorBoardTuesday #PostTest Q1️⃣ #CME
Case🎀

@doctorC369 took us on a 🛣️through metastatic #GEA. Lots of pearls🦪 here. First: two ❓...then the wrap up!

🤔These biomarkers are actionable in advanced #EsophagoGastricCancer except…

👉🏽Posttest 🔗: bit.ly/3pKtAvs

2/9 #PostTest Q2️⃣ #CME #TumorBoardTuesday
👉🏽posttest🔗: bit.ly/3pKtAvs

ALL🥇CME🔗: integrityce.com/tbt

🤔 Addition of immunotherapy to chemotherapy in the 1st line Rx of advanced #EsophagoGastricCancer significantly improves PFS and OS PDL1 CPS>1%

3/9 #TumorBoardTuesday
Thursday Case🎀- 12.14.2021

Lots of take🏠messages- 2 TWEETS!
We discussed metastatic #GEA
✅Chemo + XRT needed to be used fast when facing obstruction- biomarkers can wait
📣✅REMEMBER- no 5-FU bolus‼️📣

3.5/9 #TumorBoardTuesday

Take🏠(Continued):
✅FOLFOX + nivolumab for all PD-L1 CPS> 1%- improved OS
✅Ramucirimab + paclitaxel= 2L option. Keep biomarkers in 🧠.
✅MUST have 🧪: HER2, PD-L1, dMMR…but consider🧬

📚We captured @doctorC369’s talk: twitter.com/i/events/14708…

4/9 #TumorBoardTuesday
Thursday Case🎀
Conundrum: 72 yo👨🏽‍🦳no PO intake–headed toward obstruction in setting of
➰GEJ adenoca
HER2➖
🥐liver mets.

Pt got dose ⬇️FOLFOX w sig improvement in symptoms.

🤝Meet pt where they are. In the right pt, chemo improves PS

5/9 #TumorBoardTuesday
Thursday Case🎀

Once the onc 🚨 is solved, 🧠 about the big 🖼️–guided by biomarkers.
🧬NGS- PD-L1 CPS= 30%! Also, EGFR amp.

Add nivolumab. Why?
💡✅ CheckMate 649- nivo+1L chemo= OS of 13.1 mo vs 11.1. Some tox concerns?

thelancet.com/journals/lance…

6/9 #TumorBoardTuesday
Thurs Case🎀

Anticipate tumor evolution! 2L strat:
🌈trial ramucirimab + paclitaxel. 🐏+tax= ⬆️OS by 2 mos. Every gain (without sig added tox) counts!

✅Pre-tx w anti-PD-1 ⬆️ RR to 🐏+ tax. Case for FOLFOX + nivo upfront?
pubmed.ncbi.nlm.nih.gov/33739449/

7/9 #TumorBoardTuesday
Thurs Case🎀

We’re TBT…so we’re going to push the ✉️
➡️🔬Pt tumor w EGFR amp.
Actionable? @oncologician points out- copy number matters.
RR over 50% w anti-EGFR agent in pts with EGFR amp
pubmed.ncbi.nlm.nih.gov/29449271/

8/9 #TumorBoardTuesday
Thursday Case🎀

✅Consider low-tox chemo upfront in onc emergency- ongoing studies re: other regimens
✅NGS can illuminate future options
✅The future: PANGEA- personalized tx w ongoing
🧺trials based on NGS upfront!

https://twitter.com/ShimaghavimiMD/status/1470930896110985225?s=20

9/9 #TumorBoardTuesday
Thurs Case🎀

🙏 ‼️chemo in setting of onc 🚨
🤔 Next steps: biomarkers increasingly actionable.
1st– chemoIO, then think 🌈 trial
➡️Please join us on 12/21/2021: @ErikaHamilton9 @MPishvaian presents a tweetorial about HER2/3 in #BreastCancer 😀