Thread by @TumorBoardTues

🚨 #CME Thursday 🚨

This week at #TumorBoardTuesday @W_Park_MD discussed FGFR inhibitors in #BiliaryTractCancer #CCA...and how to find FGFR fusions!

Check out the questions below, and tap the link to claim your free #CME...and stay tuned for a special edition of case wrap up!

#PostTest Q 1️⃣ #CME #TumorBoardTuesday
👉🏽 ALL CME🔗 integrityce.com/tbt

🤔 What is a molecular biomarker for an FDA approved🎯💊in #Cholangiocarcinoma❓

#OncTwitter #GeneTesting #CCA

#PostTest Q 2️⃣ #CME #TumorBoardTuesday
👉🏽 ALL CME🔗 integrityce.com/tbt

🤔 To detect 🧬 gene rearrangement what is the preferred method❓

#OncTwitter #GeneTesting #CCA

1/8 #TumorBoardTuesday Friday Case 🎀

This week, we discussed FGFR in #BiliaryTractCancer, & choosing correct NGS testing platform to capture FGFR fusions, as well as some updates in #CCA management. We captured the discussion in this moment:

📚twitter.com/i/events/15138…

2/8 #TumorBoardTuesday
Friday Case🎀

Key Take🏠messages:
We discussed #BiliaryTractCancer:
✅Actionable #CCA mut, including FGFR fusions (up to 15% of pts), IDH, others
✅Find🎯 with right method- use seq platform that includes 🧬RNA capture!
✅Many FGFRi available!

3/8 #TumorBoardTuesday

#CCA Mgmt Pearls:

​​💡Resection, or local tx (Surgery, RFA, Y90, HAI) is 🗝, if poss
💡TOPAZ-1 suggests activity of durva added to Gem-Cis. More data req, but ?heading toward SOC?
‼️Every pt needs NGS w 🧬RNA capture platform‼️

pubmed.ncbi.nlm.nih.gov/31670750/

4/8 #TumorBoardTuesday
Friday Case🎀

@W_Park_MD presented a case of a patient with #cholangiocarcinoma, sig PV clot; deemed unresectable! OSH NGS shows NO actionable muts. PD-L1 low; MSS.

➡️What next?
➡️Consensus - start gem/cis; 2L opinion is split

5/8 #TumorBoardTuesday
Friday Case🎀

Gem/cis→stable dz for a while G2✋🏽🦶🏽neuropathy! Transition to FOLFIRI.

But:

😱Repeat liquid NGS + RNA analysis shows FGFR-BICC1 fusion (the MOST common fusion in #CCA)!!

🤔What to do now❓
💡✅FGFR inhibitor!

https://twitter.com/w_park_md/status/1514039357988089864?s=21&t=-fRi0rSQ10O11xyy0zsoBQ

6/8 #TumorBoardTuesday
Friday Case🎀

Which led to @W_Park_MD’s mini-tweetorial about post-gemcitabine tx options in #CCA, guided by NGS!

https://twitter.com/W_Park_MD/status/1514039357988089864

7/8 #TumorBoardTuesday
Friday Case🎀

✅Fusions often missed w/o using an🧬RNA technique
💡Remember FISH can detect fusions! @PancPathologist
✅FGFRi available; new agents🎯FGFRi resistance on the way
🧪Chemo: new data for irinotecan; responses to neoadjuvant gem/cis/nab-pac

8/8 #TumorBoardTuesday
Friday Case🎀
🙏 Pt doing well on pemigatinib!
🤔 NGS is 🔑: must choose the right tech. If disease has high incidence of fusions- pick RNA platform!

➡️Join us on 04/26: @FogacciJoao presents a case of Immunotherapy in #GastricCancer & other solid tumors😀

@OncBrothers @danahaviland @ZazzyMrazzy @drymtn @fernandbteich @ShimaghavimiMD @PancPathologist @LaurenBzak @JamesClearyMD @GIcancerDoc @loconte @ShaalanBeg @SalemGIOncDoc @FlavioRochaMD @md_anusha @Akopor @Charles_TanJ @GretelTerrero @dizdar_omd @edikb @SheydaDoc

@guerrero_motta @CDebyaniPhD @rcarbalhoonco @AJacomeMD @geoffwong05 @changhoon_yoo @mehmetartac1 @DanengLi @Praveen_IO @letswinpc @HassanSheikh_MD

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