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Ibrahim Halil SAHIN, MD

Jun 5 • 4 tweets • 3 min read

@asco

#ASCO22

✳️The standard of care for MMR-D rectal cancer is changing/changed❗️
✳️We should do all we can to avoid surgery for patients with MMR-D rectal cancer ❗️
✳️Although data is early and it is highly promising enough to move forward ‼️@asco @OncoAlert @MoffittNews
👇

✳️Perhaps important to note that 100% clinical response is not complete pathological response ‼️

✳️However this is higher than we achieved with OPRA in MSS rectal cancer ‼️

✳️Also, all patients had BRAF WT which is expected (Lynch cause more MMR-D rectal than sporadic event)

✳️As next step we should consider adding anti-CTLA4 blockade after seeing long term outcomes, if needed ‼️
✳️Very exciting time for patients with MMR-D CRC and great to see this change in this field and happy for our patients ‼️

@MSKCancerCenter

Congratulations to @MSKCancerCenter team Dr. @AndreaCercek Dr Diaz ‼️

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Ibrahim Halil SAHIN, MD

@IbrahimSahinMD1

Jun 6

@OncoAlert

#ASCO22
✳️Happy to say there is great progress for patients with CRC‼️
@OncoAlert @ASCO @manjuggm @CrcChange‼️
Here is summary of some key studies 👇

1️⃣ Immune checkpoint inhibitor monothetapy with dostarlimab for MMR-D is certainly practice changing❗️

✳️Although long term outcomes are needed, no need to reinvent the wheel‼️

✳️ Once a deep response achieved in MMR-D CRC it is very durable even in metastatic setting ‼️

2️⃣ #ctDNA study (DYNAMIC) was my second favorite study ❗️

✳️ We are certainly in the right pathway to use #ctDNA however we have to be careful for false negative results in high risk population: T4 disease ‼️

✳️We need more trials to get more data ❗️Enroll COBRA/CIRCULATE

Read 16 tweets

Ibrahim Halil SAHIN, MD

@IbrahimSahinMD1

Jun 4

@ASCO

#ASCO22
✳️DYNAMIC trial results are highly exciting and glad to see field is moving forward !

✳️Very encouraging findings that we are in right pathway to use #ctDNA for adjuvant tx‼️

However there are important points that we need to address 👇@ASCO @OncoAlert @MoffittNews

✳️Firstly, I am categorically against putting T4 and T3 disease into same pocket (stage II is highly heterogeneous)❗️

✳️Risk of peritoneal recurrence for T4 and T3 is not same and not even close ‼️

✳️Peritoneal microscopic disease doesn’t shed CtDNA as much as liver MRD‼️

✳️Moreover, control group was a bit vague in this study, conventional risk factors are used for ad therapy which can offer you different approaches ‼️

✳️Currently there is not consensus for high risk stage II in NCCN and options include observation vs FP alone or doublet ‼️

Read 7 tweets

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