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Jun 5 • 4 tweets • 2 min read
A thread of my #ASCO22 #ASCO2022 videos for @Plenary_Session

I aim to be educational & what discussant should have said

Suggestions accepted in replies

#1 SHINE - I-BR vs BR, Mantle Cell PFS
#2 DYNAMIC - CT DNA guided Adjuvant CRC
#3 DESTINY BREAST-04
DYNAMIC
Non-inferiority margin 8.5%!!
CT DNA in Stage II
Oxaliplatin vs 5 FU
Guarantee you will learn something from this video 👇👇
DETERMINATION
No OS gain
QoL not better
Should we recommend transplant in CR1?
DESTINY BREAST 04
What was the pre-treatment?
What was post protocol care?
Did HR neg patients get endocrine therapy?

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More from @VPrasadMDMPH

Vinay Prasad, MD MPH 🎙️📷 Profile picture
Jun 3
A lie can travel halfway around the world, while the truth is putting on its shoes
truth
Read 4 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
May 31
WH Covid Czar now tweeting misinformation & distorted statistics that exaggerate the risk to kids
Truth is 👇
Lying about COVID severity in kids is the reason school was closed for 18+ months in many places, & intermittently closed to this day, ruining the lives of children
Sad! Image
The US FDA could demand Pfizer & Moderna power their RCT to show a reduction in kids hospitalizations.

We ran a 400k person RCT for polio, and can do it again

Otherwise he hangs hat on unreliable obs studies
This is correct
Read 7 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
May 28
As you read the #ASCO22 abstracts, here are some tips I offer to separate true & useful from all the rest

PS: The Amgen ad on the banner of the abstract page is emblematic of what you have to contend with
🧵
I. Let me start with observational/ uncontrolled studies. These can be useful to describe prognosis, identify risk factors, track time trends, establish activity, etc. but there are many caveats
1. An abstract shows survival improves by decade in a cancer - author claims it is due to better drugs

Possibly yes, but also possible the definition of the cancer is different (AHEM myeloma), we look for it more often, our CT/PET scan is more sensitive (stage migration), etc.
Read 32 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
May 26
Over the 15 years I have closely read medical studies, I find this is true every single time you have a 'virtuous' issue.

Whenever you decide that good people believe x, you quickly find a proliferation of bad science.

In this case, good people believe medication adherence...
Is often suboptimal, and our efforts to improve it work magic, and as a result of those efforts, the patient is better off. But each of those propositions may not withstand scrutiny

Other issues where people have decided what is the right answer are similar...
The evidence supporting the claims is often threadbare, just absolutely incorrect, but the conclusion is the desired one. There is very little professional incentive to point this out, and a strong disincentive.

Ironically...
Read 7 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
May 24
I was just reading this superb toolkit from Urgency of Normal -- that's the group who thinks about kids & restrictions sensibly & numerically; trying to maximize kids' overall life outcomes/ health

Check out the highlights 🧵
static1.squarespace.com/static/61e5afd…
Puts it in perspective, doesn't it

We didn't cancel kids birthday parties (for years on end) for RSV
Wow, another fact
Read 7 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
May 20
#17 Our new paper @vkprasadlab is now out in @JAMANetworkOpen

SAME drug SAME cancer

Discontinuation rates are MUCH higher for toxcity in the adjuvant rather than metastatic setting

Why?

jamanetwork.com/journals/jaman…
First the effect we find is present for checkpoint inhibitors and targeted drugs, but less prominent for cytotoxics
Second it is across a wide range of drugs
For diverse indications
Check it out
Read 6 tweets

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