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Tatiana Prowell, MD

Jun 23 • 6 tweets • 5 min read

#OncTwitter
NCI Pooled analysis (N=6.9K) of antiPD1/PDL1:
👉0.6% incidence CPI-related major cardiac AEs, 77% grade 3+
👉Almost half were myocarditis
👉 Twice as common w/ combos vs monotherapy & w/ CPI + targeted agent vs CPI + antiCTLA4…
#ImmunoOnc
ascopubs.org/doi/full/10.12…

#OncTwitter
👉Major cardiac AEs were mostly early events (1-2 months) occurring after median of 2 doses of CPI
👉1/4 of cases of myocarditis were fatal, all preceded by myositis 👀
👉Diverse clinical presentations so have high index of suspicion to diagnose & intervene early…

#OncTwitter
My commentary: It’s also concerning (& not surprising given what we know about pro-inflammatory metabolic syndrome as a cardiac risk fx) that markedly ⬆️ risk of MI has been reported in pts with multi-yr use of CPIs. I predict this follows a course much like HIV…

Meaning that we now having a growing # of long-term survivors of metastatic #cancer who have been treated with #ImmunoOnc agents. Some may even be cured. We will start to recognize late AEs (eg effects of accel atherosclerosis) that #clinicaltrials were never designed to assess.

It would be ideal to have rand discontinuation #clinicaltrials to assess. Practically these are a tough sell given needed sample size/duration of follow-up/lack of incentive or even disincentive for those who can afford to conduct them to do so. #EHR data may fill a gap.

@thenasheffect

Congrats to Drs. @thenasheffect, @EladSharonMD, & all of their colleagues for their important contribution to our understanding of #Cardiotwitter adverse events with #ImmunoOnc agents. #OncTwitter /End

cc @HemOncWomenDocs @OncoAlert @HemOncFellows

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More from @tmprowell

Tatiana Prowell, MD

@tmprowell

Jun 9

Hey, #HoCoMD friends, be careful out there. This rain is crazy. Just got flash flood warning. Those of us who have lived here awhile know the history of this town, including the last tragic flash flood just 4y ago: apps.npr.org/ellicott-city/. #ECstrong

And now add a tornado warning to the flash flood warning, #HoCoMD. Done that before too in our own backyard (📸 2003). Careful out there, #EllicottCity neighbors.

#HoCoMD #EllicottCity

Read 4 tweets

Tatiana Prowell, MD

@tmprowell

Jun 4

🧵 A little vignette for #ASCO22 attendees & esp speakers/chairs. Today I spoke in an Ed session. E350 is small enough I could see faces. When we began, most were in 😷, but I counted 11 who weren’t. One had a drink. The rest didn’t appear to be eating/drinking. Importantly… 1/

a few people (not sure if in 😷 or not) were coughing. That’s something you always hear, but it takes on added significance in a #pandemic because #COVIDisAirborne & current #Covidvariants spread as easily as measles, the most contagious respiratory pathogen on earth. /2

Before I began my talk, I called attention to the fact that I would be continuing to #WearAMask while speaking. #Covid19 doesn’t care that I’m at the #ASCO22 podium. I said I was speaking masked to model the #OncTwitter behavior I hope to see. /3

Read 8 tweets

Tatiana Prowell, MD

@tmprowell

Jun 1

🧵#ASCO22 Sessions at a Glance for #OncTwitter

Friday June 3

#ASCO22 Saturday June 4

#ASCO22 Sunday June 5

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Tatiana Prowell, MD

@tmprowell

May 29

@Everytown

🧵 Imagine if 20 mins from now you had:

✅ Left a VM or sent email to Congress demanding new legislation for #GunSafetyNow

✅ Donated to @Everytown during the triple match happening now

✅ Asked self/fam/friends if guns are safely stored

✅ Volunteered with @MomsDemand

1/

congress.gov/members/find-y… /2

Triple match ends Tues 5/31 at midnight. /3

secure.actblue.com/donate/ads-eve…

Read 6 tweets

Tatiana Prowell, MD

@tmprowell

May 28

🧵 My oncology colleagues know how often I say: #WordsMatter. So I’m thinking about words we use to talk about #RobbElementary & every other incident of #GunViolence in 🇺🇸. Part of why people can scroll past these things, why they may not even register as news to us... /1

Is that somewhere along the way, we had words like “school shooter” & “gunman” drilled into our consciousness as the usual terms. These things oddly sound more like jobs—‘school shooter’ sounds like school principal or school secretary & ‘gunman’ like fireman or repairman… /2

And hear me out on this because the same sentence lands very differently if you substitute, for example, mass murderer or elem school killer. Try it. Grab any article. Listen to any news story. Swap all the words. #Uvalde school shooting m becomes #RobbElemementaryMassacre. /3

Read 5 tweets

Tatiana Prowell, MD

@tmprowell

May 25

@SenatorCardin

It’s morning. It’s time to act. I’ve just left VMs at offices of @SenatorCardin, @ChrisVanHollen, @RepKweisiMfume. I’ve confirmed my whole fam age 18+ is reg to vote, I’m donating to @MomsDemand & volunteering. #LetsGo #GunSafetyNow #RobbElementary

congress.gov/members/find-y…

Register to #Vote, confirm that you are registered, request a mail-in ballot, or find your polling place here: vote.org. Stop scrolling & act. Ask your friends & family too. Help them w/ the process if they need it. #RobbElementary #GunSafetyNow

@runforsomething

And if you feel like your views & concerns are not well-represented by your elected officials, maybe it’s time for YOU or someone else in your life to @runforsomething. #GunSafetyNow #RobbElementary