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Jun 29 • 5 tweets • 5 min read
NCI myeloma steering committee consensus on relapsed myeloma. Authored by investigators who design & conduct US randomized trials.

@BloodCancerJnl @myelomaMD @NoopurRajeMD @nsc_natalie @andrew02114 @SLentzsch @PLMcCarthyMD @theNCI #OpenAccess nature.com/articles/s4140…
The NCI myeloma steering committee is the group that reviews proposed US cooperative group @eaonc @SWOG @ALLIANCE_org phase III trials in myeloma.

@NorthTxMSG @MyelomaTeacher
At present @Myeloma_Doc @szusmani and I lead the myeloma committees in @SWOG, @ALLIANCE_org, and @eaonc, respectively.

We are constantly thinking of ideas for phase III trials, focusing on ones that industry may not run.
Our current portfolio includes RCTs to determine the value of MRD testing in escalating or de escalating therapy, to determine if finite duration of maintenance is as good as indefinite, if high risk smoldering myeloma is best treated with myeloma like therapy or Rd is sufficient
Link to PDF of the article: nature.com/articles/s4140…

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More from @VincentRK

Vincent Rajkumar Profile picture
Jun 26
I became a proponent of Evidence Based Medicine in the late 1980s after reading Sackett, Fletcher, et al. I still am.

But note that evidence based medicine without expertise, clinical acumen, or judgment is empty. To be a good doctor you need them all, and empathy. #MedTwitter
One of the best ways to use evidence based medicine is having deep knowledge of the field. Knowing the history of why things are done the way it's done.

Without deep background knowledge as well as risk benefit judgment of all the pros and cons, it's easy to make mistakes.
It's possible to find fault in any paper. And these faults are exaggerated when you look at a paper in isolation without deep background and historical knowledge.

It's worth recognizing your peers who published the paper are aware of its limitations.
Read 6 tweets
Vincent Rajkumar Profile picture
Jun 23
This is encouraging and highly important. From Justice Kavanaugh's concurring opinion.

1) 2nd amendment rights are not unlimited
2) 2nd amendment protection applies to weapons available at the time.

So Congress can act if it wanted. @shannonrwatts Image
HT @chrisgeidner for pointing this out in his tweet. 👇👇
Even with the current make up of the Court, the majority will feel this way. So the ball is in the Congress' court.
Read 4 tweets
Vincent Rajkumar Profile picture
Jun 21
With original Covid strain, we had some data that a proportion of people may not be susceptible even if exposed.

Thats not the case with current variants. With significant viral exposure, its likely everyone will get infection unless you have recently had Covid or Covid vaccine
Thread here on why we thought not everyone may be susceptible during the initial waves.
With omicron variants, when one person in a family or group is infected, almost everyone who is a close contact gets it. The variants overcame whatever cross reactive immunity or barriers that may have been. In addition they overcame immunity from prior Covid or Covid vaccines.
Read 7 tweets
Vincent Rajkumar Profile picture
Jun 21
Medicare can save billions buying generic drugs at prices offered at @costplusdrugs @mcuban

Study finds that $3.6 billion could have been saved in 2020 alone on 77 drugs. @DrHussainL @akesselheim @bnrome @AnnalsofIM @PORTAL_Research acpjournals.org/doi/10.7326/M2…
More here in this thread by @DrHussainL the lead author of the study.
I am very happy that @costplusdrugs was founded and I think it will have a big impact for individuals. We need figure out a way for Medicare to benefit. That means Medicare negotiates or pays at lowest available retail price.
Read 6 tweets
Vincent Rajkumar Profile picture
Jun 20
This is concerning since Israel has been ahead of other countries on COVID boosters and also a huge omicron wave.

It means despite all this 1) some people remain vulnerable due to inadequate or waning immunity and 2) new variants are immune evasive. timesofisrael.com/israel-sees-ov…

1/
2/ Some remain vulnerable because they have never had Covid or COVID vaccination. So their immune system can be surprised.

Some are vulnerable despite prior infection or vaccination or both because they have inadequate or waning immunity due to advanced age, chemotherapy etc
3/ Add to this the fact that the virus is constantly mutating, and variants are evading immunity conferred by prior infection with older strains or vaccines

Although vaccines/ prior infection protect against severe disease, they don't prevent infection & transmission as well.
Read 4 tweets
Vincent Rajkumar Profile picture
Jun 18
Seriously @lydian_official has talent that is mind boggling. At 16 he can play almost any instrument at concert level. Has perfect pitch. Winner of @WorldsBestCBS. Excellence thats hard to comprehend

Best wishes Lydian for Chromatic Grammatic @rameshlaus
To me he is the most talented musician in the world today.
Just watch him play piano @WorldsBestCBS in 2019.
Read 4 tweets

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