@TumorBoardTues @HwakeleeMD @manalipatelmd @jillfeldman4 @JackWestMD Alright lets go!
1/18 #TumorBoardTuesday #LCSM #OncTwitter
63 yo 👩🏻
🚭 never smoker
C/O: shortness of breath presents in 2017
PMH: None
🫁 PET: shows a RLL mass and pleural effusion
ECOG PS: 0
🔬cT2, cN2, pM1a (Stage IVA) lung adenoCA

🤨What is the next step?
@TumorBoardTues @HwakeleeMD @manalipatelmd @jillfeldman4 @JackWestMD 2/18 #TumorBoardTuesday #LCSM
Case continued..
🦠 Tissue NGS and IHC was sent 🧬
🔬 NGS: EGFR p.A767_V769dup; c.2300_2308dupCCAGCGTGG (exon 20 ins)
🔬 PD-L1 negative

🤨 What treatment plan do you initiate next? @HemOncFellows @OncBrothers @OncoAlert @lcsmchat
@TumorBoardTues @HwakeleeMD @manalipatelmd @jillfeldman4 @JackWestMD @HemOncFellows @OncBrothers @OncoAlert @lcsmchat 3/15.. #TumorBoardTuesday #LCSM
👩🏽‍🏫Mini tweetorial 1 👨🏽‍🏫
🚩🚩 for EGFR mutations
Types of EGFR mutations
🚩Classic Activating EGFR Mut
▫️L858R, del19-Outside US
🚩Uncommon EGFR Muts
▫️G719X, L861Q, S768I
🚩EGFR Exon 20 Ins: bit.ly/3nGc8Yp
@NatRevClinOncol
@TumorBoardTues @HwakeleeMD @manalipatelmd @jillfeldman4 @JackWestMD @HemOncFellows @OncBrothers @OncoAlert @lcsmchat @NatRevClinOncol @VivekSubbiah @Al3ssandroRusso @gbanna74 @UmbertoMalapel1 @Alfdoc2 @APassaroMD @DrSanjayPopat 4/15 #TumorBoardTuesday #LCSM
👩🏽‍🏫Mini tweetorial 2👨🏽‍🏫

EGFR ex20ins: 12% of EGFRm, different types: go.nature.com/3NJOmFf

🚩 No clear ethnic pattern
🚩 Higher in NEVER smoker 🚭
🚩 More prevalent in females 👩🏻
🚩 Adeno>>SCC
🚩 Less sensitive to EGFR TKIs
@TumorBoardTues @HwakeleeMD @manalipatelmd @jillfeldman4 @JackWestMD @HemOncFellows @OncBrothers @OncoAlert @lcsmchat @NatRevClinOncol @VivekSubbiah @Al3ssandroRusso @gbanna74 @UmbertoMalapel1 @Alfdoc2 @APassaroMD @DrSanjayPopat @MattGubensMD @ZPiotrowskaMD @HelenaYu923 @RachelSanbornMD @RamalingamMD @ipreeshagul @NarjustFlorezMD @teekayowo @HosseinBorghaei @BenWestphalen 5/15 #TumorBoardTuesday #LCSM
👩🏽‍🏫Mini tweetorial 3 👨🏽‍🏫

⚠️Type of EGFR mutation can change treatment plan⚠️

✅ Classic Activating EGFR Mut ⇒ Osimertinib
✅ Uncommon EGFR Muts ⇒ Osimertinib
✅ EGFR exon 20 insertion ⇒ Amivantamab/mobocertinib, etc. @lungcancerjournal

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More from @ADesaiMD

Sep 20, 2020
Folks! We return for #HOTrainees with the exciting #Day2 @myESMO #ESMO20 and some more #practice relevant studies in #breastcancer #ProstateCancer #lungcancer #GI, so sit back, relax and lets go through some data (#HO #trainee-style!) Shout out to @peters_solange @OncoAlert
1. #BreastCancer: We have #monarchE and #IMPassion031 hoping to hear from experts @ErikaHamilton9 @NicoleKuderer @DrSGraff @matteolambe @tmprowell @GeorgeSledge51 @VukovicPetra for more insights- please link to your discussions here for #trainees:
1. A) #monarchE: use of #abemiciclib in HR+, HER2-,high risk #EBC in addition to endocrine therapy.
Current #SOC: adjuvant ET (5-10 years)
#monarchE: #Abemaciclib + ET iDFS HR 0.747, here's a great summary by @ErikaHamilton9 for @OncoAlert :
Read 11 tweets
Sep 19, 2020
@myESMO #ESMO20 as a #trainee can be #overwhelming! So many good studies, some more #practicechanging then others, if you missed some and want to understand (albeit at a simplistic #trainee level), sit back, relax and enjoy as we go through some great data #ESMO20 @OncoAlert
1. #NSCLC: 2 major studies #ADAURA #CROWN for adjuvant #EGFRmNSCLC, and advanced #ALK+ experts can provide better perspective @JackWestMD @n8pennell @StephenVLiu @AMansfieldMD @CharuAggarwalMD @NarjustDumaMD @GlopesMd @DevikaDasMD @OncoAlert
1. A) #ADAURA: Stage IB-IIIA #resected #NSCLC with #EGFRm treated with #Osimertinib vs #placebo [SOC prior to this was adjuvant chemotherapy [cisplatin-based doublet based on #LACE metanalysis- pubmed.ncbi.nlm.nih.gov/18506026/] showed improvement in #DFS @NEJM nejm.org/doi/full/10.10…
Read 19 tweets
Apr 28, 2020
Missed #COVID19nCancer plenary in #AACR20 @AACR?
Here’s a thread to catch up on all the fascinating global research presented by:
@AACR @AACRPres #AntoniRibas #LiZhang @marinagarassino @barlesi #CarlosGomez #LouisVoigt #HongbingCai cc:@OncoAlert @COVID19nCCC @ASCO @ASH_hematology
#1: Chinese Experience by #LiZhang and #HongbingCai

More evidence of increased prevalence of #Cancer among #COVID19, ~2% similar to what we found in our #metanalysis @ASCO_pubs #JCOGO here: ascopubs.org/doi/10.1200/GO…
#LiZhang described 35.7% required mechanical ventilation and significant risk factors for severe outcomes on #multivariate analysis was recent #cancertreatment and #consolidation on CT
Read 12 tweets
Feb 2, 2020
"Fall in US cancer death rates: Time to pop the champagne?": the amazing @oncology_bg and myself comment on the big debate about who deserves credit for the progress in our @EClinicalMed commentary: thelancet.com/journals/eclin…. Read along for a brief tweetorial!
Researchers found that since 1991 the cancer death rate has dropped 29%, but the 2.2% decline in mortality rates from 2016 to 2017 was the largest single-year decline in cancer mortality ever reported. Image
Since this fall was primarily driven by lung cancer, many experts speculated that this was the success story of treatment advances which has dramatically changed over the decade with the introduction of genomic and immunotherapy-based drugs. Image
Read 11 tweets

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