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Sep 24 • 9 tweets • 7 min read
Sept 25. 2 years since India lost one of the greatest singers ever: SPB

What can you do in 2 mins to highlight the divine talent of a man who recorded >40,000 songs? I made this video collage in memory of the legend. A dear friend. #SPBLivesOn @rameshlaus @PSampathkumarMD
I’ll link some rare videos and some videos of him that I have made over the years in this thread. Here is Nilave Vaa. @charanproducer @ThisIsDSP @singersrinivas @_ShwetaMohan_ @HaricharanMusic
Ilaya Nila. Made this by using original recording sound with live performances. The change from C#m (original recording) to Dm (live shows) gives the song a different flavor. I made this video to celebrate the original recording.
Here is the greatest live performance in singing I have seen. The incredible skill, vocal range, control, sweetness, clarity. I remember sharing this with @singersrinivas once, and he said this is not humanly possible. Thanks to OP on YouTube. Full link:
I taped this from the front row of a concert in Chicago. He was just casually singing a few lines of various songs as a medley.

I was struck by how amazingly close he was to the original recorded 30 years earlier. I put the live & original together and you can see the greatness
When you have a divine voice like his no words are needed. #SPB #SPBAnniversary #SPBLivesOn
Here’s another unforgettable video for me personally. When your idol calls you out from the stage. #SPB
Adding the video collage I had posted last year for the one year anniversary to the thread. #SPBLivesOn #SPBalasubrahmanyam #SPB #RememberingSPB
Twitter has the Moments feature. And mine for the last two years has been this. twitter.com/i/events/13229…

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More from @VincentRK

Vincent Rajkumar Profile picture
Sep 23
Prolonged PFS doesn’t mean a thing if overall survival is worse.

In myeloma we have 3 instances in which drugs that prolonged PFS showed worse overall survival in the same trial.

Here is 6 more: with P13K inhibitors in other cancers.
endpts.com/fda-adcomm-tak…
@ZacharyBrennan
I am happy @US_FDA lets us use PFS as a surrogate. It helps us get drugs to patients early.

But they make sure that response rate, DOR, TTP all go in same direction. That there is no major safety concern. And most importantly overall survival curves don’t go the other direction
When overall survival goes the other way suggesting possible harm, it’s no point arguing that PFS was prolonged. That’s not going to get you anywhere with the agency.

No point arguing about subsets in which survival benefit was seen. That’s just hypotheses generating. No more.
Read 6 tweets
Vincent Rajkumar Profile picture
Sep 22
Breaking: ODAC votes No on melflufen for myeloma.

Given the data provided, this is the right decision.
The vote was 14 against and 2 in favor of melflufen.
In this trial there was a 2 month prolongation in median PFS with melflufen over pomalidomide. But overall survival was ~4 months inferior with melflufen.

PFS is accepted as an endpoint in myeloma because it is a reasonable predictor of overall survival in most trials. Not here Image
Read 8 tweets
Vincent Rajkumar Profile picture
Sep 22
A killer slide in the FDA presentation on the ODAC hearing for melfluen. Highly important for #MedTwitter

It shows the limitation of subgroup analysis.

Survival difference seen in subgroup analysis based on month of randomization!! Shows how subgroup analysis can mislead.
In the hearing Sponsor states an overall survival benefit is seen with melflufen in subgroup who didn’t get transplant.

FDA counters now that sub group analysis can mislead showing that survival also varies by month of randomization.
Reminiscent of an old study where they could show difference based on zodiac signs.
Read 5 tweets
Vincent Rajkumar Profile picture
Sep 22
Whats unfortunate about prescription drug prices in America is that most doctors dont know the cost of the meds they prescribe. But you cant blame them: price can vary for the same drug 10 fold depending on the pharmacy

Not seen with any other commodity on earth @ConsumerReports
Or a 100 fold.
So it’s no wonder prescription drug cost as a topic is rarely initiated by physicians in the US (at least in oncology). And even if the patient brings it up we really want to change the topic quickly. @ASCO ascopubs.org/doi/10.1200/JO…
Read 6 tweets
Vincent Rajkumar Profile picture
Sep 20
COVID deaths are deaths caused by COVID.

Excess deaths in the US from all causes mirrors reported COVID deaths. @OurWorldInData 👇
Although it’s easy to say a lot of COVID deaths are “with” not “of”, that’s not true.

This pandemic is real. And we have lost over 1 million lives. Excess mortality from all causes tracks reported COVID deaths.
We are in a better place than in 2020 or 2021. Because of vaccines and the number of people who already had COVID.

But the threat of new variants remains. Threat of waning immunity remains. Threat of serious health problems short of death remains. Deaths are still 400 per day.
Read 4 tweets
Vincent Rajkumar Profile picture
Sep 19
40,000 deaths in the last 3 months. 400 deaths a day. No. Covid is not over.
We can do a lot to prevent a bigger wave in the fall which doesn’t require mandates or lockdowns. But it requires us to be clear to the public on the daily losses, and the simple steps people can take to reduce risk.
This pandemic has proved time and again to be unpredictable.
Read 5 tweets

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