@TumorBoardTues @NarjustFlorezMD 1/23 #TumorBoardTuesday #LungCancer #OncTwitter

64y 👱🏼‍♂️with no 🚬hx
Presents w/chest pain
PMH: diabetes
☢️: 8cm mass in RUL with peribronchial lymph nodes with adrenal metastasis
🧠Brain MRI: ❌mets
🔬Stage IVA (T4N1M1a) 🫁 Squamous Cell Ca

🤨What systemic tx would YOU give?
@TumorBoardTues @NarjustFlorezMD 2/23 #TumorBoardTuesday #LungCancer

⏳ You await further testing
🔪 🫁biopsy tissue tested
🦠 IHC was sent 🧬
🔬 NGS: no actionable mutations
🔬 PD-L1 10%

🤨 Of the options below, what systemic tx would YOU give now?
@TumorBoardTues @NarjustFlorezMD 3/23 #TumorBoardTuesday

SQUAMOUS NSCLC:

🫁 20-30% of all lung Ca, with declining incidence
🫁 associated with ⬇️survival vs nonsquamous #NSCLC
🫁 treatment decision-making relies on upfront PD-L1 expression testing

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More from @ShrutiPatelMD

Feb 22
@NarjustFlorezMD @TumorBoardTues @drRTee @ADesaiMD @esinghimd @FawziAbuRous @ALKpositiveINT @Rothangpuia5 @SamuelKareffMD @AlyaShamsan @LVaezi @n8pennell 4/23 #TumorBoardTuesday
👩🏽‍🏫Mini tweetorial 1👩🏽‍🏫

📚@NCCN based #NSCLC guide for biomarker neg, PDL1 <1% ⤵️

CATEGORY 1 RECOMMENDATIONS
📍Pembro + carboplatin + paclitaxel
📍Pembro + carboplatin + nab-paclitaxel
📍Ipi/Nivo + carbo + paclitaxel
📍Cemiplimab + carbo + paclitaxel
@NarjustFlorezMD @TumorBoardTues @drRTee @ADesaiMD @esinghimd @FawziAbuRous @ALKpositiveINT @Rothangpuia5 @SamuelKareffMD @AlyaShamsan @LVaezi @n8pennell @NCCN 5/23 #TumorBoardTuesday
👩🏽‍🏫Mini tweetorial 2👩🏽‍🏫

✨KEYNOTE-407✨
♦️Phase III
♦️Untreated metastatic, squamous NSCLC
♦️Pts randomized 1:1 pembro+platinum-doublet vs plat doublet alone
♦️Median OS 15.9 mos vs 11.3 mos
♦️69.8% of grade 3+ AEs in pembro-combo vs 68.2% in placebo-combo
@NarjustFlorezMD @TumorBoardTues @drRTee @ADesaiMD @esinghimd @FawziAbuRous @ALKpositiveINT @Rothangpuia5 @SamuelKareffMD @AlyaShamsan @LVaezi @n8pennell @NCCN 6/23 #TumorBoardTuesday
👩🏽‍🏫Mini tweetorial 3👩🏽‍🏫
✨CHECKMATE 9LA ✨

♦️ Phase III in untreated metastatic NSCLC
♦️ patients randomized 1:1 nivolumab+ipilimumab + 2 cycles chemo vs 4 cycles chemo

PFS KM Curves in Squamous Pts ⬇️
Read 22 tweets
Sep 7, 2022
@TumorBoardTues 1/17 #TumorBoardTuesday #LungCancer #OncTwitter
72y 👩🏻with 58 pk-yr 🚬hx
Chest pain
PMH: diabetes
CT: 3 cm LLL nodule & left pleural effusion with 5mm nodule in LUL
PET: GGO in LLL SUV 4.5
💉thora with cytology
🔬Stage IVA (T4N0M1a) 🫁 adenoCa

🤨What systemic tx would YOU give?
@TumorBoardTues 2/17 #TumorBoardTuesday #LungCancer

🔪 🫁 tissue tested
🦠 Tissue NGS and IHC was sent 🧬
🔬 NGS: no actionable mutations
🔬 PD-L1 62%
@TumorBoardTues 3/17 #TumorBoardTuesday #LungCancer
👩🏽‍🏫Mini tweetorial 1👩🏽‍🏫

@NCCN based guideline for #NSCLC biomarker negative, PDL1 >50% ⤵️

CATEGORY 1 RECOMMENDATIONS:
📍 Pembro, atezo, and cemiplimab
📍 ipi/nivo considered in certain circumstances Image
Read 19 tweets
Jun 15, 2022
@TumorBoardTues 1/16 #TumorBoardTuesday #LungCancer #OncTwitter

38yo 👩🏻with remote 8 pk-yr 🚬hx
CP & diarrhea
PMH: None
🩻: 2 cm focal consolidations in the LLL
PET: GGO in LLL SUV 4.5
🔪+ mediastinal staging
🔬pT2a, pN1 (Stage IIB) lung adenoCa
🤨What adjuvant systemic tx would YOU give next?
@TumorBoardTues 2/16 #TumorBoardTuesday #LCSM #LungCancer

🧪 Resected 🫁 tissue tested
🦠 Tissue NGS and IHC was sent 🧬
🔬 NGS: EGFR exon 19 deleted
🔬 PD-L1 52%

🤨 What adjuvant treatment plan do you initiate next?
@TumorBoardTues 3/16 #TumorBoardTuesday #LungCancer
👩🏽‍🏫Mini tweetorial 1 👩🏽‍🏫

🚩🚩🚩 for EGFR mutations

🚩 Asian >> Western - 47.9% vs 19.2% according to metaA
🚩 Higher in NEVER smoker 🚭
🚩 More prevalent in females
🚩 Pathologic Subtype (adeno>>SCC)
Read 18 tweets
Feb 10, 2021
Many times in the past, I have not recognized the disparities that lie within our community. Part of it comes from the narrative of the monolith and my own privilege within this narrative 🙇🏽‍♀️

As I learn, I want to share these excellent infographics by @fit_pham (on @instagram)
19 origin groups
\ /
\ /
\ /
\ /
ASIANS
Within these different origin groups, there are significant differences in income, SES, health, citizenship status, education.
Read 5 tweets

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