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Ibrahim Halil SAHIN, MD Profile picture
Ibrahim Halil SAHIN, MD
@IbrahimSahinMD1
GI Medical Oncologist | @UPMC Hillman CC/@PittTweet | Clinical investigator/Trialist - Colorectal Cancer| musician-lead guitar | tweets=my own
Jun 13, 2022 • 8 tweets • 3 min read
I would like to do my 2nd deep dive post #ASCO22 analysis on #ctDNA guided adjuvant therapy for pts with stage II colon cancer‼️

✳️The DYNAMIC trial is certainly step forward (kudos) ‼️But doesn’t answer many questions❗️@OncoAlert @manjuggm @CrcChange @TheColonClub Why ?👇 1️⃣ Firstly, the whole point of ctDNA is identification of MRD so to give RIGHT chemotherapy to RIGHT patients❗️

✳️Not only reduce adjuvant tx, but offer it to patients who may potentially miss that opportunity (such as offering folfox to a patient with ctDNA (+)T3N0 disease)❗️
Jun 6, 2022 • 16 tweets • 5 min read
#ASCO22
✳️Happy to say there is great progress for patients with CRC‼️
@OncoAlert @ASCO @manjuggm @CrcChange‼️
Here is summary of some key studies 👇 1️⃣ Immune checkpoint inhibitor monothetapy with dostarlimab for MMR-D is certainly practice changing❗️

✳️Although long term outcomes are needed, no need to reinvent the wheel‼️

✳️ Once a deep response achieved in MMR-D CRC it is very durable even in metastatic setting ‼️
Jun 5, 2022 • 4 tweets • 3 min read
#ASCO22

✳️The standard of care for MMR-D rectal cancer is changing/changed❗️
✳️We should do all we can to avoid surgery for patients with MMR-D rectal cancer ❗️
✳️Although data is early and it is highly promising enough to move forward ‼️@asco @OncoAlert @MoffittNews
👇 ✳️Perhaps important to note that 100% clinical response is not complete pathological response ‼️

✳️However this is higher than we achieved with OPRA in MSS rectal cancer ‼️

✳️Also, all patients had BRAF WT which is expected (Lynch cause more MMR-D rectal than sporadic event)
Jun 4, 2022 • 7 tweets • 3 min read
#ASCO22
✳️DYNAMIC trial results are highly exciting and glad to see field is moving forward !

✳️Very encouraging findings that we are in right pathway to use #ctDNA for adjuvant tx‼️

However there are important points that we need to address 👇@ASCO @OncoAlert @MoffittNews ImageImageImageImage ✳️Firstly, I am categorically against putting T4 and T3 disease into same pocket (stage II is highly heterogeneous)❗️

✳️Risk of peritoneal recurrence for T4 and T3 is not same and not even close ‼️

✳️Peritoneal microscopic disease doesn’t shed CtDNA as much as liver MRD‼️