Mike Pishvaian Profile picture
GI Onc at Hopkins, focusing on #PancreaticCancer, #PrecisionMedicine. Striving to improve patient outcomes. Originator of #TumorBoardTuesday @TumorBoardTues
Jun 13, 2023 22 tweets 106 min read
@TumorBoardTues @JohnEbbenMDPhD #TumorBoardTuesday
📣Welcome as we summarize some of the incredible data from #ASCO23
👉There was SO much to take in, that even focusing on GI Cancers was a challenge
🙏As always, these were the🧑‍🏫that caught OUR interest, but this is not a judgement on those we do not highlight‼️ @TumorBoardTues @JohnEbbenMDPhD 1/21
🤔Speaking for myself, @knutjla ‘s data has shaken my practice the most (including twice last week)
👉He presented the NORPACT-1 trial of peri-operative FOLFIRINOX vs. upfront🔪for resectable #PancreaticCancer Image
Jan 16, 2023 21 tweets 9 min read
😀I am so excited to be at my 1⃣st IN PERSON ASCO GI in 3y

✅To prepare, I have gone through the abstract titles, and here are my Top GI ASCO 2023 abstracts

📣Disclaimer: There is no bias or exclusion intended.
These are just the ones I personally want to see👀 #GI23
➡️Starting with #Cholangiocarcinoma because it is a big year - especially because of:
✅SWOG 1815: A phase III trial of gem-cis-nab-pac vs. gem-cis as 1⃣st line💊for advanced BTC
👁️Rachna Shroff, Abs LBA490
Jun 22, 2022 17 tweets 118 min read
@TumorBoardTues @ASCO @JohnEbbenMDPhD @SushmaJonna @HeekeMd #TumorBoardTuesday
#ASCO22 Biomarker Recap

😀Don't know about you all - but I had a great time at the meeting this year!

👉I will🔦a few biomarker based studies that caught my👁️

😉Did you notice that TWO of the plenary abstracts were for biomarker based trials‼️ Image @TumorBoardTues @ASCO @JohnEbbenMDPhD @SushmaJonna @HeekeMd @pashtoonkasi @KReissMD @DrR_DUNNE @FogacciJoao @AJacomeMD @OncBrothers @oncologician @DrSteveMartin @stolaney1 #TumorBoardTuesday
✅Dr. Yoshino🧑‍🏫the results of the Ph 3 PARADIGM trial
➡️FOLFOX-Pani vs. FOLFOX-Bev for RAS WT left CRC
👉823 Pts

👏OS>with Pani 36.2 vs. 31.3 months
👏ORR also > with Pani 75% vs. 67%

🤔BUT the curves don't separate until 26 months❓

🔎Abstract #LBA1 Image
Jun 1, 2022 11 tweets 7 min read
📢In preparation for #ASCO22, I wanted to present my list for the #PancreaticCancer abstracts to👀for @ASCO

Again,🙏note - I went through a LOT of abstracts, and I definitely may have missed some‼️
👉And these are not in any particular order

✅But enjoy, RT, and reply😀 #ASCO22 #PancreaticCancer
🤔Is more better❓
✅Dr. Carrato🧑‍🏫a Rand trial
👉Gem-nab-pac➡️FOLFOX (sequenced Q6 wks)
👉Standard Gem-nab-pac
➡️mOS was 3.5mos⬆️with sequenced Tx
➡️Even though more standard pts got 2nd line Tx
🔎GI Can Oral Abst 4022
Aug 4, 2021 9 tweets 22 min read
@ShimaghavimiMD @TumorBoardTues #TumorBoardTuesday
Case 08/03/21

74 yo♂️presents with RUQ pain and fatigue, 30# weight loss, PS=2

CT scan demonstrates a large panc mass and diffuse liver metastases

Liver core biopsy confirms an acinar cell #PancreaticCancer

➡️What would be your treatment recommendation❓ @ShimaghavimiMD @TumorBoardTues #TumorBoardTuesday

He was treated with every other week Gem-nab-pac
➡️Had rapid symptomatic improvement
➡️Now essentially normal PS
➡️Nice response to treatment for 9 months🙂

But then disease progression❗️

What would be your 2nd line therapy choice❓
Jun 1, 2021 13 tweets 6 min read

🙏Thank you all for the positive feedback on the PDAC Abstracts

➡️Here now is my 2nd list
✅My Top NON-Pancreatic abstracts to watch for...in no particular order.....

📝Again, I tagged who I could (whose hashtag I could find) #ASCO21

There were several potential practice changing studies including the one Late Breaking Abstract teaser:

➡️I Chau, et al (LBA 4001)
✅Nivo + ipi or Nivo + chemo vs. chemo alone as 1st-line Tx for esophageal SCC: CheckMate 648

🧐Will dual IO be the winner❓
Jun 1, 2021 9 tweets 7 min read
#ASCO21 #PancreaticCancer

📢ASCO is a few days away, and I decided to put together my list of
✅Top Abstracts to watch for

📝I tagged who I could

Starting with my Top Pancreatic Cancer Abstracts...in no particular order.....

(A common theme: NGS and fusion testing is🗝️) #ASCO21 #PancreaticCancer

@VivekSubbiah, et al (Abstr 3079)
➡️RET inhibitor pralsetinib in patients with RET fusion-positive solid tumors

I know - he has presented this before🙄

🥳but now 3/3 patients with pancreatic cancer responded - one with a CR ongoing at 20.8 months‼️
Jan 14, 2021 8 tweets 13 min read
@TumorBoardTues #TumorBoardTuesday
Thursday Case 🎀

🧑‍🎓Great discussion on the Tx of LAPC

✳️Most preferred FFX for this pt

➡️But the only PROSPECTIVE 📋 is w/gem-nab

➡️There are ✅ retrospective 📋 for FFX

➡️For both, resection rate is 10-15% Image @TumorBoardTues #TumorBoardTuesday
Thursday Case 🎀

Other options for LAPC:

➡️Clinical trials should be our 1st option, if available
✳️KRAS G12D/V siRNA + chemo
✳️Gem-Nab +/- FG-3019

➡️Radiation (despite negative data from LAP-07)

✳️2 abstracts @ASCO #GI21
Jan 13, 2021 9 tweets 6 min read
@TumorBoardTues #TumorBoardTuesday-1/7

📣 51 yoF presents with abdominal pain

FH – Father with lung cancer (🚬)

Imaging 📷 showed a 2.9 x 2.6cm panc head mass encasing the SMA

EUS-FNA 💉 - Well-diff adenocarcinoma

➡️Dx: locally advanced unresectable PDAC

❓How you would Tx this Pt? @TumorBoardTues #TumorBoardTuesday-2/7

Case Follow Up

Patient treated with FOLFOX + SBRT ⚡️
Then maintenance capecitabine
✅(SDz for 2 years!) 👍

Eventually progression with a right ovarian metastasis

❓Poll: Now how would you treat the patient?