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Oscar Tahuahua Profile picture
Oscar Tahuahua
@OscarTahuahua
Medical Oncologist @INCanMX | Thorac. fellow | IM | #Immunotherapy & molecular target-believer | #OncoAlertAF | Op my own
Sep 16 • 14 tweets • 6 min read
1. MSI-H/dMMR: the perfect storm for immunotherapy 🔥

▫️High TMB, tons of neoantigens, and inflamed tumors. Long-term survivors, even cures.
▫️Up to 40% still fail.

Cure or collapse, the paradox of MSI-H/dMMR 🧵⤵️
doi.org/10.1038/s41571…Image 2. The success story 📈

Metastatic Colorectal Cancer: Immunotherapy vs chemo
KEYNOTE-177 →↑ PFS, ORR ~45%, CR ~30%.
CheckMate-8HW → ORR ~70%, 2-yr PFS ~72%.

Localized CRC: NICHE-2 → 95% MPR, 67% pCR, 3-yr DFS 100% 😱

ICI achieves durable survival and, in some cases, cure. Image
Image
Aug 26 • 7 tweets • 3 min read
One of oncology's paradoxes (🧵)
Testicular germ cell tumors cure >90% with cisplatin, one of medicine’s greatest triumphs.

But in mediastinal or extragonadal sites, survival drops to ~40–50%.

1. Why does one of the most curable cancers sometimes fail (~10-20%)?👇 Image 2. Genetics
Testicular GCTs usually retain wild-type TP53 → intact apoptosis.

Extragonadal tumors often show TP53 mutations or MDM2 amplification, reducing cisplatin sensitivity.
ascopubs.org/doi/10.1200/JC…Image