Elide Gutiérrez MD

👩🏻‍🔬 Biochemist and 🏥 Medical Oncology resident (R5)
🔬PhD candidate at Biogipuzkoa Health Research Institute, focusing on BTC

[Elide Gutiérrez MD @ElideGautier]

Los hospitales en su cuidar, deberían ser palabra también …

[Dr Rupam Manna MD @DrRupamOncology]

NGS Report Interpretation Series – Part 2

A negative NGS report is not always truly negative.

Before interpreting any mutation—or the absence of one—always ask:

“Can I trust the technical quality of this test?”

Tumor cellularity, sequencing depth, coverage uniformity, DNA/RNA quality, limit of detection (LOD), mapping rate, duplicate reads, and overall QC determine whether genomic findings are reliable.

Remember: A mutation is only as trustworthy as the quality of the sequencing that detected it.

This infographic provides a practical framework for oncology fellows, DrNB candidates, pathologists, and practicing oncologists to systematically assess the analytical quality of every NGS report before making clinical decisions.

What QC parameter do you check first while reviewing an NGS report?

#NGS #PrecisionOncology #MolecularOncology #CancerGenomics #GenomicTesting #MolecularPathology #MedicalOncology #Oncology #LiquidBiopsy #Biomarkers #TargetedTherapy #PrecisionMedicine #DrNB #FOAMed #MedEd #CancerConceptsExplained

[Rhenals acuña @RhenalsMedint]

Perla examen de residencia (y practica clinica):
El estudio del sindrome febril SIEMPRE tiene una pista orientadora, cada exposicion lleva a una u otra etiologia, no las olvides:

** Cuerpos de agua dulce: Leptospira, parasitos, aeromonas y M. marinum.
** Mosquitos: malaria, dengue, Zika y chikungunya.
** Garrapatas: rickettsias, Lyme, ehrlichiosis y babesiosis.
** Carne cruda: Toxoplasma y Campylobacter.
** Lácteos no pasteurizados: Listeria y Brucella.
** Agua contaminada: E. coli, Salmonella, Shigella, E. histolytica y V. cholerae.
** Sexual: sífilis, VIH, gonorrea, hepatitis A, B, C o Zika.
** Personas enfermas: TBC, meningococo, sarampión o virus respiratorios.

[Angela Lamarca @DrAngelaLamarca]

An absolute honour @HardingJJMD 😊

🗞️Just published!
Our latest review on #targeted therapies in #BiliaryMalignancies in @JHepatology

https://t.co/79b17kczg0

[Rohit Malde @roxboxfix]

Management of colorectal cancer in older adults: an expert panel recommendation to guide daily clinical practice

(Lancet Gastroenterology & Hepatology, 2026)

[Angela Lamarca @DrAngelaLamarca]

Representation from the Comite Nacional de Tumores Biliares #CNTB, our #Spanish Multidisciplinary Group for #BTC, at @myESMO #ESMOGI26 in 📍Munich

Thanks @atuvibi @EBaucellsMolera for the very nice 📸

🙌🏻Wish to join our CNTB?
📝Sign up here (Spain only)
https://t.co/oOoHf2c2Ao

[Erman Akkus @Erman_Akkus]

🚀Hepatopancreaticobiliary oral abstracts #ESMOGI26

#cancer #oncology #MedX #biliary #liver #hepatocellular #pancreatic #GI #gastrointestinal @OncoAlert

[Irene M💙 @Irenemate]

Acabo de hacer esta hoja informativa sobre el hierro para la consulta y puede estar bien compartirla por aquí

[Dr Rishabh Jain @DrRishabhOnco]

Resectable NSCLC has become one of the most crowded spaces in oncology.

The challenge is no longer whether to use systemic therapy.

It’s which strategy to choose.

🧵 Current standards:

🎯 EGFR-mutant
• ADAURA → Adjuvant osimertinib
• NeoADAURA → Neoadjuvant osimertinib (MPR improved, long-term outcomes awaited)

🎯 ALK-positive
• ALINA → Adjuvant alectinib

🛡️ Neoadjuvant chemo-immunotherapy
• CheckMate 816 → Nivolumab + chemotherapy

🔄 Perioperative chemo-immunotherapy
• KEYNOTE-671 → Pembrolizumab
• AEGEAN → Durvalumab
• CheckMate 77T → Nivolumab

🚀 Coming next
• LIBRETTO-432 (RET)
• TRUST-IV (ROS1)
• SUNRAY-02 (KRAS G12C)
• PROSPECT-Lung
• INSIGHT

The unanswered question remains:

Should patients receive immunotherapy before surgery, after surgery, or both?

We finally have multiple effective options.

Now we need the trials that tell us which patient benefits from which approach.

@ASCO @MyESMO @IASLC @oncoalert #LungCancer #NSCLC

[Erman Akkus @Erman_Akkus]

🫀Cardiac disease in cancer patients
ESMO guideline summary

#cancer #oncology #MedX #cardiac

[Rohit Malde @roxboxfix]

ASCO Guidelines 2026

HR + / Her2 -ve Mets Breast Cancer
Algorithm

https://t.co/j0rYcsmZ6Y

[Erman Akkus @Erman_Akkus]

⭕️Cancer-associated VTE
NCCN guideline summary

#cancer #oncology #MedX #thrombosis #embolism @realbowtiedoc @crisbergerot

[Dr Rupam Manna MD @DrRupamOncology]

🔬 TESTICULAR GERM CELL TUMORS: KNOW YOUR TUMOR MARKERS

Serum tumor markers are more than just numbers—they guide diagnosis, staging, prognosis, treatment response, and relapse detection in testicular germ cell tumors (GCTs).

📌 AFP
✔ Elevated in yolk sac tumors, embryonal carcinoma, and mixed GCTs
✔ NEVER elevated in pure seminoma

📌 β-hCG
✔ Highest in choriocarcinoma
✔ May be mildly elevated in seminoma
✔ Can cause gynecomastia and hyperthyroidism when markedly elevated

📌 LDH
✔ Reflects tumor burden
✔ Important prognostic marker in IGCCCG risk classification

🚨 High-Yield Pearl:
Persistent elevation of tumor markers after orchiectomy suggests residual disease (Stage IS).

🧬 Future of GCT Biomarkers:
miR-371a-3p is emerging as a highly sensitive and specific marker for active germ cell tumors and may transform surveillance strategies in the coming years.

Early detection. Accurate staging. Better outcomes.

#TesticularCancer #GermCellTumor #MedicalOncology #Oncology #UroOncology #Seminoma #NSGCT #AFP #BetaHCG #LDH #CancerEducation #MedEd #FOAMed #OncologyTeaching #MedicalStudents #Residents #DrRupamManna #CancerConceptsExplained

[Dr. Carlos Arnaud @carlos_arnaud]

El tamaño de tu abdomen y estatura
SI IMPORTAN

📢 El diagnóstico de #Obesidad se amplía, con base en el nuevo capítulo de Tamizaje y Diagnóstico de los Standards of Care de la American Diabetes Association (ADA)

⚖️ IMC > 30 = Obesidad (sin cambios)
📏 IMC > 25 + relación cintura/estatura > 0.5 = Obesidad
🌎 IMC > 27.5 en personas de origen asiático = Obesidad
🌎📏 IMC > 23 en personas de origen asiático + relación cintura/estatura > 0.5 = Obesidad

@StratCons
@doctormacias
@DrMauinforma
@docramiro
@Obesidades_mx
@WorldObesity

https://t.co/KQE4k4MKNf

[Erman Akkus @Erman_Akkus]

🟦Nausea-Vomiting Prevention
ESMO-MASCC 2023 guideline summary

#cancer #oncology #MedX @OncoAlert @CancerCareMASCC

[Erman Akkus @Erman_Akkus]

🟧Localized Rectal Cancer- ESMO 2025 guideline summary

#cancer #oncology #MedX #rectal @OncoAlert

[Erman Akkus @Erman_Akkus]

⚛️Lu-DOTA vs. sunitinib in metastatic progressive pancreatic NET
OCLURANDOM

✅12mo PFS
80.5% vs 41.9%

👉https://t.co/dmAPeq92wC

#cancer #oncology #MedX @OncoAlert @OncoThor @UGrewalMD

[Erman Akkus @Erman_Akkus]

📙Renal and hepatic dose adjustment for oncologists

#cancer #oncology #MedX #drug #treatment #therapy #renal #kidney #hepatic #liver @OncoAlert

[precis0x @precisox]

El ingeniero que creó claude code acaba de soltar un video de 28 minutos donde te enseña a escribir prompts que realmente funcionan.

He visto cursos de 300 dólares que no llegan ni a la mitad de lo que explica en los primeros 10 minutos.

Archivos CLAUDE.md, atajos de memoria, sesiones paralelas y patrones de prompting que cambian el juego.

Todo en un solo video y completamente gratis.

Da igual si eres desarrollador, principiante o ya llevas meses usando Claude. Esto te va a volar la cabeza.

[Julio @JulioFdez79]

BENZODIAZEPINAS

[Dr Rupam Manna MD @DrRupamOncology]

🚨 Neutropenic Enterocolitis (Typhlitis) is a TRUE oncologic emergency.

In any cancer patient with:
⚠️ Fever
⚠️ Abdominal pain
⚠️ Severe neutropenia

→ Think Typhlitis until proven otherwise.

Early recognition + urgent CT abdomen + prompt broad-spectrum anti-pseudomonal antibiotics can be lifesaving.

Key principles:
✅ Sepsis protocol immediately
✅ Bowel rest & supportive care
✅ Consider G-CSF in high-risk patients
✅ Add antifungal therapy if persistent fever
✅ Surgery only for complications like perforation/peritonitis

Delay in diagnosis can rapidly lead to:
❌ Septic shock
❌ Bowel necrosis
❌ Multiorgan failure

A high index of suspicion saves lives in oncology wards and ICUs.

#Oncology #MedicalOncology #Typhlitis #NeutropenicEnterocolitis #FebrileNeutropenia #CancerCare #Hematology #Leukemia #Sepsis #CriticalCare #OncoEmergency #AML #Chemotherapy #CancerEducation #DrRupamManna #CancerConceptsExplained