John Cramer, MD

Assistant Professor at Wayne State University. Head & Neck Oncologic Surgeon. Health services, quality improvement & outcomes researcher. All opinions my own.

[Eric Topol @EricTopol]

Another major advance vs cancer! @ASCO #ASCO26
Personalized neoantigen mRNA vaccine 5 year follow-up vs metastatic melanoma reduced recurrence and death by 49% (on top of Keytruda)
https://t.co/NadITTYIT2

[John Cramer, MD @Jdcramer]

4/ One actionable bright spot: receipt of palliative care was associated with lower self directed violence rates. Early palliative integration may be protective against suicide, not just a comfort measure.
https://t.co/kLOl5PjGWA

[John Cramer, MD @Jdcramer]

1/ New @JAMAOncology study (Sullivan et al, 2026) on 292K veterans with cancer reframes how we think about suicide risk. The key insight: 89% of suicide attempts were nonfatal. If we only track deaths, we miss the vast majority of the crisis — and the intervention opportunities

[John Cramer, MD @Jdcramer]

3/ This study confirms that H&N signal but reveals it was an underestimate of total suicidal burden. Including nonfatal events surfaces high-risk groups invisible to mortality data. And the #1 method overall? Poisoning from opioids and anxiolytics (26%)

[John Cramer, MD @Jdcramer]

2/2: SNB also cuts recurrence risk by 29% (HR 0.71, 95% CI 0.66–0.76) — robust on sensitivity analysis, low heterogeneity. The case for SNB is stronger than ever. https://t.co/umfoohyexb

[John Cramer, MD @Jdcramer]

1/2: MSLT-I was underpowered to show a survival benefit from SNB for melanoma. A new meta-analysis of 40,287 patients finally settles it: SNB reduces melanoma-specific mortality (HR 0.86, 95% CI 0.81–0.92). Varey et al., Lancet Oncol 2026.

[Otolaryngology–Head and Neck Surgery & OTO Open @OTOjournals]

What does nebulized ciprofloxacin-dexamethasone actually do to an obstructed airway?

🎙️The latest OTO Journal podcast episode breaks down a novel rabbit model of airway stenosis — and the first quantitative evidence of a promising treatment.

Listen → https://t.co/c8aGXO6HJZ

[John Cramer, MD @Jdcramer]

3/ Another pragmatic, practice-informing RCT in head & neck cancer from Tata Memorial. The oral cancer evidence base owes them a great deal. Awaiting the full AREST publication. #ASCO26

[John Cramer, MD @Jdcramer]

1/ Finally, RCT-level data on a question retrospective series have driven for years: should pT1-2 pN0 oral cancer with intermediate risk factors get adjuvant RT? AREST (Nair et al., #ASCO26) says yes—for loco-regional control. https://t.co/09z23vtMIK

[John Cramer, MD @Jdcramer]

2/ AREST largely supports what many of us already do for intermediate-risk early OSCC—now with prospective randomized evidence rather than retrospective inference.

[Glenn J. Hanna, M.D. @HeadNeckMD]

Sharing the results of ReACT 1.0 in @NatureComms -- the first study to use HPV ctDNA to guide CRT de-escalation in higher risk HPV+ OPC. ctDNA metrics may improve risk stratification. Grateful to our coauthors. @Naveris_inc @DanaFarberNews @jdschoenfeld1
https://t.co/53tHQtj8pl

[CW David Chang, MD, FACS @DrCWDavidChang]

Clear trend: more #preference #signals in medical residency application→ less overapplication.

As signals increase, apps/applicant decline—reducing cost, noise, and inefficiency.

Better alignment + less admin burden—is it for everbody?

#OtoMatch #MedEd #GME #Match2026

[John Cramer, MD @Jdcramer]

https://t.co/dZUmqd3XSl

[John Cramer, MD @Jdcramer]

1/4 Awan et al. (JCO) argue KEYNOTE-689 OS data are too immature to justify perioperative pembrolizumab as SOC and advocate restricting it to CPS ≥10 patients at low surgical risk. https://t.co/6fgmOyu0x2

[John Cramer, MD @Jdcramer]

4/4 OS is immature — but the CPS ≥10 HR is trending toward significance, and the Qian Markov model projects a 2.61 undiscounted LY gain (11.82 vs 9.21 yr life expectancy). Dismissing EFS as uninterpretable risks underselling a plausible forthcoming OS benefit.

[John Cramer, MD @Jdcramer]

5/ The advance: NPC risk moves from a diffuse "polygenic + viral + environmental" model to a biologically interpretable host-pathogen interaction with discrete, targetable elements — with direct implications for screening, vaccines, and T cell therapy.

[John Cramer, MD @Jdcramer]

1/ EBV infects >95% of adults worldwide. Yet ~50% of all nasopharyngeal carcinoma cases arise from ~2% of the global population in southern China. A new Nature paper finally explains why. https://t.co/IUdTaufunm

[John Cramer, MD @Jdcramer]

4/ This reframes 15 years of NPC GWAS data. HLA-A*11:01's protection isn't intrinsic — it's contingent on which EBV strain you carry. The host genotype and viral genotype only make sense together.