Joseph Joy

DM Medical oncology resident CMC vellore

Jesus i believe in you

[News Algebra @NewsAlgebraIND]

US envoy Sergio Gor -

"I love watching Indian TV news shows.

At 6 PM you have 8 people together arguing on the show.

At 10 PM, 12 people speak at the same time. You can't hear single one of them"

[Vincent Rajkumar @VincentRK]

COMPREHENSIVE MYELOMA and PLASMA CELL DISORDERS REVIEW ARTICLE THREAD. Bookmark.

A collection of our recent review articles on the spectrum of plasma cell disorders.

1/ MGUS @NEJM

Link: https://t.co/y9cHVaPZgH

[Josh Thomas Georgy @jtgeorgy]

Glad to share our invited review on systemic therapy for refractory thyroid carcinoma is now published in Current Opinion in Endocrinology, Diabetes and Obesity.
With @HK_DMonc and @todrashish
https://t.co/WKr2Pwd25p
#ThyroidCancer #PrecisionOncology

[Joseph Joy @JosephJoy945706]

@jtgeorgy @HK_DMonc @todrashish @drmpk91 @ajoyojohn @UzagareJoshua @DarwinAnil @JenniferSudahar @medoncodoc @jayastuMD @tuttsakhil @akhilrk1989 Congratulations 👏

[Dr Akhil Santhosh MD DM MRCP(UK) @tuttsakhil]

Dexamethasone-Free Antiemetic Prophylaxis for Children and Adolescents Receiving Highly Emetogenic Chemotherapy: A Multicenter, Phase III, Noninferiority Trial (CIVIC POD) | Journal of Clinical Oncology https://t.co/JuyT6o8KVk

[Dr Amol Akhade @SuyogCancer]

Excellent slides about definition of endocrine resistance and sequencing of endocrine therapy in 2026. From the talk by @AlexEniu @asco #asco26 🙂👍. Money 💰 Slides .

[Dr Amol Akhade @SuyogCancer]

Do u know that there is new FIGO scoring system for GTN in 2026 ? And new Ultra High risk GTN ? Check this . From the excellent talk by Dr Neil Horowitz @ASCO #asco26

[Dr Akhil Kapoor @drakhilkapoor1]

Two ASCO Education Book 2026 publications from Tata Memorial Centre highlight pragmatic oncology innovations for LMICs — including low-dose immunotherapy, toxicity management, affordability, and metronomic approaches in cancer care.

Honoured to contribute as co-author.

#ASCO

[Joseph Joy @JosephJoy945706]

@matteolambe @OncoAlert @UniGenova Congratulations

[Dr Rishabh Jain @DrRishabhOnco]

🧬 How to NOT miss Lynch syndrome in endometrial cancer

This ESGO flowchart is 🔥 for real-world practice.

Here’s the algorithm simplified:

🔍 Step 1: Screen ALL EC patients
👉 Start with MMR IHC (MLH1, MSH2, MSH6, PMS2)

📊 If pMMR → ✅ Stop (unless strong family history)

⚠️ If dMMR → Next step matters

🧪 Loss of MLH1?
👉 Do MLH1 promoter methylation
• Methylated → sporadic → ❌ no germline test
• Unmethylated → 🚨 suspect LS → genetic testing

🧬 Loss of MSH2/MSH6/PMS2?
👉 Direct → genetic counselling + germline testing

📈 No IHC available?
👉 Use MSI testing
• MSI-H → same pathway
• MSS → stop

Now the BIG clinical part 👇

🩺 Surveillance (start ~30–35 yrs)
🔹 MSH2 → start ~30 yrs
🔹 MLH1 → ~35 yrs
🔹 MSH6 → ~40 yrs
🔹 PMS2 → individualized

📌 Annual exam + TVUS + periodic endometrial biopsy

🔪 Risk-reducing surgery
👉 Hysterectomy ± BSO after childbearing
👉 Preferably before 40 (except PMS2 → later)

💡 Take-home:
Lynch syndrome care is gene-specific, not protocol-based

Miss this → you miss prevention.

📖 Full paper in comment ⬇️

#OncoTwitter #MedTwitter #GynOnc #LynchSyndrome
@OncoAlert @myesmo @esmo_open @ASCO_org

[Henry C Fung| MM, lymphoma, leukemia & CART @HenrychihangFu1]

Defining T-cell lymphoma doesn’t have to be complicated.

Start simple:

🔴 CD30+ → ALCL
 ALK+ vs ALK− (DUSP22 / TP63 / triple negative)

🔵 If not → check TFH markers
 PD1 / ICOS / CXCL13 / BCL6
 → often behaves like autoimmune disease

⚪ Only then → PTCL-NOS

🧬 Biology matters:
ALCL ≠ one disease
TFH = TET2 / DNMT3A / RHOA

👉 “CD30 first. TFH second. NOS last.”

#lymphoma #Hemetwitter #Medtwitter

[Shreyas Kalantri, MD @KalantriShreyas]

📌 Onc (GU) Trials Tweetorial Series

Germ Cell Tumor Index Thread:

From the trial that cured a death sentence to the survivorship costs we still manage decades later.

A series of threads tracing the evidence behind modern GCT care.

🧵 #OncTrials101 #GUTrials101 #GermCellTumor #GUsm #Medtwitter #OncTwitter

@ASCO @UrologyTimes @OncoAlert @oncodaily @TCSociety @TestesCancer @HemOncFellows @IMG_Oncologists @ASCOTECAG @EurUrolOncol

[Josh Thomas Georgy @jtgeorgy]

📢Elated to share our new paper from @OffCMCVellore in The Lancet Regional Health- SE Asia.
NeoLOCUS Phase II trial: short regimen of low-dose nivolumab+carbo/nab-pacli+ OMCT👉~90% surgical conversion borderline resectable OCSCC. Congrats to @todrashish @drmpk91 for leading!

[Dr Akhil Kapoor @drakhilkapoor1]

Sustained CR with Brigatinib with ALK-positive NSCLC harboring the I1171N mutation after Alectinib.

Highlights importance of re-biopsy & mutation-directed TKI sequencing.

DOI: 10.1155/crom/7372418
#ALK #NSCLC #PrecisionOncology @LungConnectIN @IASLC @SuyogCancer
@Bipinesh

[Vanita Noronha, MBBS MD DM @VanitaNoronha]

What if we’ve been overdosing immunotherapy all along?
In our Ph III DELII study, 20 mg nivolumab q2w beat chemo in OS, with less toxicity, better QoL. It's time to rethink ICI dosing-for science and equity! https://t.co/mBqq2sdm6v @JCO_ASCO @OncoAlert @TataMemorial @SuyogCancer

[Dr Rishabh Jain @DrRishabhOnco]

The Paclitaxel + Carboplatin "CarboTaxol" doublet is the bread and butter of oncology for a reason. 🍞🧈

But why does this specific combo work so well?
It’s all about the "Freeze and Snap" synergy. ❄️💥

1️⃣ The Freezer (Paclitaxel):
Paclitaxel stabilizes microtubules, preventing depolymerization.
It freezes the cell’s skeleton in the M-phase (Mitosis). The cell tries to divide but gets stuck. 🛑 

2️⃣ The Snap (Carboplatin):
While the cell is arrested and stressed, Carboplatin slides in.
It acts as an alkylating agent, forming reactive platinum complexes that bind to DNA (cross-linking). 🧬🔗 

🤝 The Synergy (Why 1+1 = 3):
The magic lies in the timing.
Paclitaxel arrests cells in the G2/M phase.
Cells in this phase are less efficient at repairing the DNA damage caused by Carboplatin.
The "Freeze" prevents the "Repair," leading to accumulation of DNA damage ➡️ Apoptosis (Cell Death). ☠️ 

💡 Clinical Pearl (The Sequence Matters):
This is why we often administer Taxane before Platinum.
Giving Paclitaxel first avoids the antagonistic effect where Carboplatin might inhibit the uptake or cytotoxicity of the taxane.
It also reduces thrombocytopenia! 📉🩸

#Oncology #MedTwitter #OncTwitter
@OncoAlert @myesmo @esmo_open @asco

[Dr Rishabh Jain @DrRishabhOnco]

1/5
We know BRCA1 and BRCA2 mutations both sensitize tumors to PARP inhibitors via synthetic lethality. But clinically, not all responses are equal. 🧐

Data frequently shows that BRCA2 responses are deeper and more durable than BRCA1.
Why the difference?

It comes down to their specific jobs in the DNA repair assembly line.

A short thread 🧵👇
#MedTwitter #Oncology #PrecisionMedicine #BRCA
@OncoAlert

[Vincent Rajkumar @VincentRK]

8) Details on the Tec Dara trial that changed the algorithms in relapsed a lot! @End_myeloma @mvmateos

[Praveen Kumar Marimuthu @drmpk91]

Proud moment for the Thoracic Oncology Multidisciplinary Team @OffCMCVellore
Our real-world study on induction chemotherapy ± low-dose nivolumab in stage III NSCLC featured among the Top Articles of 2025 in @JCOGO_ASCO
DOI: https://t.co/6cMfz2o2Cq
https://t.co/oWHxwBhGVz
#LCSM

[Yakup Ergün @dr_yakupergun]

Management of Cancer During Pregnancy: ASCO Guideline

It is a remarkably comprehensive guide that addresses every question thoroughly👇
https://t.co/NXtQjTcsIb