LAKSHMIN NANDAGOPAL

#oncologist Tweets are mine

[Vincent Rajkumar @VincentRK]

Daratumumab is now FDA and EU approved for treatment of high risk smoldering myeloma.
It is recommended level 1 by NCCN. My thoughts:

In the AQUILA randomized trial, daratumumab:

-Prolonged time to active myeloma
-Prolonged time to end organ damage
-Delayed time to needing active myeloma therapy
-Improved overall survival
-Improved PFS-2
-Low toxicity
-No detriment to QOL

This is a limited duration (3 years) therapy. This limited duration therapy can prevent or delay full blown typically continuous myeloma therapy by years. Full myeloma therapy is not simple. It involves 4 drug initial therapy, stem cell transplant in eligible patients, and prolonged 1-2 drug maintenance. Delaying time to full myeloma therapy by a long time is in and of itself a big deal.

Watching patients closely and starting therapy only when you see evidence of progression sounds good on paper but in reality will lead to more patients starting full myeloma therapy sooner. It also risks end organ damage between visits. Experts think they can watch carefully but in studies we find progressions are missed at top centers. In real world the type of follow up we did in AQUILA will not be possible. Patients with active myeloma in my experience are struggling to see their doctors in time.

We hope to have more overall survival information soon. But we already see an important improvement.

For more on the trial see https://t.co/3hC2E6tnxQ

[OncLive.com @OncLive]

Durability and disease control define DeLLphi-303 results—

Tarlatamab + chemoimmunotherapy achieved 71% ORR and 11-mo DOR in ES-SCLC, with nearly 50% of patients still responding at cutoff.

#ESMO25 coverage: https://t.co/fzmQlCAHdk

[OncLive.com @OncLive]

📈 DeLLphi-304: Tarlatamab Boosts OS vs Chemotherapy in SCLC

Median OS reached 10.9 mo with tarlatamab vs 6.4 mo with chemo (CFI <90 d); OS benefit seen across all CFI and PD-(L)1 subgroups.

Full results ➜ https://t.co/aPD4QVjynQ

[LAKSHMIN NANDAGOPAL @KRISHDOC]

@LeadingReport Tv in hhthu

[LAKSHMIN NANDAGOPAL @KRISHDOC]

Unfortunately we live in a world where my veteran family is being denied life saving tmt with arsenic trioxide for leukemia treatment with no justification given. Time to wake up and do the right thing @tricare @dod_ig @dod_dha @secvetaffairs @VeteranAdvocacy @DeptVetAffairs

[Guru P. Sonpavde, MD @sonpavde]

Phase 3 AMBASSADOR (A031501) trial (KEYNOTE-123) evaluating pembrolizumab (PD1 inhibitor) met one of its dual primary endpoints of disease-free survival (DFS) for the adjuvant treatment of patients with localized muscle-invasive #urothelialcarcinoma (MIUC) and locally advanced urothelial carcinoma versus observation. At a pre-specified interim analysis review conducted by an independent Data Monitoring Committee, pembrolizumab demonstrated a statistically significant and clinically meaningful improvement in DFS versus observation in these patients after surgery-other dual primary endpoint of overall survival (OS) is pending. The safety profile of pembro in this trial was consistent with that observed in previously reported studies; no new safety signals were identified. Results will be presented at an upcoming medical meeting and discussed with regulatory authorities. Honored to participate as @SWOG Principal Investigator -congrats to overall Principal Investigator @apolo_andrea @NCICCR_UroOnc and colleagues from @ALLIANCE_org @eaonc! @OncoAlert @urotoday @practiceupdate @themednet @GUOncologyNow @BladderCancerUS
https://t.co/TK0JduygEg

[LAKSHMIN NANDAGOPAL @KRISHDOC]

@arnabguonc @UABHemOncFellow @AjithaK1517 @NateraOncology @alantanmd @MattGalsky @CameronPywell @PGrivasMDPhD @koshkin85 @PBarataMD @MarkCalhoun_ @hyndukandala @montypal Good work!

[LAKSHMIN NANDAGOPAL @KRISHDOC]

Hope this ‘black box’ never needs to be opened! https://t.co/ty4TRwlFPL

[LAKSHMIN NANDAGOPAL @KRISHDOC]

Vaccine dose#1 #igotspiked @DevikaDasMD @arnabguonc @GauravGoyalMD @

[Arnab Basu @arnabguonc]

#NLR failure predicts #Immunotherapy failure on nivolumab in RCC!- @ONealCancerUAB published today #SITC2020 Annual Meeting. https://t.co/3C7gtADjOk . Expect IROC RCC Database analysis with colleagues @PBarataMD @deepak_kilari @koshkin85 @RohanGarje1 et al at #ASCOGU soon!

[LAKSHMIN NANDAGOPAL @KRISHDOC]

Cancer researchers discover new salivary gland using PSMA PET - have you seen these! @SamGalgano https://t.co/0VkvNvJkPh

[Vivek Subbiah, MD @VivekSubbiah]

My prediction in 2012 for the next 25 yrs.
1. KRAS will be druggable
2. ABVD will be replaced.
3. Precision oncology will change Lung cancer Rx.
4. Sarcoma will be 1000’s of diseases.
5. Anaplastic thyroid cancer will be treatable
👇🏼 in Hodgkin’s :) not even a decade.

[LAKSHMIN NANDAGOPAL @KRISHDOC]

@TiansterZhang @montypal @DocLHenry @LuisMezaco @HOJournalClub @DrMMurphy @PGrivasMDPhD @kalasri3 @tompowles1

[LAKSHMIN NANDAGOPAL @KRISHDOC]

@HOJournalClub If known FGFR positive- should we offer IO for these patients when we know a targeted agent may potentially work better?

[LAKSHMIN NANDAGOPAL @KRISHDOC]

@HOJournalClub Other markets will likely substitute with what is available locally

[LAKSHMIN NANDAGOPAL @KRISHDOC]

@Lymphoma_MD Congratulations! You are one of the best oncology investigators I know!

[LAKSHMIN NANDAGOPAL @KRISHDOC]

@HOJournalClub @montypal @DocLHenry @DrMMurphy A good chunk of patients progressed early even with avulumab - Need strategies to ‘flatten’ the slope!

[LAKSHMIN NANDAGOPAL @KRISHDOC]

@ajgunnmd @RaisBahrami @janjansenuk @freez_IR @LukeWilkins_UVA @DrCliffWeiss @gdkennedy88 @rkryu @MGHIR1 @uab_ir @JohnsHopkinsIR @WashUIR @thefibroidlady @Bama_IR @ahmed_kamel_ir @SIRspecialists @LessneVIR @kmadass @SDhandMD @AbhiKumar47 @jdprologo @angiowoman Congratulations!

[LAKSHMIN NANDAGOPAL @KRISHDOC]

@DevikaDasMD @lcsmchat @EGFRSummit @kRasKickers @alk_fusion @ros1cancer Would recommend 2 seperate time points - imaging to biopsy; and from biopsy to treatment. The first time point is highly variable but the second you may see a more consistent answer

[LAKSHMIN NANDAGOPAL @KRISHDOC]

Having attended the fda workshop as a fellow, this is staggering and disappointing at so many levels!

[David Steensma, MD @DavidSteensma]

The head of the United States Food and Drug Administration (!) @SteveFDA does not understand the difference between relative and absolute risk reduction -- a basic, fundamental concept in medicine, statistics and clinical trial interpretation. It just gets worse and worse.😢