Jedrzej Wykretowicz

HemOnc Doc, tweets my own

[Thor Halfdanarson @OncoThor]

When does an elevated VIP level in a patient with diarrhea mean that patient has VIPoma...? Actually, not that often. Among 76 patients, 9 had VIPoma, and 5 of them a known diagnosis of panc NET. Using the threshold of 75 pg/mL (upper end of normal), the positive predictive value for a VIPoma was 12%. The optimal VIP threshold was 442 pg/mL with statistically significant odds ratios starting at 200 pg/mL.

So bottom line is that most patients wit diarrhea and elevated VIP levels do NOT have VIPoma. What then to they have... Well, that's another project...

Excellent work led by Jack Korleski, a 1st year heme/onc fellow. Keep an eye on him, he's good!

@MayoHemeOnc @sonbol_bassam @PatrickMcGarrah @HansHofland1

https://t.co/LjvdN76QvA

[Erman Akkus @Erman_Akkus]

⭕️HERIZON-GEA-01
I am happy to see positive trials for our patients. BUT,

➡️Pembro-trastuzumab-ChT FDA accelerated approval: 05.05.2021
➡️Herizon-Gea-01 actual study start: 02.12.2021

‼️Herizon-01 has control arms "trastuzumab plus ChT" and "zanidatamab plus ChT". ➡️ patients that can be candidate for IO

#cancer #oncology #MedX @SuyogCancer @dr_yakupergun #GI26

[Thor Halfdanarson @OncoThor]

The results of the COMPETE trial (LU-177 DOTATOC vs. everolimus is mostly second line therapy (small subset 1st line). Radioligand therapy superior to everolimus. #ESMO25 @Ja_Capdevila

[Yakup Ergün @dr_yakupergun]

#ESMO25
Pegfilgrastim timing matters!

In this randomized phase III trial (n=159, early-stage BC):
Giving pegfilgrastim 72h after chemo — instead of 24–48h — cut bone pain by >50% without increasing neutropenia or FN risk.

[Thor Halfdanarson @OncoThor]

To operate or not on panc NETs <2 cm…? The answer is NOT.

Excellent presentation by @spartelli on the long term outcomes of the ASPEN trial. Almost 1000 patients observed w/o resection and progression was uncommon, mets rare and survival the same as with resection.

[Dr. Dominic Ng @DrDominicNg]

Microsoft claims their new AI framework diagnoses 4x better than doctors.

I'm a medical doctor and I actually read the paper. Here's my perspective on why this is both impressive AND misleading ... 🧵

[Timothée Olivier, MD @Timothee_MD]

https://t.co/G9kjHpRm4o

[Erman Akkus @Erman_Akkus]

☢️CT imaging and cancer risk
@JAMAInternalMed

🚨CT examinations in 2023 in USA were projected to result in 103 000 future cancers during lifetime
🚨If current practices persist, CT-associated cancer ➡️ 5% of all new cancers annually in USA

⁉️Follow-up frequency in our patients with early stage cancer treated definitively?

👉https://t.co/YfYi3m8vMv

@OncoAlert @ASCO @myESMO @EORTC @CancerCareMASCC @_atanas_ @imedverse @isciverse #cancer #oncology #MedX

[Anirban Maitra @Aiims1742]

New paper in @JAMANetworkOpen from @cityofhope calls into the question the utility of serial tumor informed ctDNA measurement versus routine imaging based surveillance for recurrence following curative intent surgery for #ColorectalCancer. Only 1.6% of patients who underwent serial ctDNA monitoring for recurrence were actually disease free following metastatecomy at the time of cutoff. Each patient underwent ctDNA measurement every three months for 1st two years following surgery, and then every six months for next three years.

[Krishan Jethwa @KrishanJethwa]

🚨PRODIGE23🚨

Long term results now published!
T3-4 rectal adenocarcinoma
Randomized:
CRT➡️🔪➡️FOLFOX
mFOLFIRINOX ➡️ CRT➡️🔪➡️FOLFOX

✅✅✅Improved OS!!!

Looking forward to JANUS clarifying if TNT with FOLFIRINOX vs. FOLFOX improves cCR and/or DFS/OS

https://t.co/8As1EhDnup

[Lizzy Smyth @LizzySmyth1]

📢📢 @myESMO Gastric Cancer Guideline update 📢📢

https://t.co/Xa1SwBkuES

Well done @FlorianLordick and team 👏 👏

Wondering what to do with those PD-L1 1-4? 🤔

See our recommendations below..

[Thor Halfdanarson @OncoThor]

A very important trial showing impressive PFS difference favoring PRRT.

Read after me: NETs are NOT rare anymore (the second most prevalent GI cancer according to some studies) and we can very successfully conduct phase III trials in this population.

[Andreana N. Holowatyj @drholowatyj]

Know the signs & symptoms of #appendixcancer—a rare cancer with rising rates, esp in younger ppl.
This @DailyMailUK @MailOnline piece draws key light on what we know & still need to learn to drive research forward for our pts.
@VUMC_Cancer @acpmpresearch
https://t.co/uWakZVpyPt

[Mark Lewis, MD, FASCO @marklewismd]

Much more recently, the abstract below caught my eye at ASCO GI earlier this year (#GI23)

"The use of a 5-FU bolus was not associated with OS (HR 0.98; 95% CI 0.91-1.06; p = 0.64)."

You can't fit a laser pointer between these survival curves 👇
https://t.co/RfZsSUHE36

[Dr. Cathy Eng @CathyEngMD]

I am ECSTATIC!!! @US_FDA Approved for 3rd line or greater for #colorectal #cancer https://t.co/sxjzwX6T59 @TakedaOncology @hutchmed🙏💙 @adasarimd + colleagues + our patients!!! #cancerreseearch #crcsm @fightcrc @fireflyann @COLONTOWN1 @VUMC_Cancer @VUMCDiscoveries @VUMCHemOnc

[Hans Hofland @HansHofland1]

And there's the next #ENETS guidance paper🤩: non-functioning Pan-NET. https://t.co/fvEFfN0Lvh Splendid effort and congrats to all involved @JustoCastano @louis_demestier @spartelli @AurelPerren @drenriquegrande

[Elliot Tapper @ebtapper]

What happens when a busy #cirrhosis program starts using TEG?

Less FFP
No more risk

check out this paper from @brittybb, @LiverFellow extraordinaire from @BrighamGI

https://t.co/ZPbWOionra #livertwitter in @HepCommJournal

[Raffaele Giusti @oncoblogger]

NGS does not seem to be valuable when performed in cases with a poor PS, rapidly progressing cancer, short expected lifetime, or cases with no standard therapeutic options.
No excuses or illusions please.

[Jedrzej Wykretowicz @drhemonc]

@DrRiyazShah I am all about adjuvant chemo, but this appears to be an example of guaranteed-time bias (immortal-time bias) as OS is measured from the time of randomization not from surgery.

[Paolo Tarantino @PTarantinoMD]

With T-DXd rapidly expanding in indications, detecting & managing ILD are becoming critical skills in oncology. In this @JCOOP_ASCO editorial we suggest an easily memorized framework for the management of ILD:

The 5 “S” rules.

Read it here: https://t.co/RX2RtsQLG8 @stolaney1