Dr Arun Chandran

Medical oncologist / theoncodoctor!/

[Dr Arun Chandran @groundhogcs]

@SuyogCancer @oncodaily Congrats boss

[Dr Arun Chandran @groundhogcs]

@PTarantinoMD What are your thoughts on the usage of nab paclitaxel in Neocarhp? Does it add any value?

[Mario Balsa @MarioBalsaMD]

💥NEOSUMMIT-01 trial in LA gastric/GEJ cancer: perioperative toripalimab + ChT vs ChT alone (3-year follow-up, n=108)
https://t.co/td1oDfl926

▪️ 3-year EFS: 74.7% vs 56.2% (HR 0.51)
▪️ 3-year OS: 81.3% vs 72.2% (HR 0.45)
▪️ Benefit maintained across most predefined subgroups

Perioperative IO TORI-pal the survival curves in GC 🍜

@OncoAlert @OncoReporte
@myESMO @_SEOM @GrupoTTD

[Mario Balsa @MarioBalsaMD]

🚨 RESET-C trial: single-cycle neoadjuvant pembrolizumab in stage I–III dMMR colon cancer (n=85)
https://t.co/j2KFLLOdVg

🎯 pCR 44% || MPR 57%
💥 DFS and OS rates: 96% and 98% at 18.4 months
▪️ Grade ≥3 AEs in 11%; only 1 recurrence reported

One shot and the tumor may already be hitting the RESET button 🔄

@OncoAlert @OncoReporte
@myESMO @_SEOM @GrupoTTD

[Dr. Deep Dutta @deepduttaendo]

Medicine is all about a lot of learning & then a lot of de-learning also!

The very popular corrected serum calcium correction should no longer be used in the setting of abnormal albumin levels

Corrected serum calcium = measured serum calcium + 0.8 (4-Albumin) formula should no longer be used

In the setting of low albumin levels, serum ionised calcium should be measured instead
@iofbonehealth @isbmrindia @ISBMRTweets @iofbonehealth @Osteoporosis_NL @osteoporosisNI @TeamSESH @RheumPearls @RheumJnl @RheumResearch @IndianRheum @nihardesai7 @j_metb @EndoSocAus @EndoSocJournals @TheEndoSociety @TheAACE @IndiaESI

[Dr Arun Chandran @groundhogcs]

@ChandrakanthMv So in practice , what would be the best test after biopsy ? Send straight for a molecular panel? CGP or targeted panel? any recommendations on indian labs ?

[Dr Arun Chandran @groundhogcs]

https://t.co/u5BcAg8bue

[Dr Arun Chandran @groundhogcs]

@ChandrakanthMv Longest OS, but the control arm also performed spectacularly well (20 months) compared to 13 months in Imbrave 150. I think the two are comparable

[Dr Arun Chandran @groundhogcs]

@ChandrakanthMv Dexa dose you mentioned is 3 mg. Think that's an error..

[Yakup Ergün @dr_yakupergun]

Premenopausal HR+/HER2+ eBC – Adjuvant ET

• RD after NAT → OFS + AI
• pCR after NAT → risk-adapted
 – Stage III → OFS + AI
 – Stage I–II → AI or TAM ± OFS
• Upfront surgery → baseline stage-driven ET

Principle:
RD = ER-dependent, chemo-resistant → needs ET intensification

Great editorial👇

https://t.co/AuDXPhHDoi

[Dr Arun Chandran @groundhogcs]

@ChandrakanthMv Would adding chemo to osi annul the advantage of lazertinib in exon 21?

[MV Chandrakanth @ChandrakanthMv]

• Censoring = patient exits before event is observed
• Non-informative = exit unrelated to event risk
• Informative = exit linked to high event risk
• Informative censoring → inflates estimated OS/PFS
#Oncology #Biostats #KMcurve #SurvivalAnalysis #Trials #MVOnco

[Dr Arun Chandran @groundhogcs]

@ChandrakanthMv CD 34 is a marker of immaturity (present on stem cells). As promyelocytes are more mature, they lack CD34 expression. That's how I remember.

[Yüksel Ürün @DrYukselUrun]

ESMO Clinical Practice Guideline: Local and locoregional prostate cancer!
@myESMO @APCCC_Lugano @AttardLab @Ecastromarcos @stefanofanti4 @Silke_Gillessen @Prof_Nick_James @piet_ost @MarkARubin1 @ChrisSweens1 @Tilki_De @ZilliThomas @alison_tree @OncoAlert
https://t.co/jbgi5KBYxs

[Yakup Ergün @dr_yakupergun]

Why Induction Should Be Performed With T-DXd + Pertuzumab (IMO)

The key distinction of DESTINY-Breast09 compared with HER2CLIMB-05 and PATINA is randomization at true treatment initiation. In both HER2CLIMB-05 and PATINA, only patients who did not progress during THP induction were randomized; early progressors were excluded by design.

DESTINY-Breast09 therefore captures the full early-risk population. At 6 months—approximately the end of induction—12.2% of patients in the THP control arm had already experienced a PFS event, compared with 7.0% in the T-DXd + pertuzumab arm, corresponding to an absolute 5.2% reduction in early progression within the first 6 months. Importantly, this separation is not transient. By 12 months, the absolute PFS difference widens to 13.5%, indicating that T-DXd + pertuzumab not only prevents early progression but continues to deepen benefit over time.

By contrast, PATINA and HER2CLIMB-05 never randomized the initial ~12% of patients who progressed during THP induction. Had induction been performed with T-DXd + pertuzumab instead of THP, a substantial proportion of these early progressions—approximately 5% in absolute terms—might have been prevented. These patients would not have been lost upfront and could have proceeded to effective maintenance strategies rather than being excluded at the outset.

At present, because maintenance trials have uniformly used THP as induction, there are no prospective data evaluating palbociclib- or tucatinib-based maintenance following T-DXd + pertuzumab induction. Nevertheless, indirect inferences from DESTINY-Breast09 suggest a pragmatic clinical strategy: in patients who develop tolerability issues, treatment may reasonably be initiated with T-DXd + pertuzumab, followed by maintenance tailored to hormone receptor subtype once maximal disease control is achieved. This approach leverages early disease suppression while preserving the opportunity for durable, subtype-specific maintenance therapy.
Critically, in HR–positive disease, ET must remain an integral component of maintenance and should not be omitted.

[Dr Arun Chandran @groundhogcs]

@Niva_Bupa @Niva_Bupa @NivaBupaSupport your people need to learn sales skills, not antagonize your customers with hate and threats. I was planning on renewal and have learnt my lesson. No way as a doctor will I ever recommend Niva Bupa to anyone. Hope the upper management knows this

[Dr Arun Chandran @groundhogcs]

@NivaBupaSupport @Niva_Bupa @irdaindia Had a terrible experience with the agents from Niva Bupa. I was explaining that I was planning to change the policy rather than renew it, and they were issuing threats of terminating the policy.
Such crass, deplorable behavior.

[Dr Arun Chandran @groundhogcs]

This person called Tanya was just shouting over the phone saying, all other agents are cheats and then just abused me and threatened termination of the policy. All this, beciased I dared to consider another policy. @Niva_Bupa

[Dr Rishabh Jain @DrRishabhOnco]

🧬 PARP Maintenance After First-Line Chemo

Huge PFS benefit… but still no OS signal?
A 7-trial meta-analysis across 4013 pts.

🔍 Study Snapshot
🧪 7 RCTs
👩‍⚕️ Advanced-stage EOC (after response to platinum)
🧬 Subgroups: BRCA, HRD, BRCA-wt, HRP
🔪Surgery types: PCS vs NACT
💊 Agents: olaparib, niraparib, veliparib, senaparib, others

📈 Overall Results
🟢 PFS improved: HR 0.57
🔵 OS unchanged: HR 0.94
🔴 Grade 3+ AEs ↑: RR 2.40

🧬 Molecular Breakdown

🔹 BRCA-mut
⭐ Strong PFS benefit (HR 0.40)
❌ No OS benefit

🔹 HRD
⭐ PFS HR 0.44
❌ No OS advantage

🔹 BRCA-wt
👍 Moderate PFS benefit (HR 0.62)
❌ No OS benefit

🔹 HRP
⚪ Minimal PFS activity (HR 0.74)
❌ OS neutral

🧵 Treatment Context
🏥 After NACT: HR 0.51
🏥 After PCS: HR 0.54
✔️ Works in both CR (HR 0.50) and PR (HR 0.57)
🔪 Across complete & incomplete cytoreduction

⚠️ Toxicity Landscape
🔥 Most toxicity: niraparib (RR 4.73)
🙂 Least toxicity: veliparib (RR 1.15)

🧩 Final Take
PARP maintenance = robust PFS benefit, strongest in BRCA/HRD.
But no OS benefit in any subgroup, and toxicity varies widely.
➡️ Use selectively, genotype-driven, toxicity-aware.

�� Full paper in comment
#OncoTwitter #MedTwitter #GYNOnc #parp
@OncoAlert @myesmo @esmo_open @asco

[Dr Rishabh Jain @DrRishabhOnco]

💗 HER2CLIMB-05: TUKYSA takes the lead in HER2+ MBC maintenance! 🚀
(PRESS RELEASE)

🧪 Phase 3 | n = 654 | 1st-line maintenance after chemo
Arms:
🔹 Tucatinib + trastuzumab + pertuzumab
🔹 Placebo + trastuzumab + pertuzumab

🎯 Primary endpoint met:
✨ Statistically & clinically meaningful PFS improvement by investigator assessment

💪 Safety:
Tolerable & consistent with known profiles of individual drugs

📊 Why it matters:
• HER2 + ≈ 15–20 % of breast cancers
• 5-yr OS ~ 41–47 %
• SOC unchanged since 2012 → most progress < 2 yrs
➡️ HER2CLIMB-05 offers a potential chemo-free maintenance path 🌈

💡 Takeaway:
TUKYSA (tucatinib) may soon move from 3rd-line → 1st-line maintenance, shaping a new standard of care in HER2 + MBC 💥

📖 Full release: https://t.co/bSTxlfwZIt

#OncoTwitter #MedTwitter #BreastCancer #HER2 #Tucatinib #ESMO #ASCO

@OncoAlert @myesmo @esmo_open @Pfizer @JournalofOncology @ASCO @DFCI_BreastOnc