Nani, MD

💉| Oncología médica.

[Allison Fitzgerald, MD, PhD @allisonoconn]

With all the excitement around daraxonrasib, I needed to refresh my RAS inhibitor knowledge, so here we go:

[Entisar saleh @Entisar_kilani]

PARPi maintenance trials in EOC .

#oncology #oncoflash #medtwitter

[Dr Rupam Manna MD @DrRupamOncology]

PARP Inhibitors 💊 in Ovarian Cancer — Exam-ready dosing you MUST remember

🔹 Olaparib → 300 mg BD
🔹 Niraparib → 200–300 mg OD (weight + platelets based ⚖️)
🔹 Rucaparib → 600 mg BD

📌 Key pearls:
• Niraparib = individualized dosing (↓ thrombocytopenia)
• Olaparib = strongest BRCA evidence
• Rucaparib = watch LFTs
• All = continuous oral maintenance till progression/toxicity

🎯 One-liner for viva:
Olaparib 300 mg BD, Niraparib 200–300 mg OD, Rucaparib 600 mg BD

— Dr Rupam Manna

#MedicalOncology #PARPInhibitors #OvarianCancer #OncologyNotes #DrNB #DMOncology #NEETSS #MedEd #CancerTherapy #OncologyLife #ExamPrep #ClinicalOncology

[Dr Rupam Manna MD @DrRupamOncology]

📌 High-Yield Immunotherapy Concept Every Oncologist & Resident Must Master

**ICI Resistance Mechanisms**
(Primary & Acquired Resistance to PD-1 / PD-L1 / CTLA-4 Inhibitors)

Complete visual masterclass in one frame:
✅ Definition: Primary vs Acquired resistance
✅ Tumor-intrinsic mechanisms (MHC-I/B2M loss, low TMB, WNT/PI3K pathways)
✅ Tumor Microenvironment (Tregs, MDSCs, TGF-β, hypoxia)
✅ Checkpoint redundancy (LAG-3, TIM-3, TIGIT)
✅ T-cell exhaustion & immune desert
✅ Host factors (Microbiome dysbiosis, steroids, antibiotics)
✅ Clinical pearls (MSI-H advantage + rational combinations)

“Understanding mechanisms of ICI resistance helps in selecting rational combinations and improving outcomes.”

Save it. Share it. Use it in clinic & viva.

Next topic dropping soon: **NTRK Inhibitors – Short Notes**

Dr Rupam Manna
@DrRupamOncology

#ICIResistance #Immunotherapy #PD1 #CancerImmunology #OncoViva #MedicalEducation #Oncology #VivaPrep

[Dr. Nina Niu Sanford @NiuSanford]

Here is Version 2.0 of when to hold systemic tx during RT. Updated & w 3 additional drug categories (ADCs, CDK4/6 inhibitors, PARPi).

More details on newer drugs in 🧵 below.

Please use this version as reference & thanks for all input/experience crowdsourcing! (1/3)

[Yakup Ergün @dr_yakupergun]

Great new, BUT

Lately, headlines claiming that “pancreatic cancer has been completely eliminated in mice” are circulating widely.

The core information is true; the conclusion drawn from it is wrong.
Mariano Barbacid and his team demonstrated a triple-targeted treatment combination that very strongly suppresses pancreatic cancer in mouse models. In some mice, tumors completely disappeared and no recurrence was observed.

But let’s pause.

This is a preclinical study. Meaning: – It has not been tested in humans
– Efficacy and safety are unknown
– It does not represent a clinical treatment
Seeing “complete responses” in mouse models is not new in pancreatic cancer research. The real challenge has always been translating these results to humans. Tumor biology and the microenvironment often break the effect when moving from mice to patients.

Why does this still matter?
Because simultaneously targeting KRAS, EGFR, and STAT3-related resistance pathways shows real biological relevance. That is a valid scientific signal.

Let’s be clear: “A cure has been found” — false
“Patients will soon be cured” — false
“A promising laboratory signal worth testing in humans” — true

[Dr Sarah Sammons @drsarahsam]

I apologize on behalf of all medical oncologists for the “I won’t see the patient until the biopsy returns” sentiment in which I disagree.

We still have a lot to offer in terms of work-up, symptom relief, expectations, onc emergency management. It’s a symptom of burnout.

[Nani, MD @nanilopezs]

@carlospeguer foto o no pasó

[Filípides @FilipidesE]

Ayer acudí a un domicilio.

Con 100 años, la abuela, la matriarca, se estaba muriendo. Había tenido demencia los últimos años.

Estaban los hijos, el nieto, la cuidadora…

El ambiente era algo hostil. Había salido hace pocos días del hospital. Aunque le habían curado la neumonía, la señora se estaba consumiendo. No lo entendían.

“¿Por qué no hacen nada? ¿Por qué le dieron el alta? ¿Por qué no come?… ¿Por que nos dejas?”

Querían volver al hospital. A urgencias.

Les expliqué que estaba en la fase final, que las necesidades de comida son muy pocas, que les honraba estar preocupados, pero que la abuela era una persona muy afortunada de tener a toda su familia alrededor y que querer es a veces dejar ir.

Me encargué de que no tuviera dolor. Les expliqué que todo lo que tenían que hacer era estar, y les dejé mi número de teléfono por si necesitaban algo.

Me acaban de llamar. Ha muerto sin dolor, en paz y acompañada de su familia.

Qué distintas habrían sido las cosas en el hospital.

[ªlexaurio 🦖 @alexauriio]

esto me acaba de hacer el día

[Påula ॐ @Aluap97]

El mir no me dejó traumada pero he visto este tweet y me ha dado una oleada de angustia pensando “dios mio y si marqué todas mal???”
Llevo 2 años de residencia.

[Chris Udalla @Cudalla]

I tried watching bojack horseman but idk if I got the right mental illnesses to enjoy that shit

[Nani, MD @nanilopezs]

@milebonino Hola no se si has contactado con un abogado pero deberías de ver si es posible hacer un recurso contencioso administrativo o en el peor de los casos retirar tu expediente y hacerlo con el nuevo decreto. Mucha suerte!

[Ramsi @crocodilecamera]

Bear season 2 episode 6 made me so anxious bro 😭😭😭

[Nani, MD @nanilopezs]

@evelyn_ch20 Normalizando el alcoholismo

[Nani, MD @nanilopezs]

copago

[david andina @daandina]

Caso 1:

Acude a Urgencias un niño de 3 años con inflamación del párpado superior.

Tras explorarlo, diagnósticas de celulitis preseptal e indicas antibiótico.

Al cargar la medicación en la receta electrónica descubres la misma prescripción hecha dos horas antes en otro centro.

[Nani, MD @nanilopezs]

kendall roy despidiendose de un candidato presidencial diciendo stay hydrated hdjfkkf que payaso es