Rohan Kapur

Hem-onc fellow @Maimohealth | Tennis fan

[Vincent Rajkumar @VincentRK]

Our one stop place to calculate risk stratification of myeloma, smoldering myeloma (SMM), MGUS, amyloidosis and Waldenstrom Macroglobulinemia.
@myelomaMD @eamadoutoure

Check it out and bookmark!
https://t.co/8e2dLjpXZg

[Papa Heme @Papa_Heme]

Some oncology guidelines I read are so out of touch with what is feasible to do in a busy community practice. Perhaps doable if you half clinic a week treating one disease.

[Luciano J Costa @End_myeloma]

I often see anti-CD 38 continued beyond progression as the partner changes, likely just adding cost and toxicity. Kudos to @NBahlis @dra_v_hungria and co-author. #mmsm

[Vincent Rajkumar @VincentRK]

For physicians who deal with lots of referrals on “abnormal free light chain ratio” incidental finding.

Our recommendation is unless the FLC ratio is <0.125 or >8 or unless you are worried about myeloma clinically, or dealing with biopsy proven AL amyloid or MIDD or PGNMID, ask referring physicians to repeat in 6 months and if stable consider it as possible LC-MGUS with subsequent testing only if symptoms concerning for myeloma, amyloid etc develop. Defer bone marrow biopsy or bone survey.

See algorithm below. @nejm
Note labs report K/L ratio. Not involved /uninvolved. For ease of use you can calculate involved (high value) / uninvolved (low value). And use 8 as cut off as shown in figure. Otherwise you have to follow one cutoff for lambda and one for kappa.

https://t.co/vxDm5hpoPx

[Benlazar S M A @smbenlazar]

Brentuximab vedotin and nivolumab in combination with chemotherapy for nonbulky, early-stage classical Hodgkin lymphoma https://t.co/ShKy2MYvIT #lymsm

[Raj Chakraborty @rajshekharucms]

Long term outcomes of stage IIIb AL #Amyloidosis with Dara-based frontline therapy. Hopefully, we will be able to do better with BCMA-targeted BsAbs upfront!
https://t.co/sQpiy8AM4l

[CoffeeBlackMD @CoffeeBlackMD]

Another very sad cancer “treatment”with ivermectin mebendazole failure in my icu.

Those selling you hope won’t be there at the end when it all falls heartbreakingly apart.

Just someone like me telling you this is it. I have no miracles to offer.

And I’m sorry.

[Vincent Rajkumar @VincentRK]

Just out!! In @NEJM - Our randomized trial in myeloma (ENDURANCE trial) shows limited duration of lenalidomide maintenance is just as good as indefinite therapy, with less side effects!!! @eaonc @theNCI

Implications are HUGE. This is a drug we spends billions on each year:

-Less side effects
-Less second cancers
-Similar overall survival
-Less cost
@myelomaMD @Myeloma_Doc @SagarLonialMD

National NCI funded trial led by @eaonc and joined by @ALLIANCE_org & @SWOG

https://t.co/k8nGWeSA03

[Anthony DiGiorgio, DO, MHA @DrDiGiorgio]

This is amazing.

[Tom Powles @tompowles1]

The FDA approval of perioperative EVP in muscle invasive bladder cancer makes platinum eligable somewhat redundant. It creates a paradigm shift in the disease and a is landmark moment . The principle of ‘EVP first, ask questions later’ becomes more relevant. The next questions are i) can we cure most of these patients without surgery and ii) how much systemic therapy is needed? @Annals_Oncology @OncoAlert

[Ulugbek S. Kamilov @prof_kamilov]

Academia is fascinating. You spend years becoming the world’s expert on something eight people care about, and three of them disagree with you.

[Robert Z. Orlowski @Myeloma_Doc]

#Myeloma Paper of the Day: Teclistamab-based induction in TE NDMM shows MRD- CR rate 91.8% (45/49) by pre-maintenance timepoint, 100% in evaluable samples &amp; post-induction cycle 3 (10-5 (46/46)), 6 (10-5 (46/46) &amp; 10-6 (46/46)); ORR was 100%: https://t.co/JI0HRixT9o. #mmsm

[Atul Gawande @Atul_Gawande]

Independent analyses estimate that your actions to dismantle USAID and drastically reduce lifesaving foreign aid have already killed 700,000 people. Here are some of those people. 🧵https://t.co/aKdQpk9QTW

[Harold J. Burstein, MD, PhD, FASCO @DrHBurstein]

The US FDA @FDAOncology approved two regimens today based on @DFCI_BreastOnc led clinical trials, including maintenance AI + palbo in HER2+ MBC, and sacituzumab govitecan in first line TNBC.
@Otto_DFCI @stolaney1 @DanaFarber

[Areej Al Fattani @AreejFattani]

🔸كيف تقرأ منحنى (Kaplan-Meier Curve) في دراسات البقاء ؟
#احصاء

وهو أحد أهم الأدوات الإحصائية في الطب وعلم الأورام لتحليل البقاء على قيد الحياة (Survival Analysis)

هذا الإنفوجرافيك تعليمي ويشرح النقاط المهمة في النتائج ، مثالي للطلاب، الأطباء، والباحثين في علم الأورام والإحصاء الطبي. يمكنك استخدامه مباشرة في العروض التقديمية أو المقالات العلمية.

النقاط الرئيسية في الصورة:

1. أين يبدأ انفصال المنحنيات؟ (Where do the curves separate?)
•انفصال مبكر: يعني أن تأثير العلاج يظهر بسرعة.
•انفصال متأخر: يعني تأخير الفائدة (شائع جداً في العلاج المناعي - Immunotherapy).

2. ما مدى كبر الانفصال؟ (How large is the separation?)
•كلما زاد البعد العمودي بين المنحنى التجريبي (Experimental) و منحنى الكنترول (Control)، زادت الفائدة المطلقة absolute effect للعلاج.
•ملاحظة مهمة: نسبة الخطر (Hazard Ratio - HR) لا تعادل الفائدة المطلقة.

3. هل يحدث تقاطع بين المنحنيات؟ (Is there crossing of curves?)
•التقاطع قد يشير إلى:
◦تأخير تأثير العلاج.
◦اختلاف في خصائص المرضى (Heterogeneous population).
◦اختلال في فرضية المخاطر (Proportional Hazards).
•في هذه الحالة يجب تفسير HR بحذر شديد.

4. ابحث عن (Plateau)
•ذيل طويل مستقيم (flat tail) يعني:
◦سيطرة طويلة الأمد على المرض.
◦وجود ناجين طويلي الأمد (Long-term survivors).
•هذا الشكل شائع جداً في العلاجات المناعية.

5. تحقق من متوسط البقاء (Median Survival)
•ارسم خطاً أفقياً عند 50%.
•حيث يتقاطع كل منحنى مع هذا الخط = المتوسط (Median Overall Survival أو Median PFS).
•في المثال:
◦العلاج التجريبي = 36 شهراً
◦الكونترول = 20 شهراً

6. دائماً تحقق من “العدد المعرض للخطر” (Number at risk)
•الأرقام في الجدول أسفل المنحنى تُظهر كم مريضاً ما زالوا تحت المتابعة في كل نقطة زمنية.
•عندما تصبح الأرقام صغيرة جداً في نهاية المنحنى → التقديرات غير موثوقة.

7. ما معنى علامات الرقابة (Censoring marks +)؟
•علامة “+” تعني أن المريض تمت “رقابته” (Censored)، أي غادر الدراسة دون حدوث الحدث (مثل الوفاة أو التقدم).
•الأسباب:
◦انتهاء الدراسة قبل حدوث الحدث.
◦فقدان المتابعة.
◦سحب الموافقة.

•كثرة علامات الرقابة في النهاية = زيادة عدم اليقين في التقديرات المتأخرة.

الخلاصة :
عندما تنظر إلى منحنى Kaplan-Meier:
1-انظر إلى مكان وكمية الانفصال.
2-تحقق من وجود Plateau أم لا.
3- اقرأ الـ Median.
4- تأكد من الأرقام في الجدول السفلي.
5- لاحظ علامات + وتأثيرها على الموثوقية.

وبس شكراً 🙏

[Hira Mian @HiraSMian]

@kansagraMD @KolPulseAI @MM_Hub @myeloma @MedwatchKate @oncodaily I’m going to think just moving these therapies into induction will entirely just change everything and likely we can have very abbreviated maintenance after. Asct I think is out, even if not, totally out, the magnitude of benefit is now so much smaller.

[CoffeeBlackMD @CoffeeBlackMD]

Doctors all report we wouldn’t do chemotherapy, right?

No. We’d all try the chemo. The radiation. The immunotherapies. The surgery if available.

What we won’t do is flog ourselves at the half dead spot or point of futility. Or pursue heroics that will leave large disability.

[Rahul Banerjee, MD, FACP @RahulBanerjeeMD]

#EHA2026 plenary session 👏

MonumenTAL-3: Tal-Dara and Tal-DaraPom both beat Dara-Pd in terms of PFS and OS.

This is despite D-Pd doing the best it ever has (mPFS &gt; 2 yrs).

BsAbs, both BCMA and GPRC5D, are here to stay in earlier lines for myeloma!

[Toby Eyre @tobyeyre82]

A huge effort from all involved! #DLBCL #HDMTX #EHA2026

[Kate Cwynarski @CwynKate]

End of Methotrexate for CNS Prophylaxis in Diffuse Large B-Cell Lymphoma | Journal of Clinical Oncology https://t.co/63890j5Upb