Ryan Holstead

GI Medical Oncologist with interests in immunotherapy, evidence, quality, and education.
🇨🇦
Co-host of the podcast @talkingtumors

[Ryan Holstead @ryangholstead]

7/

Discussion by Dr. Venook at ASCO is an excellent review

[Ryan Holstead @ryangholstead]

1/ Impressive #challenge clinical trial update at #asco26 making a financial case (from Canadian perspective)

Bottom line - SEP can improve DFS for St iii CRC and despite an upfront cost, would save health systems money overall

[Ryan Holstead @ryangholstead]

6/

Implementation is challenging as requires training of PT/therapist and local adaptation of intensive protocol

[Ryan Holstead @ryangholstead]

4/

Practice changing study and I look forward to studies incorporating oral therapy in this deadly in earlier settings and combinations that may overcome patterns of resistance.

[Ryan Holstead @ryangholstead]

1/ A novel KRAS(on) inhibitor improves survival in previously treated patients with metastatic pancreatic cancer with a RAS G12 mutation

mOS 13.2v6.6 months (HR 0.4)
Toxicities: rash (85%, Gr3 13%)
Limitations: Ctrl arm drop out (>10%), small population of non G12

[NEJM @NEJM]

Presented at #ASCO26:

Among patients with previously treated metastatic pancreatic ductal adenocarcinoma, the RAS(ON) inhibitor daraxonrasib led to significantly longer overall survival and progression-free survival than chemotherapy. Full phase 3 RASolute 302 trial results: https://t.co/xwLWBZYRzq

@ASCO

[Ryan Holstead @ryangholstead]

3/
Very small non G12 mutation population, and further data will be necessary to use in other settings

Highly selected population -not all patients have opportunity for second line therapy in PDAC

Lastly drop out in control arm is high (>10%) as unblinded

[Ryan Holstead @ryangholstead]

@NiuSanford For a device with a novel MoA being added to CT, at least one sham Ctrl trial is needed. Did those in ctrl arm drop out early and pursue BSC or seek another trial? How well was survival data collected in pt who dropped out? OS censoring seems unequal at 1yr...

[Ryan Holstead @ryangholstead]

Onc consultations are complex. AI LLMs may help providing patient friendly summaries. Grateful for @JCOOP_ASCO publishing my letter on the topic. Verification studies are required.

https://t.co/agHrG2aFc0