Sinéad A. Noonan

Medical Oncologist, @cuh_cork/@hospital_kerry via @ucdmedicine, @tcddublin and @CUSystem. Opinions are my own and don't represent the position of my employer.

[Sanjay Popat @DrSanjayPopat]

Delighted to be at @UCC with @gerryhanna @DrJNaidoo & colleagues on #WorldCancerDay highlighting the impact of ctDNA and importance of research in cancer outcomes. We continue to hunt - and find- the rainbows amongst the clouds of cancer. Have hope! @OncoAlert

[Gerry Hanna @gerryhanna]

Delighted to be in Aula Maxima in @UCC today

Professor John O'Halloran, President of UCC opened the #FutureofCancerResearch conference, setting the strong ambition and vision of @CanResUCC with new investment of €10million - fantastic to see this 👏👏👏

Fantastic line-up of international and national expert speakers and diverse topics

[Jarushka Naidoo @DrJNaidoo]

Inspiring day @CanResUCC @UCC World Cancer Day Event. Super lineup outlining cancer trial innovations

- Liquid biopsy @DrSanjayPopat
- Investigator-led trials @jgleesonirl
- Working with @cancertrials_ie @gerryhanna

Congrats @RoisinMConnolly on a dynamic & ambitious vision

[Sinéad A. Noonan @snoonanonc]

@joeroganhq I mean he knows what the Catholic Church did to the children of Ireland? We didn't have to import anything

[Jarushka Naidoo @DrJNaidoo]

Great PhD opportunity to join an exciting lab with superb PI @DrCDowling focused on KRAS+ NSCLC & @CancerCentreIre's lung cancer research group👇

Join us!
@IrishLungCancer @LungCommunity @RCSI_Irl @CancerInstIRE @tcddublin @CanResUCC @QUBelfast @RCPI_news @OncoAlert #LCSM

[CancerTrialsIreland 🌈 @cancertrials_ie]

ADCs are reshaping early breast cancer treatment 🔬💥 - with potential to replace parts of chemotherapy while introducing new questions around toxicity and patient selection.

Another great #ESMO25 Challenge Your Expert session chaired by @RoisinMConnolly @CanResUCC

Dr Barbara Pistilli @GustaveRoussy shared emerging data on 3rd-gen ADCs and their role in future treatment strategies.

#BreastCancer #ADCs #CancerTrials @myesmo @UCCCancerTrials

[Jill Feldman @jillfeldman4]

Fantastic, thoughtful discussion between @OncBrothers & @lungoncdoc about 1st line treatment options for #EGFR #NSCLC. Having options that have significant OS benefits is amazing, but all regimens have toxicities.

Every lung #onc should not just prescribe treatment, but also lean into supportive regimens to help people live better and stay on treatment.

Thanks for the callout. A reduction in side effects is important for clinical management, but the #QOL data, reported by the patients, that I presented at ASCO, is what matters. Poster attached.

COCOON is still being considered as side effect management when there is an RCT with evidence-based data showing a significant decrease in AEs (and PRO data showing it increases QOL, reported by patients) - would you give chemo without anti-nausea?
That disconnect speaks 1000 words - the message is clear that QOL is an afterthought. It's disheartening, frustrating and people are still suffering😔

All 3 of you are amazing, and I appreciate YOU!
@EGFRResisters #LCSM

[Sinéad A. Noonan @snoonanonc]

This is outrageous @myESMO #ESMO25 I had no idea that ESMO discriminated against breastfeeding mothers/parents of small children - why isn't there childcare at #ESMO25?????

[Michael Hofman @DrMHofman]

@myESMO #ESMO25 ⭐ PhD @LouiseKostos flew 24 hrs with her 3 month old baby from Melbourne to Berlin to present #AlphaBet co-published in @TheLancetOncol ... Denied entry to conference - under 18s not allowed including babies! Thoughts?

[CancerTrialsIreland 🌈 @cancertrials_ie]

At #ESMO25, Matthew Beggs @QUBelfast shared a feasibility study integrating exercise into treatment for NSCLC.

Patients completed 20 minutes of supervised cycling before radiotherapy, 5 days a week. Feedback was overwhelmingly positive, showing exercise is not only feasible but meaningful to patients 💪

#LungCancer #ExerciseOncology @myesmo

[CancerTrialsIreland 🌈 @cancertrials_ie]

The Cancer Trials Ireland team is on the way to #ESMO25 in Berlin.

We’re looking forward to meeting colleagues, collaborators and potential partners, and to supporting cancer research from 🇮🇪 on the international stage.

Many investigators and researchers from Ireland are presenting across the programme - find details of Irish participation here: https://t.co/b6uOTbtsqf

If you’re attending and would like to meet to discuss collaboration or partnership opportunities, please get in touch. @angelaclaytonL1 @Seamusoreilly18 @gerryhanna

[Bishal Gyawali, MD, PhD, FASCO @oncology_bg]

I'll have my take on the most important trials from #ESMO25 soon on my regular ESMO roundup video, so stay tuned.

In the meantime, please consider these general points before you start claiming every trial with a P < 0.05 is the new standard of care. You don't need to think critically to claim that everything is practice-changing.

1. Prognostic biomarker is not the same as predictive biomarker. A good prognostic marker alone doesn't make a good surrogate. I'm talking path CR rates and ctDNA. They are good prognostic markers but not predictive or a surrogate. https://t.co/EKg5r55IK6

2. Perioperative trials! We need to know the contribution of components. We are overtreating our patients. Having fatal AEs or life-altering AEs in a curative setting is not "acceptable" or "well tolerated". Even 1 additional cycle is too much if it's not adding any benefit. https://t.co/FySGtaR5cT

3. Don't inflate benefit by quoting relative risk reduction when absolute risk reduction is dismal or baseline (control arm) risk is pretty low to begin with.

4. When we are running 1000s of trials of immunotherapies, of course, we will get many false positives (we wouldn't know which one). Slicing an individual trial data further into dozens of subgroups further intensifies this risk of seeing things where there is nothing to see. So don't make any clincal inference based on these subgroup analysis.

[Sinéad A. Noonan @snoonanonc]

#ESMO25 standing room only at the onco-fertility session! We need a bigger room!

[Sinéad A. Noonan @snoonanonc]

#ESMO25 More Irish representation 🇮🇪 - the inimitable Prof. Donal O'Shea, I remember as a wonderful teacher from my Vincent's days - a GLP session at a cancer conference- I am intrigued!

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

There is understandable power to 'global' oncology trials, but sponsors need to assure appropriate standards of care are met. In DB-11, &gt; 40% of pts with residual HER2+ BC did not get TDM1, the standard since 2019. It means EFS data are and will be hard to interpret.

[Sinéad A. Noonan @snoonanonc]

#ESMO25 absolute tour de force presentation from @BenjaminBesse highly recommend for anyone interested in de-escalation strategies, for the benefit of patients, resource allocation and the planet! Not just for lung peeps!

[Sinéad A. Noonan @snoonanonc]

##ESMO25 biggest reaction of the day; peri-operative enfortumab vedotin plus pembro Vs alone in cis-ineligible MIBC - I don't treat bladder cancer, great to see results like this in a frail population

[Sinéad A. Noonan @snoonanonc]

#ESMO25 heard at multiple talks today; "What is the contribution of each phase of treatment?" #perioperative critical that future trials in the space evaluate this question

[Sinéad A. Noonan @snoonanonc]

##ESMO25 Wonderful to see reassuring longer follow-up in the #POSITIVE study, such an important consideration for our patients and delighted to have data to support decision making....anyone think that perhaps there is a protective effect of pregnancy??!! 🤔

[Sinéad A. Noonan @snoonanonc]

One of the most impressive studies I've seen so far at #ESMO25 low dose pembro in addition to neoadj-chemo for TNBC, huge kudos to the investigators, and very interested to see the lack of adjuvant pembro....lots of food for thought

[Sinéad A. Noonan @snoonanonc]

##ESMO25 81mths median overall survival in metastatic positive lung cancer, remarkable to see results like these when we think of where the field was not that long ago! #ALEX