Matt Spraker

Oncologist and Talking Head | ❤️ @mellysprakes, Aayla, Brooklyn the Dog, and the mountains

[Matt Spraker @SprakerMDPhD]

Im a 40 year veteran of the practice.

I should not have to do the annual hand washing module.

[HealthTree Foundation @HealthTree]

“Assessing risk can be risky” says Bill Matsui, MD of MDACC. It’s statistical, not exact. Risk can change over time and each risk factor (genetics, disease stage, etc) may contribute differently for each myeloma patient. At the HealthTree Houston Roundtable #mmsm

[John Squires 🎃 @FreddyInSpace]

THE CYCLE is one of Shudder's best original movies and one of its subgenre's best movies in a long time. A compelling mystery that transforms into something much, much cooler. Excellent practical FX. Jordan Downey is a filmmaker to watch in the horror space. Don't miss this one.

[Byoung hyuck Kim @Byoung_hkim]

Happy to share that our multicenter, randomized, sham-controlled phase II trial of low-dose whole-brain radiotherapy in mild-moderate Alzheimer’s disease is now published in Radiotherapy & Oncology!

Why we did it: LDRT reduced amyloid and neuroinflammation in AD mouse models. Our two dose arms came from early human reports: a CT-dose case report (0.04 Gy; Cuttler et al., 2016) and a single-arm pilot (0.5 Gy; Kim et al., ROJ 2023). Neither had a control group.

What we did: 41 amyloid-PET+ patients were randomized to sham, 0.24 Gy, or 3 Gy (6 fractions over 3 weeks), on top of standard medication.

What we found:
- 6-month ADAS-cog (primary endpoint) was not met
- 12 months (exploratory), −5.4 points with 3 Gy (nominal p = 0.044), though findings were not consistent across other outcomes. No treatment-related adverse events.

What’s next: LDRT was safe, but efficacy is not established. Larger, adequately powered trials with longer follow-up are needed, and we look forward to LDRT-MIND from Dr. Evan Thomas, which will add more robust data and explore maintenance.

Grateful to our patients, and co-investigators across three centers.
🔗 https://t.co/jge36kDzsS
#Alzheimers #LowDoseRT #ClinicalTrial @EvanThomas84 @jryckman3

[Todd Scarbrough @toddscarbrough]

@SprakerMDPhD chemo : chemoRT :: weight loss : weight loss+LDRT

[Matt Spraker @SprakerMDPhD]

If the healthcare overlords cut off LDRT, you can learn to manage GLP1s for your overweight patients with OA.

And probably reta soon.

[NEJM @NEJM]

In the phase 3 TRIUMPH-1 trial involving patients with obesity, retatrutide, a triple hormone receptor agonist, resulted in substantial weight reduction and a decrease in knee osteoarthritis pain and obstructive sleep apnea events. Full trial results: https://t.co/kzuY57bUTX

[Evan Thomas MD/PhD @EvanThomas84]

Congratulations Dr Kim!

Many of us have been waiting anxiously to see your published results!

Thanks for your trailblazing work, it served as inspiration for our now accruing trial, LDRT-MIND!

[Matt Spraker @SprakerMDPhD]

I think Oddity is now officially a regular in our October horror movie rotation.

It's so good, up there with Alien.

[Matt Spraker @SprakerMDPhD]

@HannahRAbrams In a way, patients are hiring us clinic physicians to help them understand this big show.

It’s okay to just tell them how it is.

Societies and journals are part of the show, they won’t fix it.

If we’re in the pre-data act, it’s a pretty short conversation.

[Evan Thomas MD/PhD @EvanThomas84]

@5_utr @jryckman3 @PDBrownOnc @DrRShaffer @Javadinia_AR @alzforum @AlzData @CTADconference @alzassociation @UsAgainstAlz @WorldDementia Also have been awaiting! Agree with @jryckman3 .

My (and now @rickysavjani’s) trial, LDRT-MIND, tests 3Gy/10fx with a 0.3Gy monthly maintenance dose, specifically to try and combat the post six month reversion they see here.

Very exciting times!

[John Asghar @JahangirAsgha10]

They don’t, though. Too many of these societies represent institutional leadership and call it physician advocacy.

Being employed doesn’t make your interests identical to those of the people running the organization. Physicians still need someone fighting for their compensation, autonomy, and ability to leave.

The assumption that gains for institutional leadership will somehow trickle down to individual physicians is insane. You can strengthen leadership’s control while leaving physicians with fewer options and less leverage.

[Jeff Ryckman @jryckman3]

Been very excited about this one!

Whole-brain LDRT for mild AD! Sham vs 0.24/6 vs 3/6.

6-mo ADAS-cog was the primary and it missed.

The 3 Gy arm tho... 🥰

📌 12-mo vs sham -5.36 (95% CI -10.58 to -0.14, nominal p=0.044)
📌 6-mo same direction, p=0.129
📌 On the figure, sham +7.11 and 3 Gy +1.75 at 12 mo

10 pts in that arm at 12 mo. No treatment-related AEs. Looking forward to a bigger trial with longer follow-up. My bias is 3 Gy is the schedule to test.

#radiotherapy #LDRT @Byoung_hkim @KoneruMd @ISTAART @DrMariaALZ @HeatherAlz

[CoffeeBlackMD @CoffeeBlackMD]

Be careful about being a medical director over a situation you are not in control of or have complete control of ALL medical and medically related issues including the documentation and risk management. Maybe especially the documentation.

[Shankar Siva @_ShankarSiva]

🚨📣 big news at #ESMO26: 🧵1/MASTERPLAN RCT shows adding SABR to perioperative chemotherapy for high-risk localized #pancreatic cancer ⬆️⬆️ median overall survival to 22.0 months vs 14.0 months (HR 0.45). #PancreaticCancer #RadOnc @TROGfightcancer in press @TheLancetOncol - https://t.co/KhPO4dgZd4

[Matt Spraker @SprakerMDPhD]

@DigiaimoRon @radoncodonk @CMSGov @ASTRO_org What does success look like to you?

[Matt Spraker @SprakerMDPhD]

Maybe my midlife crisis is realizing that I need to leave hospital medicine.

[Matt Spraker @SprakerMDPhD]

@amg3200 Haha Im okay, I promise.

You should visit the mountain west US sometime. There is a lot of adventure and QoL here.

[Matt Spraker @SprakerMDPhD]

This fall I gave a talk at @ASRT, great experience!

Others can learn from them, lookin at you @ASTRO_org.

10/10 would love to come back.

-Never bothered me for "advance" slides
-Strong IT support in ready room
-Formal audience feedback
-Offered speaker financial support

[Krishan Jethwa @KrishanJethwa]

🔥AGITG MASTERPLAN🔥

Borderline resectable or Locally advanced PDAC
n=75

🔍Randomized
3m mFOLFIRINOX or Gem+nab-Paclitaxel alone +/- SBRT (40 Gy/5 fx)

Primary endpoint: locoregional recurrence

🚨SBRT had improved:

✅12 m LRR: 20% vs. 50%
✅mOS 22m vs. 14 m

#ESMO26

[Matt Spraker @SprakerMDPhD]

@amg3200 Haha a genuine first.

Not sure I’ve ever heard someone say there’s nothing to do in the US.

[Matt Spraker @SprakerMDPhD]

@amg3200 Not ready and wouldn’t really work for my family and lifestyle.

I have a much more realistic exit path in the US if I wanted it bad enough.

I know someone who just did that though, little jealous. People should consider it.