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drfranciscomd.bsky.social
@drfranciscomd.bsky.social
Practicing Hematologist & Oncologist + nerd = me. I break down cancer news and treatments, one Middle-earth metaphor at a time. Join me for facts, laughs, and Gandalf-level wisdom. Stanford ->MSKCC -> IU -> UA -> Kaiser SF -> Intermountain Alta View
Spent the last few weeks working on my latest essay. I have Spent years in healthcare. I’ve seen what happens when profit overshadows care. My new Medium post explains why we need robust public health solutions. Let’s fight for better outcomes—together!

#Medsky #Oncology #HealthPolicy
Who’s Really Healing Us? The Dangers of Dismantling Government-Led Healthcare
I’ve spent my career in healthcare, and lately it feels like I’m watching a slow-motion demolition of the very structures that have…
medium.com
February 18, 2025 at 1:11 AM
The NCCN now recognizes ctDNA as a high-risk factor for recurrence in colon/rectal cancer and as a tool in Merkel cell carcinoma. While promising, routine use outside trials isn’t recommended yet. ctDNA’s role in personalized care is evolving! 🧬✨ #ColonCancer #Oncology #Medsky #Research
NCCN Updates ctDNA Stance in Colon, Rectal, and MCC Guidelines
The NCCN guidelines have been updated to specify the standing of ctDNA as a biomarker in colon and rectal cancer, as well as in MCC.
www.onclive.com
February 12, 2025 at 6:01 PM
Reposted
SEASONAL INFLUENZA SURGING.
Please take care

The 2024–2025 flu season — which has sickened an estimated 24 million Americans so far — is in full swing. However, there’s more to come before the season peaks

www.today.com/health/cold-...
Where is flu surging in the US? Some hospitals are overwhelmed in states with high rates
Flu has surged to high levels across the US, straining hospitals. Experts discuss 2024-25 flu season trends, symptoms to watch for, and how to stay safe.
www.today.com
February 8, 2025 at 6:02 AM
Personalized cancer vaccines are making waves! A new study shows a novel vaccine may be effective in stage III/IV clear cell RCC, offering hope for tailored treatment. Could this be the future of RCC care? Would anti vaxxers even accept this or still prefer Ivermectin?🧬✨ #Cancer #Oncology #Medsky
Novel Personalized Cancer Vaccine May Be Effective in Patients With Stage III and IV Clear Cell Renal Cell Carcinoma
Researchers have examined whether a novel personalized cancer vaccine can improve outcomes in patients with stage III or IV clear cell renal cell carcinoma.
ascopost.com
February 8, 2025 at 6:55 PM
A new study suggests tracking tumor-infiltrating lymphocytes (TILs) during radiation therapy may offer insights into prognosis and guide personalized treatment in breast cancer. Monitoring immune responses could refine therapy strategies for better outcomes. 🧬✨ #BreastCancer #CancerResearch
Longitudinal Assessment of Tumor-Infiltrating Lymphocytes in Primary Breast Cancer Following Neoadjuvant Radiation Therapy
Tumor-infiltrating lymphocytes (TILs) have prognostic significance in several cancers, including breast cancer. Despite interest in combining radiation therapy with immunotherapy, little is known abou...
www.redjournal.org
February 5, 2025 at 4:30 PM
Reposted
With science falling under increasing attack, this medical historian is here to remind people of the power of #vaccines. THREAD🧵

Hard-hitting polio advert from 1958. In the first half of the 20th century, polio was the leading cause of death in children and young adults. 1/7
February 1, 2025 at 3:29 PM
The FDA has granted accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu) for adults with unresectable or metastatic HER2-positive solid tumors who have received prior treatments . This approval offers new hope for patients with limited options. I love this drug! #BreastCancer #Oncology
FDA grants accelerated approval to fam-trastuzumab deruxtecan-nxki for
On April 5, 2024, the Food and Drug Administration granted accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu, Daiichi Sankyo, Inc.) for adult patients with unresectable or metastatic HE...
www.fda.gov
January 28, 2025 at 11:19 PM
Reposted
I was set to enter a clinical trial in February.
It's since been canceled.
You are spot on with "cancer itself will not agree to such a delay."
#Cansky
"...if NCI-supported trials really are delayed or suspended for a meaningful amount of time, that means delayed discoveries, delayed drug approvals, delayed potential treatments for people whose cancer will not itself agree to such a delay."

I talk to multiple people inside NCI and NIH:
Trump's Assault on NIH Will Kill People With Cancer
Splinter is your home for news and opinions that challenge power in our political and economic system that's becoming more unhinged each and every day.
www.splinter.com
January 26, 2025 at 10:34 PM
This week’s essay is inspired by the incredible support staff who make cancer care possible—and the tough reality of working without them. It takes a team to guide patients through their journey. Let’s not forget the value of every member of our healthcare Fellowship🧬✨ #Cancer #Oncology #Healthcare
It Takes a Fellowship: Why Support Staff Are the Unsung Heroes of Cancer Care
In my years of practice as an oncologist, I’ve come to realize that cancer care is not just about treating a disease — it’s about guiding people through one of the most challenging journeys of their…
medium.com
January 27, 2025 at 1:07 AM
This came out decades ago but remains a true and simple depiction of grief.
January 25, 2025 at 4:23 PM
Aspirin after completion of standard adjuvant therapy for colorectal cancer (ASCOLT): a phase 3 international trial.’ This study found that aspirin 200 mg daily for 3 years was well tolerated but did not significantly improve disease-free survival 🧬✨ #Oncology #Cancer
January 24, 2025 at 4:03 PM
Non-medical post: Onyx Storm dropped today, and my wife is already several chapters in. Every so often, I hear her say, ‘Just one more chapter,’ but we all know that’s book lover code for ‘leave snacks and back away slowly.’ It’s an art form, really. 📚😅 #OnyxStorm
January 20, 2025 at 7:22 PM
My weekly essay is up, inspired by the countless moments this week spent calming anxious patients after early test results. Should oncologic results wait until the doctor’s appointment? Is instant access helping or hurting? Share your thoughts. 🧬✨ #Oncology #Hematology #Medsky
Stop the Spiral: How Early Test Results Are Hurting Cancer Patients
As an oncologist, I’ve seen it happen more times than I can count. A patient gets their imaging results or tumor marker levels through their online portal days before we’re scheduled to meet. By the…
medium.com
January 19, 2025 at 4:37 PM
The FDA has approved sotorasib with panitumumab for KRAS G12C-mutated colorectal cancer. This combo therapy tackles a previously ‘undruggable’ mutation, offering new hope for advanced cases. A major milestone in precision oncology! 🧬✨ #CancerResearch #OncologyNews
FDA Approves Sotorasib With Panitumumab for <em>KRAS</em> G12C–Mutated Colorectal Cancer
On January 16, the FDA approved a KRAS G12C inhibitor in combination with a monoclonal antibody for adult patients with KRAS G12C–mutated metastatic colorectal cancer, as determined by an FDA-approved...
ascopost.com
January 18, 2025 at 10:07 PM
Phase II TROPION-Lung04 study indicate that datopotamab deruxtecan shows promising efficacy and a manageable safety profile in patients with advanced or metastatic non–small-cell lung cancer (NSCLC) who have been previously treated. ADCs are coming! #LungCancer #Oncology
Datopotamab Deruxtecan in Advanced or Metastatic Non–Small Cell Lung Cancer With Actionable Genomic Alterations: Results From the Phase II TROPION-Lung05 Study
PURPOSEDatopotamab deruxtecan (Dato-DXd) is a trophoblast cell-surface antigen-2–directed antibody-drug conjugate with a highly potent topoisomerase I inhibitor payload. The TROPION-Lung05 phase II tr...
ascopubs.org
January 14, 2025 at 5:14 AM
My weekend essay inspired by a tough week of working with insurance. Two denials and one delayed treatment start. What is your experience with prior auths?
Time Is Life: Why Oncology Patients Can’t Afford Prior Authorizations
Prior authorizations (PAs) have evolved from a cost-containment strategy into one of the most significant barriers in oncology care today. By delaying access to life-saving treatments, these…
medium.com
January 11, 2025 at 8:36 PM
Always good reminder that’s where there is a will there is a way.
*It also blows my mind that research funding for pediatric cancer is on chopping block with this new Congress. This is money well spent
Survival rates for acute lymphoblastic leukemia (ALL) in children were ∼10% in the 1960s & have risen to >90% as of the 2010s according to below. Thread below includes NEJM article: #biosky #oncsky
Childhood cancer death rates in the United States have declined six-fold over the last seventy years. 🧵
January 9, 2025 at 7:33 PM
This study suggests that a negative PSMA PET scan can help avoid unnecessary pelvic lymph node dissection in intermediate-risk prostate cancer patients, potentially reducing treatment complications without compromising outcomes. #ProstateCancer #MedicalImaging
Negative PSMA PET can be used to avoid unnecessary pelvic lymph node dissection in intermediate risk prostate cancer - Prostate Cancer and Prostatic Diseases
Prostate Cancer and Prostatic Diseases - Negative PSMA PET can be used to avoid unnecessary pelvic lymph node dissection in intermediate risk prostate cancer
www.nature.com
January 8, 2025 at 3:32 PM
Insurance denials and prior auths feel like trying to cross the Dead Marshes—every step forward is met with unseen obstacles dragging you down. Patients deserve a clear path to care, not to be lost in the bureaucracy. #Oncology #HealthcareFrustrations
January 7, 2025 at 1:52 AM
Reposted
It used to be the case that transplants were never done in cases of cancer (and for tragically practical reasons), so that it is now occasionally possible is a major step forwards:

www.bbc.co.uk/news/article...
UK's first liver transplant for bowel cancer deemed a success
Bianca Perea, a 32-year-old trainee lawyer, is now
www.bbc.co.uk
January 6, 2025 at 3:57 PM
My first article. What is your opinion?
In Defense of Doctors: Fighting the Epidemic of Mistrust
How Media, Misinformation, and a Broken System Are Undermining the Doctors Who Save Lives
medium.com
January 4, 2025 at 4:34 PM
At #1 in our countdown: ‘Efficacy and Safety of Trastuzumab Deruxtecan in HER2-Expressing Solid Tumors: Results From DESTINY-PanTumor02.’ This landmark trial expands the role of HER2-targeted therapy across multiple cancer types, marking a new frontier in precision medicine. 🧬✨ #OncologyPapers2024
Efficacy and Safety of Trastuzumab Deruxtecan in Patients With HER2-Expressing Solid Tumors: Primary Results From the DESTINY-PanTumor02 Phase II Trial
PURPOSETrastuzumab deruxtecan (T-DXd) is a human epidermal growth factor 2 (HER2)–directed antibody-drug conjugate approved in HER2-expressing breast and gastric cancers and HER2-mutant non–small-cell...
ascopubs.org
January 2, 2025 at 3:36 AM
At #2 in our countdown: ‘Long-Term Results of Organ Preservation in Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy: The OPRA Trial.’ This study highlights a step forward in organ preservation, showing promising long-term outcomes with reduced treatment intensity. 🧬✨ #OncologyPapers2024
Long-Term Results of Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy: The Randomized Phase II OPRA Trial
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or sec...
ascopubs.org
January 1, 2025 at 12:15 AM
At #3 in our countdown: ‘Lorlatinib vs. Crizotinib in Advanced ALK-Positive NSCLC: 5-Year Outcomes From the CROWN Study.’ This study confirms lorlatinib’s superior efficacy, improving long-term survival and quality of life for patients with advanced ALK-positive NSCLC. 🧬✨ #OncologyPapers2024
Lorlatinib Versus Crizotinib in Patients With Advanced <i>ALK</i>-Positive Non–Small Cell Lung Cancer: 5-Year Outcomes From the Phase III CROWN Study
PURPOSELorlatinib improved progression-free survival (PFS) and intracranial activity versus crizotinib in patients with previously untreated, advanced, ALK-positive non–small cell lung cancer (NSCLC) ...
ascopubs.org
December 30, 2024 at 5:57 AM
At #4 in our countdown: ‘Darolutamide in Combination With Androgen-Deprivation Therapy in Patients With Metastatic Hormone-Sensitive Prostate Cancer.’ Results from the Phase III ARANOTE trial show significant efficacy, setting a new standard for combination therapy. 🧬✨ #CancerResearch2024
ASCO Publications
ascopubs.org
December 26, 2024 at 11:22 PM