Hannah R. Abrams
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hannahrabrams.bsky.social
Hannah R. Abrams
@hannahrabrams.bsky.social
2.3K followers 370 following 120 posts
Heme/Onc fellow hoping to reduce costs & improve patient/caregiver experiences in cancer care. Views are my own. 🏳️‍🌈 #MedSky
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Reposted by Hannah R. Abrams
donmoyn.bsky.social
New at Can We Still Govern? New Medicaid work requirements will see an estimated 5 million lose coverage.
Small investments in in-house tech capacity could allow states to start preparing now to expand automatic renewal of clients. Here is the evidence 🧵
donmoynihan.substack.com/p/how-a-van-...
Lessons from Pandemic Era Medicaid Automation for Work Requirements
Small tech capacity investments offer big returns
donmoynihan.substack.com
November 10, 2025 at 2:22 PM
hannahrabrams.bsky.social
🚲⚠️ Look out, CAR T, there's another transportation-named cancer treatment class in town! ⚠️🚲

First-in-human trial of bicycle-drug conjugates (BDCs) hit JCO this week. So what are they, and how are they different than antibody-drug conjugates (ADCs)?

#OncSky #MedSky
Diagram comparing antibody-drug conjugates (ADC) to bicycle-drug conjugates (BDC). On the left, the ADC is larger and labelled as ~150 kDa. On the right, the BDC is small and labelled as ~4 kDA. Both have a 'bomb' emoji representing the chemotherapeutic payload attached to them. The BDC has a lock to represent the cleavable linker.
November 10, 2025 at 12:06 AM
hannahrabrams.bsky.social
🚲⚠️ Look out, CAR T, there's another transportation-named cancer treatment class in town! ⚠️🚲

First-in-human trial of bicycle-drug conjugates (BDCs) hit JCO this week. So what are they, and how are they different than antibody-drug conjugates (ADCs)?

#OncSky #MedSky
Diagram comparing antibody-drug conjugates (ADC) to bicycle-drug conjugates (BDC). On the left, the ADC is larger and labelled as ~150 kDa. On the right, the BDC is small and labelled as ~4 kDA. Both have a 'bomb' emoji representing the chemotherapeutic payload attached to them. The BDC has a lock to represent the cleavable linker.
November 10, 2025 at 12:05 AM
hannahrabrams.bsky.social
Interesting article out this week from Dr. Bishal Gyawali, arguing that we should use more superiority designs for treatment de-escalation studies in cancer.

"The burden of proof in medicine lies on more treatment."

academic.oup.com/jnci/advance...
However, SONIA trial7 proves that there is a far more efficient way to answer these questions, by running a superiority rather than a non-inferiority trial. The burden of proof in medicine lies on more treatment. Primum non nocere dictates that the burden of proof should lie on doing something or doing more, rather than on doing nothing or doing less. In other words, if the standard of care is no treatment, use of a new drug should prove to be better than doing nothing; if the standard of care is to use one drug, combination treatment should prove to be better than the single drug.
November 7, 2025 at 10:31 PM
hannahrabrams.bsky.social
Among many great talks today at @fredhutch.org HICOR Value in Cancer Care Summit, one that' I'm still thinking about on is this one re: trust in oncology, from Dr. Tony Back. His points (1/5):
Man gesturing to slide that reads, "Trust is now relational capital -- not professional capital." Slide that reads: "3. Our task is no longer to transmit knowledge but to co-curate meaning in a noisy information environment." Slide that reads: "4. We can't out-compete misinformation. We have to out-relate it."
November 6, 2025 at 10:37 PM
Reposted by Hannah R. Abrams
johnmullahy.bsky.social
www.healthaffairs.org/doi/10.1377/...
November 4, 2025 at 2:06 PM
Reposted by Hannah R. Abrams
adrianna.bsky.social
Cool new study from @pamherd.bsky.social, @giannella.bsky.social, @jbarofsky.bsky.social, @lukef.bsky.social, & @donmoyn.bsky.social finds technical assistance & capacity improvements from USDS significantly improved Medicaid renewal outcomes during unwinding

www.healthaffairs.org/doi/10.1377/...
November 4, 2025 at 1:48 PM
hannahrabrams.bsky.social
Woah! @majorajay.bsky.social thinking through just about every hematology/oncology vascular access question possible (1422 scenarios, to be exact) to guide access choice. #medsky #oncsky #nursesky

Just a few examples below:
Flowchart for vascular access device selection in hematologic cancers requiring systemic therapy, divided into acute leukemias, indolent lymphomas, and MDS/MPN, with each disease group then divided into need for urgent systemic therapy before listing appropriate options. Table listing appropriateness of PIV, midline catheter, PICC, non-tunneled CVC, tunneled CVC, and port by type of systemic treatment (vesicant/irritant or not) and intensity/urgency Table listing recommended duration of port placement by thrombotic risk, access device type, and therapy type (vesicant/irritant/neither)
November 4, 2025 at 4:28 AM
hannahrabrams.bsky.social
Love to see an implementation win in @ascocancer.bsky.social/ #JCOOP ⬇️

In a mix of community/academic practices in NE, low overall inappropriate use of denosumab/zolendronic acid for mHSPC compared to prior national studies.

ascopubs.org/doi/10.1200/...
November 4, 2025 at 3:52 AM
hannahrabrams.bsky.social
Why do eligible patients choose not to enter a clinical trial?

New in JCO OP:
- >90% cite time/travel
- Many concerned about being taken advantage of, receiving a placebo
- Fear of unknown/side effects also major contributors

Anything you would add, #oncsky #cansky?

ascopubs.org/doi/10.1200/...
Fig 1. Reasons for declining clinical trial participation. Three major themes including fear, mistrust, and additional burdens emerged from qualitative interviews with 21 patients with breast cancer who were eligible for yet declined trial enrollment.
November 1, 2025 at 12:54 AM
hannahrabrams.bsky.social
With diffusion of #medsky #healthpolicy across platforms, at times miss hearing about work posted by people on other media.

Want to share this post & study from Justin Berk @brownmedicine.bsky.social on discrimination in post acute care re: incarceration:

www.nature.com/articles/s41...
Aging individuals approved for compassionate release often remain incarcerated simply because no facility will accept them. Our new manuscript here: https://lnkd.in/esm8PQk2 We completed a secret shopper study in Rhode Island, calling all nursing home about a patient unable to preform activities of daily living. Our script said our uncle had some vision issues, a couple falls, and difficulty with his insulin. "He's private pay - is there a bed?" When nursing homes then learned he was being released from prison on compassionate release, bed availability dropped by 50% and rejections jumped from 10% to 44%. For those with serious offenses, 70% were rejected—even when they posed minimal public safety risk. Compassionate release (medical/geriatric parole) will not be effective if community resources are unavailable to support aging individuals. People continue to remain incarcerated and die incarcerated due to few SNFs willing to take patients with CLS exposure, despite low risk.
October 30, 2025 at 3:23 AM
hannahrabrams.bsky.social
#FDA's first list of 9 drugs for Commissioner's National Priority Voucher (CNPV): "We're asking reviewers, are you seeing anything that's amazing? And if we do, we're calling them up."

9 Pilot meds will get 1-2mo FDA review instead of 10-12mo. Who are the first chosen?

My #HealthPolicy takeaways:
Pie chart demonstrating percentage of CNPV pilot drugs that serve different policy needs (left) and that are already EMA approved (right). 45% of the included drugs serve an unmet clinical need, whereas the remainder will support domestic manufacturing, new delivery systems, or improve on existing drug options. 56% of the drugs are already EMA approved in some capacity, and 22% are already part of the EMA's orphan medicine program. Only 22% do not have some EMA support or designation to date. Table describing the included drugs with the following headers: name (as included in FDA press release), need served, condition, manufacturer, level of evidence, EMA approval, and first in class status. Pergoveris for infertility Need Served: Delivery System Condition: IVF Manufacturer: EMD Serono Level of Evidence: Bioequivalent to approved components EMA Approved: Yes First in Class: No Teplizumab for Type I diabetes Unmet Clinical Need Preclinical T1DM Sanofi Phase 3 (Surrogate Endpoint) No Yes Cytisinicline for nicotine vaping addiction Improve Existing Options Tobacco Use Achieve Life Sciences Phase 3 Yes No DB-OTO for deafness Unmet Clinical Need Children with OTOF variants Regeneron Phase 1/2 No (OMP) Yes Cenegermin-bkbj for blindness Delivery System Neurotrophic Keratitis, NAION Dompé Approved in alternate delivery system Yes No (New Delivery System) RMC-6236 for pancreatic cancer Unmet Clinical Need Pancreatic Cancer (2L+, RAS-mut) Revolution Medicines Phase 1/1b (Ph3 Ongoing) No Yes Bitopertin for porphyria Unmet Clinical Need Erythropoietic protoporphyria Disc Medicine Phase 2 No (OMP) Yes Ketamine for domestic manufacturing of a critical drug for general anesthesia  Domestic manufacturing Anesthesia, MDD TBA Bioequivalent to approved components Yes No Augmentin XR for domestic manufacturing of a common antibiotic  Domestic manufacturing Bacterial Infections TBA Bioequivalent to approved components Yes No
October 29, 2025 at 2:49 AM
hannahrabrams.bsky.social
I've seen a lot of discussion about this NEJM article finding ~2% of people with dx of MS, IBD, or atopic dermatitis actually had a rare genetic condition.

1. Rare disease isn't (in aggregate) rare! Will never forget this early lesson from @cpsolvers.bsky.social.
Abstract text: We identified 153 U.K. Biobank participants who carried a rare variant that contributes to a molecular diagnosis of a monogenic disorder — 53 of 1850 (2.86%) with a diagnosis of multiple sclerosis, 75 of 6681 (1.12%) with a diagnosis of inflammatory bowel disease, and 25 of 998 (2.50%) with a diagnosis of atopic dermatitis. Figure showing distribution of Rare Disease Categories in the U.K. Biobank Cohort. High representation of hematologic/immune disorders among those diagnosed with IBD and rare neurologic or cerebrovascular disorders in those diagnosed with MS. Each rare disease was systematically categorized according to ontology terms from the Open Targets project (https://www.opentargets.org).
October 28, 2025 at 1:04 AM
Reposted by Hannah R. Abrams
jrgralow.bsky.social
Medicare Telehealth Flexibilities and CMS Operations During Government Shutdown
@ascocancer.bsky.social
www.asco.org/news-initiat...
October 1, 2025 at 8:52 PM
hannahrabrams.bsky.social
What if every comprehensive cancer center were required to show they have a comprehensive AYA pathway?

Here's a thoughtful and patient-led list from the EU. #AYACSM anything you might add from the US setting?

Via @winettevandergraaf.bsky.social
A checklist for minimum standards of AYA oncology care. Standards listed include: 1. Age-appropriate built environment (including environment, social spaces, connectivity, control and comfort) 2. Clinical care organization and patient pathways (AYA multidisciplinary teams, trained professionals, case management, clinical trials, genetic counseling, digital records access, second opinions, supportive care, sexual health, mental wellbeing, late effects surveillance/long term follow up care, reproductive health, nutrition, facilitated care pathways, exercise training and physical rehabilitation.) 3. Support services (education and career support, family and social support, housing support, transportation support, children support, insurance/finance/legal assistance)
October 1, 2025 at 11:23 PM
Reposted by Hannah R. Abrams
coffeemommy.bsky.social
The indomitable @fumikochino.bsky.social highlighting Financial Toxicity: From Data to Practice and Policy Change in Plenary Session 1.
Calling out practical solutions to a huge issue (like free patient parking, streamlined visits and appropriate telemedicine that limit time off from work) #MASCC25
June 26, 2025 at 8:34 PM
Reposted by Hannah R. Abrams
middeldorps.bsky.social
This is what we were waiting for. A direct comparison between apixaban and rivaroxaban for the treatment of acute VTE. Apixaban reduces bleeding risk in the first 3 months by >50%!

Practice changing investigator-initiated RCT.

#ISTH2025
June 22, 2025 at 1:49 PM
Reposted by Hannah R. Abrams
fredhutch.org
Dr. Elizabeth Loggers of Fred Hutch presents Phase II and interim phase III trial analyses of peri-transplant supportive and palliative care and/or comorbidity management for older, medically infirm and/or frail recipients of Allo-HCT. #ASCO25 www.asco.org/abstracts-pr...
June 2, 2025 at 4:33 PM
Reposted by Hannah R. Abrams
arrianna-planey.bsky.social
Made me think of @adrianna.bsky.social 2024 study in Health Affairs www.ncbi.nlm.nih.gov/pubmed/38190...
Small Marketplace Premiums Pose Financial And Administrative Burdens: Evidence From Massachusetts, 2016-17 - PubMed
Health insurance premiums are primarily understood to pose financial barriers to coverage. However, the need to remit monthly premium payments may also create administrative burdens that negatively af...
www.ncbi.nlm.nih.gov
June 2, 2025 at 9:42 PM
Reposted by Hannah R. Abrams
arrianna-planey.bsky.social
Finishing up some coding of interview transcripts, and I'm struck by a participant / cancer survivor who experienced a lapse in their health insurance coverage because their ACA marketplace plan no longer had a $0 premium, & in that time, incurred out-of-pocket costs for surgery.
June 2, 2025 at 9:42 PM
Reposted by Hannah R. Abrams
fredhutch.org
Dr. Natalie Miller presents results final results from the proof-of-concept investigator-initiated study of combination therapy with anti–PD-1, anti–LAG-3, and anti–TIM-3 in participants with advanced or metastatic PD-(L)1 refractory #MCC. #ASCO25 meetings.asco.org/abstracts-pr...
June 1, 2025 at 4:35 PM
Reposted by Hannah R. Abrams
fredhutch.org
#ctDNA after neoadjuvant therapy may serve as an independent prognostic marker for #breastcancer recurrence, per results from the TBCRC 040 PREDICT-DNA trial presented by Dr. Natasha Hunter of Fred Hutch. #ASCO25
June 1, 2025 at 10:16 PM
hannahrabrams.bsky.social
#ASCO25 Q&A stat:

20 years ago, time to first competitor (“me too drug”) in oncology was 4-5 years. Now, it’s under 9 months.

Huge pressure on companies to pick endpoints that will turn around quickly, another pressure making it harder to get industry sponsored studies with OS primary endpoints.
June 1, 2025 at 11:00 PM
Reposted by Hannah R. Abrams
thewonkologist.bsky.social
Presenting at #ASCO25 today!
I was expecting to find evidence that oncologists prefer more-lucrative treatments, and was surprised by our results! Clinical benefit matters, drug profit did not.
Cc @dusetzinas.bsky.social
May 31, 2025 at 9:25 PM
hannahrabrams.bsky.social
Excited to share our findings re: caregiver requirements for HCT and CAR T with the National Alliance for Caregiving in 2 hours!

To join us, listen here: us06web.zoom.us/webinar/regi... #OncSky #CanSky #Caregivers
Title card for event with white text "Breaking Down Barriers: Caregivers & the Challenges of CAR-T and BMT Requirements" over a picture of two people where one has their arm slung around the other.
May 28, 2025 at 2:54 PM