Hannah R. Abrams
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hannahrabrams.bsky.social
Hannah R. Abrams
@hannahrabrams.bsky.social
2.3K followers 380 following 180 posts
Heme/Onc fellow at Fred Hutch, hoping to reduce costs & improve patient/caregiver experiences in cancer care. Social Media Editor @ JCO OP. Views are my own. #MedSky
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hannahrabrams.bsky.social
🌅 Several studies have suggested checkpoint inhibitors dosed AM may be assoc w/ improved outcomes- but strong risk of confounding.

Out now in #JCOOP: review of literature & discussion of how practices could actually implement this. Suspect will be very dependent on local AM traffic!
Fig 2. Constraints related to the patient, the pharmacy, and the outpatient infusion centers to be taken into account when concentrating outpatient ICI administrations in a stipulated time window in the morning. ICI, immune checkpoint inhibitor. Pharmacy constraints: physiochemical stability, risk of waste. Patient: distance home-hospital, diurnal preference. Day unit: priority rankings, long multi drug regimens. Proposed Action We propose the following approaches to make early ToDA of ICI feasible in daily routine practice: • ASSESS: establish a nurse-led telephone assessment on the eve of ICI administration with full blood work-up available to confirm clinical and biologic permissiveness to ICI treatment; • AVOID (as far as possible and according to the habits of each center): do not schedule medical consultation and ICI treatment on the same day to reduce risks of delays in treatment administration (prefer teleconsultations the day before treatment for patients living far from the center); • ALWAYS administer ICI first when in combination with IV chemotherapy or other agents, unless reverse sequencing is recommended; • ALLOCATE: prioritize two or three ICI mornings per week and save the remaining two or three mornings for long-term combination treatments not including ICIs; • ANTICIPATE: whenever possible, cytotoxic reconstruction units could prepare ICIs in the evening of the eve so that they are ready to be administered early on the following morning.
December 21, 2025 at 5:39 PM
hannahrabrams.bsky.social
Potential for cure in metastatic gastric cancer with actionable biomarkers?

- 51 pts/1710 treated over 9 years in Japan
- "Potential cure" = PFS >3 years, NED, >1 year since last tx w/o progression (consolidative surgery allowed)
- dMMR 23%, CPS ≥10 30%, HER2+ 24%

ascopubs.org/doi/10.1200/...
December 20, 2025 at 8:17 PM
hannahrabrams.bsky.social
What are outcomes w/ histotripsy for liver tumors/mets in real world since FDA approval in 12/2023? Out now in #JCOOP: at 3 mo, ~95% local control, 7% distant POD.

Need longer term data, not enough to distinguish b/w local control options, but helpful to have a start.
ascopubs.org/doi/10.1200/...
Fig 1. (A and B) Thirty- and 90-day outcomes of intended complete treatment with histotripsy by histologic tumor treated and (C) time-to-event analysis for primary versus secondary malignancy. CCA, cholangiocarcinoma; CRLM, common cancer, with liver metastasis; HCC, hepatocellular carcinoma; HNSC, head and neck squamous cell; NET, neuroendocrine tumor; PDAC, pancreatic ductal adenocarcinoma.
December 20, 2025 at 4:49 PM
hannahrabrams.bsky.social
Really important perspective from Ramy Sedhom on FOLFIRINOX in #panCAN patients >70 years old ("OA"). Even in selected patients who receive this intensive regimen, even w/ preemptive dose reductions, 56% G3 AE or unplanned hospitalization.

ascopubs.org/doi/10.1200/... #JCOOP #GIOnc
At first glance, Collineau's findings seem to be predictable: FOLFIRINOX is toxic, and OAs are vulnerable. But the deeper issue is whether we are asking the right question. By focusing narrowly on which OA can endure FOLFIRINOX, we risk missing the more relevant point: what is the most tolerable approach to the care of OAs with PDAC, and who truly benefits? The Edison analogy is instructive here. His lasting legacy was not the brightest bulb, but the system that made light usable, safe, and enduring. In PDAC, the lesson is similar: the discovery of an intense regimen is useless unless it is embedded in a system that makes treatment tolerable and meaningful for patients. For OAs, that grid is built through geriatric assessment (GA), supportive interventions (nutrition, prehabilitation, psychosocial support), and integration of palliative care. From “Who Can Tolerate” to “Who Will Benefit” It is time for all of us to reimagine PDAC care in OA. The central question is no longer “who can tolerate FOLFIRINOX,” but “who will truly benefit?” Answering that requires 1. Routine GA to uncover vulnerabilities 2. Supportive interventions (comorbidity management, exercise, psychosocial support, nutritional support, and palliative integration) to enhance resilience 3. Trial designs that embed tolerability and quality of life as end points that complement response and survival 4. Exploration of objective aging biomarkers (inflammation, senescence, aging clocks, sarcopenia) for future stratification
December 18, 2025 at 4:23 AM
hannahrabrams.bsky.social
⏱️ Oncologists: save patients time & reduce infusion center overload - pembro in 10 minutes instead of 30. ⏱️

Safety data now out in #JCOOP, IRR low (4%) & similar to 30 min infusion. @oncoalert.bsky.social

ascopubs.org/doi/10.1200/...
Safety, Feasibility, and Patient Experience of Ten-Minute Pembrolizumab Infusions: A Prospective Cohort Study | JCO Oncology Practice
PURPOSERising cancer incidence and staff shortages demand more efficient outpatient oncology workflows. Pembrolizumab is conventionally administered over 30 minutes. This prospective study assessed…
ascopubs.org
December 17, 2025 at 10:49 PM
Reposted by Hannah R. Abrams
sabinekaram.bsky.social
The debate about kidney function estimation in cancer patients is not over. What is important to remember is that mCrCl is not mGFR
hannahrabrams.bsky.social Hannah R. Abrams @hannahrabrams.bsky.social · 11d
Significant overestimation of renal function by eGFR compared to measured CrCl in people with nonmetastatic RCC (including Cys C-adjusted).

Wide implications re: cystectomy cutoffs. #UroSky #NephSky is this part of your practice for people near cutoff?

ascopubs.org/doi/10.1200/... #MedSky #JCOOP
At a measured GFR of 45, corresponding eGFR values ranged from 53 to 59 mL/min/1.73 m2 Estimated Glomerular Filtration Rate Equations Overestimate Renal Function Compared With Measured Glomerular Filtration Rate Using 24-Hour Urine Creatinine Clearance Full abstract beyond alt text limits but is available publicly at https://ascopubs.org/doi/10.1200/OP-25-00895 Highlighting Methods and Results: Methods In this prospective study, 72 patients with nonmetastatic RCC undergoing preoperative evaluation completed serum creatinine, cystatin C, and 24-hour urine collections. eGFR values were calculated using multiple established equations, both race-inclusive and race-neutral. The agreement between eGFR and measured GFR was assessed using Passing-Bablok regression. Linear regression estimated the discrepancy between eGFR and measured GFR at clinically relevant cutoffs of 45 and 60 mL/min/1.73 m2. Results Across all equations, eGFR consistently overestimated renal function compared with measured GFR. At a measured GFR of 45, corresponding eGFR values ranged from 53 to 59 mL/m
December 17, 2025 at 12:21 PM
hannahrabrams.bsky.social
Significant overestimation of renal function by eGFR compared to measured CrCl in people with nonmetastatic RCC (including Cys C-adjusted).

Wide implications re: cystectomy cutoffs. #UroSky #NephSky is this part of your practice for people near cutoff?

ascopubs.org/doi/10.1200/... #MedSky #JCOOP
At a measured GFR of 45, corresponding eGFR values ranged from 53 to 59 mL/min/1.73 m2 Estimated Glomerular Filtration Rate Equations Overestimate Renal Function Compared With Measured Glomerular Filtration Rate Using 24-Hour Urine Creatinine Clearance Full abstract beyond alt text limits but is available publicly at https://ascopubs.org/doi/10.1200/OP-25-00895 Highlighting Methods and Results: Methods In this prospective study, 72 patients with nonmetastatic RCC undergoing preoperative evaluation completed serum creatinine, cystatin C, and 24-hour urine collections. eGFR values were calculated using multiple established equations, both race-inclusive and race-neutral. The agreement between eGFR and measured GFR was assessed using Passing-Bablok regression. Linear regression estimated the discrepancy between eGFR and measured GFR at clinically relevant cutoffs of 45 and 60 mL/min/1.73 m2. Results Across all equations, eGFR consistently overestimated renal function compared with measured GFR. At a measured GFR of 45, corresponding eGFR values ranged from 53 to 59 mL/m
December 17, 2025 at 3:49 AM
Reposted by Hannah R. Abrams
emilymoin.com
Observational research, broadly speaking, seeks to expand our knowledge of the the data-generating processes underlying reality.

Research using synthetic data expands our knowledge of the process that generated the synthetic dataset.

They are explicitly, trivially, and facially not the same thing.
sabrinanorwood.bsky.social Sabrina Norwood @sabrinanorwood.bsky.social · 11d
Did you know that from tomorrow, Qualtrics is offering synthetic panels (AI-generated participants)?

Follow me down a rabbit hole I'm calling "doing science is tough and I'm so busy, can't we just make up participants?"
Text reads: About synthetic panels Recruiting the right participants for a study can be difficult. You may not get the exact demographics you need, and the shorter the deadline, the less sure you can be that everyone will answer on time. One possible solution can be to use synthetic panels. Synthetic panels are powered by a first party proprietary AI model developed here at Qualtrics. Our synthetic panel is trained on thousands of responses from a variety of demographic backgrounds in order to more accurately predict how certain populations would respond to a survey. Our synthetic panel is based on the United States General Population, and is only available in English. This panel comes with ready-made quotas and target breakouts in order to represent your chosen population and make it easy to launch your survey right away. Text reads: Question-writing best practices To get the most reliable and actionable results from synthetic audiences, consider these question-writing best practices: Ask forward-looking and attitudinal questions. Synthetic panels perform best with perceptions, preferences, and intent-based questions. For example, “How likely are you to try…?” Synthetic panels are less applicable for studies on past behaviors, detailed recall, brand recall, or awareness questions. For example, “When did you last visit…?” Text reads: Discussion The current study aimed to conduct a meta-analysis of the TPB when applied to health behaviours which addressed the limitations of previous reviews by including only prospective tests of behaviour, applying RE meta-analytic procedures, correcting correlations for sampling and measurement error, and hierarchically analysing the effect of behaviour type and sample and methodological moderators. Some 237 tests were identified which examined relations amongst model components. Overall the analysis indicated that the TPB could explain 19.3% of the variance in behaviour and 44.3% of the variance in intention across studies. This level of prediction of behaviour is slightly lower than that of previous meta-analytic reviews which have found between 27% (Armitage & Conner, 2001; Hagger et al., 2002) and 36% (Trafimow et al., 2002) of the variance in behaviour to be explained by intention and PBC.
December 16, 2025 at 6:30 PM
hannahrabrams.bsky.social
Adding to this - #Roon for doctors is launching in oncology today! Here's an example of how the format looks discussing #SABCS25. Join at www.roon.com.
December 16, 2025 at 6:29 PM
hannahrabrams.bsky.social
What financial advice do those who've survived AYA cancers give to people going through it now? In #JCOOP this week (among other insights), led by Tim Ohlsen @seattlechildrens.org

Notably, they highlight how much fear of future cost increases hangs over survivors.

ascopubs.org/doi/full/10....
Table of employment and financial support recommendations from survivors by time period. Across the care continuum: Consider jobs that cover financial and insurance needs Set up a health savings account, contribute a small amount from each paycheck to help pay medical bills Ask for help from the care team, especially hospital social worker and use hospital billing department regarding cancer-related finances and resources Seek college scholarships During active therapy Explore short-term disability or other benefits offered by employer Consider ways to cut nonmedical expenses Seek financial assistance grants Set up a payment plan Learn/connect with other YAs on how they handled finances and cancer Early in survivorship Maintain employment with stable health insurance coverage Build financial literacy Seek vocational counseling to mitigate cancer-related job impacts Save money to account for rising cost of living and possible future medical costs Saving, or “stockpiling” money (diagnosed 0-17 years; 21 years since diagnosis) was important to some interview participants on the basis of their cancer history, to cover future medical expenses, including the possibility of recurrence.
December 16, 2025 at 2:04 AM
Reposted by Hannah R. Abrams
tmprowell.bsky.social
#OncSky #regulatory #bcsm

📣 #FDA has approved trastuzumab deruxtecan + pertuzumab for 1st-line tx of adults w/ HER2+ unresectable or #MetastaticBreastCancer based on DB-09 trial:

🏆44% ⬇️ in risk of progression/death vs THP (mPFS: 40.7 vs 26.9 mos).

⚠️ ILD ~12%

Google drugs@FDA for current label
December 15, 2025 at 5:41 PM
Reposted by Hannah R. Abrams
thewonkologist.bsky.social
lol this month’s issue of JCO appears to have been resected with positive margins
December 12, 2025 at 2:36 AM
Reposted by Hannah R. Abrams
dusetzinas.bsky.social
Summarizing the current state of pricing and coverage for GLP1s in the US with @rachelsachs.bsky.social in @nejm.org this week!

Read it before things change (again)!
www.nejm.org/doi/full/10....
Insurance Coverage and Pricing of Weight-Loss Drugs in the United States | NEJM
The Trump administration’s agreements regarding glucagon-like peptide 1 receptor agonists could reduce prices and improve access for some patients — and lead to substantial additional spending.
www.nejm.org
December 10, 2025 at 11:35 PM
Reposted by Hannah R. Abrams
unicorncancer159.bsky.social
Recently encountered this. Medicare pays for hospice OR nursing home room & board, but not both. My husband isn't in pain but he does have terminal cancer. Not putting him on hospice just yet saves $11k a month.

There are other ways to get narcotics when that time comes.
December 9, 2025 at 1:22 AM
hannahrabrams.bsky.social
Medicaid spend-downs are one of the parts of US medicine that are so absurd & cruel they are hard to explain to people outside the field.

I have even struggled to convince people this is real because there's so little published on it - despite that it's a major mechanism of catastrophic $ tox @ EOL
gabyaboulafia.bsky.social Gaby Aboulafia @gabyaboulafia.bsky.social · 19d
Medicaid “spend down” — how we force individuals to impoverish themselves to qualify for Medicaid coverage of long-term care — is one of the most messed up things I’ve learned about the US health care system

In a new paper, we look at how often spend-down happens in nursing homes specifically
Asset Spend-Down and Medicaid Enrollment in Nursing Homes
This cohort study examines the rate of Medicaid spend-down among nursing home residents enrolled in traditional Medicare and assesses what factors are associated with Medicaid spend-down among these r...
tinyurl.com
December 9, 2025 at 1:12 AM
hannahrabrams.bsky.social
I don't know if this was intended to be a simultaneous publication with #SABCS25 but sure seems like one.

With more and more #metavivors & patients with oligometastatic disease tx with "curative hope", how do we study & support these groups? #oncsky #cansky

ascopubs.org/doi/10.1200/...
Fig 1. Phases of cancer survivorship, graphic created by the National Cancer Institute. The central ovals represent the anatomic extent of disease (ie, stage of a cancer). The ovals are encircled by a loop that denotes the corresponding goals of care. The bidirectional arrows within the loop illustrate the dynamic nature of goals of care. Over time because of changes in their cancer status, survivors may transition between different phases of survivorship, with corresponding shifts in their goals of care. Notably, the central section in the figure represents the population of interest: survivors with advanced and metastatic cancer for whom the goal of care is to prolong life.
December 8, 2025 at 10:39 PM
Reposted by Hannah R. Abrams
majorajay.bsky.social
Our budding PRO researcher Dr. Hofmeister @cuinternalmed.bsky.social in the @cuhematology.bsky.social Major Lab presented her work on quality of life in CTCL at the @ash.hematology.org #ASH25 Annual Meeting.
Thread below with our study findings. 🧵 #lymsm
December 8, 2025 at 9:58 PM
Reposted by Hannah R. Abrams
adrianna.bsky.social
Major new update to the Medicaid "spend-down" literature, led by @gabyaboulafia.bsky.social, just dropped — thread here:
gabyaboulafia.bsky.social Gaby Aboulafia @gabyaboulafia.bsky.social · 19d
One of the most striking findings to me is how dramatically spend-down varies across demographic characteristics. Individuals from racially marginalized groups are much more likely to deplete their assets and transition to Medicaid, likely reflecting pre-existing disparities in wealth
December 8, 2025 at 2:36 PM
Reposted by Hannah R. Abrams
arrianna-planey.bsky.social
Patient billed $8 for a health-related social needs (HRSN) questionnaire he completed prior to his medical appointment
Surprise! Your health care provider added a fee for that questionnaire you filled out
Some doctors now bill patients for surveys that screen for problems. Patients say they should not be charged for checking a few boxes.
www.northcarolinahealthnews.org
December 8, 2025 at 3:15 PM
Reposted by Hannah R. Abrams
survivorshipit.medsky.social
"Measurement of #healthcare administrative costs focus on clinicians and health care organizations and likely understate total costs given the in-kind work performed by #patients."

academic.oup.com/healthaffair...

#MedSky #PatientExperience #AdministrativeBurden #HealthPlicy
Patient administrative burden: a scoping review
Nonclinical patient work and access are wide-ranging concepts. Although people are casually familiar with patient administrative burden based on their own
academic.oup.com
December 7, 2025 at 3:01 AM
hannahrabrams.bsky.social
Hospital medicine #medsky: new data re safety (and benefit!) of IV iron in people with bacterial infections:
shematologist.medsky.social Shematologist, MD @shematologist.medsky.social · 21d
Practice changing plenary #ASH25‼️

Iron is hypothesized to feed infxn & IV iron often avoided in that setting.

>85k people hospitalized w/5 most common bacterial infxns, compared those who recvd IV iron to those who did not.

🩸greater hemoglobin increase
🩸lower mortality at 14 & 90 days
December 6, 2025 at 6:52 PM
Reposted by Hannah R. Abrams
shematologist.medsky.social
Practice changing plenary #ASH25‼️

Iron is hypothesized to feed infxn & IV iron often avoided in that setting.

>85k people hospitalized w/5 most common bacterial infxns, compared those who recvd IV iron to those who did not.

🩸greater hemoglobin increase
🩸lower mortality at 14 & 90 days
December 6, 2025 at 6:46 PM
hannahrabrams.bsky.social
In time for #ASH25, glad to be able to share this work in #TCT.

🔑 1. For many pts, barrier to HCT/CAR T isn't medical, but instead logistical issues like needing a caregiver or local housing.
🔑 2. These reqs aren't well tracked & vary widely between centers

www.sciencedirect.com/science/arti...
www.sciencedirect.com
December 6, 2025 at 12:48 AM
hannahrabrams.bsky.social
I appreciate Costco Magazine for raising awareness about #MaleBreastCancer. And also for identifying all interviewed medical professionals by their Costco membership status.

@Costco, if you need me, I am a gold star member.
Magazine paragraph with highlighted passage: Men's risk rises with "a strong family history of breast cancer," says Dr. Christine Brezden-Masley, senior practicing medical oncologist at Sinai Health System in Toronto and a Costco member. "If your mother, her mother and your sister has or had breast cancer, you may have a genetic predisposition toward it."
December 5, 2025 at 11:51 PM