Tumor Board Tuesday
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tumorboardtuesday.bsky.social
Tumor Board Tuesday
@tumorboardtuesday.bsky.social
Online Tumor Board with a molecular angle ~ Join us every Tuesday 8pm ET for discussions, polls, & mini tweetorials
Created by @mpishvaian.bsky.social • @MPishvaian • FREE CME
✅This #TumorBoardTuesday🗣️with @KennaKoehler & @drgattimays.bsky.social‬ is provided by @IntegrityCE

👍Supported by ed grants from Exelixis, Ferring, Ipsen, Lilly, Janssen Scientific Affairs, Merck & Taiho Oncology 🙏

👉🏽Info about 🆓 CME: integrityce.com/tbt2025
October 21, 2025 at 12:39 PM
#TumorBoardTuesday

🧠And while we finalize the case details, collect FREE #CME

👉🏽https://integrityce.com/tbt2025
October 21, 2025 at 12:39 PM
#TumorBoardTuesday

📢Join us Tuesday, 10-21-25 at 8PM ET as @drgattimays.bsky.social &
@KennaKoehler 🗣️ Tx options after CDK4/6⛔️: What to consider in the 2nd line for HR+/HER2– mBC❓

RT and bring others into the discussion‼️
October 21, 2025 at 12:39 PM
#TumorBoardTuesday

🧠And while we finalize the case details, collect FREE #CME

👉🏽integrityce.com/TBT2024
February 3, 2025 at 8:28 PM
#TumorBoardTuesday
🤔Can Claudin 18.2 be used for treatment💊outside of upper GI cancers❓

📢Join us Tuesday, 02-04-25 at 8PM ET as @ndevitomd.bsky.social & @katherinezhoumd.bsky.social from @dukemedschool.bsky.social 🗣️Claudin 18.2 as a🎯in #pancreaticcancer

RT and bring others into the discussion‼️
February 3, 2025 at 8:28 PM
✅This #TumorBoardTuesday🗣️with @dr-rshatsky.bsky.social & @zoezhang.bsky.social is provided by @IntegrityCE

👍Supported by ed grants from Astellas, AstraZeneca, Janssen, Lilly, Novartis, Seagen and Taiho Oncology🙏

Info about 🆓 CME: integrityce.com/TBT2024
January 14, 2025 at 1:19 PM
#TumorBoardTuesday
We have not heard any updates from #SABCS24 yet!

📢So join us Tuesday, 01-14-25 at 8PM ET here & on Twitter as ‪@dr-rshatsky.bsky.social‬ & @zoezhang.bsky.social🗣️SERDS & novel Tx for HR+ #breastcancer

RT and bring others into the discussion‼️
January 13, 2025 at 7:20 PM
29/29 #TumorBoardTuesday

👨‍⚕️Summary👩‍⚕️

🧑‍🔬Periop mangement increasingly complex👩‍🔬
⭐️Patient selection is key🔑
⭐️Biomarker testing necessary for early stage dz🎯
⭐️Multi-D teamwork for best decision making👫👬

👀See our suggested algorithm + consensus guidelines..
December 11, 2024 at 2:02 AM
28/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 18👨‍🏫

📣KN671 exploratory analyses of..

⭐️Residual tumor volume (RTV)⭐️
👉Med RTV 29.% in tx arm vs 52% in placebo
👉⏫RTV a/w worse EFS
👉Tx ⏫ EFS in all RTV subgroups (except RTV >60%)

🤔Can we use RTV to identify high-risk pts?
December 11, 2024 at 2:02 AM
27/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 17👨‍🏫

🫸But wait...

🙋‍♂️🙋‍♀️KN671 showed EFS ⏫for pCR + non-pCR pts
⭐️pCR 👉EFS HR 0.33
⭐️non-pCR 👉 EFS HR 0.69

🙄Is there a better measure of path response?
December 11, 2024 at 1:54 AM
26/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 16👨‍🏫

🤔💭Q: What is benefit of postop IO after preop IO?

⚠️Warning⚠️
😬Cross-trial comparison coming up..

👀Exploratory analysis of CM816 and CM77T...

⭐️Periop nivo vs prop nivo improved EFS for non-pCR

@FordePatrick
December 11, 2024 at 1:54 AM
24/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 15👨‍🏫

♟️Checkmate 77T
🔸Stage IA-IIIB (N2) NSCLC (AJCC 8)
🔸Periop nivo👇
ChemoIO▶️surg▶️IO vs Chemo▶️surg▶️placebo

⭐️Results⭐️
📈18 mo EFS (HR 0.58, p<0.001)
📈pCR rate (25.3% vs 4.7%)

🏆Another FDA Approval

👉Multiple options..
December 11, 2024 at 1:54 AM
23/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 14👨‍🏫

🔑🎵KEYNOTE-671
🔸Stage II-IIIB (N2) NSCLC
🔸Periop pembro
ChemoIO x 4▶️surg▶️IO v Chemo▶️surg▶️placebo

🤩Results🤩
📈OS (HR 0.73, p=0.02)
📈pCR rate (18.1% v 4.0%)

👏Finally an OS benefit
🏆FDA Approved
December 11, 2024 at 1:47 AM
22/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 13👨‍🏫

🥪The "sandwich" approach🥪
✨Aka perioperative chemoIO✨

🤨Multiple options..

🔑Key trials all a/w EFS 📈
1⃣KEYNOTE 671 👉pembrolizumab
2⃣AEGEAN 👉durvalumab
3⃣CM77T👉 nivolumab

@HwakeleeMD
December 11, 2024 at 1:47 AM
20/29 #TumorBoardTuesday

😷 W/u reveals...
😬Thyroiditis likely 2/2 IO ➡️sx tx w beta blocker

🏥Underwent RUL lobectomy
🫁🔬Pathologic review➡️pCR‼️

🧐Could irAE predict better outcomes?

👇600 pt cohort analysis
G1-2 irAEs w C1 a/w 📈survival (OS) (HR 0.61)
December 11, 2024 at 1:47 AM
18/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 12 👨‍🏫

📜To summarize..

👊Neoadjuvant vs 👊Adjuvant ChemoIO
🔹Both approaches with ➕ and ➖
🔹No definite OS benefit with either approach 🫤
🔹BUT CM816 shows early trend toward 📈OS
🔹Selection based on pt characteristics 👩🧑🧓👴
December 11, 2024 at 1:36 AM
16/29 #TumorBoardTuesday

👨‍🏫 Mini tweetorial 10 👨‍🏫

✅Checkmate 816✅
👉Neoadj chemoIO w nivolumab vs chemo alone

🔑Results
⭐️Med EFS 31.6 vs 20.8 mo
⭐️pCR rate 24.0% vs 2.2%
⭐️pCR a/w 📈EFS of 25.6 vs 18.0 mo
⭐️In PD-L1 TPS ≥ 50%, pCR rate of 44.7%

@FordePatrick
December 11, 2024 at 1:36 AM
15/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 9 👨‍🏫

🤩Neoadj IO w advantages
⭐️Intact tumor🫁👉tumor-specific T cell activation
⭐️Intact lymphatics👉⏫ immune priming
⭐️Immune activation👉⬇️micrometastases
December 11, 2024 at 1:30 AM
14/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 8 👨‍🏫

🏆FDA Approvals/NCCN Recs for Adjuvant IO
1⃣ Atezo (IMpower010)
2⃣ Pembro (PEARLS)

🙁But limited evidence for clinical benefit..
🤔💭Might neoadjuvant IO make a difference?
December 11, 2024 at 1:30 AM
13/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 7 👨‍🏫

🚨Adjuvant trials

✨PEARLS ✨
Adj pembro
👍Significant DFS 📈 (HR 0.76, p=0.0014)
🤨But not in PD-L1 ≥ 50% (HR 0.82, p=0.14)
⏳No OS benefit yet
🏆FDA Approved

✨BR.31✨
Adj durva
👎No DFS benefit, even in PD-L1 TPS ≥ 25%
December 11, 2024 at 1:30 AM
12/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 6 👨‍🏫

🚨Adjuvant IO trials

🌟Impower010🌟
Adj atezo vs placebo
👍Primary endpoint reached➡️DFS benefit (HR 0.66)
👎No OS improvement (79.3% vs 81.1%)
👏But📈OS for PD-L1 ≥50% (89.1% vs 77.8%)

🏆FDA Approved Option

@EnriquetaFelip
December 11, 2024 at 1:30 AM
10/29 #TumorBoardTuesday

✨Case 2✨

55👨heavy 🚬p/w R shoulder pain

Imaging shows 👇
😱Large (T4) RUL mass
🫣R paratracheal adenopathy
December 11, 2024 at 1:27 AM
7/29 #TumorBoardTuesday

👉Back to our case..

🫁T4N2 disease..."borderline resectable" 🫤
💊Pt tx with neoadjuvant osi x 10 wks
🩻Repeat imaging shows major clinical response 🙌
December 11, 2024 at 1:21 AM
5/29 #TumorBoardTuesday
👩‍🏫Mini tweetorial 4 👨‍🏫

👉PACIFIC regimen = SOC for Stage IIIB NSCLC
🧐No OS benefit for EGFRm subset..

💁‍♀️LAURA
⭐️Phase III - osi after chemoRT
⭐️Unresectable stage III EGFRm NSCLC
👏Osi vs placebo➡️med PFS 39.1 vs 5.6 mo
🏆Osi after chemoRT = new SOC
December 11, 2024 at 1:14 AM
4/29 #TumorBoardTuesday

👩‍🏫Mini tweetorial 3👨‍🏫

🤚Resectable ALKr NSCLC?

🎯ALINA ⬇️
⭐️Phase III Trial of Adjuvant Alectinib
⭐️Stage IB-IIIA (AJCC 7th ed) ALKr NSCLC
💊Adjuvant alectinib 600mg BID x 2 yrs vs chemo
👀Med DFS NR vs 41.3 mo

🏆Adjuvant alectinib FDA approved/SOC
December 11, 2024 at 1:11 AM