@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak 4/22 #TumorBoardTuesday
π¨π»βπ«Mini tweetorial 1π¨π»βπ«
Front-line SOC systemic options for mPDAC
But
ALWAYS consider & discuss clinical trial #SharedDecision
π©π»βπ¦±chose to screen for ph II 1L anti-CLDN18.2 (C)
CLDN18.2 strongly (+) > 75% IHC
π©π»βπ¦±randomized into study: receive C + Gem/Nab-P
π¨π»βπ«Mini tweetorial 1π¨π»βπ«
Front-line SOC systemic options for mPDAC
But
ALWAYS consider & discuss clinical trial #SharedDecision
π©π»βπ¦±chose to screen for ph II 1L anti-CLDN18.2 (C)
CLDN18.2 strongly (+) > 75% IHC
π©π»βπ¦±randomized into study: receive C + Gem/Nab-P
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @Kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @PeterHoseinMD @gabe_a_brooks @UqbaKhan
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @PeterHoseinMD @gabe_a_brooks @UqbaKhan 5/22 #TumorBoardTuesday #PancreaticCancer
π¨π»βπ«Mini tweetorial 2π¨π»βπ«
πWhat is CLAUDIN 18.2
πcell-to-cell tight junction protein
πmajor role in cell polarity & barrier function
πAlternative splicing variants at 1st exon of Chβsome 3q22
π@giuliagrizz
π¨π»βπ«Mini tweetorial 2π¨π»βπ«
πWhat is CLAUDIN 18.2
πcell-to-cell tight junction protein
πmajor role in cell polarity & barrier function
πAlternative splicing variants at 1st exon of Chβsome 3q22
π@giuliagrizz
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @PeterHoseinMD @gabe_a_brooks @UqbaKhan 6/22 #TumorBoardTuesday #PancreaticCancer @BiachiTiago
π¨π»βπ«Mini tweetorial 3π¨π»βπ«
πCLDN18.2
πexpresses as cancerous tissue in subgroups of
πΉPancreas
πΈGastric
π΅π»being explored in others (biliary tract & lung)
β¬οΈhighly expressed can be attractive drug delivery π― or immunotherapy
π¨π»βπ«Mini tweetorial 3π¨π»βπ«
πCLDN18.2
πexpresses as cancerous tissue in subgroups of
πΉPancreas
πΈGastric
π΅π»being explored in others (biliary tract & lung)
β¬οΈhighly expressed can be attractive drug delivery π― or immunotherapy
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria 7/22 #TumorBoardTuesday #GI23 #ASCOGI23
π¨π»βπ«Mini tweetorial 4π¨π»βπ«
πAnti-CLDN 18.2
π¦SPOTLIGHT: Ph III of FOLFOX + Zolbe/Placebo
π@KoheiShitara @ILSONDavid @JoeChaoMD @JafferAjaniMD t.ly
π―οΈGLOW: Ph III CAPOX + Zolbe/Placebo
π@mdmanishshah t.ly
π¨π»βπ«Mini tweetorial 4π¨π»βπ«
πAnti-CLDN 18.2
π¦SPOTLIGHT: Ph III of FOLFOX + Zolbe/Placebo
π@KoheiShitara @ILSONDavid @JoeChaoMD @JafferAjaniMD t.ly
π―οΈGLOW: Ph III CAPOX + Zolbe/Placebo
π@mdmanishshah t.ly
t.ly/xpUcJ
Zolbetuximab plus mFOLFOX6 in patients with CLDN18.2-positive, HER2-negative, untreated, locally advanced unresectable or metastatic gastric or gastro-oesophageal junction adenocarcinoma (SPOTLIGHT): a multicentre, randomised, double-blind, phase 3 trial
Targeting CLDN18.2 with zolbetuximab significantly prolonged progression-free survival and overall s...
t.ly/iSxBZ
Zolbetuximab plus CAPOX in CLDN18.2-positive gastric or gastroesophageal junction adenocarcinoma: the randomized, phase 3 GLOW trial
Nature Medicine - In the randomized, double-blind, phase 3 GLOW trial, capecitabine and oxaliplatin...
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @JoeChaoMD @JafferAjaniMD @mdmanishshah 8/22 #TumorBoardTuesday
π¨π»βπ«Mini tweetorial 5
πPh III studies in gastric ca: mFOLFOX +/- Zolbetuximab
π¦SPOTLIGHT
ποΈ1Β° endpoint PFS met mPFS of 10.6 for zolbe + mFOLFOX6 vs 8.7 for mFOLFOX6, HR 0.75, p=0.0066
π¦2Β° endpoint OS met mOS 18.2 for zolbe + mFOLFOX6 vs 15.5 for mFOLFOX6
π¨π»βπ«Mini tweetorial 5
πPh III studies in gastric ca: mFOLFOX +/- Zolbetuximab
π¦SPOTLIGHT
ποΈ1Β° endpoint PFS met mPFS of 10.6 for zolbe + mFOLFOX6 vs 8.7 for mFOLFOX6, HR 0.75, p=0.0066
π¦2Β° endpoint OS met mOS 18.2 for zolbe + mFOLFOX6 vs 15.5 for mFOLFOX6
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @JoeChaoMD @JafferAjaniMD @mdmanishshah 9/22 #TumorBoardTuesday
π¨π»βπ«Mini tweetorial 6π¨π»βπ«
π¦SPOTLIGHT
π―1st molecular target Tx with 1L OS benefit of aGC since Herceptin
π87% w PD-L1 CPS<5% (familiar in panc?)
πCtrl did well
ππΌStudy arm: major survival improvement!
π§β¬οΈ OS for β¬οΈCLDN18.2 expression?
π¨π»βπ«Mini tweetorial 6π¨π»βπ«
π¦SPOTLIGHT
π―1st molecular target Tx with 1L OS benefit of aGC since Herceptin
π87% w PD-L1 CPS<5% (familiar in panc?)
πCtrl did well
ππΌStudy arm: major survival improvement!
π§β¬οΈ OS for β¬οΈCLDN18.2 expression?
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @JoeChaoMD 10/22 #TumorBoardTuesday @AACR
π¨π»βπ«Mini tweetorial 7π¨π»βπ«
πLarge study #AACR23 reviewed different CLDN18.2 levels & OS
πDiffering CLDN18.2 levels at 50% & 75% showed no OS difference.
π@JafferAjaniMD t.ly
π¨π»βπ«Mini tweetorial 7π¨π»βπ«
πLarge study #AACR23 reviewed different CLDN18.2 levels & OS
πDiffering CLDN18.2 levels at 50% & 75% showed no OS difference.
π@JafferAjaniMD t.ly
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @JoeChaoMD @AACR 11/22 #TumorBoardTuesday #PanCan #PancreaticCancer
π¨π»βπ«Mini tweetorial 8π¨π»βπ«
πPhase III study of chemo + Zolbe
π―οΈGLOW
πΉN=507
πCAPOX vs CAPOX + Zolbe
πmPFS 8.21m CAPOX + Zolbe vs 6.80 CAPOX
πmOS 14.39 CAPOX + Zolbe vs 12.16 CAPOX
π@mdmanishshah t.ly
π¨π»βπ«Mini tweetorial 8π¨π»βπ«
πPhase III study of chemo + Zolbe
π―οΈGLOW
πΉN=507
πCAPOX vs CAPOX + Zolbe
πmPFS 8.21m CAPOX + Zolbe vs 6.80 CAPOX
πmOS 14.39 CAPOX + Zolbe vs 12.16 CAPOX
π@mdmanishshah t.ly
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @JoeChaoMD @AACR @mdmanishshah 12/22 #TumorBoardTuesday
π¨π»βπ«Mini tweetorial 9π¨π»βπ«
Lots of Zolbe data for CLDN in GC/GEJ, what about #PancreaticCancer?π€
βΌοΈZolbetuximab trial in mPDAC recruitingβΌοΈ
πtinyurl.com
π²IHC >75% can be randomized in 2:1 for GN+Z or GN-Z
Expected accrual β24
πStay tunedβββΌοΈ
π¨π»βπ«Mini tweetorial 9π¨π»βπ«
Lots of Zolbe data for CLDN in GC/GEJ, what about #PancreaticCancer?π€
βΌοΈZolbetuximab trial in mPDAC recruitingβΌοΈ
πtinyurl.com
π²IHC >75% can be randomized in 2:1 for GN+Z or GN-Z
Expected accrual β24
πStay tunedβββΌοΈ
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @JoeChaoMD @AACR @mdmanishshah 13/22 #TumorBoardTuesday
Back to caseπ
πAfter 1st infusion
π€’significant nausea with GN antiemetics (dexameth or 5HT3 antagonist)
π½οΈreduced appetite
β¬οΈweight
Given π©π»β𦱠severe nausea impacting multi facets, considering stopping trial
What do we know about Zolbe π€’ + anorexia?
Back to caseπ
πAfter 1st infusion
π€’significant nausea with GN antiemetics (dexameth or 5HT3 antagonist)
π½οΈreduced appetite
β¬οΈweight
Given π©π»β𦱠severe nausea impacting multi facets, considering stopping trial
What do we know about Zolbe π€’ + anorexia?
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @JoeChaoMD @AACR @mdmanishshah 14/22 #TumorBoardTuesday #PanCan #PancreaticCancer
π¨π»βπ«Mini tweetorial 10π¨π»βπ«
π¦SPOTLIGHT
π€’Nausea/Vomiting
πCommon at C1 but G3 rare
πAll G 82% in Zolbe arm vs 61% in Placebo arm
π> G3 16% in Zolbe arm vs 6% in placebo arm
πDiscontinue: 6% in ZOL arm vs 1% in placebo arm
π¨π»βπ«Mini tweetorial 10π¨π»βπ«
π¦SPOTLIGHT
π€’Nausea/Vomiting
πCommon at C1 but G3 rare
πAll G 82% in Zolbe arm vs 61% in Placebo arm
π> G3 16% in Zolbe arm vs 6% in placebo arm
πDiscontinue: 6% in ZOL arm vs 1% in placebo arm
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @JoeChaoMD @AACR @mdmanishshah 15/22 #TumorBoardTuesday #PancreaticCancer
π¨π»βπ«Mini tweetorial 11π¨π»βπ«
π―οΈGLOW
π€’Nausea/Vomiting similar to π¦SPOTLIGHT
ποΈEarly anti-emetics per institution standard
π°Supportive tx
π₯Consider supplements/dietitian
π¨π»βπ«Discuss with pt & family π€’ improves after 1-2 C
π¨π»βπ«Mini tweetorial 11π¨π»βπ«
π―οΈGLOW
π€’Nausea/Vomiting similar to π¦SPOTLIGHT
ποΈEarly anti-emetics per institution standard
π°Supportive tx
π₯Consider supplements/dietitian
π¨π»βπ«Discuss with pt & family π€’ improves after 1-2 C
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @JoeChaoMD @AACR @mdmanishshah 16/22 #TumorBoardTuesday
Back to caseπ
πNausea & anorexiaππ½2 cycles
π©»CT: PR
π©ΈCA 19-9: 300
π§ͺGenomic results:
Germline (-)
Somatic: MSS< TMB 3, KRAS G12C, TP53
π©π»βπ¦±Continuing trial
ποΈStable for 4 scans
BUT
πBack pain
β¬οΈCA 19-9
π©»CT: dz progressβ‘οΈliver & pancreas
π€¨Now what?
Back to caseπ
πNausea & anorexiaππ½2 cycles
π©»CT: PR
π©ΈCA 19-9: 300
π§ͺGenomic results:
Germline (-)
Somatic: MSS< TMB 3, KRAS G12C, TP53
π©π»βπ¦±Continuing trial
ποΈStable for 4 scans
BUT
πBack pain
β¬οΈCA 19-9
π©»CT: dz progressβ‘οΈliver & pancreas
π€¨Now what?
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid 17/22 #TumorBoardTuesday
π¨π»βπ«Mini tweetorial 12
π―KRAS G12C in PDAC
G12C rare in PDAC: 1-2%
#KRAS trial resultsπ adagrasib, sotorasib, divarasib, + more developing
π΅π»other, non-G12C muts
π@GIcancerDoc @DrShubhamPant pubmed.ncbi.nlm.nih.gov
π@RonaYaeger pubmed.ncbi.nlm.nih.gov
π¨π»βπ«Mini tweetorial 12
π―KRAS G12C in PDAC
G12C rare in PDAC: 1-2%
#KRAS trial resultsπ adagrasib, sotorasib, divarasib, + more developing
π΅π»other, non-G12C muts
π@GIcancerDoc @DrShubhamPant pubmed.ncbi.nlm.nih.gov
π@RonaYaeger pubmed.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov/36546651/
Sotorasib in KRAS p.G12C-Mutated Advanced Pancreatic Cancer - PubMed
Sotorasib showed anticancer activity and had an acceptable safety profile in patients with KRAS p.G1...
pubmed.ncbi.nlm.nih.gov/37099736/
Adagrasib in Advanced Solid Tumors Harboring a KRASG12C Mutation - PubMed
Adagrasib demonstrates encouraging clinical activity and is well tolerated in this rare cohort of pr...
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @GIcancerDoc @DrShubhamPant @RonaYaeger 18/22 #TumorBoardTuesday #PancreaticCancer
Weβve discussed PDAC assays
π§ͺCLAUDIN 18.2
π§ͺNGS including *KRAS G12C strategies
*Many other KRAS inhibitors coming in next tweets!
BUT first
Looking back to tweet 5,
π§What do we know about CLDN18.2 in PDAC?
Weβve discussed PDAC assays
π§ͺCLAUDIN 18.2
π§ͺNGS including *KRAS G12C strategies
*Many other KRAS inhibitors coming in next tweets!
BUT first
Looking back to tweet 5,
π§What do we know about CLDN18.2 in PDAC?
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @GIcancerDoc @DrShubhamPant 19/22 #TumorBoardTuesday
Transcriptomic subgroups define diff prognosis in #PancreaticCancer
π΅π»Using RNAseq, prospective evaluation of these subgroups with SOC chemo
β¨COMPASS β¨PASS01
π@graokane pubmed.ncbi.nlm.nih.gov
π pubmed.ncbi.nlm.nih.gov
Transcriptomic subgroups define diff prognosis in #PancreaticCancer
π΅π»Using RNAseq, prospective evaluation of these subgroups with SOC chemo
β¨COMPASS β¨PASS01
π@graokane pubmed.ncbi.nlm.nih.gov
π pubmed.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov/32156747/
GATA6 Expression Distinguishes Classical and Basal-like Subtypes in Advanced Pancreatic Cancer - PubMed
The basal-like subtype is chemoresistant and can be distinguished from classical PDAC by GATA6 expre...
pubmed.ncbi.nlm.nih.gov/29288237/
Genomics-Driven Precision Medicine for Advanced Pancreatic Cancer: Early Results from the COMPASS Trial - PubMed
Purpose: To perform real-time whole genome sequencing (WGS) and RNA sequencing (RNASeq) of advanced...
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @GIcancerDoc @DrShubhamPant @graokane 20/22 #TumorBoardTuesday
We got carried away~
Back to our case π
π©π»βπ¦±Pt decided CLDN18.2-ADC
πthriving & discussing other anti-CLDN18.2 strategiesππΌ
We got carried away~
Back to our case π
π©π»βπ¦±Pt decided CLDN18.2-ADC
πthriving & discussing other anti-CLDN18.2 strategiesππΌ
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @GIcancerDoc @DrShubhamPant 21/22 #TumorBoardTuesday
Other pending strategies under investigation:
πShen #ASCO23 diff anti-CLDN18.2 mAb
πCao. Biomarker Res 2021, Konno #AACR21, Jiang #AACR20
biomarkerres.biomedcentral.com
πmRNA vaccine
fiercebiotech.com
β¦@MaenAbdelrahimβ©
Other pending strategies under investigation:
πShen #ASCO23 diff anti-CLDN18.2 mAb
πCao. Biomarker Res 2021, Konno #AACR21, Jiang #AACR20
biomarkerres.biomedcentral.com
πmRNA vaccine
fiercebiotech.com
β¦@MaenAbdelrahimβ©
biomarkerres.biomedcentral.com/articles/10.11β¦
Claudin18.2 is a novel molecular biomarker for tumor-targeted immunotherapy - Biomarker Research
The claudin18.2 (CLDN18.2) protein, an isoform of claudin18, a member of the tight junction protein...
fiercebiotech.com/biotech/modernβ¦
Moderna reveals Claudin18.2 ambitions via cancer vaccine, solid tumor CAR-T combo plans
What could be hotter than Moderna getting in the Claudin18.2 race? How about pairing up a newly disc...
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @GIcancerDoc @DrShubhamPant @MaenAbdelrahim 22/22 #TumorBoardTuesday #PanCan #PancreaticCancer
Takeπ‘ points
PDAC needs comprehensive test for many biomarkersβΌοΈ
CLDN18.2 is a new defined biomarker for GI cancers, various strategiesβΌοΈ
Zolbe trial recruitingβΌοΈ
Takeπ‘ points
PDAC needs comprehensive test for many biomarkersβΌοΈ
CLDN18.2 is a new defined biomarker for GI cancers, various strategiesβΌοΈ
Zolbe trial recruitingβΌοΈ
@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @GIcancerDoc #PostTest Q1οΈβ£ #TumorBoardTuesday
ππ½#CME Eval π integrityce.com
ππ½ALL CMEπ integrityce.com
π€@CentralParkWMD @ferguskeane2 taught us CLDN18.2 in #PanCan test your π§ with quickβ
π§Which testing would you use to determine a patient's CLAUDIN 18.2 status?
ππ½#CME Eval π integrityce.com
ππ½ALL CMEπ integrityce.com
π€@CentralParkWMD @ferguskeane2 taught us CLDN18.2 in #PanCan test your π§ with quickβ
π§Which testing would you use to determine a patient's CLAUDIN 18.2 status?
integrityce.com/TBT2023
Tumor Board Tuesday 2023 Conversations
Tumor Board Tuesdays is a regularly scheduled, Twitter-based case discussion forum led by expert fac...
integrityce.com/TBTeval23
Tumor Board Tuesday Evaluation 2023 (ID: i854/i855/i862/i865)
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@CentralParkWMD @TumorBoardTues @MPishvaian @GABOUALFA @SteveMaronMD @MichaelDAngeli2 @MacarullaTeresa @OncBrothers @jhatjhmi1 @KevinCSoaresMD @MDAkhilChawla @FionnualaCrowle @wei_ac @MarkYarchoan @DeshenW @JeeyunM @AudreyKamMD @HanSangKim5 @DrElkhoueiry @guildsman @SKamath_MD @MariaDiab101 @KlempnerSam @mdbrunocosta @JohnEbbenMDPhD @TimothyJBrownMD @NajeebAl_Hallak @SalemGIOncDoc @VSahaiMD @Tarmaghany @RuthHe12 @DanielLinMD @DrKelseyKlute @kgnairmd @YouppiePancreas @PamelaKunz @CathyEngMD @DanengLi @MiteshBorad @SebasMondaca @dmukherji @JamesClearyMD @EmilyHarrold6 @DrJashDatta @DeMadaria @KoheiShitara @ILSONDavid @GIcancerDoc #PostTest Q2οΈβ£ #TumorBoardTuesday #PancreaticCancer #PanCan
ππ½ Free CME π integrityce.com
π§What regimen* would you select?
58yo π©πΌβπ¦³
metastatic pancreatic ductal adenocarcinoma
CA 19-9: 680
CLDN18.2: 86%
*approved OR investigational
ππ½ Free CME π integrityce.com
π§What regimen* would you select?
58yo π©πΌβπ¦³
metastatic pancreatic ductal adenocarcinoma
CA 19-9: 680
CLDN18.2: 86%
*approved OR investigational
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