@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca 1/24 #TumorBoardTuesday #LungCancer #OncTwitter @NarjustFlorezMD
68y 👩🏼🦳 with 🚬 hx
SOB & weight loss
PMH: diabetes
🩻: 5.4cm mass in RUL with ipsilateral peribronchial lymph node
🧠Brain MRI: ❌mets
🔬🫁biopsy - Adenocarcinoma Lung Origin
🤨What would YOU do next?
68y 👩🏼🦳 with 🚬 hx
SOB & weight loss
PMH: diabetes
🩻: 5.4cm mass in RUL with ipsilateral peribronchial lymph node
🧠Brain MRI: ❌mets
🔬🫁biopsy - Adenocarcinoma Lung Origin
🤨What would YOU do next?
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca 2/24 #TumorBoardTuesday #LungCancer @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd
🔬Stage IIIA (T3N1M0) 🫁 Adeno Ca
📺You present case at tumor board
🔪 She has resectable disease!
🧬 NGS: no actionable mutations
🔬 PD-L1 55%
🤨What therapy would YOU give now?
🔬Stage IIIA (T3N1M0) 🫁 Adeno Ca
📺You present case at tumor board
🔪 She has resectable disease!
🧬 NGS: no actionable mutations
🔬 PD-L1 55%
🤨What therapy would YOU give now?
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @RManochakian
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @RManochakian 3/24 #TumorBoardTuesday
👩🏽🏫Mini tweetorial 1👩🏽🏫
📌PERIOPERATIVE IO
📖@NCCN based #NSCLC guide for biomarker neg resectable Stage IIIA ⤵️
RECOMMENDATIONS
✂️Surgery after neoadjuvant systemic treatment
💉Nivolumab & platinum-doublet
👩🏽🏫Mini tweetorial 1👩🏽🏫
📌PERIOPERATIVE IO
📖@NCCN based #NSCLC guide for biomarker neg resectable Stage IIIA ⤵️
RECOMMENDATIONS
✂️Surgery after neoadjuvant systemic treatment
💉Nivolumab & platinum-doublet
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @RManochakian @NCCN 4/24 #TumorBoardTuesday #LCSM #LungCancer @benlevylungdoc @ADesaiMD @glopesMD
👩🏽🏫Mini tweetorial 2👩🏽🏫
📌PERIOPERATIVE IO
Platinum Doublet Options:
📍Carbo or Cisplatin+paclitaxel (any histology)
📍Carbo or Cis + pemetrexed (nonsquamous)
📍Carbo or Cis + gemcitabine (squamous)
👩🏽🏫Mini tweetorial 2👩🏽🏫
📌PERIOPERATIVE IO
Platinum Doublet Options:
📍Carbo or Cisplatin+paclitaxel (any histology)
📍Carbo or Cis + pemetrexed (nonsquamous)
📍Carbo or Cis + gemcitabine (squamous)
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @OncologyForum
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @OncologyForum 5/24 #TumorBoardTuesday #LCSM #LungCancer
👩🏽🏫Mini tweetorial 3👩🏽🏫
👍🏽Nivo approved by FDA based on
✨CHECKMATE-816
🔹PHASE III - 3 YEAR UPDATE
🔸Stage IB-IIIA (exclude EGFR & ALK muts)
💉3 rounds chemo/IO over 9wks then✂️
🔁recurrence: 28% in nivo+chemo vs 42% in mono chemo
👩🏽🏫Mini tweetorial 3👩🏽🏫
👍🏽Nivo approved by FDA based on
✨CHECKMATE-816
🔹PHASE III - 3 YEAR UPDATE
🔸Stage IB-IIIA (exclude EGFR & ALK muts)
💉3 rounds chemo/IO over 9wks then✂️
🔁recurrence: 28% in nivo+chemo vs 42% in mono chemo
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @OncologyForum 6/24 #TumorBoardTuesday #LCSM #LungCancer
👩🏽🏫Mini tweetorial 4👩🏽🏫
👍🏽Nivo approved by FDA based on
👍🏽Improved improved pathCR rates (24 vs 2.2%)
⬇️Decrease surgical times
🟰no change in grade ≥3 adverse events
🤨 Pending OS data ??
👩🏽🏫Mini tweetorial 4👩🏽🏫
👍🏽Nivo approved by FDA based on
👍🏽Improved improved pathCR rates (24 vs 2.2%)
⬇️Decrease surgical times
🟰no change in grade ≥3 adverse events
🤨 Pending OS data ??
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @OncologyForum 7/24 #TumorBoardTuesday #LCSM
👩🏽🏫Mini tweetorial 5👩🏽🏫
🧐What else is being evaluated in neoadjuvant area?
✨NEOSTAR
📚pubmed.ncbi.nlm.nih.gov
✨NADIM
📚pubmed.ncbi.nlm.nih.gov
✨Target specific neoadju (NeoAdaura, ALK +)
👀Looking for neoadju + adju, hold your 🐎 till tweet 12
👩🏽🏫Mini tweetorial 5👩🏽🏫
🧐What else is being evaluated in neoadjuvant area?
✨NEOSTAR
📚pubmed.ncbi.nlm.nih.gov
✨NADIM
📚pubmed.ncbi.nlm.nih.gov
✨Target specific neoadju (NeoAdaura, ALK +)
👀Looking for neoadju + adju, hold your 🐎 till tweet 12
pubmed.ncbi.nlm.nih.gov/33603241/
Neoadjuvant nivolumab or nivolumab plus ipilimumab in operable non-small cell lung cancer: the phase 2 randomized NEOSTAR trial - PubMed
Ipilimumab improves clinical outcomes when combined with nivolumab in metastatic non-small cell lung...
pubmed.ncbi.nlm.nih.gov/32979984/
Neoadjuvant chemotherapy and nivolumab in resectable non-small-cell lung cancer (NADIM): an open-label, multicentre, single-arm, phase 2 trial - PubMed
Bristol-Myers Squibb, Instituto de Salud Carlos III, European Union's Horizon 2020 research and inno...
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @OncologyForum 8/24 #TumorBoardTuesday #LCSM
👩🏽🏫Mini tweetorial 6👩🏽🏫
✨NEOSTAR
📍PHASE II
Stage I-IIIA: includes stage 1‼️
🤺nivolumab 🆚 nivo + 1 dose of ipilimumab ➡️ ✂️ ➡️ SOC post op tx
🆘AEs may cause delays or cancellation of surgery?
👍🏽MPR+pCR: 17% in nivo alone arm vs 33% in ipi/nivo arm
👩🏽🏫Mini tweetorial 6👩🏽🏫
✨NEOSTAR
📍PHASE II
Stage I-IIIA: includes stage 1‼️
🤺nivolumab 🆚 nivo + 1 dose of ipilimumab ➡️ ✂️ ➡️ SOC post op tx
🆘AEs may cause delays or cancellation of surgery?
👍🏽MPR+pCR: 17% in nivo alone arm vs 33% in ipi/nivo arm
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @OncologyForum 9/24 #TumorBoardTuesday #LCSM #LungCancer
👩🏽🏫Mini tweetorial 7👩🏽🏫
✨NADIM I (don’t confuse with NADIM II)
📍PHASE II
Stage IIIA (only): 51 pts
Single Arm
Neoadju nivo + platinum chemo vs chemo 💉3 cycles ➡️ ✂️ ➡️ Pts w/R0 resections adju nivo for 12 mos
1° end-point PFS at 24 mos
👩🏽🏫Mini tweetorial 7👩🏽🏫
✨NADIM I (don’t confuse with NADIM II)
📍PHASE II
Stage IIIA (only): 51 pts
Single Arm
Neoadju nivo + platinum chemo vs chemo 💉3 cycles ➡️ ✂️ ➡️ Pts w/R0 resections adju nivo for 12 mos
1° end-point PFS at 24 mos
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @OncologyForum 10/24 #TumorBoardTuesday #LungCancer
Back to our case🔎
👩🏼🦳🤝👩🏽⚕️Discussed treatment options
👍🏽No contraindications to IO
👩🏼🦳OK to get Cisplatin (geriatric assessment)
😨Afraid it will delay surgery
👩🏼🦳Opted into cis + pemetrexed with nivo #SharedDecision
Back to our case🔎
👩🏼🦳🤝👩🏽⚕️Discussed treatment options
👍🏽No contraindications to IO
👩🏼🦳OK to get Cisplatin (geriatric assessment)
😨Afraid it will delay surgery
👩🏼🦳Opted into cis + pemetrexed with nivo #SharedDecision
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @OncologyForum 11/24 #TumorBoardTuesday #LCSM
Back to our case🔎
👩🏼🦳Patient completes 3 cycles of chemotherapy with nivolumab ✅
Developed grade I hypothyroidism ➡️on Levothyroxine 💊
🩻CT scan: ⬇️ size of tumor
👩🏼🦳She returns to clinic after surgery & asks:
“Do I need more IV treatment, doc?”
Back to our case🔎
👩🏼🦳Patient completes 3 cycles of chemotherapy with nivolumab ✅
Developed grade I hypothyroidism ➡️on Levothyroxine 💊
🩻CT scan: ⬇️ size of tumor
👩🏼🦳She returns to clinic after surgery & asks:
“Do I need more IV treatment, doc?”
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @OncologyForum 12/24 #TumorBoardTuesday #LCSM #LungCancer
👩🏽🏫Mini tweetorial 8👩🏽🏫
🧐Adjuvant AFTER perioperative therapy?!?!
🕵🏼 Multiple studies in various stages of results
✨KEYNOTE-671
✨IMpower030
✨AEGEAN
✨CheckMate-77T
✨NADIM II
👩🏽🏫Mini tweetorial 8👩🏽🏫
🧐Adjuvant AFTER perioperative therapy?!?!
🕵🏼 Multiple studies in various stages of results
✨KEYNOTE-671
✨IMpower030
✨AEGEAN
✨CheckMate-77T
✨NADIM II
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @OncologyForum 13/24 #TumorBoardTuesday #LCSM #LungCancer
👩🏽🏫Mini tweetorial 9👩🏽🏫
✨KEYNOTE-671✨
🔹PHASE III
Stage II-IIIB
💉arm: 4 rounds of pembro + platinum-doublet➡️ ✂️ ➡️ adjuvant pembro
🔹24 month EFS rate: 62.4% in pembro + chemo arm vs 40.6% in placebo arm
🛟24 month OS: 80.9% vs 77.6%
👩🏽🏫Mini tweetorial 9👩🏽🏫
✨KEYNOTE-671✨
🔹PHASE III
Stage II-IIIB
💉arm: 4 rounds of pembro + platinum-doublet➡️ ✂️ ➡️ adjuvant pembro
🔹24 month EFS rate: 62.4% in pembro + chemo arm vs 40.6% in placebo arm
🛟24 month OS: 80.9% vs 77.6%
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts 14/24 #TumorBoardTuesday #NSCLC #LungCancer
👩🏽🏫Mini tweetorial 10👩🏽🏫
✨KEYNOTE-671✨
🛑awaiting regulatory approval
👍🏽Improved pathCR rates (18 vs 4%)
‼️EFS benefit for perioperative pembro regardless of whether patients achieved pCR/mPR‼️
📚@HwakeleeMD nejm.org
👩🏽🏫Mini tweetorial 10👩🏽🏫
✨KEYNOTE-671✨
🛑awaiting regulatory approval
👍🏽Improved pathCR rates (18 vs 4%)
‼️EFS benefit for perioperative pembro regardless of whether patients achieved pCR/mPR‼️
📚@HwakeleeMD nejm.org
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts 15/24 #TumorBoardTuesday
👩🏽🏫Mini tweetorial 11👩🏽🏫
✨IMpower030
PHASE III
Stage II-IIIB
💉arm: 4 rounds of atezo + platinum-doublet ➡️ ✂️ ➡️ adjuvant atezo
⭕️arm: 4 rounds of placebo + platinum-doublet ➡️ ✂️ ➡️ placebo
⌛️awaiting results!
📚@peters_solange annalsofoncology.org
👩🏽🏫Mini tweetorial 11👩🏽🏫
✨IMpower030
PHASE III
Stage II-IIIB
💉arm: 4 rounds of atezo + platinum-doublet ➡️ ✂️ ➡️ adjuvant atezo
⭕️arm: 4 rounds of placebo + platinum-doublet ➡️ ✂️ ➡️ placebo
⌛️awaiting results!
📚@peters_solange annalsofoncology.org
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @peters_solange 16/24 #TumorBoardTuesday #LungCancer #NSCLC
👩🏽🏫Mini tweetorial 12👩🏽🏫
✨AEGEAN
🔹PHASE III
Stage IIA-IIIB
💉arm: 4 rounds of durvalumab + platinum-doublet ➡️ ✂️ ➡️ adjuvant durvalumab
⭕️arm: 4 rounds of placebo + platinum-doublet ➡️ ✂️ ➡️ placebo
👩🏽🏫Mini tweetorial 12👩🏽🏫
✨AEGEAN
🔹PHASE III
Stage IIA-IIIB
💉arm: 4 rounds of durvalumab + platinum-doublet ➡️ ✂️ ➡️ adjuvant durvalumab
⭕️arm: 4 rounds of placebo + platinum-doublet ➡️ ✂️ ➡️ placebo
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts 17/24 #TumorBoardTuesday #LungCancer
👩🏽🏫Mini tweetorial 13👩🏽🏫
✨AEGEAN
👍🏽Improved pathCR rates (17.2 vs 4.3%)
📉EFS benefit with cisplatin AND carboplatin, although cisplatin preferred due to better HR
⌛️Pending OS
📚#JohnHeymach @MDAndersonNews abstractsonline.com
👩🏽🏫Mini tweetorial 13👩🏽🏫
✨AEGEAN
👍🏽Improved pathCR rates (17.2 vs 4.3%)
📉EFS benefit with cisplatin AND carboplatin, although cisplatin preferred due to better HR
⌛️Pending OS
📚#JohnHeymach @MDAndersonNews abstractsonline.com
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts 18/24 #TumorBoardTuesday
👩🏽🏫Mini tweetorial 14👩🏽🏫
✨CheckMate-77T
🔹PHASE III
Stage II-IIIB
💉arm: 4 rounds nivo + plat-doublet ➡️ ✂️ ➡️ adjuvant nivo
⭕️arm: 4 rounds placebo + plat-doublet ➡️ ✂️ ➡️ placebo
⌛️waiting results!
📚#TinaCascone @MDAndersonNews ascopubs.org
👩🏽🏫Mini tweetorial 14👩🏽🏫
✨CheckMate-77T
🔹PHASE III
Stage II-IIIB
💉arm: 4 rounds nivo + plat-doublet ➡️ ✂️ ➡️ adjuvant nivo
⭕️arm: 4 rounds placebo + plat-doublet ➡️ ✂️ ➡️ placebo
⌛️waiting results!
📚#TinaCascone @MDAndersonNews ascopubs.org
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @MDAndersonNews 19/24 #TumorBoardTuesday
👩🏽🏫Mini tweetorial 15👩🏽🏫
✨NADIM II - STAGE IIIA & IIIB
🔹PHASE II
💉arm: 3 rounds of nivo + plat-doublet ➡️ ✂️ ➡️6 months adjuvant nivo
⭕️arm: 3 rounds of plat-doublet ➡️ ✂️ ➡️ observation
OS - 2° endpoint
📚nejm.org
👩🏽🏫Mini tweetorial 15👩🏽🏫
✨NADIM II - STAGE IIIA & IIIB
🔹PHASE II
💉arm: 3 rounds of nivo + plat-doublet ➡️ ✂️ ➡️6 months adjuvant nivo
⭕️arm: 3 rounds of plat-doublet ➡️ ✂️ ➡️ observation
OS - 2° endpoint
📚nejm.org
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts @MDAndersonNews 20/24 #TumorBoardTuesday #LCSM #LungCancer
😵💫 Confused yet?! 🤷🏻♂️
Remaining challenges⁉️
⏱️ Duration of adjuvant IO: 6 vs 12 months
⚕️Uniform staging
📏 Patients with pCR - need adjuvant IO?
🧊 Pending OS for many studies
😵💫 Confused yet?! 🤷🏻♂️
Remaining challenges⁉️
⏱️ Duration of adjuvant IO: 6 vs 12 months
⚕️Uniform staging
📏 Patients with pCR - need adjuvant IO?
🧊 Pending OS for many studies
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts 21/24 #TumorBoardTuesday #LCSM #LungCancer
⚠️Caution ⚠️ about the following⚠️
🙅 NO neoadjuvant or adjuvant IO for ALK, EGFR, RET + #NSCLC
📏 Mandatory biomarker testing at DIAGNOSIS
🫄Fertility preservation (when need it)
Meme cred: @NarjustFlorezMD
⚠️Caution ⚠️ about the following⚠️
🙅 NO neoadjuvant or adjuvant IO for ALK, EGFR, RET + #NSCLC
📏 Mandatory biomarker testing at DIAGNOSIS
🫄Fertility preservation (when need it)
Meme cred: @NarjustFlorezMD
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts 22/24 #TumorBoardTuesday #LungCancer
🎉 Neoadjuvant and Adjuvant IO are here to stay 🎉
🧪 Biomarker testing
✂️ Multi-D is essential - call your friendly surgeon
⛔️ Geriatric assessment
📚 Pending OS results
Meme cred: @NarjustFlorezMD
🎉 Neoadjuvant and Adjuvant IO are here to stay 🎉
🧪 Biomarker testing
✂️ Multi-D is essential - call your friendly surgeon
⛔️ Geriatric assessment
📚 Pending OS results
Meme cred: @NarjustFlorezMD
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts 23/24 #TumorBoardTuesday
PROS
👍🏽High mPR & pCR
👍🏽Prolonged DFS
👍🏽Objective eval of response
👍🏽Increase chances of getting systemic tx
** unclear if MPR/pCR is surrogate of OS/cure**
CONS
👎🏽AE/irAEs
👎🏽risk wrong pt selection (biomarkers)
👎🏽tx discontinue
👎🏽pending OS data
PROS
👍🏽High mPR & pCR
👍🏽Prolonged DFS
👍🏽Objective eval of response
👍🏽Increase chances of getting systemic tx
** unclear if MPR/pCR is surrogate of OS/cure**
CONS
👎🏽AE/irAEs
👎🏽risk wrong pt selection (biomarkers)
👎🏽tx discontinue
👎🏽pending OS data
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts 24/24 #TumorBoardTuesday
🫁🫁Case outcome 🫁🫁
✂️Post operative course was unremarkable
🔬PATHOLOGIC COMPLETE RESPONSE
👩🏼🦳 Back to our patient’s important question, any adjuvant treatment?!
👩🏽⚕️recommended NO adjuvant IO + surveillance with imaging
🫁🫁Case outcome 🫁🫁
✂️Post operative course was unremarkable
🔬PATHOLOGIC COMPLETE RESPONSE
👩🏼🦳 Back to our patient’s important question, any adjuvant treatment?!
👩🏽⚕️recommended NO adjuvant IO + surveillance with imaging
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen @ReinaHonts For you @HannahAlison20
TLDR: IO to early stage NSCLC
TLDR: IO to early stage NSCLC
@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen #PostTest Q1️⃣ #TumorBoardTuesday
👉🏽#CME Eval 🔗 integrityce.com
👉🏽ALL CME🔗 integrityce.com
🤔@NarjustFlorezMD @ShrutiPatelMD taught us peri-op IO, test your🧠with quick❓
🧐What tx?
68yo👩🏾🦳
resectable
stage IIIA (T3N1M0) #NSCLC adeno ca
55% PD-L1
no action muts
👉🏽#CME Eval 🔗 integrityce.com
👉🏽ALL CME🔗 integrityce.com
🤔@NarjustFlorezMD @ShrutiPatelMD taught us peri-op IO, test your🧠with quick❓
🧐What tx?
68yo👩🏾🦳
resectable
stage IIIA (T3N1M0) #NSCLC adeno ca
55% PD-L1
no action muts
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@TumorBoardTues @NarjustFlorezMD @IntegrityCE @JanssenUS @AstraZeneca @MPishvaian @JohnEbbenMDPhD @FordePatrick @jennifermarksmd @minaseconomides @LVaezi @KE_Gallaway @safichintan @KellyMezaMD @random_mommy @MatthewKurianMD @guicorreiamd @PathologyPat @KevinCalsina @EshaJ15 @OncogeneCancer @fgrazz @crisbergerot @esinghimd @chungryul_oh @MomaVelez11 @SamuelKareffMD @FawziAbuRous @BRoseMDMPH @bjork5 @HamediZahra @DrJNaidoo @RogerZhuMD @cbaldotto @RohitBanwar @JineshGheeya @COlazagasti @PatelOncology @APassaroMD @azza64 @g_mountzios @drMaryOBr @LungCancerFaces @susila55 @SewantiLimaye @NReguart @BrendonStilesMD @triparnasen #PostTest Q2️⃣ #TumorBoardTuesday
👉🏽 Free CME 🔗 integrityce.com
🧐 What neoadjuvant treatment?
👆🏽68yo 👩🏾🦳
✂️ resectable
stage IIIA (T3N1M0) #NSCLC (adenocarcinoma)
55% PD-L1
no actionable mutations
👉🏽 Free CME 🔗 integrityce.com
🧐 What neoadjuvant treatment?
👆🏽68yo 👩🏾🦳
✂️ resectable
stage IIIA (T3N1M0) #NSCLC (adenocarcinoma)
55% PD-L1
no actionable mutations
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