2) The program is supported by an unrestricted educational grant from AstraZeneca. Statement of accreditation & faculty disclosures at https://t.co/8oShcATovC. Earn 0.5h 🆓CE/#CME by following this 🧵, & follow @onc_ce for more expert-authored #MedEd. #OncTwitter #FOAMed #ONCSM
— @onc_ce (@onc_ce) August 15, 2023
3b) Impt to note #healthdisparities in #endometrialcancer with Black 🚺 nearly 2x more likely to die from the dz than White 🚺. Combination of biology + social factors @ play. Must do more to close this gap! #healthequity
— @onc_ce (@onc_ce) August 15, 2023
🔗 🔓 https://t.co/sxblNMd9mi pic.twitter.com/85G9gVbV1x
5) Before we jump in – a reminder!
— @onc_ce (@onc_ce) August 15, 2023
The Cancer Genome Atlas (#TCGA) classifies #endometrial cancer into 4 molecular subgroups based on #POLE, #dMMR and #p53 status. Of these – we currently use #MMR status to make treatment decisions! 🏥
7a) First: #RUBY 🟥 trial
— @onc_ce (@onc_ce) August 15, 2023
🔗https://t.co/AN8RNIzoaT
Ph3 #RCT – 494 pts with primary advanced or recurrent #endometrialcancer
Randomized to carbo/taxol +/- #PD1 inhibitor #dostarlimab
Pts stratified by MMR status – 23% were #dMMR
Primary efficacy outcome – #PFS pic.twitter.com/7WAJYOoIcu
7c) Early trend in #OS in favor of chemo + IO but will need to follow this data to maturity. pic.twitter.com/ssNkfXzus2
— @onc_ce (@onc_ce) August 15, 2023
8b) Results:
— @onc_ce (@onc_ce) August 15, 2023
📈#PFS at 12 months:#dMMR population – 74% in pembro group vs 38% in placebo
HR 0.3, 95% CI 0.1 to 0.48
📈PFS in #pMMR population – PFS 13 mo with pembro + #chemo vs 8.7 mo with chemo alone
HR 0.54; 95% CI 0.4-0.7 pic.twitter.com/2pALRRhFok
9b) In both studies – #TEAEs more common in #immunotherapy arms: pic.twitter.com/Vi0E0sYQEx
— @onc_ce (@onc_ce) August 15, 2023
10a) 🚨New #StandardofCare in advanced #endometrialcancer – chemo ➕immunotherapy in dMMR population.
— @onc_ce (@onc_ce) August 15, 2023
10c) @NCCNguidelines have been updated to include these changes! pic.twitter.com/PTpkShYJgv
— @onc_ce (@onc_ce) August 15, 2023
11b) ✅All histologies including #carcinosarcoma
— @onc_ce (@onc_ce) August 15, 2023
Tx: platinum based chemo +/- #durvalumab followed by durva alone vs durva + #olaparib vs placebo
13) ⚙️ Shifting gears to 🔦highlight a few more studies in progress. Many excellent research studies ongoing aimed at further discovering additional options for patients with #EC. pic.twitter.com/IPHJMji3xS
— @onc_ce (@onc_ce) August 15, 2023
15) #RAINBO 🌈
— @onc_ce (@onc_ce) August 15, 2023
Umbrella program of 4 clinical trials investigating adjuvant tx in #EC based on molecular profile 🧪 pic.twitter.com/4J7PvEWDCn
17) SO many exciting updates & even so – many future questions! Studies ongoing to examine:
— @onc_ce (@onc_ce) August 15, 2023
👉Role of #chemo in advanced #endometrial cancer
👉 Whether #IO activity varies between MLH-mutated vs MLH-hypermethylated #EC
👉Further strategies to enhance #IO in #pMMR tumors
18b) Answer: HER2! #HER2 is a predictive biomarker. Amplification makes a patient eligible for addition of #trastuzumab to chemo in patients w/advanced or recurrent serous #endometrialcancer
— @onc_ce (@onc_ce) August 15, 2023
19b) – Answer: Carbo/Taxol + dostarlimab based on #RUBY trial results. GY-018 did not include pts with #carcinosarcoma so in this setting would not use #pembrolizumab. pic.twitter.com/q2fU2n514k
— @onc_ce (@onc_ce) August 15, 2023
20) and YOU DID IT! You just earned 🆓0.5h CE/#CME and you can claim your certificate RIGHT NOW at https://t.co/Wmu9rN4bl3. .@DrMMurphy thanks you for joining us and encourages you to FOLLOW @onc_ce for more expert-led education!#FOAMed #MedEd #OncTwitter #oncsm
— @onc_ce (@onc_ce) August 15, 2023