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) September 6, 2023
4) 💡Risk Assessment: Historically, risk assessment & adjuvant therapy approach has been guided by stage, histology & other pathologic factors. pic.twitter.com/6dqPOahU5M
— @onc_ce (@onc_ce) September 6, 2023
5b) ✅ Low risk dz (all listed features) – generally no adjuvant tx recommended pic.twitter.com/gBd9ihsGiv
— @onc_ce (@onc_ce) September 6, 2023
5d) 🆘 High risk dz – need #adjuvant #chemotherapy +/- RT based on high risk features pic.twitter.com/NKqpXSGc7G
— @onc_ce (@onc_ce) September 6, 2023
6b) The role of biomarkers in #endometrialcancer still being investigated 🧐. We do know that presence of #dMMR predicts response to #immunotherapy. 📈
— @onc_ce (@onc_ce) September 6, 2023
7) ⚙️ Switching gears – let’s talk about early diagnosis! Incidence & mortality of #endometrialcancer as both are on the ⬆️. We need better ways to catch this dz early as localized dz is often curable.
— @onc_ce (@onc_ce) September 6, 2023
9) 🔍Early Diagnosis: Detecting #endometrialcancer at an early stage improves prognosis. Abnormal bleeding, spotting, or discharge after #menopause or between periods should never be ignored. #EarlyDetectionSavesLives
— @onc_ce (@onc_ce) September 6, 2023
11) 🩺Diagnostic Tools: Transvaginal ultrasound, endometrial biopsy, & #hysteroscopy aid in diagnosing endometrial cancer. Recommended that ALL patients with newly diagnosed #endometrialcancer undergo molecular testing.
— @onc_ce (@onc_ce) September 6, 2023
13) 🩺 Once diagnosed, #endometrialcancer is surgically staged and classified using #FIGO staging system. The 2023 update included molecular classifications. 🔓 https://t.co/JT1oaQPWFn
— @onc_ce (@onc_ce) September 6, 2023
15) Of the 4 molecular subtypes 🧪, we currently use #MMR status to make treatment decisions. Several studies demonstrate #dMMR predicts response to #immunotherapy!
— @onc_ce (@onc_ce) September 6, 2023
17a) First: #RUBY 🟥 trial
— @onc_ce (@onc_ce) September 6, 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/M6p6NOtQov
17c) Early trend in #OS in favor of chemo + IO but will need to follow this data to maturity. pic.twitter.com/3kmHOl8uIU
— @onc_ce (@onc_ce) September 6, 2023
18b) Results:
— @onc_ce (@onc_ce) September 6, 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/lzDXbbrWs8
19b) 🩹In both studies – #TEAEs more common in #immunotherapy arms: pic.twitter.com/WyHzTf8jKB
— @onc_ce (@onc_ce) September 6, 2023
19d) 🚨New #StandardofCare in advanced #endometrialcancer – chemo ➕immunotherapy in dMMR population.
— @onc_ce (@onc_ce) September 6, 2023
21) @NCCN guidelines have been updated to include this change! pic.twitter.com/ITFFk1LPLh
— @onc_ce (@onc_ce) September 6, 2023
23) #RAINBO 🌈
— @onc_ce (@onc_ce) September 6, 2023
Umbrella program of 4 clinical trials investigating #targeted adjuvant tx in #EC based on molecular profile 🧪 Results will help us better understand molecular profile-based adjuvant tx. pic.twitter.com/43m3x9WPFH
25a) Other areas of interest in #endometrialcancer: targeting #DNArepair + #angiogenesis.
— @onc_ce (@onc_ce) September 6, 2023
26) 🌟It’s an exciting time for research in #endometrialcancer. 🗣️ As always, effective communication with patients/families about the practical implications of molecular & genetic testing remains key! pic.twitter.com/XIOPb0l2lZ
— @onc_ce (@onc_ce) September 6, 2023
27b) Answer: Liquid biopsy! While studies are ongoing, this is not a currently approved strategy for diagnosis/detection of #endometrialcancer
— @onc_ce (@onc_ce) September 6, 2023
28b) Answer: Chemotherapy + #IO now considered #standardofcare for upfront tx of #dMMR #endometrialcancer! pic.twitter.com/U13LgZZXZz
— @onc_ce (@onc_ce) September 6, 2023
29) YOU just earned 🆓0.5h CE/#CME and you can claim your certificate RIGHT NOW at https://t.co/OJB0qpUKri. .@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) September 6, 2023