2) I am Dr. Sandip Patel @PatelOncology, Professor in Medical Oncology from @UCSDCancer. @nicogirardcurie (to follow) and I will be covering Optimal Immuno-Oncologic Management of Extensive-Stage Small Cell Lung Cancer & Strategies to Develop Individualized Treatment Plans. pic.twitter.com/zcBrlVo8TJ
— @onc_ce (@onc_ce) January 11, 2023
4) A diagnosis of #SCLC requires tissue confirmation & while primarily made by 🔬 of small blue malignant cells, IHC staining w/ synaptophysin, chromogranin, NCAM, or NSE is confirmatory. NGS is typically not performed–only in rare cases (young pt, never smoker, small biopsy) pic.twitter.com/qYFJFfWaS3
— @onc_ce (@onc_ce) January 11, 2023
6) For patients with #ES_SCLC and 🧠metastases, upfront whole brain irradiation #WBI is a standard of care. Use of stereotactic radiotherapy in the #palliative setting for oligometastatic disease is reasonable as well.
— @onc_ce (@onc_ce) January 11, 2023
8) Supportive care for patients with bone mets (#zoledronic_acid, #denosumab) & assessment for #paraneoplastic phenomena (#Lambert_Eaton syndrome, #hypercalcemia, #siADH etc) is important. For pts with #superiorvenacava syndrome, prompt chemotherapy (+/-XRT) may be required.
— @onc_ce (@onc_ce) January 11, 2023
9b) Modern treatment of #ES_SCLC includes use of anti-#PD_L1 immunotherapy with #chemotherapy. Neutropenia prophylaxis may be required in certain high risk populations.
— @onc_ce (@onc_ce) January 11, 2023
11) #OS benefit with chemo+atezo in #IMP133 was independent of #TMB and broadly across subgroups. #PD_L1 #IHC did not discern between responders and nonresponders and is not a required test prior to treatment.
— @onc_ce (@onc_ce) January 11, 2023
See 🔓https://t.co/31uOxRUv7z pic.twitter.com/QOGhhE4tbn
13) Similar benefit with #durvalumab+chemo was demonstrated across all subgroups, independent of #PD_L1 #IHC status and #TMB pic.twitter.com/rnqZCW4W71
— @onc_ce (@onc_ce) January 11, 2023
15) Let’s check in with a couple polling questions: For a newly diagnosed patient with #SCLC, which of the following additional tests should be performed:
— @onc_ce (@onc_ce) January 11, 2023
17) For a patient with #ES_SCLC with NO 🧠 metastases by MRI at baseline, which of the following represents a reasonable standard of care for #CNS metastasis interception?
— @onc_ce (@onc_ce) January 11, 2023
A) Omaya Reservoir
B) Craniospinal radiation
C) MRI brain every 3 months
D) CT head every 3 months
19) Which of the following regimens should you utilize in a newly diagnosed patient with #ES_SCLC?
— @onc_ce (@onc_ce) January 11, 2023
A) Atezolizumab+carboplatin+etoposide
B) Durvalumab+carboplatin+etoposide
C) Bevacizumab+carboplatin+etoposide
D) Cisplatin+etoposide+XRT
21) Approximately 5 months into treatment, patient has improved breathing but develops watery diarrhea which 8-10 bowel movements a day. Which of the following should be done next ?
— @onc_ce (@onc_ce) January 11, 2023
A) C diff stool testing
B) Hold chemotherapy
C) Start loperamide
D) Order IV fluids
23) After negative #Cdiff testing, which of the following treatments should be utilized as the main treatment for immune-mediated colitis in either the primary or refractory setting?
— @onc_ce (@onc_ce) January 11, 2023
25) That's it! Soon on this same 🦇-station my colleague @nicogirardcurie will delve more deeply into clinical trial data on optimal #immune_oncologic tx for #ES_SCLC. For now, go grab your 🆓0.5hr CE/#CME at https://t.co/9PZYt7152x.
— @onc_ce (@onc_ce) January 11, 2023
I am @PatelOncology and I 🙏for joining! pic.twitter.com/ltXGeKfsVA