Oncology

@onc_ce on Twitter

1) Welcome to the next installment of our key #oncology meeting highlights via #accredited #tweetorials from @onc_ce, your new (only) home for the latest education from #experts on #cancer care. #Physicians #nurses #pharmacists #PAs and #NPs all earn 0.5h CE/#CME by following!

2) We are continuing with our coverage of the recent @ASCO #GI22–only the most current updates for OUR followers! Our expert author is Dr. Pashtoon Kasi (@pashtoonkasi) from @WeillCornell in New York. The topics are updates in hepatobiliary cancers #HPBCSM.

3) These meeting summaries on @onc_ce and its companion website http://oncologytweetorials-ce.com are supported by an educational grant from Bayer and content is intended for #healthcare providers. Faculty disclosures are listed at

4) @ASCO #GI22 is a primary international scientific symposium for interaction and exchange among basic scientists and clinicians working in #GIcancer. @ASCO #GI22 was a hybrid meeting this year, with many renowned researchers welcoming the opportunity to collaborate FTF!

5) So, let's start with a quick knowledge check. Which of the following is a category 1 1st-line systemic therapy option for patients with advanced/metastatic #cholangiocarcinoma? @curecc

6) For over a decade, Gem/Cis has been the preferred 1st-lne chemotherapy regimen for patients with advanced/metastatic #cholangiocarcinoma. @NEJM 2010 from the ABC-02 Trial. Overall survival of 11.7 versus 8.1 months.

7) This brings us to the first big update!
#TOPAZ1
For the first time, we have a regimen that in a large phase-3 study was noted to be superior to Gem/Cis; the addition of durvalumab #immunotherapy to this chemo backbone. #ClinicalTrials #PD-L1⛔️

8) While the improvement in median OS at face value may not seem profound, a new theme @ASCO #GI22 as we interpret the clinical value of these #immunotherapy #clinicaltrials is looking at the ‘tails of the curves’🦕 (‘milestone’ analysis). @JNCI_Now 2015 Milestone Survival.

9) Let’s look at #TOPAZ1 data again. OS is 12.8 m versus 11.5 m. However, 2-year OS is 24.9% versus 10.4%. Looking at the ABC-02 trial, the exposure to #immunotherapy is pointing towards a long-term survival and delayed clinical effects; need to redefine trial endpoints.

10) The way I (@pashtoonkasi) see it, this is likely to be @US_FDA @FDAOncology @NCCN approved ✅soon for patients with advanced/metastatic #cholangiocarcinoma.

Gem/Cis ➕Durvalumab (#immunotherapy PD-L1⛔️)

11) Next, let’s switch gears to #HepatocellularCancer #HCC. Before we discuss the next big update, quick knowledge check. Which of the following is NOT a 1st-line treatment option for patients with advanced/metastatic HCC? #HPBCSM

12) This brings us to the second big update: #clinicaltrials
HIMALAYA
Another large phase-3 study meeting the primary endpoint: OS 16.4 m versus 13.8 m.

13) Let’s circle back to the new theme @ASCO #GI22 as we interpret the clinical value of these #immunotherapy #clinicaltrials in looking at the ‘tails of the curves’🦕 (‘milestone’ analysis). @JNCI_Now 2015 Milestone Survival.

14) Let’s look at #HIMALAYA data again. OS is 16.4 m versus 13.8 m. However, 3-year OS is 30.7% versus 20.2%.

15) What is also unique about this trial is the idea of just 1 dose CTLA4⛔️; the so-called STRIDE regimen @JCO_ASCO 🔓

https://ascopubs.org/doi/pdf/10.1200/JCO.20.03555

16) The T300+D STRIDE regimen in the HIMALAYA study is also something that I (@pashtoonkasi) foresee will likely be @US_FDA @FDAOncology @NCCN approved ✅soon for patients with advanced/metastatic #HCC #HepatocellularCancer.

17) Just to recap the 2 most anticipated and talked about trials @ASCO #GI22
TOPAZ-1
HIMALAYA

No wonder #GI22 was considered the year for hepatobiliary cancers.

18) Keeping the #HCC theme and trials leading to an improvement in overall survival, the LAUNCH trial was something that caught my attention. Median OS of 17.8 m versus 11.5 m with LEN-TACE versus TACE alone.

19) Not just HCC, this trial is a good reminder for selecting locoregional therapies for the right patient, the right biology, and the right distribution of the burden of disease. I liked this slide from the @ASCO discussants on selecting the right patient for this approach.

20) With respect to LAUNCH trial and doing locoregional therapies in addition to systemic therapies, this is something that comes up in any liver multidisciplinary tumor board discussion. And there are options within the toolbox on the kind of locoregional therapy.

21) Here’s some additional rich discussion on the 3 #clinicaltrials we talked about in the #HPBCSM space:

TOPAZ-1
HIMALAYA
LAUNCH

22) Here’s a #TwitterPoll, I foresee both HIMALAYA STRIDE regimen for HCC and TOPAZ-1 regimen for cholangiocarcinoma getting approved and being an option for patients with HCC and Cholangiocarcinoma, respectively:

23) And that's it! Now go and claim your FREE CE/#CME at https://oncologytweetorials-ce.com/hepatobiliary & FOLLOW US for more #accredited #tweetorials for #physicians #pharmacists #nurses. The landscape of options is indeed quickly changing for patients with hepatobiliary cancers #HPBCSM

24) Please follow us! @KlempnerSam @AnwaarSaeed3 @aparna1024 @doctorC369 @curecc @MallaMidhun @mtmdphd @marklewismd @CCA_Alliance @profevasegelov @BrandonMeyersMD @NiuSanford @ShaalanBeg @cancerassassin1 @realbowtiedoc

Originally tweeted by @onc_ce (@onc_ce) on February 17, 2022.