1b) Our expert authors are @NarjustFlorezMD, Assoc. Director CCEP & Thoracic Oncology @DanaFarberNews and her mentee @ShrutiPatelMD, #MedOnc fellow @StanfordCancer. Earn 🆓CE/CME credit for following this 🧵! pic.twitter.com/Kvz0rtScuB
— @onc_ce (@onc_ce) January 18, 2023
3) #Lungcancer is the #1 cause of cancer-related death in ♂️ and #2 in ♀️ worldwide. Despite screening recommendations in select populations, late diagnosis is very common. Over the past 50 years, there has been ⬇️ in lung CA incidence for men and ⬆️in women. pic.twitter.com/V4XAAIKaN7
— @onc_ce (@onc_ce) January 18, 2023
5) Over the past two decades, there has been a surge of driver mutations & oncogene-targeted txs in #lungcancer that have improved PFS & OS of patients with these mutations.
— @onc_ce (@onc_ce) January 18, 2023
Mutations include:
🧬EGFR exon 19/21
🧬EGFR exon 20
🧬MET exon 14 skipping
🧬HER2
🧬KRAS G12C
🧬ALK
7) Despite these excellent developments in molecular targeted agents in NSCLC⤵️
— @onc_ce (@onc_ce) January 18, 2023
❗36% of patients do NOT have a driver mutation that is targetable by an @US_FDA approved drug
❗️Resistance is common, and frequently patients have to return to chemotherapy +/- immunotherapy
9a) You might have heard about #CEACAMs before in relation to the tumor marker CEA, which was identified as a prominent tumor-associated antigen in human #coloncancer in the mid-1960s!
— @onc_ce (@onc_ce) January 18, 2023
10) So let's talk about #CEACAMs!! These molecules are involved in a ton of day to day cellular functions including:
— @onc_ce (@onc_ce) January 18, 2023
🧫 cell–cell recognition
🧫 shaping of tissue architecture
🧫 neovascularization
🧫 regulation of insulin homeostasis
🧫T-cell proliferation.
12) Why does #CEACAM5 matter in cancer?!
— @onc_ce (@onc_ce) January 18, 2023
⚗️plays a role in contact-mediating during metastasis
⚗️facilitates tumor invasion and metastasis
See 🔓 https://t.co/7xAk91l6pX and https://t.co/lphILAeiRX
13b) What percentage of patients with #NSCLC adenocarcinoma 🫁 do you think have an overexpression of #CEACAM5?
— @onc_ce (@onc_ce) January 18, 2023
A.2%
B.5%
C.15%
D.20%
14a) #CEACAM5 can be detected using #immunohistochemical (#IHC) assays
— @onc_ce (@onc_ce) January 18, 2023
👩🏽🔬Positive staining has been defined as any partial or complete tumor cell plasma membrane staining at a minimum of 2+ intensity.
15a) Which of the following is the compound targeting #CEACAM5? 🧪
— @onc_ce (@onc_ce) January 18, 2023
A.Trastuzumab deruxtecan
B.Amivantamab
C.Tusamitamab ravtansine
D.Patritumab deruxtecan
16)
— @onc_ce (@onc_ce) January 18, 2023
🏥Phase 3 #CARMEN_LC03 trial https://t.co/Qf8QQJaImb
💉Comparing #tusamitamab ravtansine vs #docetaxel
🦠metastatic nonsquamous #NSCLC
🔬 >50% of tumor expresses #CEACAM5 at 2+ intensity
🦀disease has progressed after prior therapy pic.twitter.com/rkROTJTSWQ
18)
— @onc_ce (@onc_ce) January 18, 2023
🏥Phase 2 #CARMEN_LC05 trial https://t.co/Pwt4qSCPBo
💉Comparing #tusamitamab_ravtansine + #pembro vs pembro alone
🦠metastatic #nonsquamous #NSCLC
🔬 >50% of tumor expresses #CEACAM5 at 2+ intensity
20) The big challenge ⚠️ that we have with enrollment, especially in the frontline setting but in all settings as well, is that patients need to have a ➕ #CEACAM5 test to enroll.
— @onc_ce (@onc_ce) January 18, 2023
21b)
— @onc_ce (@onc_ce) January 18, 2023
⚗️ Corneal events are reversible and manageable by dose modification (dose delay and/or dose reductions)
⚗️ Median time to recovery was 18.5 (2-82) days pic.twitter.com/4S81aW7RJ1
23a) To 🎁 up, 🔑points:
— @onc_ce (@onc_ce) January 18, 2023
🫁 36% of patients with #NSCLC do NOT have a driver mutation that is targetable by an @US_FDA approved drug
🫁 A novel target, carcinoembryonic antigen–related cell adhesion molecule 5 (#CEACAM5) known to us from #coloncancer, may hold promise
23c)
— @onc_ce (@onc_ce) January 18, 2023
🫁 Initial efficacy looks promising, esp for #NSQ_NSCLC. See the #CARMEN portfolio. Primary safety concern is #keratopathy.
24) That's it! You just earned 0.5hr 🆓CE/#CME. Claim your certificate at https://t.co/28ugmJIEja. FOLLOW US for more expert-authored programs on the LATEST in #oncology. @NarjustFlorezMD, @ShrutiPatelMD, & @academiccme thank you for joining us!#FOAMed #onctwitter #LCSM
— @onc_ce (@onc_ce) January 18, 2023