2) Earn 0.5hr ๐CE/#CME credit w/ this ๐งต! @onc_ce is your ONLY source for serialized #accredited CE/#CME #tweetorials in #oncology. This program is supported by an educational grant from GSK plc and is intended for healthcare professionals.
— @onc_ce (@onc_ce) October 14, 2022
4) In this #tweetorial, we recent updates to @NCCN guidelines pertinent to advanced #ovariancancer. We will break it down into changes that address the most common form of #ovariancancer โ epithelial ovarian cancer (#EOC) followed by less common ovarian cancers (#LCOC).
— @onc_ce (@onc_ce) October 14, 2022
6) @NCCN update: Tumor molecular analyses on the most recent available tumor tissue should include (minimum):
— @onc_ce (@onc_ce) October 14, 2022
๐Upfront: #BRCA 1/2; LOH; homologous recombination (HR) status in the absence of a germline BRCA mutation
๐Recurrence: BRCA1/2; HR status; MSI; MMR; TMB; BRAF; NTRK
8) โ ๏ธThe continued inclusion of #olaparib as a recurrence therapy option was reassessed after the withdrawal of the @US_FDA indication in patients w/ germline #BRCA-mutated advanced #OvarianCancer who have received โฅ3 lines of chemo (based on #SOLO3).
— @onc_ce (@onc_ce) October 14, 2022
๐https://t.co/F7X1l3g2C9
10) #SOLO3 final OS data
— @onc_ce (@onc_ce) October 14, 2022
OLA vs TPC
๐mOS: 34.9 vs 32.9 mos
๐HR 1.07; 95% CI 0.76โ1.49; P=0.714
๐mPFS2: 23.6 vs 19.6 mos
๐HR 0.80; 95% CI 0.56โ1.15; P=0.229
๐No significant difference in OS or PFS2 (but โฌ๏ธtime to subsequent treatment & time to discontinuation/death) pic.twitter.com/27N4lExaIe
12) @NCCN update: For recurrence therapy for germline/somatic #BRCA-mutated epithelial #OvarianCancer (platinum-sensitive or -resistant) after โฅ2 lines of chemo, #rucaparib (RUC) was changed from a CATEGORY 2A (preferred regimen) to a CATEGORY 3 (other recommended regimen).
— @onc_ce (@onc_ce) October 14, 2022
14) #ARIEL4 final OS data presented at #ESMO22
— @onc_ce (@onc_ce) October 14, 2022
๐๐https://t.co/TIOaPTiZxY
๐คP: Patients w/ #BRCA-mutated relapsed #OvarianCancer after โฅ2 lines of chemo (N=349)
๐I: #Rucaparib (RUC) (n=233)
๐C: Chemo (CT) (n=166)
16) @NCCN update: For recurrence therapy for platinum-sensitive or -resistant epithelial #OvarianCancer w/ #BRAF V600E mutation, #dabrafenibโ#trametinib was added as a CATEGORY 2A (Useful in certain circumstances) recommendation.
— @onc_ce (@onc_ce) October 14, 2022
18) #NCIMATCH Trial Subprotocol H
— @onc_ce (@onc_ce) October 14, 2022
๐๐https://t.co/7dArDwynnA
๐คP: Patients w/ solid tumors, lymphomas or multiple myeloma whose tumors had a #BRAF V600 mutation (N=29)
๐I: #Dabrafenibโ#trametinib
๐O: ORR
โณ๏ธ45% had received โฅ3 lines of therapy pic.twitter.com/YboSkvIlrf
20) @NCCN update: #Immunotherapy w/ #pembrolizumab is considered as a useful recurrence therapy option for platinum-sensitive or -resistant epithelial #OvarianCancer patients w/ MSI-H or dMMR solid tumors, or TMB-H tumors (โฅ10 mutations/megabase).
— @onc_ce (@onc_ce) October 14, 2022
22) Le et al.
— @onc_ce (@onc_ce) October 14, 2022
๐ORR: 53%; 95% CI 42โ64
๐CR: 21%
๐PR: 33%
๐DCR: 77%; 95% CI 66โ85
๐Neither mPFS nor mOS has yet been reached
24) #GARNET combined analysis
— @onc_ce (@onc_ce) October 14, 2022
๐๐https://t.co/Y1Fi0e9Xob
๐คCohort A1: Patients w/ advanced/recurrent dMMR/MSI-H endometrial cancer (EC)
๐คCohort F: Patients w/ advanced/recurrent dMMR/MSI-H or POLฮต-hypermutated non-EC solid tumors
๐I: #Dostarlimab
๐O: ORR, DoR pic.twitter.com/084LM4pwEn
26) Letโs now turn our attention to guideline changes relevant to less common #ovarian cancers (LCOC). @DrMMurphy will walk us through those changes, now!
— @onc_ce (@onc_ce) October 14, 2022
28a) Change made based on findings of the @NCI #NCIMATCH trial resulting in accelerated approval of debrafenib-trametinib combo for metastatic/unresectable BRAF V600E mutated solid tumors with progression after primary tx. (Covered by @DrMeredithGT above!)
— @onc_ce (@onc_ce) October 14, 2022
29) @NCCN update: Multiple regimens ADDED for #palliative treatment of recurrent malignant ovarian germ cell tumors: oral #etoposide, #gemcitabine/#oxaliplatin +/- #paclitaxel, #pembrolizumab (if MSI-H/dMMR or TMB-H). pic.twitter.com/MRYBKO9oCo
— @onc_ce (@onc_ce) October 14, 2022
31) Let's close with a couple quick cases to see what you've learned! ๐ to @drdonsdizon @DrMMarkham @ShannonWestin @DrTeplinsky @LAMcAlarnenMD @gyncsm @ErikaHamilton9 @OphiraG @CParkMD @NitaKarnikLee @HOJournalClub @dsmgyo @SidYadavMD @oncology_bg @AndreaAnampaG @agz_eriksson
— @onc_ce (@onc_ce) October 14, 2022
32b) The correct choice is BRCA testing! At the time of diagnosis, all women with ovarian cancer should undergo testing for g/sBRCA mutations (see @ASCO guidelines!).
— @onc_ce (@onc_ce) October 14, 2022
33a) Case 2โฃ: A 55 yo patient with recurrent low grade serous carcinoma of the ovary. Prior treatments have included surgical resection followed by adjuvant chemotherapy 2 years ago. Tumor testing indicates the presence of a BRAF V600E mutation.
— @onc_ce (@onc_ce) October 14, 2022
33c) If you chose dabrafenib-trametinib, you chose correctly! This combo was recently approved by the FDA based on the @NCI #NCIMATCH trial for solid tumors with a #BRAF V600E mutation. Pts with #LGSOC were included in this study and all had a positive treatment response!
— @onc_ce (@onc_ce) October 14, 2022
34b) Expert authors for this program were Meredith GTrinidad MD @DrMeredithGT ๐ต๐ญ & Martina Murphy MD @DrMMurphy ๐
— @onc_ce (@onc_ce) October 14, 2022
Claim your ๐CE/#CME certificate at https://t.co/m4E3LWBLKw