Professor of medicine | medical oncologist | Head @EHCSMonash | Chair, @ANZUPtrials | husband, father, grandfather, blessed | want to make a positive difference
Fun fact: if toothpaste, even so tiny a piece that it cannot be seen, flicks off one bristle and lands in your eye, it stings like anything.
How’s your day going?
Twice today already at ASCO I have heard presenters say “patients failed treatment”.
Can we please, please stop that?
Treatments fail patients, not the other way around…
Let us not discount the importance of grade 2 xerostomia:
CTCAE v5:
“Moderate symptoms; oral intake alterations (e.g., copious water, other
lubricants, diet limited to purees and/or soft, moist foods); unstimulated saliva 0.1 to 0.2 ml/min”
#ASCO26
And @fizazi_karim just made the critically important points that:
* Referral to clinical trials should always be considered if available
* Palliative care and active treatment can (I think must!) be used together.
My footnote: understand your patient’s goals of care.
#ASCO26
Wonderful talk by @drlouiseemmett in #ASCO26 educational session on “How to Better Personalize Treatment With Lu-PSMA,” highlighting the amazing clinical and translational outcomes of many studies especially @ANZUPtrials#TheraP and #ENZAp. These great trials continue to deliver.
And @fizazi_karim just made the critically important points that:
* Referral to clinical trials should always be considered if available
* Palliative care and active treatment can (I think must!) be used together.
My footnote: understand your patient’s goals of care.
#ASCO26
A quiet and profound tragedy and indictment on society buried in the footnote of an #ASCO26 slide:
“1 patient off study after cycle 1 due to insurance coverage issues.”
Masterful discussion by @declangmurphy of #PROTEUS in #ASCO26 LBA1 plenary, complete with an incidental and effective drive by swipe at inappropriate ARPI switch controls. And nods to #ENZARAD, and to @ANZUPtrials@ChrisSweens1 proposed freedom from clinical detriment endpoint.
#ASCO26 plenary sessions are about to start. At least one will warrant a standing ovation and at least one does not, in my opinion. I hope any standing ovations that occur are actually real and not orchestrated (as if such a thing has ever happened before…)
Seriously, am I the only one affected by this? It has been going constantly in D1 for the last 30min and will continue another 10 at least, till the next session. @ASCO silence can suffice. #ASCO26
One of the best parts of #ASCO26 is reconnecting with friends and colleagues. Always wonderful to see @Prof_IanD@oncology_bg@PauloBergerot during the poster session and catch up amidst the excitement of the meeting! @ASCO
1/ #ASCO26 starts tomorrow. By Friday your feed will be full of survival curves, and the temptation will be everywhere: cross-trial/study comparison.
Before you do so, A few caveats worth keeping in mind
And the flip side of this, “well-tolerated”
In 250 Ph1 #MMSM ASCO/ASH/EHA abstracts, 194 (78%) used it or similar terms…
In those studies 15% of patients died & 28% had to discontinue tx.
#ASCO26#ASH26ascopubs.org/doi/10.1200/OP-…
Let us please ban at #ASCO18:
* “Trend towards statistical significance”
* Subgroup overinterpretation
* Forest plot mangling
The old saying: if you torture the data long enough, it will confess.