iiinova — where your digital self keeps evolving

Dr. RShatsky @dr-rshatsky.bsky.social · 09/04/2025

#medSky #OncSKy Oncology/Medical community on here are any of you considering leaving the country given the political climate? I don’t want to raise my kids in a dictatorship and it’s getting more and more hopeless here. Would love to hear people’s thoughts😔

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Society for Immunotherapy of Cancer @sitcancer.bsky.social · 18/03/2025

New Journal for ImmunoTherapy of Cancer ( #JITC ) article: Fc-mediated immune stimulating, pro-inflammatory and antitumor effects of anti-HER2 IgE against HER2-expressing and trastuzumab-resistant tumors bit.ly/41wAsiY #MedSky #OncSky #CanSky #cancer #research

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Dr. RShatsky @dr-rshatsky.bsky.social · 08/03/2025

I found the puppies at Miami Breast and they made me soooo happy #MBCC25

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Dr. RShatsky @dr-rshatsky.bsky.social · 02/03/2025

OK who’s joining me at Miami breast this week? Not excited about spending money in a state like Florida, but am excited to speak about management of breast cancer during pregnancy and getting pregnant after breast cancer!! #OncSKY #MedSky#CanSKY

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MedCaseCME @medcasecme.bsky.social · 28/02/2025

📢 all🩺#oncology #bcsm #MedSky #OncSky 🎯#TNBC patient case CME w/ @dr-rshatsky.bsky.social y.social & @ptarantinomd.bsky.social ✍️Supported by an edu grant from Gilead Sciences 🆓 #CME info 🔗 bit.ly/tnbc_casesim Provided by @bonumce.bsky.social 🖱️👇Scroll down to start

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Dr. RShatsky @dr-rshatsky.bsky.social · 24/02/2025

I spend my precious free time hiding from reality and enjoying every single moment I can with my family. Yesterday Er_OncDoc the kids a s I supported our beloved San Diego zoo! #MedSky

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Anne Fallon, MD @annefallon.bsky.social · 23/02/2025

These weren’t lazy bureaucrats doing unimportant work. They were working hard, and often for less money than they could get in the private sector, on key life-saving public health programs. They were fired to give more money to billionaires. #DOGEkills #medsky www.propublica.org/article/trum...

propublica.org

They Worked to Prevent Death. The Trump Administration Fired Them.

Public health teams are being gutted, imperiling efforts to safeguard organ donation and prevent maternal and infant death. Many workers expressed fear at what would happen to the work they left behin...

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Timothy Caulfield @caulfieldtim.bsky.social · 05/02/2025

Misinformation on social media is winning – scientists must adapt healthydebate.ca/2025/02/topi... via @healthydebate.bsky.social "It’s not just about vaccines or pandemics – misinformation about ADHD, cancer treatments, weight loss, fertility & chronic disease management thrives online."

healthydebate.ca

Misinformation on social media is winning – scientists must adapt or lose the battle - Healthy Debate

Scientists and health professionals must rethink how we communicate or risk further marginalization in the public discourse.

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Louise in Ontario🇨🇦 @grammalou.bsky.social · 05/02/2025

Healthcare workers are very welcome in Canada. #MedSky

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Dr. RShatsky @dr-rshatsky.bsky.social · 30/01/2025

I am definitely burning the candle at both ends. Spoke at the USC breast symposium last weekend and speaking at the UCSD Binyatara conference this weekend. A friend did get a good pic or me wildly gesticulating last weekend though😆. This is my the SOC is not enough face!!! #CanSKy #MedSky

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Dr. RShatsky @dr-rshatsky.bsky.social · 28/01/2025

Just when you thought your day (or month) couldn’t get any worse…. you pull a muscle in your neck…and well. It’s so much worse 😑. I’m not sure what this emoji I just found is supposed to be, but I think it’s what I need right now 💆🏼‍♀️

media.tenor.com

a cartoon of two cats laying next to each other with the words you giving me a neck and shoulder massage

ALT: a cartoon of two cats laying next to each other with the words you giving me a neck and shoulder massage

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Dr. RShatsky @dr-rshatsky.bsky.social · 24/01/2025

Most mom’s in their mid 40’s invest in cute jeans and yoga pants for themselves. But when you’re an oncology nerd on the academic conference speaking circuit. It’s badass suits that make all the difference and my houndstooth game is strong. #Medsky #AcademicMedicine #CanSky #OncSky

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Dr. RShatsky @dr-rshatsky.bsky.social · 23/01/2025

Reading the news headlines is making me so ill I needed my bestie in bed tonight. Pray for your cancer researchers to keep their jobs amid the Trump administration freezing the NIH study section groups. #CanSky #OncSky #MedSky

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Dr. RShatsky @dr-rshatsky.bsky.social · 22/01/2025

The new administration is here and I’m scared to look and find out what important life saving health measures are being cut each day. Yesterday was the plan to lower Medicare drug costs for seniors. What will tomorrow hold? #MedSky

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Dr. RShatsky @dr-rshatsky.bsky.social · 16/01/2025

Posting this as a PSA. There seems to have been some article in the media about City of Hope’s Ivermectin phase 1 in TNBC. It has been open since 2021. Not looking good. Stop messaging your poor oncologist about this. It is not some miracle cure. #MedSky #CanSky

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Dr. RShatsky @dr-rshatsky.bsky.social · 15/01/2025

And after a long day of clinic and a inaugural BlueSky breast cancer chat I get home to this! I’m a lucky lady! ❤️ He looks better in it than I do for sure. #MedSky

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

18/20 #TumorBoardTuesday @dr-rshatsky.bsky.social Beyond SERDs/SERMs…novel endocrine therapies targeting other mechanisms in pipeline: Proteolysis targeting chimeras (PROTACs), selective ER covalent antagonists, complete ER antagonists just to name a few!🤯

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

17/20 #TumorBoardTuesday @dr-rshatsky.bsky.social Beyond EMBER-3, novel combinations with SERDs and SERMs also being evaluated with CDK4/6i

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

17/20 #TumorBoardTuesday @dr-rshatsky.bsky.social ➡️Multiple novel SERDS studied in HR+/HER2- ABC 👍Elacestrant currently remains the only FDA approved option 🚧Novel SERDs w/ unique AEs from fulvestrant ⚡This is a rapidly changing landscape!

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

16/20 #TumorBoardTuesday @dr-rshatsky.bsky.social 🔙 to our case EMBER3 would be a great option, but based on availability, pt got elacestrant 🚫 abema+fulvestrant: -ESR1 Y537S 👉fulvestrant resistance. -POSTMONARCH👉modest PFS benof abema+fulv vs placebo+fulv AND 🚫benefit in subgroup w/ prior ribo

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

15/20 #TumorBoardTuesday @dr-rshatsky.bsky.social 👩‍⚕️Mini Tutorial 6👩‍⚕️ Imlunestrant: favorable safety profile vs SoC. Dc rate: 4% Imlun+abema: diarrhea=most common AE, all grade: 86%, grade≥3: 8%. Dc rate: 6% No 👁️or 💙AE signals like in other oral SERDS (i.e. photopsia, bradycardia in camizestrant)

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

14/20 #TumorBoardTuesday @dr-rshatsky.bsky.social 👩‍⚕️Mini Tutorial 5👩‍⚕️ 🔑Findings: PFS ESR1m: 5.5 (Imlun) vs 3.8 mon (SoC). HR= 0.62, p<0.001 PFS all: 9.4 (Imlun+abema) vs 5.5 mon (imlun). HR=0.57, p<0.001 Benefit of imlun+abema in key subgroups: ESR1m, PIK3CAm, visceral disease, prior CDK4/6i

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

13/20 #TumorBoardTuesday @dr-rshatsky.bsky.social 👩‍⚕️Mini Tutorial 4👩‍⚕️ Novel, oral SERDs in development w/ ⬆️efficacy ⬇️toxicities 👉💡imlunestrant, studied in the EMBER-3 trial presented at #SABCS24 🔑Pt features: ~37% with ESR1m, ~40% with PIK3CAm, >50% visceral disease 👉1/3 adj ET, 2/3 prior CDK4/6i

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

12/20 #TumorBoardTuesday @dr-rshatsky.bsky.social 2023, FDA approved elacestrant based on the EMERALD trial Pts: prior 1-2L ET, ≤1 chemo for ABC: R 1:1 ➡️elacestrant vs SoC ➡️ PFS all: HR = 0.70; p = .002 PFS ESR1m: HR = 0.55; p = .0005 Benefit in key subgroups: PIK3CA mut, ESR1 mut, and TP53 mut

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

11/20 #TumorBoardTuesday @dr-rshatsky.bsky.social 👩‍⚕️Mini Tutorial 2👩‍⚕️ ESR1 mutations are present in: ~4% of 1L setting ~30% in 2L+ setting 👉Not all ESR1 mutations are created the same! -ESR1 Y537S is associated with relative resistance to fulvestrant! pmc.ncbi.nlm.nih.gov/articles/PMC...

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

10/20 #TumorBoardTuesday 👩‍⚕️Mini Tutorial 1👩‍⚕️ Therapy options after progression on 1L ET+CDK4/6i are biomarker driven. @dr-rshatsky.bsky.social

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

10/20 #TumorBoardTuesday What would you select as next line of therapy? 1. Abemaciclib+fulvestrant 2. Elacestrant 3. Evaluate for clinical trials involving novel SERDs @dr-rshatsky.bsky.social

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

9/20 #TumorBoardTuesday ⭐Case 2⭐ 50 y/o postmenopausal F with de novo metastatic invasive ductal carcinoma, ER >95%, PR >95%, HER2– (IHC2+) involving the 🦴 and liver (intact function), progressed on 1st line ribociclib+AI after 12 months, w/ ESR1 Y537S mutation on ctDNA🤔 @dr-rshatsky.bsky.social

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

8/20 #TumorBoardTuesday ⚖️ efficacy with safety… Inavo arm: ↑AEs vs control All-grade hyperglycemia: 58.6%; grade 3 or 4: 5.6% All-grade stomatitis: 51.2%; grade 3 or 4: 5.6% All-grade diarrhea: 48.1%; grade 3 or 4: 3.7% 1° ppx for above was not offered in the trial @dr-rshatsky.bsky.social

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

7/20 #TumorBoardTuesday Back to our case🔎 Pt started inavo, palbo, and fulv 2 weeks in, developed grade 2 stomatitis self-dced inavo and palbo Started dexamethasone+mucositis mouthwash, but sxs not resolved Currently undergoing evaluation for subsequent therapy @dr-rshatsky.bsky.social

media.tenor.com

a small yellow duck is laying on a table next to a notebook and the word no .

ALT: a small yellow duck is laying on a table next to a notebook and the word no .

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

6/20 #TumorBoardTuesday 👩‍⚕️Mini Tutorial 3👩‍⚕️ Pts R 1:1 to Inavo vs placebo +palbo+fulv 🔑findings: Median f/u: 21.3 mon Median PFS: 15.0 mon(Inavo) vs 7.3 mon (control) (HR 0.43; p<0.0001) ORR: 58.4% (Inavo) vs 25% (control) Consistent benefit across key subgroups @dr-rshatsky.bsky.social

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

5/20 #TumorBoardTuesday 👩‍⚕️Mini Tutorial 2👩‍⚕️ Pt characteristics in INAVO120: No prior treatment for ABC PIK3CA mut a1c≤6.0, fasting BG<126 ~Half with ≥3 involved organ sites ~Half with liver involvement, ~40% with 🫁 involvement ~1/3 with 1° endocrine resistance, 2/3 with 2° @dr-rshatsky.bsky.social

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

4/20 #TumorBoardTuesday 👩‍⚕️Mini Tutorial 1👩‍⚕️ Oct 2024, FDA approved inavolisib, palbociclib, and fulvestrant in endocrine resistant HR+/HER2- advanced breast cancer, based on the phase 3, INAVO120 study @dr-rshatsky.bsky.social

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

3/20 #TumorBoardTuesday Tissue NGS was not performed. CtDNA 🧬analysis revealing the following: -PIK3CA H1047R How does this impact your answer to the prior poll? 🤔 @dr-rshatsky.bsky.social

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

2/20 #TumorBoardTuesday Poll: What would you do next? 1. Sequence biopsied site of metastatic recurrence +/- ctDNA 2. Start ribociclib, switch endocrine therapy to fulvestrant 3. Start inavolisib, palbociclib and fulvestrant 4. Options 1 and 3 concurrently @dr-rshatsky.bsky.social

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 15/01/2025

1/20 #TumorBoardTuesday ⭐Case 1⭐ 46 y/o pre-menopausal F with L cT2N0, G3 IDC, ER >95%, PR >95%, HER2– (2+) s/p lumpectomy (pT2N0; oncotype RS 13), adjuvant RT, and 2 years into adjuvant OFS+AI, with metastatic recurrence (involving 🫁, thoracic LNs, and 🦴). #MedSky #MBC @dr-rshatsky.bsky.social

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Dr. RShatsky @dr-rshatsky.bsky.social · 14/01/2025

This is happening tonight folks! 8pm Eastern 5 pacific!

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Xiaojie (Zoe) Zhang @zoezhang.bsky.social · 10/01/2025

So excited to begin my #Medsky journey by presenting with my amazing clinic mentor @dr-rshatsky.bsky.social at #TBT on new developments in HR+ MBC! ! It will be on Tuesday the 14th at 5pm pacific, 8pm eastern! #bcsm #OncSky #CanSky #MedSky #breastcancer #MBC

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Still Waters Osteopathic Medical Clinic @getfitnbelean.bsky.social · 10/01/2025

MedSky Influenza Questionnaire; 1. Do you feel like you got hit by a truck? If yes, go to 2. 2. Did you actually get hit by a truck? If no, go to 3. 3. You have the flu. Late surge this year, get your flu shot!

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Dr. RShatsky @dr-rshatsky.bsky.social · 09/01/2025

Hello all, wanted to let you know about a fantastic interactive learning opportunity! This Tuesday the 14th my lovely fellow and I will be presenting Tumor board Tuesday #TBT about new developments in HR+ MBC! It will be 5pm pacific, 8pm eastern! #bcsm #OncSky #CanSky #MedSky #breastcancer #MBC

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Dr. RShatsky @dr-rshatsky.bsky.social · 31/12/2024

There is a giant Flu A outbreak and EROncDoc is heading off to his night shift. I just begged him to wear his N95 all night so that he doesn’t bring it home. I Can. Not. Handle. Another virus. I think my nose will fall off and my lungs will jump out of my chest if I get another one. #MedSky #Flu

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Dr. RShatsky @dr-rshatsky.bsky.social · 31/12/2024

Ga I still haven’t figured this platform out completely I just deleted my own post by accident. I accidentally deleted a post where I was making fun of my own lack of tech skills. How ironic and poignant.

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Dr. RShatsky @dr-rshatsky.bsky.social · 31/12/2024

If I’ve been quiet on social media for awhile it’s because 1. I have been spending some much needed family time with extended family and 2.I’ve been sick with all the cold viruses one could possibly get. My toddler’s preschool keeps my family in constant virus battle. It’s not…awesome. Sigh.

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