iiinova — where your digital self keeps evolving

Reposted by Hannah R. Abrams

Larry Levitt @larrylevitt.bsky.social · 15/09/2026

New Census numbers show the number of people uninsured held steady in 2025. BUT...That's before enhanced ACA premium subsidies expired, causing millions of people to drop coverage this year. And before Medicaid cuts start to hit next year. www.census.gov/library/publ...

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Hannah R. Abrams @hannahrabrams.bsky.social · 12/09/2026

I learn something every time I read papers by oncology PharmDs. This @JCOOP_ASCO letter talks through discrepant findings between 2 studies of taxane titration. It would be great to save patients time-in-chair, but there are still some key concerns: ascopubs.org/doi/pdf/10.1...

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Hannah R. Abrams @hannahrabrams.bsky.social · 09/09/2026

Honestly, he uses “Cobenfry” consistently in the whole thread to the point that I wondered if it was an attempt to avoid this coming up in routine searches from the company

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Hannah R. Abrams @hannahrabrams.bsky.social · 09/09/2026

What's unique about financial toxicity in pediatric cancer settings? - Effect on siblings, costs of both food + babysitting for other kids & lost wages - Long-term financial effects for young families at a fragile time - Often using crowdfunding, eg GoFundMe, to help ascopubs.org/doi/pdf/10.1...

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Hannah R. Abrams @hannahrabrams.bsky.social · 24/07/2026

To a non-expert, this seems to be a neat new tool: Google can now create and export isochrones (maps of the space within a given travel time from a point) from a given point. Here's the space within 30 minutes of Seattle's trauma hospital (Harborview), for ex. developers.google.com/maps/documen...

Information page for Isochrones API.The Isochrones API calculates the area that a person can reach from a specific origin point within a set amount of time. Unlike a radius, which measures a straight-line distance, an isochrone accounts for actual road network travel times to create a polygon that represents true reachability.

Common use cases include:

Delivery logistics: Determine which customers are servable within 30 minutes of a warehouse.
Real estate: Find properties within a 45-minute commute of a workplace.
Urban planning: Analyze the accessibility of essential services like hospitals or grocery stores.
To get started, see Set up the Isochrones API.

30 minute isochrone for Harborview Medical Center

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Hannah R. Abrams @hannahrabrams.bsky.social · 17/07/2026

Great point... interestingly, they do include some ascorbic acid powder of some sort, but didn't think about grain especially

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Hannah R. Abrams @hannahrabrams.bsky.social · 08/07/2026

A3: I wish I knew! I do think that influencers & advocates who are out there spreading accurate info & modeling positive relationships with the care system are doing important work, though. #AYACSM

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Hannah R. Abrams @hannahrabrams.bsky.social · 08/07/2026

Sorry to pop in late! I'm a sarcoma medical oncologist in Seattle. Hearing from many folks, it seems like the sheer volume of information (and misinformation) only increases by the year. If there aren't good resources/groups for your specific cancer, can be a challenge to find good info. #AYACSM

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Reposted by Hannah R. Abrams

Larry Levitt @larrylevitt.bsky.social · 26/06/2026

New federal data shows that as of February, 19.2 million people were signed up for ACA plans, down about 3 million as enhanced premium subsidies were allowed to expire. That number will surely grow as more people find they can't pay much higher out-of-pocket premiums. aspe.hhs.gov/reports/aca-...

aspe.hhs.gov

ACA Exchange Enrollment in 2026

Key Points

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Hannah R. Abrams @hannahrabrams.bsky.social · 25/06/2026

Managing bone health in breast cancer survivors on aromatase inhibitors: comprehensive review out now in JCO OP! @jessicaallenmd.bsky.social ascopubs.org/doi/full/10....

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Hannah R. Abrams @hannahrabrams.bsky.social · 22/06/2026

...And in a world of near universal prior auth for cancer drugs regardless (@michaelannica.bsky.social @fumikochino.bsky.social), unclear that MA vs traditional sees a big difference there.

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Hannah R. Abrams @hannahrabrams.bsky.social · 22/06/2026

Nice editorial @thewonkologist.bsky.social & Dr. Nancy Keating about revisiting our priors re: Medicare Advantage for cancer care. While there is reason to be cautious and investigate, current data on MA vs traditional medicare in cancer is far from conclusive. ascopubs.org/doi/10.1200/...

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Reposted by Hannah R. Abrams

Gabriele Mari @gmari.bsky.social · 16/03/2026

For unpaid #carers, earning more does not always lead to economic security. Motivated by the recent #Carer's #Allowance scandal, I have a new working paper @usociety.bsky.social on how much insecurity carers experience, for how long, who's most exposed and why: osf.io/preprints/so... 1/2

The figure shows reports of economic insecurity plotted against earnings from paid work. Earnings increase from left to right. At zero, earnings cross the Carer's Allowance limit of around 150 GBP per week. Past this limit, a carer loses eligibility for the allowance.

Carers who never report receipt of the allowance in the survey experience less and less insecurity when their earnings are higher.

For those with a history of benefit receipt, instead, insecurity doesn't decline smoothly. Arrears, the inability to save regularly, and money worries all spike past the earnings limit set by the allowance.

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Hannah R. Abrams @hannahrabrams.bsky.social · 22/06/2026

Does anyone know what happens if an entire group’s games all end in draws?

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Hannah R. Abrams @hannahrabrams.bsky.social · 22/06/2026

Absolutely. Also think that we should learn the lesson of the “your google search does not replace my MD” era & not condescend to people about using LLMs to try to get more info & streamline discussion w/ medical teams. People are using them, we need to figure out how to make the most of it.

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Hannah R. Abrams @hannahrabrams.bsky.social · 22/06/2026

Here, too! This law has been in effect for 2 years and I was very surprised to learn about it because I’ve never seen anywhere charge for them. I just appreciated the article’s robust data gathering around this point.

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Hannah R. Abrams @hannahrabrams.bsky.social · 22/06/2026

To be clear: I absolutely think patient navigation should be free!

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Hannah R. Abrams @hannahrabrams.bsky.social · 22/06/2026

From what I have seen so far, they do still require either pretty skilled data entry (or time to refine to that point) & a high level of discernment to avoid quick foreclosure on a wrong answer. I also think we don’t hear many stories of the latter. I hope they get more reliable over time, though.

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Hannah R. Abrams @hannahrabrams.bsky.social · 22/06/2026

As oncologists, we often see people after a long journey of self-advocacy to even get a diagnosis. I am happy to see anything shorten that. I think these tools, like Google search and WebMD in their time, will hopefully result in another “leap“ in democratizing medical info.

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Hannah R. Abrams @hannahrabrams.bsky.social · 22/06/2026

Agree, have seen this help & am happy to see people get support for low-risk symptoms. It cost me $700 for 30 min PA visit + 1 lab last week; I understand why people are looking for alternatives. I think some caution needed re: ads, higher-risk symptoms, & bias in training data (both docs & LLMs)

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Hannah R. Abrams @hannahrabrams.bsky.social · 21/06/2026

Did not know cancer centers can technically now bill for patient navigation. I agree with the patients interviewed here: navigation is extremely high-value, and also I do not think it should be behind a paywall. ascopubs.org/doi/10.1200/...

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Hannah R. Abrams @hannahrabrams.bsky.social · 20/06/2026

Waiting for clinical teams to order NGS slows down turnaround time by 2 weeks on average. It's time for insurance companies & cancer centers to work together & set up automatic pipelines in these situations, so patients don't have a long anxious wait to start treatment. ascopubs.org/doi/10.1200/...

Fig 2. (A) TAT intervals and definitions. (B) and (E) Yearly NSCLC CGP TAT and trend analysis (2018-2024). Boxes indicate median TAT, and whiskers indicate IQR. Dotted lines are linear trendlines: (B) overall TAT [Y = –1.154 × X + 2,361.0], (C) ordering TAT [Y = 0.2143 × X – 419.5], (D) specimen TAT [Y = –0.1357 × X + 279.0], and (E) molecular TAT [Y = –1.079 × X + 2,190.0]. P values reflect linear regression analysis (*P < .05, **P < .01, ***P < .001). CGP, comprehensive genomic profiling; NSCLC, non–small cell lung cancer; TAT, turnaround time.

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Reposted by Hannah R. Abrams

Aaron Mitchell @thewonkologist.bsky.social · 18/06/2026

Timely, this recent piece in JCO Oncology Practice @ascocancer.bsky.social seems aimed towards helping private practice oncologists understand the implications of selling to their practice to PE firms: ascopubs.org/doi/10.1200/...

ascopubs.org

From Burnout to Buyout: Private Equity's Growing Appeal in Oncology | JCO Oncology Practice

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Hannah R. Abrams @hannahrabrams.bsky.social · 18/06/2026

Unfortunately, this article is a mandatory part of the "move to Seattle" welcome pack. It's well written, just a little terrifying to think about.

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Hannah R. Abrams @hannahrabrams.bsky.social · 18/06/2026

Feels like a missed opportunity adapt to any of the lessons from Prenuvo, Grail/MCEDs, or screening research generally. Making whole body screening scans ubiquitous + a data funnel to Midjourney has real privacy risks, & unfortunately there's still not clear evidence they improve care yet.

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Hannah R. Abrams @hannahrabrams.bsky.social · 18/06/2026

Midjourney has announced they're developing a full-body 60 second "ultrasonic CT". I want better & cheaper imaging. But the idea that: 50K scanners x 720 min x 30d = 1 billion scans/mo Seems totally unaware of supply/demand, logistical constraints of getting people in/out, & privacy concerns

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Hannah R. Abrams @hannahrabrams.bsky.social · 03/06/2026

On the #ASCO26 hot topics of KRAS and toxicity: systematic review & meta-analysis in JCO OP of sotorasib dosing shows trend to improved PFS with LOWER dosing. Less toxicity -> longer time on-treatment? @jco-asco.bsky.social ascopubs.org/doi/10.1200/...

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Hannah R. Abrams @hannahrabrams.bsky.social · 30/05/2026

Key #desmoid tumor takeaways from RINGSIDE presentation (varegacestat) #ASCO26 #sarcoma today: - ORR 55.7%, remainder largely shrunk but under 30% - Quick time to pain improvement - only 4 weeks in many - 80% need for dose reduction primarily d/t diarrhea

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Hannah R. Abrams @hannahrabrams.bsky.social · 30/05/2026

JCO OP at #ASCO26: Follow up yesterday's session, "Cancer Care in Times of Crisis and in Immigrant and Displaced Populations." Full case discussion out now @jco-asco.bsky.social: ascopubs.org/doi/10.1200/...

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Hannah R. Abrams @hannahrabrams.bsky.social · 30/05/2026

#ASCO26 Abstract 12160: impressive effort to review charts of n = 848 patients for whether corticosteroids for irAE → worse cancer outcomes. Adds to/confirms existing literature in this area suggesting the concern is really with high doses.

Impact of corticosteroid exposure on long-term immune checkpoint in- hibitor responses in solid tumors. First Author: Theresa Medina, University of Colorado, Aurora, CO. Text beyond allowed length; summary: The steroid exposure was defined as very high if prednisone (or equivalent) ≥ 20mg/day and length of exposure was ≥ 42 days. 64.8% of patients experienced an irAE and 44.7% of patients developed G3-4 irAE requiring corticosteroids +/- steroid sparing agent. The low impact corticosteroid exposure did not affect PFS, OS or tumor specific survival. The very high impact CS exposure was associated with decrease in PFS (p = 0.02) but not with OS or TSS (p = 0.3). The high impact steroid sparing agent was associated with decrease in PFS (not significant) but the very high impact steroid sparing agent was associated with decrease in PFS. The chronic irAE was associated with slight improvement in PFS (not significant).

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Hannah R. Abrams @hannahrabrams.bsky.social · 29/05/2026

3. BCG + CIT: Knew from the abstract: pCR 68%, 42% had any BCG tox, 9% G3. Paper adds: while largely comprehensive, notably 20% of ITT didn’t get all doses of rBCG Would love to hear from bladder experts what your thoughts were now that the full paper is out! #ASCO26 ascopubs.org/doi/pdf/10.1...

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Hannah R. Abrams @hannahrabrams.bsky.social · 29/05/2026

2. First-dose taxanes, uncommon to see an online-only abstract as sim pub but I think this one really earned it! Surprisingly, stepwise titration doesn't reduce reactions - & probably is taking up a ton of people's time! #ASCO26 ascopubs.org/doi/10.1200/... Brief thread: x.com/HannahRAbram...

x.com

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Hannah R. Abrams @hannahrabrams.bsky.social · 29/05/2026

Paper adds: Forest plot w/o other clear predictors of response. Re: huge difference between κ and ƛ AL, anselamimab was generated w/ kappa isotype immunogen. KMs for overall vs κ-only & ƛ-only pop below! #ASCO26 ascopubs.org/doi/10.1200/...

Fig 2. Kaplan-Meier analysis of time to ACM in the (A) overall population, (B) patients with the kappa isotype, and (C) patients with the lambda isotype. Censor events are shown by vertical tick marks. ACM, all-cause mortality; PCD, plasma cell dyscrasia.

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Hannah R. Abrams @hannahrabrams.bsky.social · 29/05/2026

1. Anselamimab/AL amyloid What we knew from the abstract: in n = 271 pts w newly dx stg IIIa/IIIb AL amyloid, adding Anselamimab to (+/- dara)-CyBorD → In those w/ κ-AL, ↓ all-cause mortality 62% and CV hosp 71%. Limited benefit in ƛ-AL. Dara exposure similar. #ASCO26

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Hannah R. Abrams @hannahrabrams.bsky.social · 29/05/2026

What can we tell folks w/ taxane-induced peripheral neuropathy after early-stage cancer re: whether it will recover? @SWOG.org 1714, #ASCO26 abs 12117: - Of 1321 pts, 553 had TIPN at end of tx. - 48.5%, it improved - 33.8% didn't change - 17.7% worsened @drdawnhershman.bsky.social #survivorship

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Hannah R. Abrams @hannahrabrams.bsky.social · 27/05/2026

Perhaps that's interdisciplinary collaboration going too far 🤣

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Hannah R. Abrams @hannahrabrams.bsky.social · 27/05/2026

Tips for fellows going to their first #ASCO26 (as I prepare to go to my whole of... second): Google "mccormick place floor plan" and pick your favorite version of the map to save to your phone. I'm sure the blue 3D one works for some people, but it does not for me! 😂

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Hannah R. Abrams @hannahrabrams.bsky.social · 23/05/2026

It's not in your head: prior auth has increased over the past 10 years in oncology. (Though not as much as other specialties.) @jco-asco.bsky.social ascopubs.org/doi/10.1200/...

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Hannah R. Abrams @hannahrabrams.bsky.social · 21/05/2026

We have a lot of mechanisms to prevent OVER dosing of chemotherapy. This week in #JCOOP, Dr. Ruth Choa & colleagues outline a case in which an EMR error led a patient to receive an UNDER dose -only 50%- for 4/8 cycles of curative-intent treatment. @jco-asco.bsky.social ascopubs.org/doi/10.1200/...

Inadvertent Dose Reduction of Chemotherapy in a Patient Receiving Multiagent Neoadjuvant Chemotherapy
Authors: Ruth E. Choa, MD, PhD https://orcid.org/0000-0002-4798-7565 ruth_choa@dfci.harvard.edu, Kevin H. Lin, MD, PhD, Matthew L. Meizlish, MD, PhD https://orcid.org/0000-0002-4306-5061, Christof C. Smith, MD, PhD https://orcid.org/0000-0001-6517-0439, Katherine J. Feder, MD, MS, and Joseph O. Jacobson, MD, MSc

...AL elected to proceed with chemotherapy but was concerned about the acute toxicity of one of the agents. To accommodate these concerns, he and his oncologist decided on a modified regimen in which the agent is administered in divided doses, with half doses administered on days 1 and 2 rather than the full dose on Day 1. The intention was to use this split-dosing strategy for the first cycle, then resume standard chemotherapy for cycle 2 if the treatment was tolerated. However, day 2 of the order was accidentally deleted from the chemotherapy plan, and AL inadvertently received only half of the intended dose of the agent. Patient, provider, and pharmacy team all missed catching this error in the first cycle. Using the short-cut copy-forward function of the computerized prescriber order entry system (CPOE) of a proprietary electronic health record (EHR), the error was propagated forward for an additional 2 cycles until cycle 4 of the 8 planned cycles.

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Hannah R. Abrams @hannahrabrams.bsky.social · 18/05/2026

340B as it exists now is crucial to oncology care. In JCO OP this month, @ascocancer.bsky.social releases updated policy recommendations for reform of the program: ascopubs.org/doi/10.1200/... @jco-asco.bsky.social

Title of article: 340B Drug Pricing Program: An Updated ASCO
Policy Statement

Authors:
Blase Polite, MD, MPP, FASCO 1 ; Niharika Dixit, MD 2 ; John Hennessy, BCPA 3 ; Marissa Rivera, MBA 4 ; Ashley Sumrall, MD, FACP, FASCO 5 ;
Wade Swenson, MD, MPH, MBA, FACP 6 ; Kashyap Patel, MD 7 ; Natalie Dickson, MD, MMHC, FACP 8 ; Jonathan Phillips, MPH 9 ;
Azam Masood, MPH 9 ; and Allyn Moushey, MSW 9

TABLE 2. ASCO Policy Recommendations for Reforming the 340B Drug Pricing Program
Changes to program eligibility
A new formula to determine 340B eligibility for non–hospital-af liated providers should be established. We suggest dividing the number of Medicaid,
uninsured, and dual-eligible patients by total patient visits (under a single TIN) to create a new measure known as the indigent care ratio
Independent oncology practices with multiple locations should be able to register a child site for the 340B Program as long as they bill under the same Tax ID
(TIN) as the eligible parent practice
ASCO supports reforms to ensure a covered entity’s right to engage multiple contract pharmacies. We recommend capping fees paid to contract
pharmacies and TPAs and establishing a civil monetary penalty for excessive fees
Transparency and accountability
Increase reporting and auditing requirements for 340B entities
Any institution accessing 340B discounts should be required to demonstrate they substantially meet the nancial assistance policy criteria outlined in IRS
501(r)
New civil monetary penalties (CMPs) should be broadened to include entities that fail to demonstrate transparency and adherence to requirements for
limiting patient nancial liability and directing savings back into direct patient care. Existing CMPs for manufacturers should remain in place and be
strengthened
End the exclusion of orphan drugs from 340B pricing for certain entities such as CAHs
Avoid narrowing the patient de nition to exclude insured patients and instead develop a de nition that would require the covered entity to have an ongoing
clinical relationship with the patient
Other nancial reforms
The HHS secretary or federal policymakers should either appropriate funds or implement other funding mechanisms to support reformed program oversight
and operations
Abbreviations: CAH, critical access hospitals; TPA, third-party administrator.

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Reposted by Hannah R. Abrams

SurvivorshipIT @survivorshipit.medsky.social · 17/05/2026

#Biomarker data present in EHR were missing in 80%-100% of #FHIR extracts though demographic registry variables were highly concordant, highlighting gaps in real-world data extraction/exchange methods & risks of relying on RWD w/o validation academic.oup.com/jamiaopen/ar... #MedSky #OncSky #CanSky

academic.oup.com

Follow the data: tracking data quality and completeness in oncology real-world data

Lay Summary. Cancer research is rapidly evolving, with growing emphasis on genomic data and biomarker testing to guide treatments. In this study, we manual

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Hannah R. Abrams @hannahrabrams.bsky.social · 17/05/2026

Maybe a dumb question, but how do hallucinated citations work w/ citation managers? Is this happening because people are fully copy/pasting text citations from an LLM into a text bibliography? Or manually putting in details from a fake citation into their citation manager?

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Reposted by Hannah R. Abrams

Arrianna Marie Planey, PhD MA @arrianna-planey.bsky.social · 06/05/2026

I'd like to thank Reviewer #2 for asking why my colleagues and I bothered to assess cancer care-related financial toxicity among cancer survivors who were no longer in active treatment. That is, in fact, the period when the impacts are most felt.

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Hannah R. Abrams @hannahrabrams.bsky.social · 06/05/2026

Ah, yes, to be clear, no blame to anyone in the health ecosystem here! As you said elsewhere, it's hard to navigate early stage data, especially for cancer, and I think the ecosystem on bluesky is pretty good at appraisal. I just found this duality interesting and puzzling.

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