iiinova — where your digital self keeps evolving

Jack West, MD, FASCO @jackwestmd.bsky.social · 15/03/2025

Dr. Karen Yun presenting: How Do You Read a Molecular Testing Report? What are Driver Alterations in Lung Cancer? #TargetedTherapiesInLungCancer #LungCancer #ALK #ROS1 #RET #NTRK #EGFR #BRAF #MET #HER2 #KRAS

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That was supposed to be "trained", not "raised". How sad that I find myself wishing for features of the other platform, where you can edit your post in the first hour.😩

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Jack West, MD, FASCO @jackwestmd.bsky.social · 15/03/2025

I didn't know Dr. Yun before today, but she raised at UCSD with Drs. Luda Bazhenova & Sandip Patel. She did a great job. Looking forward to seeing her career trajectory.

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Jack West, MD, FASCO @jackwestmd.bsky.social · 15/03/2025

Several of my favorite people in thoracic oncology featured in this picture.

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Reposted by Jack West, MD, FASCO

Dr. @ChristineBestv1 now presenting: ALK, ROS1 and RET: Pushing the Boundaries of Targeted Therapies #ALK #ROS1 #RET #LungCancer #TargetedTherapies #cancerGRACE

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Reposted by Jack West, MD, FASCO

#Smoking is associated with #KRAS (~100%) and #BRAF (50%) alterations. • Increases cancers of upper airway, stomach, mouth, tongue, liver, cervix, bladder… • So: Don’t start smoking+

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Reposted by Jack West, MD, FASCO

Jack West, MD, FASCO @jackwestmd.bsky.social · 10/02/2025

Q&A session with Drs. @lungoncdoc, @MMarmarelis, @LudaBazhenovaMD, and @IyengarPuneeth Is it better to continue on the same therapy as long as possible? #TargetedTherapiesInLungCancer #LungCancer

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In a self-indulgent moment, I need to say how incredibly proud I am of my stepdaughter, Mya Lauzon, who is a phenomenal gymnast, (& student, & person) at @calwgym.bsky.social: she won all-around, including a perfect 10 on floor. She is 1st Cal gymnast ever to score 10s in 3 different rotations. 😊🤩

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Jack West, MD, FASCO @jackwestmd.bsky.social · 18/01/2025

Great conference. I'm looking forward to seeing folks there!🤠

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Jack West, MD, FASCO @jackwestmd.bsky.social · 18/01/2025

Hats became far less common in the mid-60s, before I was on the scene, but I'm happy to be living through time when neckties become superfluous. I was just at another mtg where 90% of the men wore open collars: a good thing. In addition to shirts, men still have socks for colorful self-expression.

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Jack West, MD, FASCO @jackwestmd.bsky.social · 10/01/2025

Totally agree that it would be helpful to have more of an "area under the curve" approach to adverse events...but we would need to change how the clin research world collects, analyzes, and reports AE data. After that, we could address how to present those data.

Jack West, MD, FASCO @jackwestmd.bsky.social · 09/01/2025

It may take some getting used to, but I think it would be clear & distill to just what a clinician (or pt) would care about. An alternative could be to just have bar graphs show same info. Do folks like this kind of called out subset of AEs? Is one format easier (both showing same data)?

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Jack West, MD, FASCO @jackwestmd.bsky.social · 09/01/2025

IMO, it would be helpful if safety profiles for phase 3 trials highlighted where there are significant differences between 2 arms (along w/full data of all AEs elsewhere). What do ppl think of a version like this, showing a lower number for one arm & colored arrow to higher number in the other arm?

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Jack West, MD, FASCO @jackwestmd.bsky.social · 08/01/2025

She is really something. My gift to her is that I provided none of her genes.

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Jack West, MD, FASCO @jackwestmd.bsky.social · 08/01/2025

So amazingly proud of my step-daughter, Mya Lauzon, Cal Berkeley gymnast, who's at the top of her game now, in her senior year. First week of the season, second in all-around behind Olympic gymnast Jade Carey, & named ACC gymnast of the week. calbears.com/news/2025/1/...

calbears.com

Lauzon Named ACC Gymnast Of The Week - California Golden Bears Athletics

Senior Earns 4 Podium Finishes

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Jack West, MD, FASCO @jackwestmd.bsky.social · 07/01/2025

I really liked this book but just read the biography of Thomas Mutter (in anticipation of visiting his namesake museum in Philadelphia in a few months). That book provides a rich enough historical context that I want to re-read The Facemaker now.

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Jack West, MD, FASCO @jackwestmd.bsky.social · 06/01/2025

Finally, today w/streaming videos (Netflix, etc.), we see a multi-episode series tell a story over 1-10 hrs rather than fitting all narratives into a 90-120 min movie. Great! We should step back & reflect on time needed to best convey med/sci data & retain messages well: less is more! (5/5)

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Jack West, MD, FASCO @jackwestmd.bsky.social · 06/01/2025

Even if tasked w/50 min live talk, audience will stay engaged better if it is broken into sections of 10 min or less, w/few points in each. In between, interactive Q or a clinical case can transition to new section; also, a case serves as a STORY. Our brains are ready-made to encode stories. (4/5)

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Jack West, MD, FASCO @jackwestmd.bsky.social · 06/01/2025

To maximize internalization of our messages, ideally we’d break it up into mentally digestible pieces of 10 min or less (“chunking”). When programs can be made into pre-recorded videos, I’d favor breaking 45 min of content into a series of ~5 or more shorter pieces. (3/5)

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Jack West, MD, FASCO @jackwestmd.bsky.social · 06/01/2025

The idea of an attention span being fixed at 7 or 9 min (or being conditioned to <2 min by TikTok) is an oversimplified myth. It depends on how engaging data are & how easy or hard to incorporate into audience understanding. But it’s usually <10 min, not a 50 min lecture. (2/5)

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Jack West, MD, FASCO @jackwestmd.bsky.social · 06/01/2025

Working with Working Memory The first step of internalizing new info is having it retained temporarily & “understood”. Then, some fraction may be retained in long-term memory. But working memory can’t handle >3-4 ideas at once. More overwhelms us, like juggling too many balls at one time. (1/5)

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Jack West, MD, FASCO @jackwestmd.bsky.social · 06/01/2025

Quite clear. Maybe now that I'm noting them more, I am seeing more examples. I think they're catching on. Would also be a nice way to visualize evolution of acquired resistance mechanisms in pts with EGFRm+ NSCLC, etc. Could illustrate subsequent molecular findings &/or subsequent treatment.

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Jack West, MD, FASCO @jackwestmd.bsky.social · 19/12/2024

To me, these figures are a concise & clever way to show associations for a paper or handout, even if they make what might have been a simple figure far more to process. Good or bad? I’d include but would want to verbally highlight key findings in the by added layers of complexity. Thoughts? (5/5)

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Jack West, MD, FASCO @jackwestmd.bsky.social · 19/12/2024

For these figures, I welcome the added complexity, but it comes at cost of turning a figure with often a single clear message into something where you can’t process all the data during a short viewing from a talk; instead, the multilayered content is well suited to studying at length later. (4/5)

Jack West, MD, FASCO @jackwestmd.bsky.social · 19/12/2024

Following the same principle, some swimmer plots feature not just duration of treatment but enhancements like details of a patient’s past treatments, off-protocol therapies, molecular features, response milestones, & of course markers for ongoing treatment on trial. (3/5)

Jack West, MD, FASCO @jackwestmd.bsky.social · 19/12/2024

Some investigators enhance waterfall or swimmer plots in ways that add layers to the core image. For instance, here’s a waterfall plot that adds details of patient mutational & protein expression results, mut’n location, & prior Rx (here, before trastuzumab deruxtecan). (2/5)

Jack West, MD, FASCO @jackwestmd.bsky.social · 19/12/2024

Plussing our figures In oncology, figs like Kaplan-Meier curves, waterfall plots, & swimmer plots are central to how we interpret data. A stated HR or diff in med surv is compelling, but visual impact of a figure can make us feel it viscerally (here, CROWN trial 5-yr EFS). (1/5)

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Jack West, MD, FASCO @jackwestmd.bsky.social · 17/12/2024

I'm working for a company right now that would make it inappropriate for me to speak on this issue.

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Jack West, MD, FASCO @jackwestmd.bsky.social · 17/12/2024

That's just an example slide, not a direction to cover here. This really alludes to the LAURA trial that has been reported earlier this year.

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Jack West, MD, FASCO @jackwestmd.bsky.social · 16/12/2024

Finally, the issue of slides for live presentations vs permanent “leave behind”. When possible, I'd hope to create a separate, comprehensive version that doesn’t require live walk-through, or use notes view of powerpoint deck to give full text & post/share that version. Thoughts? (8/8)

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Jack West, MD, FASCO @jackwestmd.bsky.social · 16/12/2024

Besides boosting our confidence enough to not write a script on your slides, practicing helps us to identify typos, poor transitions, & places where we're prone to stumble on wording. Better to identify these issues before we're in front of an audience. (7/8)

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Jack West, MD, FASCO @jackwestmd.bsky.social · 16/12/2024

A final fix is to practice the presentation to the point that we're confident we don't need a teleprompter. I know it's easy to de-prioritize (& I'm lazy enough to ignore my own advice), but it helps to run through at least 2-3x before the actual presentation. (6/8)

Jack West, MD, FASCO @jackwestmd.bsky.social · 16/12/2024

It can also be helpful to walk through a text slide that w/animation showing JUST what you're saying at that moment, then have a new point appear as the slide grays out everything previously said. You avoid having people read ahead while you’re conveying your message. (5/8)

Jack West, MD, FASCO @jackwestmd.bsky.social · 16/12/2024

A hard habit to break, but it's fixable. First, I try to favor leaving key words/phrases on slides, maybe a telegraphic version of my points to remind me but leave me to speak spontaneously & authentically rather than just read full sentences off the slide. (revision of my prior slide here) (4/8)

Jack West, MD, FASCO @jackwestmd.bsky.social · 16/12/2024

Why do we do this? IMO, it’s a crutch: the slides are there as a teleprompter because we aren't confident we know the message well enough to speak extemporaneously. Also, we tend to prepare slides as a permanent document rather than a deck optimized for live presentation. (3/8)

Jack West, MD, FASCO @jackwestmd.bsky.social · 16/12/2024

This means that our slides are competing with what we're saying, because people aren't paying attention to us when they're reading the rest of the slide. And it keeps us from adding any insightful, new commentary to what’s on the slide. (2/8)

Jack West, MD, FASCO @jackwestmd.bsky.social · 16/12/2024

Our slides should not be a teleprompter. Among most common problems of slide presentations is a slide full of text (example of mine here). Why? When we see sentences of text, it’s hard for us to avoid temptation to read it verbatim, & audience reads faster than we speak. (1/8)

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Jack West, MD, FASCO @jackwestmd.bsky.social · 13/12/2024

My high school English teacher offered extra credit to any student who brought in a funny Nancy comic. No student ever claimed that prize.

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Jack West, MD, FASCO @jackwestmd.bsky.social · 12/12/2024

My next thread will be on the related issue of a novella of text on our slides. Unfortunately, I can illustrate this with offerings from the majority of my own slide decks. (6/6)

Jack West, MD, FASCO @jackwestmd.bsky.social · 12/12/2024

For that matter, I’d even broaden this question of “is more data better?” to some papers that can include everything from basic science to clinical data in 1 publication. I now see this in journals like JCO that have a mainly clinical readership. I welcome discussion on this debatable Q. (5/6)

Jack West, MD, FASCO @jackwestmd.bsky.social · 12/12/2024

An exception in which several figs on 1 slide is effective is where they are all share same format, making it easy to compare across them, maybe showing consistent point (eg, same EFS benefit in several trials of periop immunotherapy in early NSCLC). #Dataviz geeks call this "small multiples". (4/6)

Jack West, MD, FASCO @jackwestmd.bsky.social · 12/12/2024

Maybe point is to convey “a year of translational research went into this", but the general rule is we don't want audience to have to work hard or feel dumb & frustrated. Better to have limited data on a slide that is understandable. The goal also isn't to fill all white space on slide. (3/6)

Jack West, MD, FASCO @jackwestmd.bsky.social · 12/12/2024

Sometimes there's a cap on # of slides allowed in a talk, but more often I believe it stems from not selectively editing what should be included, instead cramming in everything. But what is the value of a slide creating a cacophony of data that distract audience & preclude a clear message? (2/6)