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pgrivasmdphd.bsky.social

@pgrivasmdphd.bsky.social
240 followers 45 following 25 posts
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
Don't forget to complete the post-survey & 🏆 Claim #CME 👉bit.ly/muc_tw2_post
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
23/🔑SUMMARY🔑 2L & later line tx in mUC 👉Erdafitinib FDA-approved w/ FGFR3 alt after prior tx 🎉NCCN guidelines updated Jan 2025 🔬Ongoing trials for SG in diff clin scenarios ✔️T-DXd for HER2 IHC3+ (based on gastric cancer scoring algorithm)
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
21/Why TROPiCS4 neg for OS? Hard to est, consider: 🔸Late-line,hvly pretx pop 🔸Ltd primary G-CSF prophy in SG arm(~20%) 🔸~5% pts randomized to control never rec’d tx(~2% in SG arm) 🚫biomarker selection(UGT1A1 gene polym→⬆️tox?) 🔸~20% in each arm rec'd salvage EV(confounding)
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
20/ @Uromigos thoroughly addressed of sacitizumab govitecan TROPiCS-04 findings presented at #ESMOAsia 🎧Worth a listen 👉 bit.ly/UromigosEp371 #OncSky
bit.ly
Episode 371: TROPICS-04 Results from ESMO Asia by The Uromigos
Jonathan Rosenberg joins Brian and Tom to discuss this important phase 3 trial and efficacy and toxicity signals.
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
19/TROPiCS-04 Ph3 RCT SG vs chemo in pretx mUC 🚫sig. improvmt in OS w/ SG compared to taxane or VIN mOS: SG 10.3 vs chemo 9.0mo (HR:0.86; 95% CI:0.73–1.02; p=0.087) Grade ≥3️ TRAEs (SG): Neutropenia(35%; FN 12%), diarrhea (15%) G5 AEs: SG 7% (16 inf w neutropenia), chemo 2%
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
18/🔬TROPHY-U-01 Cohort 3 trial safety of sacituzumab govitecan👇 TRAEs led to➡️ ✋SG interruptions in 46% ⬇️SG dose reduction in 39% 🛑SG d/c in 15% @markuseckstein3.bsky.social @amandanizammd.bsky.social #OncSky
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
17/#TROPHYU01 Cohorts 1,2,3👇 1️⃣=113 pts who progrs'd after plat chemo+ICI ✅Notable efficacy compared to hist cntls Led to accel approval 2021 2️⃣=38 cisplatin-inelig pts s/p ICI tx ✅ORR=32% 3️⃣= 41 pts who progrs'd after plat chemo w 2L SG+pembro ✅ORR=41% mPFS=5.3m mOS=12.7m
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
16/Sacituzumab govitecan(SG) an ADC 🎯Trop-2 An active agent in mUC but failed to show stat. significant longer OS over taxane or vinflunine (VIN) in TROPiCS-04 ✅FDA approval w/drawn~Oct 2024 👉Let’s look @ original approval & possible reasons for a negative P3 trial
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
15/🏁What about T-DXd in mUC? 1st tumor agnostic ADC w FDA approval for Tx-refractory HER2+ IHC3+ Cas From DESTINY-PanTumor02 16 pts w/ HER2 IHC3+ mUC 56.3% ORR, mPFS 7.4mo, mOS 13.4mo No significant neuropathy 🔑AEs: pneumonitis, neutropenia, N/V, left ventricular dysfunction
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
14/💡For phosphate of 8.0 mg/dL, withhold erdafitinib & restart once phosphate <5.5 mg/dL 🙌Erdafitinib=good option for pts w susceptible FGFR3 alt ⚖️What about pts who progress after 1L tx & no FGFR3 alt? ⚖️How does the changing 1L tx landscape w EV+P affect choice of 2L tx?
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
11/Erda. Safety Grade ≥3 TRAEs occurred in 45.9% w erdafitinib & 46.4% w chemo ⚖️Most AEs w erdafitinib manageable w dose modification & best supportive care 🛑Tx d/c rates 8.1% w erdafitinib & 13.4% w chemo #OncSky #BladderCancer
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
10/➡️Erdafitinib cont. 👍mOS and mPFS significantly ⬆️in erdafitinib group vs taxane or vinflunine THOR1 trial efficacy results 👇 #OncSky @achoud72.bsky.social @pbarata95.bsky.social @crisbergerot.bsky.social @paulobergerot.bsky.social @alisonbirtle.bsky.social @laurabukavinamd.bsky.social
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
8/Even w pembro➡️24 mo PFS rate in KEYNOTE-045 was 12.4%👉Pts likely to need subsequent line tx 🧐NCCN guidelines RE: next tx? Options (if not given prior): 🔶EV 🔶Erda for FGFR3 alt 🔶T-DXd for HER2 IHC 3+ (gastric Ca scoring) 🔶Saci(indication withdrawn, still in NCCN gdlns)
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
7/ IMvigor130 safety results 👇 🎯 Fewer AEs ➡️ withdrawal of any agent in atezo only group 🎯 Most common TRAEs mainly related to chemo ✓ Anemia ✓ Neutropenia ✓ Thrombocytopenia #OncSky
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
6/Atezolizumab EMA approved as monotx ✓1L in cisplatin-ineligible + PD-L1 +ve Based on IMvigor 210 & 130 trials 🔬IMvigor 130: ✅mPFS significantly longer in atezo+plat/Gem vs plat/Gem alone 🚫mOS not sign. longer in atezo grps vs plat/Gem alone @oncobellmunt.bsky.social @sandysrimd.bsky.social
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
5/Other 2L options(depending on prior tx): ✔️Erda for FGFR3 alterations ✔️EV monotx Taxane if no access to☝️ ✔️Nivo or avelumab if no access to pembro + ICI naïve ✔️T-DXd for HER2 3+ IHC (gastric Ca scoring) ✔️Sacituzumab govitecan (FDA indication withdrawn) @pcvblack.bsky.social #OncSky
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
4/Preferred 2L tx for cisplatin-ineligible pts after 1L ICI monoTx ✅EV or ➡️gem + carbo or ➡️erdafitinib (if FGFR alt+) 👉Pembro alone is one of2L tx options for pts who progress after 1L platinum-based chemo and have not received ICI #OncSky
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
3/Chemo-naive cisplatin eligible pts 👇Post-1L IO monotx👇 💡2L gem+cisplatin (or ddMVAC) pref'd 💡Erda for FGFR3 mut/fusion (THOR level 1 evidence for erda post-IO) 👉Cisplatin ineligible pts can get gem+carbo or EV (or erda if FGFR3+ alt) #OncSky
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
2/ 📸👇COI & CME info👇 Full #CME ℹ️ bit.ly/muc_tw2 1️⃣ Answer Pre-survey 👉 bit.ly/muc_tw2_pre 2️⃣ Review #MedTweetorial👇 3️⃣ claim CME🏆bit.ly/muc_tw2_post #MedTwitter #OncTwitter #gucsm #BladderCancer #MetastaticUrothelialCarcinoma #OncX #CommunityOncology
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/04/2025
1/ Best practices for 2L+ tx #MetastaticUrothelialCarcinoma 🧵 w🌟 @tiansterzhangmd.bsky.social & me ...assuming EV+P 1L ✅FGFR3 alts: THOR/erda 🎯Trop-2: sacituzumab govitecan 🏁HER2 IHC 3+: T-DXd Support by edu grants: Astellas, Gilead Sci, Merck, Seagen #CME from @bonumce.bsky.social ℹ️👇
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Tian Zhang, MD @tiansterzhangmd.bsky.social · 24/01/2025
This GU oncology family — wonderful first #AUC3 consensus conference! @drchoueiri.bsky.social @pgrivasmdphd.bsky.social @davidaggen.bsky.social
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Jame Abraham, MD, FACP @jameabraham.bsky.social · 31/01/2025
Expanded indication for TDXd!
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The OncoAlert Network 🚨 @oncoalert.bsky.social · 01/01/2025
Happy New Year from OncoAlert @jrgralow.bsky.social @elisabettabonzano.bsky.social @stolaney1.bsky.social @stoverlab.bsky.social @pgrivasmdphd.bsky.social @axelmerseburger.bsky.social @drnataliagandur.bsky.social @biagioricciutimd.bsky.social @fernandoonco.bsky.social
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Tian Zhang, MD @tiansterzhangmd.bsky.social · 23/01/2025
Awesome panel moderated by #MontyPal #BradMcGregor for non clear cell #Kidneycancer. Histology matters! And so do molecular markers! #AUC3 @drchoueiri.bsky.social @pgrivasmdphd.bsky.social @davidaggen.bsky.social @erplimackmd.bsky.social
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Yüksel Ürün @yukselurun.bsky.social · 09/12/2024
Redefining first-line options for advanced urothelial carcinoma! Insights on platinum chemotherapy, immunotherapy combos, and patient-tailored strategies. @tiansterzhangmd.bsky.social @oncoalert.bsky.social @oncbrothers.bsky.social #Oncology #BladderCancer
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Todd Morgan, MD @wandering-gu.bsky.social · 10/12/2024
Huge kudos to the NCCN for officially incorporating prostate cancer into the Genetic/Familial High-Risk Assessment Guidelines. We've come a long way!
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Tian Zhang, MD @tiansterzhangmd.bsky.social · 26/12/2024
This Christmas and every year I remember my current and past patients with ornaments on our tree. Have been fortunate to care for thousands in my ten year career in oncology. Hope to help thousands more in the years to come. 🎄🕯️
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Tian Zhang, MD @tiansterzhangmd.bsky.social · 23/01/2025
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Tian Zhang, MD @tiansterzhangmd.bsky.social · 23/01/2025
Launching #AUC3 in Miami, consensus across kidney and bladder cancers. From small steps to significant scientific advances that change our patients’ lives. @drchoueiri.bsky.social #MontyPal #RanaMcKay #JonathanRosenberg
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Tian Zhang, MD @tiansterzhangmd.bsky.social · 23/01/2025
#BrianShuch kicks us off, local #kidneycancer heterogeneous - guppies, goldfish and sharks! Integrating staging & biomarkers to help us evaluate risk and prognosis. #AUC3
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Tian Zhang, MD @tiansterzhangmd.bsky.social · 23/01/2025
Drs. #NaomiHaas #HansHammers debate locally advanced #kidneycancer and use of periop immunotherapy. Grading, staging, and prediction of risk/benefit leads to rigorous shared decision making with our patients. @drchoueiri.bsky.social #AUC3
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Tian Zhang, MD @tiansterzhangmd.bsky.social · 23/01/2025
#BrianRini & #MikeAtkins debate refractory #kidneycancer management after IO front line or adjuvant PD1 inhibitor. Do we rechallenge? Yes likely after a certain time point (6 vs 12 months debated). #AUC3
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Alfonso De Stefano @adestefano.bsky.social · 21/12/2024
Great milestone 🎯🥇 for #mCRC treatment #GIonc #OncSky based on the last update clinicaltrials.gov/study/NCT046... FDA grants Accelerated Approval to Encorafenib Plus Cetuximab and Chemo for BRAF V600E+ Metastatic Colorectal Cancer www.fda.gov/drugs/resour...
clinicaltrials.gov
ClinicalTrials.gov
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Aakash Desai @adesaimd.bsky.social · 21/12/2024
🔍 Does AI reduce #clinician workload? @NEJM study on @NuanceDragon DAX Copilot, an AI-powered documentation tool, found minimal impact on EHR efficiency & financial metrics❗️ 💡AI tools need to be developed in comjuction with 🩺🥼🧑‍⚕️ not in silos #AIinMedicine #LLMs @oncoalert.bsky.social
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 23/12/2024
Congratulations @n8pennell.bsky.social and all elected members @ascocancer.bsky.social
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Yvonne Diaz @yvonnediaz.bsky.social · 22/12/2024
“Why are we listening to men & not women?” asks Dr @narjustflorezmd.bsky.social of @florezlab.bsky.social This question & the increase in #lungcancer diagnoses among younger women vs men are the genesis for the #HearHer campaign. Read more & help us change this👇 healio.com/news/hematolog… #LCSM
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Jennifer A. Marks, MD @jennifermarksmd.bsky.social · 22/12/2024
Interesting article studying oncologist’s decision-making from a psychosocial perspective: #Oncologists exposed to scenarios of a “nice” or “demanding” pt were associated with less recommendations of chemotherapy near the #EOL . #heme/onc #lcsm #lcam #oncsky #medsky doi.org/10.1093/onco...
doi.org
Patients’ psychosocial attributes and aggressiveness of cancer treatments near the end of life
AbstractBackground. While the use of chemotherapy near the end of life (EOL) has been identified as a relevant criterion for assessing quality of cancer ca
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Eleonora Teplinsky, MD @drteplinsky.bsky.social · 22/12/2024
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Narjust Florez, MD, FASCO @narjustflorezmd.bsky.social · 22/12/2024
Key takeaways: •The #HearHer campaign focuses on gender disparities in lung cancer diagnosis and clinical trial enrollment. •Clinicians should take women’s concerns seriously and make use of imaging for early detection. Article here: www.healio.com/news/hematol...
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Tatiana Prowell, MD @tmprowell.bsky.social · 08/12/2024
🧵 Real world effectiveness study using #EHR from 20 health systems: #COVID19 vaccination ⬇️ risk of #longCOVID in kids/adolescents during Delta & Omicron waves. Mediation analysis suggests effectiveness is indirect, via ⬇️ the risk of #SARSCoV2 infection. #MedTwitter #MedSky
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Tatiana Prowell, MD @tmprowell.bsky.social · 08/12/2024
Link to the original study examining real world effectiveness of #COVID19 vaccination in reducing risk of #LongCovid in kids & adolescents here: www.thelancet.com/action/showP.... #MedSky #IDSky #Pediatrics #GetVaccinated
thelancet.com
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 06/12/2024
Stayed active during 17-hour flight from SEA->Singapore :-) Looking forward to present TROPiCS04 phase 3 trial data at #ESMOASIA on Dec 7 ~10am local time discussed by Dr. Friedlander @oncoalert.bsky.social @achoud72.bsky.social @erplimackmd.bsky.social @valdesan.bsky.social @fredhutch.bsky.social
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The OncoAlert Network 🚨 @oncoalert.bsky.social · 02/12/2024
Thank you Mirrors of Medicine & dear Colleagues #PROSCA24 #BLADDR24 & #RENALC24 FINAL STATS with OVER 21 million impression on X SHOUT OUT TO Our Ambassadors Specially @drnataliagandur.bsky.social @barbaramelao.bsky.social @pgrivasmdphd.bsky.social @achoud72.bsky.social
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pgrivasmdphd.bsky.social @pgrivasmdphd.bsky.social · 02/12/2024
As we return from Thanksgiving Holidays we are grateful for everyone’s hard work & @ASCO mission to support providers & patients! Would like to remind active members to participate in @ASCO election-stellar candidates across all categories-Deadline: Dec 3rd 3pm EST society.asco.org/about-asco/a...
society.asco.org
ASCO Election
ASCO Election
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Darcy Burbage, DNP, RN, AOCN @darcyburbage.bsky.social · 21/11/2024
“The effectiveness of telehealth in delivering psychosocial, nutritional, and physical activity support highlights its potential to improve patient outcomes and overcome barriers to care” @pallonccop.bsky.social #oncsky ascopubs.org/doi/10.1200/...
ascopubs.org
Enhancing Cancer Supportive Care: Integrating Psychosocial Support, Nutrition, and Physical Activity Using Telehealth Solutions | JCO Global Oncology
This review explores current guidelines for integrating psychosocial support, nutrition, and physical activity into cancer care and examines the resources available to deliver comprehensive care effec...
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Bárbara Melão @barbaramelao.bsky.social · 29/11/2024
#PROSCA24 ✨PSMA is the imaging choice in BCR ✨impact on clinical management ~60% ✨PPV 85-90% ✨different PSMA tracers with different detection rate ✨PROMISE registry to build monogram to predict survival: in BCR setting the nomogram had a strong correlation with survival ‼️for MDT: use PSMA11
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Jarushka Naidoo @drjnaidoo.bsky.social · 29/11/2024
Impact of cycle 1 irAEs on ICI outcomes: - 683pts from SWOG DART trial - g1-2 irAEs = ⬆️OS HR 0.61 p < 0.001 - g3+ irAEs = ⬇️OS HR  1.41 p= .025 - g1-2 derm irAE = ⬆️OS v other g1-2 irAE HR 0.67 p=0.002 Congrats @eladsharonmd.bsky.social @oncoalert.bsky.social academic.oup.com/jnci/advance...
academic.oup.com
First Cycle Toxicity and Survival in Patients with Rare Cancers Treated with Checkpoint Inhibitors
AbstractBackground. Associations between immune-related adverse events (irAEs) from checkpoint inhibitor therapy and outcomes have been previously evaluate
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Daniel Stover, MD, FASCO @stoverlab.bsky.social · 30/11/2024
Do systemic responses to ICI (eg irAEs) associate w outcomes? Nice use of existing basket studies by @pateloncology.bsky.social @eladsharonmd.bsky.social Razelle Kurzrock et al
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The OncoAlert Network 🚨 @oncoalert.bsky.social · 30/11/2024
Thank you Mirrors of Medicine & dear Colleagues #PROSCA24 #BLADDR24 & #RENALC24 have just concluded with OVER 20 million impression on X SHOUT OUT TO Our Ambassadors Specially @drnataliagandur.bsky.social @barbaramelao.bsky.social @pgrivasmdphd.bsky.social @achoud72.bsky.social
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The OncoAlert Network 🚨 @oncoalert.bsky.social · 30/11/2024
Join Drs. Gillessen, Omlin, Castro, Zilli, Tombel & Turco as they discuss Advanced Prostate Cancer Consensus Conference 2024, presentation at #PROSCA24 #ProstateCancer buff.ly/3B5902t @drnataliagandur.bsky.social @barbaramelao.bsky.social @achoud72.bsky.social @pgrivasmdphd.bsky.social
buff.ly
Highlights from APCCC 2024 in Prostate Cancer Final day of #PROSCA24
The 2024 Advanced Prostate Cancer Consensus Conference (APCCC) highlights significant advances in prostate cancer management while underscoring areas where h...
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