C. Jillian Tsai, MD, PhD
@CJTsaiMDPhD
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Lead, Allan and Ruth Kerbel Palliative RT & Oligomet Program (PROP) @PMcancercentre @RadMedPM @UHN . Via @MSKCancerCenter @MDAndersonNews . HN/metastatic cancers.
Toronto, ON, Canada
Joined February 2018
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Pinned Tweet
1)🚨Just out
@TheLancet
- CURB randomized phase 2 RCT of SBRT for oligoprogressive metastatic NSCLC and breast cancer.
@simonpowell213
@MSK_RadOnc
@MSKCancerCenter
@MSKBiostats
@RadMedPM
@UofTDRO
@thePMCF
@pmcancercentre
@JYangMDPhD
@ipreeshagul
29
141
332
As an epidemiologist, I'm skeptical of such studies linking diet to cancer w/o a firm biological basis. How many cancers have been examined for a potential dietary association with this cohort This is not only unhelpful but can potentially be harmful.
16
32
139
🚨CURB2 Ph3 RCT approved by
@NCICTEP_ClinRes
and will be opened through NCTN. (F/u of Ph2 CURB RCT
@TheLancet
().
Grateful to present it
@NRGonc
#NRG2024
and for the support. 🙏
@JeffBradleyMD
@SalmaJabbour1
@KHigginsMD
@IyengarPuneeth
@DrPOGaudreau
5
38
129
Treated our first case of simulation-free single fraction 16 Gy non-spine bone met SBRT today! Special thanks to our tireless physics and therapy team!
This workflow will significantly benefit our palliative patients, lessening their need for multiple procedures and eliminating
5
14
123
👏👏👏Congrats to one of the most generous, brilliant, and supportive rad oncs/scientists on your much-deserved ASTRO gold medal!
@simonpowell213
@MSK_RadOnc
@MSKCancerCenter
@MSKCC_OncoNotes
@MSKEducation
#ASTRO23
#ASTRO2023
#radonc
6
8
122
Unsure how
@ASTRO_org
annual meeting’s focus is decided but in the future would love to see something like
“Multidisciplinary Cancer Care” - incorporating radiotherapy from early to advanced disease to promote patient outcome and cutting-edge discoveries. 🙏
4
10
82
Practice changing clinical trial by
@imrtlee
@xrtGenomics
@MSK_RadOnc
@MSKCancerCenter
and the entire HN group. Results from this study again demonstrated the importance of biology driven de-escalation. One size does not fit all.
@DavidSherMD
@DanielMaMD
@henson_md
@YaoCMKL
1/N Finally out!! -- 30Gy for HPV+OPC in
@JCO_ASCO
– work by the
@MSKCancerCenter
Head and Neck team, led by
@imrtlee
, Eric Sherman, and myself on using hypoxia imaging response to cut treatment 60% (70->30Gy)!
#radonc
#hncsm
26
125
312
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14
75
Happy
#NationalWomenPhysiciansDay
! Although this is an American holiday, I wanted to take a moment to recognize my remarkable colleagues in Canada
@pmcancercentre
@UHN
!
0
11
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My 12yo’s colored pencil drawing of
@taylorswift13
- she is so proud of her work after spending 13 hrs on it.
4
1
64
Critical patient care issues should be spared of the pervasive culture of misleading click bait.
Proud that Drs. Shaverdian /
@reshmajagsi
for raising awareness.
@ASTRO_org
@MSK_RadOnc
@SameerKeoleMD
@RadOncWomen
When Headlines Harm Patients With Cancer
3
18
63
Wonderful results - can't wait to see more details.
BUT- when/why do we endorse PFS as the valid primary endpoint in drug trials in the definitive treatment, but insist on OS for some Ph3 RT trials in metastatic cancer? As we often argued to many protocol review committees, RT
4
11
56
Thanks
@MichaelYanMD
, Fadwa Abdel-Rahman,
@ldawsonmd
, Philip Wong,
@RebeccaKSWong
for contributing to this article on behalf of our Palliative Radiotherapy & Oligometastasis Program (PROP)
@RadMedPM
@pmcancercentre
@UHN
!
Link to the full article here ➡️
4
18
57
Superstar
@JYangMDPhD
presenting a phase 3
@NRGonc
CC014 RTC of prophylactic RT for asymptomatic bone mets, based on earlier evidence published by
@JYangMDPhD
@ErinGillespieMD
@MSKCancerCenter
@MSK_RadOnc
.
1
7
54
Finally out! Prev presented
@ASCO
: docetaxel-RT⬆️ DFS/OS in cis ineligible HNSCC. Should we consider this as SOC arm (instead of cetux-RT) in future trials of cis ineligible pts?
@sueyom
@drlorenmell
@imrtlee
@seanmmcbride
@xrtGenomics
@henson_md
@BhishamCheraMD
@DrNabilSaba
Phase III Randomized Trial for Use of Docetaxel in Patients With Head and Neck Cancer, Unsuitable for Cisplatin-Based Chemoradiation.
@VanitaNoronha
@Amolpatel_dr
@Nandinimenon18
@DrEzraCohen
@JCO_ASCO
@HHKhar
@TataMemorial
@DrHaddadRobert
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149
297
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18
51
An example of the exceptional patient care by our Palliative Radiotherapy & Oligomet Program (PROP)
@RadMedPM
@pmcancercentre
- a VMAT plan within 24hrs after contouring, DURING THE WEEKEND, by our Clinical Specialist Radiation Therapist
@JoannaJavor
!
@DKirschMDPhD
@ldawsonmd
1
9
50
I wish we could see some patients needing palliative RT earlier, not right before hospice, so that RT can be more effective.
#radonc
#metastasis
3
6
50
Remarkable research conducted by
@PercyLeeMD
and coauthors
@trudywu2
@MSteinbergMD
showed the effectiveness of an adaptive dose-escalation strategy in improving locoregional control for unresectable NSCLC. The trial highlighted the necessity of individualized cancer treatment
21/n Let the questions and constructive critiques begin!😂😇 Open to any and all of them in order to take this approach to the next level for our patients!
@TheWRP4LC
@EGFRResisters
@ALKPositiveinc
@LUNGevity
@LungCancerFaces
@lcrf_org
@JackWestMD
@CJTsaiMDPhD
@Dan_ChangMD
2
1
8
0
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4) Early integration of radiotherapy in multidisciplinary management of patients with metastatic cancer is crucial for optimizing patient wellbeing and outcomes.
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We need a better multi-D consensus for treating oligomet & beyond. Often the reason for resisting local therapy is the subsequent lack of "index" lesion to follow. This should not be the reason to not eradicate major local disease burden.
@rweichselbaum
@simonpowell213
thoughts?
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7
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7) For those without subscription to
@TheLancet
, here’s the link to download the article:
@simonpowell213
@JYangMDPhD
@MSK_RadOnc
@MSKCancerCenter
@xrtGenomics
@RadMedPM
@RadOncMTD
@pmcancercentre
@imrtlee
@charlesrudin
@AmyXuMDPhD
@drdavidpalma
1
16
40
It's important to recognize the patients behind all the clinical trials - their lives and their stories. And we owe it to them explore more treatment options.
@simonpowell213
@MSK_RadOnc
@MSKCancerCenter
@MSKBiostats
@RadMedPM
@UofTDRO
@thePMCF
Dr. Jillian Tsai
@CJTsaiMDPhD
@pmcancercentre
and investigators
@MSKCancerCenter
, revealed that precision radiotherapy can significantly increase survival in patients with non-small cell lung cancer.
Read more →
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On call today - impressed by the patient care
@RadMedPM
@pmcancercentre
@UHN
. We were able to perform proper CT sim & 3-D RT planning in an urgent outpatient setting after imaging this morning-within a couple of hrs!
US
#radonc
colleagues - remember the days of hand calcs? 🙃
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3
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Another productive R.O.A.M (Radiation Oncology Alliance for Metastasis) meeting today! We discussed program building, clinical trial promotion, nuances in treatment options for palliative oncology, and patient/global outreach. Looking forward to our next meeting!
@JYangMDPhD
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7
37
We had a fantastic gathering w/ some members of Radiation Oncology Alliance for Metastatsis (ROAM)
@ASTRO_org
#ASTRO23
to know each other more and discuss ideas for collaboration, followed by a memorable dinner with the superstars of the leptomeningeal panel!
@JYangMDPhD
#radonc
0
6
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🚨Just published!🚨
Our review “Metastasis-directed therapy for oligometastasis and beyond,” w/ evidence & directions of
#radonc
in mets. Special thanks to Thomas Beckham,
@TdotJY
, Dan Gomez,
@MSK_RadOnc
,
@ErinGillespieMD
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2) SBRT⬆️PFS by 4 times in NSCLC, but not in oligoprogressive metastatic breast cancer in the study population. Local therapy in patients with oligoprogressive cancer might alter patterns of anatomical progression. Patients with breast cancer in either groups mostly grow new
1
6
35
Congrats to the authors for putting together this study - it's a huge undertaking. However, similar to many studies of this nature, time to adj RT itself is likely a proxy to other crucial prognostic factors unaccounted for. QI metrics should not solely focus on the time factor.
In this multicenter cohort study of patients with oral cavity cancer requiring surgery & radiation therapy in Canada, failure to initiate adjuvant radiation therapy within six weeks was assoc with worse overall survival and disease-free survival.
#AHNS2023
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Superb and thought provoking talk by
@KaramLab
sharing results from her lab re immune response following elective nodal RT
@RadMedPM
@pmcancercentre
@UHN
research rounds.
@ldawsonmd
@DKirschMDPhD
@ScottBratman
2
6
36
Happy
#NationalWomenPhysiciansDay
! Grateful to work with so many strong women mentors, role models, and colleagues.👏
@imrtlee
@IBCradiation
@AnnKloppMD
@ldawsonmd
@RebeccaKSWong
@MeredithGiulia1
@SalmaJabbour1
@sueyom
@ErinGillespieMD
@fumikochino
@aislingbarryro
@JingLi_MD_PhD
1
3
34
Still come across this frequently in trials. Often due to lack of research staff proficient in another language (required, in addition to translated consents). But how are we going to address
#equity
in trial
#inclusion
without add'l support from the institution/government?
1
2
33
Clinical Validation of HPV ctDNA for Early Detection of Residual Disease After Chemoradiation in Cervical Cancer | JCO
Congrats
@Kathy_C_Han
for this important work!
@RadMedPM
@ScottBratman
@pmcancercentre
@UofTDRO
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@DrMLChua
@AshwinShindeMD
@DavidSherMD
@mikemejiamd
@lachiemcd
@henson_md
@Dr_AliHosni
@H_N_C_I_G
@sueyom
@naummalik
@IJROBP
@ParikhSimul
I encourage everyone to read the classic papers by R. Withers & Lester Peters regarding the elective dose. The “50Gy” wasn’t established based on any RCT. There are 2 prospective trials using 40Gy and 1 retrospective study using 30Gy already showing adequate control.
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6
34
Our article addressing radiation dose reduction in elective treatment fields to 30 Gy in HPV+ OPC
@sloan_kettering
#hncsm
#hpv
@xrtGenomics
@imrtlee
3
11
33
Agree. Pls never push off radiation before getting an opinion from
#radonc
. Every metastatic patient should be evaluated in a multi-D setting w/
#radonc
. Too often we see these patients too late. We owe them all possible treatment options upfront.
@HenningWillers
@ari_marciscano
Too late. Please stop pushing radiation until it’s too late for patients with metastatic disease. It is more toxic and less effective. There is good data supporting early RT for mets.
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3) Analyses of paired pre- and post-randomization blood showed that SBRT led to changes in circulating tumor DNA metrics in patients with NSCLC, but not breast cancer.
2
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33
Holiday greetings from members (and honorary members) of the Allan and Ruth Kerbel Palliative Radiotherapy & Oligometastasis Program (PROP)
@PMcancercentre
@RadMedPM
@UHN
!
(missing
@ldawsonmd
@SaraMheid
and a few others)
0
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5) An insightful editorial by Gerard G Hanna and Fiona McDonald outlining the nuances and caveats.
@fifimcdrmh
@drdavidpalma
@aadel_chaudhuri
@xrtGenomics
@JoeChangMD
2
9
32
Tonight our Palliative RT & Oligomet Program (PROP)
@pmcancercentre
gathered together to extend our gratitude to Mel Robson,
@HibaOth60228476
, & Daphne Valmonte, and welcome
@SaraMheid
, Phil Wong, Kathryn, Alana, Yasmin,
@MichaelYanMD
! Looking forward to⏫patient care & research!
1
3
31
Congrats to our own
@JoannaJavor
of Palliative Radiotherapy & Oligometastasis Program (PROP) for receiving TWO prestigious awards - Distinction in Teaching Award & Research Award at
@RadMedPM
@pmcancercentre
! We are so grateful for her contribution to patient care and teaching!
4
5
31
🚨 Are you aware of the reviewer recognition program
@ASTRO_org
?
- Open access fee waivers for Advances &
@IJROBP
(12 reviews in 3 yrs)!
- FASTRO credit! 💳
- ScienceDirect Access! 📖
@sueyom
@DrLesterColl
@AnnaLeeMDMPH
@fumikochino
@pipcosper
@MKnoll_MD
@GitaSuneja
We are so grateful for all our journal reviewers -- your care and time help make ASTRO journals successful. ASTRO and Elsevier offer recognition programs and incentives for reviewers. See a short list here, and more to come in 2023!
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🚨In this original report, we found that increased utilization of palliative care during hospitalization for patients with metastatic cancer, including early consultations for younger patients and irrespective of receiving invasive medical procedures, has the capacity to increase
0
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Melanie Woodside presenting the HN survivorship program at
@pmcancercentre
@UHN
#HNCS24
@ASTRO_org
@Dr_AliHosni
@DrJohndeAlmeida
@YaoCMKL
@ezrahahn
@ScottBratman
0
4
27
Hooray!
@cpso_ca
registration approved!
Looking forward to starting my clinical practice soon at
@RadMedPM
@pmcancercentre
@UHN
!
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6) We express our heartfelt thanks to our patients, their caregivers, and all those who placed their trust in us to provide care for these patients.
1
1
27
Season's greetings from the Allan and Ruth Kerbel Palliative Radiotherapy and Oligometastatic Program
@RadMedPM
@pmcancercentre
. Wishing you a peaceful and joyous holiday season!
@JoannaJavor
@ldawsonmd
@UofTDRO
@safaviaa
@MichaelYanMD
@RebeccaKSWong
@DKirschMDPhD
@thePMCF
2
3
27
@rweichselbaum
@drspdavid
@Mat_Guc
@RimaPathak1
@SahgalArjun
@_ShankarSiva
@CharuAggarwalMD
@r_glicksman
@Stevechmura
@reshmajagsi
@drkevin_chua_lm
@S_W_R_O
@Applied_RadOnc
@changjeesuk1
I completely agree. I do not think radiation basket trials work - unlike med onc basket trials that are based on tumor biology, RT basket trials have no biology basis and are unlikely to change practice. We need more biology driven RT mets trial designs to change SOC.
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4
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Every head & neck clinician will be inspired by this brave/strong woman's incredible journey. Reminds us why we do what we do, and we have to keep trying harder.
@ASTRO_org
#HNCS24
@Dr_AliHosni
@ezrahahn
@ScottBratman
@seanmmcbride
@xrtGenomics
@yaoyu_md
@YaoCMKL
New
@RTAnswers_org
's Patient Story: Molly Cassidy, JD, shares her cancer journey at ASTRO's 2024 Multidisciplinary Head and Neck Cancers Symposium.
#HNCS24
1
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1
6
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Borrowed it from another forum. Does anyone know who made this? It is too funny not to share.
@xrtGenomics
@ACKoongMDPhD
@DrewMoghanaki
@subatomicdoc
#RadOnc
3
6
24
Excited to be part of this amazing team. We are missing
@ldawsonmd
in the photo & also
@aislingbarryro
.
Looking forward to collaborating with everyone within and outside of
@RadMedPM
@UHN
@pmcancercentre
@UofTDRO
.
@MichaelYanMD
@r_glicksman
@aleberlin2
@FadwaARahman
Today we highlight the members from our outstanding multidisciplinary PROP (
#PalliativeRadiationOncology
Program) Team at
#RMPatPM
! Thank you for your amazing contributions to our program and the work you do in supporting our patients at
@pmcancercentre
@UHN
#cancer
3
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0
2
24
So fortunate to participate in the reception by
@ConquerCancerFd
@ASCO
#ASCO23
w/
@PierceLoriJ
@Dan_ChangMD
@MylinTorres
@cwspeers
@cjdevillesr
@DrWinkfield
. Importantly, also got to catch up w/ my role models Drs. Frances Shepherd & Penny Bradbury
@pmcancercentre
and
@oncostan
!
Thank you
@PierceLoriJ
for a wonderful evening
@ConquerCancerFd
@ASCO
@Dan_ChangMD
@cwspeers
@DrWinkfield
@CJTsaiMDPhD
1
2
18
0
2
23
Grateful for the support of the Wharton/Elia/Sullivan families and many of our patients as we celebrated the 25th anniversary Wharton Day.
@pmcancercentre
@thePMCF
@UHN
@UHN_Otohns
@lillian_siu
@RadMedPM
@DrJohndeAlmeida
@JohnYooMD
@EhabHannaMD
@ScottBratman
2
7
23
Our trial "A Randomized Phase II Study of SBRT for Metastatic TNBC/Lung Cancer With Oligoprogressive Disease" is finally open! Thanks for the support and let's accrue!
@MarkRobsonMD
@charlesrudin
@WanqingZhi
@TdotJY
@sloan_kettering
3
8
23
A whirlwind week started off at
@NYULH_RadOnc
with extraordinary residents/faculty and ended in Taipei
#TAROS2023
with prominent colleagues. Thanks for inviting me to share/discuss advances in
#radonc
.
@josephkimradonc
@StevenLin_MDPhD
0
3
22
Absolutely agree.
When will we be able to change our practice here
@RadMedPM
?
@Dr_AliHosni
@ezrahahn
@ScottBratman
H&N contouring tip. There are no lymph nodes inside the submandibular gland (in contrast to the parotid). So when contouring level IB, do not include the gland in your volume. It will unnecessarily increase your oral cavity dose (for non-oral cavity primaries).
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1
4
22
🤔🤔🤔
@seanmmcbride
@xrtGenomics
@imrtlee
@Dr_AliHosni
@ezrahahn
@yaoyu_md
@DrJohndeAlmeida
@YaoCMKL
@lillian_siu
@ScottBratman
@henson_md
@HNSurgeon
@cd_fuller
@Lawson_Eng
NRG-HN005 results of scheduled interim futility analysis comparing experimental arm to control arm for randomized phase II portion of the study showed that the experimental arm didn't achieve non-inferiority threshold per statistical analysis plan.
5
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6
1
22
@AnnaLeeMDMPH
@pmcancercentre
@TheLancet
@MDAndersonNews
@JoeChangMD
It was great to have a lot of time with the residents! Brought back the old visiting professor days before covid. Was equally amazing catching up with colleagues!
0
0
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@xrtGenomics
@imrtlee
@sueyom
@seanmmcbride
Many issues:
1. Neoadj IO- no proven benefit in definitive HPV+ OPC
2. Appears that many failed pts were eligible for ECOG3311 w/o adj RT at all. Why was failure rate so high? TORS approach different?
3. 25Gy/5 fx is not SBRT, but doesn't matter
@DrJohndeAlmeida
@ScottBratman
3
2
21
A nice evening bonding with our colleagues and their families.
@RadMedPM
@pmcancercentre
@marykge
It’s been a long time since the pandemic.
0
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🚨🚨🚨 Those interested in clinical and research experience in palliative/oligomet are encouraged to apply for our fellowship program!
Deadline June 30th. Please feel free to contact us for further questions.
Yes!
@UofTDRO
has an amazing
#radonc
fellowship led by
@jenncroke
25
#radonc
fellows from around the world training
@RadMedPM
@pmcancercentreon
on July 1 to learn from experts across all disease sites. Plus additional fellows will train
@Sunnybrook
with other amazing mentors.
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0
9
21
Kudos to all investigators for the fascinating and innovative HN oral abstracts
@ASCO
#ASCO23
,
@seanmmcbride
’s cogent discussions. Patient selection is key in definitive &
#metastatic
settings, and it is no longer sufficient to stratify/adjust.
@xrtGenomics
@KaramLab
@DrMLChua
1
6
20