Martin Dietrich, MD, PhD
@DoctorDietrich
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Lung cancer is largely a radiographic diagnosis. Ordering liquid bx prior to tissue confirmation accelerates timeline to treatment. Important for early and late stage disease. Thank you for the great collaboration!
@geoff_oxnard
@ChristianRolfo
@BrunaPellini
#ngs
#liquidbiopsy
Liquid Biopsy of Lung Cancer Before Pathological Diagnosis Is Associated With Shorter Time to Treatment
@JCOPO_ASCO
@isliquidbiopsy
@Al3ssandroRusso
@Marzia_DelRe
@geoff_oxnard
@TischCancer
@ASCO
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I am excited to join the team of Florida Cancer Specialist & Research Institute in Lake Mary and Oviedo. Alongside the Sarah Cannon Research Institute, we will be able to provide cutting edge clinical trial and research offerings for the Central Florida community.
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Beautiful responses (RR 75%) for BRAF inhibition in NSCLC with durable impression. More importantly, tolerance profile, esp pyrexia, seems improved >dab/tram. Time to align BRAF seq to targeted -> IO like other drivers? Data looks promising.
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Major week in the KRAS market- ODAC votes against sotorasib; BMS buys out Mirati. Adagrasib (soon) only KRASi in NSCLC, with efficacy across numerous tumor types. Congratulations to the Mirati team for getting this drug to patients!
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We are looking forward to an interesting series of case reviews. Thank you for the invitation
#totalhealthconf
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Thank you for a great
#wcs2024
- congratulations to
@edgardo_ny
and
@LuisRaezMD
for a successful meeting in paradise.
Our
#lungcancer
team at the 13th
@mecmededucation
Winter Cancer Symposium in Puerto Rico with
@marinagarassino
@DoctorDietrich
Pedro Solivan
@EdgardoSantosMD
@HosseinBorghaei
Erminia Masarelli and Tina Cascone
#lcsm
@IASLC
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Important for all cancer patients : A unified effort is needed to improve
#biomarker
testing and applying testing results in
#NSCLC
clinical practice. Learn more from the
@OncLive
Biomarker Consortium at
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Tailored selection of immunotherapies - KRAS, PD-L1, TMB and beyond. Appreciate the dialogue with my esteemed panel of
@JulieBrahmer
@JSabari
@OncLive
@LuisRaezMD
#precisionmedicine
#immunotherapy
@nsclc
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Gratefully to be part of this educational initiative to enhance testing and interpretation of results
@OncLive
#nsclc
#biomarkertesting
#liquidbiopsy
A unified effort is needed to improve
#biomarker
testing and applying testing results in clinical practice. Learn more from the Biomarker Consortium.
#NSCLC
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PACIFIC 2- negative trial with no OS signal. Pacific remains gold standard for stage III dx. IMO the end of standard XRT as "IO sensitizer" without proven clinical rationale ("abscopal" effect a true rarity). Pacific outcomes correlate with preXRT biomarker expectations (PD-L1,
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The ADC wave keeps rolling in lung cancer, options needed after some recent disappointing data for other hopefuls.
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Happy Thanksgiving! I wanted to extend my best wishes to our wonderful community of friends and colleagues that educates me, inspires and encourages me and helps me stay in touch with many of you I do not get to see as often as I would like. Grateful for all of you. 😉😉
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Amazing efforts by advocacy groups to support lung cancer patients in this extraordinary time. Patients have great allies in these partners and access to resources for help.
@LUNGevity
@teaminspire
@LungAssociation
Annette Eyer of the American Lung Association, upper right, an Inspire partner, discusses the latest in
#lungcancer
care during today's online Town Hall. HT
@LungAssociation
@LUNGevity
@DoctorDietrich
@smkazmi
@cityofhope
@pfizer
@TotalHealthConf
#lcsm
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I am looking forward to reviewing molecular testing in lung cancer with my esteemed colleague Dr Michelle Shiller. Please use the QR code to register below.
- new NCCN guideline updates for molecular testing in early and late stage disease.
- novel targeted agents for ALK, ROS1
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One of the worst contractual restrictions ever invented for medical care, holding physicians hostage and forcefully separating them from their patients is hopefully over. I am not sure how this will be implemented but my sincere hope is this will be the end of this malicious
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MET emerging : EGFR/MET bispecific antibody with best efficacy in biomarker sorted subgroup. Differences in RR consistent among multiple analyses, here RR 51% (MET+) vs. 14% (MET-). Complex biomarker with genetic and epigenetic mechanisms of activation- quantitative IHC needed
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Difficult clinical choice when two actionable alterations are overlapping. NTRK/MSI-HIGH only one of many examples, unclear why these two changes co-occur but possibly connected with underlying DNA repair defect? Thank you for sharing this information, oftentimes no data to guide
🤔What if the tumor is
#MSI
-High & has a
#TRK
-FUSION🛻 🧬❓
🆕Published today🗞👇🏾
#ColorectalCancer
❌response to
#Immunotherapy
(Pembro & IPI➕NIVO)
➡️brisk & CURATIVE response to NTRK⛔️Larotrectinib.
#ctDNA
#CRCSM
#PrecisionMedicine
@OncoAlert
Link:
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EGFRmt lung cancer is largely systemic disease. The last gap seems to be closing with postXRT space, in addition to met and post surgery. Looking forward to seeing the full data set.
Today, we announced overwhelming efficacy results from the LAURA Phase III trial that demonstrated improvement in progression-free survival for patients with unresectable, Stage III EGFR-mutated non-small cell
#lungcancer
(
#NSCLC
).
Learn more:
#AZUS
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Enjoyed my discussion with Dr. Meghan Mooradian about molecular testing in Non-smaller cell lung cancer. Testing with liquid+tissue NGS for all histologies as new standard for metastatic disease. Tissue testing on all stages to guide neoadjuvant and
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Lung cancer is an “all in” approach. 1/3 of patients do not have 2nd line opportunity. If meaningful PFS benefit similar to OPAL, I believe this will likely be practice changing for chemo eligible patients even w/o final OS analysis. Pemetrexed maintenance is well tolerated by
@DoctorDietrich
on phase 2 data evaluating
#osimertinib
+ chemotherapy in EGFR-mutated
#NSCLC
and the upcoming phase 3 FLAURA2 trial results.
#lcsm
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Sensitivity gap for early detection of precancerous lesions with only 13% detection. Colonoscopy remains the gold standard for CRC screening.
“CONCLUSIONS In an average-risk screening population, this cfDNA blood-based test had 83% sensitivity for colorectal cancer, 90%
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Prof Harald zur Hausen, pioneer in tumor virology, has died. He was my inspiration to choose oncology. A wonderful mentor and human being. An irreplaceable loss to science. My condolences to his family, may he rest in peace.
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A new resource for managing the complexity of molecular testing:
The
@OncLive
Biomarker Consortium is committed to providing accurate and relevant information about the importance of
#biomarker
testing and identification to the oncology community. Learn more at
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Great to see therapeutic progress.
Favorite update in diagnostics: the fine print of testing for stage IV disease. NCCN endorses concurrent testing with liquid and tissue biopsy “acceptable”. Wished they would have worded more unambiguously but definitely progress in one of the
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Chrysalis was the first step in 2nd line, now with further enhancements in EGFR and c-MET altered cancers in multiple combinations in Mariposa-1, Mariposa-2 and Papillon studies. Management of skin related AEs is key for successful treatment. Exon 20 with new first line
Martin F. Dietrich, MD, PhD, discusses the results of the phase 1 CHRYSALIS study of amivantamab for patients with EGFR exon 20 insertion-mutated
#NSCLC
.
#lcsm
|
@DoctorDietrich
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Exciting updates that translate into more cures: 1. Early biomarker testing of all NSCLC, independent of stage or histology. 2. Biomarker dependent assessment of benefit of IO (genetic markers and PD-L1 levels are prognostic) 3. Moving patients in need of systemic to neoadj
Martin F. Dietrich, MD, PhD, discussed his observations on the latest and upcoming trials that target biomarkers in earlier-stage
#NSCLC
.
@DoctorDietrich
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Long-term follow-up data of advanced NSCLC clinical trials helps inform my prescribing decisions.
Review the data from a trial in advanced
NSCLC here:
#LCSM
#SponsoredbyRegeneron
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Excited to be introducing this new biomarker hopeful at IASLC North America! Please join us for this update presentation in Chicago.
#nsclc
#lcsm
#ceacam5
Don’t miss the program chair, Martin F. Dietrich, MD, PhD, & expert speakers, David Planchard, MD, PhD & Ming Tsao, FRCPC, MD, at our satellite symposium on CEACAM5. Register now:
#gotoPER
#NACLC23
#lcsm
@DoctorDietrich
@dplanchard
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Congratulations to my fellowship mentor Dr. Schiller! Well deserved - ECOG 1594 is still the backbone of our most common treatments.
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Metastatic patients deserve a full genetic analysis on a DNA/RNA based panel plus a possible liquid biopsy to provide the best information to guide their treatment, not OPTIONAL.
#precisionmedicine
#egfr
@DoctorDietrich
: We need to apply precision medicine to all metastatic patients. These test are not optional, not "nice to have" but central to patient treatment. Time and money well spent
#COA2020
#lcsm
@EGFRResisters
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Squamous and nonsquamous histologies are distinctly separate in advanced NSCLC, and tailored approaches should be considered.
Read about a clinical trial in advanced NSCLC:
#LCSM
#NSCLC
#SponsoredbyRegeneron
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Adagrasib is approved for KRAS G12C mt lung cancer. Compatible with immunotherapy and active in the brain. Looking forward to unfolding MRTX849’s full potential of combination treatments beyond 2nd line. Hopefully able to replace chemo in 1st line soon.
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A great new option for nasopharyngeal carcinoma, just approved by the FDA:
LOQTORZI is the first and only FDA-approved treatment for NPC Indicated in combination with chemotherapy for 1st line treatment and as monotherapy for patients with disease progression on or after
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Impact of Checkmate-816 with neoadj chemoIO : Now (virtually) all NSCLC will need a complete molecular profile prior to initiation of therapy. Curative intent NSCLC req same diligence in biomarker dx. Biological lessons transfer from met disease-no need to reinvent the wheel.
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Her2 has become one of the most complex and refined biomarkes with genetic and epigenetic changes affecting prognosis and treatment with reach extending to lung cancer and well beyond. Thank you
@OncLive
for the invitation to discuss this important topic.
Watch as experts discuss their key takeaways on the evolving treatment landscape in HER2 non–small cell
#LungCancer
.
@edgardo_ny
@DoctorDietrich
@DrEdKim
@DRCamidge
#lcsm
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Enhanced immunotherapy beyond PD-1 reaching small cell lung cancer, hopefully soon. Dire need for patients progressing on platinum/PD-1 - will need to bring this modality to the community where patients are treated.
@FDAOncology
#lcsm
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Thank you
@bjork5
for having me on your podcast and the wonderful inspiration you are bringing to the lung cancer community. Your testimony is a wonderful example of how we should strive to deliver lung cancer care everywhere.
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Whoever says they like “traveling” doesn’t travel enough …
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The excellence housed under that roof - congratulations
@SarahCannonDocs
Good morning!
Today is the official opening of SCRI Oncology Partners, our new clinic side to our existing research w/
@SarahCannonDocs
!
This morning I feel so lucky to work in a beautiful building filled with even more beautiful people committed to helping pts facing cancer!
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Looking forward to seeing you there and to a great weekend! Thank you for the invitation
@edgardo_ny
Cheers. For NOSCM 2023, 18TH EDITION. For the City of New Orleans and its people, for my colleagues at the Medical Educator Consortium, for all my colleagues/physicians who have supported NOSCM for 18 years, our families and friends. Looking forward to see you on Friday. GO NOLA
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Disrupting protein-protein interaction not an easy task, truly the only solid tumor therapy to do so hitting a major oncogenic pathway. Congratulations for this accomplishment. Great news for patients with HIF pathway alteration. Utility beyond RCC?
There we go!!!
About time.. great drug, for 23% of ccRCC patients
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Great news for melanoma patients and the field of immunotherapy in general. Relatlimab has been approved in combination with fixed-dose Opdivo. PFS impact doubled, toxicity profile reassuring. Second IO/IO combination in melanoma.
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Empower Lung 3 data supporting cemiplimab plus chemotherapy. Fourth FDA approval and favorite sunbelt drug for non melanoma skin cancer. Always good to see competition in this space, fostering novel research and clinical trials.
FDA approved cemiplimab-rwlc (Libtayo, Regeneron Pharmaceuticals) in combination with platinum-based chemotherapy for adult patients with advanced non-small cell lung cancer with no EGFR, ALK, or ROS1 aberrations.
#OCENewsBurst
#lcsm
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Good news but really no surprise in this and hopefully the end of any sequencing discussion for selpercatinib. Interesting Q will be to see how chemoIO numbers compare and contribute to the understand of RET immunosensitivity. I suspect will be similar to EGFR in 1st large
LIBRETTO-431 shows first line selpercatinib provides longer PFS than chemo-immunotherapy in
#RET
fusion positive NSCLC. Await full data but no surprise. Selective RET inhibitors are among the more effective and better tolerated targeted agents in NSCLC.
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1st perioperative therapy for NSCLC approved, pembrolizumab now available in early stage. Unclear benefit, if any, over shorter CM-816 regimen. Risk adaptation depending on clinical and pathological response needed. Value of postoperative portion not demonstrated without
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@StephenVLiu
@LuisRaezMD
@tisdrey
@Latinamd
@ASCO
@MCIStrong
Three favorites - sad to have missed you.
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@JackWestMD
@n8pennell
Congratulations and a sad day for the academic oncology community, another excellent source of sharp data interpretation lost to industry.
@jackwestmd
wishing you the best in your transition.
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Something as simple as a biomarker rest may make ae difference in advanced NSCLC treatment decisions. As providers, we should strive to make biomarker testing more accessible.
Read more about a lung cancer trial that enrolled advanced NSCLC patients across PD-L1 expression
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Pharos trial for encorafenib/binimetinib: RR 75%/DOR NR in 1st line; RR 46% with DOR 16.7 mts in later line. Results comparable to osimertinib in 1st line; tox profile in trial/melanoma experience more tolerable than dab/tram (esp pyrexia): Time to align seq targeted therapy
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Exciting! BRAFV600E targeting en par w/ EGFR 3rd gen TKI (RR and durability). Low freq of pyrexia. Next trial: enco/bini +/- IO in 1st line, harnessing dual biomarker susceptibility (esp interesting for h/o smoking, high TMB).
New treatment in the horizon for patients with +BRAFV600E NSCLC waiting for a new treatment options.
Phase II, Open-Label Study of
#Encorafenib
Plus
#Binimetinib
in Patients With
#BRAFV600
Mutant Metastatic Non–Small-Cell Lung Cancer
@RielyMD
et al.
N=98
💊ORR by IRR was 75%
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For the first time in my (American) life, I’m allowed to donate blood. Apt tomorrow. I am starting to think of Covid19 as a great chance for improvement along with the challenge.
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Despite difficult times, Happy Doctors' Day to all my wonderful colleagues. What you are doing matters, and I appreciate you.
Please stay safe and strong in these difficult times!
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Additional postmarketing requirement for sotorasib in KRAS G12C mutant NSCLC.
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Thanks to MJH CancerNetwork for inviting me to this important discussion: tumor markers, radiographs and beyond
#precisionmedicine
#MRD
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I make it a point to screen my patients for tobacco use often and encourage them to quit if needed. These in-office interventions tend to make patients feel more motivated and supported.
#LCAM
#LCSM
#SponsoredbyRegeneron
How often do you screen your patients for tobacco
a. Every month
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b. Every few months
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c. Once a year
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d. Only at first visit
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Discussion with colleagues Drs. Shelly Gunn, Andrew McKenzie and James Reeves re: biomarker testing.
Thank you
#genentech
for the opportunity to present our efforts and share thoughts on best practices in the community.
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Atezolizumab approved for first line NSCLC. Cannot even begin to describe the difficulty and variability of measuring 10% positivity of Tumor-infiltrating immune cells. Standardization would be key to ensure comparability.
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FLAURA2 Update: OS trend HR=0.75, not final but improved from HR=0.9 at 1st interim analysis. Median OS in osi arm 36 months, similar to FLAURA results . Postprogression tx with old concern of ?combination > sequential tx. SOC for 1st line EGFRmt NSCLC for chemo eligible
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Metabolic side effects of alectinib - class effect of ALK inhibitors? No significant increase in CV AEs, should not be factor for selection of best 1st line treatment.
Analysis of Serious Weight Gain in Patients Using Alectinib for ALK-Positive Lung Cancer -
@JTOonline
(N=46)
⬆️central obesity from 27-47%
➡️ as pts get treated for years, weight gain is a serious AE
#lcsm
@ALKPositiveinc
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@StephenVLiu
@JTOonline
Important point of secondary mutations but “inactivating” or “activating” mutations not uniformly classified/easily identified on NGS reports, needs more than front page review. Addition of CTLA4 here with interesting data- PD-1 resistance rather than general immunoresistance?
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Wide open 2nd line space in NSCLC with multiple approvals expected to be added in the near future. More than ever, precision approaches are needed to guide best therapy.
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Interesting AACR presentation today - is OS enough fo justify subgroup approval for EGFRm disease. Also, need to see EGFR mutation breakdown.
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Poseidon : PD-L1 and CTLA4 combinations are providing long term sustained benefit in difficult to treat PD-L1 levels. Three positive phase 3 trials supporting use. Glad to have this novel confirmatory data. Improved long term outcomes will come from stronger immune responses.
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A good reason to obtain baseline PFTs on patient to assess impact of therapy and additional comorbodities. Many reports with ongoing lung symptoms following recovery from
#COVID19
@BrendonStilesMD
My greatest concern is that even though a large proportion of our patients will be affected, we don't know anything about long term effects- what does SARS-CoV2 do to lung function? I worry about sequelae, which are largely unknown at this time.
#LCSM
#COVID19
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This decision will further narrow opportunities for difficult-to-treat EGFR exon 20 patients. Amivantimab will be only approved option with different challenges. Landscape to shift significantly- new TKI approaches urgently needed. Sad day for patients.
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