Director of Breast Cancer Research Program at Sarah Cannon Research Institute | Wife | Mom to 2 Girls | Tweets are My Own
#Oncology
#BCSM
,
#Cancer
, COI at link.
Theresa & the other
#clinicaltrial
patient volunteers are the heroes of
#oncology
, these brave 👨👩👧👦 make every drug advance possible.
I'm lucky to be Theresa's doctor and I LOVE celebrating these milestones in
@SarahCannonDocs
clinic, just motivates us to go further faster!
A 🧵:
For any of you that haven't read the full transcript of Todd Beamer's call from United flight 93 ✈️ on
#September11
.
Didn't take being a 👮♂️ or 👨🚒 to be a hero that day. Nope. Sure didn't. There were many heroes.
I will fear no evil, for thou art with me…..
Todd: (softer) God help me…Jesus help me….(clears throat and louder)
Are you guys ready?……..
Let’s Roll……………………
@tmprowell
@Uber
@lyft
When I was in Florida last week, my Uber driver had his vaccination card laminated and taped inside AND still required masks (for both of us!).
Extra tip he got!
Want to hear a happy inspiring 🧵 from oncology clinic? A story of perseverance and grit?
I saw a young woman this month in f/u that I first met almost 7 years ago...
#ASCO22
is only 2 weeks away! Below are my Top 10 abstracts I'm looking forward to in
#bcsm
across early & metastatic settings.
I've also attached the "why" - what is intriguing me about these particular abstracts or why they are important IMO.
@SarahCannonDocs
@OncoAlert
@ShikhaJainMD
@arghavan_salles
People make families in all types of ways. Rock on.
My 👧🏼 👧🏼 both know they lived in petri dishes 🧫 frozen 🥶 before mommy's tummy 🤰and they think it's so cool how they were made from us and how much they were wanted!
Praying for you!
@acweyand
Going to the bathroom for any reason should be a given. Periods, diarrhea, UTI...No one should have to justify themselves. Even my 8 year old is fully capable of making good decisions on when to go to the bathroom.
Todd: Hello… Operator…listen to me…I can’t speak very loud. – This is an emergency. I’m a passenger on a United flight to San Francisco.. We have a situation here….Our plane has been hijacked…..can you understand me?
Lisa: (exhaling a deep breath to herself) I understand…
Yes, it shocked me, to be honest. Thank you for noticing, and for speaking up. Acknowledgment is how we will eliminate this.
Everyone should be treated AND addressed equally regardless of gender, ethnicity, sexual orientation.
@fumikochino
@NarjustDumaMD
@tmprowell
@OncoAlert
To the male physician who acknowledged the esteemed panel of drs during the SERDS presentation as Dr. Turner & the “other two ladies”
@ErikaHamilton9
@jhaveri_komal
,an apology is in order. Misogyny has no place in this cancer space.
#ASCO22
#womeninoncology
as my wife…Lisa….We’ve been married for 10 years. She’s pregnant with our 3rd child. Tell her that I love her…….(choking up)..I’ll always love her..(clearing throat) We have two boys.. David, he’s 3 and Andrew, he’s 1…..Tell them……(choking) tell them that their daddy loves
them and that he is so proud of them. (clearing throat again) Our baby is due January 12th…..I saw an ultra sound…..it was great….we still don’t know if it’s a girl or a boy………Lisa?
Lisa: (barely able to speak) I’ll tell them, I promise Todd.
Todd: I’m going back to the
Listen to me….I want you to hear this….I have talked with the others….we have decided we would not be pawns in these hijackers suicidal plot.
Lisa: Todd, what are you going to do?
Todd: We’ve hatched a plan. Four of us are going to rush the hijacker with
…….Lisa, will you do something for me?
Lisa: I’ll try….if I can….Yes.
Todd: I want you to call my wife and my kids for me and tell them what’s happened. Promise me you’ll call..
Lisa: I promise – I’ll call.
Todd: Our home number is 201 353-1073…….You have the same name
you pray with me?
They pray: Our father which art in Heaven
Hallowed be thy name,
Thy kingdom come, thy will be done
on earth as it is in heaven.
Give us this day our daily bread,
@jbullockruns
So what did others on your team do about it? The intern, the co-resident, the attending?
Because in situations like this, it isn't your job to stand up for yourself, it's their job to make it clear that behavior like that isn't accepted. You deserve to be supported.
It was very broken English, and… I’m telling you…it sounded fake!
Lisa: Ok sir, please give me your name.
Todd: My name is Todd Beamer.
Lisa: Ok Todd….my name is Lisa…Do you know your flight number? If you can’t remember, it’s on your ticket.
Todd: It’s United Flight 93.
And forgive us our trespasses
As we forgive our trespassers,
And lead us not into temptation
But deliver us from evil
For thine is the kingdom, and the power, and the glory
Forever…..Amen
The Lord is my shepherd, I shall not want…
He makes me to lie down in green pasture
He leads me beside the still waters
He restores my soul
He leads me in paths of righteousness
for His name’s sake
Yea, though I walk through the valley of the shadow of death
destroyed.
Todd: Oh God —help us!
Lisa: A third plane was taken over by terrorists. It crashed into the Pentagon in Washington DC. Our country is under attack….and I’m afraid that your plane may be part of their plan.
Todd: Oh dear God.
talking to his wife just before the hijacking started.She told him that hijackers had crashed two planes into the World Trade Center……Lisa is that true??
Lisa: Todd…..I have to tell you the truth…..it’s very bad. The World Trade Center is gone. Both of the towers have been
Can the hijackers see you talking on the phone?
Todd: No
Lisa: Can you tell me how many hijackers are on the plane?
Todd: There are three that we know of.
Lisa: Can you see any weapons? What kind of weapons do they have?
Todd: Yes…. they don’t have guns….they have knives
with the bomb. After we take him out, we’ll break into the cockpit. A stewardess is getting some boiling water to throw on the hijackers at the controls. We’ll get them….and we’ll take them out. Lisa, …..will you do one last thing for me?
Lisa: Yes…What is it?
Todd: Would
– they took over the plane with knives.
Lisa: Do you mean…like steak knives?
Todd: No, these are razor knives…like box cutters.
Lisa: Can you tell what country these people are from?
Todd: No…..I don’t know. They sound like they’re from the mid-east.
Please send prayers, well wishes, luck, and pixie dust to Demi tomorrow!!!
She is receiving cells tomorrow for her bone marrow transplant. She has defied odds so far and we need that to keep happening so she can beat leukemia!
(Thread w/ permission)
Todd: Yes, ..they…they killed one passenger sitting in first class. There’s been lots of shouting. We don’t know if the pilots are dead or alive. A flight attendant told me that the pilot and copilot had been forced from the cockpit and may have been wounded.
Lisa: Where is the
Lisa: Have they said what they want?
Todd: Someone announced from the cockpit that there was a bomb on board. He said he was the captain and to stay in our seats and stay quiet.
He said that they were meeting these men’s demands and returning to the airport…
group—if I can get back I will…
Lisa: Todd, leave this line open…are you still there?…
Lisa: (dials the phone..) Hello, FBI, my name is Lisa Jefferson, I’m a telephone supervisor for GTE. I need to report a terrorist hijacking of a United Airlines Flight 93….Yes I’ll hold.
She makes me teary every visit. Remembering the hopelessness and trepidation *I* felt with her situation and needing chemo in a shelter, to now.
Thriving. Secure. Happy. Healthy.
Never underestimate what people can accomplish. Never think any situation is hopeless.
So....tomorrow am is my 1st race since I was 29 and stopped running to try to have kids (long story of IVFs).
It's only a 10k and I've been running 6+ miles for a month now training for a half marathon this fall, but I don't like hills so will accept all good vibes sent. 🤞 🍀
States Capital Building.
Todd: I understand…hold on……I’ll…….I’ll be back..
Lisa: Mr. Goodwin, how much time do they have before they get to Washington?
Goodwin: Not long ma’am. They changed course over Cleveland;
they’re approaching Pittsburgh now. Washington may be twenty minutes away.
Todd: (breathing a little heavier) The plane seems to be changing directions just a little. It’s getting pretty rough up here. The plane is flying real erratic….We’re not going to make it out of here.
the FBI. We have been monitoring your flight. Your plane is on a course for Washington, DC. These terrorists sent two planes into the World Trade Center and one plane into the Pentagon. Our best guess is that they plan to fly your plane into either the White House or the United
Goodwin is on the line and will be talking to you as well.
Todd: The others all know that this isn’t your normal hijacking. Jeremy called his wife again on his cell phone. She told him more about the World Trade Center and all.
Goodwin: Hello Todd. This is Agent Goodwin with
Goodwin: Hello, this is Agent Goodwin.. I understand you have a hijacking situation?
Lisa: Yes sir, I’ve been talking with a passenger, a Todd Beamer, on Flight 93 who managed to get to an air phone unnoticed.
Goodwin: Where did this flight originate, and what was its
destination?
Lisa: The flight left Newark New Jersey at 8 A.M. departing for San Francisco. The hijackers took over the plane shortly after takeoff, and several minutes later the plane changed course – it is now flying east.
Goodwin: Ms. Jefferson…I need to
talk to someone aboard that plane. Can you get me thru to the planes phone?
Lisa: I still have that line open sir, I can patch you through on a conference call…hold a mo…..
Todd: Hello Lisa, Lisa are you there?
Lisa: Yes, I’m here. Todd, I made a call to the FBI, Agent
Lisa: Now Todd, can you try to tell me exactly what happened?
Todd: Two of the hijackers were sitting in first class near the cockpit. A third one was sitting near the back of the coach section. The two up. front got into the cockpit somehow; there was shouting. The third
turning around…..That’s it – we changed directions. Do you hear me….we’re flying east again.
Lisa: Ok Todd…. What’s going on with the other passengers?
Todd: Everyone is… really scared. A few passengers with cell phones have made calls to relatives. A guy, Jeremy, was
ordered us to sit on the floor in the rear of the plane……….oh Jesus.. Help!
Lisa: Todd….are you ok? Tell me what’s happening!
Todd: Hello…..We’re going down….I think we’re going to crash……Wait – wait a minute. No, we’re leveling off….we’re ok. I think we may be
3rd hijacker now Todd?
Todd: He’s near the back of the plane. They forced most of the passengers into first class. There are fourteen of us here in the back. Five are flight attendants. He hasn’t noticed that I slipped into this pantry to get the phone. The guy with the bomb
hijacker said he had a bomb. It looks like a bomb. He’s got it tied to his waist with a red belt of some kind.
Lisa: So is the door to the cockpit open?
Todd: No, the hijackers shut it behind them.
Lisa: Has anyone been injured?
Can we say it AGAIN? Louder? 🗣Shout it maybe? 🙏
⚡️ When ASKED, racial groups participate in trials in similar frequency 💣 💡
We should discuss trials with all patients. Every one. Or at tell them why they aren't eligible so they know it was considered.
#SABCS22
@OncoAlert
Did you know that
@RedCross
is super low on 🩸products including red cells and platelets?
Today, I donated platelets. Takes a little time, but otherwise no worse for the wear. Easy way to help your community- including those facing cancer.
@SarahCannonDocs
@OncoAlert
#bcsm
Lots of talk about "negative" abstracts in
#ASCO20
plenary.
@ASCO
scientific committee felt that this type of neg study to help settle a decade old debate was infinitely impt.
What do u think: - studies just as impt as + ones?
@OncoAlert
Savituzumab efficacy in TROPICS02 by HER2 IHC status:
✅ Benefit of saci regardless of HER2 IHC
IMO 👩⚕️ : I will use TDXd 1st and saci 2nd for patients eligible for both
#ESMO22
@OncoAlert
#bcsm
#SABCS22
is 4 weeks away! Excited for
#bcsm
updates including overall survival data, novel compound activity, tx sequencing info, molecular data to inform tx decision, & info about pregnancy post cancer.
Attached are the top 10 (yes, I cheated) I'm excited to see!
@oncoalert
In Alexandria at
#ASCO
headquarters planning
#ASCO24
. Quick break from discussions for an 🚙 to see the cherry blossoms 🌸.
Beautiful scenery AND company with '23 Scientific Chair
@KimmieNgMD
, '24 Scientific Chair
@AngieDemichele
, and myself '25 making 3 years of continuity.
#DB04
#bcsm
#HER2low
Wow. For pts typically classified as having TNBC, PFS improved almost 6 months, OS improved by 10 months!
HR 0.46 and 0.48
⭐️TDXd for patients with low
#HER2
expression is a big deal! ⭐️
Can you believe? In a period of 7 years went from homeless with a stage III breast cancer and despite the horrible situation, DURING chemo pulled herself out and up.
Supported her kid, got a home, a job, her daughter is graduating, and they are THRIVING.
Fantastic algorithm by Dr. Mayer how to approach the treatment of early HR
#bcsm
now that we have some more agents to the stage.
#SABCS21
#bcsm
@OncoAlert
Excited to share our publication of T-DXd vs. T-DM1 in pts with brain 🧠 mets from DB-03.
⭐️ PFS 15 months w/T-DXd vs. 3 months w/ T-DM1
Trastuzumab deruxtecan vs trastuzumab emtansine in brain metastases in DESTINY-Breast03 trial - ESMO Open
@kylegriffin1
@Cleavon_MD
We need to continue to impose restrictions on activities, attractions, travel, etc. for those unvaccinated. If it's a choice, then it's also the venue's choice to not allow people who could harm others.
Concerts, museums, restaurants, & travel arent rights. They are privileges.
Increased incidence in radiation ☢️ necrosis when delivered 7 days before to 21 days after ADC.
Symptomatic Necrosis With ADCs and Concurrent Stereotactic Radiotherapy for Brain Metastases | Targeted and Immune Cancer Therapy | JAMA Oncology
#bcsm
Dr. LoRusso bringing up the super important point 📌that many places have gone away from
#IHC
in favor of
#FISH
.
Very important for us all to talk to our pathologists 🔬 and let them know how important HER-2 IHC 1+ and 2+ is now.
#bcsm
#ASCO22
@OncoAlert
SURVIVAL worse when pts with ER low (1-10%) breast cancer don't get endocrine therapy.
ET omission is common in this population- 42% ‼️
Benefit here specifically appears to be among those with no pCR vs. pCR to chemotherapy
#ASCO24
#bcsm
I saw her today. She is over 6 years out.
She now has a government job- get this- a special program focused in educational resources for homeless youth! Has fabulous gvmt insurance and benefits.
Her daughter is graduating college. Has an Etsy business grossing over 50k/year
Hot take from
#HallD1
:
PALOMA-2 was more disappointing than even expected.
FAKTION impressed me more than expected in terms of magnitude of benefit.
#ASCO22
#bcsm
@OncoAlert
If one airline would come out and require vaccination to travel - I would exclusively fly my family and myself on that airline.
I think the amount of business they would gain vs. lose would be astoundingly positive.
@SouthwestAir
@Delta
@UnltedAirlines
@AmericanAir
#COVID19
United Airlines just placed the biggest aircraft order in its history and expects to create 25,000 unionized jobs by 2026 in an effort to capitalize on the astonishing rebound in passenger travel. ✈️
Everything about her was inspiring- her path to her career, her palpable love for her Sun and her Moon, her transparency as her body declined. Soar in peace.
Obituary: Facing death, neuroscientist Nadia Chaudhri taught us how to live | Montreal Gazette
So all- it's official- we are excited to welcome
@VivekSubbiah
and
@IshwariaMD
to
@SarahCannonDocs
and Nashvegas! 🤠
Ishwaria Subbiah, MD Joins SCRI as Executive Director for Cancer Care Equity and Professional Wellness
Pat Lorusso says:
"everyone says grade 1 diarrhea is nothing...until you have to live with it."
"And live with it for a long time because you are NED and maybe cured"
True that, Pat.
#ASCO21
@OncoAlert
Today the FDA approved fam-trastuzumab deruxtecan-nxki (Enhertu, Daiichi Sankyo) for adult patients with locally advanced or metastatic HER2-positive gastric or gastroesophageal (GEJ) adenocarcinoma who have received a prior trastuzumab-based regimen.
#HER2
90% reproducibility among pathologists 🥼 on HER-2 high
But only 60% concordance on HER-2 low-eek 🫣
Frankly with DAISY data, I'm more worried about missing lows than the overcalling of lows that are actually 0. Missing out on a tx option is a big concern.
#SABCS22
@OncoAlert
Thoughts? Do articles that use the term “prevention” bother you? I think “risk reduction” is a more accurate term. We can reduce the chance of cancer, but can’t prevent it all together.
@OncoAlert
#bcsm
Shifting the Focus of Breast Cancer to Prevention
First oral
#SERD
approved for HR+ metastatic
#bcsm
w/ ESR1 mutation- welcome
#elacestrant
.
Much more work being done with this class of compounds including: 1) earlier settings, 2) combinations, 3) additional novel oral SERDs coming, 4) benefit in all comers.
@OncoAlert
#abemaciclib
#monarchE
positive and significantly reduces cancer recurrences in the ⬆️ risk adjuvant setting.👏 to the patients involved who made this possible.
Verzenio® Significantly Reduced Cancer Recurrence in High Risk HR+ Early Breast Cancer
Im on call this wknd rounding in 2 hospitals, thoughts:
1) For the love of everything Holy, please get vaccinated. It doesn't have to be this way. VAST majority are unvaccinated.
2) Nurses are the 💜 & soul of a hospital and the care of patients. I worry about them the most.
@jmugele
😍 Really learned this moonlighting as a fellow in rural NC. In medicine when someone asks it's b/c they don't have the resources and they need help.
Saying "yes" (when possible) is so important to help a colleague AND get their patient the treatment they deserve.
#Team
Wow - bold move! Head to head CDK4/6 trial led by
@Novartis
.
#bcsm
#CDK4and6
Novartis, determined to dethrone Pfizer, will launch bold Kisqali-Ibrance head-to-head trial in breast cancer
Ok
#OncTwitter
, are you all surprised at oncology?
On one hand I feel like most people in oncology really feel called to it and are super passionate, but is satisfaction so low because it's just so so hard? Losing patients? Having tough conversations?
#bcsm
@OncoAlert
@McNeill_Tweets
Our dog has an insatiable appetite for socks. Only socks. Nothing else.
Luckily they have all come back up a day or two later and she has been fine...but this is essentially a monthly affair 🤞🫣😬
Study w/ annual vs. less frequent mammo for surveillance after
#bcsm
. No change in
#bcsm
specific survival.
The thing that bothers me about this is : does only survival matter? What about the less tx and less morbidity when a recurrence is caught earlier vs to later?
#SABCS23
NEWS: Capivasertib approved in combination w/ fulvestrant for
#MBC
with a PI3/AKT/PTEN alteration.
Ok
#bcsm
community, what do you think about the approval for only for those with alterations? Altered subset didn't look so different than wild-type subset to me.
#TDXd
showing a 73% response rate for patients with
#brainmets
that were either newly diagnosed or progressive post local tx.
@oncoalert
#bcsm
TUXEDO-1 Efficacy of T-DXd for Patients With HER2 Breast Cancer and Active Brain Metastases - The ASCO Post
Not all deleterious BRCA mutations are created equal 🚫.
Copy number variants (CNV) associated with increased risk of breast cancer in BRCA1 carriers.
#bcsm
@OncoAlert
#BRCAm
Definite disadvantages of
#RemoteASCO2020
:
1) my step count is 1,126...would have been at 10,000 by now walking McCormick Place
2) love the Twitter, texts, and email communication. However, can't beat in-person interactions with colleagues, patients, & pharma.
#ASCO20
@OncoAlert
I am so sorry,
@NCIDirector
, that you are having to go through this.
Amazing display of leadership not only sharing her
#bcsm
diagnosis, but also publicly showing her confidence in clinical trials.
NCI Director has cancer - The Cancer Letter
In preparation for Mother's Day tomorrow, posting this in support of those who have lost children or mothers, who desire to be mothers and have struggled, or for whom it may not be a healthy relationship. It's not a happy day for many.
Hugs to you all, I see you🤗.
On my way home ✈️...quick trip for a conference 👩⚕️with a half marathon 🏃🏽♀️ tacked on today.
Have to admit, it was much harder at 42 years old compared to the last I ran when I was 29😬 🏃🏽♀️...but ✅ it's done!
Big fan of meetings/zooms being 25 minutes instead of 30 or 50 minutes instead of 60 to allow 5-10 minutes for breaks in-between.
Also nice to be able to go to the bathroom or get something to eat/drink!
Why isn't this the standard?
If you sit in back-to-back meetings at work, read this:
Microsoft's Human Factors Lab studied 14 participants across two days of video meetings.
• Day 1: 4 back-to-back 30-min meetings.
• Day 2: 4 30-min meetings with 10-minute breaks in between.
Participants wore EEG caps
Anyone else inspired going back and revisiting the discovery of
#HER2
, the original therapeutics.... seeing how far we have come, how many drugs we have, and how much the natural history to this disease has been changed?
I am.
#ASCO21
@OncoAlert