Tom Newsom-Davis
@tnewsomdavis
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Thoracic medical oncologist | Consultant @ChelwestFT | Chair Elect @BTOGorg |
London, England
Joined June 2014
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@bbcnickrobinson
As an oncologist, I know that a cancer diagnosis should be private if that is what the patient wants.
It doesn’t matter who you are.
This is unarguable.
Those who spread rumours and force the loss of that privacy should be ashamed of themselves.
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👉 Things you learnt about in medical school but almost never see in practice
Here’s my offering from clinic today
No prizes for diagnosis
What’s your example?
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People having poster nightmares, a series.
I feel your pain. We’ve all been there.
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Activity of ALK TKIs still stops me in my tracks after all these years. Astounding.
Before (L) and after (R) 3 month’s Alectinib
@ALKpositiveINT
@ALKLungCancer
[Images with patients permission]
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Can’t claim responsibility for this, and thank you for person who sent it to me, but reckon this is the most useful
#ASCO23
list there is:
Free food available in Exhibition Hall:
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Anyone else always see a smiling bat with wings, when looking at bone windows of a CT pelvis?
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First patient on Sotorasib = first response to Sotorasib.
Seeing new drugs work in lung cancer is still the most exciting thing there is.
(3 months between scans. Images with patient’s permission)
#LCSM
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And so it starts:
Acute Oncology inpatient list has gone from <1 page to 3 pages in past week.
Great majority COVID -ve.
Large number of Emergency Presentations of new cancer, as we suspected would happen.
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@drphiliplee1
Followed by this when they realise you have forgotten to sign it (and you are 4 floors upstairs)
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Requesting NGS after NSCLC patient has started platinum chemotherapy
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‼️ Sotorasib approved by NHS for KRAS G12C NSCLC ‼️
2nd lung cancer drug via Project Orbis.
This is a good news day.
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Early Christmas present!
Appointed to
@IASLC
Multidisciplinary Clinical Science Committee.
Thank you IASLC.
Looking forward to working with colleagues to develop world-class education and to answer the major research questions we face.
👊👊
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Who knew?
UK is best at palliative care (we knew, of course).
Palliative medicine an essential part of
#BTOG20
.
So pleased my colleagues Ruth Caulkin & Antonia Field-Smith are at their First BTOG.
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Beautiful new
@macmillancancer
centre just opened on LG floor of
@ChelwestFT
. Excellent news for our patients.
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Today I had my first beer from a pub since March (outdoors, at a responsible 2m distance from all and sundry).
I almost cried I was so happy.
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7th patient recruited to West London Genomics Medicine ctDNA pilot = first actionable 1L mutation.
👉 Report read by me this am.
👉 TKI lined up.
👉 Tissue NGS has only been requested today.
👍 This will cut 3-4 weeks off treatment timeline. 💥
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‼️ Adjuvant Atezolizumab (IMpower-010) approved by NHS England via Project Orbis‼️
Was so busy at
#BTOG22
I completely missed this today
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Emerging biomarkers in NSCLC: what will we be doing in the near future?
Great review from Dr Paul Hofman
#ILCS23
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One of the most intriguing findings in cancer immunotherapy.
I can’t explain why it happens, but we now have repeated studies finding the same thing, even when confounding factors (age, PS) taken into account.
Accumulative publications showing that immunotherapy is more potent when given early in the day. Time to change our practice and give our IOs in the morning? At least until evidence of a circadian biology supporting the hypothesis & availability of data from phase III trials?
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Weekly referrals to our
@ChelwestFT
Acute Diagnostic Oncology Clinic.
Very worried: referrals have stopped with COVID.
To our Primary Care friends: if you suspect cancer, please do not delay referral to appropriate clinic.
Cancer still happens, despite COVID.
@cwpluscharity
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Seen this poem on the tube for a few months now.
Seems especially apt this week.
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Some advantages to working late:
Cycle home through empty Richmond Park & 9pm sunset.
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KEYNOTE-789: Pem/Carbo vs. Pembro/Pem/Carbo post-TKIs in EGFR+ve
👉 Non significant OS benefit
👉 Non significant PFS benefit
So if chemoIO preferred in this patient group, use IMPower150, not Pem/Pem/Carbo.
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EMA approves atezolizumab, carboplatin, paclitaxel & bevacizumab (i.e. IMpower150) for 1st non-squamous NSCLC. Includes EGFR mutation & ALK positive patients (if failed prior TKIs).
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‼️ NICE approve Selpercatinib ‼️
Make sure your molecular testing covers all fusions, including RET.
Rare, but essential we find it when it is there.
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NICE approve IMpower150 (Atezolizumab, Carboplatin, Paclitaxel, Bevacizumab) in:
• 1L, nonsquamous, PD-L1 0-49%
• EGFR or ALK mutation post TKI failure (no mention of PD-L1 cut-off)
Good news for our patients. Post-EGFR and ALK indication especially interesting.
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Very excited to be appointed Vice Chair of BTOG Steering Committee. Thank you
@BTOGORG
@DrSanjayPopat
and
@_johnedwards
for your votes of confidence.
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Wow.
Check out how many KRAS inhibitors are currently in trials 🤯
Beautifully clear summary from Tina Cascone
#ILCS23
@KRASKickers
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Errr… I think the correct term is ‘Specialist Palliative Medicine Physician’
Cerner strikes again!
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Well, it’s been a great day 1 of
#BTOG21
Delighted so many people registered, impressed with quality of talks, enjoyed Q&A sessions
But...
Should now be heading to the bar with friends and colleagues, not sitting at home doing my emails
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Alison runs our fantastic
@macmillancancer
centre
@ChelwestFT
Our patients will miss her but we know
@NightingaleLDN
needs her more.
Not surprised Alison was amongst the first to volunteer: confirms the high esteem we all hold her in.
Induction complete, currently waiting for the rosta for the family communication and support team
@NightingaleLDN
#WhatATeam
Our Macmillan centre is being looked after by my amazing centre volunteers who are answering any voicemails
#Macmillan
#Proud
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First Acute Oncology board round since COVID kicked off
#gettingthebandbacktogether
🤗
@ChelwestFT
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Ph3 trials during COVID with teleconsultations reinforces wastefulness of study requirements every cycle:
Full neuro exam: Why, if no symptoms?
Clotting: Why, if no Ph2 concerns?
6 weekly scans: Why so often?
Hope we learn from this and have better protocols in future.
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In clinic, seeing new patients and teleconsultations for all others.
Every patient lovely.
Everyone so grateful.
Everyone telling me they will be clapping at 8pm.
And then free lunch box arrives, unrequested.
😊
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Who needs some good news?
🙋♂️
@NICEComms
have approved Lorlatinib in relapsed ALK+ve NSCLC.
@BTOGORG
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Lived in London for >40yrs
Still surprises me with beautiful views
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2nd two slides that should be in every oncology clinic room this winter.
Answer:
✅ Yes: Get a flu vaccine if your GP is offering it.
❌ No: It won’t stop immunotherapy working and is highly unlikely to cause you any problems.
@BTOGORG
#ESMOAsia19
Practical questions with IO presented by
@barlesi
at
#ESMOAsia19
@myESMO
and clear messages, thank you !
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All set for
@BTOGORG
‘ASCO in an Hour’ webinar:
Laptop ✅
Headphones ✅
Cup of tea ✅
Kids banished upstairs ✅
Kick off in 30 mins
>450 delegates
Note to self: don’t muck it up
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Exactly 1 year after we moved out, when our chemotherapy unit was converted into a COVID ward, we are back in the Gazzard Day Unit.
Our itinerant days are over. 🤗
✅ all patients offered COVID vaccine
✅ all staff vaccinated
✅ all staff weekly PCR tested
@ChelwestFT
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#BTOG22
base all set up.
Huge luxury to be able to spend 48hrs educating myself with the good and the great of lung oncology.
Only thing missing is hangover from excess Guinness in Clayton bar from night before.
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More good news, folks?
🙋♂️
NICE approve Larotrectinib for advanced NTRK fusion cancer (adult & paediatric) via Cancer Drugs Fund.
Challenge is now to get national testing in place and to find the patients.
@GenomicsEngland
@BTOGORG
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This is great news, and not before time.
Although it may sound trivial, in fact loss of driving license and associated independence is one of greatest quality of life issues I see for patients with CNS metastases.
Today saw the DVLA agree to review current driving rules/restrictions with asymptomatic brain mets . They commented they had learnt a great deal from the
@UKALK
+ panel and asked for a copy of our survey
#patientadvocacy
#qualityoflife
@LCN_UK
@BTOGORG
@EgfrUk
@ros1dersuk
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Sad to read that Prof Kenneth Bagshawe has died.
A true pioneer: He set up the first medical oncology unit in 🇬🇧, cured the first patient in Europe with choriocarcinoma, amongst many other achievements.
@ACPUK
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Meeting
@acmedsci
this evening. Beautiful building and a great institution.
Wandered upstairs to find a suite named after my dear dad, who sadly died 12 years ago.
He would have been SO pleased!
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Great to see
@BBCNews
picking up this important good news story for lung cancer patients in England
You can hear more about the pilot phase of this work at
@BTOGORG
conference next month
@DrSanjayPopat
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Delighted to be representing
@BTOGORG
at joint
@Roy_Castle_Lung
and
@MSDintheUK
reception in the House of Commons, hosted by Nicola Richards MP
Focus on improving outcomes across the UK
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Beautiful morning for 300th Westminster Hospital Anniversary at Westminster Abbey.
Best venue I have ever been asked to speak at!
#Westminster300
@cwpluscharity
@ChelwestFT
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Very proud to be presenting our Acute Diagnostic Oncology Clinic at
#ESMO2019
Abhijit Gill showing the world how integrate primary care into hospital-based oncology to diagnose patients better and faster.
@cwpluscharity
@ChelwestFT
@macmillancancer
@CR_UK
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Great art installation from
@cwpluscharity
in outpatient corridor
@ChelwestFT
Camera tracks your movement and imposes it on the graphics
Mesmerising
Almost made me late for clinic
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@DrSanjayPopat
addressing the plenary session.
We have 1,000 delegates for the first time!
#BTOG20
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Landing page for virtual
#BTOG2021
is the reception of the Clayton (aka Burlington) Hotel in Dublin.
😍
All kicks off at 9am tomorrow.
If I could just turn right, I would be in the bar.
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Did you know.... PD-1 was first described in 1992?
(The year I started medical school 😳)
Slide thanks to
@CelineMascaux
#BTOG20
#LCSM
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It’s been a good couple of days:
👍 Adjuvant immunotherapy approved
👍 Finished new raspberry cane bed
(Who knew? No raspberry emoji!)
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Clear benefits of liquid biopsy in lung cancer in keeping with what we would expect
Prospective real world data coming from ongoing
@NHSEngland
multi-centre pilot in 🇬🇧
For anyone who spends their time waiting for NGS results, this is a no-brainer
@DrSanjayPopat
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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Present from a lovely lady i have looked after for a few months but not very well and an inpatient at the moment.
So kind.
And a magnificent choice.
😋
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Alex Lyon: Cardio-oncology
Last talk of BTOG, but have saved best till last:
🔴 Many of our drugs are cardiotoxic
🔴 Range of cardiac toxicites
🔴 Osimertinib important here
🔴 5% immunotherapy patients affected
#BTOG21
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(Self-isolation compliant) cycle ride with daughter.
Found that one of the great minds of 20th century lived just down the road in Hampton.
Died so young.
Treated so badly.
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Pembrolizumab monotherapy gets additional EMA approval for a 6-weekly regimen (400mg). Should help with pressures on chemotherapy units, and be more convenient for patients. Data comes from modelling / simulation, as opposed to clinical studies.
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What’s the diagnosis?
(I am told it is rare to see on CXR)
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@AlastairGreyst2
flying the flag for 🇬🇧 research at
#ASCO24
with the outstanding CONCORDE study
@finn_corinne
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@gerryhanna
@ASCO
…and by Day 2, it gives an interesting poll of how we want to interact with colleagues.
Elbow bumps win, it seems.
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From
@BTOGORG
Trainee Representative to fully-fledged plenary presenter:
@AdamJanuszewski
gives a beautifully clean and clear talk on controversies in NSCLC with driver mutations
#BTOG23
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1 month wait for NGS results unacceptable, but all too familiar
I encourage colleagues to take advantage of
@NHSEngland
ctDNA pilot. This is greatly reducing wait times
Just received +ve MET Ex14 result for patient I am not due to meet until next week! 👊
New research confirms genomic testing is 🔑 to understand non-smokers with
#lungcancer
. Yet 40% of UK
#EGFR
+ pts faced delays in mutation ID & only 40% were offered rebiopsy on progression. 🚨 Patients need better testing to benefit from advances & get effective treatment!
#LCSM
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@StephenVLiu
@JTOonline
Being a 3rd generation TKI, can’t help thinking they should have called it Aftertertinib, not Befotertinib.
(No need to thank me)
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@rintoul_robert
: estimated 5 year survival for lung cancer has fallen from 17.6% to 13% as consequence of COVID
Upsetting news
#BTOG22
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TIL therapy in NSCLC:
Clonal neo-antigens seem to drive response to immunotherapy
As such, an important target fits TIL therapy
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Fabulous presentation from Michelle Rosario, our lung cancer CNS
@ChelwestFT
Beautifully clear description of benefits & challenges of running
@NHSEngland
ctDNA pilot
Michelle has single handedly run this service: awesome 👏
#BTOG24
#LCSM
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