drfranciscomd.bsky.social

drfranciscomd.bsky.social

@drfranciscomd.bsky.social

Practicing Hematologist & Oncologist + nerd = me. I break down cancer news and treatments, one Middle-earth metaphor at a time. Join me for facts, laughs, and Gandalf-level wisdom. Stanford ->MSKCC -> IU -> UA -> Kaiser SF -> Intermountain Alta View

559 followers337 following80 posts

Spent the last few weeks working on my latest essay. I have Spent years in healthcare. I’ve seen what happens when profit overshadows care. My new Medium post explains why we need robust public health solutions. Let’s fight for better outcomes—together! #Medsky #Oncology #HealthPolicy

medium.comWho’s Really Healing Us? The Dangers of Dismantling Government-Led HealthcareI’ve spent my career in healthcare, and lately it feels like I’m watching a slow-motion demolition of the very structures that have…

The NCCN now recognizes ctDNA as a high-risk factor for recurrence in colon/rectal cancer and as a tool in Merkel cell carcinoma. While promising, routine use outside trials isn’t recommended yet. ctDNA’s role in personalized care is evolving! 🧬✨ #ColonCancer #Oncology #Medsky #Research

onclive.comNCCN Updates ctDNA Stance in Colon, Rectal, and MCC GuidelinesThe NCCN guidelines have been updated to specify the standing of ctDNA as a biomarker in colon and rectal cancer, as well as in MCC.

ctDNA is like the Palantíri—seeing-stones revealing hidden truths. Just as they offered glimpses into distant events, ctDNA uncovers cancer’s covert activities, helping us anticipate recurrence. Knowledge is power! 🔮🛡️ #LOTRNerd #OncologyWithPurpose

drfranciscomd.bsky.social reposted

Personalized cancer vaccines are making waves! A new study shows a novel vaccine may be effective in stage III/IV clear cell RCC, offering hope for tailored treatment. Could this be the future of RCC care? Would anti vaxxers even accept this or still prefer Ivermectin?🧬✨ #Cancer #Oncology #Medsky

ascopost.comNovel Personalized Cancer Vaccine May Be Effective in Patients With Stage III and IV Clear Cell Renal Cell CarcinomaResearchers have examined whether a novel personalized cancer vaccine can improve outcomes in patients with stage III or IV clear cell renal cell carcinoma.

A personalized cancer vaccine is like the Nauglamír, the Dwarven-crafted necklace remade to hold a Silmaril for Eärendil. Each piece was unique, but when tailored for its purpose, it became a beacon of hope. Similarly, these vaccines are custom-forged to target cancer with precision. 💎⚔️

A new study suggests tracking tumor-infiltrating lymphocytes (TILs) during radiation therapy may offer insights into prognosis and guide personalized treatment in breast cancer. Monitoring immune responses could refine therapy strategies for better outcomes. 🧬✨ #BreastCancer #CancerResearch

redjournal.orgLongitudinal Assessment of Tumor-Infiltrating Lymphocytes in Primary Breast Cancer Following Neoadjuvant Radiation TherapyTumor-infiltrating lymphocytes (TILs) have prognostic significance in several cancers, including breast cancer. Despite interest in combining radiation therapy with immunotherapy, little is known abou...

Tracking TILs during radiation therapy is like the watchful Ents of Fangorn—silent observers who notice changes others miss. Just as they stir when the forest is threatened, monitoring TILs helps oncologists adjust treatment, making care more precise and adaptive. 🌳🔍 #LOTRNerd #OncologyWithPurpose

The FDA has granted accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu) for adults with unresectable or metastatic HER2-positive solid tumors who have received prior treatments . This approval offers new hope for patients with limited options. I love this drug! #BreastCancer #Oncology

fda.govFDA grants accelerated approval to fam-trastuzumab deruxtecan-nxki forOn April 5, 2024, the Food and Drug Administration granted accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu, Daiichi Sankyo, Inc.) for adult patients with unresectable or metastatic HE...

In Middle-earth terms, fam-trastuzumab deruxtecan-nxki is like the Dawnless Day before the Ride of the Rohirrim. Just as the shadow of Mordor spread over Gondor, patients with HER2-positive tumors faced limited options—but now, a new charge against the darkness begins. 🌅⚔️

This week’s essay is inspired by the incredible support staff who make cancer care possible—and the tough reality of working without them. It takes a team to guide patients through their journey. Let’s not forget the value of every member of our healthcare Fellowship🧬✨ #Cancer #Oncology #Healthcare

medium.comIt Takes a Fellowship: Why Support Staff Are the Unsung Heroes of Cancer CareIn my years of practice as an oncologist, I’ve come to realize that cancer care is not just about treating a disease — it’s about guiding people through one of the most challenging journeys of their…

Aspirin after completion of standard adjuvant therapy for colorectal cancer (ASCOLT): a phase 3 international trial.’ This study found that aspirin 200 mg daily for 3 years was well tolerated but did not significantly improve disease-free survival 🧬✨ #Oncology #Cancer

In Middle-earth terms, aspirin in this trial is like the Fellowship’s attempt to cross Caradhras. A well-reasoned effort with potential merit, but ultimately, the path did not lead to success, and another way had to be sought. Aspirin was well-tolerated but didn’t significantly improve OS. 🗻⚔️

Non-medical post: Onyx Storm dropped today, and my wife is already several chapters in. Every so often, I hear her say, ‘Just one more chapter,’ but we all know that’s book lover code for ‘leave snacks and back away slowly.’ It’s an art form, really. 📚😅 #OnyxStorm

My weekly essay is up, inspired by the countless moments this week spent calming anxious patients after early test results. Should oncologic results wait until the doctor’s appointment? Is instant access helping or hurting? Share your thoughts. 🧬✨ #Oncology #Hematology #Medsky

medium.comStop the Spiral: How Early Test Results Are Hurting Cancer PatientsAs an oncologist, I’ve seen it happen more times than I can count. A patient gets their imaging results or tumor marker levels through their online portal days before we’re scheduled to meet. By the…

The FDA has approved sotorasib with panitumumab for KRAS G12C-mutated colorectal cancer. This combo therapy tackles a previously ‘undruggable’ mutation, offering new hope for advanced cases. A major milestone in precision oncology! 🧬✨ #CancerResearch #OncologyNews

ascopost.comFDA Approves Sotorasib With Panitumumab for <em>KRAS</em> G12C–Mutated Colorectal CancerOn January 16, the FDA approved a KRAS G12C inhibitor in combination with a monoclonal antibody for adult patients with KRAS G12C–mutated metastatic colorectal cancer, as determined by an FDA-approved...

In Middle-earth terms, sotorasib with panitumumab is like the reforging of Andúril—created to conquer what was thought invincible. KRAS mutations, like Sauron, seemed unstoppable, but this combination cuts through the darkness, bringing hope to advanced colorectal cancer patients. ⚔️✨ #Oncology

Datopotamab deruxtecan in NSCLC is like the Huorns’ intervention at Helm’s Deep—subtle but devastating. While unseen in the battle’s chaos, the Huorns eradicated Saruman’s retreating forces with precision and power. 🌲⚔️ #LOTR #Oncology

Always good reminder that’s where there is a will there is a way. *It also blows my mind that research funding for pediatric cancer is on chopping block with this new Congress. This is money well spent

Pearl Freier@pearlf.bsky.social

Survival rates for acute lymphoblastic leukemia (ALL) in children were ∼10% in the 1960s & have risen to >90% as of the 2010s according to below. Thread below includes NEJM article: #biosky #oncsky

This study suggests that a negative PSMA PET scan can help avoid unnecessary pelvic lymph node dissection in intermediate-risk prostate cancer patients, potentially reducing treatment complications without compromising outcomes. #ProstateCancer #MedicalImaging

nature.comNegative PSMA PET can be used to avoid unnecessary pelvic lymph node dissection in intermediate risk prostate cancer - Prostate Cancer and Prostatic DiseasesProstate Cancer and Prostatic Diseases - Negative PSMA PET can be used to avoid unnecessary pelvic lymph node dissection in intermediate risk prostate cancer

Using a negative PSMA PET scan to avoid surgery is like Faramir scouting the enemy’s movements in Ithilien. His vigilance prevents reckless attacks and ensures that Gondor’s forces act only when truly necessary. Strategic insight spares harm while achieving the mission. 🛡️🌿 #LOTRNerd #Prostatecancer

Insurance denials and prior auths feel like trying to cross the Dead Marshes—every step forward is met with unseen obstacles dragging you down. Patients deserve a clear path to care, not to be lost in the bureaucracy. #Oncology #HealthcareFrustrations

At #1 in our countdown: ‘Efficacy and Safety of Trastuzumab Deruxtecan in HER2-Expressing Solid Tumors: Results From DESTINY-PanTumor02.’ This landmark trial expands the role of HER2-targeted therapy across multiple cancer types, marking a new frontier in precision medicine. 🧬✨ #OncologyPapers2024

ascopubs.orgEfficacy and Safety of Trastuzumab Deruxtecan in Patients With HER2-Expressing Solid Tumors: Primary Results From the DESTINY-PanTumor02 Phase II TrialPURPOSETrastuzumab deruxtecan (T-DXd) is a human epidermal growth factor 2 (HER2)–directed antibody-drug conjugate approved in HER2-expressing breast and gastric cancers and HER2-mutant non–small-cell...

In Middle-earth terms, TXDX is like the Silmarils, forged by Fëanor to harness the light of the Two Trees. While originally intended for one purpose, their radiance became a beacon of hope for all of Arda. HER2-targeted therapy extends to multiple tumor types, illuminating new paths in cancer care🌟✨

At #2 in our countdown: ‘Long-Term Results of Organ Preservation in Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy: The OPRA Trial.’ This study highlights a step forward in organ preservation, showing promising long-term outcomes with reduced treatment intensity. 🧬✨ #OncologyPapers2024

ascopubs.orgLong-Term Results of Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy: The Randomized Phase II OPRA TrialClinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or sec...

Organ preservation with neoadjuvant therapy is like Elrond healing Frodo with athelas after Weathertop—not removing Frodo’s arm but preserving it while targeting the Morgul wound. This precise approach spares what’s vital while addressing the source of the threat. 🌿🛡️ #LOTRNerd #OncologyWithPurpose

At #3 in our countdown: ‘Lorlatinib vs. Crizotinib in Advanced ALK-Positive NSCLC: 5-Year Outcomes From the CROWN Study.’ This study confirms lorlatinib’s superior efficacy, improving long-term survival and quality of life for patients with advanced ALK-positive NSCLC. 🧬✨ #OncologyPapers2024

ascopubs.orgLorlatinib Versus Crizotinib in Patients With Advanced <i>ALK</i>-Positive Non–Small Cell Lung Cancer: 5-Year Outcomes From the Phase III CROWN StudyPURPOSELorlatinib improved progression-free survival (PFS) and intracranial activity versus crizotinib in patients with previously untreated, advanced, ALK-positive non–small cell lung cancer (NSCLC) ...

In Middle-earth terms, lorlatinib is like the hidden power of Vilya, Elrond’s ring of air. While crizotinib acts like the brute strength of conventional forces, lorlatinib’s precision mirrors the subtle, enduring magic of Vilya—warding off destruction and preserving life over time. 🌿💨

Combining darolutamide with ADT is like Turgon’s Gates of Gondolin from The Silmarillion—layers of stone, iron, and bronze working together to shield the city from Morgoth. This synergy mirrors how these therapies form a strong defense against prostate cancer. 🏰⚒️ #LOTRNerd #OncologyWithPurpose

At #5 in our countdown: ‘Exagamglogene Autotemcel for Severe Sickle Cell Disease.’ This groundbreaking study demonstrates that 97% of patients treated with exa-cel were free from vaso-occlusive crises for at least 12 months, marking a significant advancement in gene therapy for sickle cell disease.

nejm.orgExagamglogene Autotemcel for Severe Sickle Cell Disease | NEJMExagamglogene autotemcel (exa-cel) is a nonviral cell therapy designed to reactivate fetal hemoglobin synthesis by means of ex vivo clustered regularly interspaced short palindromic repeats (CRISPR...

In Middle-earth terms, exa-cel is akin to the healing at the Houses of Healing in Minas Tirith, where Aragorn uses athelas to cure those afflicted by the Black Breath. Just as ancient remedies bring renewed life, this gene therapy offers new hope to patients battling severe sickle cell disease. 🌿✨

Exciting news! We’re counting down the top 5 most popular oncology papers of 2024Join me each as we explore the breakthroughs shaping cancer care. (Will add LOTR) doing for each of them From precision medicine to cutting-edge therapies, let’s dive into the science. 🧬✨ #TopOncologyPapers #2024Review

🩸 Liquid biopsy technology for detecting minimal residual disease (MRD) in lung cancer shows great promise, but is it ready for prime time? As we refine its accuracy and clinical utility, this tool could revolutionize early intervention and personalized care. #LungCancer #LiquidBiopsy

targetedonc.comLiquid Biopsy Techniques Test Lung Cancer MRD LevelLuis E. Raez, MD, discusses the current liquid biopsy options for patients with lung cancer through assessing circulating tumor DNA.

In Middle-earth terms, utilizing liquid biopsies to detect MRD is akin to the vigilance of the Rangers of Ithilien, monitoring Sauron’s troop movements on the borderlands. Early detection from ctDNA is much like these rangers intercepting enemy plans before they unfold. 🛡️🔍 #OncologyWithPurpose

Another Lung Cancer Update: FDA approves ensartinib for ALK+ NSCLC based on eXALT3 trial results: improved PFS (25.8m vs 12.7m, HR 0.56) and CNS response (64% vs 21%) compared to crizotinib, but no OS difference. Cost may limit its use. #LungCancer #Oncology

fda.govFDA approves ensartinib for ALK-positive locally advanced or metastatiOn December 18, 2024, the Food and Drug Administration approved ensartinib (Ensacove, Xcovery Holdings, Inc.) for adult patients with anaplastic lymphoma kinase (ALK)-positive locally advanced or meta...

LOTR Connection: Ensartinib is like Saruman’s reforging of Orthanc’s defenses—far superior to its predecessor (crizotinib) in holding back assaults (CNS ORR 64% vs 21%). But without a decisive victory in the War of the Ring (no OS gain), its long-term legacy remains uncertain 🛡️⚔️ #OncologyWithPurpose

The FDA has granted Breakthrough Therapy Designation to sacituzumab govitecan (Trodelvy) for adults with extensive-stage small cell lung cancer (ES-SCLC) progressing after platinum-based chemotherapy, highlighting its potential as a promising second-line treatment. #LungCancer #CancerResearch

targetedonc.comFDA Grants Breakthrough Status to Sacituzumab Govitecan in ES-SCLCThe FDA granted breakthrough therapy designation to sacituzumab govitecan for patients with ES-SCLC progressing on platinum chemotherapy, supported by promising antitumor activity in the phase 2 TROPi...

In Middle-earth terms Trodelvy is like the Elves of Lothlórien repurposing their gifts for the Fellowship -such as the rope that saved Frodo from disaster in Emyn Muil A tool designed for one purpose can become a lifeline in an another, just as this drug is now aiding in the fight against ES-SCLC 🌿🛡️

Navigating RCC treatment beyond first-line IO therapy is like Frodo and Sam finding their way through Shelob’s Lair. The path is dark, resistance lurks, and survival depends on strategy and tools—like Sting and the Phial of Galadriel. With the right choices, there’s a way. 🕷️💡#OncologyWithPurpose

At #SABCS24, the SUPREMO trial reports that post-mastectomy chest wall irradiation offers no survival benefit for most intermediate-risk breast cancer patients, suggesting many can safely forgo this treatment. #BreastCancer #CancerResearch

emjreviews.comNo Benefit from Chest Wall Irradiation in Intermediate-Risk Breast Cancer: SABCS 2024Study shows chest wall irradiation post-mastectomy offers no survival benefit for most intermediate-risk breast cancer patients.

Skipping chest wall irradiation for intermediate-risk breast cancer is like the decision to leave the Mirror of Galadriel behind when departing Lothlórien. The Fellowship knew its value but understood not every tool was necessary for every battle. Sometimes, wisdom lies in restraint