Kesar @Kesar_MD2

🔹 148,709 women analyzed after matching 🔹 GLP-1 RAs were associated with a 12% lower risk of HR+/HER2− breast cancer (RR 0.88) 🔹 25% lower risk of death (HR 0.75) 🔹 Benefits were also seen in postmenopausal women 🔹 No significant association with HER2+ or TNBC incidence

Roswell Park @RoswellPark

a month ago

Join us at #ASCO26 as Zunairah Shah, MBBS, presents: "GLP-1 Therapy and Hormone Receptor-Positive Breast Cancer Risk and Survival: A Real-World Analysis" 📌 Abstract #10548 | Poster #509
📍 Hall A
🗓️ June 1 | 1:30–4:30 PM CDT

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A MUST-READ! This is probably one of my most important papers where I try to teach how to fish rather than offer fish. How I Read a Clinical Trial Report? BG’s primer for Busy Clinicians. Thank you @JCOOP_ASCO @EthicsdoctorP for the kind invitation. I hope the readers will find this useful. ascopubs.org/doi/10.1200/OP…

Are you going to be at #ASCO26? See you there at this satellite discussion on Saturday! In Person: May 30, 2026 ⏰ Time: 6:30-9:00 PM ✅ Register here: bit.ly/aioasco26 ⭐️Lung Ca: @NarjustFlorezMD @StephenVLiu and @RManochakian ⭐️GU: @apolo_andrea @TiansterZhang and @montypal ⭐️Breast Ca: @jhaveri_komal @hoperugo and @curijoey ⭐️GI: @CathyEngMD @rachnatshroff and @GIcancerDoc #OncTwitter #MedX

Our paper is online @JTOonline Molecular Profiling across 80,000 Patients with Lung Cancer. A robust demonstration that we need to test all patients with NSCLC & ALL histologies and open the door for nomenclature change. jto.org/article/S1556-… @Al3ssandroRusso @OhioStateMedOnc

Clinical Insights Shaping Current Breast Cancer Practice with Dr. Shipra Gandhi @gandhi_shipra binaytara.org/cancernews/art…

MPN (Myeloproliferative Neoplasms) Board/ITE Key Clinical Pearls 🩸🧬 Mnemonic🙂 “⚡JAK ate 🍁MAPL syrup when 📜CALR came to visit the 🏠MPN house'' MPN Categories 🔹 Chronic Myeloid Leukemia – BCR-ABL1 driven, highly treatable 🔹 Chronic Neutrophilic Leukemia – CSF3R mutation; transplant often needed 🔹 Chronic Eosinophilic Leukemia – clonal eosinophilia; transplant main option 🔹 JAK2-related MPNs: • Polycythemia Vera • Essential Thrombocythemia • Primary Myelofibrosis Driver Mutations 🧬 ⚡ JAK2 V617F – almost all PV, ~50% ET/PMF ⚡ CALR – common in JAK2-negative ET/PMF ⚡ MPL – less common ⚡ 10–20% triple-negative Diagnosis 🩺 • PV: ↑Hb + JAK2 → diagnosis likely • ET: mutation panel (JAK2/CALR/MPL) + CBC/smear • PMF:bone marrow + cytogenetics + NGS essential Not Every Erythrocytosis Is PV ⚠️ Common causes: 💊 SGLT2 inhibitors 💊 Testosterone ➡️ Check JAK2 first ➡️ Don’t stop beneficial meds automatically Major Risks in MPNs • Thrombosis • Symptoms / QoL 😴 • Leukemic transformation AML risk: • ET <5% • PV ~10% • PMF ~30% ET Management 🩸 🎯: prevent thrombosis PLT>450X109/L 🦶 Erythromelalgia, 🤕 Headache, 🩸 Clots 🔍 Diagnosis: BM Biopsy  with predominent predominant Risk factor: prior thrombosis Platelet number is not a risk factor for thrombosis!!! Treatment: 🟢 Low-risk (<60 no clot) → Aspirin 🔴 High-risk (>60 +/- clot) → Cyto reduction (Hydroxyurea) ± anticoagulation Aspirin strategy: • JAK2+ (High risk of thrombosis) → twice daily • Others → once daily • CALR type 2 / triple-negative → may skip aspirin The "Triple-A" Score: Modern prognosis in ET now uses Absolute Neutrophil, Monocyte, and Lymphocyte counts to identify patients who will live as long as the general population. PV Management 🧪 Low-risk: 🩸 Phlebotomy + Aspirin 🎯 Hct <45% or Females <16, Males <16.5 High-risk: 💊 Hydroxyurea (Cytoreductive therapy-1L) 💊 Interferon (alternative) 💊 Ruxolitinib (2L- line-✅ Pruritis, 📉 Decreases EFS) 💊 Buslphan (Older patients ) New therapy: 💉 Ropeginterferon-alfa (FDA approval recently) 💉 Rusfertide – hepcidin mimetic (reduces phlebotomy) Myelofibrosis 🔥 → Most aggressive MPN. Night Sweats, 🌡️ Fever, 🦴 Bone Pain, Weight Loss,  Organomegaly  Hepatomegaly &  Splenomegaly),  Cytopenia, insomnia, fatigue, early satiety, abdominal pain 📊 IPSS Scoring System: Risk Groups 📉🧬Worsening prognosis: CALR+ (22.7%-17.7 yr)—>JAK2+ (65%-9.2yr) or MPL+ (4%-3.2yr)—> Triple Negative. (8.6%) 🚨High Molecular risk: 🧬IDH1/2, EZH2, ASXL1, SRSF2 Only cure: 🏥 Allogeneic stem cell transplant If not eligible: ->Low risk/not symptomatic: observation ->Low risk/symptomatic: clinical trial/ruxolitinib/peginterferon /hydroxyuria ->High risk: transplant elgible-allo HSCT 💊 JAK inhibitors 1. Ruxolitinib – best tolerated and for spleen size and constitutional symptoms- Side effects-Zoster, TB activation, avoid interruptions causes SIRS so bridge with steroids 2. Momelotinib (MF+Anemia)(SE-Peripheral neuropathies) – helpful for anemia 3. Fedratinib-2L (SE-GI, WE (monitor thiamine) 4. Pacritinib (ACVR1- MF + platelets <50k or anemia) ->No constitutuation symptoms/splenomegaly 1. EPO>500mIU/ml→Luspatercept, danzol, iMids 2. EPO<500mIU/ML→ESA ➡️ Improve symptoms & spleen ❌ Do not cure disease Emerging Therapies 🚀 • Navitoclax • Pelabresib • Selinexor -CAR-T, CALR vaccines, TGF-β inhibitors- are in development 🧬 Clonal Eosinophilia 🧪 Key Molecular Screens 1. FIP1L1–PDGFRA: 🧬 (~10% of HES). Detect via FISH (look for CHIC2 deletion) or RNA-Seq. 2. PDGFRB: 🧬Often an MDS/MPN overlap. 3. FGFR1: 🧬🔥 (8p11 syndrome). Highly aggressive; often transforms to AML/Lymphoma. 4. JAK2 Rearrangements: 🧬 (Not V617F mutation!). 💊 Targeted Treatment Table ->FIP1L1–PDGFRA- Imatinib- Exquisitely sensitive (100mg dose) ->PDGFRB- Imatinib - High response rates 👍 ->FGFR1- Pemigatinib -Requires Chemo + Transplant ->JAK2 Rearr-Ruxolitinib -Specific for rearrangements- CEL-NOSCytoreduction 📉Diagnosis of exclusion 🔍 Chronic Neutrophilic Leukemia (CNL) 🩸 Hallmark: CSF3R mutation (G-CSF receptor). 🧬🔗 Presentation: Neutrophils/Bands >80% + Splenomegaly Treatment: Ruxolitinib  (Symptom relief) ➡️ SCT 🏥 (Curative). Systemic Mastocytosis (SM) 🐝 Hallmark: KIT D816V mutation. 🧬 Physical Exam: Darier Sign (rubbing skin causes hives) 🤏+ Urticaria Pigmentosa. Markers: Tryptase 📈, CD25, and CD117 (KIT). 🧪 Treatment: Avapritinib or Midostaurin 🎯. #Hematology #Oncology #MedEd #HemOnc #FOAMed #MPN #BoardReview #MedStudentTwitter #InternalMedicine #Pathology #MPN @ASH_hematology @MPNVoice @ASCOPost @IMG_Oncologists @OncoAlert @oncodaily @realbowtiedoc @VJHemOnc @JCO_ASCO @LeukemiaJnl #HemOnc #MedTwitter #FOAMed @HemOncFellows

Conf Highlights #GU26 from #CommunityOnc: 1. #POSEIDON: recurrent CSPC 2. #PEACE3 mCRPC 3. #BRCAAway: HRRm mCRPC 4. #KEYNOTEB15: MIBC 5. #LITESPARK022: Adj RCC 6. #LITESPARK011: RCC 2L #OncTwitter #gusm @ASCO @OncoAlert @OncUpdates 1/7

TTFields (+chemo) now @US_FDA ✅ for locally advanced pancreatic ductal adenocarcinoma based off #PANOVA3: - mOS 16.2 vs. 14.2mos (HR: 0.82) - AEs: 76% device related skin side effects - Is this going to be rapidly adopted in practice? #gism #OncTwitter #MedTwitter #pancsm

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