Discover and read the best of Twitter Threads about #ClinicalTrials
Most recents (24)
💊 Older adults make up 56% of the global cancer population, yet they're just 40% of participants in new cancer therapy trials. The underrepresentation of this key demographic in clinical trials is a major concern. #clinicaltrials #healthcare #aging 
💊Trials biased towards younger patients without comorbidities and multiple prescription drugs yield cleaner datasets but may not provide sufficient evidence on drug safety and efficacy for older populations. 2/3
#ClinicalTrials #aging #healthcare
#ClinicalTrials #aging #healthcare
💊 US and UK regulators recognize the problem and have issued guidelines to address it recently. While guidelines and incentives can make a difference, legislation may be necessary to fully tackle the problem in the end. ⚖️ 3/3
#ClinicalTrials #aging #healthcare #FDA
#ClinicalTrials #aging #healthcare #FDA
In May 2019, Dr. @rschilsky & I co-chaired the #AAADV19 Workshop Plenary Session "Decentralized #ClinicalTrials: The Future is Now." An incredible group of panelists from academia, industry, govt, & patient #advocacy 👇discussed the rationale, challenges, & opportunities of DCTs.
No one knew yet that the #COVID19 #pandemic was just around the corner. In Mar 2020, FDA released a guidance on conduct of #clinicaltrials during the pandemic: fda.gov/media/136238/d…, & colleagues wrote about the impact on #OncTwitter trials: ncbi.nlm.nih.gov/pmc/articles/P…. /2
FDA has now released a draft guidance on decentralized #clinicaltrials for drugs, biological products, & devices covering #telehealth, remote assessments, consent, shipping of IP, & more: fda.gov/media/167696/d…. #MedTwitter #regulatory #drugdevelopment
2022 was the year mutant KRAS in #PancreaticCancer truly became actionable.
Direct KRAS targeting & #PancreaticCancer, a 🧵:
Direct KRAS targeting & #PancreaticCancer, a 🧵:
In @NEJM by @DavidHongMD & colleagues:
Sotorasib in KRAS p.G12C–Mutated Advanced #PancreaticCancer
nejm.org/doi/full/10.10…
G12C is ~1.6% of KRAS alleles in pancreatic cancer, & monotherapy responses in pre-treated patients are mostly transient stable disease, but a step forward.
Sotorasib in KRAS p.G12C–Mutated Advanced #PancreaticCancer
nejm.org/doi/full/10.10…
G12C is ~1.6% of KRAS alleles in pancreatic cancer, & monotherapy responses in pre-treated patients are mostly transient stable disease, but a step forward.
In addition to Sotorasib, Adagrasib is the other KRAS G12C inhibitor with demonstrated Phase 1 activity in #PancreaticCancer (2022 data).
The expansion cohort in pancreatic cancer will start accrual at @MDAndersonNews soon.
clinicaltrials.gov/ct2/show/NCT05…
@DrShubhamPant @DanZhaoMD
The expansion cohort in pancreatic cancer will start accrual at @MDAndersonNews soon.
clinicaltrials.gov/ct2/show/NCT05…
@DrShubhamPant @DanZhaoMD
@TumorBoardTues @jane_meisel @MPishvaian @JohnEbbenMDPhD 1/17 #TumorBoardTuesday #BreastCancer #OncTwitter @JasmineSukumar @DrGattiMays
👩🏽 65 yo post-menopausal
🚫comorbidities
🔺Triple-neg MBC, germline BRCA1 mut+, PD-L1 neg
👉On carbo/gem for 6 cycles
🩻NOW: Scans show progression in liver
🤨What 2L treatment do you recommend?
👩🏽 65 yo post-menopausal
🚫comorbidities
🔺Triple-neg MBC, germline BRCA1 mut+, PD-L1 neg
👉On carbo/gem for 6 cycles
🩻NOW: Scans show progression in liver
🤨What 2L treatment do you recommend?
@TumorBoardTues @jane_meisel @MPishvaian @JohnEbbenMDPhD @JasmineSukumar @DrGattiMays 2/17 #TumorBoardTuesday #bcsm
🤨 Poll: What percent of all people diagnosed with #BreastCancer carry a germline BRCA 1 and/or 2 mutation?
🤔Are there features that might make you more likely to suspect a patient is a mutation carrier?
@StoverLab @sardesai_sagar @OncoAlert
🤨 Poll: What percent of all people diagnosed with #BreastCancer carry a germline BRCA 1 and/or 2 mutation?
🤔Are there features that might make you more likely to suspect a patient is a mutation carrier?
@StoverLab @sardesai_sagar @OncoAlert
@TumorBoardTues @jane_meisel @MPishvaian @JohnEbbenMDPhD @JasmineSukumar @DrGattiMays @StoverLab @sardesai_sagar @OncoAlert 3/17 #TumorBoardTuesday
👩🏽🏫Mini tweetorial 1👩🏻🏫
📌BRCA1/2 mutation
🔸Repair double-stranded breaks thru HRR
🔸Unable to fix 🧬 when damaged ➡️ add’l muts ➡️ cancer
🔸~5% of #BreastCancer;⬆️w/ TNBC
🔸Assoc w/ 40-65% of BC dx in 🚺, ≤ 9% in 🚹
📚science.org/doi/10.1126/sc…
👩🏽🏫Mini tweetorial 1👩🏻🏫
📌BRCA1/2 mutation
🔸Repair double-stranded breaks thru HRR
🔸Unable to fix 🧬 when damaged ➡️ add’l muts ➡️ cancer
🔸~5% of #BreastCancer;⬆️w/ TNBC
🔸Assoc w/ 40-65% of BC dx in 🚺, ≤ 9% in 🚹
📚science.org/doi/10.1126/sc…
Landmark trial thread🧵
This series of tweets will be about key trials studying SGLT-2 inhibitors in heart failure. While initially studied for DM, these meds were shown to improve CV outcomes in CHF patients, regardless of DM status.
#MedEd #EBM #CardioTwitter #clinicaltrials
This series of tweets will be about key trials studying SGLT-2 inhibitors in heart failure. While initially studied for DM, these meds were shown to improve CV outcomes in CHF patients, regardless of DM status.
#MedEd #EBM #CardioTwitter #clinicaltrials
1) DAPA-HF trial:
Among patients with a reduced EF, the risk of worsening heart failure or death from CV causes was lower among those who received dapagliflozin vs placebo.
Link: nejm.org/doi/full/10.10…
Among patients with a reduced EF, the risk of worsening heart failure or death from CV causes was lower among those who received dapagliflozin vs placebo.
Link: nejm.org/doi/full/10.10…
2) DELIVER trial:
Dapagliflozin reduced the combined risk of worsening heart failure or CV death in patients with heart failure and a mildly reduced or preserved EF.
Link:
nejm.org/doi/10.1056/NE…
Dapagliflozin reduced the combined risk of worsening heart failure or CV death in patients with heart failure and a mildly reduced or preserved EF.
Link:
nejm.org/doi/10.1056/NE…
So I realized it might be good to do a recap here of my story, otherwise known as, “No, really, I promise I almost died six years ago.”
(I guess this is probably a good time to warn you all that I have a warped sense of humor. #thankscancer )
(I guess this is probably a good time to warn you all that I have a warped sense of humor. #thankscancer )
May 2016, five days after my 29th birthday, I am diagnosed in an @StRoseHospitals ER when a CT scan finds a 13 cm tumor that has taken over my right kidney. The amazing ER doctor & PA had already called a local urologist so I can see him first thing in the morning.
My local (Vegas) urologist says, “I’ve got one surgeon in town who *might* be willing to take your case.” Yikes! He encourages going to CA instead, specifically to @UCLAHealth. He steps out of the room & calls the surgeon who did *his* nephrectomy on his cell phone to get me in.
1/ Between 2020 and the first half of 2022, our #healthcare business has grown 267%. Our impact scales far beyond #COVID19 response. @PalantirTech is the most comprehensive health tech startup you’ve never heard of. 🧵
2/ At #Palantir, our health & life sciences customers are on the frontlines of the toughest #publichealth challenges. We work with leading institutions to solve their hardest problems - from drug discovery to care delivery - at speed.
1/3: In part 1 of this #MedProf series, learn about @CherylWillmanMD, executive director of @MayoClinic Cancer Programs and director of Mayo Clinic Comprehensive Cancer Center: mayocl.in/3az4ZpC
2/3: @CherylWillmanMD discusses Mayo Clinic's roots and commitment to diversity, inclusion and #HealthEquity, and the importance of community involvement and support in #CancerCare: mayocl.in/3yzkA0C
3/3: @CherylWillmanMD discusses the role data plays in @MayoClinic's cancer programs, innovative and upcoming treatment options, and
Mayo Clinic's plan for cancer #ClinicalTrials: mayocl.in/3aBVFBl
Mayo Clinic's plan for cancer #ClinicalTrials: mayocl.in/3aBVFBl
#OncTwitter
NCI Pooled analysis (N=6.9K) of antiPD1/PDL1:
👉0.6% incidence CPI-related major cardiac AEs, 77% grade 3+
👉Almost half were myocarditis
👉 Twice as common w/ combos vs monotherapy & w/ CPI + targeted agent vs CPI + antiCTLA4…
#ImmunoOnc
ascopubs.org/doi/full/10.12…
NCI Pooled analysis (N=6.9K) of antiPD1/PDL1:
👉0.6% incidence CPI-related major cardiac AEs, 77% grade 3+
👉Almost half were myocarditis
👉 Twice as common w/ combos vs monotherapy & w/ CPI + targeted agent vs CPI + antiCTLA4…
#ImmunoOnc
ascopubs.org/doi/full/10.12…
#OncTwitter
👉Major cardiac AEs were mostly early events (1-2 months) occurring after median of 2 doses of CPI
👉1/4 of cases of myocarditis were fatal, all preceded by myositis 👀
👉Diverse clinical presentations so have high index of suspicion to diagnose & intervene early…
👉Major cardiac AEs were mostly early events (1-2 months) occurring after median of 2 doses of CPI
👉1/4 of cases of myocarditis were fatal, all preceded by myositis 👀
👉Diverse clinical presentations so have high index of suspicion to diagnose & intervene early…
#OncTwitter
My commentary: It’s also concerning (& not surprising given what we know about pro-inflammatory metabolic syndrome as a cardiac risk fx) that markedly ⬆️ risk of MI has been reported in pts with multi-yr use of CPIs. I predict this follows a course much like HIV…
My commentary: It’s also concerning (& not surprising given what we know about pro-inflammatory metabolic syndrome as a cardiac risk fx) that markedly ⬆️ risk of MI has been reported in pts with multi-yr use of CPIs. I predict this follows a course much like HIV…
A positive step at #WHA75 today! Cochrane is pleased to see that @WHO Member States passed the resolution on strengthening #clinicaltrials and improving research quality & coordination. ➡️apps.who.int/gb/ebwha/pdf_f… 1/5
This @WHO resolution that was passed at #HA75 calls on Member States to:
⬆️increase #clinicaltrial capacity globally
🌟 prioritise well-designed trials
🤝 better coordinate trial efforts
🔎affirms the importance of clinical trial transparency
2/5
⬆️increase #clinicaltrial capacity globally
🌟 prioritise well-designed trials
🤝 better coordinate trial efforts
🔎affirms the importance of clinical trial transparency
2/5
Many of the #clinicaltrials issues highlighted in today's passed #WHA75 resolution were recommendations in the Cochrane Convenes report. 📜convenes.cochrane.org/report
#ConvenesReport @CConvenes 3/5
#ConvenesReport @CConvenes 3/5
1/8
May 8th = World Ovarian Cancer Day 2022 #WOCD2022
A thread 🧵 on some points I wish to relay as a Medical Oncologist with subspecialty in GYN oncology and based in fair Ireland 🇮🇪
May 8th = World Ovarian Cancer Day 2022 #WOCD2022
A thread 🧵 on some points I wish to relay as a Medical Oncologist with subspecialty in GYN oncology and based in fair Ireland 🇮🇪
2/8
The most common symptoms of ovarian cancer are the #BEAT symptoms - always get checked out by your GP if you have these or other symptoms that are not resolving
#knowyourbody
The most common symptoms of ovarian cancer are the #BEAT symptoms - always get checked out by your GP if you have these or other symptoms that are not resolving
#knowyourbody
3/8
There is no reliable #screening test for ovarian cancer
❌ Pap smears do not diagnose ovarian cancer
❌ Ca125 is not a reliable test
❌ Pelvic/vaginal USS may miss a diagnosis or overdiagnose a normal cyst
Until we have better screening, symptoms are all we have #BEAT
There is no reliable #screening test for ovarian cancer
❌ Pap smears do not diagnose ovarian cancer
❌ Ca125 is not a reliable test
❌ Pelvic/vaginal USS may miss a diagnosis or overdiagnose a normal cyst
Until we have better screening, symptoms are all we have #BEAT
EMA Press Briefing on COVID-19 related activities, 5 May 2022 twitter.com/i/broadcasts/1…
#COVID19 infections are still in the millions worldwide. This pandemic is far from over. COVID-19 will continue to impact our lives. #EMAPresser #pandemic
Vaccines are a central pillar of the response to the #pandemic. Nearly half a million lives among people 60 years of age and older have been saved in Europe thanks to #vaccination. #COVID19 #EMAPresser
Yesterday at #TargetedChat we talked about a challenging case of a young individual with recurrent UNRESECTABLE colon cancer after adjuvant.
Here’s a 🧵 on the questions/answers. No one right away. What would you do differently?👇🏾Read/reply along #ColorectalCancerAwarenessMonth
Here’s a 🧵 on the questions/answers. No one right away. What would you do differently?👇🏾Read/reply along #ColorectalCancerAwarenessMonth
It was interesting to see the distribution on the chemo backbone options.
TRIPLETS 🆚 DOUBLETS #TargetedChat #CRCSM
TRIPLETS 🆚 DOUBLETS #TargetedChat #CRCSM
👇🏾With the doublets and triplets discussion, a little bit of art 🖼 to the science 🧪
Have to see and individualize in each patient which tools 🛠 from the toolbox 🧰.
#TargetedChat #CRCSM #ColorectalCancer #ColorectalCancerAwarenessMonth
Have to see and individualize in each patient which tools 🛠 from the toolbox 🧰.
#TargetedChat #CRCSM #ColorectalCancer #ColorectalCancerAwarenessMonth
Preguntas y respuestas con #InmunoUnicornio 🦄💫
Pregunta: ¿Nos podrías explicar que está pasando con la #vacuna para menores de 5 años? ¿Qué ue diferencia tiene un niño 4 años 11 meses y uno de 5 años que no acaban por sacar la vacuna?
Respuesta 🧵👇🏼
1/11
#WomenInSTEM
Pregunta: ¿Nos podrías explicar que está pasando con la #vacuna para menores de 5 años? ¿Qué ue diferencia tiene un niño 4 años 11 meses y uno de 5 años que no acaban por sacar la vacuna?
Respuesta 🧵👇🏼
1/11
#WomenInSTEM
Lo que sucede es lo siguiente:
En los #EnsayosClínicos 📑 (y en #ciencia en general) se deben controlar las condiciones de la intervención lo más posible para asegurar que los resultados observados 👁 sean atribuibles a dicha intervención y no a factores externos
2/11
En los #EnsayosClínicos 📑 (y en #ciencia en general) se deben controlar las condiciones de la intervención lo más posible para asegurar que los resultados observados 👁 sean atribuibles a dicha intervención y no a factores externos
2/11
En este caso, la intervención es la aplicación de la #vacuna 💉
Y dos de las condiciones principales a controlar son la dosis del antígeno (la molécula contra la cual se van a formar los #anticuerpos) y la edad de las personas que participan en el estudio
3/11
#Science
Y dos de las condiciones principales a controlar son la dosis del antígeno (la molécula contra la cual se van a formar los #anticuerpos) y la edad de las personas que participan en el estudio
3/11
#Science
Today we're thrilled to announce results of our PREVENT-19 Phase 3 pediatric expansion to adolescents (ages 12 through 17). Let's talk about the data and what they mean. Thread:
Today's results build on findings from the adult main study, investigating the safety & efficacy of NVX-CoV2373 in the United States and Mexico amidst an evolving #COVID19 pandemic: nejm.org/doi/full/10.10… #clinicaltrials
The pediatric expansion randomized adolescents age 12 through 17, in the U.S., in a 2:1 ratio to receive 2x 5μg doses of NVX-CoV2373, our investigational #vaccine candidate, or placebo, 21 days apart. Protocol: novavax.com/sites/default/…
While it wasn't the same as being in person, the 2022 @SU2Cscience Scientific Summit Community Gathering was inspiring as always. Excellent talk from @NCIDirector on strides being made, and work yet to be done. A few key points that resonated. 🧵 1/7
Cancer mortality is down. Oncology leads the way in biomedical research that translates to tangible results for patients, with a striking number of new FDA approvals annually. One of the drivers of this success is our growing understanding of cancer biology through basic science
A great example of this is the #kidneycancer drug belzutifan. Building upon the @NobelPrize winning research from @kaelin_lab researchers at @UTSWNews developed this drug, it was further tested and re-formulated by a small biotech (Peleton therapeutics) then bought by @Merck
Shout out to participants in #clinicaltrials. I’m enrolled in an NIH RADx-supported trial that requires me to do #COVID19 rapid tests & PCR every other day within a time window, & then drive a pkg to a FedEx every other day by 3p. This is the 4th study I’ve joined in my life…
The studies I’ve been in have ranged from pregnancy outcomes yrs ago to #COVID19 diagnostics. I keep joining them because I believe #ScienceWillWin, but also because it’s important to be reminded what a genuine hassle it is to be in a study. /2
In the very best of circumstances, it’s an inconvenience. It ALWAYS costs participants something, whether it’s missed work, lost wages, childcare, gas for a 🚗, discomfort, or more. And it’s always one more thing in a day that may already have way too many things already (🙋🏻♀️). /3
Well, I got 2 messages before 9am from friends telling me they have #COVID19 in their households. And in the 12 mins since, I’ve just heard about 4 more. So Merry Exponential Growth #Omicron #Christmas. 🌲 😫
A quick 🧵 on what to do if that’s you since I’m typing it anyway.
A quick 🧵 on what to do if that’s you since I’m typing it anyway.
1/ The first thing to say is that if someone has #COVID19 symptoms (#Omicron most common: nasal congestion/runny nose, scratchy sore throat, fever, & aches), you have to assume they have it. You may not have a test (urgent cares are still open & do) or they may still be neg.
2/ You, as the person exposed to the one with symptoms, have to assume that you both do & don’t have #Omicron too. Wait, what? 🤔
I mean: assume you could infect others now & take care to avoid exposing them, BUT don’t assume it’s too late for you to avoid getting it.
I mean: assume you could infect others now & take care to avoid exposing them, BUT don’t assume it’s too late for you to avoid getting it.
Scientific Basis for #Novavax #Covovax NVX-CoV2373 Superior Efficacy against broad range of Variants
Unlike the mRNA and adenovirus vaccines which only present a portion of the spike protein RBD (Receptor Binding Domain) to the immune system, Nuvaxovid presents the entire 1/9
Unlike the mRNA and adenovirus vaccines which only present a portion of the spike protein RBD (Receptor Binding Domain) to the immune system, Nuvaxovid presents the entire 1/9
“prefusion stabilized” Recombinant spike protein in a virus-like particle. The remainder of the spike protein apart from RBD’s in Nuvaxovid is also a site of neutralizing epitopes and that region is not heavily mutated in omicron.
NVAX (academic 2/9
NVAX (academic 2/9
collaborators actually) used a wild-type virus assay which means they used actual prototype and omicron viruses in the assays. They tested against the real deal. Moderna OTOH measured neutralization in a more common pseudo-virus assay – a non-coronavirus engineered to have 3/9
1/14 🆕 🚨Accelerated article on #breastcancer just out in @nature! #bcsm
We asked:
1️⃣ What drives response to #chemotherapy in #breast #cancer❓
2️⃣ Can we use #machinelearning to predict response to chemotherapy❓
Link: nature.com/articles/s4158…
A 🧵👇👇👇 @OncoAlert
We asked:
1️⃣ What drives response to #chemotherapy in #breast #cancer❓
2️⃣ Can we use #machinelearning to predict response to chemotherapy❓
Link: nature.com/articles/s4158…
A 🧵👇👇👇 @OncoAlert
2/14 We are unable to #predict #response to treatment in clinic…
✅Good response ➡️treatment very effective ➡️better survival
❌Poorer response ➡️treatment less effective ➡️worse survival
Being able to forecast response would be a landmark advance!
✅Good response ➡️treatment very effective ➡️better survival
❌Poorer response ➡️treatment less effective ➡️worse survival
Being able to forecast response would be a landmark advance!
3/14 We ran a study in women with #breastcancer @CUH_NHS+@CRUK_CI:
1️⃣who had a #cancer biopsy (which we analysed)
2️⃣received 18 weeks of chemo+/-targeted therapy
3️⃣had surgery (and we measured how much cancer remained)
We associated PRE-therapy profiles↔️POST-therapy response👇
1️⃣who had a #cancer biopsy (which we analysed)
2️⃣received 18 weeks of chemo+/-targeted therapy
3️⃣had surgery (and we measured how much cancer remained)
We associated PRE-therapy profiles↔️POST-therapy response👇
Volume 100 of @jstatsoft: Software for Bayesian Statistics
Guest editors: @micameletti & @precariobecario
20 contributions on a wide range of methods #rstats #python #bayesian #inla @mcmc_stan #nimble #brms #rjags
URL: jstatsoft.org/v100
Guest editors: @micameletti & @precariobecario
20 contributions on a wide range of methods #rstats #python #bayesian #inla @mcmc_stan #nimble #brms #rjags
URL: jstatsoft.org/v100
Van Niekerk, Bakka, Rue, Schenk:
New Frontiers in Bayesian Modeling Using the INLA Package in R
#rstats #inla #bayesian
doi.org/10.18637/jss.v…
New Frontiers in Bayesian Modeling Using the INLA Package in R
#rstats #inla #bayesian
doi.org/10.18637/jss.v…
Michaud, De Valpine, Turek, Paciorek, Nguyen:
Sequential Monte Carlo Methods in the nimble and nimbleSMC R Packages
#rstats #bayesian #nimble
doi.org/10.18637/jss.v…
Sequential Monte Carlo Methods in the nimble and nimbleSMC R Packages
#rstats #bayesian #nimble
doi.org/10.18637/jss.v…
The most meaningful comment from #NORDSummit for me was by @DrMichelleBIO on a panel on the impact of COVID on #raredisease research and drug development: "...the social compact around #clinicaltrials is broken." (🧵1/7)
"You know, it's hard to expect
people to leave their jobs, leave their children without childcare, come to clinical centers for numerous appointments on top of what's required for their illness to test a product that they might not have access to at the end of the day." (🧵2/7)
people to leave their jobs, leave their children without childcare, come to clinical centers for numerous appointments on top of what's required for their illness to test a product that they might not have access to at the end of the day." (🧵2/7)
"We have depended on the overwhelming goodwill of patients to conduct trials up to now and I think it's time for us to reconsider the incentives because what's at stake is huge." (🧵3/7)
We're thrilled to announce that PREVENT-19 (US/Mex Phase 3) results were submitted for publication. The manuscript is now available as a pre-print. Let's dive into what we found. Thread: medrxiv.org/content/10.110…
PREVENT-19 builds on observations from other/ongoing #clinicaltrials, investigating the safety & efficacy of NVX-CoV2373 in the United States and Mexico amidst an evolving #COVID19 pandemic. ir.novavax.com/2021-08-05-Nov…
The trial randomized adults age 18+ in a 2:1 ratio to receive 2x 5μg doses of NVX-CoV2373, our investigational #vaccine candidate, or placebo, 21 days apart. novavax.com/sites/default/…
Daily Bookmarks to GAVNet 10/05/2021 greeneracresvaluenetwork.wordpress.com/2021/10/05/dai…
martyrmade on Twitter and ThreadReader
threadreaderapp.com/thread/1445021…
#history #society #culture #internet
threadreaderapp.com/thread/1445021…
#history #society #culture #internet
Coronavirus mRNA vaccines won’t just end the pandemic. They could change vaccines forever
cnet.com/news/coronavir…
#mRNAVaccines #TechnologyDevelopment #FutureTrends
cnet.com/news/coronavir…
#mRNAVaccines #TechnologyDevelopment #FutureTrends
