#LCSM Transcript
Healthcare social media transcript of the #LCSM hashtag.
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See #LCSM Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Jill Feldman @jillfeldman4 Hello from Chicago! Looking forward to tonight's chat #LCSM |
 | #LCSM Chat @lcsmchat RT @ArpanAshokPatel: My first #LCSM chat! Very excited!! Current onc fellow @UFHealthCancer , moving a wee bit north for a thoracic faculty position this summer. |
 | Aki Alzubaidi @aki_alzubaidi @eonhealth and NationalJewish IP in the house for this chat! Excited for it! #LCSM |
 | Brendon Stiles @BrendonStilesMD Welcome everyone to tonight's #lcsm chat by @lcsmchat. We are talking about what is new in early stage lung cancer! |
| Brendon Stiles @BrendonStilesMD @ArpanAshokPatel @UFHealthCancer Thanks for joining! #lcsm |
| #LCSM Chat @lcsmchat @ArpanAshokPatel @UFHealthCancer Welcome! We’re excited you’ve joined us tonight. #lcsm |
| Brendon Stiles @BrendonStilesMD You can read about how to participate in the chat at https://t.co/93SziNyHT6 #lcsm |
| Brendon Stiles @BrendonStilesMD To join, enter the URL “https://t.co/RK0CDZY557” in your browser and type in #lcsm or just follow along on regular twitter. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: Welcome everyone to tonight's #lcsm chat by @lcsmchat. We are talking about what is new in early stage lung cancer! |
| Brendon Stiles @BrendonStilesMD We'll get started in a few minutes -- please take a moment to introduce yourselves. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: You can read about how to participate in the chat at https://t.co/93SziNyHT6 #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: To join, enter the URL “https://t.co/RK0CDZY557” in your browser and type in #lcsm or just follow along on regular twitter. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: We'll get started in a few minutes -- please take a moment to introduce yourselves. #lcsm |
| Brendon Stiles @BrendonStilesMD @jillfeldman4 A professional! Glad you made it. #lcsm |
 | Tom Varghese Jr. MD, MS, MBA, FACS 🇺🇸 @TomVargheseJr RT @coffeemommy: Excited about @asco, frustrated by embargoes and want to chat about the latest & greatest in early stage #lungcancer NOW? Join the #lcsm chat. All are welcome. Always a good mix of patients, advocates, researchers & clinicians. cc: #hcldr https://t.co/BmaAq9n8CV |
| Brendon Stiles @BrendonStilesMD I’m your moderator Brendon Stiles, a thoracic surgeon who loves taking care of patients with early stage lung cancer. #lcsm |
 | Sara Whitlock @sjwhitlock Sara from Ohio here! #lcsm |
| Brendon Stiles @BrendonStilesMD I would like to disclose conflicts – I chair @lcrf_org & have worked with @astrazeneca & @medtronic. These don’t affect opinions expressed tonight. #lcsm |
 | LungCancer.net @LungCancer_HU Margot here! #lcsm |
 | Faces of Lung Cancer @LungCancerFaces Deana in Los Angeles here. I’ll be tweeting from the @lcsmchat account this evening. #lcsm |
| Brendon Stiles @BrendonStilesMD @sjwhitlock Whoa! All my favorites are showing up! #lcsm |
| Brendon Stiles @BrendonStilesMD In this week’s chat we hope to explore what’s new in early stage #LungCancer. #lcsm |
 | Dr. Miriam Knoll @MKnoll_MD RT @coffeemommy: Excited about @asco, frustrated by embargoes and want to chat about the latest & greatest in early stage #lungcancer NOW? Join the #lcsm chat. All are welcome. Always a good mix of patients, advocates, researchers & clinicians. cc: #hcldr https://t.co/BmaAq9n8CV |
 | dearmaizie @dearmaizie @BrendonStilesMD #lcsm Finally, I remembered in time to join a chat! Might have to jump off, but interesting topic. I'm an early stager. |
| Brendon Stiles @BrendonStilesMD We often hear about all the incredible progress with new targeted and immunotherapy drugs for stage IV patients. #lcsm |
 | Devika Das, MD, MSHQS @DevikaDasMD @lcsmchat VA oncologist in the Deep South- interested in providing high quality lung cancer care #lcsm |
| Brendon Stiles @BrendonStilesMD But it is important to know that incredible advances are also being made in early stage cancer. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: I would like to disclose conflicts – I chair @lcrf_org & have worked with @astrazeneca & @medtronic. These don’t affect opinions expressed tonight. #lcsm |
| Brendon Stiles @BrendonStilesMD @dearmaizie Thanks for joining! #lcsm |
| #LCSM Chat @lcsmchat @LungCancer_HU Hi Margot! #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: In this week’s chat we hope to explore what’s new in early stage #LungCancer. #lcsm |
| Brendon Stiles @BrendonStilesMD @DevikaDasMD @lcsmchat Glad you are here. #lcsm |
 | Henning Willers, MD @HenningWillers @HenningWillers @mghcancercenter trying to navigate this https://t.co/9lrwjszOZn interface for the first time - Hi All #lcsm |
| Brendon Stiles @BrendonStilesMD We will get started soon. First, a few reminders… #lcsm |
| Brendon Stiles @BrendonStilesMD Please remember to include #LCSM in ALL your tweets so the other chat participants will see them during the chat. #lcsm |
 | Christina Lizaso @btrfly12 RT @coffeemommy: Excited about @asco, frustrated by embargoes and want to chat about the latest & greatest in early stage #lungcancer NOW? Join the #lcsm chat. All are welcome. Always a good mix of patients, advocates, researchers & clinicians. cc: #hcldr https://t.co/BmaAq9n8CV |
| Brendon Stiles @BrendonStilesMD @HenningWillers @HenningWillers @MGHCancerCenter Thank you very much for joining! Just fire away! #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: We often hear about all the incredible progress with new targeted and immunotherapy drugs for stage IV patients. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: But it is important to know that incredible advances are also being made in early stage cancer. #lcsm |
| Brendon Stiles @BrendonStilesMD If you prefer just to listen, please tweet “#LCSM” so we know you’re in the audience #lcsm |
 | Stacey Tinianov (she/her) MPH, BCPA @coffeemommy Stacey from NorCal. Patient advocate focused on improving access to quality care, accelerating research & #myhealthmydata Almost six years out from breast cancer diagnosis. Kids are in wonky end of year schedule and I've got some minutes - excited to spend them with #lcsm chat! |
| Brendon Stiles @BrendonStilesMD I will announce FIVE topics (T1 T2 etc). Please label your responses with T1, T2, etc to make transcript easier to follow. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: We will get started soon. First, a few reminders… #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: Please remember to include #LCSM in ALL your tweets so the other chat participants will see them during the chat. #lcsm |
 | Deborah Levesque, RDMS @dtanz25 #LCSM |
 | Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD Tim here. #LCSM |
| Brendon Stiles @BrendonStilesMD We’ll start with Topic T1 in a minute. Great to have such a diverse group here! Thanks to everyone for joining. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: If you prefer just to listen, please tweet “#LCSM” so we know you’re in the audience #lcsm |
| #LCSM Chat @lcsmchat @coffeemommy Hi Stacey! #lcsm |
| Brendon Stiles @BrendonStilesMD T1. What advances might improve diagnosis of lung nodules found on CT scans? #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: I will announce FIVE topics (T1 T2 etc). Please label your responses with T1, T2, etc to make transcript easier to follow. #lcsm |
| #LCSM Chat @lcsmchat @dtanz25 Welcome Deborah. #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T1. What advances might improve diagnosis of lung nodules found on CT scans? #lcsm |
 | Matthew Steliga MD FACS @SteligaMD Matt Steliga here. Looking forward to it. #LCSM |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: We’ll start with Topic T1 in a minute. Great to have such a diverse group here! Thanks to everyone for joining. #lcsm |
 | Frank Ingram, MD @Chucktowndoc Ingram here. Community pathologist in the Carolinas. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T1. What advances might improve diagnosis of lung nodules found on CT scans? #lcsm |
 | Denise Cutlip @dennycee #lcsm Glad to see familiar faces. Katie! Laura! |
 | Katie Keane @KatieKeaneMD Hi from Boston! Looking forward to tonight’s https://t.co/RnnXV5fgL8 #lcsm |
| Brendon Stiles @BrendonStilesMD T1. Interventional pulmonology (IP) is exploding with new technology to make diagnosis easier and safer. And better. #lcsm |
| Aki Alzubaidi @aki_alzubaidi T1. True computer vision and not CAD #LCSM |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD In vivo microscopy. #LCSM |
| Stacey Tinianov (she/her) MPH, BCPA @coffeemommy @lcsmchat Long time! Sending a hug down the coast and right to your laptop, Deana! #lcsm |
| Brendon Stiles @BrendonStilesMD T1. Pulmonologists can often perform “one stop shopping” diagnosis and staging of new lung cancers, even of small peripheral tumors. #lcsm |
| #LCSM Chat @lcsmchat @SteligaMD Welcome! #lcsm |
| Brendon Stiles @BrendonStilesMD @TimAllenMDJD Love that. #lcsm |
 | Janet Freeman-Daily @JFreemanDaily Janet here, lung cancer patient/activist usually in Seattle, but currently in Columbus Ohio (visiting family) on a slow hotel connection. #LCSM |
| #LCSM Chat @lcsmchat @Chucktowndoc Thank you for joining. #lcsm |
| Brendon Stiles @BrendonStilesMD @aki_alzubaidi For sure. #lcsm |
| #LCSM Chat @lcsmchat @KatieKeaneMD Welcome! #lcsm |
| Brendon Stiles @BrendonStilesMD T1. I strongly prefer to have diagnosis prior to surgery. Even highly suspicious nodules won’t be cancer at least 16% of the time. https://t.co/QIGiZYRB4f #lcsm |
| Brendon Stiles @BrendonStilesMD T1. Many new platforms exist that allow for more accurate localization and biopsy of lung nodules. #lcsm |
| Henning Willers, MD @HenningWillers T1. Before actual diagnosis, multidisciplinary evaluation of CT scan and deciding if , when, and how to biopsy! #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T1. Interventional pulmonology (IP) is exploding with new technology to make diagnosis easier and safer. And better. #lcsm |
| Jill Feldman @jillfeldman4 T1 The Auris Monarch platform. Kyle Hogarth at just did biopsy on me with it to reach a nodules that the standard nav bronch couldn't. PNA = high risk pneumo. So grateful for this! #LCSM |
| #LCSM Chat @lcsmchat RT @aki_alzubaidi: T1. True computer vision and not CAD #LCSM |
 | Rachael @PollywogPrinces Did I stumble on the chat tonight? How bout that! #lcsm |
 | KC Dill @kasedill Hello KC from Texas. #lcsm |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: In vivo microscopy. #LCSM |
| Denise Cutlip @dennycee #lcsm praying for an inexpensive early dx test can be given annually. Someday. |
| Janet Freeman-Daily @JFreemanDaily @ES_SCLC @BrendonStilesMD Our topic today is early stage lung cancer. Hope to address SCLC in another chat. #LCSM |
 | Pablo Pérez Castro, MD, FACS @pabloperezc RT @BrendonStilesMD: T1. I strongly prefer to have diagnosis prior to surgery. Even highly suspicious nodules won’t be cancer at least 16% of the time. https://t.co/QIGiZYRB4f #lcsm |
 | Peggy Dennis @peggyddennis Denver is here #lcsm #lcsm |
| #LCSM Chat @lcsmchat @JackWestMD @cityofhope Thunderstorms coming. Did you bring Seattle weather? ;) #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T1. Pulmonologists can often perform “one stop shopping” diagnosis and staging of new lung cancers, even of small peripheral tumors. #lcsm |
 | Robert C. Doebele, MD, PhD @rdoebele RT @IASLC: Attention M.D.s! The IASLC is seeking a Chief Science Officer to help us further enhance our work and make an even greater difference in the thoracic cancer community. #LCSM #LungCancer #Oncology Find out more about this exciting new opportunity --> https://t.co/8rB6Y9gz0C. https://t.co/OeZo7EklRN |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T1. I strongly prefer to have diagnosis prior to surgery. Even highly suspicious nodules won’t be cancer at least 16% of the time. https://t.co/QIGiZYRB4f #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T1. Many new platforms exist that allow for more accurate localization and biopsy of lung nodules. #lcsm |
| #LCSM Chat @lcsmchat RT @HenningWillers: T1. Before actual diagnosis, multidisciplinary evaluation of CT scan and deciding if , when, and how to biopsy! #lcsm |
| Brendon Stiles @BrendonStilesMD T1. At same time as biopsy, endobronchial ultrasound (EBUS) can be performed, improving accuracy and timeliness of staging. #lcsm https://t.co/X3JU6wr0sL |
| Matthew Steliga MD FACS @SteligaMD T1- Bio markers will improve diagnostic accuracy with less invasive procedures. |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T1 The Auris Monarch platform. Kyle Hogarth at just did biopsy on me with it to reach a nodules that the standard nav bronch couldn't. PNA = high risk pneumo. So grateful for this! #LCSM |
| Stacey Tinianov (she/her) MPH, BCPA @coffeemommy @BrendonStilesMD Love this! As people are considering where to go for screening/care, are we finding these new platforms only in academic medical centers or are they in the community setting as well? #lcsm |
| Jill Feldman @jillfeldman4 @BrendonStilesMD When it's a duck, not a pig, right - lol #LCSM |
| #LCSM Chat @lcsmchat @kasedill Hello! #lcsm |
| Brendon Stiles @BrendonStilesMD T1. Critical for bronchoscopic biopsy to get enough tissue for molecular studies – EGFR, ALK, ROS1, etc. #lcsm https://t.co/OOzJev8bAi |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD Biopsy provides accurate diagnosis, but is not without risk. #lcsm |
| #LCSM Chat @lcsmchat @PollywogPrinces Hey stranger. #lcsm |
| Brendon Stiles @BrendonStilesMD @HenningWillers This is a great point. #lcsm |
| #LCSM Chat @lcsmchat RT @dennycee: #lcsm praying for an inexpensive early dx test can be given annually. Someday. |
| Janet Freeman-Daily @JFreemanDaily @lcsmchat @JackWestMD @cityofhope No, I brought the rain to Columbus! #LCSM |
| Rachael @PollywogPrinces Rachael here - Oncology coder/biller/etc as well as lung cancer advocate here in Louisiana....and I finally made a chat! #lcsm |
| Brendon Stiles @BrendonStilesMD @jillfeldman4 I have seen some piggy looking ducks. #lcsm |
| Aki Alzubaidi @aki_alzubaidi @peggyddennis Denver also in the house! #LCSM |
| Devika Das, MD, MSHQS @DevikaDasMD @HenningWillers @lcsmchat Join in for virtual tumor boards with the closest facility #lcsm |
| #LCSM Chat @lcsmchat @ES_SCLC @BrendonStilesMD Please save this for after the chat. #lcsm |
| Rachael @PollywogPrinces RT @dennycee: #lcsm praying for an inexpensive early dx test can be given annually. Someday. |
| Brendon Stiles @BrendonStilesMD T1. Also key to follow up false negative results of suspicious nodules. Recent NAVIGATE study in @JTOonline showed low negative predictive value. https://t.co/EheQBUMitw #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD #WhyPathologistsMatter #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: @TimAllenMDJD Love that. #lcsm |
 | Arpan Patel @ArpanAshokPatel T1 KEY is when to biopsy...I love picking the brain of our #pulmonary colleagues during #tumorboard #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T1. At same time as biopsy, endobronchial ultrasound (EBUS) can be performed, improving accuracy and timeliness of staging. #lcsm https://t.co/X3JU6wr0sL |
| #LCSM Chat @lcsmchat RT @coffeemommy: @BrendonStilesMD Love this! As people are considering where to go for screening/care, are we finding these new platforms only in academic medical centers or are they in the community setting as well? #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T1. Critical for bronchoscopic biopsy to get enough tissue for molecular studies – EGFR, ALK, ROS1, etc. #lcsm https://t.co/OOzJev8bAi |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: Biopsy provides accurate diagnosis, but is not without risk. #lcsm |
| Pablo Pérez Castro, MD, FACS @pabloperezc @BrendonStilesMD Thoracic Fellow from Toronto here. #LCSM. |
| Brendon Stiles @BrendonStilesMD T1. CT guided biopsy likely more accurate than bronchoscopic and is very safe in experienced hands. #lcsm https://t.co/Rv1UFHEsUa |
| Brendon Stiles @BrendonStilesMD @ArpanAshokPatel I agree with you. WHEN is key. Most nodules are benign. #lcsm |
| Jill Feldman @jillfeldman4 T1 I think for spn watch and wait is the best first step before biopsy. Behavior on scan can tell a lot and then least invasive way to reach the nodule. #lcsm |
 | Rosely Yamamura @RoselyYamamura Hello! I’m a Medical Oncologist from Brazil! First LCSM Chat 🙂! #lcsm |
| #LCSM Chat @lcsmchat RT @DevikaDasMD: @HenningWillers @lcsmchat Join in for virtual tumor boards with the closest facility #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T1. Also key to follow up false negative results of suspicious nodules. Recent NAVIGATE study in @JTOonline showed low negative predictive value. https://t.co/EheQBUMitw #lcsm |
| #LCSM Chat @lcsmchat RT @ArpanAshokPatel: T1 KEY is when to biopsy...I love picking the brain of our #pulmonary colleagues during #tumorboard #lcsm |
| Rachael @PollywogPrinces T1 Hoping as advances are made, less tissue will be necessary. Especially as more mutational markers are discovered #lcsm |
| Brendon Stiles @BrendonStilesMD T1. However, CT guided doesn’t allow staging with EBUS at same time and has more risk of pneumothorax #lcsm |
| Rachael @PollywogPrinces @RoselyYamamura Welcome! #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T1. CT guided biopsy likely more accurate than bronchoscopic and is very safe in experienced hands. #lcsm https://t.co/Rv1UFHEsUa |
| Brendon Stiles @BrendonStilesMD @RoselyYamamura Welcome! So glad you can make it. #lcsm |
| #LCSM Chat @lcsmchat @pabloperezc @BrendonStilesMD Welcome! #lcsm |
 | Tim Kruser @TimothyKruserMD T1. Key I find is pt selection. If the clinicians aren't going to believe a (-) study, don't ask pulm to pull off a miracle #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: @ArpanAshokPatel I agree with you. WHEN is key. Most nodules are benign. #lcsm |
| Brendon Stiles @BrendonStilesMD @PollywogPrinces @RoselyYamamura Hi Rachael! #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T1 I think for spn watch and wait is the best first step before biopsy. Behavior on scan can tell a lot and then least invasive way to reach the nodule. #lcsm |
| Rachael @PollywogPrinces RT @BrendonStilesMD: T1. CT guided biopsy likely more accurate than bronchoscopic and is very safe in experienced hands. #lcsm https://t.co/Rv1UFHEsUa |
| #LCSM Chat @lcsmchat RT @RoselyYamamura: Hello! I’m a Medical Oncologist from Brazil! First LCSM Chat 🙂! #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD With my telling them what it is and when to stop. The fewer the passes the lower the risk. But there has to be enough tissue for molecular biomarker testing. #lcsm |
| #LCSM Chat @lcsmchat RT @PollywogPrinces: T1 Hoping as advances are made, less tissue will be necessary. Especially as more mutational markers are discovered #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T1. However, CT guided doesn’t allow staging with EBUS at same time and has more risk of pneumothorax #lcsm |
| #LCSM Chat @lcsmchat RT @TimothyKruserMD: T1. Key I find is pt selection. If the clinicians aren't going to believe a (-) study, don't ask pulm to pull off a miracle #lcsm |
| Brendon Stiles @BrendonStilesMD T2 coming soon. #lcsm |
| Devika Das, MD, MSHQS @DevikaDasMD @coffeemommy @lcsmchat @BrendonStilesMD They could be/ should be done closer and accessible. Reading and interpretation could be done remotely as well as multi D tumor board with faculty who are “experts” community + academic collaboration #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @TimothyKruserMD: T1. Key I find is pt selection. If the clinicians aren't going to believe a (-) study, don't ask pulm to pull off a miracle #lcsm |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: With my telling them what it is and when to stop. The fewer the passes the lower the risk. But there has to be enough tissue for molecular biomarker testing. #lcsm |
 | Dr. David Tom Cooke @DavidCookeMD T1 I've been pleasantly happy with our electromagnetic navigation experience for accurate biopsy. Also can add EBUS for real-time mediastinal assessment. Key is to have onsight cytopath tech in the OR #LCSM |
| KC Dill @kasedill RT @TimAllenMDJD: With my telling them what it is and when to stop. The fewer the passes the lower the risk. But there has to be enough tissue for molecular biomarker testing. #lcsm |
| Denise Cutlip @dennycee RT @RoselyYamamura: Hello! I’m a Medical Oncologist from Brazil! First LCSM Chat 🙂! #lcsm. Welcome! |
 | Benjamin King, MD @BenjaminKingMD @JackWestMD @cityofhope #radonc @CedarsSinai checking in before another meeting. also not so sunny in #WestLA either but I don't think we can ever complain about weather living in #SoCal #LCSM |
| Brendon Stiles @BrendonStilesMD T2. What is “targeted surgical therapy”? When can lung cancer surgery take less tissue than a complete lobe (lobectomy)? #lcsm https://t.co/0Xn7jCwe3p |
| Arpan Patel @ArpanAshokPatel T1 - is tissue an issue? w/ early stage, do we need ngs? #foreshadowing? #lcsm |
| #LCSM Chat @lcsmchat RT @DevikaDasMD: @coffeemommy @lcsmchat @BrendonStilesMD They could be/ should be done closer and accessible. Reading and interpretation could be done remotely as well as multi D tumor board with faculty who are “experts” community + academic collaboration #lcsm |
| Aki Alzubaidi @aki_alzubaidi T1. Tracking all actionable nodules #LCSM |
| Janet Freeman-Daily @JFreemanDaily @ES_SCLC @BrendonStilesMD @ES_SCLC please stay on topic during #LCSM Chat. You can read about the topic and questions we will be discussing on the LCSM Chat blog. Tonight's topic is here: https://t.co/PO1Wi7yjQu |
| Henning Willers, MD @HenningWillers T1. At MGH we manage to get medonc, surgeon, IR radiol, pulm, and radonc together in 1 room to go through scans. On Fri PM no less #lcsm |
| Brendon Stiles @BrendonStilesMD T2. What is “targeted surgical therapy”? When can lung cancer surgery take less tissue than a complete lobe (lobectomy)? #lcsm |
| Devika Das, MD, MSHQS @DevikaDasMD RT @BrendonStilesMD: T1. Also key to follow up false negative results of suspicious nodules. Recent NAVIGATE study in @JTOonline showed low negative predictive value. https://t.co/EheQBUMitw #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD But CT guided biopsy usually provides more tissue for accurate diagnosis and molecular biomarker testing. #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T2. What is “targeted surgical therapy”? When can lung cancer surgery take less tissue than a complete lobe (lobectomy)? #lcsm |
| Janet Freeman-Daily @JFreemanDaily @RoselyYamamura Welcome! Glad you could join us. #LCSM |
| #LCSM Chat @lcsmchat RT @BenjaminKingMD1: @JackWestMD @cityofhope #radonc @CedarsSinai checking in before another meeting. also not so sunny in #WestLA either but I don't think we can ever complain about weather living in #SoCal #LCSM |
| Rachael @PollywogPrinces @ArpanAshokPatel I've seen path reports in which they couldn't get definitive answer for ALK, ROS because of not enough sample left. #lcsm |
| Brendon Stiles @BrendonStilesMD @ArpanAshokPatel Indeed not, although in future perhaps. But enough tissue to accurately make diagnosis without multiple procedures is key. #lcsm |
| Jill Feldman @jillfeldman4 @NarjustDumaMD @BrendonStilesMD No meat, no treat :) #LCSM |
| #LCSM Chat @lcsmchat @BenjaminKingMD1 @JackWestMD @cityofhope @CedarsSinai Welcome! #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. What is “targeted surgical therapy”? When can lung cancer surgery take less tissue than a complete lobe (lobectomy)? #lcsm https://t.co/0Xn7jCwe3p |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD Some are getting it. #lcsm |
| #LCSM Chat @lcsmchat RT @ArpanAshokPatel: T1 - is tissue an issue? w/ early stage, do we need ngs? #foreshadowing? #lcsm |
| Brendon Stiles @BrendonStilesMD T2. In my mind (admittedly small mind), surgery is the ORIGINAL targeted therapy. #lcsm |
| #LCSM Chat @lcsmchat RT @aki_alzubaidi: T1. Tracking all actionable nodules #LCSM |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T2. What is “targeted surgical therapy”? When can lung cancer surgery take less tissue than a complete lobe (lobectomy)? #lcsm https://t.co/0Xn7jCwe3p |
| #LCSM Chat @lcsmchat RT @HenningWillers: T1. At MGH we manage to get medonc, surgeon, IR radiol, pulm, and radonc together in 1 room to go through scans. On Fri PM no less #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. What is “targeted surgical therapy”? When can lung cancer surgery take less tissue than a complete lobe (lobectomy)? #lcsm |
| Brendon Stiles @BrendonStilesMD @TimAllenMDJD We do. #lcsm |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: But CT guided biopsy usually provides more tissue for accurate diagnosis and molecular biomarker testing. #lcsm |
| Dr. David Tom Cooke @DavidCookeMD CALGB/Alliance 140503 trial results are pending, but many surgeons suspect for peripheral < 2cm tumors, sublobar resection is oncologic fine. #LCSM |
 | Drew Moghanaki 🐕 @DrewMoghanaki Hi everyone. I’m a radiaton oncologists who is working hard to improve outcomes for Veterans with lung cancer. #lcsm #radonc |
| #LCSM Chat @lcsmchat RT @PollywogPrinces: @ArpanAshokPatel I've seen path reports in which they couldn't get definitive answer for ALK, ROS because of not enough sample left. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: @ArpanAshokPatel Indeed not, although in future perhaps. But enough tissue to accurately make diagnosis without multiple procedures is key. #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: @NarjustDumaMD @BrendonStilesMD No meat, no treat :) #LCSM |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: Some are getting it. #lcsm |
| Dr. David Tom Cooke @DavidCookeMD A2 CALGB/Alliance 140503 trial results are pending, but many surgeons suspect for peripheral < 2cm tumors, sublobar resection is oncologic fine. #LCSM |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. In my mind (admittedly small mind), surgery is the ORIGINAL targeted therapy. #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD Add the pathologist! #lcsm |
| Devika Das, MD, MSHQS @DevikaDasMD @PollywogPrinces @ArpanAshokPatel Absolutely ! This is an absolute night mare and leads to treatment delays #lcsm |
| Brendon Stiles @BrendonStilesMD T2. The idea that every patient needs the same surgical procedure is antiquated – we used to think every patient needed a pneumonectomy! #lcsm https://t.co/FPviSFOjNr |
| Tim Kruser @TimothyKruserMD Nice to see another #radonc out there with me @drewmoghanaki. Others here with us? #lcsm |
| Stacey Tinianov (she/her) MPH, BCPA @coffeemommy @jillfeldman4 @NarjustDumaMD @BrendonStilesMD Thanks for the *coffee snort* laugh Jill. I will now have to watch myself in mixed company. #lcsm |
| #LCSM Chat @lcsmchat @DrewMoghanaki And part-time comedian. Welcome. #lcsm |
| Rachael @PollywogPrinces RT @DevikaDasMD: @PollywogPrinces @ArpanAshokPatel Absolutely ! This is an absolute night mare and leads to treatment delays #lcsm |
| Brendon Stiles @BrendonStilesMD T2. Several options for lung preservation now exist – wedge, segmentectomy, lobectomy. #lcsm https://t.co/T2Iu9RcCbq |
 | Robert L. Hill, MD @harmonigenic RT @hilaryarobbins: |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: Add the pathologist! #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. The idea that every patient needs the same surgical procedure is antiquated – we used to think every patient needed a pneumonectomy! #lcsm https://t.co/FPviSFOjNr |
| Brendon Stiles @BrendonStilesMD T2. Two large ongoing clinical trials (JCOG 0802 CALGB 140503) are examining the oncological efficacy of removing less than a whole lobe to treat #LungCancer. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. Several options for lung preservation now exist – wedge, segmentectomy, lobectomy. #lcsm https://t.co/T2Iu9RcCbq |
| Aki Alzubaidi @aki_alzubaidi @DrewMoghanaki Love what you do! Thank you for helping our vets. #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD Sometimes additional procedures are necessary for diagnosis, but these situations should be minimized. #lcsm |
| Dr. David Tom Cooke @DavidCookeMD A2 I agree. Often need to tailor approach based on functionality, lung function, previous medical history, etc... #LCSM |
| Brendon Stiles @BrendonStilesMD T2. CALGB has reported perioperative outcomes. Both sublobar resection and lobectomy are incredibly safe (1.4% 90 day mortality with 15% G3/4 complications). https://t.co/xs7myqZTMH #lcsm |
| Henning Willers, MD @HenningWillers T2. for targeted surgery, need to do full path eval of lesion. if no concerning features (which?) skip lobe? #lcsm |
| Jill Feldman @jillfeldman4 T2 Taking less tissue is always better, depending on location of nodule, margins & maybe histology. Only finite amount !of lung we can lose-don't want to run out of real estate if not necessary. #LCSM |
| Brendon Stiles @BrendonStilesMD T2. As we learn more about radiographic characterization of different types of lung nodules, we can let often let imaging guide resection strategies. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. Two large ongoing clinical trials (JCOG 0802 CALGB 140503) are examining the oncological efficacy of removing less than a whole lobe to treat #LungCancer. #lcsm |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: Sometimes additional procedures are necessary for diagnosis, but these situations should be minimized. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. CALGB has reported perioperative outcomes. Both sublobar resection and lobectomy are incredibly safe (1.4% 90 day mortality with 15% G3/4 complications). https://t.co/xs7myqZTMH #lcsm |
| #LCSM Chat @lcsmchat RT @HenningWillers: T2. for targeted surgery, need to do full path eval of lesion. if no concerning features (which?) skip lobe? #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T2 Taking less tissue is always better, depending on location of nodule, margins & maybe histology. Only finite amount !of lung we can lose-don't want to run out of real estate if not necessary. #LCSM |
| Brendon Stiles @BrendonStilesMD @HenningWillers Concerning for me - micropapillary or solid, LVI, STAS, close margin. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. As we learn more about radiographic characterization of different types of lung nodules, we can let often let imaging guide resection strategies. #lcsm |
| Drew Moghanaki 🐕 @DrewMoghanaki @HenningWillers It’s been really nice to learn about increased #radonc participation in team based care for lung cancer. Though, we continue to hear that many still hang out in their basements waiting for referrals. #lcsm @KHigginsMD |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD Too common. Perhaps combining the Radiology and Pathology departments would help. #lcsm |
 | IrisPortny @WriterIris "PBMs" (pharmacy benefit managers) "- ASCO rpts resesarch advances saving lives but the Community Oncology Alliance compiled hundreds of horror stories...[re] how pharmacy benefit managers come between patients & their docs,... #lcsm #bcsm @RoseGerberCOA https://t.co/R5mJT0SbqW |
| Brendon Stiles @BrendonStilesMD T2. Similarly, pathologic subtypes may play a role in who should get limited resection. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: @HenningWillers Concerning for me - micropapillary or solid, LVI, STAS, close margin. #lcsm |
| #LCSM Chat @lcsmchat RT @DrewMoghanaki: @HenningWillers It’s been really nice to learn about increased #radonc participation in team based care for lung cancer. Though, we continue to hear that many still hang out in their basements waiting for referrals. #lcsm @KHigginsMD |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: Too common. Perhaps combining the Radiology and Pathology departments would help. #lcsm |
| Brendon Stiles @BrendonStilesMD T2. Certainly, in screen detected lung cancers, less than a lobectomy may be preferred. https://t.co/AZmQ58XT0S #lcsm |
| Tim Kruser @TimothyKruserMD @BrendonStilesMD SBRT should be mentioned along with lung preservation strategies! :) #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. Similarly, pathologic subtypes may play a role in who should get limited resection. #lcsm |
 | Dr. Essa AlGhunaim د. عيسى الغنيم @drealghunaim RT @BrendonStilesMD: T2. The idea that every patient needs the same surgical procedure is antiquated – we used to think every patient needed a pneumonectomy! #lcsm https://t.co/FPviSFOjNr |
| Devika Das, MD, MSHQS @DevikaDasMD @TimAllenMDJD @lcsmchat What is an acceptable QNS rate for a high performanjng facility ? #lcsm |
| Jill Feldman @jillfeldman4 T2 More is not always better. Lung preservation is key #LCSM |
| Brendon Stiles @BrendonStilesMD @TimothyKruserMD Coming next! #lcsm |
| Pablo Pérez Castro, MD, FACS @pabloperezc RT @DavidCookeMD: A2 CALGB/Alliance 140503 trial results are pending, but many surgeons suspect for peripheral < 2cm tumors, sublobar resection is oncologic fine. #LCSM |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. Certainly, in screen detected lung cancers, less than a lobectomy may be preferred. https://t.co/AZmQ58XT0S #lcsm |
| Arpan Patel @ArpanAshokPatel @DevikaDasMD @PollywogPrinces @ArpanAshokPatel for dx of cancer I agree, but do we need enough for NGS that early? #lcsm |
| #LCSM Chat @lcsmchat RT @TimothyKruserMD: @BrendonStilesMD SBRT should be mentioned along with lung preservation strategies! :) #lcsm |
| #LCSM Chat @lcsmchat RT @JackWestMD: |
 | Stephen V Liu, MD @StephenVLiu RT @IASLC: Attention M.D.s! The IASLC is seeking a Chief Science Officer to help us further enhance our work and make an even greater difference in the thoracic cancer community. #LCSM #LungCancer #Oncology Find out more about this exciting new opportunity --> https://t.co/8rB6Y9gz0C. https://t.co/OeZo7EklRN |
| #LCSM Chat @lcsmchat RT @DevikaDasMD: @TimAllenMDJD @lcsmchat What is an acceptable QNS rate for a high performanjng facility ? #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T2 More is not always better. Lung preservation is key #LCSM |
| Brendon Stiles @BrendonStilesMD T2. Technology also making remarkable advances in lung cancer surgery – whether video assisted or robotic. Advances that incorporate real-time imaging or sentinel node mapping may also improve targeted surgery. #lcsm https://t.co/JzOB8UcERA |
| Henning Willers, MD @HenningWillers @TimothyKruserMD @BrendonStilesMD that the next topic! ;-) #lcsm |
| Dr. David Tom Cooke @DavidCookeMD In multifocal lung cancer, after multidisciplinary tumor board discussion we have had hybrid approaches, where resection of the most dominant lesion, and SBRT for smaller lesion for lung preservation. #LCSM |
| Brendon Stiles @BrendonStilesMD @jillfeldman4 Spoken like a young woman with a long life to live! #lcsm |
| Frank Ingram, MD @Chucktowndoc @BrendonStilesMD @ArpanAshokPatel Always a good idea to do CT guided FNA first (with a pathologist present to confirm tissue in the specimen) and then the biopsy. If you have tumor in the cell block from FNA AND tumor in the biopsy...better chance at meeting tissue needs for diagnosis and ancillary studies #LCSM |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. Technology also making remarkable advances in lung cancer surgery – whether video assisted or robotic. Advances that incorporate real-time imaging or sentinel node mapping may also improve targeted surgery. #lcsm https://t.co/JzOB8UcERA |
| Brendon Stiles @BrendonStilesMD @TimAllenMDJD This would be the key to the kingdom! #lcsm |
| Pablo Pérez Castro, MD, FACS @pabloperezc RT @BrendonStilesMD: T2. CALGB has reported perioperative outcomes. Both sublobar resection and lobectomy are incredibly safe (1.4% 90 day mortality with 15% G3/4 complications). https://t.co/xs7myqZTMH #lcsm |
| #LCSM Chat @lcsmchat @BrendonStilesMD Hey, I know that guy! #lcsm |
| Rachael @PollywogPrinces @TimothyKruserMD @DrewMoghanaki I'm the radonc cheerleader. Not a provider, but I got my billing/coding start in radonc setting. #lcsm |
| #LCSM Chat @lcsmchat RT @Chucktowndoc: @BrendonStilesMD @ArpanAshokPatel Always a good idea to do CT guided FNA first (with a pathologist present to confirm tissue in the specimen) and then the biopsy. If you have tumor in the cell block from FNA AND tumor in the biopsy...better chance at meeting tissue needs for diagnosis and ancillary studies #LCSM |
| Dr. David Tom Cooke @DavidCookeMD We've used electromagnetic and CT guided methylene blue/ICG marking, then immediate robotic resection of small, unable to feel nodules, using visual and bio-luminescence. #LCSM |
| Tim Kruser @TimothyKruserMD RT @DavidCookeMD: In multifocal lung cancer, after multidisciplinary tumor board discussion we have had hybrid approaches, where resection of the most dominant lesion, and SBRT for smaller lesion for lung preservation. #LCSM |
| Brendon Stiles @BrendonStilesMD @Chucktowndoc @ArpanAshokPatel Agree it is key to have rapid and on site path eval. #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD In my experience segmentectomy has sounded good but has not shown clearly superior outcomes over lobectomy. #lcsm |
| Jill Feldman @jillfeldman4 @BrendonStilesMD Amen. While I am now starting Tagrisso, I bought 10 years with that strategy! #LCSM |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @Chucktowndoc: @BrendonStilesMD @ArpanAshokPatel Always a good idea to do CT guided FNA first (with a pathologist present to confirm tissue in the specimen) and then the biopsy. If you have tumor in the cell block from FNA AND tumor in the biopsy...better chance at meeting tissue needs for diagnosis and ancillary studies #LCSM |
| Brendon Stiles @BrendonStilesMD T2. A previous editorial from me summarizing targeted surgical therapy. https://t.co/56Jtmby7UO #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T2. Technology also making remarkable advances in lung cancer surgery – whether video assisted or robotic. Advances that incorporate real-time imaging or sentinel node mapping may also improve targeted surgery. #lcsm https://t.co/JzOB8UcERA |
| Brendon Stiles @BrendonStilesMD @TimAllenMDJD This is true oncologically. Also doesn't always preserve as much lung as we would think. #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T2. Similarly, pathologic subtypes may play a role in who should get limited resection. #lcsm |
| Brendon Stiles @BrendonStilesMD @TimAllenMDJD But... you have to pick the right segments! #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T2. Certainly, in screen detected lung cancers, less than a lobectomy may be preferred. https://t.co/AZmQ58XT0S #lcsm |
| Dr. David Tom Cooke @DavidCookeMD Plenty of single institution data suggest for the right sized and location tumor, segmentectomy is oncologic equivalent. However CALGB study results will soon answer this question. #LCSM |
| Arpan Patel @ArpanAshokPatel RT @BrendonStilesMD: T2. A previous editorial from me summarizing targeted surgical therapy. https://t.co/56Jtmby7UO #lcsm |
 | Eon @eonhealth Dr. Aki joining the #LCSM conversation this evening. #DefyDisease |
| Brendon Stiles @BrendonStilesMD Great comments. I love talking about surgery. But...moving on to radiation for T3. #lcsm |
| Stacey Tinianov (she/her) MPH, BCPA @coffeemommy @ArpanAshokPatel @DevikaDasMD @PollywogPrinces If you need it and you don't have it, another procedure would be required, correct? Sounds like a typical Three Bears situation: not to much, not too little but Juuuuusssst Right is critical. #lcsm |
| #LCSM Chat @lcsmchat @GalassoMarcos @pabloperezc @BrendonStilesMD #LCSM Chat happening now. What’s new in early stage Lung Cancer is the topic. Follow & include #LCSM hashtag to participate. |
| Drew Moghanaki 🐕 @DrewMoghanaki T2: There is a high likelihood that in the future we'll cut less, and zap more with SBRT. This can leave more healthy lung behind for those who may have more curable tumors pop up. @jillfeldman4 #lcsm https://t.co/zNyMe93zbp |
| Tim Kruser @TimothyKruserMD @BrendonStilesMD Do you tend to have a rule of thumb for a segment, size wise? #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD 2d that, @BrendonStilesMD #lcsm |
| Jill Feldman @jillfeldman4 @TimAllenMDJD Yes, and every patient is different and should be evaluated that way. Age and patient preferences should also always be considered #LCSM |
| Brendon Stiles @BrendonStilesMD T3 - prepare to hear me cheerleading for SBRT. #lcsm |
| Rachael @PollywogPrinces RT @lcsmchat: @GalassoMarcos @pabloperezc @BrendonStilesMD #LCSM Chat happening now. What’s new in early stage Lung Cancer is the topic. Follow & include #LCSM hashtag to participate. |
| Dr. David Tom Cooke @DavidCookeMD The key is not to be married to the anatomic confines of the segment. Must get a negative pathologic margin. #LCSM |
| Stacey Tinianov (she/her) MPH, BCPA @coffeemommy @DrewMoghanaki @jillfeldman4 Wondering if this might be the wave of the future for non-primary lung mets as well... thoughts? #lcsm |
| Tim Kruser @TimothyKruserMD RT @DrewMoghanaki: T2: T2: There is a high likelihood that in the future we'll cut less, and zap more with SBRT. This can leave more healthy lung behind for those who may have more curable tumors pop up. @jillfeldman4 #lcsm https://t.co/zNyMe93zbp |
| Brendon Stiles @BrendonStilesMD @TimothyKruserMD I like to split the left upper lobe. Also think just taking superior segment of lower lobes can be good cancer operation and leave lots of lung. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: @Chucktowndoc @ArpanAshokPatel Agree it is key to have rapid and on site path eval. #lcsm |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: In my experience segmentectomy has sounded good but has not shown clearly superior outcomes over lobectomy. #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: @BrendonStilesMD Amen. While I am now starting Tagrisso, I bought 10 years with that strategy! #LCSM |
| Brendon Stiles @BrendonStilesMD T3. Can stereotactic radiation be an alternative to surgery for some patients with early stage lung cancer? #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T2. A previous editorial from me summarizing targeted surgical therapy. https://t.co/56Jtmby7UO #lcsm |
| #LCSM Chat @lcsmchat RT @JackWestMD: |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: @TimAllenMDJD This is true oncologically. Also doesn't always preserve as much lung as we would think. #lcsm |
 | Ian Pereira @IanJPereira @BrendonStilesMD I'm here just for that :) #lcsm #sorryimlate |
| #LCSM Chat @lcsmchat RT @coffeemommy: @ArpanAshokPatel @DevikaDasMD @PollywogPrinces If you need it and you don't have it, another procedure would be required, correct? Sounds like a typical Three Bears situation: not to much, not too little but Juuuuusssst Right is critical. #lcsm |
| Brendon Stiles @BrendonStilesMD T3. OF COURSE it can be! The key is picking the right patients. #lcsm |
| #LCSM Chat @lcsmchat RT @DrewMoghanaki: T2: T2: There is a high likelihood that in the future we'll cut less, and zap more with SBRT. This can leave more healthy lung behind for those who may have more curable tumors pop up. @jillfeldman4 #lcsm https://t.co/zNyMe93zbp |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: @TimAllenMDJD This is true oncologically. Also doesn't always preserve as much lung as we would think. #lcsm |
| #LCSM Chat @lcsmchat RT @TimothyKruserMD: @BrendonStilesMD Do you tend to have a rule of thumb for a segment, size wise? #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: @TimAllenMDJD Yes, and every patient is different and should be evaluated that way. Age and patient preferences should also always be considered #LCSM |
| Janet Freeman-Daily @JFreemanDaily RT @lcsmchat: @GalassoMarcos @pabloperezc @BrendonStilesMD #LCSM Chat happening now. What’s new in early stage Lung Cancer is the topic. Follow & include #LCSM hashtag to participate. |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @DavidCookeMD: Plenty of single institution data suggest for the right sized and location tumor, segmentectomy is oncologic equivalent. However CALGB study results will soon answer this question. #LCSM |
| #LCSM Chat @lcsmchat RT @coffeemommy: @DrewMoghanaki @jillfeldman4 Wondering if this might be the wave of the future for non-primary lung mets as well... thoughts? #lcsm |
| Drew Moghanaki 🐕 @DrewMoghanaki Wait a minute. We even have our own cheerleader? Where are the thoracic surgery cheerleaders? I'm sure @TomVargheseJr can quickly get thousands to raise their hands! #lcsm |
| Henning Willers, MD @HenningWillers T3. SBRT can be an alternative in high risk operative pts. Operable pts is highly investigational. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: @TimothyKruserMD I like to split the left upper lobe. Also think just taking superior segment of lower lobes can be good cancer operation and leave lots of lung. #lcsm |
| Tim Kruser @TimothyKruserMD RT @BrendonStilesMD: T3. OF COURSE it can be! The key is picking the right patients. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T3. Can stereotactic radiation be an alternative to surgery for some patients with early stage lung cancer? #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T3. OF COURSE it can be! The key is picking the right patients. #lcsm |
| Brendon Stiles @BrendonStilesMD T3. Proportionally, have seen steady increases in stereotactic radiation treatment of lung cancer patients. #lcsm https://t.co/VcL4wrUi7j https://t.co/FlVtcbtImq |
| Dr. David Tom Cooke @DavidCookeMD A3 For patients who are a poor surgical candidate, and surgery can be risky, SBRT is a good plan B to attempt for cure. But, of course, a surgeon is needed to determine if someone is a poor surgical candidate. #LCSM |
| Ian Pereira @IanJPereira RT @lcsmchat: @GalassoMarcos @pabloperezc @BrendonStilesMD #LCSM Chat happening now. What’s new in early stage Lung Cancer is the topic. Follow & include #LCSM hashtag to participate. |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @JackWestMD: |
| #LCSM Chat @lcsmchat RT @HenningWillers: T3. SBRT can be an alternative in high risk operative pts. Operable pts is highly investigational. #lcsm |
| Benjamin King, MD @BenjaminKingMD #SurgeonsforXRT! @ASTRO_org invite him to #ASTRO19 this year! |
| Tim Kruser @TimothyKruserMD T3. I think the data on salvage lobectomy from @maraantonoff opens a potential window for upfront SBRT, salvage surgery #lcsm |
| Jill Feldman @jillfeldman4 T3 SBRT great option for inoperable patients or patients with co-morbidities such as COPD #LCSM |
| Brendon Stiles @BrendonStilesMD T3. “Competition” between surgeons and #radonc leads to faster advances. Collaboration makes both techniques better. This is a win for patients. #lcsm https://t.co/K7Z7fu8imF |
| Rachael @PollywogPrinces RT @BrendonStilesMD: T3. Proportionally, have seen steady increases in stereotactic radiation treatment of lung cancer patients. #lcsm https://t.co/VcL4wrUi7j https://t.co/FlVtcbtImq |
| Drew Moghanaki 🐕 @DrewMoghanaki T3: A few well-designed randomized clinical trials are helping us answer when SBRT may be a good alternative. Here's the one with the most enrolled to date. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T3. Proportionally, have seen steady increases in stereotactic radiation treatment of lung cancer patients. #lcsm https://t.co/VcL4wrUi7j https://t.co/FlVtcbtImq |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T3 SBRT great option for inoperable patients or patients with co-morbidities such as COPD #LCSM |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T3. “Competition” between surgeons and #radonc leads to faster advances. Collaboration makes both techniques better. This is a win for patients. #lcsm https://t.co/K7Z7fu8imF |
| Brendon Stiles @BrendonStilesMD @BenjaminKingMD1 @ASTRO_org I knew I would hear this one again! #lcsm |
| Henning Willers, MD @HenningWillers T3. challenge with upfront SBRT salvage lobe is lack of upfront nodal eval #lcsm |
 | Dr. Jan Marie Eberth @jmeberth @BrendonStilesMD A1. Double read images by 2 different radiologists. Adherence to proper follow up intervals for low LungRADS nodules. #lcsm |
| Jill Feldman @jillfeldman4 T3 SBRT also great option for recurrence when contained to the lungs. #LCSM |
| Brendon Stiles @BrendonStilesMD T3. Stereotactic radiation (SBRT) extends curative treatment possibility to many patients who previously had no options. #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @DrewMoghanaki: T3: T3: A few well-designed randomized clinical trials are helping us answer when SBRT may be a good alternative. Here's the one with the most enrolled to date. #lcsm |
| #LCSM Chat @lcsmchat RT @DrewMoghanaki: T3: T3: A few well-designed randomized clinical trials are helping us answer when SBRT may be a good alternative. Here's the one with the most enrolled to date. #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T3. “Competition” between surgeons and #radonc leads to faster advances. Collaboration makes both techniques better. This is a win for patients. #lcsm https://t.co/K7Z7fu8imF |
| Tim Kruser @TimothyKruserMD @jillfeldman4 other reasons too sometimes. Had a healthy pt--caregiver for demented husband. Few days in hospital a no go for her... #lcsm |
| Tom Varghese Jr. MD, MS, MBA, FACS 🇺🇸 @TomVargheseJr RT @BrendonStilesMD: T2. Several options for lung preservation now exist – wedge, segmentectomy, lobectomy. #lcsm https://t.co/T2Iu9RcCbq |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T3. Proportionally, have seen steady increases in stereotactic radiation treatment of lung cancer patients. #lcsm https://t.co/VcL4wrUi7j https://t.co/FlVtcbtImq |
| #LCSM Chat @lcsmchat RT @HenningWillers: T3. challenge with upfront SBRT salvage lobe is lack of upfront nodal eval #lcsm |
| Dr. David Tom Cooke @DavidCookeMD It really shouldn't be a "competition", it should be evidenced based multidisciplinary collaboration. Patients expect as much. Similar to the Hall of Justice or the Avengers tower, or the Baxter Building (fantastic four reference; #MakeMineMarvel) #LCSM |
| Benjamin King, MD @BenjaminKingMD T3. SBRT definitely an option and selecting appropriate patients is best done in multidisciplinary setting so patients get a consensus plan #lcsm |
| Brendon Stiles @BrendonStilesMD T3. And previous data suggests that SBRT may be a reasonable alternative for operable patients. https://t.co/HQaTqqM1Fb #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: @TimothyKruserMD I like to split the left upper lobe. Also think just taking superior segment of lower lobes can be good cancer operation and leave lots of lung. #lcsm |
| Brendon Stiles @BrendonStilesMD @HenningWillers This is not unimportant! #lcsm |
| Rachael @PollywogPrinces Learning so much with this chat #lcsm |
| Devika Das, MD, MSHQS @DevikaDasMD @ArpanAshokPatel @PollywogPrinces Ok this is confusing to navigate - NGS no for early stage but definitely need enough tissue to add on all molecular markers with FDA approved therapies. #lcsm |
| #LCSM Chat @lcsmchat RT @jmeberth: @BrendonStilesMD A1. Double read images by 2 different radiologists. Adherence to proper follow up intervals for low LungRADS nodules. #lcsm |
| Jill Feldman @jillfeldman4 T3 But, there's also only so much SBRT that can be done in one area & location can be tricky if possible damage to structures or important airways #LCSM |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T3 SBRT also great option for recurrence when contained to the lungs. #LCSM |
| Tim Kruser @TimothyKruserMD @HenningWillers @dralexlouie has shown you need 200 LN samplings to save 1 life. Surgical mortality exceeds 1/200. Flawed argument #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T3. Stereotactic radiation (SBRT) extends curative treatment possibility to many patients who previously had no options. #lcsm |
| Brendon Stiles @BrendonStilesMD There...I did it. I tweeted out the Chang article in a positive light. Check that off my bucket list of equipoise. #lcsm |
| #LCSM Chat @lcsmchat RT @JackWestMD: |
| Frank Ingram, MD @Chucktowndoc @JackWestMD @ArpanAshokPatel @DevikaDasMD @PollywogPrinces NGS may be the right call when Path specimen is limited. Better chance at getting an answer w/ NGS, rather than splitting the specimen for separate EGFR/ROS1/PDL1/ALK and risking having an inadequate specimen for one or more of those four. The price gap is narrowing also #LCSM |
| Dr. David Tom Cooke @DavidCookeMD Thank you @tedlieu ; remember #lungcancerscreening saves lives! #LCSM |
| Arpan Patel @ArpanAshokPatel T3 -- being around a VA population, patients seem to like the idea of RT>Surgery if both are on the table... #lcsm |
| Brendon Stiles @BrendonStilesMD @PollywogPrinces Hooray! #lcsm |
| Henning Willers, MD @HenningWillers T3. local failure after lobe is 0%, after SBRT ~5-15% #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD Perhaps. Often though resection of lung metastases does not improve survival. #lcsm |
| Jill Feldman @jillfeldman4 @DavidCookeMD And patient's health, age and overall preferences taken into consideration #LCSM |
| Brendon Stiles @BrendonStilesMD @TimothyKruserMD @HenningWillers @DrAlexLouie I don't totally buy that. Sorry. #lcsm |
| Benjamin King, MD @BenjaminKingMD @ASTRO_org seriously not kidding about that #ASTRO19 invite. Mind as well throw in a #radonc official team jersey while we're at it! #LCSM |
| Dr. David Tom Cooke @DavidCookeMD Reference? #LCSM |
| #LCSM Chat @lcsmchat RT @TimothyKruserMD: @jillfeldman4 other reasons too sometimes. Had a healthy pt--caregiver for demented husband. Few days in hospital a no go for her... #lcsm |
| Dr. Jan Marie Eberth @jmeberth Hi all! Cancer epidemiologist joining tonight’s from South Carolina. @USCArnoldSchool #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T3. And previous data suggests that SBRT may be a reasonable alternative for operable patients. https://t.co/HQaTqqM1Fb #lcsm |
| #LCSM Chat @lcsmchat RT @BenjaminKingMD1: T3. SBRT definitely an option and selecting appropriate patients is best done in multidisciplinary setting so patients get a consensus plan #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T3. And previous data suggests that SBRT may be a reasonable alternative for operable patients. https://t.co/HQaTqqM1Fb #lcsm |
| Tom Varghese Jr. MD, MS, MBA, FACS 🇺🇸 @TomVargheseJr RT @BrendonStilesMD: T3. Proportionally, have seen steady increases in stereotactic radiation treatment of lung cancer patients. #lcsm https://t.co/VcL4wrUi7j https://t.co/FlVtcbtImq |
| Ian Pereira @IanJPereira @ArpanAshokPatel @DevikaDasMD @PollywogPrinces For early-stage, I've seen #SBRT/#SABR alone (for patient not amenable to biopsy who have otherwise had a full staging workup). So...it depends. #context #lcsm T1 |
| #LCSM Chat @lcsmchat RT @DevikaDasMD: @ArpanAshokPatel @PollywogPrinces Ok this is confusing to navigate - NGS no for early stage but definitely need enough tissue to add on all molecular markers with FDA approved therapies. #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T3 But, there's also only so much SBRT that can be done in one area & location can be tricky if possible damage to structures or important airways #LCSM |
| Tim Kruser @TimothyKruserMD @BrendonStilesMD @TimothyKruserMD @HenningWillers @DrAlexLouie It's math, not religion. Adjuvant chemo isn't good enough. #lcsm |
| #LCSM Chat @lcsmchat RT @TimothyKruserMD: @HenningWillers @dralexlouie has shown you need 200 LN samplings to save 1 life. Surgical mortality exceeds 1/200. Flawed argument #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @Chucktowndoc: @JackWestMD @ArpanAshokPatel @DevikaDasMD @PollywogPrinces NGS may be the right call when Path specimen is limited. Better chance at getting an answer w/ NGS, rather than splitting the specimen for separate EGFR/ROS1/PDL1/ALK and risking having an inadequate specimen for one or more of those four. The price gap is narrowing also #LCSM |
| Brendon Stiles @BrendonStilesMD @ArpanAshokPatel Informed consent is key. #lcsm |
| Eon @eonhealth RT @DavidCookeMD: Thank you @tedlieu ; remember #lungcancerscreening saves lives! #LCSM |
| #LCSM Chat @lcsmchat RT @Chucktowndoc: @JackWestMD @ArpanAshokPatel @DevikaDasMD @PollywogPrinces NGS may be the right call when Path specimen is limited. Better chance at getting an answer w/ NGS, rather than splitting the specimen for separate EGFR/ROS1/PDL1/ALK and risking having an inadequate specimen for one or more of those four. The price gap is narrowing also #LCSM |
| #LCSM Chat @lcsmchat RT @ArpanAshokPatel: T3 -- being around a VA population, patients seem to like the idea of RT>Surgery if both are on the table... #lcsm |
| Dr. David Tom Cooke @DavidCookeMD Age: It's not years, it's the mileage. #LCSM |
| #LCSM Chat @lcsmchat RT @HenningWillers: T3. local failure after lobe is 0%, after SBRT ~5-15% #lcsm |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: Perhaps. Often though resection of lung metastases does not improve survival. #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: @DavidCookeMD And patient's health, age and overall preferences taken into consideration #LCSM |
| #LCSM Chat @lcsmchat RT @DavidCookeMD: It really shouldn't be a "competition", it should be evidenced based multidisciplinary collaboration. Patients expect as much. Similar to the Hall of Justice or the Avengers tower, or the Baxter Building (fantastic four reference; #MakeMineMarvel) #LCSM |
| Brendon Stiles @BrendonStilesMD T3. I completely agree with need for more randomized trials (and am pretty sure surgery will be superior at 3-5 years). #lcsm |
| #LCSM Chat @lcsmchat RT @BenjaminKingMD1: @ASTRO_org seriously not kidding about that #ASTRO19 invite. Mind as well throw in a #radonc official team jersey while we're at it! #LCSM |
| Tim Kruser @TimothyKruserMD I tweet pro-SBRT. I should say--I push a lot of my consults to lobectomy. Its undoubtedly superior for local control. #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: @ArpanAshokPatel Informed consent is key. #lcsm |
| Frank Ingram, MD @Chucktowndoc @DevikaDasMD @TimAllenMDJD @lcsmchat It’s not so much the quality of the facility as it is the adequacy of the specimen. Sometimes big biopsies contain very little tumor. Sometimes tiny specimens are adequate b/c they’re all lesional tissue. #LCSM |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T3. I completely agree with need for more randomized trials (and am pretty sure surgery will be superior at 3-5 years). #lcsm |
| Brendon Stiles @BrendonStilesMD T3. @DrewMoghanaki VALOR trial will be pivotal and is accruing well. #lcsm https://t.co/UAbEhkoCG5 |
| #LCSM Chat @lcsmchat RT @Chucktowndoc: @DevikaDasMD @TimAllenMDJD @lcsmchat It’s not so much the quality of the facility as it is the adequacy of the specimen. Sometimes big biopsies contain very little tumor. Sometimes tiny specimens are adequate b/c they’re all lesional tissue. #LCSM |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD #PatientsFirst #lcsm |
| Dr. David Tom Cooke @DavidCookeMD The problem is, the proper randomized trial will not accrue to the appropriate power. Down this road before. #LCSM |
| Janet Freeman-Daily @JFreemanDaily @DevikaDasMD @ArpanAshokPatel @PollywogPrinces Yes, confusing. Targeted therapies for NSCLC are (for now) only approved for metastatic patients. Question is, do you test for biomarkers when you have the tissue (early stage surgery), or wait until the cancer happens to spread but is no longer easily accessible? #LCSM |
| #LCSM Chat @lcsmchat RT @TimothyKruserMD: I tweet pro-SBRT. I should say--I push a lot of my consults to lobectomy. Its undoubtedly superior for local control. #lcsm |
| Katie Keane @KatieKeaneMD T3. Agree that multiD assessments critical, especially in those with multifocal ca who may benefit from combo of surgery for some lesions and SBRT for others #lcsm |
| Jill Feldman @jillfeldman4 T3 My SBRT days are over :( but if it can prolong targeted/systemic therapy (as it has w/me for 5 years) then it's a win for the patient as there most likely will be new & better options #LCSM |
| Brendon Stiles @BrendonStilesMD T3. We still need to understand long term outcomes after SBRT, but it certainly may be a safer alternative in high risk patients. #lcsm |
| Drew Moghanaki 🐕 @DrewMoghanaki Well put, and a position that was endorsed by America's largest radiation oncology society. In 2017, @ASTRO_org published their Lung SBRT Guidelines that provides additional insights into this issue for those who want to learn more. #lcsm #radonc https://t.co/MWDpVKFmQR |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @Chucktowndoc: @DevikaDasMD @TimAllenMDJD @lcsmchat It’s not so much the quality of the facility as it is the adequacy of the specimen. Sometimes big biopsies contain very little tumor. Sometimes tiny specimens are adequate b/c they’re all lesional tissue. #LCSM |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T3. @DrewMoghanaki VALOR trial will be pivotal and is accruing well. #lcsm https://t.co/UAbEhkoCG5 |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: #PatientsFirst #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T3. We still need to understand long term outcomes after SBRT, but it certainly may be a safer alternative in high risk patients. #lcsm |
| #LCSM Chat @lcsmchat RT @JFreemanDaily: @DevikaDasMD @ArpanAshokPatel @PollywogPrinces Yes, confusing. Targeted therapies for NSCLC are (for now) only approved for metastatic patients. Question is, do you test for biomarkers when you have the tissue (early stage surgery), or wait until the cancer happens to spread but is no longer easily accessible? #LCSM |
| #LCSM Chat @lcsmchat RT @KatieKeaneMD: T3. Agree that multiD assessments critical, especially in those with multifocal ca who may benefit from combo of surgery for some lesions and SBRT for others #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T3. We still need to understand long term outcomes after SBRT, but it certainly may be a safer alternative in high risk patients. #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T3 My SBRT days are over :( but if it can prolong targeted/systemic therapy (as it has w/me for 5 years) then it's a win for the patient as there most likely will be new & better options #LCSM |
| Brendon Stiles @BrendonStilesMD @DavidCookeMD VALOR is getting there. #lcsm Randomization through pulmonologist is key. #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @JFreemanDaily: @DevikaDasMD @ArpanAshokPatel @PollywogPrinces Yes, confusing. Targeted therapies for NSCLC are (for now) only approved for metastatic patients. Question is, do you test for biomarkers when you have the tissue (early stage surgery), or wait until the cancer happens to spread but is no longer easily accessible? #LCSM |
| Dr. David Tom Cooke @DavidCookeMD Not sure the role of testing, if will not act on the results. Especially as patient may get hit with a bill. #LCSM |
| Devika Das, MD, MSHQS @DevikaDasMD @Chucktowndoc @TimAllenMDJD @lcsmchat Thank you ! Is there a quality metric you follow ? There clearly is a difference based on the skill set #lcsm |
| #LCSM Chat @lcsmchat RT @DrewMoghanaki: Well put, and a position that was endorsed by America's largest radiation oncology society. In 2017, @ASTRO_org published their Lung SBRT Guidelines that provides additional insights into this issue for those who want to learn more. #lcsm #radonc https://t.co/MWDpVKFmQR |
| Brendon Stiles @BrendonStilesMD T3. Whether surgery or SBRT, treatment should be discussed at MDT and tailored to individual patients. #lcsm |
| Stephen V Liu, MD @StephenVLiu @DevikaDasMD @ArpanAshokPatel @PollywogPrinces Will NGS change management? I don’t offer TKIs in this setting but I like to understand the biology more. For example, if I find an ALK fusion, I am sure to incorporate brain MRIs as part of surveillance given the high tropism for this type of lung cancer to the brain. #LCSM |
| Tim Kruser @TimothyKruserMD Key is that surgical advances and now SBRT leave no early stage pt w/o an effective, safe option for potential cure #lcsm |
| Rachael @PollywogPrinces RT @DavidCookeMD: Thank you @tedlieu ; remember #lungcancerscreening saves lives! #LCSM |
| Rachael @PollywogPrinces RT @TimothyKruserMD: Key is that surgical advances and now SBRT leave no early stage pt w/o an effective, safe option for potential cure #lcsm |
| Brendon Stiles @BrendonStilesMD @TimothyKruserMD This is true and what it is all about. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: @DavidCookeMD VALOR is getting there. #lcsm Randomization through pulmonologist is key. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T3. Whether surgery or SBRT, treatment should be discussed at MDT and tailored to individual patients. #lcsm |
| #LCSM Chat @lcsmchat RT @TimothyKruserMD: Key is that surgical advances and now SBRT leave no early stage pt w/o an effective, safe option for potential cure #lcsm |
| Brendon Stiles @BrendonStilesMD Time to move past local therapy and on to systemic. Too many “early stage” lung cancer patients recur. Higher rates than breast, colon, or prostate. Can we do better? #lcsm |
| Henning Willers, MD @HenningWillers T3. every pt who is candidate for sublobar surgery should have a radonc consult as well #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD Hope is that liquid biopsy will solve the problem. But as yet it's not the answer for primary diagnosis. #lcsm |
| Devika Das, MD, MSHQS @DevikaDasMD @JFreemanDaily @ArpanAshokPatel @PollywogPrinces When you work in a setting with limited resources and tons of delay - it’s best to get it upfront. I am studying that currently #lcsm |
| Stacey Tinianov (she/her) MPH, BCPA @coffeemommy @BrendonStilesMD In 20 words or less 🙃 - is SBRT preferable to RFA? Has RFA been applied to the lungs. Apologies for the ignorance but in the oligomets setting, we are hearing a lot about RFA so I'm now curious if they are interchangeable in anyway. #lcsm |
| Dr. David Tom Cooke @DavidCookeMD Is this a T4? #LCSM |
| Brendon Stiles @BrendonStilesMD @HenningWillers Maybe not the GGO or barely part solid healthy patient that gets pushed to surgery. #lcsm |
| Brendon Stiles @BrendonStilesMD T4. Should targeted therapy be given to early stage lung cancer patients with driver mutations (like EGFR, ALK, ROS1, RET)? #lcsm |
| Jill Feldman @jillfeldman4 T3 Even early stage patient should always be evaluated by multidisciplinary team! #LCSM |
| Dr. David Tom Cooke @DavidCookeMD A4 Neoadjuvant or Adjuvant? #LCSM |
| Drew Moghanaki 🐕 @DrewMoghanaki @ArpanAshokPatel We have a similar experience recruiting patients to our randomized trial of SBRT vs Lobectomy. As such, we have to remind folks that surgery is a great treatment too! @BrendonStilesMD #lcsm https://t.co/zqADl0bDST |
| Brendon Stiles @BrendonStilesMD @coffeemommy Easy: "yes" for lung cancer. Oligomets may be different story. #lcsm |
| Stacey Tinianov (she/her) MPH, BCPA @coffeemommy @BrendonStilesMD (waiting with bated breath for this #lcsm community's reply on this but could you also add a WHY?) |
| Brendon Stiles @BrendonStilesMD T4. Right now, the answer is only in the context of clinical trials. #lcsm |
 | Dr. Fabio Moraes @fabiomoraesmd @BrendonStilesMD Looking forward to it #lcsm |
| Tim Kruser @TimothyKruserMD T4. Surgery (or SBRT) should always be 1st line. They cure. Drugs unfortunately to this point only slow growth (but thank god for 'em) #lcsm |
| Drew Moghanaki 🐕 @DrewMoghanaki @jmeberth @USCArnoldSchool Hey neighbor. Welcome aboard. #lcsm |
| Brendon Stiles @BrendonStilesMD @DavidCookeMD Take your pick. I'll give thoughts on both. #lcsm |
| Brendon Stiles @BrendonStilesMD T4. Large RADIANT trial examining adjuvant EGFR TKI after resection was negative statistically, but compelling for EGFR mutant patients. Median DFS 48 vs. 28.5 months. https://t.co/DtPSQaQypT #lcsm |
| Brendon Stiles @BrendonStilesMD T4. SELECT trial by @n8pennell was single arm but also showed compelling results. https://t.co/wf7d9DylJW #lcsm |
| Janet Freeman-Daily @JFreemanDaily @BrendonStilesMD Do we have any data on late effects and/or toxicities of SBRT? I have a permanently broken rib and a closed-off jugular from radiation (not SBRT) -- but it was effective on the tumors it treated. #LCSM |
| Aki Alzubaidi @aki_alzubaidi @BrendonStilesMD What about places where rad onc has a service line but no thoracic surgery? Access to true thoracic surgery is a real issue. #lcsm |
| Drew Moghanaki 🐕 @DrewMoghanaki @BrendonStilesMD There you go again with the over-confidence thing. #lcsm @jillfeldman4 |
| Brendon Stiles @BrendonStilesMD T4. My personal opinion is that adjuvant trials are long, large, and marginal (MAGRIT, RADIANT, bevaciz, etc). I love idea of neoadjuvant. #lcsm |
| #LCSM Chat @lcsmchat RT @TimAllenMDJD: Hope is that liquid biopsy will solve the problem. But as yet it's not the answer for primary diagnosis. #lcsm |
| Brendon Stiles @BrendonStilesMD T4. Recently, there have been some small trials using targeted therapy in the neoadjuvant space, a concept which I love. https://t.co/6feMzsOxrU #lcsm |
| Frank Ingram, MD @Chucktowndoc @DevikaDasMD @TimAllenMDJD @lcsmchat We’ve switched reference labs before because of QNS rates, but it’s hard to assess b/c the reasons for QNS specimens are multifactorial...often preanalytic. #LCSM |
| Dr. David Tom Cooke @DavidCookeMD I think not off trial at this point, but on a clinical trial. But I predict in the future, when molecular testing is even more advanced, we will identify early stage patients who will benefit from systemic therapy. #LCSM |
| Jill Feldman @jillfeldman4 T4 I was on Tarceva for 18 months after my first surgery - the only time in 10 yrs I haven't had cancer. It may prolong recurrence, but at what cost? #LCSM |
| Rachael @PollywogPrinces RT @BrendonStilesMD: T4. SELECT trial by @n8pennell was single arm but also showed compelling results. https://t.co/wf7d9DylJW #lcsm |
| Drew Moghanaki 🐕 @DrewMoghanaki @coffeemommy @BrendonStilesMD How about 280 characters? The answer is, we don't know. It might depend on physical location proximity to major vessels, and patient fitness to tolerate a pneumothorax that can happen with RFA. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4. Should targeted therapy be given to early stage lung cancer patients with driver mutations (like EGFR, ALK, ROS1, RET)? #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T3 Even early stage patient should always be evaluated by multidisciplinary team! #LCSM |
| #LCSM Chat @lcsmchat RT @DrewMoghanaki: @ArpanAshokPatel We have a similar experience recruiting patients to our randomized trial of SBRT vs Lobectomy. As such, we have to remind folks that surgery is a great treatment too! @BrendonStilesMD #lcsm https://t.co/zqADl0bDST |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: @coffeemommy Easy: @coffeemommy Easy: "yes" for lung cancer. Oligomets may be different story. #lcsm |
| Henning Willers, MD @HenningWillers T4. I am not a medonc but I'd feel compelled to consider adjuvant TKI for ALK+ (tend to be almost always metastatic) - wrong? #lcsm |
| Stacey Tinianov (she/her) MPH, BCPA @coffeemommy @DrewMoghanaki @BrendonStilesMD @jillfeldman4 I'm just gonna toss this out there... some well sprinkled over-confidence feels damn good when coming from your surgeon, your med onc and your rad onc sometimes! #lcsm |
| Brendon Stiles @BrendonStilesMD @DrewMoghanaki @jillfeldman4 I like to call it "education/experience/intuition based confidence" #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4. Right now, the answer is only in the context of clinical trials. #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @Chucktowndoc: @DevikaDasMD @TimAllenMDJD @lcsmchat We’ve switched reference labs before because of QNS rates, but it’s hard to assess b/c the reasons for QNS specimens are multifactorial...often preanalytic. #LCSM |
| #LCSM Chat @lcsmchat RT @TimothyKruserMD: T4. Surgery (or SBRT) should always be 1st line. They cure. Drugs unfortunately to this point only slow growth (but thank god for 'em) #lcsm |
| Sara Whitlock @sjwhitlock T4. My TKI Trial drug saved me from a hemicolectomy for my latest recurrence. But until they are proven to cure maybe only for patients not up to rigor of surgery or rad? #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4. Large RADIANT trial examining adjuvant EGFR TKI after resection was negative statistically, but compelling for EGFR mutant patients. Median DFS 48 vs. 28.5 months. https://t.co/DtPSQaQypT #lcsm |
| #LCSM Chat @lcsmchat RT @JackWestMD: |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4. SELECT trial by @n8pennell was single arm but also showed compelling results. https://t.co/wf7d9DylJW #lcsm |
| Janet Freeman-Daily @JFreemanDaily @coffeemommy @BrendonStilesMD We're talking early stage LC today, so oligomets is not part of the topic. Good question for another chat, though! #LCSM |
| #LCSM Chat @lcsmchat RT @JFreemanDaily: @BrendonStilesMD Do we have any data on late effects and/or toxicities of SBRT? I have a permanently broken rib and a closed-off jugular from radiation (not SBRT) -- but it was effective on the tumors it treated. #LCSM |
| Devika Das, MD, MSHQS @DevikaDasMD @Chucktowndoc @TimAllenMDJD @lcsmchat Thank you ! This is helpful #lcsm |
| #LCSM Chat @lcsmchat RT @aki_alzubaidi: @BrendonStilesMD What about places where rad onc has a service line but no thoracic surgery? Access to true thoracic surgery is a real issue. #lcsm |
| Drew Moghanaki 🐕 @DrewMoghanaki @aki_alzubaidi @BrendonStilesMD This is a great point. Especially since approximately 50% of lung cancer surgeries in the US are done by general surgeons, who typically operate on hernias and the appendix. #lcsm |
| Brendon Stiles @BrendonStilesMD T4. CTONG 1103 showed that neoadjuvant erlotinib prolonged PFS in patients w/ stage III EGFR mutated tumors compared to chemo – but response wasn’t as robust as hoped for. #lcsm https://t.co/NyF3eoWWo3 |
| #LCSM Chat @lcsmchat RT @coffeemommy: @DrewMoghanaki @BrendonStilesMD @jillfeldman4 I'm just gonna toss this out there... some well sprinkled over-confidence feels damn good when coming from your surgeon, your med onc and your rad onc sometimes! #lcsm |
| Brendon Stiles @BrendonStilesMD Here were results. #lcsm https://t.co/ALuuHmsJ3o |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4. My personal opinion is that adjuvant trials are long, large, and marginal (MAGRIT, RADIANT, bevaciz, etc). I love idea of neoadjuvant. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4. Recently, there have been some small trials using targeted therapy in the neoadjuvant space, a concept which I love. https://t.co/6feMzsOxrU #lcsm |
| #LCSM Chat @lcsmchat RT @Chucktowndoc: @DevikaDasMD @TimAllenMDJD @lcsmchat We’ve switched reference labs before because of QNS rates, but it’s hard to assess b/c the reasons for QNS specimens are multifactorial...often preanalytic. #LCSM |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T4 I was on Tarceva for 18 months after my first surgery - the only time in 10 yrs I haven't had cancer. It may prolong recurrence, but at what cost? #LCSM |
| Stacey Tinianov (she/her) MPH, BCPA @coffeemommy @JFreemanDaily @BrendonStilesMD I'm an opportunist and Brendon was at his keyboard... 😉 #lcsm |
| #LCSM Chat @lcsmchat RT @DrewMoghanaki: @coffeemommy @BrendonStilesMD How about 280 characters? The answer is, we don't know. It might depend on physical location proximity to major vessels, and patient fitness to tolerate a pneumothorax that can happen with RFA. #lcsm |
| #LCSM Chat @lcsmchat RT @HenningWillers: T4. I am not a medonc but I'd feel compelled to consider adjuvant TKI for ALK+ (tend to be almost always metastatic) - wrong? #lcsm |
| Ian Pereira @IanJPereira @HenningWillers Based on the lack of long-term data for #SBRT/#SABR in this subset. Perhaps mature data will come, but we may have to smell more than rosels and look further than stars :) #lcsm T3 |
| #LCSM Chat @lcsmchat RT @sjwhitlock: T4. My TKI Trial drug saved me from a hemicolectomy for my latest recurrence. But until they are proven to cure maybe only for patients not up to rigor of surgery or rad? #lcsm |
 | Enlightening Results 💡 @GraceCordovano RT @BrendonStilesMD: T4. My personal opinion is that adjuvant trials are long, large, and marginal (MAGRIT, RADIANT, bevaciz, etc). I love idea of neoadjuvant. #lcsm |
| #LCSM Chat @lcsmchat RT @JackWestMD: |
| Brendon Stiles @BrendonStilesMD T4. Recent @JTOonline publication with neoadjuvant crizotinib for ALK rearranged lung cancer patients showed 91% PR by imaging, and 18% complete path response. #lcsm https://t.co/a92r4UkKD1 https://t.co/ye1eEecqHd |
| Rachael @PollywogPrinces RT @TimothyKruserMD: T4. Surgery (or SBRT) should always be 1st line. They cure. Drugs unfortunately to this point only slow growth (but thank god for 'em) #lcsm |
| Stacey Tinianov (she/her) MPH, BCPA @coffeemommy @DrewMoghanaki @BrendonStilesMD 280 is even better! Thank you for the extra context! #lcsm |
| #LCSM Chat @lcsmchat RT @DrewMoghanaki: @aki_alzubaidi @BrendonStilesMD This is a great point. Especially since approximately 50% of lung cancer surgeries in the US are done by general surgeons, who typically operate on hernias and the appendix. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4. CTONG 1103 showed that neoadjuvant erlotinib prolonged PFS in patients w/ stage III EGFR mutated tumors compared to chemo – but response wasn’t as robust as hoped for. #lcsm https://t.co/NyF3eoWWo3 |
| Brendon Stiles @BrendonStilesMD And here were those responses. #lcsm https://t.co/eD7lNIvYCM |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: Here were results. #lcsm https://t.co/ALuuHmsJ3o |
| #LCSM Chat @lcsmchat RT @IanJPereira: @HenningWillers Based on the lack of long-term data for #SBRT/#SABR in this subset. Perhaps mature data will come, but we may have to smell more than rosels and look further than stars :) #lcsm T3 |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4. Recent @JTOonline publication with neoadjuvant crizotinib for ALK rearranged lung cancer patients showed 91% PR by imaging, and 18% complete path response. #lcsm https://t.co/a92r4UkKD1 https://t.co/ye1eEecqHd |
| Enlightening Results 💡 @GraceCordovano RT @BrendonStilesMD: T1. I strongly prefer to have diagnosis prior to surgery. Even highly suspicious nodules won’t be cancer at least 16% of the time. https://t.co/QIGiZYRB4f #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: And here were those responses. #lcsm https://t.co/eD7lNIvYCM |
| Brendon Stiles @BrendonStilesMD T4. To me, seems like jury is still out on neoadjuvant targeted therapy trials. Conceptually make sense, but data not there yet. #lcsm |
| Drew Moghanaki 🐕 @DrewMoghanaki @coffeemommy @BrendonStilesMD @jillfeldman4 Don't worry, he loves it. Right @jillfeldman4? #lcsm |
| Enlightening Results 💡 @GraceCordovano RT @BrendonStilesMD: T3. Can stereotactic radiation be an alternative to surgery for some patients with early stage lung cancer? #lcsm |
| Enlightening Results 💡 @GraceCordovano RT @JackWestMD: |
| Rachael @PollywogPrinces RT @BrendonStilesMD: And here were those responses. #lcsm https://t.co/eD7lNIvYCM |
| Brendon Stiles @BrendonStilesMD T4. Need to understand effect of neoadjuvant therapy on resistance mechanisms in targetable mutation driven tumors. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4. To me, seems like jury is still out on neoadjuvant targeted therapy trials. Conceptually make sense, but data not there yet. #lcsm |
| Brendon Stiles @BrendonStilesMD T5 coming….like everything, moving onto immunotherapy! #lcsm |
| Janet Freeman-Daily @JFreemanDaily @coffeemommy @BrendonStilesMD You should know by now: don't distract the moderator! #LCSM |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4. Need to understand effect of neoadjuvant therapy on resistance mechanisms in targetable mutation driven tumors. #lcsm |
| Brendon Stiles @BrendonStilesMD T5. Is there a role for immunotherapy in patients with early stage lung cancer? #lcsm |
| Devika Das, MD, MSHQS @DevikaDasMD RT @JackWestMD: |
| Jill Feldman @jillfeldman4 T4 Is there a chance that treating with TKI post op will hasten development of resistance by enhancing EMT? If TKI could kill, not suppress, cells then worth it - Patients are looking for CURE in early stage, PFS! #LCSM |
 | Narjust Florez, M.D. @NarjustFlorezMD @BrendonStilesMD this is going to get interesting #lcsm |
| Arpan Patel @ArpanAshokPatel T4 trials over the next years will guide - targeted vs IO-X? NeoAdj? adj? IO+Targeted? EXCITING time for #lungcancer research #lcsm |
| Brendon Stiles @BrendonStilesMD T5. Of course there is! Lots of ongoing trials. From @PeerView #lcsm https://t.co/qAjhIeU4nE |
| Rachael @PollywogPrinces RT @ArpanAshokPatel: T4 trials over the next years will guide - targeted vs IO-X? NeoAdj? adj? IO+Targeted? EXCITING time for #lungcancer research #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. Is there a role for immunotherapy in patients with early stage lung cancer? #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T4 Is there a chance that treating with TKI post op will hasten development of resistance by enhancing EMT? If TKI could kill, not suppress, cells then worth it - Patients are looking for CURE in early stage, PFS! #LCSM |
| #LCSM Chat @lcsmchat RT @ArpanAshokPatel: T4 trials over the next years will guide - targeted vs IO-X? NeoAdj? adj? IO+Targeted? EXCITING time for #lungcancer research #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. Of course there is! Lots of ongoing trials. From @PeerView #lcsm https://t.co/qAjhIeU4nE |
| Brendon Stiles @BrendonStilesMD T5. Neoadjuvant makes SO MUCH more sense than adjuvant to me for immunotherapy trials. #lcsm |
 | Martín Angel @Martin_AngelMD #oncologia #lcsm @flor_reinhold @juandfar @MariaBluthgen @RodRogSan https://t.co/QdNXW2UFbW |
| Denise Cutlip @dennycee @ArpanAshokPatel #lcsm exciting time to be a patient too. |
| Brendon Stiles @BrendonStilesMD T5. Need an in situ tumor (not a resected one) to generate an immune response. #lcsm |
| Brendon Stiles @BrendonStilesMD T5. And these with both neoadjvuant and adjuvant. #lcsm https://t.co/hFK0AFuN0s |
 | Gina @EAustin1969 I’m lurking as I suffer from this dang cold #lcsm |
 | Lecia Sequist, MD, MPH @LeciaSequist @BrendonStilesMD We had a small neo-adjuvant trial of afatinib in EGFR stage III pts at ASCO 2 years ago. There was also neo-adj chemoRT but results were remarkable (though small n) and I think might be even better w/ more well-tolerated TKI. https://t.co/whmLAaPdnP #LCSM |
| Brendon Stiles @BrendonStilesMD T5. Some great responses have already been reported in small early trials. #lcsm |
| Tim Kruser @TimothyKruserMD T5. We know that there remains an unfortunate % of pts who recur after lobe or SBRT. Adjuvant chemo not the answer. ImmunoTx may be #lcsm |
 | Mudit Chowdhary, MD @DrChowdharyMD @jillfeldman4 Absolutely correct! In addition, #SBRT is a great and efficacious option for those who simply do not want to undergo surgery #radonc #lcsm |
| Stacey Tinianov (she/her) MPH, BCPA @coffeemommy Chat time is up for me - high school music boosters meeting up next! Always love spending time in the company of the #lcsm community. Thank you all for doing what you do every day to move the needle forward and improve outcomes and quality of life. 💗 |
| Henning Willers, MD @HenningWillers T5. SBRT can be used as an in situ vaccine to synergize with immunotherapy #lcsm |
| Arpan Patel @ArpanAshokPatel T5 - possibly? https://t.co/dQSGoT9xHB ? is WHICH patients benefit? once we figure out markers for that...IO-X for all who fit #lcsm |
| Katie Keane @KatieKeaneMD T5. Trials of IO-SBRT in early stage inoperable patients are also critical #lcsm |
| Brendon Stiles @BrendonStilesMD T5. A 45% major pathologic response was reported in @NEJM for lung cancer patients getting nivolumab prior to surgical resection. #lcsm https://t.co/3U9ajUQxXW |
| Jill Feldman @jillfeldman4 @BrendonStilesMD and @DrewMoghanaki at it live on #LCSM chat! https://t.co/XWuhyT16DH |
| Narjust Florez, M.D. @NarjustFlorezMD @BrendonStilesMD Agree. Breast cancer has demonstrated the benefit of neoadjuvant therapy #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. Neoadjuvant makes SO MUCH more sense than adjuvant to me for immunotherapy trials. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. Need an in situ tumor (not a resected one) to generate an immune response. #lcsm |
| Brendon Stiles @BrendonStilesMD T5. NADIM trial in stage III patients had almost 80% rate of major path response and 60% rate of complete path response when nivolumab added to chemo! #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. And these with both neoadjvuant and adjuvant. #lcsm https://t.co/hFK0AFuN0s |
| Drew Moghanaki 🐕 @DrewMoghanaki Whether or not it is, operable patients with stage I NSCLC who prefer SBRT should be followed by both a talented thoracic surgeon as well as their radiation oncologist. Just in case they're the 1 in 10 whose tumor might regrow after SBRT. @HenningWillers #lcsm |
 | Maria Virginia Bluthgen @MariaBluthgen Gran evento AstraZeneca |
| #LCSM Chat @lcsmchat RT @LeciaSequist: @BrendonStilesMD We had a small neo-adjuvant trial of afatinib in EGFR stage III pts at ASCO 2 years ago. There was also neo-adj chemoRT but results were remarkable (though small n) and I think might be even better w/ more well-tolerated TKI. https://t.co/whmLAaPdnP #LCSM |
| Brendon Stiles @BrendonStilesMD #lcsm https://t.co/UOCWFZG8uf |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. Some great responses have already been reported in small early trials. #lcsm |
| #LCSM Chat @lcsmchat RT @TimothyKruserMD: T5. We know that there remains an unfortunate % of pts who recur after lobe or SBRT. Adjuvant chemo not the answer. ImmunoTx may be #lcsm |
 | Saman Maleki, PhD @SMImmunology Important question we need to ask for early stage lung cancer #LCSM |
| #LCSM Chat @lcsmchat RT @DrChowdharyMD: @jillfeldman4 Absolutely correct! In addition, #SBRT is a great and efficacious option for those who simply do not want to undergo surgery #radonc #lcsm |
| #LCSM Chat @lcsmchat RT @HenningWillers: T5. SBRT can be used as an in situ vaccine to synergize with immunotherapy #lcsm |
| #LCSM Chat @lcsmchat RT @ArpanAshokPatel: T5 - possibly? https://t.co/dQSGoT9xHB ? is WHICH patients benefit? once we figure out markers for that...IO-X for all who fit #lcsm |
| Tim Kruser @TimothyKruserMD RT @KatieKeaneMD: T5. Trials of IO-SBRT in early stage inoperable patients are also critical #lcsm |
| #LCSM Chat @lcsmchat RT @KatieKeaneMD: T5. Trials of IO-SBRT in early stage inoperable patients are also critical #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. A 45% major pathologic response was reported in @NEJM for lung cancer patients getting nivolumab prior to surgical resection. #lcsm https://t.co/3U9ajUQxXW |
| #LCSM Chat @lcsmchat RT @jillfeldman4: @BrendonStilesMD and @DrewMoghanaki at it live on #LCSM chat! https://t.co/XWuhyT16DH |
| Brendon Stiles @BrendonStilesMD T4. Back to targeted. Forgot to share this. #lcsm https://t.co/78x947BFml |
| Maria Virginia Bluthgen @MariaBluthgen @AstraZeneca #LCSM |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T5. A 45% major pathologic response was reported in @NEJM for lung cancer patients getting nivolumab prior to surgical resection. #lcsm https://t.co/3U9ajUQxXW |
| Devika Das, MD, MSHQS @DevikaDasMD @BrendonStilesMD T5 Early data is promising based on major pathological response. Ongoing phase 3 trials pending and will it have an OS benefit remains to be answered #lcsm https://t.co/ovqyLchAr1 |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. NADIM trial in stage III patients had almost 80% rate of major path response and 60% rate of complete path response when nivolumab added to chemo! #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: #lcsm https://t.co/UOCWFZG8uf |
| Matthew Steliga MD FACS @SteligaMD RT @BrendonStilesMD: T5. A 45% major pathologic response was reported in @NEJM for lung cancer patients getting nivolumab prior to surgical resection. #lcsm https://t.co/3U9ajUQxXW |
| Ian Pereira @IanJPereira @BrendonStilesMD Interesting conclusion by the authors of that study :) #lcsm T3 |
| Brendon Stiles @BrendonStilesMD T5. LCMC3 multicenter trial reported good rates of response to neoadjuvant IO. #lcsm https://t.co/P1LALM3oXo |
| #LCSM Chat @lcsmchat RT @DrewMoghanaki: Whether or not it is, operable patients with stage I NSCLC who prefer SBRT should be followed by both a talented thoracic surgeon as well as their radiation oncologist. Just in case they're the 1 in 10 whose tumor might regrow after SBRT. @HenningWillers #lcsm |
| Arpan Patel @ArpanAshokPatel RT @BrendonStilesMD: T4. Back to targeted. Forgot to share this. #lcsm https://t.co/78x947BFml |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4. Back to targeted. Forgot to share this. #lcsm https://t.co/78x947BFml |
| Drew Moghanaki 🐕 @DrewMoghanaki RT @jillfeldman4: @BrendonStilesMD and @DrewMoghanaki at it live on #LCSM chat! https://t.co/XWuhyT16DH |
| #LCSM Chat @lcsmchat RT @DevikaDasMD: @BrendonStilesMD T5 Early data is promising based on major pathological response. Ongoing phase 3 trials pending and will it have an OS benefit remains to be answered #lcsm https://t.co/ovqyLchAr1 |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. LCMC3 multicenter trial reported good rates of response to neoadjuvant IO. #lcsm https://t.co/P1LALM3oXo |
| Brendon Stiles @BrendonStilesMD T5. In our trial with neoadjuvant durvalumab and low dose SBRT, I have seen terrible tumors completely killed. Here is one. #lcsm https://t.co/ho5OI9fB3O |
| Devika Das, MD, MSHQS @DevikaDasMD @BrendonStilesMD T5 potential benefits of neoadjuvant therapy #lcsm https://t.co/hquoLPzdgT |
| Brendon Stiles @BrendonStilesMD T5. We just presented a study that showed complications with neoadjuvant IO aren’t really any different than with neoadjuvant chemo. https://t.co/psK8GIx2R5 #lcsm |
| Brendon Stiles @BrendonStilesMD @jillfeldman4 @DrewMoghanaki Please show him again how much cooler my lego guy is than his... #lcsm |
| Janet Freeman-Daily @JFreemanDaily RT @LeciaSequist: @BrendonStilesMD We had a small neo-adjuvant trial of afatinib in EGFR stage III pts at ASCO 2 years ago. There was also neo-adj chemoRT but results were remarkable (though small n) and I think might be even better w/ more well-tolerated TKI. https://t.co/whmLAaPdnP #LCSM |
| Dr. David Tom Cooke @DavidCookeMD RT @DevikaDasMD: @BrendonStilesMD T5 potential benefits of neoadjuvant therapy #lcsm https://t.co/hquoLPzdgT |
| Brendon Stiles @BrendonStilesMD T5. The LCMC group also presented excellent safety data with neoadjuvant immunotherapy. https://t.co/tWFgaM9EDb #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T5. We just presented a study that showed complications with neoadjuvant IO aren’t really any different than with neoadjuvant chemo. https://t.co/psK8GIx2R5 #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @BrendonStilesMD: T5. In our trial with neoadjuvant durvalumab and low dose SBRT, I have seen terrible tumors completely killed. Here is one. #lcsm https://t.co/ho5OI9fB3O |
| KC Dill @kasedill RT @BrendonStilesMD: T5. In our trial with neoadjuvant durvalumab and low dose SBRT, I have seen terrible tumors completely killed. Here is one. #lcsm https://t.co/ho5OI9fB3O |
| Brendon Stiles @BrendonStilesMD @DevikaDasMD Hey!!! I was going to tweet that too! #lcsm |
| Janet Freeman-Daily @JFreemanDaily @coffeemommy Happy music boosting! #LCSM |
| Katie Keane @KatieKeaneMD T5. SBRT can also stimulate the immune system and potentiate the immune response from IO. #lcsm |
| Brendon Stiles @BrendonStilesMD RT @DevikaDasMD: @BrendonStilesMD T5 potential benefits of neoadjuvant therapy #lcsm https://t.co/hquoLPzdgT |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. In our trial with neoadjuvant durvalumab and low dose SBRT, I have seen terrible tumors completely killed. Here is one. #lcsm https://t.co/ho5OI9fB3O |
| #LCSM Chat @lcsmchat RT @DevikaDasMD: @BrendonStilesMD T5 potential benefits of neoadjuvant therapy #lcsm https://t.co/hquoLPzdgT |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. We just presented a study that showed complications with neoadjuvant IO aren’t really any different than with neoadjuvant chemo. https://t.co/psK8GIx2R5 #lcsm |
| Rachael @PollywogPrinces RT @DevikaDasMD: @BrendonStilesMD T5 potential benefits of neoadjuvant therapy #lcsm https://t.co/hquoLPzdgT |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. The LCMC group also presented excellent safety data with neoadjuvant immunotherapy. https://t.co/tWFgaM9EDb #lcsm |
| #LCSM Chat @lcsmchat RT @KatieKeaneMD: T5. SBRT can also stimulate the immune system and potentiate the immune response from IO. #lcsm |
| Brendon Stiles @BrendonStilesMD T5. Despite the hype, questions about neoadjuvant IO remain. #lcsm https://t.co/BAWlx2iJgj |
| Rachael @PollywogPrinces RT @KatieKeaneMD: T5. SBRT can also stimulate the immune system and potentiate the immune response from IO. #lcsm |
| Brendon Stiles @BrendonStilesMD T4/5. Great review on neoadjuvant therapy for lung cancer here from @JTOonline: https://t.co/BeC5yslCWT #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T5. Despite the hype, questions about neoadjuvant IO remain. #lcsm https://t.co/BAWlx2iJgj |
| Jill Feldman @jillfeldman4 T5 From what I have read, abscopal effect is no longer anecdotal. It makes sense that IO has a role, it's figuring out in whom, when and what. Easy for me (a patient) to say :) #LCSM |
| Drew Moghanaki 🐕 @DrewMoghanaki @IanJPereira @BrendonStilesMD I am always entertained by academicians passive-aggressive use of the words "suggests" and "potentially significant". #lcsm |
| Brendon Stiles @BrendonStilesMD T4/5. LCMC planning massive multi-institution neoadjuvant trial. #lcsm |
| Katie Keane @KatieKeaneMD @BrendonStilesMD Have you found neoadj IO makes resection more challenging? Or similar to neoadjuvant chemo/ chemoRT? #lcsm |
| Dr. David Tom Cooke @DavidCookeMD In regards to an intense immune response making surgical resection challenging, I think surgeons can rise to the occasion. #LCSM |
| Brendon Stiles @BrendonStilesMD Almost time to wind the chat down. This has been an incredible discussion! #lcsm |
| Dr. David Tom Cooke @DavidCookeMD #LCSM |
| Tim Kruser @TimothyKruserMD There are a lot of questions about IO and surg complications. The ? w/ IO and SBRT is usually "They complement, do they synergize?" #lcsm |
| Aki Alzubaidi @aki_alzubaidi Thanks @BrendonStilesMD this was cool. #lcsm |
 | teens get cancer too @trials4now RT @METUPorg: We are hoping between right to try and broadening #clinicaltrial guildelines more will be allowed into trials. Transparency will be even more important ensuring researchers learn from failures. #bcsm #metastaticBC #lcsm |
| Brendon Stiles @BrendonStilesMD I saw @LeciaSequist - what is the scoop on neoadjuvant targeted therapy? #lcsm |
| Lecia Sequist, MD, MPH @LeciaSequist @BrendonStilesMD Companion tests looking for biomarker signatures in blood, urine, and/or breath. We have so much opportunity to improve on lung nodule diagnostics! Really important topic #LCSM |
| Brendon Stiles @BrendonStilesMD Please share your closing thoughts! #lcsm |
| KC Dill @kasedill @BrendonStilesMD This has been incredible! I love all the treatment option combos and trials coming out way.. #lcsm |
| Tim Kruser @TimothyKruserMD RT @jillfeldman4: T5 From what I have read, abscopal effect is no longer anecdotal. It makes sense that IO has a role, it's figuring out in whom, when and what. Easy for me (a patient) to say :) #LCSM |
| Dr. David Tom Cooke @DavidCookeMD RT @LeciaSequist: @BrendonStilesMD Companion tests looking for biomarker signatures in blood, urine, and/or breath. We have so much opportunity to improve on lung nodule diagnostics! Really important topic #LCSM |
| Brendon Stiles @BrendonStilesMD Thanks to all of the #lcsm community who joined. And BIG thanks to all of our new folks tonight. Incredible turnout! #lcsm |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD It has been a privilege to participate. #lcsm |
 | Shilpa Gupta @shilpaonc RT @JackWestMD: |
| Jill Feldman @jillfeldman4 T5 I think the biggest challenge of getting patients enrolled in IO clinical trials is when they are randomized. Many patients don't want to go through infusions if 50% chance they are getting sugar water. #LCSM |
| Henning Willers, MD @HenningWillers @BrendonStilesMD Biggest challenge in stage I to reduce distant failures - thanks and I learned quite a bit here! #lcsm |
| KC Dill @kasedill @DavidCookeMD Fabulous program in my neighborhood I follow daily.. #lcsm |
| Matthew Steliga MD FACS @SteligaMD T4. That is a great question, and very complex issue- it may help some with occult metastatic disease, but would delay (hopefully curative) treatment for most patients. #LCSM. it would be interesting to see if there was a benefit, the number needed to treat, & the side effects. |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: T4/5. Great review on neoadjuvant therapy for lung cancer here from @JTOonline: https://t.co/BeC5yslCWT #lcsm |
| Drew Moghanaki 🐕 @DrewMoghanaki @jillfeldman4 Agree. Fortunately, @BrendonStilesMD isn't the only thoracic surgeon who sees the light, and hope for the beam, to find more ways to treat lung cancer successfully. #lcsm |
| Brendon Stiles @BrendonStilesMD @TimothyKruserMD Maybe for pneumonitis.... Couldn't help it. :-) #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T5 From what I have read, abscopal effect is no longer anecdotal. It makes sense that IO has a role, it's figuring out in whom, when and what. Easy for me (a patient) to say :) #LCSM |
| Denise Cutlip @dennycee #lcsm I learned much tonight. Thank you. |
| #LCSM Chat @lcsmchat RT @KatieKeaneMD: @BrendonStilesMD Have you found neoadj IO makes resection more challenging? Or similar to neoadjuvant chemo/ chemoRT? #lcsm |
| Frank Ingram, MD @Chucktowndoc @BrendonStilesMD Goodnight all. I always learn so much. #LCSM |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: Almost time to wind the chat down. This has been an incredible discussion! #lcsm |
| #LCSM Chat @lcsmchat RT @TimothyKruserMD: There are a lot of questions about IO and surg complications. The ? w/ IO and SBRT is usually "They complement, do they synergize?" #lcsm |
| Brendon Stiles @BrendonStilesMD @HenningWillers Agree and thanks for joining. #lcsm |
| Dr. David Tom Cooke @DavidCookeMD Great chat everyone! Thanks @BrendonStilesMD @lcsmchat #LCSM |
| Tim Kruser @TimothyKruserMD Closing thoughts--these are tremendous chats. Learn a lot. Great data sharing for pts & MDs alike. Thanks to @brendonstilesMD !! #lcsm |
| #LCSM Chat @lcsmchat RT @JackWestMD: |
| #LCSM Chat @lcsmchat RT @LeciaSequist: @BrendonStilesMD Companion tests looking for biomarker signatures in blood, urine, and/or breath. We have so much opportunity to improve on lung nodule diagnostics! Really important topic #LCSM |
| Lecia Sequist, MD, MPH @LeciaSequist @BrendonStilesMD I think as our drugs become more selective and are better tolerated, neoadjuvant targeted therapy is a great strategy to explore in more depth and may be especially helpful when it can facilitate a smaller surgery that spares more lung function #LCSM |
| Brendon Stiles @BrendonStilesMD Lots of exciting stuff happening in early stage lung cancer. Finding cancer early can lead to cures. #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: Please share your closing thoughts! #lcsm |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: Thanks to all of the #lcsm community who joined. And BIG thanks to all of our new folks tonight. Incredible turnout! #lcsm |
| Rachael @PollywogPrinces RT @TimothyKruserMD: Closing thoughts--these are tremendous chats. Learn a lot. Great data sharing for pts & MDs alike. Thanks to @brendonstilesMD !! #lcsm |
| #LCSM Chat @lcsmchat RT @jillfeldman4: T5 I think the biggest challenge of getting patients enrolled in IO clinical trials is when they are randomized. Many patients don't want to go through infusions if 50% chance they are getting sugar water. #LCSM |
| #LCSM Chat @lcsmchat RT @HenningWillers: @BrendonStilesMD Biggest challenge in stage I to reduce distant failures - thanks and I learned quite a bit here! #lcsm |
| Rachael @PollywogPrinces RT @BrendonStilesMD: Lots of exciting stuff happening in early stage lung cancer. Finding cancer early can lead to cures. #lcsm |
| #LCSM Chat @lcsmchat RT @SteligaMD: T4. That is a great question, and very complex issue- it may help some with occult metastatic disease, but would delay (hopefully curative) treatment for most patients. #LCSM. it would be interesting to see if there was a benefit, the number needed to treat, & the side effects. |
| KC Dill @kasedill @jillfeldman4 Exactly! We want IO. #LCSM |
| Brendon Stiles @BrendonStilesMD Thanks to everyone for participating! Great stuff happening. #lcsm |
| Eon @eonhealth RT @BrendonStilesMD: Lots of exciting stuff happening in early stage lung cancer. Finding cancer early can lead to cures. #lcsm |
| #LCSM Chat @lcsmchat RT @TimothyKruserMD: Closing thoughts--these are tremendous chats. Learn a lot. Great data sharing for pts & MDs alike. Thanks to @brendonstilesMD !! #lcsm |
| LungCancer.net @LungCancer_HU RT @BrendonStilesMD: Lots of exciting stuff happening in early stage lung cancer. Finding cancer early can lead to cures. #lcsm |
| Brendon Stiles @BrendonStilesMD @LeciaSequist That is what I was hoping to hear! I agree. #lcsm |
| Janet Freeman-Daily @JFreemanDaily Great discussion of early stage #lungcancer tonight, #LCSM Chat! As a patient, I'm very encouraged by the new treatment options. Now we just need to get more people screened so we catch the disease in early stages. #LCSM |
| #LCSM Chat @lcsmchat Thank you @BrendonStilesMD for moderating! Excellent chat. #LCSM |
| KC Dill @kasedill Thank you for the exciting information. Can’t wait for next months topic. #lcsm |
| #LCSM Chat @lcsmchat RT @LeciaSequist: @BrendonStilesMD I think as our drugs become more selective and are better tolerated, neoadjuvant targeted therapy is a great strategy to explore in more depth and may be especially helpful when it can facilitate a smaller surgery that spares more lung function #LCSM |
| #LCSM Chat @lcsmchat RT @BrendonStilesMD: Lots of exciting stuff happening in early stage lung cancer. Finding cancer early can lead to cures. #lcsm |
| Brendon Stiles @BrendonStilesMD @ArpanAshokPatel @lcsmchat Thanks so much for joining! #lcsm |
| #LCSM Chat @lcsmchat RT @JFreemanDaily: Great discussion of early stage #lungcancer tonight, #LCSM Chat! As a patient, I'm very encouraged by the new treatment options. Now we just need to get more people screened so we catch the disease in early stages. #LCSM |
| Drew Moghanaki 🐕 @DrewMoghanaki Closing thought: @BrendonStilesMD was amazing. Terrific leadership once again for tonight's chat. We are all more knowledgable because of all you do to help people who have to endure this annoying disease. #lcsm |
| #LCSM Chat @lcsmchat @EdenLake Best hopes. xo #lcsm |
| #LCSM Chat @lcsmchat RT @DrewMoghanaki: Closing thought: Closing thought: @BrendonStilesMD was amazing. Terrific leadership once again for tonight's chat. We are all more knowledgable because of all you do to help people who have to endure this annoying disease. #lcsm |
| Brendon Stiles @BrendonStilesMD @DrewMoghanaki Thanks. This was a good one to bring everyone together. We can work as a team to cure early stage #LungCancer. #lcsm |
| Drew Moghanaki 🐕 @DrewMoghanaki RT @JFreemanDaily: Great discussion of early stage #lungcancer tonight, #LCSM Chat! As a patient, I'm very encouraged by the new treatment options. Now we just need to get more people screened so we catch the disease in early stages. #LCSM |
| Devika Das, MD, MSHQS @DevikaDasMD @lcsmchat Screenjgn is key to find these cancers in early stage and then equitable / feasible pathways to get tissue ASAP while preventing delays to curative therapy is key. Academic and community centers need to work together on this #lcsm |
| Ian Pereira @IanJPereira RT @DrewMoghanaki: Closing thought: Closing thought: @BrendonStilesMD was amazing. Terrific leadership once again for tonight's chat. We are all more knowledgable because of all you do to help people who have to endure this annoying disease. #lcsm |
| Brendon Stiles @BrendonStilesMD @jillfeldman4 @DrewMoghanaki Yep...and it captured him perfectly in person as well. :-) Going to show that in all future debates.... #lcsm |
| Katie Keane @KatieKeaneMD Great chat! Thanks to @BrendonStilesMD for moderating. A high-yield discussion to say the least #lcsm |
| Brendon Stiles @BrendonStilesMD @KatieKeaneMD Thanks so much for joining us! #lcsm |
| Mudit Chowdhary, MD @DrChowdharyMD @kasedill @jillfeldman4 Great question @kasedill! It depends on the location of the cancer, surrounding structures, and number/dose of prior treatments. Generally speaking though multiple #SBRT treatments are doable #lcsm |
 | Liseloth Garrido Mata @LiselothGarrido RT @BrendonStilesMD: T4. Recent @JTOonline publication with neoadjuvant crizotinib for ALK rearranged lung cancer patients showed 91% PR by imaging, and 18% complete path response. #lcsm https://t.co/a92r4UkKD1 https://t.co/ye1eEecqHd |
| Drew Moghanaki 🐕 @DrewMoghanaki @jillfeldman4 @BrendonStilesMD That is quite the mighty sword. I thought he's a minimally invasive surgeon. #lcsm |
| Janet Freeman-Daily @JFreemanDaily Thanks to @BrendonStilesMD for a terrific #LCSM Chat and great job as moderator! |
| Brendon Stiles @BrendonStilesMD @SBRT_CR @TimothyKruserMD Yes...still giggling. #lcsm |
| Jill Feldman @jillfeldman4 Great chat! Of course I can’t keep up so will have to go back and review transcript 😨 but thank you! #LCSM |
| Matthew Steliga MD FACS @SteligaMD I haven't operated on lung cancer w neoadj IO, but have resected 3 patients' metastatic melanoma in lung after ipilumimab. Fibrosis & response was much more robust than after cytotoxic chemo or XRT. It may not matter peripherally, but in the hilum, its a tough dissection. #LCSM |
| Brendon Stiles @BrendonStilesMD @DrewMoghanaki @jillfeldman4 Speak softly and carry a big stick... #lcsm |
 | Dennis Keim @denniskeim RT @JFreemanDaily: Great discussion of early stage #lungcancer tonight, #LCSM Chat! As a patient, I'm very encouraged by the new treatment options. Now we just need to get more people screened so we catch the disease in early stages. #LCSM |
| Sara Whitlock @sjwhitlock Goals. Have @jillfeldman4 make a lego character of me #lcsm |
| Lecia Sequist, MD, MPH @LeciaSequist @BrendonStilesMD We in the #LCSM tribe need to take charge of educating the 🌎🌍🌏 about #lungcancer re: screening. Three (yes, 3!) randomized trials now show a cancer survival benefit! Time to make screening a reality NOW for all smokers, and find effective ways to screen non-smokers |
| Brendon Stiles @BrendonStilesMD @LeciaSequist Totally agree. It is time. #lcsm |
 | Angie Derrick @AngieBDerrick Why lung cancer is the deadliest cancer type and many patients suffer in silence https://t.co/8Tx4r3NZYB via @postandcourier #lcsm |
| Brendon Stiles @BrendonStilesMD Signing off. Thanks so much to everyone. What a great team! Proud and happy to know and learn from you all. #lcsm |
| Eon @eonhealth RT @LeciaSequist: @BrendonStilesMD We in the #LCSM tribe need to take charge of educating the 🌎🌍🌏 about #lungcancer re: @BrendonStilesMD We in the #LCSM tribe need to take charge of educating the 🌎🌍🌏 about #lungcancer re: screening. Three (yes, 3!) randomized trials now show a cancer survival benefit! Time to make screening a reality NOW for all smokers, and find effective ways to screen non-smokers |
| Tim Kruser @TimothyKruserMD RT @LeciaSequist: @BrendonStilesMD We in the #LCSM tribe need to take charge of educating the 🌎🌍🌏 about #lungcancer re: @BrendonStilesMD We in the #LCSM tribe need to take charge of educating the 🌎🌍🌏 about #lungcancer re: screening. Three (yes, 3!) randomized trials now show a cancer survival benefit! Time to make screening a reality NOW for all smokers, and find effective ways to screen non-smokers |
| Timothy Craig Allen, MD, JD, FCAP @TimAllenMDJD RT @JFreemanDaily: Great discussion of early stage #lungcancer tonight, #LCSM Chat! As a patient, I'm very encouraged by the new treatment options. Now we just need to get more people screened so we catch the disease in early stages. #LCSM |
 | MrsB @SENebMom RT @AngieBDerrick: Why lung cancer is the deadliest cancer type and many patients suffer in silence https://t.co/8Tx4r3NZYB via @postandcourier #lcsm |
| Liseloth Garrido Mata @LiselothGarrido RT @BrendonStilesMD: T5. And these with both neoadjvuant and adjuvant. #lcsm https://t.co/hFK0AFuN0s |
| KC Dill @kasedill @DrChowdharyMD @jillfeldman4 Nice to know, thanks so much! #lcsm |
| Liseloth Garrido Mata @LiselothGarrido RT @BrendonStilesMD: #lcsm https://t.co/UOCWFZG8uf |
 | Rodrigo Sanchez Roger @RodRogSan RT @Tincho_Angel: Diego kaen presentando #osimertinib #1L 👏👏👏👏 #lcsm https://t.co/DwuJnbvrn5 |
| Janet Freeman-Daily @JFreemanDaily Transcript for tonight's 5/9 #LCSM chat on "What's New in Early Stage Lung Cancer" is here: https://t.co/dH0uvcYAle |
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