#LCSM Transcript

Healthcare social media transcript of the #LCSM hashtag.
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Jill @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…
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 twi…
#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 @TomVargheseJr
RT @coffeemommy: Excited about @asco, frustrated by embargoes and want to chat about the latest & greatest in early stage #lungcancer NOW?…
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?…
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 @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 affe…
Brendon Stiles @BrendonStilesMD
@dearmaizie Thanks for joining! #lcsm
#LCSM Chat @lcsmchat
@LungCancer_HU Hi Margot! #lcsm
Brendon Stiles @BrendonStilesMD
@DevikaDasMD @lcsmchat Glad you are here. #lcsm
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: In this week’s chat we hope to explore what’s new in early stage #LungCancer. #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?…
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 @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 @dtanz25
#LCSM
Timothy Craig Allen @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
Small Cell Lung Cancer @ES_SCLC
@BrendonStilesMD Yes, almost 100% of targeted and immunotherapy drugs for stage IV patients is for NSCLC. There is really nothing, except Tecentriq, for ES SCLC. Why almost 100% of funding goes to NSCLC and almost 0% to SCLC? I'm tired of this shit. Nothing makes sense. #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 fol…
#LCSM Chat @lcsmchat
@dtanz25 Welcome Deborah. #lcsm
Timothy Craig Allen @TimAllenMDJD
RT @BrendonStilesMD: T1. What advances might improve diagnosis of lung nodules found on CT scans? #lcsm
Matthew Steliga MD @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 @TimAllenMDJD
In vivo microscopy. #LCSM
H. Jack West, MD @JackWestMD
Med onc now at @cityofhope joining #LCSM chat from not that sunny SoCal... looking forward to an interesting topic.
Stacey Tinianov @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
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
#LCSM Chat @lcsmchat
@KatieKeaneMD Welcome! #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.…
Jill @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
Narjust Duma M.D. @NarjustDumaMD
@BrendonStilesMD A1: Learn and study pulmonary nodules in more depth with the hope to develop accurate prognostic tools #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 https://t.co/h1sRGBRpor
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 @pabloperezc
RT @BrendonStilesMD: T1. I strongly prefer to have diagnosis prior to surgery. Even highly suspicious nodules won’t be cancer at least 16%…
Small Cell Lung Cancer @ES_SCLC
@BrendonStilesMD And, as a result of lobbying of far left extremists -- feminists, women's organizations, liberal cucks, etc -- breast cancer is OVERFUNDED, and lung cancer UNDERFUNDED. Is this justice? People are dying. We need more funding. smarter scientists. #LCSM #LungCancer #BreastCancer https://t.co/mNlN0966up
Narjust Duma M.D. @NarjustDumaMD
@HenningWillers Agree! Not everything needs a needle. #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 per…
Robert C. Doebele @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 diffe…
#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%…
#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 @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 bro…
Stacey Tinianov @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 @NarjustDumaMD: @BrendonStilesMD A1: Learn and study pulmonary nodules in more depth with the hope to develop accurate prognostic tools…
Jill @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
Narjust Duma M.D. @NarjustDumaMD
@lcsmchat @JackWestMD @cityofhope 😆 #lcsm
Timothy Craig Allen @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
Narjust Duma M.D. @NarjustDumaMD
@jillfeldman4 @BrendonStilesMD love your answer! #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 @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
#LCSM Chat @lcsmchat
RT @NarjustDumaMD: @HenningWillers Agree! Not everything needs a needle. #lcsm
Timothy Craig Allen @TimAllenMDJD
#WhyPathologistsMatter #lcsm
Timothy Craig Allen @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 st…
#LCSM Chat @lcsmchat
RT @coffeemommy: @BrendonStilesMD Love this! As people are considering where to go for screening/care, are we finding these new platforms o…
Small Cell Lung Cancer @ES_SCLC
@BrendonStilesMD Our only hope is to attack lung cancer with the best scientific minds. There is simply not enough money for lung cancer research. We need a team of award winning scientists to outsmart lung cancer. We need to think different if we want to win this war. #LCSM #LungCancer https://t.co/HpQZRyBMcm
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T1. Critical for bronchoscopic biopsy to get enough tissue for molecular studies – EGFR, ALK, ROS1, etc. #lcsm https:…
#LCSM Chat @lcsmchat
RT @TimAllenMDJD: Biopsy provides accurate diagnosis, but is not without risk. #lcsm https://t.co/1RlKeWFapX
Brendon Stiles @BrendonStilesMD
T1. CT guided biopsy likely more accurate than bronchoscopic and is very safe in experienced hands. #lcsm https://t.co/Rv1UFHEsUa
Pablo Pérez Castro @pabloperezc
@BrendonStilesMD Thoracic Fellow from Toronto here. #LCSM.
Brendon Stiles @BrendonStilesMD
@ArpanAshokPatel I agree with you. WHEN is key. Most nodules are benign. #lcsm
Jill @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
#LCSM Chat @lcsmchat
RT @DevikaDasMD: @HenningWillers @lcsmchat Join in for virtual tumor boards with the closest facility #lcsm
Rosely Yamamura @RoselyYamamura
Hello! I’m a Medical Oncologist from Brazil! First LCSM Chat 🙂! #lcsm
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T1. Also key to follow up false negative results of suspicious nodules. Recent NAVIGATE study in @JTOonline showed l…
#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.c…
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 in…
Rachael @PollywogPrinces
RT @BrendonStilesMD: T1. CT guided biopsy likely more accurate than bronchoscopic and is very safe in experienced hands. #lcsm https://t.c…
#LCSM Chat @lcsmchat
RT @RoselyYamamura: Hello! I’m a Medical Oncologist from Brazil! First LCSM Chat 🙂! #lcsm
Timothy Craig Allen @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 Chat @lcsmchat
RT @BrendonStilesMD: T1. However, CT guided doesn’t allow staging with EBUS at same time and has more risk of pneumothorax #lcsm
Brendon Stiles @BrendonStilesMD
T2 coming soon. #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 mi…
Devika Das,MD @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 @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 mi…
#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 ti…
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 ti…
Denise Cutlip @dennycee
RT @RoselyYamamura: Hello! I’m a Medical Oncologist from Brazil! First LCSM Chat 🙂! #lcsm. Welcome!
Benjamin King, MD @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
H. Jack West, MD @JackWestMD
Could see exhaled volatile organic compounds (VOCs), eventually shed tumor DNA from a cancerous nodule (though would need to be much more sensitive than now)
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 co…
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 @DevikaDasMD
RT @BrendonStilesMD: T1. Also key to follow up false negative results of suspicious nodules. Recent NAVIGATE study in @JTOonline showed l…
Timothy Craig Allen @TimAllenMDJD
But CT guided biopsy usually provides more tissue for accurate diagnosis and molecular biomarker testing. #lcsm
Narjust Duma M.D. @NarjustDumaMD
@BrendonStilesMD Tissue is always the issue #lcsm
Timothy Craig Allen @TimAllenMDJD
RT @BrendonStilesMD: T2. What is “targeted surgical therapy”? When can lung cancer surgery take less tissue than a complete lobe (lobectom…
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 b…
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 @jillfeldman4
@NarjustDumaMD @BrendonStilesMD No meat, no treat :) #LCSM
#LCSM Chat @lcsmchat
@BenjaminKingMD1 @JackWestMD @cityofhope @CedarsSinai Welcome! #lcsm
H. Jack West, MD @JackWestMD
RT @BrendonStilesMD: T2. What is “targeted surgical therapy”? When can lung cancer surgery take less tissue than a complete lobe (lobectom…
Timothy Craig Allen @TimAllenMDJD
Some are getting it. #lcsm
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T2. What is “targeted surgical therapy”? When can lung cancer surgery take less tissue than a complete lobe (lobectom…
#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 @TimAllenMDJD
RT @BrendonStilesMD: T2. What is “targeted surgical therapy”? When can lung cancer surgery take less tissue than a complete lobe (lobectom…
#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…
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T2. What is “targeted surgical therapy”? When can lung cancer surgery take less tissue than a complete lobe (lobectom…
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 https://t…
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
#LCSM Chat @lcsmchat
RT @NarjustDumaMD: @BrendonStilesMD Tissue is always the issue #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 enoug…
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: @ArpanAshokPatel Indeed not, although in future perhaps. But enough tissue to accurately make diagnosis without multi…
#LCSM Chat @lcsmchat
RT @jillfeldman4: @NarjustDumaMD @BrendonStilesMD No meat, no treat :) #LCSM
#LCSM Chat @lcsmchat
RT @TimAllenMDJD: Some are getting it. #lcsm https://t.co/sZafwV7aXf
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 @TimAllenMDJD
Add the pathologist! #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
Devika Das,MD @DevikaDasMD
@PollywogPrinces @ArpanAshokPatel Absolutely ! This is an absolute night mare and leads to treatment delays #lcsm
Tim Kruser @TimothyKruserMD
Nice to see another #radonc out there with me @drewmoghanaki. Others here with us? #lcsm
Stacey Tinianov @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: The benefits & harms of screening for #LungCancer are complex. We developed a new @IARCWHO infographic based on @theNC
#LCSM Chat @lcsmchat
RT @TimAllenMDJD: Add the pathologist! #lcsm https://t.co/UuPvwLJHvq
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T2. The idea that every patient needs the same surgical procedure is antiquated – we used to think every patient need…
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 @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 @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 les…
#LCSM Chat @lcsmchat
RT @TimAllenMDJD: Sometimes additional procedures are necessary for diagnosis, but these situations should be minimized. #lcsm https://t.co…
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T2. CALGB has reported perioperative outcomes. Both sublobar resection and lobectomy are incredibly safe (1.4% 90 day…
#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 !o…
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 ima…
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 @TimAllenMDJD
Too common. Perhaps combining the Radiology and Pathology departments would help. #lcsm
Brendon Stiles @BrendonStilesMD
T2. Similarly, pathologic subtypes may play a role in who should get limited resection. #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
#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.…
Brendon Stiles @BrendonStilesMD
T2. Certainly, in screen detected lung cancers, less than a lobectomy may be preferred. https://t.co/AZmQ58XT0S #lcsm
#LCSM Chat @lcsmchat
RT @TimAllenMDJD: Too common. Perhaps combining the Radiology and Pathology departments would help. #lcsm https://t.co/ERTaaMRSsC
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 need…
H. Jack West, MD @JackWestMD
Glad to be carefully assessing value of "sub-lobectomy" for smaller (esp < 1 cm). Trials establishing lobectomy over sub-lobectomy were largely w/more squamous & larger cancers. Japanese surgeons really moving field forward, as they see lots of small, lower risk adenos. #LCSM
Devika Das,MD @DevikaDasMD
@TimAllenMDJD @lcsmchat What is an acceptable QNS rate for a high performanjng facility ? #lcsm
Jill @jillfeldman4
T2 More is not always better. Lung preservation is key #LCSM
Brendon Stiles @BrendonStilesMD
@TimothyKruserMD Coming next! #lcsm
Pablo Pérez Castro @pabloperezc
RT @DavidCookeMD: A2 CALGB/Alliance 140503 trial results are pending, but many surgeons suspect for peripheral < 2cm tumors, sublobar resec…
#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: Glad to be carefully assessing value of "sub-lobectomy" for smaller (esp < 1 cm). Trials establishing lobectomy over sub-lo…
Stephen V Liu @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 diffe…
#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…
Brendon Stiles @BrendonStilesMD
@TimAllenMDJD This would be the key to the kingdom! #lcsm
Pablo Pérez Castro @pabloperezc
RT @BrendonStilesMD: T2. CALGB has reported perioperative outcomes. Both sublobar resection and lobectomy are incredibly safe (1.4% 90 day…
#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 tis…
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
Brendon Stiles @BrendonStilesMD
@Chucktowndoc @ArpanAshokPatel Agree it is key to have rapid and on site path eval. #lcsm
Tim Kruser @TimothyKruserMD
RT @DavidCookeMD: In multifocal lung cancer, after multidisciplinary tumor board discussion we have had hybrid approaches, where resection…
Timothy Craig Allen @TimAllenMDJD
In my experience segmentectomy has sounded good but has not shown clearly superior outcomes over lobectomy. #lcsm
Jill @jillfeldman4
@BrendonStilesMD Amen. While I am now starting Tagrisso, I bought 10 years with that strategy! #LCSM
Timothy Craig Allen @TimAllenMDJD
RT @Chucktowndoc: @BrendonStilesMD @ArpanAshokPatel Always a good idea to do CT guided FNA first (with a pathologist present to confirm tis…
Brendon Stiles @BrendonStilesMD
T2. A previous editorial from me summarizing targeted surgical therapy. https://t.co/56Jtmby7UO #lcsm
Timothy Craig Allen @TimAllenMDJD
RT @BrendonStilesMD: T2. Technology also making remarkable advances in lung cancer surgery – whether video assisted or robotic. Advances…
H. Jack West, MD @JackWestMD
@ArpanAshokPatel @DevikaDasMD @PollywogPrinces The answer is no. There is no established or even anticipated value in doing NGS on a small pulm nodule, even if it's proven to be a cancer. Molecular testing is not clearly indicated for every lesion you can identify on a CT, nor for a stage I NSCLC. #LCSM
Brendon Stiles @BrendonStilesMD
@TimAllenMDJD This is true oncologically. Also doesn't always preserve as much lung as we would think. #lcsm
Timothy Craig Allen @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 @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 @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 @TimAllenMDJD
2d that, @BrendonStilesMD #lcsm
Jill @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. Fo…
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 @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: There is a high likelihood that in the future we'll cut less, and zap more with SBRT. This can leave more healthy lu…
H. Jack West, MD @JackWestMD
Goal isn't only or primarily to improve OS w/sub-lobectomy. Equal survival while preserving more lung & pulm function is a valuable goal.
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 https:/…
#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: @ArpanAshokPatel @DevikaDasMD @PollywogPrinces The answer is no. There is no established or even anticipated value in doing…
#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,…
Brendon Stiles @BrendonStilesMD
T3. OF COURSE it can be! The key is picking the right patients. #lcsm
#LCSM Chat @lcsmchat
RT @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 lu…
Timothy Craig Allen @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 al…
Janet Freeman-Daily @JFreemanDaily
RT @lcsmchat: @GalassoMarcos @pabloperezc @BrendonStilesMD #LCSM Chat happening now. What’s new in early stage Lung Cancer is the topic. Fo…
Timothy Craig Allen @TimAllenMDJD
RT @DavidCookeMD: Plenty of single institution data suggest for the right sized and location tumor, segmentectomy is oncologic equivalent.…
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
#LCSM Chat @lcsmchat
RT @coffeemommy: @DrewMoghanaki @jillfeldman4 Wondering if this might be the wave of the future for non-primary lung mets as well... though…
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 g…
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. Fo…
Timothy Craig Allen @TimAllenMDJD
RT @JackWestMD: Goal isn't only or primarily to improve OS w/sub-lobectomy. Equal survival while preserving more lung & pulm function is a…
#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 @BenjaminKingMD1
#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 @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 htt…
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 htt…
#LCSM Chat @lcsmchat
RT @jillfeldman4: T3 SBRT great option for inoperable patients or patients with co-morbidities such as COPD #LCSM
Brendon Stiles @BrendonStilesMD
@BenjaminKingMD1 @ASTRO_org I knew I would hear this one again! #lcsm
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T3. “Competition” between surgeons and #radonc leads to faster advances. Collaboration makes both techniques better.…
Henning Willers, MD @HenningWillers
T3. challenge with upfront SBRT salvage lobe is lack of upfront nodal eval #lcsm
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 @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 @TimAllenMDJD
RT @DrewMoghanaki: T3: A few well-designed randomized clinical trials are helping us answer when SBRT may be a good alternative. Here's the…
#LCSM Chat @lcsmchat
RT @DrewMoghanaki: T3: A few well-designed randomized clinical trials are helping us answer when SBRT may be a good alternative. Here's the…
H. Jack West, MD @JackWestMD
More & more data support this for sicker patients. Such patients are prone to die from other medical issues aside from lung cancer. I think real debate now is around whether stereotactic RT can replace surgery for pts who can tolerate surgery OK but wish to avoid it. #LCSM
Timothy Craig Allen @TimAllenMDJD
RT @BrendonStilesMD: T3. “Competition” between surgeons and #radonc leads to faster advances. Collaboration makes both techniques better.…
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 @TomVargheseJr
RT @BrendonStilesMD: T2. Several options for lung preservation now exist – wedge, segmentectomy, lobectomy. #lcsm https://t.co/T2Iu9RcCbq
Timothy Craig Allen @TimAllenMDJD
RT @BrendonStilesMD: T3. Proportionally, have seen steady increases in stereotactic radiation treatment of lung cancer patients. #lcsm htt…
#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 @BenjaminKingMD1
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 @TimAllenMDJD
RT @BrendonStilesMD: @TimothyKruserMD I like to split the left upper lobe. Also think just taking superior segment of lower lobes can be g…
Brendon Stiles @BrendonStilesMD
@HenningWillers This is not unimportant! #lcsm
Rachael @PollywogPrinces
Learning so much with this chat #lcsm
Devika Das,MD @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…
Jill @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 optio…
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: More & more data support this for sicker patients. Such patients are prone to die from other medical issues aside from lung…
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 @TimAllenMDJD
Perhaps. Often though resection of lung metastases does not improve survival. #lcsm
Jill @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
Dr. David Tom Cooke @DavidCookeMD
Reference? #LCSM
Benjamin King, MD @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
#LCSM Chat @lcsmchat
RT @TimothyKruserMD: @jillfeldman4 other reasons too sometimes. Had a healthy pt--caregiver for demented husband. Few days in hospital a no…
Jan Marie Eberth @jmeberth
Hi all! Cancer epidemiologist joining tonight’s from South Carolina. @USCArnoldSchool #lcsm
Timothy Craig Allen @TimAllenMDJD
RT @BrendonStilesMD: T3. And previous data suggests that SBRT may be a reasonable alternative for operable patients. https://t.co/HQaTqqM…
#LCSM Chat @lcsmchat
RT @BenjaminKingMD1: T3. SBRT definitely an option and selecting appropriate patients is best done in multidisciplinary setting so patients…
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T3. And previous data suggests that SBRT may be a reasonable alternative for operable patients. https://t.co/HQaTqqM…
Tom Varghese Jr. MD @TomVargheseJr
RT @BrendonStilesMD: T3. Proportionally, have seen steady increases in stereotactic radiation treatment of lung cancer patients. #lcsm htt…
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 tis…
#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 struct…
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. Fla…
Timothy Craig Allen @TimAllenMDJD
RT @Chucktowndoc: @JackWestMD @ArpanAshokPatel @DevikaDasMD @PollywogPrinces NGS may be the right call when Path specimen is limited. Bett…
Brendon Stiles @BrendonStilesMD
@ArpanAshokPatel Informed consent is key. #lcsm
Eon @eonhealth
RT @DavidCookeMD: Thank you @tedlieu ; remember #lungcancerscreening saves lives! #LCSM https://t.co/W6WmOKqj91
#LCSM Chat @lcsmchat
RT @Chucktowndoc: @JackWestMD @ArpanAshokPatel @DevikaDasMD @PollywogPrinces NGS may be the right call when Path specimen is limited. Bett…
#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 https://t.co/88CzzlfBVs
#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…
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 whil…
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 @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…
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.…
Timothy Craig Allen @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.…
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
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
Jill @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
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 @TimAllenMDJD
RT @Chucktowndoc: @DevikaDasMD @TimAllenMDJD @lcsmchat It’s not so much the quality of the facility as it is the adequacy of the specimen.…
#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 https://t.co/KxVs6S2SKK
Timothy Craig Allen @TimAllenMDJD
RT @BrendonStilesMD: T3. We still need to understand long term outcomes after SBRT, but it certainly may be a safer alternative in high ri…
#LCSM Chat @lcsmchat
RT @JFreemanDaily: @DevikaDasMD @ArpanAshokPatel @PollywogPrinces Yes, confusing. Targeted therapies for NSCLC are (for now) only approved…
#LCSM Chat @lcsmchat
RT @KatieKeaneMD: T3. Agree that multiD assessments critical, especially in those with multifocal ca who may benefit from combo of surgery…
#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 ri…
#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…
Brendon Stiles @BrendonStilesMD
@DavidCookeMD VALOR is getting there. #lcsm Randomization through pulmonologist is key. #lcsm
Timothy Craig Allen @TimAllenMDJD
RT @JFreemanDaily: @DevikaDasMD @ArpanAshokPatel @PollywogPrinces Yes, confusing. Targeted therapies for NSCLC are (for now) only approved…
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
#LCSM Chat @lcsmchat
RT @DrewMoghanaki: Well put, and a position that was endorsed by America's largest radiation oncology society. In 2017, @ASTRO_org publishe…
Devika Das,MD @DevikaDasMD
@Chucktowndoc @TimAllenMDJD @lcsmchat Thank you ! Is there a quality metric you follow ? There clearly is a difference based on the skill set #lcsm
Eden Lake @EdenLake
So late to party, but I was planting my new HOPE garden.. to complement/counterpoint my two memorial gardens @lcsmchat #lcsm
Brendon Stiles @BrendonStilesMD
T3. Whether surgery or SBRT, treatment should be discussed at MDT and tailored to individual patients. #lcsm
Stephen V Liu @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 https://t.co/W6WmOKqj91
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 #l
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 #l
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 @TimAllenMDJD
Hope is that liquid biopsy will solve the problem. But as yet it's not the answer for primary diagnosis. #lcsm
Stacey Tinianov @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
Devika Das,MD @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
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 @jillfeldman4
T3 Even early stage patient should always be evaluated by multidisciplinary team! #LCSM
Eden Lake @EdenLake
RT @BrendonStilesMD: T1. Critical for bronchoscopic biopsy to get enough tissue for molecular studies – EGFR, ALK, ROS1, etc. #lcsm https:…
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 @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
Fabio Y. Moraes, MD, PhD(c) @Fymoraes
@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
H. Jack West, MD @JackWestMD
@JFreemanDaily @DevikaDasMD @ArpanAshokPatel @PollywogPrinces Not unreasonable to do testing on a pt w/high risk of recurrence (e.g., st 3, maybe st 2), but pts w/stage I smaller cancers have low risk of recurrence, & if it happens, you should biopsy recurrence then. More important to treat current cancer than 1 from 2 yr earlier. #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 https://t.…
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 @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,…
#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,…
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: @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
Brendon Stiles @BrendonStilesMD
@DrewMoghanaki @jillfeldman4 I like to call it "education/experience/intuition based confidence" #lcsm
Stacey Tinianov @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
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T4. Right now, the answer is only in the context of clinical trials. #lcsm
Timothy Craig Allen @TimAllenMDJD
RT @Chucktowndoc: @DevikaDasMD @TimAllenMDJD @lcsmchat We’ve switched reference labs before because of QNS rates, but it’s hard to assess b…
#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 th…
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
H. Jack West, MD @JackWestMD
Not THAT compelling. Didn't show any pt actually LIVED longer, & you end up treating pts already cured w/prolonged EGFR TKI that has major cost & real tox. You may do just as well treating only pts who recur, at time of relapse. That's also a compelling strategy. #LCSM
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T4. Large RADIANT trial examining adjuvant EGFR TKI after resection was negative statistically, but compelling for EG…
#LCSM Chat @lcsmchat
RT @JackWestMD: @JFreemanDaily @DevikaDasMD @ArpanAshokPatel @PollywogPrinces Not unreasonable to do testing on a pt w/high risk of recurre…
#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 cl…
Devika Das,MD @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 sur…
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 fe…
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…
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T4. Recently, there have been some small trials using targeted therapy in the neoadjuvant space, a concept which I lo…
#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…
#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 r…
Stacey Tinianov @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 locati…
#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) -…
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…
Enlightening Results @GraceCordovano
RT @BrendonStilesMD: T4. My personal opinion is that adjuvant trials are long, large, and marginal (MAGRIT, RADIANT, bevaciz, etc). I love…
#LCSM Chat @lcsmchat
RT @JackWestMD: Not THAT compelling. Didn't show any pt actually LIVED longer, & you end up treating pts already cured w/prolonged EGFR TKI…
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
Stacey Tinianov @coffeemommy
@DrewMoghanaki @BrendonStilesMD 280 is even better! Thank you for the extra context! #lcsm
Rachael @PollywogPrinces
RT @TimothyKruserMD: T4. Surgery (or SBRT) should always be 1st line. They cure. Drugs unfortunately to this point only slow growth (but th…
#LCSM Chat @lcsmchat
RT @DrewMoghanaki: @aki_alzubaidi @BrendonStilesMD This is a great point. Especially since approximately 50% of lung cancer surgeries in th…
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T4. CTONG 1103 showed that neoadjuvant erlotinib prolonged PFS in patients w/ stage III EGFR mutated tumors compared…
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…
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T4. Recent @JTOonline publication with neoadjuvant crizotinib for ALK rearranged lung cancer patients showed 91% PR b…
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%…
#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: Not THAT compelling. Didn't show any pt actually LIVED longer, & you end up treating pts already cured w/prolonged EGFR TKI…
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 no…
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.…
Eden Lake @EdenLake
RT @BrendonStilesMD: T3. @DrewMoghanaki VALOR trial will be pivotal and is accruing well. #lcsm https://t.co/UAbEhkoCG5
Brendon Stiles @BrendonStilesMD
T5. Is there a role for immunotherapy in patients with early stage lung cancer? #lcsm
Devika Das,MD @DevikaDasMD
RT @JackWestMD: Not THAT compelling. Didn't show any pt actually LIVED longer, & you end up treating pts already cured w/prolonged EGFR TKI…
Eden Lake @EdenLake
RT @JFreemanDaily: @DevikaDasMD @ArpanAshokPatel @PollywogPrinces Yes, confusing. Targeted therapies for NSCLC are (for now) only approved…
Jill @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 Duma M.D. @NarjustDumaMD
@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 r…
#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…
#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 r…
#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
Denise Cutlip @dennycee
@ArpanAshokPatel #lcsm exciting time to be a patient too.
Martin Angel @Tincho_Angel
#oncologia #lcsm @flor_reinhold @juandfar @MariaBluthgen @RodRogSan https://t.co/QdNXW2UFbW
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
Eden Lake @EdenLake
RT @BrendonStilesMD: Time to move past local therapy and on to systemic. Too many “early stage” lung cancer patients recur. Higher rates…
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 @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 @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 @jillfeldman4
@BrendonStilesMD and @DrewMoghanaki at it live on #LCSM chat! https://t.co/XWuhyT16DH
Narjust Duma M.D. @NarjustDumaMD
@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…
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. Im…
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…
#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…
#LCSM Chat @lcsmchat
RT @KatieKeaneMD: T5. Trials of IO-SBRT in early stage inoperable patients are also critical #lcsm
Tim Kruser @TimothyKruserMD
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 surgica…
#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 @TimAllenMDJD
RT @BrendonStilesMD: T5. A 45% major pathologic response was reported in @NEJM for lung cancer patients getting nivolumab prior to surgica…
Devika Das,MD @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 respon…
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: #lcsm https://t.co/UOCWFZG8uf
Matthew Steliga MD @SteligaMD
RT @BrendonStilesMD: T5. A 45% major pathologic response was reported in @NEJM for lung cancer patients getting nivolumab prior to surgica…
Brendon Stiles @BrendonStilesMD
T5. LCMC3 multicenter trial reported good rates of response to neoadjuvant IO. #lcsm https://t.co/P1LALM3oXo
Ian Pereira @IanJPereira
@BrendonStilesMD Interesting conclusion by the authors of that study :) #lcsm T3
#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 thoraci…
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…
#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 @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…
Eden Lake @EdenLake
RT @BrendonStilesMD: T4. Need to understand effect of neoadjuvant therapy on resistance mechanisms in targetable mutation driven tumors.…
Brendon Stiles @BrendonStilesMD
T5. The LCMC group also presented excellent safety data with neoadjuvant immunotherapy. https://t.co/tWFgaM9EDb #lcsm
Dr. David Tom Cooke @DavidCookeMD
RT @DevikaDasMD: @BrendonStilesMD T5 potential benefits of neoadjuvant therapy #lcsm https://t.co/hquoLPzdgT
Timothy Craig Allen @TimAllenMDJD
RT @BrendonStilesMD: T5. We just presented a study that showed complications with neoadjuvant IO aren’t really any different than with neo…
Eden Lake @EdenLake
RT @BrendonStilesMD: T5 coming….like everything, moving onto immunotherapy! #lcsm
Timothy Craig Allen @TimAllenMDJD
RT @BrendonStilesMD: T5. In our trial with neoadjuvant durvalumab and low dose SBRT, I have seen terrible tumors completely killed. Here…
KC Dill @kasedill
RT @BrendonStilesMD: T5. In our trial with neoadjuvant durvalumab and low dose SBRT, I have seen terrible tumors completely killed. Here…
Eden Lake @EdenLake
RT @jillfeldman4: T4 Is there a chance that treating with TKI post op will hasten development of resistance by enhancing EMT? If TKI could…
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
Eden Lake @EdenLake
RT @BrendonStilesMD: T5. Of course there is! Lots of ongoing trials. From @PeerView #lcsm https://t.co/qAjhIeU4nE
#LCSM Chat @lcsmchat
RT @BrendonStilesMD: T5. In our trial with neoadjuvant durvalumab and low dose SBRT, I have seen terrible tumors completely killed. Here…
#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 neo…
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
Eden Lake @EdenLake
RT @BrendonStilesMD: T5. And these with both neoadjvuant and adjuvant. #lcsm https://t.co/hFK0AFuN0s
#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 @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
Eden Lake @EdenLake
RT @BrendonStilesMD: #lcsm https://t.co/UOCWFZG8uf
Eden Lake @EdenLake
RT @BrendonStilesMD: T4. Back to targeted. Forgot to share this. #lcsm https://t.co/78x947BFml
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
Eden Lake @EdenLake
RT @DevikaDasMD: @BrendonStilesMD T5 potential benefits of neoadjuvant therapy #lcsm https://t.co/hquoLPzdgT
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 w…
H. Jack West, MD @JackWestMD
T5. Neoadjuvant is great "window of opportunity" setting, but w/results just in a few dozen pts here & there, it's still just proof of principle. At end of day, pathologic response is really of value only to extent it predicts vy good clin outcome, esp survival. #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…
Dr. David Tom Cooke @DavidCookeMD
RT @LeciaSequist: @BrendonStilesMD Companion tests looking for biomarker signatures in blood, urine, and/or breath. We have so much opportu…
Timothy Craig Allen @TimAllenMDJD
It has been a privilege to participate. #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
Shilpa Gupta @shilpaonc
RT @JackWestMD: T5. Neoadjuvant is great "window of opportunity" setting, but w/results just in a few dozen pts here & there, it's still ju…
Jill @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 @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…
Denise Cutlip @dennycee
#lcsm I learned much tonight. Thank you.
H. Jack West, MD @JackWestMD
RT @BrendonStilesMD: Thanks to all of the #lcsm community who joined. And BIG thanks to all of our new folks tonight. Incredible turnout!…
#LCSM Chat @lcsmchat
RT @KatieKeaneMD: @BrendonStilesMD Have you found neoadj IO makes resection more challenging? Or similar to neoadjuvant chemo/ chemoRT? #lc
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 the…
H. Jack West, MD @JackWestMD
Well done! #LCSM
Brendon Stiles @BrendonStilesMD
@HenningWillers Agree and thanks for joining. #lcsm
Dr. David Tom Cooke @DavidCookeMD
Great chat everyone! Thanks @BrendonStilesMD @lcsmchat #LCSM
#LCSM Chat @lcsmchat
RT @JackWestMD: T5. Neoadjuvant is great "window of opportunity" setting, but w/results just in a few dozen pts here & there, it's still ju…
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 @LeciaSequist: @BrendonStilesMD Companion tests looking for biomarker signatures in blood, urine, and/or breath. We have so much opportu…
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!…
Rachael @PollywogPrinces
RT @TimothyKruserMD: Closing thoughts--these are tremendous chats. Learn a lot. Great data sharing for pts & MDs alike. Thanks to @brendons
#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 pat…
#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 (hope…
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 @brendons
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
Eden Lake @EdenLake
Sorryto be late, glad to catch up, will be through more thorpughly later. Big blood labs after grandsons birthday this month, low dose ct scan for my bday in June. Please think good thoughts for me. #lcsm
#LCSM Chat @lcsmchat
RT @LeciaSequist: @BrendonStilesMD I think as our drugs become more selective and are better tolerated, neoadjuvant targeted therapy is a g…
#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…
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: @BrendonStilesMD was amazing. Terrific leadership once again for tonight's chat. We are all more knowle…
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…
Devika Das,MD @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: @BrendonStilesMD was amazing. Terrific leadership once again for tonight's chat. We are all more knowle…
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 @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 b…
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 @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 @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…
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: screening. Three (y…
Tim Kruser @TimothyKruserMD
RT @LeciaSequist: @BrendonStilesMD We in the #LCSM tribe need to take charge of educating the 🌎🌍🌏 about #lungcancer re: screening. Three (y…
Timothy Craig Allen @TimAllenMDJD
RT @JFreemanDaily: Great discussion of early stage #lungcancer tonight, #LCSM Chat! As a patient, I'm very encouraged by the new treatment…
Dr. Matthew Schabath @MatthewSchabath
The latest issue of 'Science, Society, and Sports'! https://t.co/1irgpGSHrI Thanks to @erinhsiao3 @BrendonStilesMD @QMBCI #lcsm #bcsm
Kimberly Buchmeier @kimbuchmeier
RT @AngieBDerrick: Why lung cancer is the deadliest cancer type and many patients suffer in silence https://t.co/8Tx4r3NZYB via @postandcou
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
#LCSM content from Twitter.