
#TumorBoardTuesday
@tumorboardtues
Online Tumor Board with a molecular angle ~ Join us every Tuesday 8pm ET for discussions, polls, & mini tweetorials โข Created by @MPishvaian โข FREE CME
ID: 1338667350829244428
https://linktr.ee/TumorBoardTues 15-12-2020 02:09:08
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#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 9/17 #TumorBoardTuesday ๐จ๐ฝโ๐ซMini Tweetorial 7๐จ๐ฝโ๐ซ LT-005 enrolled ~740 patients, despite of VHL status ๐ฒ 1:1 everolimus ๐ฅ belzutifan ๐ฅ 1o. EP of PFS / OS. โฌ๏ธPFS at 18 mo. (24% vs 8%, p < 0.05) โค๏ธ OS of 21.4 vs 18.1 mo (ns).


#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 10/17 #TumorBoardTuesday ๐จ๐ฝโ๐ซMini Tweetorial 8๐จ๐ฝโ๐ซ ๐ฉปBest ORR (~22% vs. 3.5%) โฑ๏ธmTTR of 3.8 vs 3.7 mo. โ๏ธmDoR of 19.5 vs 13.7 mo. ๐จ34% had early PD with belzu.

Paulo Amaral, MD #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #TumorBoardTuesday When I use everolimus for NETs, it can be kind of hard to tolerate. Do you all the same experience in RCCโ

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 11//17 #TumorBoardTuesday ๐จ๐ฝโ๐ซMini Tweetorial 9๐จ๐ฝโ๐ซ HIFi causes โฌ๏ธ EPO, anemia๐ฉธ most common AE, G3 ~33% ๐ซ Hypoxia, AE of interest (G3 ~11%), mechanism is unclear. โฑ๏ธMedian time for both AEs ~ 1 month. ๐ก Mgmt: ๐ ESAs (anemia), oxygen (hypoxia), and โฌ๏ธ dose.


#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 12/17 #TumorBoardTuesday ๐จ๐ฝโ๐ซMini Tweetorial 10๐จ๐ฝโ๐ซ Despite ~62% grade 3-5 AE in both arms Belzu had โฌ๏ธ tx related discontinuation (~6% vs 15%) Different safety profile ( โฌ๏ธrash, stomatitis, hyperglycemia, pneumonitis)

Paulo Amaral, MD #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #TumorBoardTuesday Any๐งฌ๐ฌbiomarkes that predict for response/benefit from belzutifanโ

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 13/17 #TumorBoardTuesday ๐จ๐ฝโ๐ซMini Tweetorial 11๐จ๐ฝโ๐ซ ๐ ๐ฏ ๐ belzutifan-based combinations are being tested in refractory RCC


Paulo Amaral, MD #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #TumorBoardTuesday Any concerns about adding an ESA with an active malignancy (RCC)โ โ๏ธOr is it just a risk-benefit decisionโ

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 14/17 #TumorBoardTuesday ๐จ๐ฝโ๐ซMini Tweetorial 12๐จ๐ฝโ๐ซ A ph3 trial is testing a HIFi โTKI vs. TKI monotherapy post-IO tx.


Paulo Amaral, MD #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #TumorBoardTuesday Hmmm - it seems like the lenvatinib is doing the bulk of the work here?

Mike Pishvaian #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers So far, we do not have an biomarker that predicts responde to belzutifan

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 15/17 #TumorBoardTuesday ๐จ๐ฝโ๐ซMini Tweetorial 13๐จ๐ฝโ๐ซ ๐Prospective randomized trials are needed. LITESPARK-012 is testing triplets regimens in frontline Arm A using IO โ TKI โ belzu.


#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 16/17 #TumorBoardTuesday ๐จ๐ฝโ๐ซMini Tweetorial 14๐จ๐ฝโ๐ซ ๐ New HIFis, like Casdatifan, are on the way ORR ~33% on 100 mg QD PEAK-1 trial (CAS + CABO vs. CABO + PBO)


Paulo Amaral, MD #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #TumorBoardTuesday What's the toxicity of belzutifan + lenva? Lenvatinib can also be tough to tolerate (especially for HCC patients). Wonder how much the belza adds to this?

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 17/17 #TumorBoardTuesday ๐ to our case๐ทOur pt s/p PD IO-TKI, PR w/ belzu, w/ & tolerance. ๐ทPt selection consider: ๐ท disease volume, ๐ทorgan function, ๐ทtoxicities ๐ท Attention to anemia and hypoxia.๐คฎ๐โผ๏ธ


#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #PostTest Q1๏ธโฃ #TumorBoardTuesday ๐๐ฝ#CME Eval ๐ integrityce.com/TBTeval25 ๐๐ฝALL CME๐ integrityce.com/TBT2025 ๐ง 70-year-old mccRCC pt progressed on axi + pembro โ cabo. Next?

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #PostTest Q2๏ธโฃ #TumorBoardTuesday ๐๐ฝ Free CME ๐ integrityce.com/TBT2025 Most common belzutifan-related AEs & median onset in RCC?

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers David Muniz

Mike Pishvaian #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers Once decreased EPO is the reason for anemia, EPO replacement was encouraged in LT-005 protocol. However safety analysis is still lacking. In clinical practice, it seems to be safe enough.

Mike Pishvaian #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN ๐๐ก๐๐ง๐๐ฅ๐๐ซ ๐๐๐ซ๐ค ๐๐ ๐ ๐๐๐ jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers Hard to tolerate and low efficacy...