#FDA recently approved #pembrolizumab- a tissue agnostic indication in metastatic tumors with high #TMB (>10 mut/MB) using Foundation One Dx companion diagnostic test. I want to share a tweetorial on why this indication could be problematic and hope to share some nuances on #TMB

City of Hope welcomes Dr. Christine M. Lovly as head of our national thoracic oncology program. A leader in lung cancer research and care, Dr. Lovly brings deep expertise in precision medicine to help improve outcomes for patients nationwide. More: https://t.co/BPCenCWIYL

A magical evening celebrating @cityofhopeoc. Huge congrats to our fearless leaders @AWalkerHealth & @DrEdKim, as well as our visionary CEO Robert Stone, who have guided us through a remarkable expansion. I recall when @franksstillhere brought up the notion of @cityofhope opening

Sucralose consumption ablates cancer immunotherapy response through microbiome disruption ⁦@CD_AACR⁩

1/ We are thrilled to share our latest research in Cancer Discovery! Grateful to all collaborators in this work, work led by Paul Mischel and Ben Werner, and to @drimrannoorani and @magnushaughey for driving this work! Special thanks: team eDyNAmic, UCL, @TheCrick , and CGC/CRUK

To my friends at #WCLC25: please check out this incredible poster from @CityofHopeChi faculty member @AmitKulkarniMD. Amit joined us from @UMNCancer where he had cultivated an interest in #microbiome work & specifically fecal microbiome transplant (#FMT) . He wrote & received

On a recent work trip to the UK 🇬🇧, met with my aunt, @drkalyanipal (my dad’s little sis). She worked at @GSTTnhs & @ICR_London. I knew she spent a considerable amount of time in the lab, but had no idea she did early foundational work linking polycyclic aromatic hydrocarbons

Also published in @NEJM #MARIPOSA trial reassuring to see similar HR 0.75 MARIPOSA VS FLAURA2 - Overall similar results, different side effects, and $$ . Will access and patient preference determine selection of regimen ?

#WCLC25 Presidential symposium Dr. Planchard presenting #FLAURA2 OS data, HR =0.77, 12% absolute benefit at 3 yrs, with 72% of patients in Osi arm getting subsequent platinum chemo 🙌 ➡️longer period of osi treatment duration in combo arm ➡️Median time on chemo ~8 months

14/14 Lastly, I am very grateful to my current institution @cityofhope, and the leadership @DrRaviSalgia @AlanBryce9 for supporting to opening the study at Phoenix @cityofhope, hopefully very soon !!

13/14 Grateful to my mentors at @UMNews, Dr. Manish Patel and Dr. Robert Krazke, for their unwavering support. Thanks to AstraZeneca for supporting the study

12/14 Excited to report that the randomized trial is now enrolling, where participants will be randomized to RMT or placebo in a double-blinded fashion ➡️It was a very challenging study to execute and enroll. 🙏Thanks to the patients and the families for their contribution

11/14 ➡️Confirmed ORR was 50%, with 2 CR and 3 PR ➡️ Durable response lasting >24 months in 3/5 responders (across all PD-L1 levels) ➡️16S rRNA seq showing significantly higher abundance of Colinsella in responders vs non-responders (previously reported by Matson et al 2018)

10/14 Grade ≥3 TEAE were consistent with the known AE profile of the combination doublet chemoIO ➡️Common AE related to RMT were diarrhea, bloating, constipation, anorexia, and fever ➡️No Rx discontinuation was related to RMT ➡️ No cases of bacteremia or Rx-related deaths

9/14 ➡️Data cut-off was March 19, 2025, with a median follow-up time of 15 months ➡️Median age is 62 years, 50% were female, and all patients had adenocarcinoma histology ☠️One grade 5 AE (Respiratory failure was related to disease progression)

8/14 RMT was initiated 1 week before C1D1 of chemoIO, and received a weekly dose (3-4 capsules/dose) for 16 weeks during the induction phase of chemoIO ➡️Here we present the preliminary safety and efficacy of RMT in the open-label safety run-in phase (first N=10 patients)

7/14 The safety of RMT has been previously established in cancer (BMT/AML) and non-cancer settings (C. diff), with several ongoing studies for other indications ➡️We used treatment-naive metastatic NSCLC as study population 🎯 The co-primary endpoints are safety and efficacy

6/14 We collaborated with Dr. Khoruts @UMNews to test the 💊encapsulated FMT product he pioneered for Rx of #recurrent C.Diff as an adjunct to chemoIO backbone (#POSEIDEN durva/treme/chemo). We named this FMT product restorative microbiota therapy (RMT)

5/14 Several leading investigators have shown the feasibility of bacterial Rx with IO, either by utilizing bacterial consortia, colonoscopic/encapsulated FMT from IO responders, or encapsulated FMT from healthy donors, showing promising results

4/14 Following the first protocol draft in 2019, I presented @ASCO @AACR #Vailworkshop all excited to finalize the draft Thanks to COVID-19, the study was shelved ➡️Late 2022, after several changes in protocol due to evolving SOC, the study opened at @UMNews