Stephen V Liu, MD
@StephenVLiu
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Director of Thoracic Oncology & Developmental Therapeutics @Georgetown @LombardiCancer ; Host @IASLC Podcast; Chair #DCLung24 #TexasLung24 #HereWeGo
Georgetown, Washington, DC
Joined September 2011
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Saturday, June 1, 7pm CDT at
#ASCO24
- join Drs.
@benlevylungdoc
@JessicaJLinMD
@peters_solange
and me for a free comprehensive
#CME
symposium on targeted therapy in NSCLC. We cover it all in 90min! Register now, live/virtual:
[]
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@JimPSP
@JustAnother_Ben
Why would you not accept a telemedicine visit? This would be preferred if the patient had a contagious illness and is no less valid than a clinic visit.
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2K
How I spend a non-clinic, academic day:
20% calling patients
20% catching up on emails
20% filling rx, reviewing scans
20% meet w/ collaborators
20% admin meetings / P&T / DSMB etc
20% prior auth, FMLA forms etc
20% teaching, preparing talks
20% reading
20% charting
20% clinic
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@ReutersScience
After watching My Octopus Teacher, I can't imagine something like this existing. Very against this.
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@OrangePaulp
Tracy: The subtle racism of lowered expectations. My man Bing Crosby said that.
Jack: I think you mean Bill Cosby.
Tracy: That’s racist!
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@jtrebach
There are old mushroom hunters. And there are bold mushroom hunters. But there are no old, bold mushroom hunters.
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@TheHyyyype
This joke is perfect except it reminds me that Olive Garden gave the slogan to Jimmy Fallon. I think he then gave it to Post Malone? The world is so weird.
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I know we're far from perfect, but this is how I feel after almost every meeting with a clinical trial monitor
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Tom Brady: You would have NOT have liked me back then. Red hat. Slicked back hair. White bathing suit. Sloppy steaks. White couch.
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@humidfluid
@TheHyyyype
If I stand like that, I'm still on my way to do whatever errand I was assigned - just pausing, not sitting and watching...
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PACIFIC-2 does not meet PFS endpoint. Phase III study of concurrent chemoradiation + duvalumab vs CRT alone for stage III NSCLC. Toxicity? Negative interaction? Or due to intrinsically different population: PACIFIC enrolled only those who completed CRT.
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Working from home is a mixed bag but an outdoor working lunch with my fav co-worker is a definite plus!
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#ASCO20
Characterization of 4,712
#KRAS
NSCLC cases shows G12C is the most common subtype (40%) and among the different KRAS mutations, differences noted in PDL1, TMB, STK11 and others. Different KRAS mutation = different biology.
#OncoAlert
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Live shot of me on hold forever trying to appeal an insurance denial on a staging PET/CT.
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Atezolizumab now FDA approved for first line treatment of ES-SCLC with carboplatin and etoposide based on IMpower 133: improvement in overall survival (HR 0.70), first in decades. Extremely proud to have been a part of this pivotal study.
#LCSM
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PACIFIC 5y update
@JCO_ASCO
. Phase III study of durvalumab (anti-PDL1) for 1y after chemoradiation for unresectable stage III NSCLC. mOS 47.5 vs 29.1m (HR 0.72); 5y OS rate 43% vs 33%. mPFS 16.9 vs 5.6m (HR 0.55); 5y PFS rate 33% vs 19%.
@OncoAlert
#LCSM
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Dear trial sponsors and CROs. Please take a moment to review your shipping procedures. This getup was for two EDTA tubes of blood. It could hold like two thousand. Why?
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More data showing the importance of *waiting* for NGS results before starting NSCLC therapy whenever possible!
Retrospective analysis
@JCOOP_ASCO
show that when treatment of driver+ NSCLC before biomarker results is associated with inferior survival.
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Thanks to
@cancerGRACE
for this unexpected but greatly appreciated honor. All the more meaningful to receive it from
@JackWestMD
- a mentor and a true friend.
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#ESMO23
Dr.
@DoctorJSpicer
presents OS data from KEYNOTE 671: neoadjuvant pembrolizumab + chemotherapy followed by surgery and adjuvant pembro x 1 year. Perioperative IO improves survival. OS HR 0.72, 3y OS rate 71% vs 64%, impressive tails. Now an FDA approved standard.
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Amazing melanoma data
@JCO_ASCO
. Long term outcomes with nivolumab + ipilimumab (CheckMate 067) in pts with metastatic melanoma show median OS 72m, median melanoma-specific survival not yet reached. Reporting 6.5y OS rate of 57% in BRAF+ and 46% in BRAF-!
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FDA approves first perioperative immunotherapy regimen for resectable NSCLC. Based on KEYNOTE 671,
#neoadjuvant
pembrolizumab + chemotherapy followed by one year of adjuvant pembrolizumab now FDA approved for pts with resectable (T≥4 cm or N+) NSCLC.
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Adjuvant alectinib significantly improves DFS for resected
#ALK
NSCLC! Phase III ALINA trial meets primary endpoint, per press release. Given tolerability, potency, CNS efficacy - fully expected ALK to follow/surpass ADAURA/EGFR paradigm. Await full data.
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As study coordinators, data managers, and regulatory managers get recruited away to sponsors and CROs, I think that staffing shortages represent a major threat to academic research and the types of trials universities can open. And I think it will get worse before it gets better.
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Aggregate safety data for pembrolizumab monotherapy across trials in European Journal of Cancer with Dr.
@JulieBrahmer
et al (n=8937). G3+ AEs in 51% of pts, discontinuation from AE in 13%, fatal AEs 6%. Median time to immune-mediated AE was 85d.
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Me shouting at 1:00 - I’ll be in the office watching the plenary!
Me shouting at 1:05 - who gave her a kazoo?
#ASCO20
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Survival benefit in ADAURA: adjuvant osimertinib for resected
#EGFR
NSCLC hits secondary endpoint of overall survival. For those not convinced by the profound DFS benefit (HR 0.23 in stage II/IIIA), we now have OS data.
@FordePatrick
@DrSteveMartin
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Great discussion of KEYNOTE 671 by Dr.
@DrMarkAwad
at
#ASCO23
. Notes challenges of comparing studies given differences in populations. But EFS curves do appear to widen over time and plateau - perhaps more than CM816. And data more reassuring with longer f/u than AEGEAN.
#LCSM
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@FootbaIIism
Also: Joe Theismann had a secretary named Lincoln and Alex Smith had a secretary named Kennedy.
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Clinical trials are often the most promising option in cancer. Medicaid, which disproportionately covers minority & rural populations, is the only major payor that doesn't cover routine trial costs. Close the coverage gap, reduce disparities, and improve care!
#ASCOAdvocacySummit
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Ready for the
#ASCO22
lung orals with Drs.
@JackWestMD
@n8pennell
@AlexSpiraMDPhD
@Jbauml
@benlevylungdoc
and Camidge!
#LCSN
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Congratulations to Dr.
@FordePatrick
who delivered a wonderful award lecture on neoadjuvant chemo-immunotherapy. CheckMate 816 is a landmark study, to be followed by several others including NEOCOAST.
#WCLC22
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Press release: KEYNOTE 671 (neoadjuvant chemotherapy + pembrolizumab, surgery, adjuvant pembro x 1y for resectable NSCLC) meets OS endpoint. Had already met EFS endpoint, now news that perioperative IO led to significant improvement in survival.
#ESMO23
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#ESMO20
Happy to share the first results of RAIN-701, a phase II study of
#tarloxotinib
in patients with NSCLC harboring an
#EGFR
exon 20 insertion or an activating
#HER2
mutation and any solid tumor with an
#NRG1
or ERBB gene fusion.
#LCSM
@OncoAlert
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#OncoAlert
Today,
@FDAOncology
approved sotorasib (AMG 510) for
#KRAS
G12C NSCLC after at least 1 prior therapy. KRAS is in ~25% of NSCLC and G12C is the most common mutation. Approval based on CodeBreak100 with RR 37%, PFS 6.8m. Major impact.
#LCSM
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Details of ADAURA aside, can we compliment Dr.
@bensolomon1
on coordinating his suit and tie to the
#ASCO23
slide template colors?!!
#ASCOfashion
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Congratulations to Dr.
@FordePatrick
- recipient of the 2022 Daniel C. Ihde Lectureship for Medical Oncology! Very well deserved!
#WCLC22
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@sheelasinharoy
Unacceptable - please send a note to the editor as this reviewer really should be removed from their list of potential reviewers. Seeing these types of reviews is what makes me accept too many reviewer requests - just to make sure unqualified reviewers aren’t then pulled in.
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If you hear some weird “thwock” noises during our zoom meeting, I don’t know, it must be your connection cause I don’t hear it.
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TROP2 overexpression in NSCLC associated with primary resistance to immunotherapy
@CCR_AACR
. Increased TROP2 expression associated with worse PFS and OS with PD-L1 blockade (no impact on chemo) and associated with decreased T-cell infiltration.
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Press release: phase III LAURA trial meets primary endpoint. Stage III
#EGFR
NSCLC post chemoradiation, indefinite osimertinib superior to placebo. No surprise - eager to see magnitude of benefit, patterns of relapse, OS trends, and crossover rate…
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What is the optimal strategy for unresectable stage III NSCLC after chemoradiation in
#EGFR
mutant NSCLC? Retrospective look
@JTOonline
(n=136) shows 2y rwPFS rate 86% with osimertinib, 30% w/ durvalumab, 27% w/ observation. Await prospective data from the phase III LAURA trial.
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A warm
#NYLung23
Happy Birthday to our best friend
@HosseinBorghaei
from
@DrSteveMartin
and the whole team
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#OncoAlert
Entrecrinib approves today for ROS1 positive NSCLC and approved for NTRK+ tumors (tumor agnostic). Great to have a highly CNS penetrant option available.
#LCSM
’s-Rozlytrek-entrectinib-People-ROS1-Positive
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If I have not yet responded to your email, please accept my apology but take solace in knowing that you are not alone.
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Thanks to all who came to
#TexasLung23
including our outstanding faculty! Hope to see you all next year at Austin City Limits, April 18-21 for
#TexasLung24
!
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#OncoAlert
Update from PACIFIC (consolidation durvalumab after chemoradiation in stage III NSCLC)
@JTOonline
by Dr.
@finn_corinne
et al. Durva improved median OS (47.5m vs 29.1m), 4y OS rate (49.6% vs 36.3%), and 4y PFS rate (35.3% vs 19.5%).
#LCSM
@IASLC
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NRG-LU002 does not meet phase II PFS endpoint. Randomized study of the addition of local ablation (SBRT, surgery) to systemic therapy alone for oligometastatic NSCLC. Will need to examine these data very closely as they unfold.
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This is hard to watch. He’s not debating. He’s arguing, rambling, lying. There’s nothing presidential about this behavior. I cast my ballot already. We all have to do the same.
#VoteEarly
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New naming system for antibodies. "mab" stem being dropped for "tug", "bart", "mig", or "ment" in this new system. Reflects the complexity and heterogeneity of therapeutic antibody products in development.
#MedTwitter
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@ITYSL
@BetterCallSaul
@mrbobodenkirk
This man is my friend. We go way back. We’re the same age. We know the same things. I know his wife. This man is me. Future me. Past me. Present me. We’re gonna be ok. We’re gonna get better.
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Perioperative immunotherapy for resectable NSCLC will be a very crowded space. Press release tells us AEGEAN and KEYNOTE 671 hit their endpoints. Expect a lot of cross-trial comparisons over the next year or two. Ready for the next wave of trials to further refine delivery!
#LCSM
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Phase I study of intrathecal pemetrexed for pts (n=23) with lung adeno and leptomeningeal metastasis
@ClinicalLung
. RR 44%, DCR 83%, mPFS 6.3m, mOS 9.5m. Dose is 30mg pemetrexed d1 and d8 q21d. Ommaya reservoir led to higher concentrations than serial LP.
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Reminder that Tim Robinson's love affair with the hot dog goes back pretty far, even before ITYSL.
@ITYSL_memes
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Brace yourself for a plethora of perioperative immunotherapy trials for NSCLC reading out in the near future. Highlights here from Prof.
@t_mitsudomi
at
#ESMOAsia22
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