Gallbladder Cancer

Hey #MedTwitter what’s your take for 3rd line treatment in HER2 3+ gallbladder #cancer currently achieving stable disease under FOLFIRI? @DrAngelaLamarca @ArndtVogel @SaborowskiAnna @JavleMilind @pashtoonkasi @MPishvaian @SebLange #PrecisionMedicine @OncoAlert 🚨 (@BenWestphalen)

Many people suffer from subclinical scurvy. Caused by Vitamin C deficiency. The implications are many - osteoarthritis, stroke, gall bladder disease, cancers and heart disease. https://t.co/pKyZ4XSEiR. (@ForgiveAll777)

How was the diagnosis of cancer made? What happened to those patients? Professor @ewenharrison has just discussed the importance of capturing gallbladder cancer in the #GECKO study. @NIHR_GSU @GlobalSurg #GlobalSurg4 #GECKO #Cholecystectomy (@gecko_study)

If you haven’t registered your center in the US and elsewhere please do. A great international center looking at outcomes of cholecystectomy including subtotal, incidental gallbladder cancers, etc 🌎 @gecko_study @CovidSurg @GlobalSurg @dnepo @aneelbhangu @Sivesh93 @NIHR_GSU (@OsaidesserMD)

#ASCO23: Consolidation Chemoradiotherapy Versus Observation After Chemotherapy for #GallbladderCancer: https://t.co/vuU83aHqkE #HPBCSM #JNCCN360 (@JNCCN)

Dear CHD family I’m just lost with words, last year my brother in law was diagnosed with gallbladder cancer and me and my husband sent our savings for his treatment to india I particularly went for almost a month to energize him and he improved a lot . (@dietgyde)

🔥Risk of Young-Onset GI Cancers Among Young Adults Age 20-39 yrs With NAFLD @JCO_ASCO https://t.co/nLkUetCtNA 👉NAFLD increases risk of young-onset overall digestive tract,stomach, colorectal, liver, pancreatic, biliary tract & gallbladder cancer ✅preventable risk factor.....… https://t.co/vLqAvaPvn2 (@ArndtVogel)

4- A multicenter, open-label, randomized phase It study evaluating adjuvant gemcitabine plus Cisplatin vs capecitabine with concurrent capecitabine radiotherapy (CAPE-RT) in patients with operated gallbladder adenoca @AnantRamaswamy (@Prasshmehta)

Do we finally have an RCT of RT in biliary cancers? Look forward to RACE-GB study #ASCO23 N=135 pts w unresectable gallbladder cancer s/p chemo x 4 mo --> chemoRT (45Gy + 9Gy boost) vs. obs. ChemoRT improved OS (1 endpt), 10 vs. 4 months (p=0.001). https://t.co/tm9512W6Jv (@NiuSanford)

"At 7% of cholangiocarcinomas/gall bladder cancers, a HER2 mutant-only trial would have been difficult if not impossible with older clinical trial designs. Below is our cholangio/GB MSK-IMPACT as of today (>1350 pts profiled as part of the MSK-IMPACT initiative over 9 years)." (@DSolit)

Interestingly, #PDL1 and #CA19-9 may be bad #prognostic predictors in #gallbladdercancer (GBC) cases. https://t.co/6Qs6YmOab7 (@Dr_Ivanoncologo)

#GI23 #HER2 🎯 in @curecc More in extrahepatic #cholangiocarcinoma & #gallbladdercancers. Very relevant with more HER2 drugs and novel therapies coming along. @OncoAlert (@pashtoonkasi)

🔥Comprehensive clinicopathological & genomic profiling of #gallbladdercancer🔥 @Nature_NPJ https://t.co/1A13WE67dc… ✅RWD 642 pts🇳🇱 👉100 pts with NGS/TSO500 ->GA for🎯💊rare, most frequent: ERBB2 9% & TMB >10 muts/Mb 18% IO? ➡️<< compared to iCCA @myESMO @EASLedu #livertwitter ()

IMMUCHEC trial in naïve cholangio-/gallbladder carcinoma ✅Adding IO (durvalumab +/- tremelimumab) to chemo (gemcitabine/cisplatin) did not improve efficacy ➡️Subgroup with dominant PD-1 in immune cells seems to benefit more from the combo @ArndtVogel @EASLedu @OncoAlert #ESMO22 (@AMalfettonePhD)

👇🏾This is the cliff you want the cancer to fall off from. #PrecisionOncology #Cholangiocarcinoma #HER2 #GallbladderCancer @curecc You have to test ALL tumors💯. Especially for extrahepatic/gallbladder cancer, HER2 can be assessed on a quick IHC. The best part is pain went away. (@pashtoonkasi)

Screen enough & you’ll find ALL these actionable markers. ✅Universal💯🧬 testing #Cholangiocarcinoma This week ✔️EBV➕PD-L1 40% ✔️MSI⬆️ ✔️HER2➕➕➕ HER2 particularly enriched amongst gallbladder cancers, & more of an extrahepatic phenomenon. #PrecisionMedicine #ctDNA helps (@pashtoonkasi)

#ASCO22 most imp takeaway as a reminder when seeing a pt with #cholangiocarcinoma #gallbladdercancer #BiliaryTractCancer @curecc is that it’s indeed a 🎯“TARGET-RICH” disease The focus today was #HER2 ➡️EXTRA-hepatic/GB phenomenon. ✅#ctDNA💡 See our📝 https://t.co/MTJOuGtCH0 (@pashtoonkasi)

Rounding inpatient #KRASG12C 🫁 #NTRK 🫁 #HER2➕➕➕ gallbladder cancer/cholangiocarcinoma More 🧬 tests brewing. Welcome #PrecisionMedicine #PrecisionOncology. (@pashtoonkasi)

Any implications for high copy number MDM2 amplification in addition to ERBB2 (HER2) amplification in #gallbladdercancer? @PTarantinoMD @SKabrajiMD @Aiims1742 @PancPathologist @JavleMilind #HPBCSM #Cholangiocarcinoma #HER2 What else would you use post trastuzumab progression? (@pashtoonkasi)

The #PBPS Abstract Award goes to Dr. Burcin Pehlivanoglu! TPPP-BRD9 Fusion-Related Gallbladder Carcinomas are Associated w/Intracholecystic Neoplasia, Neuroendocrine CA and a Distinctive Small Tubular-Type Adenocarcinoma Commonly Accompanied w/Syringomatous Pattern #USCAP2022 (@pbpath)

As different biomarker assays are developed, should we screen #HER2 via IHC, ERBB2 via FISH, or molecular testing? Certainly, new ADCs may drive these assays. An example is this HER2-positive gallbladder adenocarcinoma (#ERBB2 amplified). #TumorBoardTuesday #Pathology #GIPath (@PancPathologist)

Currently helping a patient w/advanced #GallbladderCancer. Their @FoundationOne Liquid CDx revealed a FGFR2 splice site 2038-78_*7del91; relevant to current discussion in this thread? (@GraceCordovano)

Origin of GBC beyond adenoma dysplasia seq, role of CTNNB1. Genomic characterization of co-existing neoplasia and carcinoma lesions reveals distinct evolutionary paths of gallbladder cancer. Jianzhen Lin. Nat Com 12: 4753 (2021) @SirohiBhawna @JesusMBanales @Amolpatel_dr @AHBPA (@JavleMilind)

Interesting paper-genomic origins and role of CTNNB1. More than adenoma-dysplasia sequence in GBC. Genomic characterization of co-existing neoplasia and carcinoma lesions reveals distinct evolutionary paths of gallbladder cancer. Jianzhen Lin et al, Nat Comm 12: 4753 (Aug 2021) (@JavleMilind)

Following up on this discussion: best trials for HER2+ advanced (resected) gallbladder cancer previously treated w/FOLFOX + kanjinti w/some progression? (@GraceCordovano)

I won’t say that actionable alterations don’t exist for EHCC. They are different and some that are mutually exclusive. #HER2🎯 for example is very enriched in EHCC & gallbladder cancers. #PrecisionMedicine >30% minimum. Definitely NGS comprehensive upfront. If⬇️tissue➡️#ctDNA🧬🩸 (@pashtoonkasi)