MSI-H/dMMR

JUST IN: @FDAOncology approved dostarlimab (PD-1 inh, GSK) w/carboplatin+paclitaxel, followed by single-agent dostarlimab, for dMMR/MSI-H metastatic endometrial cancer. Approval based on RUBY trial published in @NEJM 2023 https://t.co/QAkLNAnmWy @OncoAlert @OncBrothers (@DrChoueiri)

Delighted to share our latest paper on “Tumor-agnostic drug development in dMMR/MSI-H solid tumors” just published in Trends in Cancer – @VivekSubbiah #cancer #immunotherapy #drugs #research #precisionmedicine #tumor #oncology #oncodaily https://t.co/u1dVByzRJM (@oncodaily)

WATCH: Dr Mirza on the FDA Approval of Dostarlimab Plus Chemotherapy in dMMR/MSI-H Endometrial Cancer @MirzaCPH @Rigshospitalet @US_FDA #gyncsm https://t.co/znzrC40eHt (@OncLive)

FDA Approves Dostarlimab Plus Chemotherapy in dMMR/MSI-H Advanced Endometrial Cancer https://t.co/cJNILT0V1t via @targetedonc #MedTwitter #OncTwitter #ecsm (@dawood_findakly)

Hot in #JITC - #ICYMI: Safety and antitumor activity of dostarlimab in patients with advanced or recurrent DNA dMMR/MSI-H or proficient/stable (MMRp/MSS) endometrial cancer: interim results from GARNET—a phase I, single-arm study https://t.co/CFWk7OrrN7 @AnaOaknin @BPothuri (@jitcancer)

#3--> Tumor-agnostic drug development in dMMR/MSI-H solid tumors @OncoAlert @weoncologists @trendscancer @PavlosMsaouel @MyriamChalabi @BenWestphalen https://t.co/P9TbY8ieaH (@VivekSubbiah)

Great work by the team around @FilippoPietran4, @ChiaraCrem1 and @sara_lonardi1 investigating ICI in dMMR #colorectalcancer 👉TMBhigh: excellent response 👉TMBlow: poor response 👉more biomarkers needed for TMB intermediate 🧐 @OncoAlert 🚨 https://t.co/lBveXH6apZ (@heinrich_kat)

And yet we have update to NCCN for dMMR colon cancer with ICI, based on less numbers and very short follow up 🤷‍♂️ Let’s not try to make a L from what is clearly a W. We need a STABLE-MATES type trial of SBRT + IO vs. sublobar/lobar resection. Organ preservation! (@5_utr)

Microsatellite instability in non-colorectal & non-endometrial malignancies in patients with Lynch syndrome @JNCI_Now https://t.co/oW2kfivE38 👉85% of Lynch-spectrum tumors are MSI-H/dMMR 👉37% of non–Lynch-spectrum cancers are MSI-H/dMMR @myESMO @OncoAlert (@ArndtVogel)

Two important points: ➡️ this paper supports the idea of reflex testing in every solid tumor as it may open up the opportunity of different therapies ➡️ despite high rate of dMMR/MSI breast cancer (30%) there is no elevated life time risk in Lynch patients (@RHuneburg)

It’s also important to confirm MSI-H diagnosis by PCR when secondary MMR single protein is lost. Misdiagnosis of MSI could explain part of short PFS in some patients treated with ICI. I think we should do now NGS for every patient with a new mCRC diagnosis… (@BallenDF)

Checkpoint Inhibitors in MSI-H Colorectal Cancer at #WCGIC2023 👉excellent overview by @KristenCiombor 👉Test in every stage! 👉We need predictive biomarker 👉current evidence & ongoing studies such as ATOMIC, NEOPRISM-CRC, EA2201 @WCGIC @myESMO @OncoAlert (@ArndtVogel)

@WCGIC great review by @KristenCiombor evolving field in MSI H CRC! 👏 now in #WCGIC2023 (@Juanmaoconnor)

Applauses for @KristenCiombor for her detailed talk on ICI in MSI-H CRC. #WCGIC2023 Congrats! (@alfdestefano)

.@KristenCiombor @VUMCHemOnc on IO in MSI-H met #colorectalcancer - need to test (!) to find & figure out why some don’t respond: non-Lynch? KRASmt? Higher ECOG PS from symptom burden, maybe they need doublet? Need better biomarkers, hopefully Immunoscore IC! #WCGIC2023 @WCGIC (@benweinbergmd)

The outcome of stage II dMMR T4 colon cancer receiving standard rx is not great—> presented at #WGIC23 today—> pls enroll these patients in neoadjuvant immunotherapy (NIT) trials. ⁦@Amitmahipal79⁩ ⁦@MallaMidhun⁩ ⁦⁩ ⁦@SKamath_MD⁩ ⁦@PMBolandMD⁩ (@doctorC369)

An absolute pleasure to speak with @KristenCiombor of @VUMC_Cancer who discussed the use of checkpoint inhibitors in MSI-H #ColorectalCancer, predictive biomarkers in MSI-H CRC, and more! @myESMO #WCGIC2023 #GastrointestinalCancer #GIsm #CRCsm (@VJOncology)

Indeed. Enjoyed our conversations on research in MSI-H CRC. @WCGIC #WCGIC2023 (@MallaMidhun)

Thierry André presents the Studies in MSI-H Local Rectal Cancer at #WCGIC2023 @myESMO @WCGIC (@HosseinTaghiz11)

Thanks for the tweet👍 be cool.. please enroll colon cancer patients with dMMR stage II T4 disease in neoadjuvant IO trials.. manuscript on the way. @Amitmahipal79 @ali_fasih @JMillerOcuin @UHhospitals @aparna1024 (@doctorC369)

Good start of the third day of #WCGIC2023 1) outcome of pts with dMMR T4 stage II tumors is NOT good! 2) neoadjuvant IO will also be important in achieving more cure in high risk stage 2 disease @myESMO @AndreaCercek (@MyriamChalabi)

Understanding resistance to ICIs important in MSI-H cancers ➡️concept of immune priming-even if PD on IO ?possible to salvage with chemo /other strategies 👇🏻great case from INFINITY neoadjuvant STRIDE in GEJ/GC ➡️fabulous talk @FilippoPietran4 @myESMO #WCGIC2023 @CancerInstIRE (@graokane)

Fantastic talk by @FilippoPietran4 on MSI-H/dMMR esophagogastric cancers. I encourage everybody to rewatch! #WCGIC2023 @myESMO (@MyriamChalabi)

Giovanni Randon presents data about PD-1 blockade in 130 patients with MSI-H mGC at #WCGIC2023 @myESMO @WCGIC (@HosseinTaghiz11)

@DSolit at #PCFAcademy talking about exceptional responders, how to detect genomic markers, and how to cure metastatic disease, for example #immunotherapy for rare MSI-H #prostatecancer. Now, are we looking for exceptional #radiotherapy responders also?🤓 #radonc #radbio (@HenningWillers)

#TwuesdayTweetss Today in #TwuesdayTweetss, we feature Dr. Yakup Ergün [@dr_yakupergun] regarding his tweet about the efficacy of #Immunotherapy in mismatch repair-deficient #Advanced #ColorectalCancer in routine clinical practice. #MedTwitter (@4baseCare)

Now in @JCO_ASCO ➡️ KEYLYNK-010 trial: Pembro + Olaparib vs 2nd NHA in mCR #prostatecancer (https://t.co/Owpcfb6XS0) ➡️ Despite promising early phase data, no diff. in rPFS or OS j ➡️ My take: outside of selected biomarker groups (MSI-high, CDK12?), no role for ICI in PCa (@AzadOncology)

Advanced Endometrial cancers 1st line- Pacli+Carbo +/- Pembro/Dostarlimab dMMR cohort (25%) -> Excellent HR as expected But what about the rest 75% pMMR ? NCCN approves for all comers, thoughts ? @myESMO @rakesh_boya @rajitrattan @rushabh1388 @drvineetgovinda @OncBrothers (@shikharkumar89)

'The outcome of stage II dMMR T4 colon cancer: An NCDB analysis'->my GIFT to neoadjuvant immunotherapy enthusiasts->Pls stop by @WCGIC Barcelona short oral.@MyriamChalabi @ArndtVogel @aparna1024 @VanMorrisMD @colontown @IbrahimSahinMD1 @GlobalCRC @OncBrothers @TwoOncDocs (@doctorC369)

The #FDA has accepted the sNDA for and granted priority review to #dostarlimab + chemotherapy for patients with dMMR/MSI-H primary advanced or recurrent endometrial cancer. #gyncsm | @bhemato @MedicalCollege https://t.co/kq7Az7ZT3e (@TargetedOnc)

Congratulations to @EliasChandran, our advanced GU oncology fellow at @theNCI working with @apolo_andrea, for two poster presentations at ASCO 2023: dMMR and MSI-H in urothelial carcinoma and trial in progress of olaparib in non-prostate GU tumors (NCT03375307) #ASCO2023 @ASCO (@NCICCR_MOS)

.@AndreaCercek’s #ASCO23 poster abstract on a phase II, single-arm, open-label study of dostarlimab monotherapy in previously un-treated patients with stage II/III dMMR/MSI-H locally advanced #rectalcancer. (@MSKCancerCenter)

@KristenCiombor masterfully highlights all the multiple data sets we have with immunotherapy for MSI-H rectal cancer calling our attention to critical differences. #ASCO23 (@Dr_M_Tejani)

No one gives a better talk on immunotherapy in dMMR rectal cancer than @KristenCiombor. She also crushed the Q & A where 99% of questions were fielded her way. Enjoyed my front row seat #ASCO23 https://t.co/Jy0JdEGV7n (@NiuSanford)

What a wonderful talk delivered by @KristenCiombor ! Immunotherapy may have come front and center in management of MSI high rectal cancer (@NVijayvergiaMD)

Great session at #ASCO23 held by @KristenCiombor @NiuSanford @JoseGuillemMD on the evolving treatment of rectal cancer patients, talking about the role of Neoadjuvant Immunotherapy in MSI-H pts, the optimization of RT and non-operative management in cCR (@alfdestefano)

Very complete overview by @KristenCiombor on the use of Immunotherapy in MSI-H rectal cancer pts. Interesting and shareable take-away points and a new trial, congrats! 👏🏻 (@alfdestefano)

The management of rectal cancer is becoming more and more complex. Wait-watch if there is an answer? Neoadjuvant therapy without radiotherapy? ICI on MSI-H.... (@dr_yakupergun)

Characterizing the landscape of RING-type E3 ubiquitin transferase-altered (RNF43 alt) colorectal cancer (CRC) & defining unique subsets w/ potential Tx vulnerabilities in MSI-H CRC [2023] Naqash et al. #ASCO23 Abst 3134, Poster 332 https://t.co/V3itMoQthw #crcsm @TempusLabs (@mtmdphd)

So honored to mentor 🤩 @VUMCMedicineRes @VUMC_Cancer fellow @EricLanderMD . He gave a GREAT presentation on our collaboration with @NateraOncology noting: ⬆️ Her-2 and ⬆️ Her-3 in MSI-H/TMB high #earlyonset #colorectal #cancer ⬆️ MSS/TMB-high w/ ⬆️ POLE MT ⬆️ ACVR2A Vs avg age… https://t.co/V8XX1P4zS4 (@CathyEngMD)

So honored to mentor 🤩 @VUMCMedicineRes @VUMC_Cancer fellow @EricLanderMD . He gave a GREAT presentation on our collaboration with @NateraOncology noting: ⬆️ Her-2 and ⬆️ Her-3 in MSI-H #earlyonset #colorectal #cancer ⬆️ MSS/TMB-high w/ ⬆️ POLE MT ⬆️ ACVR2A Vs avg age onset… https://t.co/uEPgKiYtkb (@CathyEngMD)

Neoadjuvant IO is the way to go. Future is 😎in both MSI-H and MSS colorectal cancer -and many tumor types. Excited to see this planned study with bot/ bal! Woke up a little too late to see @MyriamChalabi live but watched on the shuttle bus! 😂#ASCO2023 #ASCO23 @pashtoonkasi (@smitha42)