Matthew Abrams, MD

Rad onc + radiology like peas and carrots 🟢 🥕

@aiims2738 That’s my department!

@NiuSanford @rweichselbaum @ACRORadOnc @RadoncROVER Me too please

@rweichselbaum Can Ralph and I sign up under "other" category @ACRORadOnc @RadoncROVER?

This looks great! I’m going to sign up (if allowed).

@olsonplanner Start doing a backdoor roth IRA right away, and do it every year

What’s the best piece of financial advice you’ve ever received?

@olsonplanner Lot of truths to all of this

Academic docs who actually want to do research are getting squeezed HARD. The system says it values discovery. The paychecks say: “More RVUs, less thinking.” Let’s talk about the quiet collapse of the research track in medicine.

@olsonplanner Look for other jobs and see what they are offering

Attendings - How do you know your comp is fair?

@jryckman3 Hope that comes with a healthy pay raise

Thrilled to share that I’ve been promoted to Associate Professor! Endlessly grateful to those who’ve supported me along the way, too many to tag, and more generous than I could ever deserve. I’m looking forward to continuing to grow, learn, and give back in whatever way I can.

🚨SPRING-01🚨 🔍Locally Advanced Rectal Cancer RCT: 25 Gy x 5 ➡️ CAPOX +- Sintilimab 🔥+ Sintilimab demonstrated: ✅⬆️pCR 59% vs 33% ✅No significant adverse surgical or safety signals Time to explore with organ preserving approaches⁉️ #ASCO25

@NiuSanford ctDNA is the classic scenario of make a product then determine its usefulness. All it does is provide anxiety to patients

DYNAMIC III: another study showing ctDNA prognostic, but not predictive.
 At this point, the main scenario I see for ctDNA guiding treatment decision making in CRC is potentially selecting patients for non-operative management after chemo/chemoRT in rectal cancer.

X-torial: Cleaning up the misinformation about @JoeBiden and #ProstateCancer that I am reading everywhere. The purpose of this is to provide education from someone who treats and studies PCa for a living, lead the USA @NCCN PCa guidelines, hold leadership in @NRGonc @theNCI @US_FDA and dedicated my career to help men and their families suffering from PCa @nytimes @WSJ @FoxNews @CNN @NBCNews @Reuters @ASCO @PCFnews @DeptofDefense

✨ Practice-changing for gallbladder cancer? A randomized phase 3 trial from 🇮🇳 evaluated NACTRT vs NACT in locally advanced GBC (T3/T4, N1, liver infiltration). Results: ✂️ R0 resection: 51.6% (NACTRT) vs 29.7% (NACT) p=0.01 ⏳ Median OS: 21.8 vs 10.1 mo HR: 0.56 (95% CI 0.37–0.84), p=0.006 ⏱ EFS: 10.6 vs 4.9 mo HR: 0.58 (95% CI 0.39–0.85), p=0.006 5-year OS: 27% vs 18% Grade 3+ post-op morbidity: similar (~18–28%) Conclusion: NACTRT significantly improves resectability & long-term survival in unresectable LAGBC. #GIonc #GallbladderCancer #ASCO25 #OncoTwitter @NiuSanford @5_utr @ASCO

Wow, this trial showed no OS benefit to FOLFIRINOX vs. single agent gemcitabine in locally advanced pancreas cancer (different than adjuvant & metastatic trials - both w OS improvement!) PFS increased by 2 mo, but this came at cost of increased toxicity, $, treatment burden.

@Hatchisyodaddy @olsonplanner False. Get more than you think you need, as soon as you can

@olsonplanner Have been told it’s probably not necessary right out of residency. Any rule of thumb for when it is time to start looking into it? 1M net worth?

Physicians - How much umbrella insurance do you have?

@NiuSanford I’m much more likely to offer it now, especially if any concern for excess toxicity

PLATO ACT 4: Ph II RCT of 50.4 vs. 41.4 Gy for T1-2 (<4 cm) N0 anal SCC. No difference in 3-year local recurrence (primary endpoint) or OS, & better toxicity/QOL with dose-reduction. Should 41.4 Gy be a SOC option (ahead of Ph III DECREASE trial reporting)? #ESTRO25

⚡️⚡️NEW STUDY - presented today at #ARS2025 in an oral talk by MS2 Yarelis Roque-Reyes from UCC School of Medicine, PR 🧠💥 Does whole brain RT (WBRT) help patients hospitalized with symptomatic leptomeningeal disease (LMD)? Our @MountSinaiRO study suggests: rarely — and in reality, it may be more harmful to patients’ quality of life and end-of-life care. 🧵👇 #radonc #neuroonc #endoflifecare #ARS2025 LMD is a devastating CNS complication with 3–6 mo survival. WBRT is often used for palliation — but for patients sick enough to need hospital admission, we asked: 👉 Does it actually help? We reviewed 58 such patients (2014–2023). Here’s what we found ⬇️ 📊 Symptom response after WBRT: ❌ 74% worsened ➖ 21% no change ✅ Only 5% improved 💀 Short-term mortality: 40% at 30 days 60% at 60 days 76% at 90 days 📉 ECOG declined in 79% ⏳ 30% spent >⅓ of their remaining lifespan on treatment — often in the hospital 🎯 Our takeaways ➡️ In hospitalized patients with symptomatic LMD, WBRT provides little to no clinical benefit ➡️ with few exceptions, best supportive care — not burdensome WBRT — should be the priority ➡️time to rethink WBRT in hospitalized pts with LMD? 👏 Congrats to Yarelis Roque-Reyes on her #ARS2025 oral talk! @sindhu_kunal @MountSinaiRO @QuadShotNews

@RabbiWolpe When I was a resident, Harvard took money from Krupp I naïvely thought this has to be a different company/family than the one that funded the third Reich. This was in the early 70s. I was wrong should’ve known.

@JoeChangMD Which plants?

I was called about my patient who was diagnosed with highly curable stage I adenocarcinoma in February 2023. We recommended SABR or surgery, but she declined standard care and pursued alternative plant-based treatment instead. Now, She developed diffuse brain metastasis. SAD!

All due respect, but it is relatively common knowledge that radiotherapy works for many months after it has been delivered. One must not conflate pCR, especially short term pCR, after radiotherapy as a surrogate for LC or residual tumor. This has been well demonstrated across many disease sites. For reference, MISSILE cut at 10 weeks s/p RT while SABR-BRIDGE cut at 4.5 mo post-SBRT (range 2-17.5 mo). Take anal cancer, for example. When biopsied at 3 months, if positive, 3/4 of patients with positive biopsy converted to negative biopsy by 6 months. Of course, the whole specimen was not removed, so there is a potential there could be "residual," but robust data supports very high cure rates in the long term (~85%, generally speaking) with CCRT alone for anal SqCC. Receipt here: pmc.ncbi.nlm.nih.gov/articles/PMC53… Take prostate cancer, for example. Post treatment biopsies are essentially not recommended until two years after radiotherapy. Receipt here: pubmed.ncbi.nlm.nih.gov/33558660/ Take RCC, for example, where routine post-treatment biopsy is not recommended as it is not predictive of patient outcome. Receipt here: pubmed.ncbi.nlm.nih.gov/38181809/ So, why should lung cancer be any different? Similarly to RCC, if post-treatment biopsies after lung RT do not predict outcomes, is this meaningful to patients or multidisciplinary discussion? Radiotherapy can also induce cellular senescence, where the cell will no longer divide but can still make proteins at low levels. We must not perpetuate misinformation suggesting short-term pCR is predictive of patient outcomes after RT, as it harms existing biases against radiotherapy. I have seen this fallacy posted repeatedly on X, so I felt it was time to address this head-on.

🎙 Randomized Trial 🚨: SBRT vs. RFA for Recurrent Small HCC—Is It Time to Rethink Local Treatment? @OncoAlert 🔬 Study Highlights: 📌 Phase III trial, 166 👥 with recurrent HCC (≤5 cm, single lesion). 📌 Randomized to RFA (n=83) or SBRT (n=83) Key Outcomes: ✅ Local progression-free survival (LPFS): •2-year LPFS: 92.7% (SBRT)🏆 vs. 75.8% (RFA) (HR: 0.45, p=0.014). ✅ Progression-free survival (PFS): •Median PFS: 37.6 months (SBRT) vs. 27.6 months (RFA) (p=0.19).👌 ✅ Overall survival (OS): •2-year OS: 97.6% (SBRT) vs. 93.9% (RFA) (p=0.83).👌 ✅ Safety: Comparable acute and late adverse events.👍 📣 Implications for Practice: SBRT demonstrated ⬆️ local control while maintaining similar safety and OS compared to RFA.

Our comprehensive assessment of NCI cooperative group trials is out in @JNCI_Now! If you are involved or enrolling in coop trials, please consider reading. A 🧵of our major findings. 1/12 academic.oup.com/jnci/advance-a…