Casey Kim

1/ 🚨 NEW #5Pearls: Neutropenia 🦠 Let’s review the what, when, and why of neutropenia, including management of febrile neutropenia 🥵 🖥️: coreimpodcast.com/2025/08/13/neu…

Still, a cool paper. I think it shows: - Further dev/integration of AI predictive models for personalized medicine in Oncology - Modeling to help better ID which patients could benefit from earlier palliative care/geriatrics As pt live longer w/ cancer, this will only 📈

CRP:Albumin ratio was also highlighted as a key predictive factor. Easy to get or include with monitoring labs for patients getting treatment. The only issue is on its own, seems to have fairly mild predictive effect (as estimated in the Cox proportional hazards method)

“How much time do I have left?” As an oncology hospitalist, this is the most common ? I hear from my patients. An interesting paper just came out in JCO using Machine Learning to predict mortality for geriatric oncology patients: ascopubs.org/doi/full/10.12… My thoughts 👇

It's flu season, so that means it's also COPD exacerbation season in the hospital. I always got a little confused as to what to do with all of their inhalers, but the gist is: - Continue their long acting inhalers - Duonebs will cover their rescue inhalers #MedTwitter

One of the hardest things I do in #oncology clinic is translate results from a clinical trial to the #patient in front of me. In @NatureMedicine, we introduce TrialTranslator, a #machinelearning framework for individualized #cancer trial emulation. nature.com/articles/s4159…

Back to our pt, after the scan showed likely LC, he decided to stop tx and go home with hospice. If time was short, he wanted to spend with family, not healthcare system My take away point: Dx of LC can ground prognosis/time (months) for patients to help guide goals of care

The data is not great on prognosis (only case series b4 2000s), but roughly 2-7 months. Even patients with resectable lung cancer (so not metastatic) had earlier mortality by about 2 years if they had positive post op cancer in lymphatics than those who did not

I took care of a patient with lung cancer who went to the ICU for respiratory failure of unclear etiology. CT chest done that suggested “lymphangitic carcinomatosis” Though he got better, that dx changed what happened next for him A 🧵 on lymphangitic carcinomatosis

Ever wonder if a certain symptom your patient with cancer is endorsing is related to their chemotherapy? The short answer is usually "maybe", but here's a helpful chart of common toxicities by chemotherapy classes. From hemeoncnotes.com, the solid cancer intro lecture!

@doctorsaluja I couldn't find anything regarding an exact date/timeframe (not sure it's been tested/studied), sounds like DNA in particular can last up to years, RNA is a little less stable. pmc.ncbi.nlm.nih.gov/articles/PMC42… pmc.ncbi.nlm.nih.gov/articles/PMC10…

@caseyjkim And the tissue preserved in formalin or the slides can be used for molecular tests years later?

"Tissue is the issue" For new pts admitted for new malignancy w/u, almost universally, the next ? is “is the biopsy done?” Seems obvious, but choosing when and where to biopsy has some nuance and directly impacts time to dx and tx A 🧵 on biopsy tips and tricks: #MedTwitter

@doctorsaluja Interesting question! Not my area of expertise, but looks like formalin is a common buffer to preserve & then they go into parafin blocks to be cut & make slides. Apparently slides can be held up to 20 years! This article goes into some detail: cancer.org/cancer/diagnos…

@caseyjkim While taking a biopsy in what all media should the sample be taken and kept? Need could arise for molecular tests after histopathology or sometimes years later

7/ For more tips on biopsies and a general introduction to solid cancers, check out the Solid Cancers Introductory Lecture [Residents] on hemeoncnotes.com

6/ Cancer of unknown primary Path can show "carcinoma of unknown primary” The cancer is so undifferentiated, there are no specific tissue markers. Repeat biopsy usually not helpful unless you don’t have enough tissue to run molecular/genetic studies. ascopubs.org/doi/10.1200/OA…