Michael Fisch MD MPH

@oncology_bg Congratulations on your well-deserved promotion! You are making tremendous contributions in our field with clear focus on what is important for patients

I officially start as Professor of Oncology at Queen’s University from today. This has been quite an incredible journey from being a fellow to a professor in 8 years. I’m very grateful to everyone who has unwaveringly supported me throughout this, specially my incredible family, friends, mentors, mentees, colleagues, collaborators, and patients. Thank you Queen’s University and Department of Oncology for this honour and recognition through promotion. 🙏🙏

A really thought-provoking study at #ASCO26 (Abstr 4512, Clinical Science Symposium): decision regret after adjuvant pembrolizumab in RCC. 🔹 The question Do patients regret receiving adjuvant pembro — and if so, is it driven by long-term toxicity that CTCAE grading doesn't adequately reflect? They built a patient co-designed tool focused on long-term toxicity. 🔹 The study 104 RCC pts post-adjuvant pembro across 3 London centres, median f/u 30 mo. Pts completed the Ottawa Decision Regret Scale alongside their own rating of irAEs as life-changing, significant, or non-significant. 🔹 What they found 28% rated their toxicity as significant and 11% as life-changing — but these ratings did NOT correlate with CTCAE grade (a third of G1–2 events were rated significant), and regret was identical for G1–2 vs G3–4 irAEs. Regret was driven by patient-perceived long-term toxicity, especially permanent endocrine and MSK irAEs — and not by disease recurrence (only 1/14 who relapsed expressed regret). Lower baseline expectations of toxicity → more regret. 🔹 My take Striking that >1 in 4 reported significant and >1 in 10 life-changing toxicity. What concerns me most isn't that CTCAE missed these events — it's that the grade didn't correlate with how significant patients found them, nor with regret at all. That deviates from the very purpose of grading. The hard part: a regret analysis is tough to contextualize when the alternative, no treatment, risks recurrence — arguably worse than a long-term toxicity. Adjuvant therapy is challenging by nature: most patients are either cured already or destined to recur regardless — we expose everyone to toxicity to benefit a minority. We urgently need biomarkers to find the few who truly benefit. This slide from @Prof_IanD says it all 👇 Looking forward to seeing the presentation! 🔗 asco.org/abstracts-pres… #kcsm #ASCO26 @BethN01 @tompowles1

@crisbergerot @PauloBergerot @montypal @WilliamDale_MD @neerajaiims @DrChoueiri @Prof_IanD @fumikochino @AmandaBinDC @NarjustFlorezMD Congratulations Cris!!

Special moment #ASCO26 Proud & honored to receive the FASCO designation & celebrate w outstanding colleagues Grateful to be part of this incredible community Thanks @PauloBergerot for your constant support, and @montypal for your mentorship & countless opportunities

Wow! The absolute BEST symptom management & survivorship committee meeting @SWOG spring meeting! Energized & Excited after the brainstorming session! Cannot wait for the future! ☀️🕶️#APP #Research #scientist #collaboration

Fascinating, important convo on the role of APPs in #clinicaltrial research & patient access to trials. APPs have been an important part of my cancer experience, including a PA who advocated to get me scanned the night I was diagnosed. Let’s break down the barriers! #SWOGSpring26

Highlights from @SWOG’s high-impact oncology trials & future vision 🧬 by our new #SWOG co-chairs, @PrimoLaraMD @DrDawnHershman ✅ S1609 DART: 53 rare cancer cohorts, one basket study ✅ ctDNA clearance predicts outcomes in NSCLC And so many more! 🔭 SWOG’s next era: public-powered research tackling what industry can’t 🚀 • Fewer phase I → more definitive phase III trials 📊 • Pragmatic, efficient studies (⅓ of portfolio) ⚡ • Multi-modality strategies & treatment de-escalation 🎯 • AI + real-world data accelerating innovation 🤖📈 @SupportingSWOG #Oncology #ClinicalTrials #CancerResearch

In the 2026 @SWOG plenary session, new co-chairs @PrimoLaraMD @DrDawnHershman honor the outgoing chair @CharlesBlanke & share SWOG’s history, extensive membership, accomplishments& their vision on next generation of @SWOG trials (important for young investigators to know)👇

@minasedrakmd @hoperugo @stolaney1 @AnnPartridgeMD @maryam_lustberg @ErikaHamilton9 @stales @Dr_RShatsky @hmcarthur @KalinskyKevin Congratulations Mina!!

The older I get, the more I realize the greatest honors in life aren’t the ones we hang on walls, but the people who stand beside us. “Our people are the most valuable asset.” — #KingHussein bin Talal of #Jordan My name might be on the award, but the story belongs to so many others. To parents who gave up their dreams so my sister and I could chase ours. To mentors who believed in me before I believed in myself. To mentees who keep me learning and growing. To patients who remind me every day why this work matters. And to a wife and three kind kids who love me through the missed moments — the dinners, dance recitals, and bedtime stories I couldn’t make. This honor isn’t mine. It’s ours. Thank you, Princesses @GhidaTalal and @KHCFKHCC, for this incredible recognition. Your tireless commitment to advancing #ArabCancerResearch reflects a love for humanity, healing, and hope. Because in the end, it’s not about the plaque or the award. It’s about people. Always people. #Gratitude #Family #Mentorship #Purpose .@UCLAHealth .@DOM_UCLA .@UCLAHealthJCCC .@dgsomucla .@IntMedAbel .@ASCO .@BCRFcure .@myCARG .@ALLIANCE_org .@SupportingSWOG .@PhaseOneLA .@SusanGKomen @AACR .@montypal .@ArmenianSaro .@dradityabardia .@tmprowell .@WilliamDale_MD .@DrDawnHershman .@FaltasLab .@NagiSaghir .@GevTamamyan .@ArafatTfayli .@QueenRania

Scheduled lorazepam, alone or combined with haloperidol, more effectively reduced agitation and restlessness in palliative care patients with advanced cancer and delirium than haloperidol or placebo. ja.ma/3IYTzwh @drdavidhui

Microsoft claims their new AI framework diagnoses 4x better than doctors. I'm a medical doctor and I actually read the paper. Here's my perspective on why this is both impressive AND misleading ... 🧵

Happy Birthday to MD Anderson! As @DGlaucomflecken recently told us, growing up as a child in Deer Park, Houston, he simply couldn’t figure out why the good “Dr. Anderson” had the “MD” before his name. 😆 P.S. - it’s Monroe Dunaway

Love this quote from @jrgralow. We can't view #AI as a physician replacement, nor can we reduce #efficiency gained by #AI as turning #docs into a cog ⚙️ Thanks @ravi_b_parikh for advocating for protections both for now and the future. @ca_chung @dougflora2 @HundalJasmin

#AI has improved my efficiency in clinic. But in other industries, AI in the name of efficiency turns employees into "Quantified Workers". #Doctors aren't immune. In @NEJM,@CohenProf @iajunwa & I propose a Clinician Bill of Rights to prioritize autonomy during the AI revolution

Did you know you can donate blood in honor of an @MDAndersonNews patient? If they don't need🩸, they get an honorarium credited to their account. I'm giving platelets today in honor of one of my pts. Talk about immediately reducing #financialToxicity in small but measurable ways!

This painting (Fildes’ The Doctor) is like a Rorschach test of how I’m feeling as a physician Often I see the virtue of presence, where we literally cultivate our bedside manner Other times I discern the intractable progression of disease we are powerless to halt It’s both

Two reasons for caution in our expectations for how AI may affect administrative overhead in healthcare are: - Most areas of admin friction were readily addressable through the technology of 10-20 years ago, but remain with us - Most problems are not computational at their core

Good summary of the question from @WillShrank, @suhas_gondi et al: jamanetwork.com/journals/jama-…

Our patients deserve honest prognostic discussions and quality EOL care. Even "novel" therapies don't change the fundamental importance of knowing when to shift focus from disease-directed to comfort-focused care

Very excited the primary psychosocial outcomes of the MATCH (Mindfulness and Taichi for Cancer Health) trial were published today in the @ASCO Journal of Clinical Oncology. Largest comparative trial of #mindbody therapies to date. Free full-text here: ascopubs.org/doi/pdf/10.120…

Malnutrition in Older Adults. nejm.org/doi/full/10.10… @NEJM @JWatch @NEJMEvidence @NEJMGroup #Geriatrics #GeriOnc #PallOnc