Houssein Safa, MD

🧵- 🩸Hematology for The Non-Hematologist🩸 🎗️Oncology for The Non-Oncologist🎗️ This series reached +1.5M views, +12k likes, & +3k new followers in under 8 weeks. Very Grateful for the support. I put together a collection of all 20 episodes so far in the links below 👇🏻

3 studies testing Perioperative immune bases therapy (EVP or Gem/Cis/Durva) in muscle invasive bladder all have shown an OS advantage vs standard of care. KN905 (EVP) is distinct in that it’s in a cisplatin ineligible population (accounting for the poor performance of the control arm). It’s also a smaller trial. The control arm of KN-B15 performed slightly better than NIAGARA (Gem/cis for both), but the trials are otherwise similar. The pCR in the EVP trails and the consistent efficacy of EVP is striking. #GU26

The standard of care for MIBC will now include perioperative EVP for both cisplatin eligible and ineligible #BladderCancer pts. The EV304 study presented today @MattGalsky shows an improvement in EFS (HR 0.53) and OS (HR 0.65) for EVP over GC. @ASCO #GU26

KN-B15/EV303: R3 Perioperative EVP vs Gem/cis in MIBC shows EFS HR 0.53 (0.41–0.70), OS HR 0.65 (0.48-0.89), pCR 56% vs 33%, G3+ tox 76% vs 67% #GU26. About half the patients completed 9 cycles of EVP. These are great results. Gem/cid is harder to beat when not all patients are at risk of relapse. Bladder sparing approaches for cCR (~60%) will be where this ends. ‘EVP 1st, ask questions later’. These studies are needed soon.

Truck test passed ✅ #ADCs

🎗️Oncology for The Non-Oncologist🎗️ (A practical educational series for internal medicine trainees and physicians) Episode 11: When you hear “small cell carcinoma”, think urgency 🚨. Here’s what you need to do… Listen up - 🧵

🎗️Oncology for The Non-Oncologist🎗️ Episode 11: When you hear “small cell carcinoma”, think urgency 🚨. Here’s what you need to do…

@dreamer3332 @hsafaMD @dreamer3332 Bonjour, the unroll you asked for: threadreaderapp.com/thread/1968085… Talk to you soon. 🤖

A great cover letter can make or break your manuscript submission. As an editor and author, I've seen how a strong cover letter helps editors grasp your paper’s significance. 🧵 [1/9]

And that’s a wrap, folks! That’s it for today. If you’ve been following along, I’m hoping to grow this series into a go-to resource for hospital-based docs navigating hematology oncology cases. Open to suggestions or feedback. If you like this format, like, repost, and share the love. Also, below is a link to the library thread with all my episodes so far 👇🏻

19/ 💭 “So what’s the prognosis with small cell carcinoma?”🤔 Let me put it this way: small cell is a paradox. On one hand, it’s one of the fastest-growing tumors we see in oncology. Patients often present sick, symptomatic, with bulky disease. But the moment chemotherapy (platinum + etoposide) is infused, it’s like watching a switch flip . Tumors that were choking airways, flooding the liver, or weighing patients down start to shrink within days. Patients feel their breathing improve, their pain lighten, their appetite return. It’s dramatic. In fact, oncologists often say: “small cell melts.” 🫠 That’s not poetry that’s exactly how it behaves. But here’s the tragedy: while small cell melts, it also comes roaring back. Resistance develops quickly, sometimes within months. And unlike the first response, the second is never as strong. That’s why, despite initial chemosensitivity, the median survival remains modest. 🔥🧊 Think of it like fire and ice: it burns fast, but it also melts fast. And then it returns just as fiercely. That’s the bittersweet reality of small cell tumors that vanish before your eyes, only to reappear with a vengeance.