Daniel Lin, MD

Clinical guideline for the diagnosis and treatment of fibrolamellar carcinoma @HEP_Journal doi.org/10.1097/HEP.00… 👏Timely guideline 👉still very difficult to treat tumor @ASCO @myESMO @EASLnews @ILCAnews

Delighted to share results of phase 2 ILUSTRO in @NatureMedicine @KlempnerSam @ASCOPost Zolbetuximab+FOLFOX+nivo showed encouraging activity in CLDN18.2+ gastric cancer with mPFS 14.8 months (18months in high CLDN). Supporting the ongoing phase 3 LUCERNA. doi.org/10.1038/s41591…

Someone suggested I make a table summarizing the video. Here it is!

Long-term outcomes of atezolizumab-bevacizumab in unresectable hepatocellular carcinoma: A real-world study @HEP_Journal 👉538 pts 🇮🇹 👉mOS 19.7 mo, 36-month survival rate 30.0% 👉4.4% drug-free disease-free 👉14.1% liver decompensation @myESMO @ASCO @EASLnews @ILCAnews

Lung-only metastatic pancreatic cancer: Differences in patients ‘characteristics, molecular profile and survival European Journal of Cancer doi.org/10.1016/j.ejca… 👉better OS than others, were more often women, and harbored less KRAS mutations @myESMO @ASCO

Pleased to share this. CLDN18.2 is generally not prognostic with chemo±A–PD1, but it may matter with T-DXd. Along with prior report @GUTJournal_BMJ @sundar__raghav showing↑ CLDN in some pts after T-DXd, this supports testing combo such as T-DXd+ CLDN ADC (sone-vid etc.) @myESMO

Some of the most impactful moments @ASCO #GI26 happen between sessions—connecting with collaborators, colleagues, and shaping what comes next. Grateful to connect with #kras, #ctdna, #immunotherapy #collaborators moving research forward #TeamScience #GIOncology #Collaboration

Interpreting the results of noninferiority trials—a review British Journal of Cancer doi.org/10.1038/s41416… 👏great review 👉option of define advantage beyond efficacy 👉Key is to define clinical noninferiority margin 👉determining its efficacy versus no treatment can be a challenge @myESMO @ASCO

Multicenter single-arm phase II trial of lenvatinib in patients with advanced HCC after progression on first-line atezolizumab plus bevacizumab @JHepatology doi.org/10.1016/j.jhep… 👉Valid option in 2nd line 🧐IMbrave251 avaited, stay tuned... @myESMO @ASCO @EASLedu

Longitudinal study on the influence of physical activity in managing cancer-related fatigue in patients with colorectal cancer. 👉Walking reduces fatigue and improve Qol in non-metastatic CRC 🧐 Easy to implement, we need stage specific recommendations @myesmo @ASCO

Pleased to share combined analysis from the phase III trials of zolbetuximab @myESMO @ESMO_Open. Optimal antiemetic prophylaxis—at least an NK1 RA + 5-HT3 RA + steroid—improves treatment adherence and helps maximize benefit.@KlempnerSam @LizzySmyth1 esmoopen.com/article/S2059-…

Rph2 #PDAC Elraglusib (GSK-3betai) + GnP v GnP #GI26 ➡️n=155 no diff in ORR or mPFS ➡️mOS 10.1 v 7.2mo (eligibility broad) ⭐️matched bx - ⬆️CD8 /NK and GrzB+ cells ?some effect here but biomarkers 🔑 @ASCO @OncoAlert

For your interest: Abs #122 Here are the post-hoc analyses KM PFS and OS curves for #earlyonset #colorectalcancer vs. #averageonset patients in the original #BREAKWATER trial (FOLFOX+ encorafenib + cetuximab). @PfizerOncMed 👉⬇️Median PFS 10.9 vs. 14M 👉⬇️Median OS 23.8 vs. 30.3M 👉Emphasizing the importance of NGS testing 👉More research needed in EOCRC @asco #GI26 @VUMCDiscoveries

#GI26 🏃‍♂️ Physical activity & CRC fatigue | ColoCare study (n=1718) 🚶 Walking = strongest & most consistent fatigue reduction ⏱️ PA at 12 months predicts better long-term QoL 📉 Clear benefit in non-metastatic disease ➡️ Walking emerges as a simple, scalable survivorship intervention @OncoAlert @Larvol

“Sustained habitual vigorous activity was significantly associated with less future fatigue in all patients” #GI26

More on the biology of lung NETs and GEPNETs... Do recently described markers of transcriptional subtypes in SCLC; ASCL1, NEUROD1, POU2F3 and YAP1, matter in lung NETs and GEPNETs? And what about DLL3? 🔸109 lung carcinoids and 191 enteropancreatic neuroendocrine tumours (EP-NETs) 🔸ASCL1, NEUROD1, OTP and TTF1 were positive in 56%, 0%, 84% and 35% of lung carcinoids, respectively 🔸Of the OTP-negative lung carcinoids (n = 18), 4 (22%) were ASCL1-positive, of which one was TTF1-positive 🔸59% of EP-NETs were NEUROD1-positive, whereas only rare tumours focally expressed ASCL1 (1.1%) and OTP (0.5%) and none expressed TTF1 🔸DLL3 was positive in 57 (52%) lung carcinoids versus 5 (2.6%) EP-NETs 🔸All lung carcinoids and EP-NETs were completely negative for POU2F3 and YAP1 🔸ASCL1 and TTF1 were associated with peripheral location, OTP with low Ki67 and low stage and DLL3 with high Ki67 Should we be using ASCL1 and NEUROD1 to help differentiate between lung NETs and GEPNETs? Also a reminder that TTF1 is not a great lung NET marker. Excellent work by @natasharekhtman @IHC_guy @rohit_thum and team! And last comment... why, why, why put the supplementary materials in multiple different formats as separate files. Combining all in a single PFD file is not that hard... onlinelibrary.wiley.com/doi/full/10.11…

Very interesting findings presented @ASCO #GI26. Could GLP1 have different effects on different GI cancers?Some preclinical data in NETs have shown some possibility of increased risk. Definitely an area of interest to watch out for moving forward.

Liver-directed Tx #CRCLM👏 more🔧for MDT #GI26 ❤️molecular/biology each talk ➡️Rads as std & future role ➡️IR-PVE &Y90/ablation NB COLLISION ➡Transplant debate: selection 🔑need control!-but in right pt high OS; more CRCLM will have sx/other @ASCO @OncoAlert @_ILTS_ @ldawsonmd

#GI26 @ASCO #oncofertility in early-onset GI cancers: ⭐️@ShrutiPatelMD’s great talk featuring our study where 44% #crcsm pt reported fertility pres discussion b4 tx: bit.ly/4sy9Zhz ⭐️Our PGY2 @VUMChealth, Zoe Finer, presenting on pt insurance access to fert pres services

Results of cohort 3 #BREAKWATER FOLFIRI + encorafenib + cetuximab for newly dx'd #BRAFV600E MT #colorectal #cancer 👉ORR: 64.4% vs. 39.2% 👉60% with liver mets 👉Premature OS but trend (HR = 0.49); PFS: Pending 👉No dramatic increase in SAE 👉 Therefore, you can use FOLFOX or FOLFIRI @PfizerOncMed #GI26 @asco #crcsm #cancerresearch @VUMCDiscoveries