Mike Pishvaian

#ASCO25
📢Join me & my colleagues EileenMOReilly, Gabi Chiorean, & Brian Wolpin to discuss #PancreaticCancer management in a case-based format
📅Friday, May 30th, 6:30- 8:00pm CDT
📍Sheraton Grand Chicago Riverwalk 4th Floor

📋Link to Registration: (tinyurl.com/mra3pt9s

@hopkinspress.bsky.social
#GIOnc

🌇And in our last discussion of the day, @EileenMOReilly shared with us her experience with, and promise of the many ongoing trials of novel KRAS⛔️
🙏There is real promise here that KRAS⛔️will improve the mOS of #pancreaticcancer patients across the board🙏

@hopkinspress.bsky.social
#GIOnc

➡️Pancreatic enzyme insufficiency is very challening for patients with #pancreaticcancer (and difficult for their physicians to manage)
✅We need dieticians like Mary-Eve Brown to help us manage these patients

@hopkinspress.bsky.social
#GIOnc

✅@NeehaZaidi presented a slightly different view that we need studies to understand which patients with oligometastatic #pancreaticcancer would benefit from surgery
🤔Should we be considering adjunctive Tx, such as vaccines, that might⬆️long-term control❓

@hopkinspress.bsky.social
#GIOnc

👉Some patients with limited metastatic #colorectalcancer can be cured
🤔Can we find which patients with metastatic #pancreaticcancer might also benefit from surgery❓
Dr. Rick Burkhart🗣️the support for surgery for limited, oligometastatic pancreatic cancer

@hopkinspress.bsky.social
#GIOnc

🤔We🗣️the use of radiation☢️for localized pancreatic cancer
➡️Randomized trials (with some flaws) have not supported☢️
BUT there is some evidence that ablative☢️may actually⬆️mOS
Dr. Amol Narang reviewed this data - giving us a lot of food for thought💭

@hopkinspress.bsky.social
#GIOnc

👉You have listen to @EileenMOReilly 🗣️ #PancreaticCancer
➡️Not only does she present a truly comprehensive review of treatment options
🙏But, she has a real knack for raising our hope for improvement for this devastating disease‼️
@PanCAN
#WageHope

@hopkinspress.bsky.social
#GIOnc

😀I have been eagerly awaiting this Keynote👩‍🏫session on targeting🎯KRAS and the KRAS⛔️ by Dr. Nilo Azad
➡️KRAS inhibition looks so promising for out #GICancer patients particularly #pancreaticcancer and #colorectalcancer

@hopkinspress.bsky.social
#GIOnc

✅Keeping the patient's very personal experience front and center, Cindy Papesh Shephard, our wound/ostomy nurse educates all of us - especially the docs on how to manage and live with an ostomy

@hopkinspress.bsky.social
#GIOnc

@skopetz is back on stage to🗣️targeted therapies🎯💊for #colorectalcancer
➡️His group brought encorafenib + cetuximab to the forefront for BRAFV600E-mutated CRC🙏
➡️Overcoming resistance to KRAS⛔️with chemo or IO
➡️Epigenetics
➡️Other2⃣-ary🧬mutations

@hopkinspress.bsky.social
#GIOnc

🤔How are you usuing ctDNA testing after resection of a #colorectalcancer ❓
✅Dr. Valerie Lee presented the current data, and the many persistent questions in this space

@hopkinspress.bsky.social
#GIOnc

✅Whereas, Dr. Ada Graham makes the case for the importance and essential nature of surgery🔪(and some of the challenges with radiation therapy☢️) for rectal cancer

@hopkinspress.bsky.social
#GIOnc

✅Dr. Rachit Kumar, from Radiation Oncology makes a case for chemoradiation, followed by watchful-waiting for rectal cancer with a complete clinical response

@hopkinspress.bsky.social
#GIOnc

#RectalCancer mgmt is IMHO the most complicated part of CRC Tx
😟It's harder to decide what we DON'T need to include (i.e. no🔪 or no☢️)
Dr. Valerie Lee from @HopkinsMedicine set up the🗣️and debate on how to manage a patient with a localized rectal cancer

@hopkinspress.bsky.social
#GIOnc

✅@skopetz.bsky.social guides us through what has become a very complicated field - the management of metastatic, newly diagnosed #colorectalcancer
➡️Triplet vs. doublet chemotherapy
➡️Right vs. Left-sided cancers
➡️Incorporating biomarkers

@hopkinspress.bsky.social
#GIOnc

🧑‍⚕️We have to consider symptom management in our patients with upper GI cancers
✅Dr. Saowanee Ngamruengphong from Johns Hopkins is a gastroenterologist that provided her advice on the management of severe gastroesophageal reflux after an esophagectomy

@hopkinspress.bsky.social
#GIOnc

🗒️Treatment options for advanced upper GI cancers have expanded quite a bit in the last ~10 years

✅Dr. Manish Shah highlighted🔦the many options, in particular targeted therapy🎯💊options in the treatment of advanced gastric/GEJ/esophageal cancers

@hopkinspress.bsky.social
#GIOnc

✅Dr. Jeremy Davis from @ummedschool.bsky.social gave a very⏲️timely🗣️, fresh off the #GI25 👩‍🏫of the DRAGON-01 trial
🤔Should we consider surgery🔪(gastrectomy + cytoreduction +/- HIPEC) for a patient with metastatic gastric cancer with peritoneal carcinomatosis

@hopkinspress.bsky.social
#GIOnc

🤔Or, do you prefer to incoroporate radiation☢️
➡️Dr. Adi Halthore makes a case for chemoradiation (i.e. the CROSS regimen)

@hopkinspress.bsky.social
#GIOnc

🤔What are your thoughts on the management of a localized esophageal/gastroesophageal cancer❓
➡️Do you prefer perioperative chemotherapy alone ❓
✅Dr. Bever makes a case for the ESOPEC data supporting the use of perioperative FLOT

@hopkinspress.bsky.social
#GIOnc

🌇Starting the day out with Upper GI Cancers
Dr. Manish Shah is walking🚶us through all the updates, and highlighting the progress that has been made in the fight against gastric/gastroesophageal/esophageal cancers

@hopkinspress.bsky.social
#GIOnc

➡️It is really important to me personally that we are able to share these sessions with anyone who wants to watch

✅So, as always - the conference is free to register and all sessions are available streaming🖥️on line
t.co/fMVgpQJ4b7

@hopkinspress.bsky.social
#GIOnc

📢Launching Day 2⃣‼️
😀I am confident that today's sessions will be as GREAT as yesterday's sessions

So - join us NOW for this 3rd Annual Johns Hopkins Updates in Gastrointestinal Cancers Conference

@hopkinspress.bsky.social
#GI Onc

➡️In a recurrent theme for today (and possibly most relevant for NETs) for patients with low grade NETs with limited liver metastatic Dz, should we pursue "local" Tx❓
👉Surgery
👉Or liver-directed Tx
@KLafaro and Dr. Kelvin Hong discussed these2⃣options

@hopkinspress.bsky.social
#GIOnc

⏲️It is time for Dr. Aman Chauhan from the University of Miami Sylvester Cancer Center to talk to us about peptide radiotherapy #PRRT

@hopkinspress.bsky.social
#GIOnc

👉Ana DeJesus Acosta helps us understand how best to manage patients with high grade neuroendocrine carcinomas
✅Standard of care is still cisplatin + etoposide and cape-tem
🙏Need novel therapeutic options for this disease

@hopkinspress.bsky.social
#GIOnc

🚶‍♀️On to #neuroendocrine tumors starting with Jennifer Chan from @danafarber.bsky.social who gave us a super comprehensive review on systemic therapy for this disease

@hopkinspress.bsky.social
#GIOnc

➡️While we have all these new treatments for #cholangiocarcinoma patients, our hands👐are tied if the patient's biliary tree remains blocked
✅Dr. Olaya Brewer Gutierrez presented to us all the options for managing recurrent biliary obstruction

@hopkinspress.bsky.social
#GIOnc

😀Dr. Shroff detailed the multiple >2⃣nd line treatments available for #Cholangiocarcinoma including chemotherapy⚗️(e.g. FOLFOX), and the many targeted therapies🎯💊
Lesson: 🧬TEST, 🧬TEST, 🧬TEST your patients

@hopkinspress.bsky.social
#GIOnc

➡️In a patient who does have an operable, and potentially curable #cholangiocarcinoma, surgery🔪is standard - but could there be a role for "liver-directed" therapy❓
Dr. Flavio Rocha and Dr. Robert Liddell consider these two options