Dr Rajesh Bollam @CancerDochyd

🚀 Novel targets in PTCL 🔹 PI3K inhibitors 🔹 EZH2 inhibitors 🔹 JAK/STAT pathways 🔹 Novel surface molecules 🔹 Combination therapies 🔹 CAR-T 👉 Expanding options beyond conventional chemo for aggressive T-cell lymphomas. #PTCL #SOHO25

🧬 Approved JAK inhibitors in MF 📌 Ruxolitinib (2011) – 1st-in-class 📌 Fedratinib (2019) – 2nd-line / ruxo-fail 📌 Pacritinib (2022) – for cytopenic MF (PLT <50×10⁹/L) 📌 Momelotinib (2023–24) – for MF + anemia ➡️ All target splenomegaly & symptoms #MF #SOHO25

🔹️ER-low tumors show poor prognosis, similar to TNBC. 🔹️Phenotypic switch from ER+ → ER-low at relapse = marked survival drop 🔹️Nivolumab response rates match TNBC (~20%) 🔹️Similar immune profile & PD-L1 positivity 💬ER-low patients need TNBC-focused trials & drug…

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🚧 Blood–Brain Barrier: nature’s checkpoint… and the drugs that outsmart it. 🧠💊 🔒 The BBB (tight junctions + efflux pumps) blocks most chemo. But some oncology drugs cross effectively ⬇️ 🦾 EGFR TKIs (NSCLC) • Osimertinib, Lazertinib, Furmonertinib → strong CNS activity…

⚡🧬 Blinatumomab CRS (Cytokine Release Syndrome) – Grading & Management 📌 Definition: CRS = immune hyperactivation 💥 after T-cell engaging therapy (blina, CAR-T). 🔢 ASTCT CRS Grading (Blinatumomab, NCCN 2025 / ASH 2024) 1️⃣ Grade 1 😅 •Fever ≥38°C 🌡️ •No hypotension, no…

Goodbye chemo? 👋 The new face of Follicular Lymphoma is immunotherapy. 📊 BJH 2025 Review | Towards chemo-free FL 🔑 Key takeaways: • 2L+ → R² (rituximab+lenalidomide) or Tafa-R² ✅ • BsAbs: mosunetuzumab, epcoritamab, odronextamab 🤖 • CAR-T (axi-cel, tisa-cel,…

🚨 ALL: From chemo marathon ➝ targeted era 🎯 📊 Lancet 2025 | Seminar | Acute Lymphoblastic Leukaemia 🔑 Big takeaways: 🧬 >23 B-cell & 17 T-cell ALL subtypes now genomically defined 📈 Paeds OS >90% Adults (Ph+) catching up ~80–90% 💊 Ponatinib + Blina = chemo-free…

🧬🔥 JAK Inhibitors in Myelofibrosis – Major Adverse Effects (ASCO-SEP 2025 📖) 🔹 Ruxolitinib ⚠️ Anemia & thrombocytopenia 🦠 Herpes simplex & zoster reactivation (💉 vaccinate first) 🧫 TB reactivation 🧠 PML (rare) 🦠 Hepatitis B reactivation ☀️ Non-melanoma skin cancers 🧬…

🔥 CAR-T in Myeloma: Don’t Burn the Bridge 🔥 🧪 Frenking et al. (Blood Adv 2025;9:4151-66, n=158) • 🚫 Intensive alkylator bridging → longer cytopenias (ANC 63d vs 21d) • ⚠️ 50% ↑ severe infections • 📉 Worse PFS & OS vs lower-intensity / no alkylator BT 📖 Take-home:…

👵💊 Chemo ≥70y: more harm, no gain 📍 ASTER 70s (Lancet 2025) | Phase III | n=1089 | 🇫🇷🇧🇪 🧬 GGI = 8-gene cell-cycle signature (RT-PCR on FFPE) ➡️ High-risk → randomised ⚖️ Arms • 💉 Chemo (4 cycles) ➡️ HT • 🌿 HT alone 📊 Results (7.8y FU): • 🕗 8-yr OS: 72.7% vs 68.3%…

🌺 Beyond 5 years: Who really benefits from extended endocrine therapy? 📊 ESMO Open 2025 review • HR+ early BC = relapse risk persists 20 yrs after dx • Extending ET ↓ recurrence, esp. node+ / high-risk pts 🧪 Key trials 🔹 ATLAS / aTTom → Tam 10y > 5y (DFS & OS ↑, but…

🎯 Targeted. 💉 Immune. 🔬 Precise. The new face of early NSCLC — ESMO 2025 ⚡ 🔑 Key updates 🧬 Biomarker testing (EGFR, ALK, PD-L1) now mandatory in stage IB–III 💊 Adjuvant targeted therapy ADAURA → Osimertinib (EGFR) ALINA → Alectinib (ALK) 💉 Peri-op immunotherapy…

Numerology in Oncology 4,14 14,16 14,20 are bad myeloma s 14 is common to all 14 has IGH gene It is a strong enhancer Triggers the partner ON Partners (4,16, 20) have strong oncogene, which gets triggered , hence highly proliferative myelomas.

🤰🩸 Thrombocytopenia in Pregnancy – Timing & Causes 🟢 1st trimester: Rare overall Most cases = ITP (Immune Thrombocytopenia) 🎯 GT (Gestational Thrombocytopenia) uncommon this early 🟡 2nd trimester: ↑ Frequency of thrombocytopenia ITP still common GT begins to appear…

9 Systems That Create 10+ Hours Every Week: (Bookmarks it. Use it)

Honored to share results of our IIT Phase II trial of osimertinib + consolidative RT in EGFR+ NSCLC, now published in @eClinicalMed @utswnews & @cityofhope. Grateful to my mentor Dr. David Gerber, collaborators and patients.

📢 A decade later, CHAARTED proves: disease volume + PSA nadir decide the game. 🧬 mHSPC 10-year update: •🚀 Docetaxel + ADT → OS benefit in high-volume disease (20.9% vs 11.4% at 10y) •❌ No OS gain in low-volume groups 🔑 PSA nadir <0.2 ng/mL at 6mo = strongest…

🧵 Iron Deficiency in Adult Males — Why, Causes, & Management 🔹 Intro Iron deficiency (ID) in men 🚹 is always pathologic until proven otherwise. Unlike menstruating women, males do not lose iron physiologically → must search for cause. ⸻ 🧬 Rationale •Iron = 🔑 for Hb…

🧵 IM Injections & Platelet Cut-offs 💉🩸 ⸻ 🔹 Def: IM = injection into muscle. ⚠️ Risk of hematoma if thrombocytopenic. ⸻ 📊 Cut-offs from evidence 👉 “>20k/µL platelets = adequate for IM injection” — Emory Hematology FAQ 【emoryhealthcare.org】 👉 “20–30k/µL =…

Eosinophilia Always Think Secondary Causes First!.... #hematology #medtwitter #meded #blooducation #medicaleducation