Thoracic Med Oncologist | Community Oriented Clinical Trialist | @UTSWHemeOnc | #LCSM #globaloncology #patienteducation #meded| @ASCOTECAG | Views are mine

Joined January 2017
Hot off the press!! Our recent paper got published in J of Cancer Policy. Our study estimated over $1.44 billion in savings using alternative dosing strategies for ICU. Thank you to @ADesaiMD and @ASridharMD for their mentorship on this project. sciencedirect.com/science/ar…
New in J Cancer Policy: lower-dose ICIs ➡️ Pembro 2, nivo 2, atezo 10 mg/kg ➡️ Est. Medicare savings 2018–2021: nearly $1.44B ➡️ Nivo $943.1M, pembro $382.2M, atezo $114.4M What moves first: FDA, CMS or vials? doi.org/10.1016/j.jcpo.2026.… @LungCancerRx @OncoAlert @oncodaily
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Amazing Jekyll and Hyde edition of @NEJM this week! First- rand ph 3 trial showing impressive and durable benefit of in vivo gene editing to ameliorate hereditary angioedema by CRISPR mediated inactivation of the prekallikrein gene in liver cells Then- the dark side of gene therapy: AAV gene therapy leading to a paraspinal neoplasm caused by integration of AAV sequences driving GLI1 expression leading to tumor formation xitter.cf/nejm/status/2111638404… Well- what is not just crisp but getting crispr and crispr based on such amazing studies is that molecular medicine is now yielding true wonders but needs to be very carefully designed/supervised/monitored for success!
In a phase 3, randomized trial of lonvo-z, an in vivo gene-editing therapy, patients with hereditary angioedema who received the drug had a significantly lower attack rate than those who received placebo. Full HAELO trial results and Research Summary: nej.md/4gaSsbi
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🇯🇵 DECIDE-MET (JCOG2506) is a randomized phase III trial in 1L METex14 NSCLC ⚖️ Capmatinib/tepotinib vs pembrolizumab (PD-L1 ≥50%) or pembro + platinum chemo (<50%) 🔗 clinical-lung-cancer.com/art…
METex14 occurs across histologies. RNAseq can identify additional cases missed by DNAseq. Capmatinib and tepotinib remain preferred. 1L IO may have a role in select pts based on clinicopathologic factors. The DECIDE-MET trial will help clarify this. #DCLung2026 @jennifermarksmd
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⭐️🚨Hot off the press👉published in @ASCO 's flagship journal #JCO @JCO_ASCO 👉 Pleased to share our perspective👉"Nivolumab/Ipilimumab and Pembrolizumab for All Cancers: Australia's Landmark Tumor-Agnostic Immunotherapy Reimbursement" ⭐️On March 1, 2026, Australia did something no national health system had done: a PAN-TUMOR listing for nivolumab + ipilimumab, open to any patient with advanced cancer whose oncologist deems it appropriate. Pembrolizumab followed that. ⭐️We lay out what supports the decision + take on the real controversy: no mandatory predictive biomarker/ across all tumors+ call on regulators + payers in the United States, Europe, & beyond to heed this precedent with urgency, especially as these agents edge toward generics @Dr_R_Kurzrock @OncoAlert @oncodaily Link: ascopubs.org/doi/10.1200/JCO…
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📚 Preparing for Heme/Onc boards? Join @ABIMcert, @ASCO & @ASH_hematology for a TEC Town Hall on the Board Certification Process. 📘 Blueprints & pathways ⏱️ Study strategies 📊 ITEs & exam readiness 💬 Live Q&A 🗓 Oct 7 | 5–6 PM ET 🔗 REGISTRATION LINK: shorturl.at/7SQks
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biorxiv.org/content/10.64898… #LCSM @BZhangMD In 138 SCLC patients, our @UTMDAnderson CLIA DLL3 IHC predicted response and long-term outcomes with TARLATAMAB, while Dynamic monitoring (ctDNA/CTCs) revealed tarlatamab resistance. To our knowledge, this is the largest to validate DLL3
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An important update on reduced monitoring for Tarlatamab. @FDA approves reduced monitoring for Tarlatamab for cycle 1 day 1 and day 8 of tarlatamab 👉 observation reduced to 6-8 hrs 👉🏽vital signs & assessment follow up on day 2 and 9 👉🏿Patients to be within 1 hr of the healthcare setting for 48 hrs, following cycle 1 day 1 and day 8, + encouraged to have caregiver Important update to make Tarlatamab more accessible for ALL patients. @SclcSMASHERS @drshieldsmd @LUNGevity
🚨🔥@OncoAlert Hot off the press. ⭐️@FDA approves: ❇️#Reduced #MonitoringTime for first two doses of #Tarlatamab in #SmallCell #LungCancer. ⏳22-24 hrs ➡️ 6-8 hrs. Important update/change that supports broader #access & ⬇️complexity for #Patients. 👇🏻 amgen.com/newsroom/press-rel…
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Replying to @AmgenOncology
@AmgenOncology received approval on September 14, 2026 to REDUCE the recommended monitoring period for tarlatamab, which is currently FDA approved for the 2L setting for ES-SCLC. Specifically, this approved label update reduces the recommended monitoring for cycle 1 day 1 and day 8 of tarlatamab: ⭐️ observation 22-24 hrs ➡️ 6-8 hrs ⭐️ vital signs & assessment follow up on the subsequent day (days 2 & 9) Note: Patients should remain within 1 hr of the appropriate healthcare setting for 48 hrs, following cycle 1 day 1 and day 8, and care partner support is encouraged. 🔑 These vital updates help our SMASHERS gain improved access to life-changing therapeutics by reducing barriers, such as need for hospitalization for administration and monitoring. ‼️Unmet need: Validated risk assessment tools will be helpful to identify those who may be at risk for high grade CRS and early interventions. @SclcSMASHERS @FDA @LUNGevity @lungoncdoc @StephenVLiu @HHorinouchi @g_mountzios @sands_jacob @LauraAlderMD @oncodaily @OncoAlert @Latinamd @LuisPaz_Ares @RManochakian @LuisRaezMD @triparnasen @LaurenByersMD @LungCancerEu @alissajcooper @BZhangMD @NaglaAKarimMD @Annechiangmd @IASLC @NCCN @ASCO
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Dr. Ross Camidge honored with the Paul Bunn Jr. Scientific Award - one of the brightest minds in thoracic medical oncology, a true pioneer, and a role model to so many. #WCLC26
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Will you avoid PCI based upon this trial in SCLC ? NI of 1.25 . Not all received IO . More Brain Mets in non pci arm . Primary end point changed mid trial. @DrewMoghanaki @StephenVLiu @IASLC @LauraAlderMD @Latinamd @RManochakian
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Sevabirtinib is now @FDA ✅ in 1L HER2/ERBB2 TKD mutated mNSCLC based off SOHO-01: - ORR: 75% - 73% of responding pts had DOR ≥ 6 months and 38% had ≥ 12 months - AEs: Diarrhea, LFTs, and Pneumonitis #Lcsm #WCLC26 #OncTwitter @OncUpdates
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Wonderful news for our patients with SCLC! Looking forward to reading the full paper. The big unanswered question is how we can effectively operationalise tarlatamab administration such that it reaches the patients who need it? Big congrats to the investigators and patients who made this landmark milestone happen. @SclcSMASHERS @AmgenOncology @sands_jacob
📢 #SCLC news: Amgen announced that a Phase 3 study evaluating its DLL3-targeting therapy as part of first-line maintenance treatment for patients with extensive-stage small cell lung cancer met its primary endpoint ➡️ Learn more: amgen.ly/4ihHq5p $AMGN
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Approval is only the first step. Access is the finish line. Excellent @jco piece by @IbiayiMD and an important call to action to ensure post-approval operational readiness after novel drug approvals. We can’t celebrate FDA approval if patients still can’t access the therapy. Sunvozertinib and daraxonrasib are timely examples of the gap between regulatory approval and real-world availability. Speeding to a Stop: Postapproval Barriers to Accessing New Lung Cancer Therapies | Journal of Clinical Oncology ascopubs.org/doi/full/10.120… #acesstocare
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An excellent and all encompassive article published in the @nytimes about the challenges in the current regulatory system within the United States. A must read for patients, family members and clinical trialists. The article highlights a few key points to me: 1. There are tangible changes in the pharmaceutical dynamics globally. Close to 40% of the trials originate from China in contract to 5% a decade ago. Many are from smaller biopharmaceutical companies for whom regulatory delays could be make or break and therefore find it easier to conduct Phase 1 trials outside of the USA 2. With the large amount of real world data and AI assisted analytics, the quality of data that feeds these algorithms are important and with the advent of precision oncology, it is imporant that we are able to bring novel therapies to diverse patient groups. 3. Therefore its more important now than ever that we address the regulatory pathways for early phase clinical trials, where innovation begins. 3. Operation #TraillBlazer from the @FDAOncology is an important step and with regulatory changes, this could be a catalyst in changing the lens through which the FDA looks at data from trials @lungoncdoc @RManochakian @AditiSinghMD @jennifermarksmd @NarjustFlorezMD @FawziAbuRous @ipreeshagul @TiansterZhang @CharlesJiangMD @WinnAwards @SyedKazmiMD @COlazagasti @DrJedDowell @Latinamd
We are on the cusp of a wave of new therapies for some of the worst diseases. But the world won’t benefit unless the US fixes its drug regulatory system. My new essay for @nytimes, on how slow clinical trials are now the biggest obstacle to curing cancer. nytimes.com/2026/09/04/opini… - I interviewed dozens of researchers, especially oncologists at leading U.S. centers. A striking consensus emerged: science is no longer the main bottleneck to new cancer drugs. It is our ability to test discoveries in patients through clinical trials. - The cost of starting a Phase 1 trial in America has roughly doubled over the past decade. As a result, companies increasingly take early trials abroad: Australia’s Phase 1 trial volume has nearly doubled in a decade, driven mainly by U.S. companies. - Unfortunately, the underlying incentives are badly asymmetric: Institutions can be blamed for harms caused by moving too fast, but almost no one is blamed when patients deteriorate during avoidable delays. One doctor called the emerging system “ritualized safety over actual risk assessment.” Or as, @DavidHongMD put it: "We often forget that the biggest risk is the cancer itself." - This problem is becoming more urgent because medicine itself is changing. Sequencing, biological engineering and A.I. make increasingly personalized therapies possible. But our regulatory system was mostly built for standardized drugs tested in large populations. - @sytse, the co-founder of GitLab, shows what personalized medicine can achieve: after relapsed osteosarcoma and being told there were no options left, he pursued a highly individualized approach and has now been cancer-free for a year. But doing so required extraordinary resources and regulatory expertise. - Pierce Ogden’s father was less lucky. After molecular analysis identified a drug that might target his glioblastoma, the manufacturer agreed to provide it. But administrative barriers delayed access until it was too late. “My dad was ready to try anything,” Pierce told me. “But the system is paternalistic.” - The A.I. revolution is making this bottleneck more important, not less. A.I. relies on relevant data. Information from early-stage trials could compound with A.I. tools to achieve truly revolutionary medicines. Without the data, this is far less likely to happen. - Another important shift is that innovation increasingly comes from academic labs and small biotech companies rather than Big Pharma. These small companies find it far harder to unable to absorb delays and regulatory barriers. - Apart from cancer, China is the biggest winner from America's outdated medical regulations. China has a much faster trial system, with testing often starting a full year earlier. This allows Chinese pharmaceutical companies to experiment and improve medicines while American companies play with mice. Today, half of all drugs licensed by major pharmaceutical companies originate there, up from less than 5 percent only a decade ago. - But we don't need to copy China. The best model is Australia: lots of on-site scientific and ethics reviews, and requirements that are proportionate to small, early-stage trials. Phase 1 studies there begin roughly 6–12 months faster, without any notable increases in adverse safety events. - Operation TrialBlazer, a 2026 HHS initiative is a good start in this direction, but we need legislative action by Congress to truly make Phase I trials faster and more efficient! I want to thank everyone who helped me with this article: everyone I interviewed and the amazing editors at the Times. This is the result of a months long journey of extensive interviews and research. Special thanks go to those who came on the record. One of the features of the system is an atmosphere of fear, where practitioners are afraid to publicly come out and explain these issues. So anyone who does is a hero in my book!
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RAS(ON)i daraxonrasib in pretreated RAS mutant (non G12C) lung cancer, high grade tox in 54% incl 2.9% deaths. Tumor responses in 31-37% of pts, PFS 8.3m. So far not the breakthrough in lung cancer that it has been in pancreatic cancer #lcsm
In a phase 1–2 study of daraxonrasib, 54% of patients with RAS-mutant non–small-cell lung cancer had grade 3 or higher adverse events, mainly pneumonia, diarrhea, and rash; more than 30% of patients had a response. Full study results: nej.md/4h0GHUW
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Press release: Phase III REZILIENT3 trial meets its primary endpoint. Adding zipalertinib to first line chemotherapy for advanced NSCLC with an EGFR exon 20 insertion mutation significantly improved PFS over chemo alone. taihooncology.com/us/news/zi…
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