Saroj Niraula
@sarojniraula
A cancer physician's personal account
Cancer is not a statistical gamble It is a battle for time, for second chances, for lives that should not be lost And if we keep justifying treatments without survival, how long before we stop asking that question at all? More here..... tinyurl.com/yc2vcpsa
Resurrection Sunday read: A fair (I think) and critical review about all you need to know about adjuvant CDK4/6 inhibitors in breast cancer sciencedirect.com/science/articl…
Head into the weekend with this 5-minute read on the myths and misunderstandings around surrogate endpoints in early breast cancer. I don’t bluff; this one’s worth your time. #BCSM #Oncology #EvidenceMatters
Just published: Is iDFS a strong surrogate for OS in #bcsm? My @JCO_ASCO LTE challenges the claim: R² = 0.46 means 54% of OS variance remains unexplained, yet iDFS continues to drive decisions! Oncology needs stronger evidence standards Here: ascopubs.org/doi/10.1200/JC…
Inappropriate Conclusions on Surrogate End Points in Early Breast Cancer Trials ‼️ ascopubs.org/doi/10.1200/JC…
Nice read!
Just published: Is iDFS a strong surrogate for OS in #bcsm? My @JCO_ASCO LTE challenges the claim: R² = 0.46 means 54% of OS variance remains unexplained, yet iDFS continues to drive decisions! Oncology needs stronger evidence standards Here: ascopubs.org/doi/10.1200/JC…
Great discussion on Surrogate End Points. Are we measuring what matters, or just what's easy and fast? ⬇️⬇️⬇️ ascopubs.org/doi/pdf/10.120…
Just published: Is iDFS a strong surrogate for OS in #bcsm? My @JCO_ASCO LTE challenges the claim: R² = 0.46 means 54% of OS variance remains unexplained, yet iDFS continues to drive decisions! Oncology needs stronger evidence standards Here: ascopubs.org/doi/10.1200/JC…
Telling your patient to exercise and giving them information on it was the control arm in CHALLENGE.
Great appraisal! Methodological clarity like this is essential, regardless of an intervention’s popularity Not a critique of exercise or investigators Gutsy to raise amid such enthusiasm Caveat: I’d be less concerned about discussed “toxicity” cause intervention broadly healthy
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In an infrequent cost-effectiveness publication in @JCO_ASCO T-DXd in HER2-low breast cancer costs $400K–$2.2M per QALY. Prior CEAs in JCO have stayed academic, with little policy traction. Regardless, nice to see major journals publishing politically inconvenient truths.
Cost and Cost-Effectiveness of Treating Human Epidermal Growth Factor Receptor 2–Low Metastatic #BreastCancer. Read the full article. brnw.ch/21wTbGy #BCSM
🚨 Wow! #ASCO25 @ASCO was absolutely massive! 10 @NEJM papers published simultaneously 👉 all practice-changing studies ! 🔬✨🧵 See below for these studies 👇@oncoalert
#ASCO25 @ASCO Back to the basics If a new therapy: - Doesn't improve survival - Doesn't improve QoL - May delay progression marginally without lasting gain, yet adds sig. toxicity, inconvenience & cost That's not therapeutic. That fits the definition of a HARMFUL intervention
This is a major story from #ASCO25. Randomized phase 3 trial of time of day of immunotherapy infusion. Randomized to infusion before or after 3pm. Early infusion far superior: PFS 11.3 vs 5.7 HR 0.42, OS HR 0.45! Impactful, pragmatic, not costly. This should be a bigger story.