Shankar Siva @_ShankarSiva Twitter profile

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Shankar Siva

7 months

1/ Thank you 🙏🏾, patients, families, and investigators, for contributing to the SEISMIC 🫁trial out now @LancetRespirMed - . Led by 🫁 @DanSteinfort , this international multicentre recruited n=155 trial from 🇦🇺, 🇨🇦, 🇺🇸, 🇳🇱 #radonc @tssmn @PeterMacRadOnc

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Shankar Siva

@_ShankarSiva

2 years

@ErinGillespieMD presents a provocative phase II RCT of prophylactic #radiotherapy to asymptomatic but high risk bone Mets. N=93 Convincing home run, 29% vs 1.6% skeletal related events, with an ⬆️ OS benefit! Remained significant on MVA #ASTRO22 #OncoAlert

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Shankar Siva

@_ShankarSiva

1 year

🧵1/ 🙏🏾🙏🏾Thank you patients, families, trial staff and investigators for participating in @TROGfightcancer 15.03 FASTRACK II! This trial recruited n=70 across 8 sites in 🇦🇺 and 🇳🇱 #ASTRO23 ! #radonc #kcsm #radiotherapy @ANZUPtrials @KidneyCancer

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Shankar Siva

@_ShankarSiva

2 years

🧵1/ Wide adoption of SABR for primary #kidneycancer is limited by long-term data. Online today @TheLancetOncol ; 5-yr outcomes in 190 patients. 5% local failure rates, 95% cancer-specific survival. Thanks @ElsevierConnect for 50-day link: #radonc #kcsm

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Shankar Siva

@_ShankarSiva

3 years

1/ 🙏 patients, investigators and funders for @TROGfightcancer 13.01 SAFRON II trial at #ESTRO21 . n=90 pts with 133 pulmonary oligometastases, across 13 centers in 🇳🇿+🇦🇺. Median F/U = 3 years, randomization for single (SF) 28Gy vs 48Gy in 4fx (MF). #radonc #LCSM @PeterMacCC

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Shankar Siva

@_ShankarSiva

1 year

🍾😋🤗 yay! Thank you for all the support from mentors, mentees and collaborators along the way 🙌🏽 ….As they say it takes a village to raise a child….. #radonc @PeterMacRadOnc

Peter Mac Research

@PeterMacRes

1 year

Congratulations to @_ShankarSiva on his appointment to Honorary Clinical Professor with the Sir Peter MacCallum Department of Oncology, at the University of Melbourne. Prof Siva leads the Stereotactic Ablative Body Radiotherapy (SABR) program @PeterMacCC . #radiotherapy #cancer

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Shankar Siva

@_ShankarSiva

2 years

Late breaking abstracts #ASTRO22 - @ChadTangMD EXTEND trial; oligometastatic #prostatecancer . Intermittent ADT + SABR versus ADR alone extends PFS, but importantly time men enjoy off ADT in the long term (eugonadal PFS). Important patient centric endpoint! 👏🏽⭐️ @OncoAlert #pcsm

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Shankar Siva

@_ShankarSiva

2 years

Joe O’Sullivan presents CHHiP trial update 10-year data confirms 60/20 hypofractionated #radiotherapy as the standard of care for #prostatecancer (mostly intermediate). Good to see late significant GI/GU toxicity <1-2% at 10 years! @asco #GU23 #radonc #pcsm @OncoAlert

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Shankar Siva

@_ShankarSiva

3 years

💪🦾 @CDNCancerTrials @SahgalArjun in collab. with @TROGfightcancer - SC.24 phase III here - . n=229 from 🇨🇦 +🇦🇺, SBRT (24Gy/2) vs standard #radiotherapy (20Gy/5) for painful spinal mets. 3-month pain CR ⬆️36% vs ⬇️14%, p<0.01. Is SBRT the new SoC? #radonc

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Shankar Siva

@_ShankarSiva

5 years

It's here! SABR-COMET published in @TheLancet - - randomised trial of ablation in oligometastastic (1-5) #cancer . Double median PFS (6 mo vs 12 mo) and increased med overall survival (28 mo vs 41mo, p=0.09). @drdavidpalma et al. #lcsm #pcsm #radonc #tssmn

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Shankar Siva

@_ShankarSiva

2 years

STOMP and ORIOLE long term outcomes. Metastasis-directed SABR in oligometastatic #prostatecancer ⬆️PFS from 5.9mo to 11.9mo (HR 0.44, p<0.001). Men without Hi-risk mutations on nGEN seq. had rPFS of 22.6mo. Article here ➡️ @JCO_ASCO #radonc #pcsm @gu_onc

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Shankar Siva

@_ShankarSiva

5 years

Finally! A randomised trial of upfront SABR in #lungcancer patients with oligometastatic eGFR driver mutations. At #WCLC19 Dr Li Zhang 🇨🇳presents in n=61 a doubling of PFS outcomes with addition of SABR #lcsm #RadOnc

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Shankar Siva

@_ShankarSiva

6 months

What I learned in 🇨🇱 today … $5mill = one #radiotherapy machine☢️, can treat 10k patients. $5mill = 135 patients worth of trastuzumab. 🧐 @TheLancetOncol - “an essential pillar in multi-D oncology…an inexpensive modality” - 👏🏽 well said @TargetingCancer

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Shankar Siva

@_ShankarSiva

2 years

Trimodality bladder preservation versus cystectomy for muscle invasive bladder cancer; matched cohort #ASTRO22 @OncoAlert . Dr J Efstathiou - outcomes similar for TMT versus cystectomy. 13% required salvage cystectomy, but did not impact survival. Hydronephrosis a bad player ☹️

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Shankar Siva

@_ShankarSiva

4 years

Pleased to present RAPPORT PhI/II trial at #GU21 @ASCO in oligometastatic #kidneycancer . Median F/U 2.3 years, n=30 with 83 mets. Multi-site SABR + 6 mo #ImmunoOnc was safe with 13% G3 tox, no G4/G5 tox. Effective with 2-year PFS=45% and LC=92%, and ORR 63%. Warrants further Ix!

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Shankar Siva

@_ShankarSiva

5 years

"The Abscopal Effect of Stereotactic Radiotherapy and Immunotherapy: Fool’s Gold or El Dorado?" - #radonc

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Shankar Siva

@_ShankarSiva

1 year

🔥 @ErinGillespieMD randomized trial of SoC +/- #radiotherapy , n=78 with 122 high-risk bone metastases, mixed histology, - ⬇️ Skeletal-related events 1.6% vs 22% (p<0.001) - ⬆️OS - HR [0.49] with RT, p=0.018 👏👏👏 amazing outcomes #radonc !! #lungcancer

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Shankar Siva

@_ShankarSiva

1 year

🧵2/ Metastasis-directed Tx to the 🫁 has limited trial evidence (surgery or SABR). Whilst convenient, popular during #COVID19 , there is reluctance for single fraction fraction 🥊 SABR for perceived toxicity. @TROGfightcancer SAFRON II randomised n=90 with 133 🫁 mets to 1 vs 4fx

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Shankar Siva

@_ShankarSiva

2 years

Ever wondered about PSMA PET for #kidneycancer ? series of n=61 @PeterMacCC , n=40 also had FDG-PET. Change in management for 49% (patients screened for oligometastatic dx). Detection rate for PSMA 88% vs 75% FDG, SUVmax 15.2 vs 8.0. Article➡️. @cristian_udo

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Shankar Siva

@_ShankarSiva

7 months

1/ For #KidneyCancerAwareness month @TheLancetOncol has a 50-day full link to @TROGfightcancer FASTRACK II! . Thank you @CancerAustralia , @ANZUPtrials , @VarianMedSys . A new #radiotherapy standard of care option for inoperable primary #kidneycancer #radonc

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Shankar Siva

@_ShankarSiva

5 years

The Wash U Cru helped us plan our first cardiac VT #radonc ablation. My already huge admiration of @SBRT_CR + @DoctorPhillEP just blew up. They spent an hour with us giving us tips on the case, no hubris, genuinely interested in sharing knowledge. This is academic leadership 🙌👏👏

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Shankar Siva

@_ShankarSiva

1 year

🧵1/ 🙏🏾🙏🏾🙏🏾Thank you patients, families, trial staff and investigators for participating in @TROGfightcancer 13.01 SAFRON II! This trial recruited n=90 across 13 sites in 🦘🇦🇺 and 🥝🇳🇿 between 2015-2018. We report the long-term 5-year outcomes at #ESTRO2023 live! #radonc #LCSM

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Shankar Siva

@_ShankarSiva

2 years

NRG/RTOG 1005 - concurrent versus sequential boost #ASTRO22 for breast #radiotherapy . Concurrent boost is non-inferior. No difference in QoL. Concordance with IMPORT High results. This patient-centric trial will save time for patients with #breastcancer . #bcsm #oncoalert

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Shankar Siva

@_ShankarSiva

5 years

Pneumonitis and bacterial pneumonia superinfection is a major issue in #COVID19 - in the past, #radiotherapy was used to treat pneumonia. Nice review here - - any interest in testing this hypothesis #radonc ? 🐺 @SteveFDA

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Shankar Siva

@_ShankarSiva

2 years

Breaking news 💥🗞CALGB104503/Alliance lobectomy Vs sublobar resection for stage IA #WCLC22 . N=697. Sublobar resection was non-inferior for DFS, non-inferior for OS either. 2% worse FEV1 post lobectomy (?clinically significant?). Consistent with JCOG 0802. New standard of care?

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Shankar Siva

@_ShankarSiva

4 years

Starting a very special day in a very special way... happy retirement @DavidDbal !!! Inspiring doctor, mentor to many, compassionate doctor and all-round nice guy. Lung MDT wheeled out the old palliative upright #radiotherapy chair for him! 👏👏👏 in @PeterMacCC purple too. #radonc

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Shankar Siva

@_ShankarSiva

3 years

Marginal failures after bone SBRT is a thing! This guideline may help target delineation - 11 cases, 9 #radonc contours international effort 🇨🇦🇺🇸🇨🇭🇦🇺🇰🇷🇳🇱. Suggest a 5mm-10mm intraosseous margin for microscopic disease. Extraosseous margin for cortex breach

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Shankar Siva

@_ShankarSiva

5 years

1st Cardiac SABR went without a hitch! Massive thanks to @PeterMacCC Anaesthetic & @TheRMH ICU/cardiac teams for support, the fabulous #radiotherapy staff @PeterMacRadOnc - collaborators at @WashURadOnc - and of course @DrGeoffLee for believing it can be done 😉🙏🏽 #EPeeps #Radonc

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Shankar Siva

@_ShankarSiva

4 months

📢🚨 #ASCO24 plenary @DavidRSpigel - pivotal ADRIATIC ph III trial; adjuvant durvalumab arm after chemoradiotherapy (cCRT) ± PCI in small cell #lungcancer ; ⬆️ OS (HR 0.73), median OS 55.9 vs 33.4 for placebo. Grade 3/4 AEs in 24.3% vs 24.2%. 💥Practice changing!!! #radonc #lcsm

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Shankar Siva

@_ShankarSiva

2 years

Three thoracic surgeons and two #radonc walk into a bar…. Vienna 🇦🇹 multidisciplinary #lungcancer knowledge sharing at its best! #WCLC2022 #lcsm

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Shankar Siva

@_ShankarSiva

2 years

Late breaking #ASTRO22 - LUSTRE phase III N=233, randomised SABR vs conventional #radiotherapy in #lungcancer median F/U 3.1 yrs. BOTH central and peripheral tumours. Closed earlier than expected, no statistical diff between arms. So close!! 🫣 @OncoAlert #radonc #lcsm

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Shankar Siva

@_ShankarSiva

4 years

Looking to reduce hospital visits during #COVID19 ? Single fraction SABR could be an option. @PeterMacRadOnc series of n=371 patients with 494 oligometastases. Rate of G3/4 toxicity=3%. At 3 yrs, freedom from systemic therapy = 43%, local failure rate = 8%.

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Shankar Siva

@_ShankarSiva

4 years

Big #kidneycancer in a borderline or inoperable patient? Stereotactic radiotherapy (SABR)⚡️to the rescue 🦸‍♂️ - . Report from IROCK on >T1b RCC. Mean GFR ⬇️ by 7.9mls/min, CSS at 2/4yrs = 96.1% & 91.4%. Local & distant failure at 4yrs = 2.9% & 11.1% #radonc

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Shankar Siva

@_ShankarSiva

1 year

🇮🇹 ARTO team RCT in mCRPC; - 157 mCRPC randomized ph II trial of Abi vs Abi+SBRT on oligometastatic #prostatecance (3 or less) - mostly staged with Choline (~65%) or PSMA PET (~25%) - HR for PFS 0.35 (P < .001) in favour of Abi+SBRT arm #radonc #pcsm @ChrisSweens1

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Shankar Siva

@_ShankarSiva

1 year

Dr Mercier late-breaking #ESTRO2023 - !!!BLINDED!!! RCT of #radiotherapy for painful bone Mets, ➡️single 8Gy 3DCRT versus SABR 20Gy. ⬆️ complete pain response 54% versus 33% at 3 months with SABR, but not 1 month. Higher rates of re-irradiation in conv RT arm. #radonc

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Shankar Siva

@_ShankarSiva

3 years

Title says it all 🥊🥊.... . 1-year local control ranges between 90-95% in prospective trials for pulmonary oligomets and for primary #lungcancer with 1-fraction stereotactic #radiotherapy . What are we waiting for #radonc ? 🙏 @ClinOncology

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Shankar Siva

@_ShankarSiva

1 year

Twice daily radiotherapy to 54Gy BID ⬆️⬆️ OS and PFS in small cell #lungcancer as compared to 45Gy BID. compared to CONVERT and RTOG, higher once daily RT did not ⬆️ OS. #lcsm - abstract ➡️ - time to change?

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Shankar Siva

@_ShankarSiva

5 years

Thank you patients, families and collaborators - we just completed recruitment for the RAPPORT trial! Combo #Immunotherapy & SABR for oligometastatic (1-5) #kidneycancer - . Results due in 2020. Supported by @PeterMacCC foundation & @Merck #radonc #kcsm

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Shankar Siva

@_ShankarSiva

4 years

Here is a rough guide that might help approaches for SBRT to non-spine bone metastases. Consensus BED <100Gy, and fractionation for complex lesion in weight-bearing bone. CTV expansion at extraosseous extension too... #radonc by Tim Nguyen & @SahgalArjun

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Shankar Siva

@_ShankarSiva

1 year

Dr Denise Bernhardt shows RCT of #radiosurgery versus whole brain #radiotherapy for small cell #lungcancer . ➡️Primary endpoint cognitive decline. #lcsm ➡️ 24% decline in WBRT versus 7% in SRS alone OS data to mature!👏🏽👏🏽👏🏽 #ASTRO23

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Shankar Siva

@_ShankarSiva

1 year

👍🏽All packed!!! Running out of room. Hmmm…. Decisions, decisions…. Hopping on a ✈️ tonight, excited to see friends and colleagues at #ESTRO2023 #Vienna , and looking forward to presenting @TROGfightcancer @PeterMacCC trial data! #radonc #lungcancer

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Shankar Siva

@_ShankarSiva

2 years

🔥🔥 primary endpoint analysis from @nickva1 of PACE-A; SBRT versus robotic prostatectomy for #prostatecancer RCT. Co-primary toxicity endpoints (continence/bowel) #GU23 @ASCO @OncoAlert @NHSuk . N=123, SBRT had ⬇️ pad use ⬇️ sexual dysfunction but ⬆️ bowel bother. All low grade.

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Shankar Siva

@_ShankarSiva

1 year

Can you imagine a more thoughtful gift from your observer? 🙏🏽🙏🏽 Thank you so much Dr Thirada Vongvanichvathana from Thailand 🇹🇭 @BangkokHospital for this gift…. If you #twitterati have a cool present from your trainee/mentee please post!!! 😝 #radonc @PeterMacRadOnc @PeterMacCC

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Shankar Siva

@_ShankarSiva

1 year

Thanks for all the iROCKers for coming along! Very please to announce the official launch of the prospective registry at #ASTRO23 !! Click here to find out more ➡️ #radonc

Chad Tang, MD

@ChadTangMD

1 year

Irock registry grand opening happening now at half door brewery. @_ShankarSiva

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Shankar Siva

@_ShankarSiva

2 years

@ldawsonmd NRG/RTOG 1112 phase III RCT, n=293. Median size 8.6cm. 22% in control arm crossover to SBRT at failure. ⬆️OS (HR0.77), still significant after MVA! Near double PFS, and no ⬆️ toxicity. All subgroups benefit. SABR is the new standard of care! 👏🏽👏🏽👏🏽🍾 #ASTRO22 @OncoAlert

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Shankar Siva

@_ShankarSiva

4 years

With modern PET imaging, oligoprogression in CRPC is a new #prostatecancer entity. @DrStish & co. demonstrate that SABR can be used safely delay PSA recurrence by 10mo & delay next intervention by 16mo - - a new paradigm in the making? #pcsm @EUplatinum

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Shankar Siva

@_ShankarSiva

5 years

Two studies of Abscopal effects investigating of SBRT and I/O reported at #GU20 for #kidneycancer Signal finding studies not too much different from SOC. Is it time to stop hunting for abscopal effects, and time to choose more carefully which lesions to irradiate? #kcsm #radonc

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Shankar Siva

@_ShankarSiva

1 year

🧵5/ Tumour size ⬆️⬆️ than RCTs of PN v RN. Toxicity acceptable. As yet, there are no published clinical trials of thermal ablation; therefore, SABR is now a acceptable standard of care for inoperable RCC. FASTRACK II findings should lead to an RCT vs surgery. #ASTRO23 #radonc

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Shankar Siva

@_ShankarSiva

5 years

David Dearnley from @royalmarsdenNHS updates CHHiP hypofractionated #radiotherapy study in #prostatecancer - with 8 yr F/U outcomes are consistent, 60/20 is most promising, with no increase in toxicity with longer term reporting (<2% GU/GI toxicity RTOG 2+) #GU20 #Radonc #pcsm

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Shankar Siva

@_ShankarSiva

1 year

Real-world 🇯🇵 data for operable #lungcancer patients who choose to have SABR. 20 institutions, n=399, median F/U 38mo. 2/3rds >20mm. 3 yr LC=84.2%, OS=77%. Worse for SCC. Seems like a good option when wanting to avoid intubation / major surgery? #radonc

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Shankar Siva

@_ShankarSiva

2 years

Bye bye San Fran @ASCO #GU23 - great so see so many friends and great science. @TargetingCancer made it out too! #radonc

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Shankar Siva

@_ShankarSiva

4 years

Dang thats a lot of SABR for pulmonary oligometastases... - Japanese 🇯🇵 teams treat n=1172 patients, show that local control of irradiated site is critical to avoid pulmonary causes of death. Only 16% had chemo after SBRT, yet 3 yr OS=70% #radonc #LCSM

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Shankar Siva

@_ShankarSiva

2 years

Three stages of investigating metastasis-directed therapy for oligometastatic disease .... #radonc #radiotherapy

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Shankar Siva

@_ShankarSiva

2 years

Use of Gabapentin as prophylaxis during chemoRT for H&N SCC reduced need for opiate analgesia to manage #radiotherapy mucositis. Very cool trial! 👏🏽👏🏽👏🏽 #radonc . @ASCOPost coverage here 👉🏽 #radonc @seanmmcbride @cd_fuller

Gabapentin Use and Rate of Feeding Tube Placement Among Patients With Head and Neck Cancer

This comparative-effectiveness study uses data from 2 clinical trials to evaluate whether the use of gabapentin for pain management is associated with less opioid use and feeding tube placement among...

jamanetwork.com

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Shankar Siva

@_ShankarSiva

4 months

📢 plenary #ASCO24 LAURA ph III RCT!! 👏🏽👏🏽 @RamalingamMD ➡️ n=216, adjuvant osimertinib after chemoRT for stage III #lungcancer ➡️ astonishing PFS HR 0.16💥 ➡️ immature survival outcomes, trend at HR 0.81 ➡️ ≥Grade 3 AEs in 35% vs 12% ➡️ crossover to osi allowed #lcsm #radonc

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Shankar Siva

@_ShankarSiva

5 years

@NatRevUrol article on PSMA beyond standard #prostatecancer staging; utility in other GU malignancies (RCC+bladder),☢️ #theranostics ,⚡️ #radiotherapy guidance, response assessment after therapy. Article from our @gu_onc group here - . #pcsm #kcsm #radonc

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Shankar Siva

@_ShankarSiva

5 years

The ORIOLE study #ASTRO19 - RCT of SABR in n=54 #prostatecancer patients versus standard of care #pcsm . SABR resulted in improved PFS. T-cell clonality might be a prognostic biomarker, and SABR induces peripheral blood systemic #ImmunoOnc responses! Well done hopkins team!

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Shankar Siva

@_ShankarSiva

1 year

@AsalRahimiMD from UTSW presents a provocative neoadjuvant #breastcancer ➡️SABR, surgery up to 1 year, doses up to 34Gy/1. ➡️93% CMR, and very low Ki67+ (<3%) in any residual cells suggesting senescence. Super interesting ! 👏🏽👏🏽 #bcsm

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Shankar Siva

@_ShankarSiva

5 years

Nodal recurrence in #ProstateCancer - SABR or elective nodal radiation? Multinational study (506 pts, 15 centres) by @EliseDeBleser & @piet_ost sheds light - . Caveat; More ADT use in ENRT group (60%v23%, adjusted). Thx for involving @PeterMacRadOnc ! #pcsm

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Shankar Siva

@_ShankarSiva

1 year

Delighted to announce an all-star faculty for @PeterMacCC SABR symposium 2023! . @AnnA25_03 @ldawsonmd @drdavidpalma @piet_ost & J.Grimm. Nov 17 & 18th! 🥳🎉🎊 #radonc #SABR2023 @PeterMacRadOnc #radiotherapy

SABR Symposium | Radiation Therapy | Melbourne

Peter MacCallum Cancer Centre has been running highly successful symposia on Stereotactic Ablative Body Radiation Therapy (SABR) since 2014. In November we will once again host the SABR Symposium in...

www.sabrsymposium.com

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Shankar Siva

@_ShankarSiva

1 year

➡️ Ongoing shift in adjuvant #Immunotherapy trials to evaluate PFS as the primary endpoint, as industry hopes to accelerate drug approvals. @JNCI_Now suggests a poor correlation of PFS with Overall Survival. . Time to switch to OS? @VPrasadMDMPH #radonc

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Shankar Siva

@_ShankarSiva

2 years

We are back baby!!!! After a 2-year hiatus the Peter Mac SABR symposium 🇦🇺is being held Nov 18th-19th @PeterMacCC ! Stellar all-star faculty, with more TBA; Tickets out soon. Pls register interest on website, and pls RT 🙏🏽 - #sabr2022 #radonc #radiotherapy

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Shankar Siva

@_ShankarSiva

6 years

Presidential symposium #ESMO18 - breaking news, STAMPEDE - #radiotherapy to the prostate in hormone naive mPCa; OS benefit in pre-specified subgroup low volume (<4 mets) disease [42% ⬇️ death]. Lancet paper here - is prostate RT new SOC? More data? #pcsm

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Shankar Siva

@_ShankarSiva

5 years

In an era of virtual scientific meetings for the foreseeable future, let’s at least make #SocialDistancing fun. Challenge accepted? #TROG2020 @TROGfightcancer #lcsm #radonc #pcsm

Alex Tan

@DrAlexTan

5 years

@_ShankarSiva presenting a trial proposal at #TROG2020 virtual ASM - trying very hard to take him seriously!

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Shankar Siva

@_ShankarSiva

2 years

Got to show off our place @PeterMacCC this evening to the great @wallyjc ! @NRGOncology 🥳 #radonc @PeterMacRes @sueyom

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Shankar Siva

@_ShankarSiva

1 year

@VedangMurthy #ESTRO2023 reports 307 patients of PRIME RCT of SABR in #prostatecancer . He argues that other RCTs of conventional #radiotherapy vs SABR do not include the high-risk (many T3b and GG5 +/- N1) men seen in 🇮🇳. Early toxicity low and no different between arms ☢️

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Shankar Siva

@_ShankarSiva

3 years

Pleased to announce @TROGfightcancer DECREASE trial is now open! 1st patient randomized today @PeterMacCC . M0CRPC #prostatecancer on conventional imaging, PSA DT 2.8mo, pelvic + M1 extrapelvic node on PSMA PET! Thanks to all for support! @AzadOncology

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Shankar Siva

@_ShankarSiva

3 years

IVC thrombus is a challenging scenario in #kidneycancer . This multi-national collaboration reports stereotactic #radiotherapy (mostly pre-op) as a solution 🥳 n=15, no high grade toxicity despite >50% high level thrombus. #radonc

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Shankar Siva

@_ShankarSiva

4 months

@NRGonc LU-002 #ASCOO24 . Oligomet/oligoinduced #lungcancer RCT phase II, SoC +/- local consolidation #radiotherapy . NEGATIVE trial; n=215, 2-yr PFS = 36% in SoC systemic therapy arm 40% in LCT arm (HR 0.93). @IyengarPuneeth argues for biomarker selection. What next #radonc 🧐?

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Shankar Siva

@_ShankarSiva

8 months

Cost-effectiveness from 🇨🇦 +🇦🇺 SC.24 phase III RCT of conventional #radiotherapy versus SABR for painful spine mets; full-text @IJROBP 50-day link🙏 ➡️Base case for SABR had an ICER of $9,040 CAD per ⬆️QALY; dominant on cost and efficacy over SoC #radonc

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Shankar Siva

@_ShankarSiva

5 years

Outcomes from SABR In #lungcancer from @nhsleeds - >1200 patients, local control >90%, but 5-year OS is ~30%. Pleasingly, patients are not succumbing from their cancers. But how do we improve the general health of #UKSABR19 patients? #lcsm

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Shankar Siva

@_ShankarSiva

2 years

FLASH-01 presented at plenary session by @NerdicasMaximus #ASTRO22 . First clinical trial of Proton FLASH at>40Gy per second! N=10. No severe AEs, minimal pain flare. Efficacy appears comparable to conventional #radiotherapy . Feasibility of FLASH established!

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Shankar Siva

@_ShankarSiva

2 years

A very nice welcome by the GU team @UTSWUrology ! Super chuffed to be visiting prof at @UTSW_RadOnc tomorrow…. And @TiansterZhang even put in the effort to make me feel at home! What a host! #GUcast #radonc

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Shankar Siva

@_ShankarSiva

5 years

Plenary session at #ASTRO19 - Dr Ryu presents RTOG 0613 spinal mets palliative study. N=353, Single 8Gy #radiotherapy vs 16-18Gy SABR. Arms balanced, but better performance in EBRT arm. SABR ✖️improve pain response! Look forward to CCTG/TROG SC.24 #radonc

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Shankar Siva

@_ShankarSiva

4 months

#ASC024 neoadjuvant FLOT (5-FU/ leucovorin/oxaliplatin/docetaxel) is superior to chemo☢️ CROSS (41.4Gy plus carboplatin/paclitaxel) in locally advanced esophageal cancer ➡️ (cT1 cN+ cM0 or cT2-4a cNany cM0) RESECTABLE ➡️ conclusions; neoadjuvant FLOT is preferred #radonc @ASCO

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Shankar Siva

@_ShankarSiva

2 years

Cost-effective analysis of @TROGfightcancer 15.03 SAFRON II trial in press! Long-term ICER for SF-SABR = A$15,821/QALY vs A$23,265 for MF. 97% probability of cost-effectiveness willingness-to-pay of A$50,000/QALY @ElsevierConnect @CancerAustralia #radonc

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Shankar Siva

@_ShankarSiva

1 year

🧵4/ Median F/U=43months. 100% local control + cancer specific survival throughout the lifetime of the trial – i.e. no patient failed or died of cancer. Renal function decline similar to partial nephrectomy; baseline eGFR=60mls/min, ⬇️14.6mls/min post SABR. #ASTRO23 @KidneyCancer

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Shankar Siva

@_ShankarSiva

6 years

TROG 13.01 SAFRON II is fully recruited, n=90. - single vs multi-fraction SABR for lung oligometastases. Thank you to patients and their families, AUS/NZ investigators, @CancerAustralia for funding. Data is off to mature like a fine wine 😀 #radonc #tssmn

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Shankar Siva

@_ShankarSiva

1 year

Late breaking #ESTRO2023 - HypoG-01. N=1,222 patients, ➡️ non-inferiority of hypofractionated #breastcancer radiotherapy in patients needing nodal irradiation. ➡️Primary endpoint lymphoedema 24% vs 23%; ➡️secondary shoulder movement 23% vs 26% ➡️ no drop in safety, LRF #radonc

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Shankar Siva

@_ShankarSiva

2 years

Thanks @StephenVLiu for organising a 🔥hotrod tour 🏎🚗 of Vienna @delvysra @BrendonStilesMD @DrJNaidoo @benlevylungdoc #lungcancer #LCSM

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0

86

Shankar Siva

@_ShankarSiva

4 years

Thank you patients, funders @CancerAustralia , sponsors @TROGfightcancer @TOGAANZ & of course my home @PeterMacCC for making this trial happen. Primary endpoint analysis - 10 years of work - getting presented in just a few short hours! @PeterMacRadOnc

Peter Mac Cancer Centre

@PeterMacCC

4 years

A trial led by @_ShankarSiva confirms "ultra-short" single-dose radiotherapy is safe and effective for secondary cancers in the lung. Read more about this @TROGfightcancer study just presented at the @ASTRO_org conference:

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Shankar Siva

@_ShankarSiva

1 year

Late breaking - #ESTRO2023 . CORE RCT in 1-3 oligometastatic disease, Investigating SABR. N=245 patients, prostate and breast accounted for 220. No diff in G3+ tox. PFS HR=0.79, with 5mo ⬆️ of mPFS. ➡️ SABR + SoC better than SoC alone 🥳🎉🎊 @TROGfightcancer @DavePryorRO

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Shankar Siva

@_ShankarSiva

4 years

Hi there #twitterati , #radonc #urology , we would love to have more international centres contribute to the IROCK #kidneycancer database! If you have >10 cases treated before end 2016, and minimum F/U of 2 years, please PM me! pls retweet to friends that could be interested.....

Europäisches Radiochirurgie Centrum München

@CYN_Muc

4 years

IROCK rocks! Our new red journal paper shows that SRS/SABR is a viable option even in large renal cell carcinoma. @MichaelStaehler @_ShankarSiva #renalcellcancer #radiosurgery #rcc #cyberknife @Accuray

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Shankar Siva

@_ShankarSiva

23 days

📣📢🗣️ amplifying this - results speak for themselves! QoL outcomes are really important for patient decision making. Quite consistent with protect! #pcsm #prostatecancer #radonc @gu_onc

Nicholas van As

@nickva1

24 days

#PACE A published in European Urology! SBRT vs Radical prostatectomy. Spread the word #SBRT should be discussed with eligible patients ⁦ @DrTolan ⁩ @alison_tree ⁩ ⁦ @cpeedell ⁩ @DrAndrewLoblaw ⁩ ⁦ @EmmaHall71 ⁩ @ProfJOSullivan ⁩

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Shankar Siva

@_ShankarSiva

2 years

Great job from our @PeterMacRadOnc rising ⭐️ resident, Therese Kang for pulling this together! A nice multi-national collaboration 🇦🇺🇪🇸🇳🇱🇨🇭🇺🇸🇨🇦. Please read if you are a #radonc interested in practical tips for single fraction SABR 🙏

Felipe Couñago PhD

@fcounago

2 years

Great honor to participate with these Superstars in this assessment of Practical Considerations of Single-Fraction Stereotactic Ablative Radiotherapy to the Lung #lungcancer #Radonc #medtwitter @_ShankarSiva @Mat_Guc @bslotman @OncoAlert @radoncreview

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Shankar Siva

@_ShankarSiva

8 months

🧐 Why is SABR lumped with RFA under "Thermal Ablation" - and @Uroweb suggests that efficacy ⬇️ >3cm? Most SABR studies report tumours above 4cm, rarely under 3cm! Needs more nuance here 🙏 @amerseburger @grantissimus @KidneyCancerDoc @wandering_gu @Dr_Klatte @spsutkaMD #radonc

European Association of Urology (EAU)

@Uroweb

8 months

❗ New Cheat Sheet on Renal Cell Carcinoma. With comprehensive insights on disease management, highlighting surgery's role in reducing mortality, evaluating nephrectomy techniques, and more. #EAUguidelines Download and read it here:

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Shankar Siva

@_ShankarSiva

2 years

Early start at #ASTRO2022 ; but well worth it for the @ASTRO_org editorial board meeting (comes with @sueyom , @ShaunaRadOnc and socks 🥳). Thank you all the @IJROBP reviewers, remember perks including waivers on open access fees, access to @sciencedirect and upcoming CME. #radonc

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Shankar Siva

@_ShankarSiva

2 years

Good morning #ASTRO22 ! Looking forward to seeing old and new friends at the meeting! @ASTRO_org @TargetingCancer #radonc

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Shankar Siva

@_ShankarSiva

4 years

#radiotherapy remodels intratumoral T cell responsesin #kidneycancer . Neoadj SABR ➡️ nephrectomy - = ⬆️ intratumoral T-cell clonality compared to controls (54% v 43%), ⬆️ tracking of tumour enriched clonotypes in blood. #immunotherapy #immunonc #radonc

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32

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Shankar Siva

@_ShankarSiva

1 year

Dr Stephanie Kroeze presents a Delphi consensus of combination systemic therapy and SRS/SABR. ➡️Consensus to interrupt with targeted therapy ➡️large body of evidence with checkpoint blockade (ICI) ➡️ but why interrupt ICI for a week? Half-life of many, many weeks… 🧐 #ESTRO2023

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Shankar Siva

@_ShankarSiva

5 years

Esophageal Cancer at #ASTRO19 - proton therapy versus IMRT Randomized trial, n=145 pts, similar oncological outcomes but ⬇️ adverse events. 😳I’m not smart enough to understand the Bayesian statistical design, or the primary endpoint graph! Can someone pls explain?🥴 @ASTRO_org

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Shankar Siva

@_ShankarSiva

2 years

@a_dalpra reports on the adequacy of current RTOG contouring guidelines. Fully 13% of cases have disease outside of the guideline CTV templates. Should we be careful about inferior borders? @OncoAlert #ASTRO22

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37

84

Shankar Siva

@_ShankarSiva

1 year

Two aussies 🇦🇺🦘 at the 🌏 stage #ASTRO23 👏🏽👏🏽 EMBARK study in #prostatecancer #pcsm demonstrates that patients with prior #radiotherapy benefit from enzalutamide +/- ADT in the high risk recurrent setting.

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32

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Shankar Siva

@_ShankarSiva

5 years

SABR is not a panacea - investigators @utswcancer show that SABR boost after pelvic #radiotherapy to advanced cervical cancers not suited to brachytherapy may be too risky. Avg. boost volume 139cc, 2 year cumulative grade ≥ 3 toxicity of 26.7%. #radonc

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84

Shankar Siva

@_ShankarSiva

5 years

PORTEC-3 of High Risk endometrial carcinoma, Randomized trial of 686 women. Addition of chemotherapy to radiotherapy improved 5-yr overall survival and FFS(HR 0.70), but T cost of additional toxicity. A nice summary of the trials in context by Dr Stephanie De Boer. #ASTRO19

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46

82

Shankar Siva

@_ShankarSiva

5 years

#ASTRO19 Plenary session: @DrSpratticus presents a secondary analysis of RTOG.9601. Many patients had late salvage #radiotherapy after RP. At lower Pre-RT PSA, no benefit in adding bicalutamide, likely risk of other cause mortality outweighs the benefit of ADT #pcsm @ASTRO_org

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81

Shankar Siva

@_ShankarSiva

6 years

A study of SABR + Pembro in #lungcancer investigates abscopal responses... and this time finds it. #lcsm @bensolomon1 @TommyJohn00 @WeickhardtOnc @DrewMoghanaki @finn_corinne @gerryhanna #ASCO18

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83

Shankar Siva

@_ShankarSiva

3 years

🇩🇪 🇦🇹German/Austrian RCT of SABR in oligometastatic #breastcancer (OLIGOMA) - 💕 the ambitious protocol on the cards, seeking n = 564 participants across 50 centres. Protocol now available; #bcsm

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30

83

Shankar Siva

@_ShankarSiva

4 years

SBRT for #kidneycancer metastases from the @the_RSS registry. Real world data, 1-and 2-year LC rates of 88.2% and 82.7%. Osseous mets did worse than others. Selective use, but given standard wisdom is RCC=radioresistant, should we be using more #radiotherapy ? #radonc @JohnVargoMD

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38

81

Shankar Siva

@_ShankarSiva

3 years

🎄came a little early this year! RAPPORT trial out now, thank you @ELS_Oncology for providing 50-day link here; . This trial evaluated total metastatic irradiation in oligometastatic #kidneycancer + short course #immunotherapy . #radonc

Shankar Siva

@_ShankarSiva

4 years

Pleased to present RAPPORT PhI/II trial at #GU21 @ASCO in oligometastatic #kidneycancer . Median F/U 2.3 years, n=30 with 83 mets. Multi-site SABR + 6 mo #ImmunoOnc was safe with 13% G3 tox, no G4/G5 tox. Effective with 2-year PFS=45% and LC=92%, and ORR 63%. Warrants further Ix!

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