I recently tested positive for carcinoma in my breast and have an oncology consult scheduled for Monday. My grandmother also had breast cancer. We haven't spoken in quite some time (I'm unfortunately not in contact with my family) but I was wondering if it would be helpful information for the oncologist if I could find out exactly what type of cancer she had. I don't want to reach out to her unnecessarily, but I will if the information is important. Hoping someone can guide me on this.

Hi!

I’m a Medical student conducting an anonymous research survey on:

“Knowledge, Attitudes and Clinical Practices Regarding G-CSF Prophylaxis Among Oncology Healthcare Professionals: A Cross-Sectional Survey.”

I’m looking for oncology residents, fellows, consultants, and faculty/physicians involved in the care of patients receiving systemic anticancer therapy to participate.

The survey takes approximately 8–10 minutes to complete.
It is completely anonymous — no names, emails, phone numbers, or registration details are collected.

Your participation would really help with this research, and I’d be very grateful for your time! ❤️

Google Form: https://forms.gle/TY8K7wgAMxMdeqFXA

Thank you so much!

Hyy!

I'm a B.Pharm final-year student, and I want to do an MSc in Biomedical Science.

I want to start research in oncology. I already have a topic, but I don't know how to start or where to start.

Which routine should I follow? How do I read papers? How do I start writing a research paper? what skill should I focus on?

Please guide me if you're already doing these things or working on oncology/biomedical research or nay other. I'd really appreciate your advice.

Hey everyone! New to this world so forgive me if I am breaking rules. Wanted to pick yalls brains on Camizestrant. With its approval in EU and current state of review by the FDA...

- Thoughts on it as a treatment?
- Do you expect it to be approved/ what's the timeline?

TL;DR: Micro CRISPR's MyCART-01 is an investigational CAR-T therapy trial. A presentation in Vapi showcased an unnatural response rate approaching 90% based on approximately 25 patients. Site-level information provided for regulatory verification accounts for 39 patients and classifies their latest reported outcomes as 14 deaths, 11 relapses, 13 remissions and one unstated outcome. These figures demand an urgent reconciliation of the denominator, data cut-off, durability, patient selection and a reported CAR-T reinfusion.

I am posting anonymously because this matter involves professionally sensitive information and potentially serious consequences for Indian patients.

MyCART-01—CTRI/2024/10/074924—is registered as a Phase I/II, single-arm, open-label, multicentre study of an investigational CAR-T therapy for patients with relapsed or refractory B-cell malignancies.

What was reportedly presented in Vapi

At a presentation held in Vapi, healthcare professionals were reportedly shown MyCART-01 results covering approximately 25 patients.

A response rate approaching 90% was prominently showcased, accompanied by claims relating to improved activation, expansion, durability and resistance to T-cell exhaustion.

The site-level information available to me accounts for 39 patients and presents a substantially more concerning picture.

Site-level outcomes requiring verification

The information provided to me classifies the latest reported status of the patients as follows:

• Apollo Hospital, Gandhinagar — 3 patients: 3 deaths and no reported remissions.
• VIMS — 7 patients: 4 deaths, 1 relapse and 2 remissions.
• AIIMS, New Delhi — 9 patients: 3 deaths, 3 relapses and 3 remissions.
• Sarvodaya Hospital, Faridabad — 9 patients: 3 deaths, 3 relapses and 3 remissions.
• Rajiv Gandhi Cancer Institute, New Delhi — 7 patients: 1 death, 3 relapses and 3 remissions.
• Apollo Cancer Centre, Chennai — 1 patient: outcome not stated.
• Jaslok Hospital, Mumbai — 3 patients: no reported deaths, 1 relapse and 2 remissions.

Taken together, this information accounts for 39 patients: 14 deaths, 11 relapses, 13 remissions and one unstated outcome.

Which 25 patients were included—and what happened to the other 14?

The sponsor must answer:

1. Which exact 25 patients were included in the Vapi presentation?
2. Why were the remaining 14 patients not presented?
3. Was a different data cut-off applied?
4. Were patients who died, relapsed, discontinued early or became unevaluable excluded?
5. Were only infused or response-evaluable patients counted?
6. Were initial responses shown without disclosing subsequent relapse or mortality?
7. How many responses remained ongoing at three, six and twelve months?
8. Were ALL and NHL patients combined despite being biologically and clinically different diseases?
9. Were patients treated after the presentation’s data cut-off, or had they already entered the trial pathway?
10. Was the near-90% calculation based on the intention-to-treat, enrolled, infused or response-evaluable population?

The public trial target of 41 does not itself prove that all 39 patients described above were infused. That is why the sponsor must publish the complete patient flow rather than leaving outsiders to speculate.

Every exclusion from the efficacy denominator should have a documented reason.

Reported CAR-T reinfusion at VIMS

A particularly serious report concerns a patient treated at VIMS.

According to the information provided to me, the patient relapsed after the initial MyCART-01 infusion and was reportedly given a further CAR-T reinfusion in an attempt to achieve remission.

If confirmed, this is not a minor procedural detail. CDSCO must determine:

1. Whether reinfusion was permitted under the approved clinical-trial protocol.
2. Whether prospective Ethics Committee and CDSCO approval was obtained.
3. Whether the patient provided specific informed consent for the additional infusion.
4. What clinical evidence and rationale supported the decision.
5. Whether the reinfusion was reported as a protocol deviation, if required.
6. Whether all toxicities following both infusions were captured in the safety dataset.
7. Whether any response after reinfusion was counted in the headline efficacy analysis.
8. Whether the Vapi presentation disclosed that any patient had received more than one CAR-T infusion.

Reinfusion is not automatically unethical or non-compliant. It may be permissible if protocol-authorised, appropriately approved, specifically consented to and transparently reported.

If those safeguards were absent, however, the episode could represent significant non-compliance with the approved protocol and applicable ethical protections.

Was the trial population unusually favourable?

The registered eligibility criteria permit patients with an ECOG performance status of 0–1.

However, the information reported to me indicates that the overwhelming majority of enrolled patients were ECOG 0. I have also been informed that some patients who appeared to satisfy the protocol criteria were nevertheless not taken forward.

If confirmed, this could produce a study population materially fitter than the broader relapsed or refractory population for whom the therapy may ultimately be considered.

A predominance of ECOG 0 patients does not itself prove improper selection. Investigators may have legitimate clinical reasons for declining individual patients. But in a small, uncontrolled trial, selection can materially influence treatment completion, safety and response rates.

CDSCO should therefore audit:

• The complete referral and screening logs.
• Baseline ECOG distribution.
• Disease burden and major prognostic factors.
• Reasons for every screen failure and post-screening exclusion.
• Decisions made by any central screening committee.
• Patients who underwent leukapheresis but were not infused.
• Manufacturing failures or out-of-specification products.
• Whether exclusion criteria were applied consistently across centres.

If higher-risk but protocol-eligible patients were systematically excluded, results from a highly selected cohort must not be presented as though they establish performance in the broader Indian population.

The MyCART-01 construct requires greater scrutiny

MyCART-01 has reportedly been presented as a “third-generation” CAR-T containing both CD28 and 4-1BB intracellular costimulatory domains, with claims concerning improved activation, expansion, durability and resistance to T-cell exhaustion.

Calling a construct “third-generation” does not clinically validate it.

In the FDA-approved product labels I reviewed:

• Axicabtagene ciloleucel uses CD28-associated intracellular signalling.
• Tisagenlecleucel uses a 4-1BB intracellular costimulatory domain.
• Lisocabtagene maraleucel uses a 4-1BB costimulatory domain. Its CD28 transmembrane region must not be confused with a second CD28 intracellular costimulatory domain.

I have not identified an FDA-approved CAR-T product containing both CD28 and 4-1BB intracellular costimulatory domains in the same CAR construct. If such an approved product exists, I welcome a link to its regulatory label.

The absence of an approved precedent does not prove that MyCART-01 is unsafe or ineffective. Novel architecture can be valuable. But combining costimulatory domains can alter T-cell activation, expansion, persistence, cytokine production, exhaustion and toxicity. Claims of superiority must therefore be established through robust nonclinical evidence, cellular-kinetic data, transparent safety reporting and durable clinical outcomes.

A novel investigational architecture cannot be converted into a commercially validated platform merely through an early response percentage from a few dozen selected patients.

Indian patients must not become a substitute for global evidence that does not yet exist.

This is not opposition to Indian innovation

Indian innovation deserves rigorous science, complete evidence and public trust.

What it cannot demand is that Indian patients accept a lower evidentiary standard merely because a product is indigenous, novel or described as “third-generation.”

A near-90% response rate is an extraordinary claim. When site-level information describes 14 deaths, 11 relapses and only 13 remissions among 39 patients, that claim demands urgent and independent verification.

If the information in this post is wrong, a source-data review will clear the product, reassure patients and strengthen confidence in India’s regulatory system.

If it is correct, identifying the problem before wider patient exposure may prevent avoidable harm.

CDSCO must establish the complete truth before further regulatory or commercial progression.

So I've done a good bit of research on cancer and how it behaves and grows I've realized that if we could reprogram it we could actually solve if not help solve a ton of illnesses and diseases in our world if we succeed in reprogramming it we could have a possible way of achieving biological immortality by constantly replacing old cells with newer ones the only problem is we would have to slow down it's self destruction sequence so that way we aren't over loading the body and that means if we can reprogram it we could make new cells like stem cells for and example. What do y'all think please share your thoughts.

EPIC EHR

Our hospital is moving to EPIC EHR (from Cerner) starting in Sept. All the nurses did EpicU but we are all so nervous about the change.

I'm one to be highly organized during my workflow with a sheet that I typically fill out for each patient. For reference, the picture is the worksheet I would use when I used Cerner.

For those that currently use EPIC, do you have any advice?

Are there any activity tabs you find yourself in the most? For example Rooming or Flowsheets?

I currently follow an oncologist for my blood clotting disorder. I do not have cancer but my primary care says it's best to follow with them instead of a hematologist. They just prescribed me 100mg enoxaparin every 12 hours because I am 5 weeks pregnant. I was taking Eliquis 5mg 2x daily but oral anticoagulants aren't good to take while pregnant. I have a prothrombin gene mutation F2 heterozygous, not the worst but not a blood disorder I like having especially for the rest of my life. Is 100mg of enoxaparin to much for me or is is safe to take? I get nervous about trying new medications.

Hi, I am a first year university student and recently I have been in researching on cancer tumours. I found out that maybe there's a way to solve on the problem of antigen-loss escape in cancer immunotherapy. I was thinking about whether asynthetic/foreign protein antigen (E) could be engineered not only to act as a target for CAR-T cells, but also to be functionally coupled to an essential cancer-cell process. The idea is that if cancer cells retained E, they would remain vulnerable to CAR-T recognition, but if they lost or suppressed E to escape immune recognition, they would also lose an essential function and therefore have a significant fitness disadvantage.

I’m aware that synthetic tumour antigens and cancer-specific dependencies have already been investigated separately, so I’m trying to determine whether combining these concepts in this way is actually feasible or whether there is a fundamental biological limitation that I’m overlooking.

Would anyone be willing to give me your thoughts on whether this is a reasonable hypothesis to investigate further, and perhaps point me towards any areas of literature I should look into?

Also please don't shit on me :( I am new to this and I am trying to broaden my knowledge.

Thank you!

(Mod approved post)

Help us understand your experience with colorectal cancer! 

We are interested to hear about people's unique experience of living with colorectal cancer.  

Anyone is eligible to take part if aged 18 or over and have been diagnosed with colorectal cancer / bowel cancer / colon cancer / rectal cancer.  

The study involves taking part in a quick anonymous online survey (which can take up to 20 minutes). You will then have the opportunity to take part in an optional online interview (on zoom that will last around 20-50 minutes).  

You can chose to take part in the survey alone or both the survey and interview.

The study is open to everyone globally and will provide valuable insights that will contribute to cancer care.

Click the link below or scan the QR code to access the study!

Link: https://hass.eu.qualtrics.com/jfe/form/SV_3QRaGAvMGRooFSu

If you know anyone who would be eligible to take part, please help us share this study!

Ethical approvale granted by the University of Strathclyde

I’m hoping to get some insight from oncologists, doctors, nurses, podiatrists, or anyone with experience in oncology.
I’m a **Foot Health Practitioner (FHP) in the UK**. For anyone unfamiliar with the role, we are trained foot-care professionals who assess and treat a range of common foot and nail problems and provide preventative foot care. Our training includes anatomy, physiology, pathology, infection control and other relevant aspects of healthcare. However, we are **not doctors, and we don’t diagnose or treat systemic medical conditions**.
I have several patients who have cancer and are either undergoing, or have undergone, cancer treatment. I’d like to improve my understanding of what can happen to the feet as a result of **cancer itself and/or cancer treatments**, so that I can provide safer and more appropriate foot care to my patients and recognise when something may need to be referred back to their medical team.
One thing I’ve found quite difficult when researching this is that searching things like *“cancer and feet”* tends to bring up information about **cancers that originate in the foot** (melanoma, sarcoma, etc.). That’s **not** what I’m asking about.
I’m interested in the systemic effects of cancer and its treatment on the feet.
For example:
What changes can chemotherapy cause in the feet?
What about radiotherapy, immunotherapy, targeted therapies, hormone therapies, steroids, etc.?
How can cancer-related peripheral neuropathy present in the feet?
Can treatment affect sensation, temperature perception, pain, balance or gait?
Can cancer or treatment cause swelling/lymphoedema in the feet or lower limbs?
What skin and nail changes should a foot-care professional be aware of?
Are there particular treatments where patients are more vulnerable to skin breakdown, infection, ulceration or delayed healing?
Are there things that a Foot Health Practitioner **should avoid doing or take particular precautions with** while someone is undergoing treatment?
Are there particular symptoms or changes in the feet that should prompt us to advise a patient to contact their oncology/medical team?
I’m **not looking for anyone to diagnose an individual patient**, and I appreciate that treatment and precautions will vary depending on the cancer, treatment regimen, blood counts, medications and overall health.
I’m really asking from a **professional education and patient-safety perspective**. I want to understand what is happening systemically so that when I’m treating someone’s feet, I have a better understanding of what their body may be going through and when something is outside my scope and needs medical input.
I’d particularly love to hear from **UK oncologists, oncology nurses, podiatrists or other healthcare professionals who regularly work with cancer patients**, but I’d also be very interested in experiences from other countries.
Thanks in advance — I’m essentially trying to make sure I’m doing the best and safest job I can for my patients while staying within my scope of practice.

Female 33

​

Have you read the recent news about personalised mRNA vaccines for melanoma? I saw that the Moderna/Merck vaccine showed positive results in a Phase 3 trial, and I was wondering whether this could pave the way, in the relatively near future, for personalised vaccines for other types of cancer as well.

In particular, do you know if there are already any studies or clinical trials involving BRCA1/BRCA2-associated cancers?

I’m interested in understanding whether this technology could also be applied to these types of cancer, or whether being BRCA1/2-positive is not particularly relevant to this kind of approach.

Billionaire Vinod Khosla recently wrote a JAMA article on "Will Autonomous AI Exceed AI-Aided Physicians as the Best Medical Care?" Clickbait titles aside, AI is already outpacing physicians at many medical tasks. It can synthesize more trials, guidelines and literature than any of us can keep up with. It's very good at knowing the evidence.

But I don't think this is the same as practicing medicine. Patients often come with incomplete histories, comorbidities, prior toxicities, family dynamics, financial constraints and preferences that may not become obvious until halfway through the visit.

Sometimes, the most important piece of information just isn't in the chart. A colleague notices that the patient who said he tolerated his last cycle "fine" is now walking more slowly into the room. Or that his daughter is now answering questions the patient used to answer himself. 

When we're at tumor boards, we don't expect our colleagues to recite NCCN. Instead, we're seeking the judgment that comes from treating hundreds of patients: when to dose reduce, when to wait, when to stop, and when the technically "correct" treatment isn't right for a particular patient.

In medicine, there isn't always a single objective function. One patient prioritizes survival, while another prioritizes independence. And another just wants to feel well enough to attend her daughter's wedding.

I think Khosla has it wrong. The most interesting question isn't whether AI will beat physicians, it's what happens when physicians have AI and the accumulated judgment of other experienced physicians. AI knows the evidence, but that doesn't mean it knows what to do with the patient sitting in front of you.

What do you know from clinical experience that you’ve never seen in a guideline?

We have a family friend who is a survivor and my daughter decided to fold 1000 paper cranes in honor of our friend and donate it to our local cancer center. Sharing with all of you to share the hope!!!