Standard vs. reduced dose of everolimus for patients with advanced NETs...? A retrospective study of 170 patients from Mayo Clinic and University Hospitals in Cleveland. @sonbol_bassam @Faresjamall @PatrickMcGarrah and others not found on X. Key findings: -- Patients in the reduced-dose cohort were older, with worse PS and more heavily pretreated -- Median OS was shorter in the reduced dose cohort, 43.7 vs. 81.5 months (p=0.02) -- After multivariate adjustment, the difference was no longer statistically significant -- Similarly, the observed difference in PFS (7 vs. 12.4 months), was no longer significant after adjusting -- Almost half of the full-dose starters needed dose reduction Lower doses may be reasonable in patients expected to have poor tolerance but cannot be routinely recommended. A prospective trial (NCT06472388) is ongoing, led by @RachelRiechelm2 onlinelibrary.wiley.com/doi/…

Have you ever wondered what the outcomes are of patients with small bowel NETs and liver mets following cytoreductive hepatectomy if there is co-existing carcinoid heart disease (CHD)? Are the outcomes different in the CHD population when compared to those without CHD? As it seems, probably not. In this retrospective study done at Mayo Clinic, the outcomes of 311 patients were analyzed. 163 had nonfunctional NETs, 110 had carcinoid syndrome (CS) and 38 had CS + CHD. Median overall survival after debulking was very similar, 12.5 vs. 9.1 vs 11.4 years. With optimal cardiac management, cytoreductive hepatectomy in CHD is feasible and provides long-term survival comparable to patients without CHD. Careful multidisciplinary evaluation and management is key. onlinelibrary.wiley.com/doi/… @MayoCancerCare @MayoClinicSurg

This is an absolutely outstanding review on the management of patients with metastatic gastric cancer. I may have posted about this review before but it is so good that it deserves another round of applause... Thanks @KlempnerSam @YJanjigianMD @amalsargsyan and all the other co-authors I could not find on X... Sorry AI, I love you but you are just not there yet. True content experts writing a practical review still beat you easily. This should be a required read for all who take care of patients with gastric cancer. nature.com/articles/s41571-0…