Dr.Ayaz Afridi

04/01/2026

Khorana score
For determination of thromboembolism prophylaxis in cancer patients

27/12/2025

🚨 FDA changes 1st-line HER2+ mBC practice (Dec 15, 2025) 🚨

Now the FDA has approved a new first-line option: T-DXd (Enhertu) + pertuzumab for unresectable/metastatic HER2+ breast cancer (IHC 3+ or ISH+) ✅

For >10 years, THP (taxane + trastuzumab + pertuzumab) was the default first-line standard.
Now the FDA has approved a new first-line option: T-DXd (Enhertu) + pertuzumab for unresectable/metastatic HER2+ breast cancer (IHC 3+ or ISH+) ✅ 

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🧬 What drove the approval?
📌 DESTINY-Breast09 (Phase III) 

📈 Key efficacy (BICR PFS):
✅ Median PFS: 40.7 months with T-DXd + P
vs 26.9 months with THP
🔻 HR 0.56 (≈44% risk reduction) 

🎯 Tumor response:
🔥 ORR 87% vs 81% 

⏳ OS: still immature at time of analysis (ongoing follow-up). 

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🧪 Companion diagnostics cleared (important for eligibility):
🔬 PATHWAY anti-HER2/neu (4B5)
🔬 HER2 Dual ISH DNA Probe Cocktail 

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⚠️ Clinical pearl (real-world):
If we’re moving an ADC to 1st line, we must tighten toxicity surveillance:
🫁 ILD/pneumonitis vigilance + early steroid pathway
🩸 Neutropenia monitoring
❤️ Cardiac function follow-up (esp. HER2 pathway) 

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🧩 Bottom line:
This is a practice-changing shift: ADC-based first-line therapy becomes FDA-endorsed for HER2+ metastatic disease — with the largest PFS leap we’ve seen vs THP. 🚀 

24/12/2025

11/11/2025

🧬 𝗛𝗼𝗱𝗴𝗸𝗶𝗻 𝗟𝘆𝗺𝗽𝗵𝗼𝗺𝗮 — 𝗛𝗶𝗴𝗵-𝗬𝗶𝗲𝗹𝗱 𝗦𝘂𝗺𝗺𝗮𝗿𝘆

📘 𝗢𝘃𝗲𝗿𝘃𝗶𝗲𝘄
🧫 Hodgkin Lymphoma (HL) = B-cell malignancy with classic Reed–Sternberg cells (bilobed “owl-eye” nuclei)
🧩 Starts in one lymph node group → spreads contiguously (orderly)
👩⚕️ Bimodal age → young adults & >55 yrs

🧠 𝗣𝗮𝘁𝗵𝗼𝗽𝗵𝘆𝘀𝗶𝗼𝗹𝗼𝗴𝘆
🧬 Reed–Sternberg cells release cytokines → attract eosinophils, plasma cells, lymphocytes
🌡️ Cause B symptoms → fever, night sweats, weight loss

🔬 𝗦𝘂𝗯𝘁𝘆𝗽𝗲𝘀
🌸 Nodular Sclerosis → most common, young females, collagen bands + lacunar cells
🦠 Mixed Cellularity → linked with EBV
🌈 Lymphocyte-Rich → best prognosis
⚠️ Lymphocyte-Depleted → worst prognosis, HIV-associated

🔍 𝗗𝗶𝗮𝗴𝗻𝗼𝘀𝗶𝘀
🧫 Reed–Sternberg cells → CD15⁺, CD30⁺
📈 ↑ ESR & LDH
🔬 Lymph node biopsy → confirms diagnosis

⚕️ 𝗖𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗙𝗲𝗮𝘁𝘂𝗿𝗲𝘀
🦴 Painless lymphadenopathy (cervical or mediastinal)
🌡️ B symptoms → fever, drenching sweats, weight loss
😣 Pruritus, fatigue
🍷 Alcohol-induced pain at nodes
🫁 Mediastinal mass (esp. nodular sclerosis)

💊 𝗧𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁
💉 ABVD regimen → Adriamycin, Bleomycin, Vinblastine, Dacarbazine
☢️ Radiation therapy for localized stages
💯 Excellent cure rate — especially early detection

🧩 𝗞𝗲𝘆 𝗙𝗮𝗰𝘁𝘀
🦉 Reed–Sternberg = diagnostic hallmark
🧬 CD15⁺ / CD30⁺ markers
🧭 Orderly spread (unlike Non-Hodgkin Lymphoma)
🦠 EBV linked (esp. mixed cellularity)

Copied.(Source in image)

08/11/2025

There is a can in cancer.