Hannah R. Abrams
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hannahrabrams.bsky.social
Hannah R. Abrams
@hannahrabrams.bsky.social
2.3K followers 390 following 200 posts
Heme/Onc fellow at Fred Hutch, hoping to reduce costs & improve patient/caregiver experiences in cancer care. Social Media Editor @ JCO OP. Views are my own. #MedSky
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hannahrabrams.bsky.social
It's taken over 10 years for an erroneous reference to (almost) make it out of the citation chain.

Less about the reference itself (incorrect claim re: cisplatin ototoxicity) and more about our science.

Case report here @jco-asco.bsky.social:
ascopubs.org/doi/10.1200/...
Fig 1. Reference characteristics to the article by Ross et al by year of publication. Stacked area chart depicting the distribution of citation characteristics referencing the article by Ross et al, categorized by publication year (2010-2025). Each color represents a distinct citation characteristic: Affirmative, contrastive, assumptive, conceptual, methodologic, perfunctory, and negative. Vertical dashed lines mark two key regulatory events: the 2011 cisplatin label update and the 2015 label revision.
February 5, 2026 at 4:23 AM
hannahrabrams.bsky.social
"Curative hope" in oligometastatic breast cancer: ~50% of surveyed US medical oncologists recommend consolidative tx to all cancer sites.

It's a brave new world, and a setting where patients often deserve to get second/multiple opinions! @jco-asco.bsky.social #OncSky

ascopubs.org/doi/10.1200/...
February 1, 2026 at 5:39 PM
hannahrabrams.bsky.social
Time from cancer diagnosis → treatment is rising: 21 days in 2004 to 28 days in 2015.

Much of this is because of ⬆️ in stage 1 & there may be some good reasons - eg careful shared-decision making & planning. But how do we support people during the (often) anxious wait?

ascopubs.org/doi/full/10....
January 31, 2026 at 4:49 PM
hannahrabrams.bsky.social
If you're interested in learning more about how we might reduce overuse/waste, we wrote this review in @jco-asco.bsky.social JCO OP including some of the earlier low-dose nivo data, and I also highly recommend oncdoc.org for oral oncology drugs.

ascopubs.org/doi/10.1200/...
January 31, 2026 at 3:30 AM
hannahrabrams.bsky.social
2. Xeloda (capecitabine) was approved in 1998, & in 2025 FDA has added a black box warning to test for DPYD variants. As we catch up to a pharmacogenomic era, Mark Ratain & Peter O'Donnell summarize the dire need for data: when you find a variant, what dose to Rx?

Helpfully, they provide some recs:
January 31, 2026 at 3:30 AM
hannahrabrams.bsky.social
"What dose?" is the name of the game this week @jco-asco.bsky.social as ghosts of 2000s haunt modern oncology.

1. We've known since 2010 nivo is active at low doses/long intervals. This week Vanita Noronha & team show just 20mg (vs 240mg) is active in 5 ca types.
ascopubs.org/doi/10.1200/...
January 31, 2026 at 3:30 AM
hannahrabrams.bsky.social
#Telehealth has been a huge boon to oncology: save pts time, see people who might not be able to travel.

Q in new study @jco-asco.bsky.social: is "webside manner" affecting quality? Are we just adding extra appts?

A: Largely, no! Similar communication, slight ⬆️ appts.

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January 29, 2026 at 4:23 AM
hannahrabrams.bsky.social
In this small pilot study, #PanCan pancreatic cancer patients randomized to receive medical cannabis while starting chemotherapy had improvement in pain (44% vs 20%), appetite (56% vs 30%), and insomnia (67% vs 30%).
January 28, 2026 at 3:49 AM
hannahrabrams.bsky.social
Where are US patients with cancer traveling for care?

Medicare claims analyzed in JCO CCI: unsurprisingly, community-based networks carry a large load. Notably, confined to 12h drive & unclear how satellite sites included, but a close look at the map may surprise you:

ascopubs.org/doi/10.1200/...
January 27, 2026 at 2:04 AM
hannahrabrams.bsky.social
What, it isn't straightforward?
January 26, 2026 at 7:01 PM
hannahrabrams.bsky.social
From theory to practice: in #JCOOP, a conceptual model to describe how practices cope with losing a rural oncologist - and a new podcast interview with @fumikochino.bsky.social to really dive into a real-world example. #HealthPolicy
FIG 1. The inferred relationships between theme components.
January 26, 2026 at 6:28 PM
hannahrabrams.bsky.social
Just adding a "🚩 suspected cancer" flag reduced the time from referral to appointment by over 50%(and dropped the time from referral -> diagnosis of cancer by 63 days)
@nychealthsystem.bsky.social @jco-asco.bsky.social

ascopubs.org/doi/10.1200/...
Fig A3. Improvements in efficiency of care by age.
January 26, 2026 at 5:37 PM
hannahrabrams.bsky.social
How important is #HCT donor age in the #PTCy era? Large single-center study in JCO OP raises the question of how strongly age should be prioritized:

ascopubs.org/doi/10.1200/... @EJShpallMD
Fig 1. Association of donor age with OS. (A) The plot shows the unadjusted HR for death according to donor age. A linear model (red line) is compared with a more flexible spline model (blue line), which allows for a non-linear relationship. Shaded ribbons represent 95% CIs. The similarity between the two models and the fact that their CIs consistently overlap an HR of 1.0 indicates that there is no significant linear or nonlinear association between donor age and survival in this cohort. (B) Kaplan-Meier analysis of OS stratified by dichotomized donor age: donors younger than 32 years (red) versus those 32 years and older (blue). There was no statistically significant difference in survival between the two groups (log-rank P = .51). HR, hazard ratio; OS, overall survival.
January 17, 2026 at 12:55 AM
hannahrabrams.bsky.social
SNF capacity is the bottleneck that keeps people waiting in ER hallways and make-shift hospital rooms. SNF beds are crucial to our health system. Since 2020, capacity is down 5%, with less slack, due to staffing shortages.

@jamainternalmed.com @mlbarnett.bsky.social: jamanetwork.com/journals/jam...
January 14, 2026 at 3:49 AM
hannahrabrams.bsky.social
🌅 Several studies have suggested checkpoint inhibitors dosed AM may be assoc w/ improved outcomes- but strong risk of confounding.

Out now in #JCOOP: review of literature & discussion of how practices could actually implement this. Suspect will be very dependent on local AM traffic!
Fig 2. Constraints related to the patient, the pharmacy, and the outpatient infusion centers to be taken into account when concentrating outpatient ICI administrations in a stipulated time window in the morning. ICI, immune checkpoint inhibitor. Pharmacy constraints: physiochemical stability, risk of waste. Patient: distance home-hospital, diurnal preference. Day unit: priority rankings, long multi drug regimens. Proposed Action We propose the following approaches to make early ToDA of ICI feasible in daily routine practice: • ASSESS: establish a nurse-led telephone assessment on the eve of ICI administration with full blood work-up available to confirm clinical and biologic permissiveness to ICI treatment; • AVOID (as far as possible and according to the habits of each center): do not schedule medical consultation and ICI treatment on the same day to reduce risks of delays in treatment administration (prefer teleconsultations the day before treatment for patients living far from the center); • ALWAYS administer ICI first when in combination with IV chemotherapy or other agents, unless reverse sequencing is recommended; • ALLOCATE: prioritize two or three ICI mornings per week and save the remaining two or three mornings for long-term combination treatments not including ICIs; • ANTICIPATE: whenever possible, cytotoxic reconstruction units could prepare ICIs in the evening of the eve so that they are ready to be administered early on the following morning.
December 21, 2025 at 5:39 PM
hannahrabrams.bsky.social
Potential for cure in metastatic gastric cancer with actionable biomarkers?

- 51 pts/1710 treated over 9 years in Japan
- "Potential cure" = PFS >3 years, NED, >1 year since last tx w/o progression (consolidative surgery allowed)
- dMMR 23%, CPS ≥10 30%, HER2+ 24%

ascopubs.org/doi/10.1200/...
December 20, 2025 at 8:17 PM
hannahrabrams.bsky.social
What are outcomes w/ histotripsy for liver tumors/mets in real world since FDA approval in 12/2023? Out now in #JCOOP: at 3 mo, ~95% local control, 7% distant POD.

Need longer term data, not enough to distinguish b/w local control options, but helpful to have a start.
ascopubs.org/doi/10.1200/...
Fig 1. (A and B) Thirty- and 90-day outcomes of intended complete treatment with histotripsy by histologic tumor treated and (C) time-to-event analysis for primary versus secondary malignancy. CCA, cholangiocarcinoma; CRLM, common cancer, with liver metastasis; HCC, hepatocellular carcinoma; HNSC, head and neck squamous cell; NET, neuroendocrine tumor; PDAC, pancreatic ductal adenocarcinoma.
December 20, 2025 at 4:49 PM
hannahrabrams.bsky.social
Sure, I've heard of that, but have you heard about
Image of Victor Wembanyama, star of the San Antonio Spurs, over an image of a burr cell
December 19, 2025 at 12:55 AM
hannahrabrams.bsky.social
Really important perspective from Ramy Sedhom on FOLFIRINOX in #panCAN patients >70 years old ("OA"). Even in selected patients who receive this intensive regimen, even w/ preemptive dose reductions, 56% G3 AE or unplanned hospitalization.

ascopubs.org/doi/10.1200/... #JCOOP #GIOnc
At first glance, Collineau's findings seem to be predictable: FOLFIRINOX is toxic, and OAs are vulnerable. But the deeper issue is whether we are asking the right question. By focusing narrowly on which OA can endure FOLFIRINOX, we risk missing the more relevant point: what is the most tolerable approach to the care of OAs with PDAC, and who truly benefits? The Edison analogy is instructive here. His lasting legacy was not the brightest bulb, but the system that made light usable, safe, and enduring. In PDAC, the lesson is similar: the discovery of an intense regimen is useless unless it is embedded in a system that makes treatment tolerable and meaningful for patients. For OAs, that grid is built through geriatric assessment (GA), supportive interventions (nutrition, prehabilitation, psychosocial support), and integration of palliative care. From “Who Can Tolerate” to “Who Will Benefit” It is time for all of us to reimagine PDAC care in OA. The central question is no longer “who can tolerate FOLFIRINOX,” but “who will truly benefit?” Answering that requires 1. Routine GA to uncover vulnerabilities 2. Supportive interventions (comorbidity management, exercise, psychosocial support, nutritional support, and palliative integration) to enhance resilience 3. Trial designs that embed tolerability and quality of life as end points that complement response and survival 4. Exploration of objective aging biomarkers (inflammation, senescence, aging clocks, sarcopenia) for future stratification
December 18, 2025 at 4:23 AM
hannahrabrams.bsky.social
Significant overestimation of renal function by eGFR compared to measured CrCl in people with nonmetastatic RCC (including Cys C-adjusted).

Wide implications re: cystectomy cutoffs. #UroSky #NephSky is this part of your practice for people near cutoff?

ascopubs.org/doi/10.1200/... #MedSky #JCOOP
At a measured GFR of 45, corresponding eGFR values ranged from 53 to 59 mL/min/1.73 m2 Estimated Glomerular Filtration Rate Equations Overestimate Renal Function Compared With Measured Glomerular Filtration Rate Using 24-Hour Urine Creatinine Clearance Full abstract beyond alt text limits but is available publicly at https://ascopubs.org/doi/10.1200/OP-25-00895 Highlighting Methods and Results: Methods In this prospective study, 72 patients with nonmetastatic RCC undergoing preoperative evaluation completed serum creatinine, cystatin C, and 24-hour urine collections. eGFR values were calculated using multiple established equations, both race-inclusive and race-neutral. The agreement between eGFR and measured GFR was assessed using Passing-Bablok regression. Linear regression estimated the discrepancy between eGFR and measured GFR at clinically relevant cutoffs of 45 and 60 mL/min/1.73 m2. Results Across all equations, eGFR consistently overestimated renal function compared with measured GFR. At a measured GFR of 45, corresponding eGFR values ranged from 53 to 59 mL/m
December 17, 2025 at 3:49 AM
hannahrabrams.bsky.social
Adding to this - #Roon for doctors is launching in oncology today! Here's an example of how the format looks discussing #SABCS25. Join at www.roon.com.
December 16, 2025 at 6:29 PM
hannahrabrams.bsky.social
What financial advice do those who've survived AYA cancers give to people going through it now? In #JCOOP this week (among other insights), led by Tim Ohlsen @seattlechildrens.org

Notably, they highlight how much fear of future cost increases hangs over survivors.

ascopubs.org/doi/full/10....
Table of employment and financial support recommendations from survivors by time period. Across the care continuum: Consider jobs that cover financial and insurance needs Set up a health savings account, contribute a small amount from each paycheck to help pay medical bills Ask for help from the care team, especially hospital social worker and use hospital billing department regarding cancer-related finances and resources Seek college scholarships During active therapy Explore short-term disability or other benefits offered by employer Consider ways to cut nonmedical expenses Seek financial assistance grants Set up a payment plan Learn/connect with other YAs on how they handled finances and cancer Early in survivorship Maintain employment with stable health insurance coverage Build financial literacy Seek vocational counseling to mitigate cancer-related job impacts Save money to account for rising cost of living and possible future medical costs Saving, or “stockpiling” money (diagnosed 0-17 years; 21 years since diagnosis) was important to some interview participants on the basis of their cancer history, to cover future medical expenses, including the possibility of recurrence.
December 16, 2025 at 2:04 AM
hannahrabrams.bsky.social
Spend-downs are also not equally distributed & are more likely to affect Black families - generational wealth saved getting diverted to long term care industry at end of life.
Table 2: Likelihood of Spend-Down Among Individuals Initially Non-Medicaid Enrolled by Demographic Characteristics and Length of Nursing Home Stay Highlighted statistic showing that at 4 years after index nursing home stay, Black individuals have a 72.3% predicted probability of having undergone a spend down (difference 0.11, 95% CI 0.05-0.17), as compared to 61.2% for White individuals.
December 9, 2025 at 1:12 AM
hannahrabrams.bsky.social
Especially appreciated this note on terminology citing terms from #patientadvocate community @metavivor.bsky.social & Natl Coalition for Cancer Survivorship.

Would love to hear from advocates in this space - what else should we be talking about here?

@lisadtrice.bsky.social
@morefor4.org
December 8, 2025 at 10:39 PM
hannahrabrams.bsky.social
I don't know if this was intended to be a simultaneous publication with #SABCS25 but sure seems like one.

With more and more #metavivors & patients with oligometastatic disease tx with "curative hope", how do we study & support these groups? #oncsky #cansky

ascopubs.org/doi/10.1200/...
Fig 1. Phases of cancer survivorship, graphic created by the National Cancer Institute. The central ovals represent the anatomic extent of disease (ie, stage of a cancer). The ovals are encircled by a loop that denotes the corresponding goals of care. The bidirectional arrows within the loop illustrate the dynamic nature of goals of care. Over time because of changes in their cancer status, survivors may transition between different phases of survivorship, with corresponding shifts in their goals of care. Notably, the central section in the figure represents the population of interest: survivors with advanced and metastatic cancer for whom the goal of care is to prolong life.
December 8, 2025 at 10:39 PM