Clinical trial research fellow & PhD candidate @BartsECMC @QMBCI Medical Oncology SpR @NHSbartshealth
London via Manchester
Joined January 2009
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Is it time to reconsider how we assess toxicity and QoL with adjuvant ICI? ⏱️
In our new @Annals_Oncology editorial, we explore how we can better capture the long term impact of ICI on patients in the curative setting.
@OncoAlert @tompowles1
annalsofoncology.org/article…
Totally agree! Fantastic to see this impressive international investigator-led effort coming together #ESMO26
With 5 UK sites now open, we’re excited to contribute to answering one of the key outstanding questions in first-line RCC.
@BartsECMC @CARE1Project @AlbigesL
Inspiring to be at the first presidential session of #ESMO26 with two P3 trials pushing the boundaries of perioperative cancer treatment in very different ways.
Firstly, mRNA vaccine demonstrating efficacy alongside ICI in adj melanoma. An exciting new era in cancer therapy. Encouraging tolerability, with no obvious signal of additional life-altering toxicity so far. Looking forward to seeing how this translates into RCC in V940-004 💉
And VOLGA. Looks v likely that we can optimise periop treatment in MIBC by reducing EV exposure. Lower neuropathy rates will be important for cured pts. On treatment QoL looks reassuring. Long term QoL data will be key 🧩 particularly given early impact of cystectomy @tompowles1
Beth Nally retweeted
Pleased to share our latest work, published today in @ESMO_Open 👇
As HER-targeted ADCs continue to evolve, understanding HER1–HER4 co-expression may help inform future drug development and patient selection.
sciencedirect.com/science/ar… @OncoAlert
🧵Key findings:
>50% G3-4 tox in Pembro/Belz arm of LITESPARK22, yet reassuringly only a temporary ⬇️ in QoL.
CTCAE captures acute, reversible tox but may not reflect the tox that matters most to patients or predict long-term QoL impact, as we’ve seen with adjuvant ICI at #ASCO26
Also loved the coverage of data from @BethN01 & @tompowles1 @BartsECMC related to novel methods of #HRQOL characterization. Such important work that Beth presented at #ASCO26 suggesting that characterizing toxicity as “life altering” may be far more meaningful! #KCRS26
Really interesting LITESPARK22 QoL data. The temporary ⬇️ during tx appears consistent with the short-term, reversible tox with belzutifan. As periop therapy evolves, life-altering ICI tox likely remains key driver of long-term QoL. Better ways needed to identify & measure this.
Quality of life data from LITESPARK-22 #KCRS26 (pembro+belzutifan in adjuvant RCC). Three different tools (FKSI/EORTCQLQ30/GP5) show a temporary dip in global and physical/role function QOL while on therapy, which didn’t hit predefined clinically meaningful levels. This is consistent with the reversible belzutifan toxicity signal (fatigue/anaemia). There is a need to look at quality of life analysis in different ways @BethN01 @DrChoueiri @montypal @Annals_Oncology @OncoAlert
Beth Nally retweeted
Also loved the coverage of data from @BethN01 & @tompowles1 @BartsECMC related to novel methods of #HRQOL characterization. Such important work that Beth presented at #ASCO26 suggesting that characterizing toxicity as “life altering” may be far more meaningful! #KCRS26
Exciting to see more options for patients with RCC in the adjuvant space.
Overall toxicity ⬆️ with belzutifan but irAE rates similar. Will addition of a targeted therapy impact HRQoL? Or will ICI remain the driver for 'Life Changing' tox?
Looking forward to the PRO data 🧩
In patients with resected clear-cell renal-cell carcinoma, pembrolizumab plus belzutifan led to higher disease-free survival than pembrolizumab alone but with an increased risk of grade 3 or higher adverse events. Full phase 3 LITESPARK-022 trial results: nej.md/4y03AhE
NEJM subscribers can use AI Companion to ask questions about this article and quickly find the details you need.
ALT A line graph from an Original Article published in the New England Journal of Medicine titled "Adjuvant Pembrolizumab plus Belzutifan for Renal-Cell Carcinoma" shows disease-free survival as assessed by the investigator in the primary analysis. The graph shows two lines: one for pembrolizumab–belzutifan and another for pembrolizumab–placebo. The y-axis indicates the percentage of participants, while the x-axis represents months since randomization. The trial name, LITESPARK-022, is in parentheses after the title.
Beth Nally retweeted
Excellent talk by @brian_rini on adjuvant therapy in RCC.
Benefit matters.
Toxicity matters.
The key question is “Who truly needs it?”
@DrOmarMian @bergsa83 @BradMcG04 @IMyrtaly @gbanna74 @DrYukselUrun @brian_rini @tompowles1 @fredhutch @OncoAlert @shilpaonc @EvanHallMD @FunchainMD @ManiamAkash @PGrivasMDPhD @Uromigos
Beth Nally retweeted
Perspective by Jonathan Falconer, MB, BS, Linda-Gail Bekker, PhD, and Joseph N. Jarvis, PhD: Long-Acting Treatment and Advanced HIV Disease — Addressing a Public Health Priority nej.md/43Th69m
#GlobalHealth #MedicalEthics
ALT A quote from a Perspective published in the New England Journal of Medicine discusses challenges faced by people with advanced HIV, such as interruptions in antiretroviral therapy and periods of disengagement. The Perspective is titled “Long-Acting Treatment and Advanced HIV Disease — Addressing a Public Health Priority.” Authors listed include Jonathan Falconer, M.B., B.S., Linda-Gail Bekker, Ph.D., and Joseph N. Jarvis, Ph.D.
Beth Nally retweeted
POTOMAC QOL: A year of durvalumab with BCG shows a delay in DFS and is FDA approved #ASCO26 . Here durvalumab appears to have little effect on QOL. We know ICIs have a ~10% rate of life changing toxicity (~10% @BethN01 ) which ⬇️QOL. New tools/methods are needed to unpick the details for patients.
Thank you - this work was driven by conversations with patients who felt that conventional toxicity grading didn’t always capture the real impact of treatment on both daily life and long-term quality of life. Really pleased it has resonated!
I used to think many QoL studies missed the point.
“No significant difference”—really?
One of my favorite presentations at #ASCO26 was Beth Nally et al.’s work on decision regret and patient-defined toxicity after adjuvant ICI for RCC.
Great science starts with better questions.
Beth Nally retweeted
Can we measure QOL completely differently? #ASCO26 This podcast with Peter O’Donnell and @BethN01 covers the KN905 EVP data and IM010 data. podcasts.apple.com/gb/podcas…
Beth Nally retweeted
Terrific data. Super ⭐ @BethN01 - @QMBCI @NHSBartsHealth
Re-categorisation of AEs according to patient-informed framework demonstrated significant association with deterioration.
Aligned with @NHS cancer priorities. One step closer to personalised care. #ASCO26
Today we presented our work #ASCO26 "Long-term toxicity perception and decision making with adjuvant immunotherapy in RCC: an exploratory HRQoL analysis from IMmotion010"
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@oncodaily @OncoAlert @tompowles1
Beth Nally retweeted
Love this practical and clinically meaningful way of capturing impact of dug related toxicities!
@IBCG_BladderCA @UroDocAsh @Uromigos @OncoAlert
Data from @BethN01 showing we can look at treatment related toxicity and its effects on quality of life in a different way. Longer term effects need some focus @OncoAlert @DrChoueiri @montypal @crisbergerot
Beth Nally retweeted
A Great Start to Day Two of #ASCO26 and no better way to start than our @OncoAlert 🚨from the Podium to your feed with Dr. Elizabeth Nally from Barts Cancer institute🇬🇧 discussing Abstract 4512 : Decision regret and toxicity perception following adjuvant pembrolizumab in renal cell carcinoma.
In this multicentre London study of 104 patients with RCC treated with adjuvant pembrolizumab, decision regret was uncommon (13%) after a median 30-month follow-up. Regret was driven primarily by long-term, patient-perceived significant or life-changing toxicities rather than disease recurrence or CTCAE-graded severity. Permanent endocrine and musculoskeletal toxicities were associated with the highest regret.
Patient-informed toxicity assessments outperformed CTCAE criteria in identifying regret, highlighting the importance of patient education and shared decision-making. #KidneyCancer
Elizabeth Nally
@veda13k @scocmem @b_szabados @Naveed_Sarwar @tompowles1 @montypal @crisbergerot
Pinging OncoAlert Faculty
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Beth Nally retweeted
Incredibly proud of @BethN01 and this work. I've watched her building this project with patients at the center, and it now shapes how we define and measure long‑term ICI toxicity in adjuvant RCC. A really big step forward for our field and patients. #ASCO26
@OncoAlert @BartsECMC
Today we presented our work #ASCO26 "Long-term toxicity perception and decision making with adjuvant immunotherapy in RCC: an exploratory HRQoL analysis from IMmotion010"
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@oncodaily @OncoAlert @tompowles1