The top tweeted terms are the trending industry discussions happening on Twitter by key individuals (influencers) as tracked by the platform.

1. Breast Cancer – 1,456 Mentions

Covid-19 leading to delay in cancer diagnoses, the road to recovery from breast cancer, and the cost of breast cancer treatment were the popularly discussed topics in the fourth quarter of 2020. Elaine Schattner a journalist, tweeted about the decline in mammograms and other screening procedures during the Covid-19 pandemic, which led to missed or delayed cancer diagnoses.

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Several types of cancer advance rapidly, and delayed detection could result in fewer available treatment options for patients and more deaths, the article noted. The 21st Century Oncology, a provider of cancer care services operating in 300 locations in the US, highlighted that approximately 18% of its newly-diagnosed breast cancer patients in 2020 through August were at an advanced stage of the disease compared with 12% in 2019.

Dr. Minas Chrysopoulo, plastic surgeon, further shared an article on how breast reconstruction is an important part of recovery for a breast cancer patient. Interactive sessions among the patient, radiologists and plastic micro-surgeons for breast reconstruction make the breast cancer journey for the patients easier and less frightening, the article added.

Breast cancer also trended in discussions shared by Susan G. Komen, a breast cancer foundation, on how more than 275,000 women were projected to be diagnosed with breast cancer in the US in 2020. The average cost of treatment for breast cancer ranges between $20,000 and $100,000. The cost of treatment for women in advanced stages of the disease is higher compared with patients in earlier-stages.

Health insurance often does not cover all the medical costs associated with the treatment forcing patients to pay out of pocket. The medical costs can be evaluated by the patient before starting the treatment and exploring various options with their medical team, the article detailed.

2. Immunotherapy – 607 Mentions

The activation of the immune system for the treatment of BRCA2 mutation cancer, the connection between microbiome and immunotherapy, and oncolytic herpes virus with immunotherapy for cancer treatment were widely discussed topics during Q4. Lisa M Guzzardi, a patient advocate, highlighted a study underway at Memorial Sloan Kettering that demonstrated how tumours with mutations in the BRCA2 gene responded better to checkpoint inhibitor immunotherapy than tumours with BRCA1 gene mutation. The study highlighted that immune system activation could be a promising treatment for people with BRCA2 mutations.

Dr Kathleen D. Hoffman, a healthcare content writer, further, tweeted about a new study linking the role of gut bacteria in cancer treatment. In the study, patients with diverse gut microbiome responded to immunotherapy and had a larger number of killer T-cells compared to those patients who did not respond to the immunotherapy. The level of gut bacteria and microbes in a patient’s digestive tract can influence treatment in terms of its possible side effects, the article highlighted.

Another discussion surrounding immunotherapy was shared by Bernard A Fox, co-founder and president of immunotherapy company UbiVac, on how oncolytic herpes virus in combination with BRAF inhibitors was found to significantly improve the survival level in BRAF-mutant thyroid cancer mouse models by improving the immune-mediated antitumour effects.

The therapy was further enhanced by triple combination therapies, including either PD-1 or CTLA-4 inhibitors. The study concluded that oncolytic viruses can be modified to alter the tumour microenvironment and can be combined with checkpoint inhibitors for improved therapeutic effect.

3. Lung Cancer – 488 Mentions

AstraZeneca and partnering to develop artificial intelligence (AI)-based solutions for lung cancer, the improved survival rate in lung cancer patients, and immunotherapy for lung cancer were the popular topics discussed in Q4 2020. Amine Korchi, a radiologist, retweeted about the collaboration between AstraZeneca and, an Indian healthcare start-up, for the development of AI-based solutions for the early diagnosis of lung cancer and reducing mortality rates. The two companies will utilise deep learning algorithms to detect lung abnormalities in patients.

Janel Freeman, a writer, further shared a report published by the American Cancer Society that found the survival rate in lung cancer patients having doubled in recent years due to improved screening technologies and targeted therapies. Lung cancer death rates decreased by 51% among men from 1990 to 2017 and 26% among women from 2002 to 2017 in the US. The decline will continue further with more improved screening tools and breakthrough therapies, the report added.

Lung cancer was also discussed by Nathan A. Pennell, director of Cleveland Clinic, a non-profit medical centre, who retweeted results from a phase III clinical trial of Bristol Myer Squibb’s Opdivo in combination with chemotherapy. The combination therapy showed improved pathologic complete response in non-small cell lung cancer (NSCLC) patients who received it before surgery. The results of the study can push immunotherapy towards becoming an integral part of operable lung cancer, Pennell added.

4. Multiple Myeloma – 460 Mentions

Off-the-shelf CAR therapy for multiple myeloma, approval of Selinexor combination drug and Johnson and Johnson’s talquetamab showing promising results were popularly discussed topics during the last three months of 2020. Dr Miguel Perales, an oncologist, tweeted that ALLO-715, an off-the-shelf CAR T-cell therapy, showed promising results in the treatment of heavily pre-treated patients with relapsed/refractory multiple myeloma in a first-in-human study. The study showed responses in six out of ten patients including partial response in four patients.

Robert Z. Orlowski, director of Myeloma Section at MD Anderson Cancer Center, further, shared an article on the approval of Xpovio (selinexor) in combination with Velcade (bortezomib) and dexamethasone by the US Food and Drug Administration (FDA) for the treatment of adults with multiple myeloma. The combination therapy showed 47% improvement in progression-free survival in patients compared with standard twice-weekly bortezomib-dexamethasone in a phase III clinical study.

Another discussion involving multiple myeloma was shared by Jacob Plieth, a journalist, about Johnson & Johnson’s GPRC5D inhibitor, talquetamab, showing promising results in early clinical trials with an overall response rate of 69% in multiple myeloma patients. A very good partial response or better was also observed in 39% of patients. Talquetamab interacts with T-cells by targeting CD3, which makes the bispecific antibody a viable treatment choice for heavily pre-treated patients.

5. Pancreatic Cancer – 223 Mentions

Advanced research improving the survival rate for pancreatic cancer, hallmarks of pancreatic cancer and germline testing for managing pancreatic cancer were widely discussed topics in Q4 2020. Mike Pishvaian, an oncologist, highlighted that the advent of novel treatments and the rise in research funding has improved the survival rate for pancreatic cancer patients. The five-year survival rate for pancreatic cancer patients diagnosed in the early stage is 39.4%, according to the National Cancer Institute (NCI).

NCI increased the research funding for pancreatic cancer from $17m in 1999 to more than $178m in 2017. Funding from other organisations has also made such an increment. The diagnosis of cancer with AI-based technologies, as well as blood and urine screenings have also made early detection of the cancer possible.

In another discussion, Emil Lou, a physician and scientist, tweeted as article about the deadly hallmarks of pancreatic cancer. The chronic inflammation of the pancreas leads to the formation of pancreatic tumours and its supporting tissues around the tumour. The supporting tissue contains fewer blood vessels, so the tumour adopts aggressive methods to produce energy and grow. Pancreatic cancer often grows and spreads to other organs quickly, the article noted.

Lisa M Guzzardi further discussed pancreatic cancer with regards to how patients should undergo genetic testing at the time of diagnosis to identify workable mutations, which are present in up to 20% of patients. Identifying mutations such as BRCA, KRAS, BRAF, and even microsatellite instability can help in administering targeted treatments. Patients with BRCA mutations, for example, respond well to treatment with olaparib (Lynparza), while those with NTRK fusions have responded well to entrectinib (Rozlytrek) and larotrectinib (Vitrakvi).