Alexia

Siguiendo la Luna. Residente de radiooncología ⚡️

[Dr Rishabh Jain @DrRishabhOnco]

🚨 THE 15 MOST IMPORTANT TRIALS OF #ASCO26

May 29 - June 2 | Chicago
Which trial are you watching most closely?

🌟 PLENARY GAME-CHANGERS

1️⃣ PROTEUS
Perioperative apalutamide + ADT in high-risk localized prostate cancer

2️⃣ LIBRETTO-432
Adjuvant selpercatinib in RET+ NSCLC

3️⃣ HARMONi-6
Ivonescimab + chemo vs tislelizumab + chemo in squamous NSCLC

4️⃣ RASolute 302
Daraxonrasib (RMC-6236) in metastatic pancreatic cancer

5️⃣ SARC041
Abemaciclib in dedifferentiated liposarcoma

⚡ FRONTLINE & PERIOPERATIVE SHIFTS

6️⃣ KEYNOTE-B15 / EV-304
EV + pembrolizumab vs chemo in MIBC

7️⃣ LITESPARK-022
Pembrolizumab + belzutifan in adjuvant ccRCC

8️⃣ AMBITION
Paclitaxel/bevacizumab ± atezolizumab in HR+ breast cancer

9️⃣ NeoADAURA
Neoadjuvant osimertinib in EGFR+ NSCLC

🔟 A-DREAM
ADT interruption strategies in mCSPC

🧬 PRECISION, ADCs & NEXT-GEN IMMUNOLOGY

1️⃣1️⃣ DESTINY-Breast06
T-DXd expands into HER2-ultralow disease

1️⃣2️⃣ CROWN (7-year update)
Lorlatinib durability in ALK+ NSCLC

1️⃣3️⃣ DeLLphi-312
Tarlatamab in frontline SCLC

1️⃣4️⃣ COMMIT
Atezolizumab + FOLFOX/Bev in MSI-H mCRC

1️⃣5️⃣ IMvigor011
ctDNA-guided adjuvant atezolizumab in bladder cancer

#OncoTwitter #MedTwitter #ASCO26 #CancerResearch @OncoAlert @ASCO @JCOPO_ASCO @OncBrothers

[Adam B. Weiner, MD @Adam_Weiner535]

🚨Testosterone replacement therapy after surgery for #prostatecancer🚨

@JAMAInternalMed

⭐️SPIRIT trial

📊 RCT, n=136, low/int-grade PCa, post-RP, hypogonadal men
⏱️ TRT started ≥2 yrs post-RP w/ undetectable PSA
💉 12 wks testosterone vs placebo
✅ ↑ sexual activity (+0.9 events/day), desire, lean mass, VO₂ peak
🛡️ ZERO biochemical recurrences

⚠️ Short-term, proof-of-concept.
👉Bigger/longer trials including patients with higher-risk disease needed

@PCFnews @PCF_Science @urotoday @renalandurology @UrologyTimes

🔗https://t.co/nPtK3EahPQ

[Dr Rupam Manna MD @DrRupamOncology]

Neuroendocrine Tumors (NETs) — one-page mastery 🧬

From Ki-67 grading → classification → targeted therapy, this is the framework you need for both exams & clinics.

🔑 Remember:
• Grade drives treatment
• SSA = first-line (low-grade)
• PRRT = game changer
• NEC → treat like SCLC

#MedicalOncology #NETs #Oncology #DrNB #DMOncology #OncoTwitter #MedEd #CancerEducation #PRRT #ExamPrep

[Carmelo Tuscano🇮🇹🇪🇺 @CTuscanoMD]

What is the real α/β in Prostate Cancer?
In this meta-analysis in the 🟢 Journal on regard BRFS :
α/β = 1.5 → no correlation
α/β = 3 → everything changes (R² 68%)
Practical translation : we don't know the real α/β value
#radonc

[Yakup Ergün @dr_yakupergun]

My Top 10 Breast Cancer Abstracts at #ASCO26 👇

[Adam B. Weiner, MD @Adam_Weiner535]

🎧 Music during prostate biopsy = real clinical impact

🚨VIVALDI RCT in @EurUrolOpen

✅Patient-selected music during transperineal prostate biopsy lead to....

↓ Pain at every step (VAS consistently lower)
↓ Anxiety & distress post-procedure
↓ Sedation needs (37% vs 57%)
↑ Patient satisfaction & willingness to repeat

🫰Simple. Scalable. Zero downside.

⭐️So critical for anyone with a large Active Surveillance population

💡Nonpharmacologic interventions aren’t “soft”—they’re effective.

🔗https://t.co/0eicfj7Vxz

@PCFnews @PCF_Science @EUplatinum

[Dra. María Natalia Gandur Quiroga @nataliagandur]

⭐ Neoadjuvant therapy in high-risk prostate cancer where do we stand in 2026? 🔬

@OncoAlert @APCCC_Lugano
#IPCS26 #APCCC26 @Silke_Gillessen @AOmlin

Presented by Alberto Briganti

🔹 Big picture:
🔹 1. Neoadjuvant strategies improve pathologic endpoints, but NOT survival (OS/DFS).
🔹 2. ADT ± ARPI increases response rates → but clinical benefit remains limited.

🔹 Biomarkers & response:
🔹 3. pCR, MRD and especially RCB refine response assessment → RCB strongest prognostic signal.
🔹 4. PSMA PET correlates with response → emerging non-invasive biomarker.
🔹 5. ctDNA remains limited in localized disease.

🔹 Biology of resistance:
🔹 6. Residual tumors retain AR signaling.
🔹 7. RB1 loss + TP53 alterations drive resistance and progression.
🔹 8. Distinct genomic profiles define responders (SPOP) vs non-responders.

🔹 Future direction:
🔹 9. Biomarker-driven trials (GUNS) → precision neoadjuvant strategies.
🔹 10. Pathologic response may guide escalation/de-escalation (learning from breast cancer).

@EAntonarakis @DrRanaMcKay @LoebStacy @ChrisSweens1
@fabioturco92 @UrsulaVogl @SScagliarini @Tylersbrt @neerajaiims @amerseburger @Cdanicas @AarmstrongDuke @BertrandTOMBAL @ChrisSweens1 @EAntonarakis @KOSJ12 @VedangMurthy @DrRanaMcKay @LoebStacy @stefanofanti4 @mirrorsmed @profkhermann @dr_coops @piet_ost @_ShankarSiva @DrSpratticus @scocmem @AmandaNizamMD @tompowles1 @EUplatinum @Uromigos
#ProstateCancer #UroOncology #Oncology

[Advanced Prostate Cancer Consensus Conference @APCCC_Lugano]

[68Ga]PSMA-11 PET/CT vs. mpMRI in patients with a high suspicion of prostate cancer and previous negative biopsy: head to head, parallel, prospective trial (PROSPET-BX)

https://t.co/Ytf1goIUkH

This prospective trial compared [68Ga]PSMA-11 PET/CT and mpMRI in men with suspected #ProstateCancer after a prior negative biopsy. Among 130 patients, PET/CT demonstrated higher diagnostic accuracy for clinically significant disease than mpMRI. PSA density, PRIMARY score, SUVratio, and PI-RADS predicted significant cancer.

Investigators developed the PRIMER nomogram, which showed strong performance (AUC 0.896) for predicting clinically significant prostate cancer before repeat biopsy.

Egesta Lopci,
@FasuloVittorio
@RobPeschechera
@GLughezzani

@OncoAlert 🚨
@silkegillessen
@AOmlin
@weoncologists

[Advanced Prostate Cancer Consensus Conference @APCCC_Lugano]

PEACE-2 Presented at #GU26

https://t.co/9lYVA4QnHJ

PEACE-2 evaluated whether adding upfront cabazitaxel to long-term ADT and prostate radiotherapy improves outcomes in very high-risk localized #ProstateCancer .

In this 2×2 factorial phase III trial of 761 patients, no interaction was seen with pelvic radiotherapy☢️, and cabazitaxel did NOT🚫improve clinical progression-free survival (HR 1.11), with similar overall survival across arms after a median 85 months. Toxicity was higher with cabazitaxel, and prostate cancer–related deaths were rare.

Karim Fizazi
@PaulSargos
Igor Latorzeff @AFUrologie
@EnriqueGallar12
@PBlanchardMD

@OncoAlert 🚨
@silkegillessen
@AOmlin
@weoncologists

[Dr. Andrew Loblaw @DrAndrewLoblaw]

For unfavourable risk prostate cancer, @CDNCancerTrials #PR24 is accruing and is just about to randomize patient 200!

[Dr Rishabh Jain @DrRishabhOnco]

🚨 ASCO GU 2026 - The Precision Era of Prostate Cancer 🚨

Here are 10 practice-shaping highlights every GU oncologist should know:

1️⃣ PEACE-3
Radium-223 + Enzalutamide improved OS in bone-only mCRPC
42.3 vs 35.0 months - HR 0.69

2️⃣ PSMAddition
177Lu-PSMA-617 + ADT + ARPI improved rPFS in mHSPC
Frontline radioligand therapy has arrived

3️⃣ MEVPRO-3
Mevrometostat + Enzalutamide
49% reduction in rPFS risk post-abiraterone

4️⃣ CiPHeR
Carboplatin shows strong activity in HRR-mutated mCRPC
Genomic testing is no longer optional

5️⃣ CAPItello-281
Capivasertib + Abiraterone in PTEN-deficient mHSPC
Tolerability confirmed - AKT pathway matters

6️⃣ PEACE-2
Cabazitaxel intensification in very high-risk localized disease
Metastasis-free survival signal

7️⃣ BRCAAway
Concurrent Abi + Olaparib > sequential strategy
Timing of PARP inhibition matters

8️⃣ PAnTHA
Actinium-225 PSMA - alpha emitter strategy emerging
Potential rescue after Lu-177

9️⃣ CLIMATE
miR-371a-3p validated for MRD in stage I TGCT

🔟 Decipher GRID
Transcriptomics refines who benefits from docetaxel intensification

#ASCOGU26 #GU26 #ProstateCancer #OncTwitter #MedTwitter #PrecisionOncology
@OncoAlert @myesmo @esmo_open @asco @larvol

[David Sher @DavidSherMD]

I’ve been looking forward to this paper since the ASTRO Plenary talk in 2023.

HYPNO-RT is out: is it worth the wait?

https://t.co/RbBrDOriMo

[Dr Rishabh Jain @DrRishabhOnco]

🚨 ASCO GU 2026
Top 15 Clinical Trials to Watch
#GU26

🔵 Prostate Cancer
|Precision & Intensification

🧪 CIPHER
Testing platinum as a low-cost option in HRR-mutated mCRPC

☢️ PSMAaddition
¹⁷⁷Lu-PSMA-617 moves into mHSPC

🎯 PEACE-2
Systemic intensification (abiraterone + ADT) with definitive prostate RT

🔗 PEACE-3
Radioligand + ARPI combination in mCRPC

🧬 CAPItello-281
AKT pathway targeting in PTEN-deficient mHSPC

🟢 Bladder & Urothelial Cancer
| ADCs & Bladder Preservation

🧬 KEYNOTE-B15 / EV-304
Perioperative EV + pembrolizumab as a new backbone in MIBC

🧪 VOLGA
IO–ADC triplet strategy in perioperative MIBC

🫙 SunRISe-2
Bladder-sparing TAR-200 + cetrelimab in BCG-unresponsive NMIBC

🧫 Disitamab vedotin + pembrolizumab
ADC expansion beyond enfortumab in HER2-expressing disease

🩸 RETAIN trials (LBA632)
ctDNA-guided, response-adapted bladder preservation in MIBC

🟡 Renal Cell Carcinoma
| Post-IO Sequencing

🧪 LITESPARK-011
Belzutifan combinations after IO–TKI failure

🛡️ LITESPARK-022
HIF-2α inhibition enters the adjuvant setting

🔁 TiNivo-2
IO rechallenge tested rigorously

💊 STELLAR-001
Next-generation TKI (XL092) strategies

🔪 CYTOSHRINK
Response-adapted cytoreductive nephrectomy after systemic therapy

#ASCOGU26 #GUOncology #OncoTwitter #MedTwitter
@OncoAlert @myesmo @esmo_open @asco @Larvol

[Dr Rishabh Jain @DrRishabhOnco]

5 to 20 brain metastases.
Is whole-brain radiation still inevitable? 🧠☢️

This phase III trial challenges a long-held assumption.

🧪 Trial
Stereotactic Radiation vs Hippocampal-Avoidance WBRT
Phase III RCT | N = 196

👥 Study population
Solid tumors with 5–20 brain metastases
No prior brain RT
Median mets = 14
KPS 70–100

⚖️ Arms
🎯 Stereotactic radiation to all visible lesions
🧠 HA-WBRT (30 Gy/10 fx) + memantine

📌 Primary endpoint
Patient-reported symptom burden and daily function
(MDASI-BT over 6 months)

📊 Key result
Symptoms improved with stereotactic RT
Mean difference −1.06
Clinically meaningful
P < 0.001 ✅

🧠 Function & cognition
Better KPS and Barthel Index at multiple timepoints
Several neurocognitive tests favored stereotactic RT
None favored HA-WBRT

⏳ Survival
Median OS 8.3 vs 8.5 months
No OS difference

📉 Trade-offs
More new brain mets with stereotactic RT
Higher radiographic radionecrosis
But less steroid initiation and better QoL

🎯 Clinical takeaway
For patients with 5–20 brain metastases, stereotactic radiation improves quality of life and daily functioning compared with HA-WBRT, without compromising survival.
Precision wins when patients live with disease, not just survive it.

📖 Full paper in comment ⬇️
🔖 Save for tumor boards

#OncoTwitter #RadOnc #NeuroOncology #BrainMets
@myESMO @OncoAlert @ASCO

[European Urology Oncology @EurUrolOncol]

Now online!

Prognosis and Treatment Response in Aggressive-variant Prostate Cancer and Treatment-related Neuroendocrine Prostate Cancer: A Systematic Review and Meta-analysis
by Martino Pedrani et al

Read full article: https://t.co/6htV2pN5Pp

Thank you to the authors for choosing #EUO to publish your work.

@PedraniMartino
@Silke_Gillessen
@uroweb
@mroupret
@jteoh_hk
@Ric_Campi
@CaPsurvivorship
@UroDocAsh
@LauraMarandino
@RenuEapen
@Ecastromarcos
@OncoAlert
@Sciencedirect

[ASTRO @ASTRO_org]

New in #practicalRO: Tongue-Out Radiation Therapy for Patients With Head and Neck Cancer Facilitated a Rapid Recovery From Post-Radiation Therapy Dysgeusia by Lowering Oral Tongue Dose. https://t.co/ueA0NUzRup

[Advanced Prostate Cancer Consensus Conference @APCCC_Lugano]

Metastasis-directed therapy and standard of care versus standard of care for oligometastatic prostate cancer (WOLVERINE)

https://t.co/axU4Pz3YZf

This systematic review and individual patient data meta-analysis evaluated metastasis-directed therapy (MDT) for oligometastatic #ProstateCancer using data from seven randomized phase 2 trials. MDT plus standard of care significantly improved progression-free survival, radiographic progression-free survival, and castration resistance-free survival compared with standard care alone.

Although a trend toward improved overall survival was observed, it did NOT 🚫reach statistical significance, highlighting the need for further research.

@ChadTangMD
@DavidPFarris
@aaparicioMD
@GabSimontacchi
@jarey_wang
@fontev1
@ReneeBultijnck
@matthewdeek
@DrOlsonOncology
@GiuliaMarvaso84
@ChiaraLorubbio
@BarbaraJereczek
@PBlanchardMD
@drdavidpalma
@piet_ost

@OncoAlert 🚨
@Silke_Gillessen
@AOmlin
@weoncologists

[Karamvir Yadav @K_Yadavir]

New article alert from JCO:
RAPIDO &amp; PRODIGE-23 proved TNT works.
NEOTERIC asks how to make TNT smarter.
Signal-seeking today. Practice-changing tomorrow?
#rectalcancer #immunotherapy #medtwitter #medscape @ASCO @JCO_ASCO @OncoAlert @OncBrothers @CancerNetwrk

[Pathology mcqs @Pathology_mcqs]

WHO CNS 2021 simplified ✨
🔹 IDH mutant vs wildtype
🔹 Molecular overrides morphology
🔹 CDKN2A = Grade 4
Save this for quick revision 📌
Follow for more high-yield pathology content📚
#PathologyNotes #Neuropathology #WHOClassification #DiffuseGlioma #Glioblastoma #Astrocytoma

[小 @lostyouinmay]

mood กุในวันหยุด :