Daniel Castellano

Medical Oncologist. Hospital Univ. 12 de Octubre. Madrid. UCM. Head GU Unit. Executive Member @GUARDconsortitum

[OncoAlert @OncoAlert]

An Amazing end to #ASCO26
Thank you @ASCO 🇺🇸For Another GREAT Meeting!!
3⃣4⃣6⃣Million Impressions
2⃣2⃣.4⃣K Posts
1⃣.6⃣K Participants on X

THANK YOU COLLEAGUES WORLDWIDE🌐 FOR SUPPORTING YOUR @OncoAlert 🚨 NETWORK

Huge thanks to OUR OncoAlert Pulse ❤️
@DrChoueiri 🇺🇸 @hoperugo 🇺🇸 @matteolambe 🇮🇹 @TiansterZhang 🇺🇸 @CathyEngMD 🇺🇸 @stolaney1 🇺🇸 @montypal 🇺🇸 @tompowles1 🇬🇧 @brian_rini 🇺🇸 @cdanicas 🇪🇸 @NiuSanford 🇺🇸 @amerseburger 🇩🇪 @GlopesMd 🇺🇸 @Icro_Meattini 🇮🇹 @PGrivasMDPhD 🇺🇸 @DrYukselUrun 🇹🇷 @nataliagandur 🇦🇷 @ElisaAgostinett 🇧🇪 @HHorinouchi 🇯🇵 @realbowtiedoc 🇺🇸 @to_be_elizabeth 🇮🇹 @UOzkerim 🇹🇷 @p_ciracimd 🇮🇹 @DrVilmaPBarcia 🇪🇸 @DraMartinezLago 🇪🇸 @DrMirallas 🇺🇸 @GaiaGriguolo 🇮🇹 @MarioBalsaMD 🇪🇸 @scocmem 🇬🇧 @AmandaNizamMD 🇺🇸 & @weoncologists 🇺🇸

@OncBrothers @neerajaiims @crisbergerot @StephenVLiu @lungoncdoc @NazliDizman @CParkMD @RenoHemonc @EileenMOReilly @chavarriagaj
We Are ALL OncoAlert
For Colleagues...By Colleagues

⭐️Stats courtesy of https://t.co/SIKYS5Kmax

[OncoAlert @OncoAlert]

Dear Colleagues at #ASCO26
Thank you for joining us and reminding you that THE COMPLETE ONCOALERT NEWSLETTER with ALL of our picks from #ASCO26 comes out this Thursday and conveniently to your Inbox
REGISTER HERE 👉https://t.co/utvJCzZt7J

@DrChoueiri 🇺🇸
@hoperugo 🇺🇸
@matteolambe 🇮🇹
@TiansterZhang 🇺🇸
@CathyEngMD 🇺🇸
@stolaney1 🇺🇸
@montypal 🇺🇸
@tompowles1 🇬🇧
@brian_rini 🇺🇸
@cdanicas 🇪🇸
@NiuSanford 🇺🇸
@amerseburger 🇩🇪
@GlopesMd 🇺🇸
@Icro_Meattini 🇮🇹
@PGrivasMDPhD 🇺🇸
@DrYukselUrun 🇹🇷
@nataliagandur 🇦🇷
@ElisaAgostinett 🇧🇪
@HHorinouchi 🇯🇵
@realbowtiedoc 🇺🇸
@to_be_elizabeth 🇮🇹
@UOzkerim 🇹🇷
@p_ciracimd 🇮🇹
@DrVilmaPBarcia 🇪🇸
@DraMartinezLago 🇪🇸
@DrMirallas 🇺🇸
@GaiaGriguolo 🇮🇹
@MarioBalsaMD 🇪🇸
@scocmem 🇬🇧
@AmandaNizamMD 🇺🇸
& @weoncologists 🇺🇸

[Daniel Castellano @cdanicas]

🙃 Totally agree. The question isn't who is the best, but what is best for our patients. We have to keep working forward @ASCO @ESTRO_RT @ASTRO_org @Uroweb

[Declan Murphy @declangmurphy]

Is there a name for that condition where people are incontinent of thoughts and words on Twitter?!! You see it on other platforms. Must be some meds or some sort of sphincter you can put on the post button. Or just focus on day job. THANK YOU FOR YOUR ATTENTION TO THIS MATTER 😀

[Mario Balsa @MarioBalsaMD]

👋🏼 After covering my #ASCO26 Top 10 melanoma studies, one thing feels clear: the future is personal!!!!
🎯 Personalized vaccines
🎯 Next-generation TILs
🎯 PRAME-targeted TCR therapies
🎯 Smarter neoadjuvant IO

Different approaches. Same goal: helping more patients live longer and better.

Thank you to the amazing @OncoAlert community, and especially to @weoncologists for the mentorship, inspiration, and countless lessons along the way 🙏

I came to #ASCO26 looking for answers. I’m leaving with even better melanoma questions 🖤

The science was inspiring…but people behind it even more @OncoAlert 📡

@DrChoueiri 🇺🇸
@hoperugo 🇺🇸
@matteolambe 🇮🇹
@TiansterZhang 🇺🇸
@CathyEngMD 🇺🇸
@stolaney1 🇺🇸
@montypal 🇺🇸
@tompowles1 🇬🇧
@brian_rini 🇺🇸
@cdanicas 🇪🇸
@NiuSanford 🇺🇸
@amerseburger 🇩🇪
@GlopesMd 🇺🇸
@Icro_Meattini 🇮🇹
@PGrivasMDPhD 🇺🇸
@DrYukselUrun 🇹🇷
@nataliagandur 🇦🇷
@ElisaAgostinett 🇧🇪
@HHorinouchi 🇯🇵
@realbowtiedoc 🇺🇸
@to_be_elizabeth 🇮🇹
@UOzkerim 🇹🇷
@p_ciracimd 🇮🇹
@DrVilmaPBarcia 🇪🇸
@DraMartinezLago 🇪🇸
@DrMirallas 🇺🇸
@GaiaGriguolo 🇮🇹
@scocmem 🇬🇧
@AmandaNizamMD 🇺🇸
& @weoncologists 🇺🇸

[OncoAlert @OncoAlert]

Dear Colleagues, It has been a pleasure to be here in Chicago and covering the GREAT Science out of Chicago!! First and Foremost OncoAlert Would like to Thank ASCO, their faculty and staff and all that have made #ASCO26 one to remember!!

We would like to thank all colleagues who joined us in Chicago and specially those unable to make it but that trusted us to bring them up to the minute oncology information straight from Chicago!! We thank all colleagues posting from the floor and making sure the right information was being amplified. We are ONE Oncology Community🌐 And We are ALL OncoAlert 🚨

@DrChoueiri 🇺🇸
@hoperugo 🇺🇸
@matteolambe 🇮🇹
@TiansterZhang 🇺🇸
@CathyEngMD 🇺🇸
@stolaney1 🇺🇸
@montypal 🇺🇸
@tompowles1 🇬🇧
@brian_rini 🇺🇸
@cdanicas 🇪🇸
@NiuSanford 🇺🇸
@amerseburger 🇩🇪
@GlopesMd 🇺🇸
@Icro_Meattini 🇮🇹
@PGrivasMDPhD 🇺🇸
@DrYukselUrun 🇹🇷
@nataliagandur 🇦🇷
@ElisaAgostinett 🇧🇪
@HHorinouchi 🇯🇵
@realbowtiedoc 🇺🇸
@to_be_elizabeth 🇮🇹
@UOzkerim 🇹🇷
@p_ciracimd 🇮🇹
@DrVilmaPBarcia 🇪🇸
@DraMartinezLago 🇪🇸
@DrMirallas 🇺🇸
@GaiaGriguolo 🇮🇹
@MarioBalsaMD 🇪🇸
@scocmem 🇬🇧
@AmandaNizamMD 🇺🇸
& @weoncologists 🇺🇸

[OncoAlert @OncoAlert]

Dear Colleagues at #ASCO26
A great way to end this final day of the meeting that with a presentation straight from the Podium to your feed.

@OncoAlert proudly presents Dr. Roger Von Moos 🇨🇭who just presented Abs 1004 at ASCO:

Prevalence of symptomatic skeletal events (SSE) with reduced denosumab (Dmab) dose density (every 12 weeks versus every 4 weeks): A randomized phase III non-inferiority trial SAKK 96/12 REDUSE.

The phase III SAKK 96/12 REDUSE trial randomized 1,380 patients with bone-metastatic breast cancer or castration-resistant prostate cancer to denosumab 120 mg every 4 weeks or, after a 3-month loading phase, every 12 weeks. The reduced-frequency schedule was non-inferior for preventing symptomatic skeletal events, with similar efficacy and lower rates of hypocalcemia and osteonecrosis of the jaw. These findings support every-12-week denosumab as a new standard of care, reducing toxicity, treatment burden, and costs.

@Silke_Gillessen
@RothschildSacha

@DrChoueiri 🇺🇸 @hoperugo 🇺🇸 @matteolambe 🇮🇹 @TiansterZhang 🇺🇸 @CathyEngMD 🇺🇸 @stolaney1 🇺🇸 @montypal 🇺🇸 @tompowles1 🇬🇧 @brian_rini 🇺🇸 @cdanicas 🇪🇸 @NiuSanford 🇺🇸 @amerseburger 🇩🇪 @GlopesMd 🇺🇸 @Icro_Meattini 🇮🇹 @PGrivasMDPhD 🇺🇸 @DrYukselUrun 🇹🇷 @nataliagandur 🇦🇷 @ElisaAgostinett 🇧🇪 @HHorinouchi 🇯🇵 @realbowtiedoc 🇺🇸 @to_be_elizabeth 🇮🇹 @UOzkerim 🇹🇷 @p_ciracimd 🇮🇹 @DrVilmaPBarcia 🇪🇸 @DraMartinezLago 🇪🇸 @DrMirallas 🇺🇸 @GaiaGriguolo 🇮🇹 @MarioBalsaMD 🇪🇸 @scocmem 🇬🇧 @AmandaNizamMD 🇺🇸 & @weoncologists 🇺🇸 @APCCC_Lugano @AOmlin

[OncoAlert @OncoAlert]

The #OncoAlertTopTweet 🚨Day FOUR #ASCO26
Post by @OncoAlert Faculty @DrChoueiri 🇺🇸

PSMAddition: consistent efficacy of 177Lu-PSMA-617 across all evaluated mHSPC populations, with no differences in safety profiles. #ProstateCancer

@DrChoueiri 🇺🇸 @hoperugo 🇺🇸 @matteolambe 🇮🇹 @TiansterZhang 🇺🇸 @CathyEngMD 🇺🇸 @stolaney1 🇺🇸 @montypal 🇺🇸 @tompowles1 🇬🇧 @brian_rini 🇺🇸 @cdanicas 🇪🇸 @NiuSanford 🇺🇸 @amerseburger 🇩🇪 @GlopesMd 🇺🇸 @Icro_Meattini 🇮🇹 @PGrivasMDPhD 🇺🇸 @DrYukselUrun 🇹🇷 @nataliagandur 🇦🇷 @ElisaAgostinett 🇧🇪 @HHorinouchi 🇯🇵 @realbowtiedoc 🇺🇸 @to_be_elizabeth 🇮🇹 @UOzkerim 🇹🇷 @Erman_Akkus 🇹🇷 @yekeduz_emre 🇹🇷 @p_ciracimd 🇮🇹 @DrVilmaPBarcia 🇪🇸 @DraMartinezLago 🇪🇸 @DrMirallas 🇺🇸 @GaiaGriguolo 🇮🇹 @MarioBalsaMD 🇪🇸 @scocmem 🇬🇧 @AmandaNizamMD 🇺🇸 & @weoncologists 🇺🇸

[OncoAlert @OncoAlert]

The #OncoAlertTopTweet 🚨Day FOUR #ASCO26
Post by @OncoAlert Faculty @StephenVLiu 🇺🇸

Presented by Dr. @LaurenByersMD
SEZ ADC ABBV-706 in #SCLC RR 52% (82% at 1.8mg/kg pure 2L, n=14) and with budigalimab (PD-1) RR 55% (6/11). Encouraging, but small numbers. G3+ TRAEs in 61% of patients with 3 deaths (thrombocytopenia, ILD, pneumonitis). #LungCancer 🫁

@DrChoueiri 🇺🇸 @hoperugo 🇺🇸 @matteolambe 🇮🇹 @TiansterZhang 🇺🇸 @CathyEngMD 🇺🇸 @stolaney1 🇺🇸 @montypal 🇺🇸 @tompowles1 🇬🇧 @brian_rini 🇺🇸 @cdanicas 🇪🇸 @NiuSanford 🇺🇸 @amerseburger 🇩🇪 @GlopesMd 🇺🇸 @Icro_Meattini 🇮🇹 @PGrivasMDPhD 🇺🇸 @DrYukselUrun 🇹🇷 @nataliagandur 🇦🇷 @ElisaAgostinett 🇧🇪 @HHorinouchi 🇯🇵 @realbowtiedoc 🇺🇸 @to_be_elizabeth 🇮🇹 @UOzkerim 🇹🇷 @Erman_Akkus 🇹🇷 @yekeduz_emre 🇹🇷 @p_ciracimd 🇮🇹 @DrVilmaPBarcia 🇪🇸 @DraMartinezLago 🇪🇸 @DrMirallas 🇺🇸 @GaiaGriguolo 🇮🇹 @MarioBalsaMD 🇪🇸 @scocmem 🇬🇧 @AmandaNizamMD 🇺🇸 & @weoncologists 🇺🇸

[OncoAlert @OncoAlert]

The #OncoAlertTopTweet 🚨Day FOUR #ASCO26
Post by @OncoAlert AF @DraMartinezLago 🇺🇸

LBA4000 EMERALD-3💎
✔️ Unresectable eeHCC ✔️ STRIDE/- LEN+TACE vs TACE 📈 PFS: 13.0 vs 9.8 mo • HR 0.70 (P=0.0007) 📈 OS trend • HR 0.84 📈 STRIDE+TACE • PFS HR 0.71 • OS HR 0.70

@DrChoueiri 🇺🇸 @hoperugo 🇺🇸 @matteolambe 🇮🇹 @TiansterZhang 🇺🇸 @CathyEngMD 🇺🇸 @stolaney1 🇺🇸 @montypal 🇺🇸 @tompowles1 🇬🇧 @brian_rini 🇺🇸 @cdanicas 🇪🇸 @NiuSanford 🇺🇸 @amerseburger 🇩🇪 @GlopesMd 🇺🇸 @Icro_Meattini 🇮🇹 @PGrivasMDPhD 🇺🇸 @DrYukselUrun 🇹🇷 @nataliagandur 🇦🇷 @ElisaAgostinett 🇧🇪 @HHorinouchi 🇯🇵 @realbowtiedoc 🇺🇸 @to_be_elizabeth 🇮🇹 @UOzkerim 🇹🇷 @Erman_Akkus 🇹🇷 @yekeduz_emre 🇹🇷 @p_ciracimd 🇮🇹 @DrVilmaPBarcia 🇪🇸 @DraMartinezLago 🇪🇸 @DrMirallas 🇺🇸 @GaiaGriguolo 🇮🇹 @MarioBalsaMD 🇪🇸 @scocmem 🇬🇧 @AmandaNizamMD 🇺🇸 & @weoncologists 🇺🇸

[OncoAlert @OncoAlert]

The #OncoAlertTopTweet 🚨Day FOUR #ASCO26
Post by @OncoAlert Faculty @graokane 🇮🇪

EMERALD-3
STRIDE/Len/TACE v STRIDE+TACE v TACE #HCC

N=760 , prim endpoint PFS arm A v C(multiple testing) ➡️ includes BCLC A/B/C ➡️mPFS arm A v C 13.0 v 9.8 mths ➡️mPFS arm B v C 12.9 v 8.1 mths ?OS benefit? 👇Mature data needed!

@DrChoueiri 🇺🇸 @hoperugo 🇺🇸 @matteolambe 🇮🇹 @TiansterZhang 🇺🇸 @CathyEngMD 🇺🇸 @stolaney1 🇺🇸 @montypal 🇺🇸 @tompowles1 🇬🇧 @brian_rini 🇺🇸 @cdanicas 🇪🇸 @NiuSanford 🇺🇸 @amerseburger 🇩🇪 @GlopesMd 🇺🇸 @Icro_Meattini 🇮🇹 @PGrivasMDPhD 🇺🇸 @DrYukselUrun 🇹🇷 @nataliagandur 🇦🇷 @ElisaAgostinett 🇧🇪 @HHorinouchi 🇯🇵 @realbowtiedoc 🇺🇸 @to_be_elizabeth 🇮🇹 @UOzkerim 🇹🇷 @Erman_Akkus 🇹🇷 @yekeduz_emre 🇹🇷 @p_ciracimd 🇮🇹 @DrVilmaPBarcia 🇪🇸 @DraMartinezLago 🇪🇸 @DrMirallas 🇺🇸 @GaiaGriguolo 🇮🇹 @MarioBalsaMD 🇪🇸 @scocmem 🇬🇧 @AmandaNizamMD 🇺🇸 & @weoncologists 🇺🇸

[OncoAlert @OncoAlert]

The #OncoAlertTopTweet 🚨Day FOUR #ASCO26
Post by @OncoAlert Faculty @tompowles1 🇬🇧

POTOMAC QOL
A year of durvalumab with BCG shows a delay in DFS and is FDA approved . 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.

@DrChoueiri 🇺🇸 @hoperugo 🇺🇸 @matteolambe 🇮🇹 @TiansterZhang 🇺🇸 @CathyEngMD 🇺🇸 @stolaney1 🇺🇸 @montypal 🇺🇸 @tompowles1 🇬🇧 @brian_rini 🇺🇸 @cdanicas 🇪🇸 @NiuSanford 🇺🇸 @amerseburger 🇩🇪 @GlopesMd 🇺🇸 @Icro_Meattini 🇮🇹 @PGrivasMDPhD 🇺🇸 @DrYukselUrun 🇹🇷 @nataliagandur 🇦🇷 @ElisaAgostinett 🇧🇪 @HHorinouchi 🇯🇵 @realbowtiedoc 🇺🇸 @to_be_elizabeth 🇮🇹 @UOzkerim 🇹🇷 @Erman_Akkus 🇹🇷 @yekeduz_emre 🇹🇷 @p_ciracimd 🇮🇹 @DrVilmaPBarcia 🇪🇸 @DraMartinezLago 🇪🇸 @DrMirallas 🇺🇸 @GaiaGriguolo 🇮🇹 @MarioBalsaMD 🇪🇸 @scocmem 🇬🇧 @AmandaNizamMD 🇺🇸 & @weoncologists 🇺🇸

[OncoAlert @OncoAlert]

The #OncoAlertTopTweet 🚨Day FOUR #ASCO26
Post by @OncoAlert Faculty @DrChoueiri 🇺🇸

POTOMAC
5-year OS update presented by Dr Maria De Santis: Durvalumab + BCG (I+M) continues to show no detriment to OS vs BCG alone in BCG-naive high-risk NMIBC (5-yr OS 87.6% vs 86.3%), with no major impact on quality of life

@DrChoueiri 🇺🇸 @hoperugo 🇺🇸 @matteolambe 🇮🇹 @TiansterZhang 🇺🇸 @CathyEngMD 🇺🇸 @stolaney1 🇺🇸 @montypal 🇺🇸 @tompowles1 🇬🇧 @brian_rini 🇺🇸 @cdanicas 🇪🇸 @NiuSanford 🇺🇸 @amerseburger 🇩🇪 @GlopesMd 🇺🇸 @Icro_Meattini 🇮🇹 @PGrivasMDPhD 🇺🇸 @DrYukselUrun 🇹🇷 @nataliagandur 🇦🇷 @ElisaAgostinett 🇧🇪 @HHorinouchi 🇯🇵 @realbowtiedoc 🇺🇸 @to_be_elizabeth 🇮🇹 @UOzkerim 🇹🇷 @Erman_Akkus 🇹🇷 @yekeduz_emre 🇹🇷 @p_ciracimd 🇮🇹 @DrVilmaPBarcia 🇪🇸 @DraMartinezLago 🇪🇸 @DrMirallas 🇺🇸 @GaiaGriguolo 🇮🇹 @MarioBalsaMD 🇪🇸 @scocmem 🇬🇧 @AmandaNizamMD 🇺🇸 & @weoncologists 🇺🇸

[OncoAlert @OncoAlert]

The #OncoAlertTopTweet 🚨Day FOUR #ASCO26
Post by @OncoAlert Faculty @UOzkerim 🇹🇷

🫁It is Also about the NEGATIVE🚫 TRIALS

✅Alliance A081105 showed that adjuvant erlotinib improved DFS but failed to improve OS in resected EGFR-mutant #NSCLC.

✅ALCHEMIST EA5142 showed no DFS benefit with adjuvant nivolumab after surgery and chemotherapy in EGFR/ALK-negative disease.
#LungCancer

@DrChoueiri 🇺🇸 @hoperugo 🇺🇸 @matteolambe 🇮🇹 @TiansterZhang 🇺🇸 @CathyEngMD 🇺🇸 @stolaney1 🇺🇸 @montypal 🇺🇸 @tompowles1 🇬🇧 @brian_rini 🇺🇸 @cdanicas 🇪🇸 @NiuSanford 🇺🇸 @amerseburger 🇩🇪 @GlopesMd 🇺🇸 @Icro_Meattini 🇮🇹 @PGrivasMDPhD 🇺🇸 @DrYukselUrun 🇹🇷 @nataliagandur 🇦🇷 @ElisaAgostinett 🇧🇪 @HHorinouchi 🇯🇵 @realbowtiedoc 🇺🇸 @to_be_elizabeth 🇮🇹 @UOzkerim 🇹🇷 @Erman_Akkus 🇹🇷 @yekeduz_emre 🇹🇷 @p_ciracimd 🇮🇹 @DrVilmaPBarcia 🇪🇸 @DraMartinezLago 🇪🇸 @DrMirallas 🇺🇸 @GaiaGriguolo 🇮🇹 @MarioBalsaMD 🇪🇸 @scocmem 🇬🇧 @AmandaNizamMD 🇺🇸 & @weoncologists 🇺🇸

[Erika Ruiz-Garcia, MD, FASCO @Betzabe100]

Science and best time with friends !!! What else ? #ASCO26 @ASCO

[Declan Murphy @declangmurphy]

Wonderful few days at #ASCO26 catching up with so many mates. And what a fantastic experience to do an @ASCO Plenary Discussion on the wonderful PROTEUS Trial! Amazing room. Massive trial, look forward to diving into details in @NEJM paper and more to come. Huge congrats to all

[Daniel Castellano @cdanicas]

Yes sure, is an Excellent workshops and thanks @NazliDizman for supporting the early career programme!! @ASCO @ASCOTECAG @OncoAlert @H12Octubre

[Lola R.Nogueira @LolaRNogueira]

As #ASCO2026 wraps up, I can’t recommend the Early Career Lounge enough for residents attending next year! ✨

The workshops , mentoring meetings and talks from @ASCOTECAG were a real highlight. Apply to the Abstract Forum to present your work and get valuable feedback, take advantage of the Presentation Skills Webinar beforehand, and connect with fellow trainees along the way! 🤝 Thank you @NazliDizman & @cdanicas !

[OncoAlert @OncoAlert]

THE @ONCOALERT RoundUp🚨 DAY 3 of #ASCO26
🚨For the FULL NEWSLETTER 👉https://t.co/Ou3rJ6A8W6

🔹 #RASolute302: Daraxonrasib became the first RAS-targeted therapy to improve OS in previously treated metastatic pancreatic cancer (13.2 vs 6.6 mo).
🔹 #LIBRETTO: Adjuvant selpercatinib cut recurrence/progression risk by 83% in RET+ early-stage NSCLC.
🔹 #PROTEUS: Perioperative apalutamide improved pathologic response and long-term outcomes in high-risk localized prostate cancer.
🔹 #BREAKWATER: EC + FOLFIRI further expanded frontline options for BRAF V600E mCRC.
🔹 #HorizonCRC01: Trastuzumab rezetecan showed strong activity in refractory HER2+ mCRC.
🔹 #PLUDO: New data inform optimal sequencing of LuPSMA and docetaxel in mCRPC.
🔹 #OBX115: IL-15–engineered TIL therapy achieved a 67% ORR in heavily pretreated melanoma.
🔹 Ultra-low-dose nivolumab + metronomic chemotherapy improved survival and QoL in recurrent/metastatic HNSCC.
🔹 #SARC041: Abemaciclib became the first CDK4 inhibitor to improve PFS in dedifferentiated liposarcoma.

@GIMedOnc
@DrChoueiri
@jamecancerdoc
@Rodrosb
@YannickBuccella
@HHorinouchi
@MarioBalsaMD
@g_mountzios
@OncBrothers
@lungoncdoc
@diegoadiazg
@AnaVManana
@UOzkerim
@declangmurphy
@DrYukselUrun
@DrSpratticus
@tugbawitter
@DrRishabhOnco
@KalantriShreyas
@josemarciofigu1
@nataliagandur
@DraMartinezLago
@ozdogan_md

[Zach Klaassen @zklaassen_md]

Validation of PSA ⏬ among Latin American (LA) subgroup of LIBERTAS - Ph 3 study APA + continuous vs intermittent ADT in mCSPC @urotoday #ASCO26

n=118 from LA
🌟Med PSA: 22.95 (vs 7.32 ITT)
@ 6 mos:
🌟PSA50: 96%
🌟PSA90: 83%
🌟PSA < 0.2: 61%
🌟n=62 randomized to Rx phase

[Nazli Dizman @NazliDizman]

Huge thanks @UTMDAnderson for featuring @ASCOTECAG #ASCO26 @ASCO! Trainees and early career oncologists, please swing by to the #TEC Lounge at Hall C next to the registration.

@OncoAlert @IMG_Oncologists

[Dra. María Natalia Gandur Quiroga @nataliagandur]

#ASCO26 GU Oncology Spotlight 🚨

🔬 Abstract 5017 | PROTRACT
ctDNA-guided biomarker-directed therapy vs physician/patient choice in mCRPC progressing after abiraterone/prednisone
Presented by Corinne Maurice-Dror, MD
@ASCO
@OncoAlert
This is a very relevant precision-oncology question in prostate cancer:

➡️ Can ctDNA help guide whether a patient should receive docetaxel or enzalutamide after progression on abiraterone?
PROTRACT tested a simple treatment-selection strategy:
🔵 Biomarker-directed arm

• ctDNA ≥2% → docetaxel
• ctDNA <2% → enzalutamide

vs

🟠 Physician/patient choice

• docetaxel or enzalutamide, based on clinical preference

Primary endpoint: PFS
Secondary endpoints included OS, PSA50 response, PFS2, safety, and ctDNA correlatives.
🔵 Why this matters

This trial directly addresses a common real-world problem:

After abiraterone progression in mCRPC, treatment choice is often based on clinical judgment, patient preference, fitness, access, and toxicity concerns.

But biology may matter.

A higher ctDNA fraction may reflect more aggressive disease biology and could potentially support moving toward chemotherapy rather than sequential AR pathway inhibition.
🔵 Feasibility signal

The study randomized 42 patients before early termination due to slow accrual.

Importantly:

➡️ 57% of patients had discordance between physician/patient preference and ctDNA-directed assignment.

That is the key signal.

ctDNA guidance would have changed the treatment direction for more than half of patients.

🟠 Important caveat

This was underpowered and stopped early.

So PROTRACT should not be read as a definitive efficacy trial.

But it is still highly informative because it shows how often biomarker-directed treatment selection may differ from usual clinical choice.

🔵 My take

PROTRACT is important not because it settles the sequencing question, but because it frames the next one:

➡️ Can ctDNA move from prognostic biomarker to treatment-selection tool in mCRPC?

The future algorithm may not simply ask:

“ARPI again or chemotherapy?”

It may ask:

What does the tumor biology suggest this patient needs next?

#ASCO26 #GUOnc #ProstateCancer #mCRPC #ctDNA #PrecisionOncology #Biomarkers #ClinicalTrials #TreatmentSequencing

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