Frida Rivera

You may say I'm a dreamer, but I'm not the only one.

[Frida Rivera @FridaRgtz]

“Memoria selectiva para recordar lo bueno, prudencia lógica para no arruinar el presente, y optimismo desafiante para encarar el futuro”. (Isabel Allende)

[Erman Akkus @Erman_Akkus]

🫀Cardiac disease in cancer patients
ESMO guideline summary

#cancer #oncology #MedX #cardiac

[Dr Rishabh Jain @DrRishabhOnco]

💥 JCOG1008 5-year update is here.

The long-standing debate over weekly vs 3-weekly cisplatin in postoperative head & neck cancer may finally have an answer.

📌 JCOG1008
👥 Postoperative high-risk LA-SCCHN
⚖️ Weekly cisplatin (40 mg/m²) + RT vs 3-weekly cisplatin (100 mg/m²) + RT

Key results (median follow-up: 5.6 years):

✅ 5-year OS
• 71.2% vs 58.7%
• HR 0.76 (95% CI 0.52-1.12)
• Noninferiority confirmed

✅ 5-year RFS
• 64.3% vs 53.0%
• HR 0.81

✅ 5-year Local RFS
• 68.8% vs 57.2%
• HR 0.79

🛡️ No clinically meaningful increase in late toxicity.
⬇️ Acute toxicity remained more favorable with weekly cisplatin.

🎯 Take-home:
Weekly cisplatin is no longer just the “more convenient” option.

It now has mature 5-year randomized data supporting it as a standard postoperative CRT regimen for high-risk LA-SCCHN.

Will this change your practice?

@ASCO @myESMO @oncoalert

#HeadNeckCancer #RadOnc #MedOnc

[Yakup Ergün @dr_yakupergun]

Algorithm for Systemic Therapy in Early TNBC

(Based on NCCN and ESMO guidelines; recommendations in gray areas reflect the St. Gallen 2025 consensus and, in part, my own clinical judgment)

[JAMA @JAMA_current]

Gastric cancer is the fifth most diagnosed #cancer and the fifth leading cause of cancer-related deaths worldwide.

📌 This Review summarizes the epidemiology, pathophysiology, diagnosis, and management of #GastricCancer.

https://t.co/fAdPCeSz3a

[Dr Rishabh Jain @DrRishabhOnco]

🚨 ASCO 2026 Living Guideline Update | Stage IV NSCLC with Driver Alterations

Precision oncology just leveled up 🧬
This update is heavily trial-driven and finally aligns guidelines with what we already see in practice.

🔹 EGFR exon 19 del / L858R - the biggest shift
Combination therapy is now preferred based on landmark phase III data:
• FLAURA2 → Osimertinib + platinum–pemetrexed ⬆️ PFS & OS
• MARIPOSA → Amivantamab + lazertinib ⬆️ PFS & OS
👉 Osimertinib monotherapy (from FLAURA) remains an option if toxicity or patient preference dominates

🔹 EGFR exon 20 insertions
• PAPILLON trial → Chemo + amivantamab beats chemo alone

🔹 ALK-positive NSCLC
First-line options supported by mature data:
• ALEX / J-ALEX / ALESIA → Alectinib
• ALTA-1L → Brigatinib
• CROWN → Lorlatinib (deepest CNS control)

🔹 ROS1 fusions
• TRIDENT-1 → Repotrectinib
• TRUST-I / TRUST-II → Taletrectinib (durable systemic + CNS activity)

🔹 RET rearrangements
• LIBRETTO-431 → Selpercatinib superior to chemo ± IO
• ARROW → Pralsetinib (alternative if selpercatinib unavailable)

🔹 MET exon 14 skipping
• GEOMETRY mono-1 → Capmatinib
• VISION → Tepotinib

🔹 BRAF V600E
• PHAROS → Encorafenib + binimetinib
• Earlier data → Dabrafenib + trametinib

📌 Core message of ASCO 2026
Broad NGS upfront + trial-backed upfront intensification for fit patients.
Single-agent immunotherapy still has no role in EGFR-driven disease.

📖 Published in Journal of Clinical Oncology
DOI: 10.1200/JCO-25-02822

🔖 Save for boards and clinics
💬 Which EGFR combination are you leaning toward post-FLAURA2 vs MARIPOSA?

#OncoTwitter #LungCancer #NSCLC #TargetedTherapy #PrecisionOncology @ASCO @myesmo @esmo_open @OncoAlert

[Erman Akkus @Erman_Akkus]

📘Gastric cancer

✅A practical review

https://t.co/dhaPe1BW88

#cancer #oncology #gastric #MedX @OncoAlert

[Ma Elena Pérez-Jaén Zermeño🇲🇽 @MElenaPerezJaen]

I have a dream...

[Yakup Ergün @dr_yakupergun]

2025 is coming to a close, and one thing is clear:
It has been an exceptionally intense year in breast cancer.

Clinical trials that have the potential to change practice and defined the year 👇

#bcsm ✨️🎄

[Dr Rishabh Jain @DrRishabhOnco]

🧬 KANNON Study | JTO 2025

Andamertinib (240 mg OD) in previously treated EGFR Exon 20 insertion NSCLC
- platinum-chemo ± IO pretreated - shows promising activity.

🎯 Trial Snapshot
•Phase 2 | n = 92
•EGFR Ex20ins, ≥1 prior line (platinum ± IO)
•Dose: 240 mg once daily

📈 Efficacy (IRC-assessed)
•ORR: 42.7 percent
•DCR: 86.5 percent
•Median DoR: 8.7 months
•Median PFS: 6.2 months
•12-month OS: 70.5 percent
•Brain mets subgroup ORR: 47.4 percent

🛡 Safety
•Grade ≥3 TRAEs: 40.2 percent
•Most common: diarrhea (12 percent), rash (7.6 percent)
•No ILD reported
•No grade ≥3 QT prolongation

💡 Takeaway
An oral, selective EGFR Ex20ins TKI with meaningful responses, good brain activity, and manageable toxicity in a population with major unmet need.

🔖 Save for later
📖 Full paper in comments ↓

#OncoTwitter #LCSM #MedTwitter #TargetedTherapy
@OncoAlert @myESMO @esmo_open @ASCO @IASLC

[Yakup Ergün @dr_yakupergun]

With the continued positive long-term results from the monarchE and NATALEE trials (including favorable OS outcomes), the use of adjuvant CDK4/6i will likely increase.
So, what strategies should we follow when these patients relapse?
A must-read, excellent review on this topic👇

https://t.co/RMKP3ivn1K

[Ben Solomon @bensolomon1]

Lung Cancer in Nonsmoking Individuals - now out in JAMA
🫁 15-20% of lung cancers
🏭 Risk factors include environmental air pollution (PM2.5) and indoor cooking fumes
🎯Potentially actionable oncogene targets in majority of cases

https://t.co/98lEUd0QqM

[Elvina Almuradova @Dr_ElvinaA]

The first, evidence-based ESMO-ESTRO consensus statements to guide the combination of RT with targeted cancer therapies and immunotherapy!!!
They have expected that the toxicity of combining RT with ICIs is low, particularly for PD-(L)1 inhibitors.
For most combinations with VEGF(R) inhibitors and multitargeted TKIs, exercising caution is recommended.
@myESMO @Larvol @SuyogCancer @OncoAlert @OncoDailyIO

[Dr Rishabh Jain @DrRishabhOnco]

Not just coffee - even pembrolizumab works better before 11 AM ☕💉

📊 Eur J Cancer 2025 | 9-center retrospective | n=450
1L Pembrolizumab monotherapy in advanced NSCLC

Timing groups:
🌅 Early ≤11:00 AM
🌙 Late >11:00 AM

Results (PSM, n=206 | median f/u 62.5 mo):
•OS: 43.7 vs 32.4 mo ➝ HR 0.67 (95% CI 0.46–0.97, p=0.03) ✅

•PFS: 13.8 vs 11.6 mo ➝ NS (HR 0.80)

•irAEs ≥G3: 26.2% vs 13.6% (p=0.04) ⚠️

✨ Take-home:
First-dose timing may prime immune activation.
Morning infusion → better OS, but higher severe irAEs.
A simple, low-cost tweak worth prospective testing.

🔗 Eur J Cancer 2025
DOI: 10.1016/j.ejca.2025.115748
Full text: https://t.co/d4b8yWcHc0

#LungCancer #Immunotherapy #Chronotherapy #OncoTwitter
@OncoAlert @OncoDailyNet
@oncodaily @myesmo @asco

[Oscar Arias @OACerebro]

Enjoy

https://t.co/4vuMeN49Qg

[Yakup Ergün @dr_yakupergun]

Liver Segments: Axial CT and 3D Reconstruction

Source: xray_iq

[Oscar Tahuahua @OscarTahuahua]

Perioperative Durvalumab in Gastric & Gastroesophageal Junction Cancer

@NEJM 2025
https://t.co/mXL5VktYGG

[Nieves Martinez Lago MD PhD @DraMartinezLago]

Omitting bolus 5-FU in GI cancer chemo: a meta-analysis 🔬
https://t.co/OQYRq05S2F
In 12,698 pts, skipping bolus 5-FU ➡️ ↓ grade 3–4 neutropenia (🧪 OR 0.46) & thrombocytopenia (🩸 OR 0.53) without compromising PFS or OS ✅
💪Safer option, same efficacy.

[Goutham Sunny @medoncodoc]

Molecular and therapeutic landscape of non-clear cell renal carcinoma

https://t.co/wItFicOpBg

@DrChoueiri @urotoday @DrRosenbergMSK @BradMcG04 @DrKarineTawagi @DrRanaMcKay @MattGalsky @BhardwajLab @sonpavde @nataliagandur @drgaganprakash @vedangmurthy @paulobergerot @andreanecchi @tapiajc1 @drenriquegrande @SScagliarini_ @tompowles1 @shilpaonc @pgrivasmdphd @albertobossial @montypal @AlbigesL