Nauman Saleem Siddiqui, MD MPH FACP

#Hematology #Oncology #Medicine #Bigdata #AI #MachineLearning #Python #SAS #R
#intermittentfasting

#intermittentfasting #wholefoodplantbaseddiet

[Dr Amol Akhade @SuyogCancer]

Short-term fasting during neoadjuvant chemotherapy for advanced ovarian cancer is one of the more intriguing non-drug interventions presented at #ASCO2026.

The study met its primary endpoint: fasting prevented the chemotherapy-associated rise in insulin levels and demonstrated a favorable metabolic shift.

The headline result was a PFS signal:
• mPFS 38 months with fasting vs 24 months with free diet •
HR 0.26 • Log-rank p=0.045

Before we get too excited, several important limitations deserve attention:

🔹 Only ~18 patients per arm after exclusions
🔹 Trial was powered for insulin changes, not PFS
🔹 Open-label design
🔹 Borderline statistics (95% CI 0.06–1.00; Cox p=0.056)
🔹 Multiple secondary and exploratory analyses increase the risk of false-positive findings
🔹 BRCA-mutated patients were more common in the fasting arm (50% vs 33%), which could influence outcomes
🔹 Median follow-up was only 16 months despite reporting a large difference in mPFS
🔹 Immune findings were hypothesis-generating with p-values around 0.06–0.07
🔹 Analysis appears vulnerable to selection bias from withdrawals and compliance-related exclusions

The most convincing finding is that short-term fasting is feasible and biologically active, affecting insulin and metabolic pathways.

The least convincing finding is a 14-month absolute PFS improvement from a dietary intervention in a 36-patient study.
Interesting study.
But extraordinary efficacy claims require validation in a larger multicenter randomized trial before fasting enters routine ovarian cancer practice.
@OncoAlert
@ASCO #asco26

[Mario Nawfal @MarioNawfal]

🇺🇸🇵🇰 A man from the US flew to Pakistan and paid $4,000 to free a family that had been enslaved for 140 years.

The family's bondage started in the 1880s when an ancestor took out a small loan. Under Pakistan's "peshgi" system, kiln owners issue advances to workers. Then manipulate accounts, add interest and arbitrary fines, and declare the debt a family obligation passed to children and grandchildren.

Kids as young as 4 or 5 work to help "repay" it. The math is designed to never reach zero.

Pakistan banned bonded labour in 1992. Estimates suggest hundreds of thousands remain trapped across the country's 20,000+ brick kilns.

Enforcement is nearly nonexistent. Kiln owners have political connections, police frequently collude, and families who try to leave face armed guards, false arrests, or violence against relatives left behind.

Aaron Hutchings paid $4,000. One family. 140 years. Done.

Source: @visegrad24

[Pashtoon Kasi MD, MS @pashtoonkasi]

Help open my Mom’s hospital🏥in🇵🇰. Read her inspirational story🔗. Support this #GoFundMe by donating or sharing—every bit of help makes a difference.

🔗 https://t.co/VmL2jhZZDR

[Pashtoon Kasi MD, MS @pashtoonkasi]

🆕 🗞️ Press release:
👏🏽Finally: One more option🔜for patients with #PancreasCancer, &💡promising for other cancers who have #KRAS 🧬.

Overall Survival:
DaraxonRASib⛔️(RMC-6236)💊
13.2 months
🆚
Chemotherapy
6.7 months
Hazard ratio of 0.40 (p < 0.0001)!
➕➕➕

@OncoAlert

[Open Medicine Insights @OpenMedInsights]

🚨 #POLAR trial just published in Nature Medicine

🧬 Pembrolizumab + olaparib as maintenance in metastatic #PancreaticCancer — a new biomarker-driven strategy emerges

🔹 HRD cohort (BRCA/PALB2):
• ORR 35%
• mPFS 8.3 mo
• mOS 28 mo
• 3y OS: 44%
🔹 Did NOT meet primary endpoint… but 👇
💥 Signal matters:
🟣 Durable responses in a subset
🟣 Strong biology: HRD → ↑ neoantigens & TILs
🟣 ctDNA negativity → potential marker of benefit
💡 Take-home:
Not practice-changing yet — but supports PARPi + IO in selected patients
🔗 https://t.co/Ci0i266XZ0
#PancreaticCancer #Immunotherapy #PARP #PrecisionOncology #OncoTwitter

@CentralParkWMD
@CpcrMsk
@MSKCancerCenter
@PICIatMSK
@NatureMedicine

[Adam B. Weiner, MD @Adam_Weiner535]

🚨Tansdermal Estradiol (tE2) vs ADT for locally advanced #prostatecancer🚨

@NEJM New phase 3 RCT (PATCH/STAMPEDE-1)

🔑tE2 patches are noninferior to LHRH agonists for metastasis-free survival (n=1,360)

✅ 87.1% vs 85.9% 3-yr MFS
🌡️ Way fewer hot flashes (44% vs 89%)
🦴 Lower fracture rates
⚠️ More gynecomastia

🔥Same cancer control. Better side effect profile. Patient-applied. Cheaper.

👀Time to rethink ADT? 👀

@PCFnews @PCF_Science @UrologyTimes @renalandurology @urotoday

🔗https://t.co/xVByp9TljJ

[NEJM @NEJM]

Among men with locally advanced prostate cancer, transdermal estradiol was noninferior to LHRH agonists for 3-year metastasis-free survival and led to a lower incidence of hot flashes but a higher incidence of gynecomastia. Full results of the STAMPEDE-1 and PATCH trials: https://t.co/sKJ6Sr6WiW

[Pashtoon Kasi MD, MS @pashtoonkasi]

Help My Mom Open a Women &amp; Children’s Hospital in Our Village — Samali, Kuchlak, Pakistan. 🇵🇰 Read her inspiring story. Please donate and share.❤️
https://t.co/fYEtDvdgyz

[Healthcare AI Guy @HealthcareAIGuy]

Australian tech founder with no biology background sequenced his dog’s tumor DNA and used ChatGPT+AlphaFold to design a custom mRNA cancer vaccine (all for ~$3k). The tumors shrank 50-75%.

The intersection of RNA tech, genomics, AI will transform medicine.

[Satya Nadella @satyanadella]

We’ve trained a multimodal AI model to turn routine pathology slides into spatial proteomics, with the potential to reduce time and cost while expanding access to cancer care.

[NEJM @NEJM]

RECITE: In a phase 3 trial in patients with persistent chemotherapy-induced thrombocytopenia, 84% of those receiving romiplostim had no chemotherapy dose modifications, as compared with 36% of those receiving placebo (odds ratio, 10.16). Full trial results: https://t.co/5GoloaFC0A

Editorial: Thrombopoietin-Receptor Agonists in Chemotherapy-Induced Thrombocytopenia https://t.co/LdbOSSeGxt

[Vishal Khandelwal @safalniveshak]

If you have a father who can still pick up your call...call.

[Toni Choueiri, MD @DrChoueiri]

High-yield discussion by @DrTylerStewart how to place peri-op EV+pembro in cis-eligible MIBC, and where HER2 ADCs may land
#GU26 #BladderCancer
@OncoAlert
@OncBrothers

[Andrea Apolo, M.D. @apolo_andrea]

The standard of care for MIBC will now include perioperative EVP for both cisplatin eligible and ineligible #BladderCancer pts. The EV304 study presented today @MattGalsky shows an improvement in EFS (HR 0.53) and OS (HR 0.65) for EVP over GC. @ASCO #GU26

[Ilhan Niaz @IlhanNiaz]

Dr Azra Raza delivers a great convocation address )Vancouver, Canada). Not going to summarise- just watch the video:

[Nauman Saleem Siddiqui, MD MPH FACP @HemOnc_AI]

Early to bed and early to rise makes a man healthy, wealthy, and wise

[Aya Mohamed | MSc, MD 🎗 @Dr_Oncologista]

Phase III trial @NatureMedicine 🫁

In advanced NSCLC, giving chemo-immunotherapy before 3 PM vs after significantly improved outcomes;
PFS 11.3 vs 5.7 mo (HR 0.40)
OS 28.0 vs 16.8 mo (HR 0.42)
No added toxicity.

@OncoAlert #lcsm
https://t.co/DaSvUc8gLH

[Nauman Saleem Siddiqui, MD MPH FACP @HemOnc_AI]

@allisonoconn I still like carbo pem pem

[Paolo Tarantino @PTarantinoMD]

PATINA is now out in @nejm. Among pts with HR+/HER2+ MBC progression-free after chemo induction, adding palbociclib to 1L ET+HER2-blockade maintenance prolonged PFS from 29 mo to an astonishing 44 months (HR 0.75, p=0.02). Congrats @Otto_DFCI &amp; coauthors! https://t.co/YoE3Pje9Be

[Nauman Saleem Siddiqui, MD MPH FACP @HemOnc_AI]

@Papa_Heme Did they use CNS prophylaxis?

[NEJM @NEJM]

In patients with previously untreated, PD-L1–positive, advanced triple-negative breast cancer, sacituzumab govitecan plus pembrolizumab led to significantly longer progression-free survival than chemotherapy plus pembrolizumab. Full phase 3 ASCENT-04/KEYNOTE-D19 trial: https://t.co/GnPUpnyPLK