Lαura Montezuma

Oncología Radioterápica.

[Giulia Marvaso @GiuliaMarvaso84]

🚨 🚨🚨New Editorial in @EurUrolOncol !
#PROTEUS trial: a landmark study, but are we ready for treatment intensification in high-risk PCa?
We discuss the evidence, unanswered questions, biomarkers, and the evolving role of multimodal care.
https://t.co/Pq9WFJTDve

[C. Jillian Tsai, MD, PhD @CJTsaiMDPhD]

🆕 ReCOG/@ESTRO_RT/@ASTRO_org re-RT rHNC, @LancetOncology.
31 statements, 🔑takeaways:
✅ No re-RT <6mo post-RT
✅ RPA-based (time from RT, surgical status, organ dysfunction)
✅ IMRT vs SBRT by size (25cc)/site; ⛔️ENI
✅ EQD2 sum essential
✅ Carotid (<120Gy)/mandible (<114Gy)

[Melvin LK CHUA | FRCR, PhD, FASCO @DrMLChua]

#ESTRO26

Happy to be attending the annual European meeting @ESTRO_RT to showcase our work as a #headneckcancer #NasopharyngealCancer community working TOGETHER to improve care for our patients

💪🏻💪🏻💪🏻

Glad to see a packed audience at 8AM on D3 of the conference

[OncoAlert @OncoAlert]

Day TWO of #ESTRO26 Coverage by OncoAlert 🚨
De-intensification of postoperative radiotherapy in HNSCC by omitting contralateral elective neck irradiation– long term outcomes of the DIREKHT trial Presented by Charlotte Frei 🇩🇪
#RadOnc ☢️

The DIREKHT trial is a prospective multicentre phase II trial investigating de-intensified risk-adapted radiation in patients with newly diagnosed, non-metastatic HNSCC after surgery. A total of 140 patients were included in the analysis. After five years, overall locoregional recurrence rate was 6.0% (95% CI [1.9; 9.9]). Cumulative incidence of locoregional recurrence was 3.0% (95%-CI [0.1; 5.8]). Details on recurrence patterns and dysphagia rates are presented at ESTRO 2026.

@ESTRO_RT
@yasemin09896924
@LindaMrissa
@christian_roenn
@Valeriadionisi
@gerryhanna
@clchiang_hk
@mtugceyilmaz
@B_Tomasik
@gmpetrianni
@CiroFranzese1
@Atem84
@piet_ost
@brachyexpert
@BlanceS90
@The_PT_Explorer
@BarbaraJereczek
@Mat_Guc
@ZilliThomas
@AnnaKirby17
@PBlanchardMD
@achoud72

Pinging OA faculty
@MKnoll_MD
@_ShankarSiva
@Icro_Meattini
@seanmmcbride
@NiuSanford
@nataliagandur
@acampsmalea
@to_be_elizabeth

[Pierre Blanchard, MD @PBlanchardMD]

@DrAPathmanathan @DrSuneil_PCa: Pace NODES early side effects at #ESTRO26. 5 fractions pelvic RT feasible. resulted in slightly higher GI (acute, settled by week 12) but not GU side effects.
Looking forward to longer term outcomes. Congrats!

[Entisar saleh @Entisar_kilani]

Endometrial cancer guidelines summary
#oncology #medrwitter

[Emre Yekedüz @yekeduz_emre]

NICE 2026 guideline for the diagnosis and management of #kidneycancer :
👉https://t.co/nEkyzojcrC

@OncoAlert #cancer #oncology @DrYukselUrun @urotoday @AUC3_Official

[Lαura Montezuma @Laura_Montezuma]

@fcounago 👏🏻

[OncoAlert @OncoAlert]

Day TWO of #PROSCA25
#GlobalForum25 in Portugal 🇵🇹

Presentation @ZilliThomas 🇨🇭on #ProstateCancer Management in 2026, the view of the Radiation Oncologist

@mdesantis234
@FontesMario
@fontev1
@Silke_Gillessen
@karolien_goffin
@PGrivasMDPhD
@bkonety
@Uro_Kris
@Dolmos77
@AOmlin
@HenningPlage
@DanieleRaggi83
@Tilki_De
@BertrandTOMBAL
@vandamme_jvd
@roodvdb
@UrsulaVogl
@ZilliThomas
@nataliagandur
@DrRishabhOnco
@mirrorsmed
@Achard_Verane

[Dr Rishabh Jain @DrRishabhOnco]

🚨 RT + targeted therapy is NOT the same for all drugs
This new ESMO-ESTRO consensus finally settles it 👇

🟢 Anti-HER2 (trastuzumab, pertuzumab)
→ RT usually safe
→ Minor or no treatment changes

🟠 CDK4/6 inhibitors
→ Watch the gut
→ GI and mucosal toxicity signal
→ Extra caution for abdomen, pelvis, thorax

🔴 PARP inhibitors
→ Potent radiosensitizers
→ Even low doses amplify RT toxicity
→ Major treatment adaptation needed

🟠 mTOR inhibitors
→ Pneumonitis, mucositis, cytopenias
→ Avoid high-dose thoracic RT when possible

🧠 Clinical pearl
RT + targeted therapy is a timing and biology problem, not a yes or no question.

📖 Full paper in comments ⬇️
🔖 Save this for tumor boards

#OncoTwitter #RadOnc #MedTwitter #TargetedTherapy #BreastCancer
@myESMO @ESTRO_RT @esmo_open @OncoAlert

[Dr Rishabh Jain @DrRishabhOnco]

Doublet vs Triplet in mHSPC: Fast Takeaways 🔍
#GlobalForum25 #PROSCA25

🧬 ADT + ARPI = SOC
Intensify only when biology or volume demands it.

💥 Doublet enough
😊 Metachronous low volume
😊 Elderly low volume
😊 Low risk biology
👉 ADT + ARPI

🔥 Biology driven intensification
🚨 TP53 or RB1 loss
🚨 PTEN loss
🚨 BRCA or HRR mutations
👉 Add docetaxel

💜 Clear Triplet candidates
⚡ De novo high volume
⚡ AR independent or high proliferative biology
👉 Triplet gives strongest OS effect

🌫️ Avoid intensification
🧓 Frail or comorbid
👉 ADT alone or ARPI if tolerated

New Triplets 🆕
🟦 AMPLITUDE: Niraparib
🟩 CAPItello: Capivasertib
🟧 PSMAddition: LuPSMA
Different biology, different triplet.

#OncoTwitter #MedTwitter #ProstateCancer #mHSPC
@oncoalert @asco @myesmo @esmo_open @mirrorsmed

[Dra. María Natalia Gandur Quiroga @nataliagandur]

💫🌟Sequential Approaches with ARPI and Chemotherapy in CRPC
By Amit Bahl🌟💫
#PROSCA25 #GlobalForum25 @OncoAlert @mirrorsmed

🔷 mCRPC Survival & Treatment Patterns
🔹 Median OS ~25.6 months; mortality ~3 years
🔹 Only ~48.7% receive 2L; just ~21.8% reach 3L

🔷 When to Switch Treatment
🔹 Standard rule: 2 of 3 criteria → PSA progression, radiologic progression, symptomatic progression
🔹 Clear radiologic progression alone can justify switch

🔷 Principles of Optimal Sequencing
🔹 Patient factors: fitness, comorbidities, prior response, goals of care
🔹 Disease factors: burden, biology, symptoms
🔹 Treatment factors: biomarkers, tolerability, clinician expertise

🔷 Post–ADT + ARPI Progression
🔹 Molecular profiling critical → consider PARPi if appropriate
🔹 Further ARPI unlikely to provide meaningful benefit
🔹 Radium-223 for bone-only metastases remains relevant
🔹 ¹⁷⁷Lu-PSMA available in taxane-ineligible patients (UK)

🔷 Key Question Ahead
🔹 What is the optimal role and timing of subsequent ARPI + PARPi in this setting?

[OncoAlert @OncoAlert]

Day ONE of #PROSCA25
#GlobalForum25 in Portugal 🇵🇹

Presentation by Bertrand Tombal 🇧🇪 during the Case discussion session: mHSPC Session

Discussing Treatment de-escalation in mHSPC

In metastatic hormone-sensitive #ProstateCancer , many patients achieve a deep PSA response (≤0.2 ng/mL) with ADT plus an ARPI, and sub-analyses of major trials show these responders often experience prolonged survival—and thus prolonged treatment exposure. This creates a rationale for revisiting intermittent therapy as a de-escalation strategy to reduce side effects, improve quality of life, and lower costs. However, determining why, how, who, and when to de-escalate requires careful evaluation, and such strategies should be validated in well-designed clinical trials that accurately weigh their risks and benefits.

@mdesantis234
@FontesMario
@fontev1
@Silke_Gillessen
@karolien_goffin
@PGrivasMDPhD
@bkonety
@Uro_Kris
@Dolmos77
@AOmlin
@HenningPlage
@DanieleRaggi83
@Tilki_De
@BertrandTOMBAL
@vandamme_jvd
@roodvdb
@UrsulaVogl
@ZilliThomas
@nataliagandur
@DrRishabhOnco
@mirrorsmed

[Jordan Ciuro, MD @jordanciuro]

🚨 New in NEJM Evidence! Age & its Impact in mHSPC

Check out important work by @CaPsurvivorship & team on how age impacts treatment benefit in mHSPC
🔗 Morgans et al: https://t.co/odx4nenHAs

Also just out➡️my accompanying editorial with mentor Brad Carthon exploring what age really means for personalized prostate cancer care
📝 Editorial: https://t.co/Qaaj9sqDhv

#ProstateCancer #Oncology #mHSPC #CancerResearch @NEJMEvidence @WinshipAtEmory @OncoAlert @PCFnews @ASCO

[Lαura Montezuma @Laura_Montezuma]

@ESTRO_RT 👏🏻

[ESTRO @ESTRO_RT]

📢 Be part of a landmark moment in head & neck cancer care! Join this ESTRO webinar, supported by IBA Proton Therapy.
🗓 12 Nov 2025 | 16:00–17:30 CET | Online
🔗 Free & open to all: https://t.co/6OvIxiuxA9
ℹ️ More info: https://t.co/j6zW3aahGC
#HeadandNeckCancer #Radonc

[Lαura Montezuma @Laura_Montezuma]

URONCOR 🇪🇸
https://t.co/SvP7yIW0hA

[Oscar Tahuahua @drtahuahua]

ESGO-ESTRO-ESP guidelines for the management of patients with endometrial carcinoma: update 2025

= FIGO 2023 + molecular subtypes (POLEm, MMRd, NSMP, p53abn)

◽️Risk low < 8%, intermediate 8–14%, high-intermediate 15–24%, high ≥ 25%

◽️Test HER2 in serous/p53abn, ER in all

◽️Adds ICI for MMRd & supports minimally invasive care
https://t.co/5WkeUQx3Wv @OncoAlert @ZaniruRaul

[Sameer Keole @SameerKeoleMD]

Congratulations to President @JoeBiden for finishing RT under the care of @ASTRO_org President @NehaVapiwala

@PennMedicine #radonc

[Gustavo @gusviani]

🔥 RTOG 9601 – Long-Term Data Just Dropped! @OncoAlert

📌 Salvage RT with vs. without Anti-Androgen Therapy (AAT) in men with post-prostatectomy recurrence (PSA 0.2–4.0, pT2/3N0)
💊 24 months of bicalutamide 150 mg during & after RT

🎯 18-Year Outcomes (n=760):
• 🧬 Overall Survival: 53% (AAT) vs. 43% (Placebo) – HR 0.82
• ⚰️ PC-specific mortality: 18% vs. 28% – sHR 0.63
• 🌍 Distant mets: 22% vs. 31% – sHR 0.62
• 📈 Biochemical failure: 49% vs. 71% – HR 0.49

💡 Who benefits most?
✔️ Gleason 8–10
✔️ PSA >1.5 ng/mL
✔️ Positive margins

🧪 No increase in GU, GI or CV toxicities.
📌 More gynecomastia in AAT arm

📣 Bottom line: For high-risk patients, RT + AAT improves OS, metastasis-free survival & PC-specific survival