nel cuevas muñoz

Oncologo clinico HNERM

[Lung Cancer Europe @LungCancerEu]

‼️ A tumour isn’t necessarily the same all the way through.

Different populations of cancer cells can exist within it and evolve over time, including under the pressure of treatment.

A new Nature Cancer review looks at how understanding and tracking that evolution could lead to better ways to diagnose, monitor and treat cancer.

#LungCancer research has been central to building that understanding. #LCSM

https://t.co/SiV3LbBDLA

[NEJM @NEJM]

Original Article: Perioperative Apalutamide in High-Risk Localized Prostate Cancer (phase 3 PROTEUS trial) https://t.co/dJMlGVWc04

Editorial: A Watershed Moment in the Perioperative Treatment of Prostate Cancer https://t.co/YEfC0j9pC6

#Oncology #Urology

[Giuseppe Procopio @g_procopio_]

🔬 New evidence in #mHSPC
PSA nadir ≤0.2 ng/mL was strongly associated with better outcomes:
📈 OS: 92.8 vs 34 mo (HR 0.27)
📈 PFS: NR vs 12.1 mo (HR 0.19) Supporting PSA nadir as an early prognostic marker. #ProstateCancer #GUOncology
Full Article: https://t.co/3KgAAaukPr

[Yüksel Ürün @DrYukselUrun]

The first-line question in metastatic urothelial cancer is becoming easier. The second-line question is getting harder.
EV + pembrolizumab, if available, changed the algorithm. Now we need to define what comes next.
@OncoAlert @Uromigos @OpenMedicineHQ @myESMO

[Adam B. Weiner, MD @Adam_Weiner535]

🚨 177Lu-PSMA-617 to ADT + ARPI improves rPFS (PSMAddition) 🚨

@TheLancet

👥 1144 pts w/ PSMA+ metastatic APMN/S #ProstateCancer (50% de novo, 68% high-volume)

📊 Phase 3 RCT, 1:1, open-label, 169 sites, crossover allowed at progression
💊 177Lu-PSMA-617 (7.4 GBq q6w x6) + ADT/ARPI vs ADT/ARPI
⏱️ Median f/u 19.6 mo for rPFS
✅ rPFS HR 0.72 (95% CI 0.58-0.90), p=0.0021; median not reached in either arm

BUT👇
⚠️ G3+ AEs 51% vs 43%; dry mouth 46% vs 4% (all G1-2); more cytopenias and GI events
⚠️ QoL trended worse w/ RLT: time to FACT-P worsening 11.3 vs 17.1 mo (HR 1.14, CI crosses 1); gap seen mainly during treatment cycles, similar arms after week 36

🎯 RLT moves into earlier stage PCa. But we need to keep an eye on QoL

@AmerUrological @UroOnc @SUO_YUO @PCFnews @urotoday @UrologyTimes @PCF_Science

🔗https://t.co/gP8mbU4ojm

[Luis G. Medina @LuisMedinaMD]

Sharing a new publication in @UrolOncol exploring key gaps in penile cancer care and where the field is headed—from patient advocacy and organ preservation to optimizing surgical management and emerging systemic therapy options.

Thanks to the entire team @SalvadorjcMD @f_eskenazi_MD @jpdugartemd @JadChahoud @SpiessPhilippe @GTumors

https://t.co/QJpTFd4hgC

[Andrea Necchi, MD, FASCO @AndreaNecchi]

@OncoAlert @MyUniSR @SanRaffaeleMI

[Enrique Grande @drenriquegrande]

⚡️ VESPER trial: basal molecular subtype is an independent prognostic factor for OS in MIBC treated with neoadjuvant chemotherapy, regardless of the regimen used.

Molecular subtyping beyond clinical staging — increasingly relevant in treatment decision-making.

https://t.co/QNdWhFEXTT

#BladderCancer @EurUrolOncol

[Paolo Ciracì @p_ciracimd]

Next-generation precision oncology in pMMR/MSS CRC beyond RAS and BRAF:
👉 ADCs and bispecific antibodies
👉 TME-targeted strategies
👉 Cellular therapies
🧬 Integrating multiomic profiling
@OncoAlert

https://t.co/ZYmOBOcwGZ

[Andrea Necchi, MD, FASCO @AndreaNecchi]

Tumor mutational burden predicts the outcome of patients with muscle-invasive bladder cancer undergoing immune-checkpoint inhibitor-based neoadjuvant therapy - a combined analysis of #PURE01 #SURE02 #NureCombo @CMercinelli @Anto_cigliola @BrigidaMaiorano et al. @SanRaffaeleMI @MyUniSR #TMB @FoundationATCG https://t.co/xTtHLnDsJT

[NEJM @NEJM]

Original Article: PARP and Androgen-Signaling Inhibition plus ADT in Metastatic Prostate Cancer (phase 3 TALAPRO-3 trial) https://t.co/NIEgLZ9cPR

Editorial: Precision Intensification in Metastatic Prostate Cancer https://t.co/BWxAVFh2ZM

#Oncology #Urology

[Yüksel Ürün @DrYukselUrun]

Impressive efficacy. Substantial toxicity.
🧬TALAPRO-3: 3-year rPFS 77% vs 56% (HR 0.48)
Grade ≥3 anemia occurred in 51%.
Should upfront PARP intensification be for all HRR-altered mHSPC?
@neerajaiims @OncoAlert @OpenMedicineHQ @NEJM @APCCC_Lugano

[Adam B. Weiner, MD @Adam_Weiner535]

🚨 PARP-i in metastatic hormone-sensitive #ProstateCancer🚨

📜#TALAPRO3 out in @NEJM

In HRR-altered mHSPC, adding talazoparib to enzalutamide + ADT:

✅ Reduced risk of progression/death by 52% (HR 0.48)
📈 3-year rPFS: 77% vs 56%
⏳ OS trend favors combination (HR 0.77), but immature.
⚠️ More anemia (Grade ≥3: 51%).

👉Potential new standard for a biomarker-selected population

@neerajaiims @urotoday @renalandurology @UrologyTimes @UroOnc @SUO_YUO @PCFnews

🔗https://t.co/YXCiIWPwqg

[ESMO Open @ESMO_Open]

ERBB2/HER2 landscape & prognostic impact: large-scale, RW analysis across solid cancers in @ESMO_Open. >200,000/80,000 samples for NGS/ IHC. Mut & ampl correlation, with mut associated with higher IHC levels (even w/o ampl). 3+IHC vs 0 = longer survival. https://t.co/cYTwXeA4aB

[Adam B. Weiner, MD @Adam_Weiner535]

🚨 PSA can be flat while #prostatecancer grows 🚨

@JCO_ASCO

👥 >2,500 pts, advanced PCa
📊 pooled ARCHES + PROSPER, enzalutamide
📊 radiographic progression vs PSA change
✅ ~1 in 4 had progression on imaging w/ stable or undetectable PSA
✅ those pts had worse survival
⚠️ post-hoc, ARSI-treated pts only

🎯 on potent AR inhibitors, PSA is necessary but not sufficient. scan f/u matters, esp the first 2 yrs.

@PCFnews @PCF_Science @AarmstrongDuke

[Adam B. Weiner, MD @Adam_Weiner535]

🚨 ~90% 9-yr cancer-specific survival in very high-risk #prostatecancer.

❓The question is no longer "can we cure?" It's "at what cost?" 💸

👏 @CedricPetersRT et al: measure who's alive, failure-free, AND living well. One endpoint. Patient-centered.

⚖️ Our job now: personalize care. Less overtreatment for the many we cure. Less undertreatment for the few we miss.

🎯Cure alone isn't success.🎯

@PCFnews @PCF_Science @EurUrolOncol @Movember

🔗https://t.co/KsrTF3dgQu

[Enrique Grande @drenriquegrande]

⚡️ Adjuvant therapy after cystectomy in MIBC: cisplatin remains standard for eligible patients with high-risk pathology. Two ICIs have shown meaningful DFS benefit.

But the field is moving toward ctDNA-guided strategies. IMvigor011 and MODERN will define what comes next.

https://t.co/EVs6YsDV9z

#BladderCancer

[NEJM @NEJM]

Original Article: Enfortumab Vedotin and Pembrolizumab in Cisplatin-Eligible Bladder Cancer (phase 3 KEYNOTE-B15/EV-304 trial) https://t.co/5Y1ZnAvBFK

Editorial: A New Standard in Muscle-Invasive Bladder Cancer — The End of the Cisplatin Era? https://t.co/Jkuc0w9hhV

#Oncology

[Juan Gómez Rivas @JGomezRivas]

Long live DRE, die DRE ☝️

DRE may be dying as a screening test, but it is far from dead. The latest evidence supports removing DRE from routine screening in asymptomatic men, yet it still retains an important role in clinical staging until imaging fully replaces it

https://t.co/CvHkYpEzoC

[Paolo Ciracì @p_ciracimd]

Adjuvant aspirin for colorectal cancer with PIK3CA-mutated and COX-2 overexpressed tumours: the ASCOLT translational research study and meta-analysis
https://t.co/qNY69lk4L9
@OncoAlert