SamFar DS

Médico, poeta y loco... y de geek otro poco... ¬¬

[Felipe Templo Jr. ,MD, MBA 🕊 @thejourneymate]

Algorithm of Immunohistochemistry in Soft Tissue Sarcomas 🔬

(c): Dr Rakesh Kumar

[Dr. Éctor Jaime @ectorjaime]

Subsecretario @EduardoClark sostengo que están comprando medicamentos a sobreprecio, a proveedores de dudosa procedencia, menos claves y con afectaciones para los pacientes👇

Revisen sus datos: el precio promedio por pieza de medicamento en 2018 fue de $38.72 pesos, y con la presidenta Sheinbaum, en 2026, de $91.83 pesos.

Ustedes dicen que se debe a que están comprando más medicamentos de especialidad, pero eso también está en duda.

El 30 de marzo de 2026 se anunció una reducción del catálogo de medicamentos del sector público de 2,753 a 1,929 claves. La justificación oficial habla de priorizar los tratamientos más eficaces, seguros y disponibles, y de optimizar el uso de los medicamentos. En la práctica, eliminaron más de 800 claves de medicamentos sin que su decisión pudiera ser evaluada por especialistas externos y sin consultar a los pacientes, una restricción sin precedentes de las opciones terapéuticas disponibles para los médicos y pacientes del sector público.

A esto se suma que también compran medicamentos falsificados que ponen en riesgo la vida de los pacientes. Está el caso de las 11 mil piezas de Keytruda, la mayoría adquiridas por el ISSSTE y el IMSS-Bienestar. Todo por seleccionar proveedores apócrifos, sin antecedentes, sin verificar registros sanitarios y a precios de “ganga”, según el gobierno.

Hoy el sector privado concentra 72.8% de las piezas de medicamentos distribuidas a los mexicanos. Esto confirma que, ante las fallas del sistema público, el acceso a medicamentos descansa cada vez más en el bolsillo de las familias y en el mercado privado.

Le comparto las ligas de estas investigaciones que el gobierno se ha empeñado en desacreditar, pero no en atender:

https://t.co/qC8WleDGj2

https://t.co/RGCT8syMrv

https://t.co/PDIoi4tTxi

https://t.co/p4K9mO9s8M

[Karamvir Yadav @K_Yadavir]

Can we safely STOP immunotherapy early in MSI mCRC? 🤔

New real-world data says YES — if patients respond.

✔ No OS/PFS compromise
✔ ctDNA-negative → very low relapse risk (~7%)
✔ Fixed 2-year duration? Probably arbitrary

👉 Time for response-adapted ICI duration?

#Oncology #CRC #Immunotherapy #MedTwitter @ESMO_Open #precisiononcology @OncoDailyGI @OncoDailyIO

[Erman Akkus @Erman_Akkus]

🟪Oral abstracts #ESMOGI26 @myESMO
Gastric/gastroesophageal

#cancer #oncology #MedX #GI #gastrointestinal #gastric #esophageal @OncoAlert

[Mayank Tripathi @Mayank_Oncology]

https://t.co/roXv3yn1iW

A comprehensive, step-by-step video guide on Pancreatoduodenectomy. We cover:
✅ Dissection planes
✅ Vascular preservation
✅ Reconstruction technique
​Perfect for trainees looking to master the steps.

[Julie Hallet @HalletJulie]

🦓PanNETs @BJS_Surgery Commission: MEN1

👀NF ≤2 cm without growth → observe
🔪Functional → resect, but parenchyma-sparing
🚫NO total pancreatectomy
🔄Expected recurrence 21-63% — nature of the disease, not surgical failure

🔗https://t.co/fqS90z6MkO
@spartelli

[JAMA @JAMA_current]

#Obesity is associated with higher risk for 12 #cancer types and accounts for approximately 10% of annual new cancer cases in the US.

📄 This Review summarizes the primary biological pathways connecting obesity and cancer development.

https://t.co/1ggRbdtW56

[Dr Rishabh Jain @DrRishabhOnco]

The new ESMO guideline just made sequencing CRYSTAL clear.

Let’s simplify the FULL pathway 👇

🧬 Step 1: Check biology FIRST
→ dMMR / MSI-H → Immunotherapy (nivolumab-ipilimumab preferred)
→ Everything else → Go chemo + targeted

🧬 Step 2: If pMMR/MSS → split by mutations

👉 RAS-mutant
→ FOLFOXIRI + bevacizumab (fit patients)

👉 BRAF V600E
→ FOLFOX + encorafenib + cetuximab (practice-changing 🔥)

👉 RAS wt / BRAF wt
→ LEFT sided → anti-EGFR combos win
→ RIGHT sided → bevacizumab-based therapy preferred

🧬 Step 3: Maintenance = not optional anymore
→ Ox-based → Fluoropyrimidine + bevacizumab
→ Anti-EGFR → Fluoropyrimidine + anti-EGFR

🧬 Step 4: Second line = switch backbone
→ Ox → Irinotecan
→ Irinotecan → Ox
+ Continue anti-VEGF pressure

🧬 Step 5: Third line (BIG update 🚨)
→ FTD-TPI + bevacizumab = NEW standard
→ Then regorafenib / fruquintinib

🧬 Precision layer (don’t miss this)
→ HER2 → tucatinib-trastuzumab / T-DXd
→ KRAS G12C → adagrasib + EGFR
→ ctDNA → EGFR rechallenge

💡 Bottom line:
mCRC is no longer “lines of chemo”
It’s a sequencing game driven by biology.

Are you still using one fixed pathway… or fully personalizing now? 🤔

📖 Full paper in comment ⬇️

#OncoTwitter #MedTwitter #colorectalcancer #crc @OncoAlert @myesmo @esmo_open @asco @larvol

[Yakup Ergün @dr_yakupergun]

About 25 years in pancreatic cancer, what we’ve really done is the same: rearranging treatment sequence and intensity.

For the first time, that cycle may be breaking👇

Daraxonrasib (pan-RAS inh)
was reported to nearly double OS compared with chemotherapy.

https://t.co/GaDveHpf2v

[Annals of Surgical Oncology @AnnSurgOncol]

April Issue: Survival of Open Versus Thoracoscopic #Esophagectomy for Esophageal Squamous Cell Cancer by Tumor Location: An Energy Balancing Weights Analysis

https://t.co/kU2TfPuAsv

#EsophagealCancerAwarenessMonth
@AndrewFlemingMD
@SyedAAhmad5
@SocSurgOnc

[Dr Rishabh Jain @DrRishabhOnco]

TNBC is no longer a chemo disease.

This 1 algorithm shows the shift:
👉 ADCs + biomarkers are now driving frontline decisions.

🧬 Metastatic TNBC - how to think today

PD-L1 ≥10
• Pembro + chemo
• OR Pembro + SG

PD-L1 <10
• SG or Dato-DXd now competing with chemo

BRCA-mut
• PARP inhibitors

HER2-low
• T-DXd option

Later lines
• ADC sequencing
• Biomarker-directed therapy

🧠 Paradigm shift

❌ Before: one-size chemo
✅ Now: IO + ADCs + PARPi + precision oncology

⚠️ What matters next

Not just “which drug”
👉 but “what sequence”

Topo-1 ADCs → real cross-resistance concern

🎯 Takeaway

Advanced TNBC has entered the ADC era.

Smart sequencing will define outcomes. 🔖

📖 Full paper in comment ⬇️

#OncoTwitter #MedTwitter #TNBC #BreastCancer @OncoAlert @myesmo @esmo_open @JCOPO_ASCO

[Dr Rishabh Jain @DrRishabhOnco]

Biliary tract cancers summarised concisely by @OncBrothers

[Dr Rishabh Jain @DrRishabhOnco]

🚨 New ASCO Guidelines (2026): Anaplastic Thyroid Cancer (ATC)

One of the most aggressive cancers.
Now finally algorithm-driven.

🧠 Step 1 = GENOMICS (don’t skip this)

👉 Test for: BRAF | RET | NTRK

🔥 If BRAF V600E → THIS CHANGES EVERYTHING

👉 Dabrafenib + Trametinib = STANDARD

📊 ROAR trial
• ORR ~69%
• Durable responses in a historically lethal disease

👉 Consider adding Pembrolizumab (selected cases)

🧠 If NO actionable mutation

👉 Options:
• Lenvatinib ± Pembrolizumab
• Ipilimumab + Nivolumab

📊 Evidence: small phase II / non-randomized studies

⚠️ Modest activity vs BRAF-targeted therapy

🧠 RET / NTRK fusion (rare but important)

👉 Treat like precision oncology
• RET → Selpercatinib (LIBRETTO-001)
• NTRK → Larotrectinib / Entrectinib (TRK pooled / STARTRK)

🧠 After progression

👉 Clinical trial = BEST option

If not available:
• Lenvatinib ± Pembrolizumab
• Chemotherapy (last-line)

🔖 Save this - ATC decisions are time-critical

📖 Full paper in comment ⬇️

#OncoTwitter #MedTwitter #ThyroidCancer #ATC #PrecisionOncology @OncoAlert @myesmo @esmo_open @asco

[IJGC @IJGConline]

De-escalation in Stage IC epithelial ovarian cancer—can we safely do less? 🤔
🔬 Histology-driven decisions
🟢 Safe omission possible in select subtypes
⚖️ Balance survival benefit vs toxicity
🤝 Shared decision-making is essential

Not all Stage IC needs chemo — precision matters.

🔗 https://t.co/lawQryhd0g

@pedroramirezMD @HsuMd @JayrajAarthi @AndreFernandes2 @IGCSociety @ESGO_society @ENYGO_official @OncoAlert @IJGCfellows @GynMe4 @RParejaGineOnco @lchiv4 @annafagottimd @HousseinELHAJJ3 @AinhoaMada @luribero26 @beatesarta @AlwynDO @PeppeParisi_ @ilkerselcukmd @VinTarantino @NSeminario27498 @dranushak88

#IJGConline #Research #Prevention #Treatment #Diagnostic #GynCancer #GynOnc #WomenHealth #SoMe #SoMe4GynOnc

[IJGC @IJGConline]

⚖️ De-escalation in definitive #cervical cancer surgery aims to preserve survival while reducing morbidity.
✨ Simple hysterectomy in selected tumors
🧭 Sentinel node mapping
🔬 Intra-operative tailoring
🎯 Pre-operative brachytherapy

@pedroramirezMD @HsuMd @JayrajAarthi @AndreFernandes2 @IGCSociety @ESGO_society @ENYGO_official @OncoAlert @IJGCfellows @GynMe4 @RParejaGineOnco @lchiv4 @annafagottimd @HousseinELHAJJ3 @AinhoaMada @luribero26 @beatesarta @AlwynDO @PeppeParisi_ @ilkerselcukmd @VinTarantino @NSeminario27498 @dranushak88

🔗 https://t.co/j8e6ZS6CSC

#IJGConline #Research #Prevention #Treatment #Diagnostic #GynCancer #GynOnc #WomenHealth #SoMe #SoMe4GynOnc

[Elisabetta Bonzano MD, PhD @to_be_elizabeth]

📌 Lymph Node Management of Patients With Breast Cancer in the Era of Therapy De-escalation
🔗 https://t.co/UpfZoB0ZH5
@OncoAlert #OncoAlertAF #BreastCancer

[Nieves Martinez Lago MD PhD @DraMartinezLago]

🧬 Durvalumab (Imfinzi) approved in EU

📍 1st perioperative IO for resectable GC/GEJ (stage II–IVA)

💊 + FLOT ± surgery → durva maintenance

📊 Based on Ph III MATTERHORN (↑ EFS &amp; OS)

🔎 New SoC in early GC/GEJ

🔗 https://t.co/PO5hmOPurW
@OncoAlert @Larvol @GrupoTTD

[Dr Rishabh Jain @DrRishabhOnco]

🧬 More treatment is not always better in metastatic colorectal cancer.

The phase 3 ORCHESTRA trial tested whether adding aggressive tumor debulking to systemic therapy improves outcomes in multiorgan mCRC.

The answer: No survival benefit.

🧪 Trial design

Patients with multiorgan metastatic colorectal cancer whose disease was controlled after induction chemotherapy were randomized to:

🔹 Chemotherapy alone
🔹 Tumor debulking + chemotherapy

📊 Key results

Overall survival
• 27.5 vs 30.0 months
• HR 0.88 (NS)

Progression-free survival
• 10.4 vs 10.5 months
• HR 0.83 (NS)

⚠️ Toxicity
Serious adverse events were higher with debulking
53% vs 39%

🎯 Clinical takeaway
In multiorgan mCRC, adding aggressive tumor debulking to palliative chemotherapy does not improve survival and increases complications.

An important negative trial for MDT decision making.

🔖 Save for GI oncology discussions.

📖 Full paper in comment ⬇️

@OncoAlert @myesmo @esmo_open @asco

#OncoTwitter #MedTwitter #ColorectalCancer #GIonc

[Giovanni Marchegiani @Gio_Marchegiani]

Liver resection for non colorectal mets 🫧 biology biology biology!

🧬 Survival depends on indication 🦓 NET and GIST after TKI best

✋ Pancreas and UpperGI ONLY in extremely selected oligo and liver-only

https://t.co/FksGq9T7p9

[Karamvir Yadav @K_Yadavir]

dMMR/MSI-H CRC in 2026:

• NICHE-2: 98% pathologic response
• ATOMIC: HR 0.50 (50% recurrence reduction)
• CheckMate 8HW: Dual ICI improves PFS
• Liver mets = poorer response

Immunotherapy works.
But resistance & sequencing still matter.

#CRC #Oncology #MSI #dMMR @On@OncoAlert @ColonCancerFdn @coloncancertask @OncoThor @CancerNetwrk @ozdogan_md @dr_yakupergun @Gut_BMJ