Rocio Perez

R3 Oncología Radioterápica 💕 Amo a los animales, los bebés y la música❤️ Mamá eterna de Motita 🕊 #2MIR23

[Rocio Perez @Rooxii]

Descansa en Paz mi amor, te voy a amar eternamente 🥺💕🕊 Gracias por estos 13 años llenos de amor, lamidas ásperas y ronroneos. Te amo🫰🏻

[MV Chandrakanth @ChandrakanthMv]

TRIPLE-NEGATIVE BREAST CANCER #ASCO2026

A clear theme emerged this year:

From immunotherapy-driven gains in early disease to ADC-driven advances in metastatic TNBC.

Key takeaways:

🔹 KEYNOTE-522: Durable 7-year survival benefit

🔹 ASCENT-04: ADC + IO moves into 1L PD-L1+ mTNBC

🔹 ASCENT-03: SG benefit observed across biomarker groups

🔹 TROPION-Breast02: Dato-DXd validates the TROP2 ADC class

🔹 PANKU-BREAST02: Bispecific ADCs represent the next wave of innovation

ASCO 2026 reinforced the transition from conventional chemotherapy toward ADC-based precision therapy in TNBC.

#TNBC #BreastCancer #ASCO #Oncology #ADC #SacituzumabGovitecan #DatoDXd #MVOnco

[Dr Rishabh Jain @DrRishabhOnco]

🚨 THE 15 MOST IMPORTANT TRIALS OF #ASCO26

May 29 - June 2 | Chicago
Which trial are you watching most closely?

🌟 PLENARY GAME-CHANGERS

1️⃣ PROTEUS
Perioperative apalutamide + ADT in high-risk localized prostate cancer

2️⃣ LIBRETTO-432
Adjuvant selpercatinib in RET+ NSCLC

3️⃣ HARMONi-6
Ivonescimab + chemo vs tislelizumab + chemo in squamous NSCLC

4️⃣ RASolute 302
Daraxonrasib (RMC-6236) in metastatic pancreatic cancer

5️⃣ SARC041
Abemaciclib in dedifferentiated liposarcoma

⚡ FRONTLINE & PERIOPERATIVE SHIFTS

6️⃣ KEYNOTE-B15 / EV-304
EV + pembrolizumab vs chemo in MIBC

7️⃣ LITESPARK-022
Pembrolizumab + belzutifan in adjuvant ccRCC

8️⃣ AMBITION
Paclitaxel/bevacizumab ± atezolizumab in HR+ breast cancer

9️⃣ NeoADAURA
Neoadjuvant osimertinib in EGFR+ NSCLC

🔟 A-DREAM
ADT interruption strategies in mCSPC

🧬 PRECISION, ADCs & NEXT-GEN IMMUNOLOGY

1️⃣1️⃣ DESTINY-Breast06
T-DXd expands into HER2-ultralow disease

1️⃣2️⃣ CROWN (7-year update)
Lorlatinib durability in ALK+ NSCLC

1️⃣3️⃣ DeLLphi-312
Tarlatamab in frontline SCLC

1️⃣4️⃣ COMMIT
Atezolizumab + FOLFOX/Bev in MSI-H mCRC

1️⃣5️⃣ IMvigor011
ctDNA-guided adjuvant atezolizumab in bladder cancer

#OncoTwitter #MedTwitter #ASCO26 #CancerResearch @OncoAlert @ASCO @JCOPO_ASCO @OncBrothers

[Dr. Luis A. Pérez-Romasanta @LuisAlberto3P]

#ESTRO26
Top embargoed abstracts.

[Dr. Luis A. Pérez-Romasanta @LuisAlberto3P]

Desescalada en SPB (LPS mixoide).
RT preop: 36Gy/18fx es suficiente.
#ESTRO26

[Dr. Luis A. Pérez-Romasanta @LuisAlberto3P]

Cáncer de mama en #ESTRO26
La división en grupos de riesgo tras tratamiento neoadyuvante permite indicar la RT: desestimar, local o locoregional.

[MV Chandrakanth @ChandrakanthMv]

If you remember only one thing from BRCA biology, remember this👇
• BRCA1 → detects DNA damage
• BRCA2 → repairs DNA
• PARP → fixes small damage
Block PARP + lose BRCA2 → no repair left → cell dies
👉 That’s why PARP works best in BRCA2
#MVOnco #Oncology #MedOnc

[Dr Rishabh Jain @DrRishabhOnco]

🚨 ASCO GU 2026
Top 15 Clinical Trials to Watch
#GU26

🔵 Prostate Cancer
|Precision & Intensification

🧪 CIPHER
Testing platinum as a low-cost option in HRR-mutated mCRPC

☢️ PSMAaddition
¹⁷⁷Lu-PSMA-617 moves into mHSPC

🎯 PEACE-2
Systemic intensification (abiraterone + ADT) with definitive prostate RT

🔗 PEACE-3
Radioligand + ARPI combination in mCRPC

🧬 CAPItello-281
AKT pathway targeting in PTEN-deficient mHSPC

🟢 Bladder & Urothelial Cancer
| ADCs & Bladder Preservation

🧬 KEYNOTE-B15 / EV-304
Perioperative EV + pembrolizumab as a new backbone in MIBC

🧪 VOLGA
IO–ADC triplet strategy in perioperative MIBC

🫙 SunRISe-2
Bladder-sparing TAR-200 + cetrelimab in BCG-unresponsive NMIBC

🧫 Disitamab vedotin + pembrolizumab
ADC expansion beyond enfortumab in HER2-expressing disease

🩸 RETAIN trials (LBA632)
ctDNA-guided, response-adapted bladder preservation in MIBC

🟡 Renal Cell Carcinoma
| Post-IO Sequencing

🧪 LITESPARK-011
Belzutifan combinations after IO–TKI failure

🛡️ LITESPARK-022
HIF-2α inhibition enters the adjuvant setting

🔁 TiNivo-2
IO rechallenge tested rigorously

💊 STELLAR-001
Next-generation TKI (XL092) strategies

🔪 CYTOSHRINK
Response-adapted cytoreductive nephrectomy after systemic therapy

#ASCOGU26 #GUOncology #OncoTwitter #MedTwitter
@OncoAlert @myesmo @esmo_open @asco @Larvol

[MV Chandrakanth @ChandrakanthMv]

𝐖𝐡𝐞𝐧 𝐭𝐡𝐞 𝐩𝐫𝐢𝐦𝐚𝐫𝐲 𝐢𝐬 𝐮𝐧𝐤𝐧𝐨𝐰𝐧, 𝐈𝐇𝐂 𝐭𝐞𝐥𝐥𝐬 𝐭𝐡𝐞 𝐬𝐭𝐨𝐫𝐲.
𝐇𝐢𝐠𝐡-𝐲𝐢𝐞𝐥𝐝 𝐦𝐚𝐫𝐤𝐞𝐫𝐬 𝐞𝐯𝐞𝐫𝐲 𝐨𝐧𝐜𝐨𝐥𝐨𝐠𝐲 𝐞𝐱𝐚𝐦 𝐞𝐱𝐩𝐞𝐜𝐭𝐬 𝐲𝐨𝐮 𝐭𝐨 𝐤𝐧𝐨𝐰.

[Jordi Remon @JordiRemon]

2025: Summary of Ttx for NSCLC in 3 slides
➕: IO is SoC in early stage
➖: multiple « me too » agents but cost of drugs is ⬆️ and access is ⬇️ worldwide
✏️: optimal Ttx duration with IO or TT
✏️: access to TT for rare 🧬altertions
✏️: role of ADCs?
We need more Academic trials!

[Emre Yekedüz @yekeduz_emre]

☢️New meta-analysis in JAMA Network Open:

🎯Stereotactic body radiotherapy (SBRT) alone for oligometastatic cancer achieved 70% systemic therapy-free survival at 1-2 years, highest in renal (87%) and prostate cancer (78%).

🎯Low toxicity rates suggest SBRT may safely defer chemotherapy in selected patients.

10.1001/jamanetworkopen.2025.49685

@OncoAlert @DrYukselUrun #MedX #Cancer #Oncology @JAMANetworkOpen

[Dr Rishabh Jain @DrRishabhOnco]

Why does PD-1 before radiotherapy work better than giving both together?
This paper explains it beautifully 👇

🧠 Tumors fail RT mainly because of hypoxia
🩸 Hypoxia exists because tumor vessels are abnormal
🧬 Anti–PD-1 given before RT fixes this problem

🔍 What happens biologically
🩺 PD-1 blockade normalizes tumor vessels
🫁 Better perfusion → less hypoxia → RT works better
🧠 This effect is driven by CD4+ T cells, not CD8+

📊 Key finding
Induction PD-1 + RT
✅ Better tumor control
✅ Better survival
❌ Concurrent PD-1 + RT underperforms

🎯 Clinical takeaway
This is not just “ICI + RT synergy”
This is sequence-dependent biology

Immune priming first
Radiation next

📖 Full paper in comment ⬇️

#OncoTwitter #MedTwitter #RadiationOncology #Immunotherapy

@OncoAlert @ASCO @myESMO @ESMO_Open

[Rocio Perez @Rooxii]

@AMAZlNGNATURE @Kushio_chan

[Yakup Ergün @dr_yakupergun]

Prostate cancer

https://t.co/N7OqDlTndW

[Elvina Almuradova @Dr_ElvinaA]

NCCN Breast Cancer Guidelines 2025 (v5) #update focuses on localized therapy:
• Less extensive axillary surgery—SLN biopsy may replace ALND in select pts.
• Hypofractionated post-mastectomy RT safe with reconstruction.
• Partial breast irradiation recommended for low-risk pts ≥40.
#BreastCancer #NCCN @Larvol @OncLive @ONCOLife_HP @OncoAlert

[Dr Rishabh Jain @DrRishabhOnco]

🇪🇺 ESGO–ESTRO–ESP 2025 GUIDELINES UPDATE

🔹 Core Update
2023 FIGO staging + Molecular classification (POLEmut / MMRd / NSMP / p53abn)
➡️ Biology now defines stage, risk & therapy

🧪 Universal Testing
✅ MMR IHC ± MLH1 methylation → all ECs
🔍 POLE, p53, ER, HER2 testing → guides management
🧠 ER for NSMP, HER2 for p53abn/serous
🧬 Foundation from PORTEC-4a, PROBE, and TCGA data

🏥 Surgery
🤖 Minimally invasive approach = standard
🧭 Sentinel LN biopsy preferred
🚫 Avoid tumour spillage / morcellation

💊 Adjuvant Therapy by Risk

🟢 Low-risk (POLEmut/MMRd/NSMP-ER⁺) → ❌ No adjuvant Rx

🟡 Intermediate (MMRd/NSMP-ER⁺) → 🎯 Vaginal brachy ± omit (<60 yrs)

🟠 High-intermediate → ☢️ EBRT / VBT (if pN0)

🔴 High-risk (p53abn / NSMP-ER⁻ / high-grade) → 💥 EBRT + concurrent/adjuvant chemo

🧬 MMRd stage III–IV → Chemo + ICI (based on NRG-GY018, RUBY-1, DUO-E)

💡 Systemic Therapy
1️⃣ MMRd: Chemo + ICI → ICI maintenance (dostarlimab/pembro/durva)
2️⃣ Non-MMRd: Chemo ± ICI/PARP (DUO-E: durvalumab + olaparib)
3️⃣ HER2 3⁺: Add trastuzumab (NCT01367002)
4️⃣ ER⁺ low-grade: Consider endocrine therapy (PALEO, NSGO-EORTC)

🎯 Bottom line:
Molecular classification is now the treatment compass.
🧬 Precision > anatomy in 2025.

📓 Full paper: Concin N et al., Lancet Oncol. 2025.
https://t.co/kuYDHADdGi

#OncoTwitter #GynOnc #EndometrialCancer
@myesmo @esmo_open @OncoAlert @ESGO_society @ASCO

[Yakup Ergün @dr_yakupergun]

ESMO HANDBOOK OF CANCER GENETICS AND GENOMICS #ESMO25

List of Actionable Genes and the FDA-approved Molecularly Matched Drugs👇

[Dr Rishabh Jain @DrRishabhOnco]

💥 Boost or Not to Boost? That’s the Cervical Question 🩸

In FIGO IIIC cervical cancer with radiologically positive LNs - does an external beam RT boost really help?

📊 Study Design
Retrospective (n = 231, 2012–2019)
All had node-positive disease
Compared: RT Boost vs No Boost

🎯 Key Outcomes

🕒 Median OS: 107 mo (Boost) vs 91 mo (No-boost) — p = 0.01 ✅

📏 No OS benefit if:
 • LN > 2 cm → 105 vs 99 mo (p = 0.048)
 • > 4 positive nodes → 91 vs 73 mo (p = 0.04) ❌

💊 Concurrent chemo improved survival + 22 mo (p = 0.023)
⏱️ Median DFS = 93 mo | Median OS = 84 mo overall

🧩 Best Outcomes Observed When
✅ LN < 2 cm
✅ < 4 nodes
✅ Concurrent chemo given

🧠 Take-Home Message
External RT boost 💪 improves survival in selected Stage IIIC cases-
but nodal size & burden matter more than dose.

📖 Rishi KS et al., IJGC Oct 2025
🔗 https://t.co/4COPqefmtH

#CervicalCancer #GynOnc #RadOnc #OncoTwitter

@ASCO @ESGO_society @myESMO @ESMO_Open @OncoAlert

[Dr Rishabh Jain @DrRishabhOnco]

“Can surgery still matter in metastatic prostate cancer?” 🩺

💥 RAMPP trial says maybe yes - even in low-volume mHSPC.

🧪 Design:
De novo low-volume mHSPC (≤5 bone mets ± nodes)
👥 Fit for RP + systemic therapy (ADT ± ARPI)
🆚 Radical prostatectomy (RP) + BST vs BST alone
🎯 Primary: Cancer-specific mortality (CSM)

📊 Results (~5 yrs):
•🩸 CSM: 13% vs 23% → HR 0.39, p=0.045 ✅
•🧭 Progression: 59% vs 60% (NS)
•💀 OS: 81% vs 74% (p=0.13)
•⚙️ Complications ≥ G3: 14%, no peri-op deaths

💬 Takeaway:
RP added to BST reduced CSM in low-volume mHSPC — mirroring the STAMPEDE RT signal 🔁
But OS gain unproven → discuss in MDT before adopting.

📖 Graefen et al. European Urology 2025.

🔗DOI: https://t.co/XMhMFVLHPW

#OncoTwitter #ProstateCancer #mHSPC #UroOnc
@OncoAlert @myESMO @ESMO_Open @ASCO @EuropeanUrology @EUplatinum @Uroweb

[Mario Balsa @MarioBalsaMD]

💥 It’s here! The new ESMO Clinical Practice Guidelines for localized rectal cancer (@Annals_Oncology)
🔗 https://t.co/cdCezBb6G7

📌 Covers:
•Imaging & diagnosis
•Staging & risk assessment
•Treatment & follow-up
•Algorithms for local & LA disease

When it comes to rectal cancer, guidance just got…straight to the point 🎯

@OncoAlert #OncoAlertAF @OncoReporte @myESMO @seom @GrupoTTD

[Dr Rishabh Jain @DrRishabhOnco]

🌟 The Abscopal Effect : When local radiation has systemic impact ✨

👥 What is it?
Radiation to a single tumor site → unexpected regression of distant, non-irradiated tumors.

⚙️ How does it work?
• 🔥 Radiation kills cancer cells → releases tumor antigens
• 🛡️ Immune system gets activated → T-cells attack metastases elsewhere
• 💉 Often boosted with immunotherapy (RT + ICI combos)

📊 Reality check
Rare in clinic, but growing evidence with IO combinations.

💡 Takeaway
Radiation = not just local control… it can spark systemic anti-tumor immunity.
👉 Turning the body into its own “vaccine factory.”

#OncoTwitter #RadOnc #medtwitter #ImmunoOncology
@OncoAlert @astro @asco @myesmo