Ang Choon Seong

a doctor. trying to find a balance between best of service to self, family and society. All my tweets are my own opinion nothing to do with my employer(s)

[Erman Akkus @Erman_Akkus]

📫My letter on CARES-005 has been published in @JCO_ASCO

➡️CARES-005
Camre-Rivo-TACE vs TACE in unresectable HCC
BCLC B and C: 44% and %42
Extrahepatic: 0%
PFS benefit✅
❗️mOS: 24.0 mo

➡️CARES-310
Camre-Rivo in advanced HCC
BCLC B and C: 14% and %86
Extrahepatic: 64%
❗️mOS: 23.8

🚨Patient selection (not all is key for intermediate HCC to add systemic treatment ➡️ Future research

🙏Thanks JCO and editors, and answering authors for giving this disccusion opportunity😊

👉https://t.co/60Q4ygu3rz

#cancer #oncology #MedX #liver #hepatocellularcarcinoma #GI #gastrointestinal @OncoAlert

[Thor Halfdanarson @OncoThor]

This is the best paper you will read on nuclear imaging in patients with NETs this summer. Trust me!

https://t.co/z5TYbljIbX

@ENETS_ORG @deroose_c @HansHofland1 @DrAngelaLamarca

This is the table I always needed for myself and for teaching...

[Arndt Vogel @ArndtVogel]

Effectiveness & safety of SIRT using yttrium-90 glass microspheres for HCC
@eClinicalMed
https://t.co/ctn30G2k0b
🔎RWD multi-center prospective PROACTIF, 989 pts pts
👉mOS: 21⋅8 mo
👉ORR: 45%, 10⋅7% underwent surgery
🧐interesting & supportive, but not overly impressive OS data, pts selection remains key
@myESMO @ASCO @ILCAnews

[Nieves Martinez Lago MD PhD @DraMartinezLago]

🧬 KRAS G12D is no longer an “undruggable” target. #ESMOGI26

🚀 Zoldonrasib + ChT showed promising early activity in 1L PDAC:

📈 ORR 82% + mFOLFIRINOX (DCR 96%)
📈 ORR 61% + Gem/Nab-P (DCR 90%)
✅ No new safety signals.

⏳ Phase III RASolute 305 is now underway.
@OncoAlert

[Angela Lamarca @DrAngelaLamarca]

Data on #ORR from #EMERALD3 at @myESMO #ESMOGI26

Following the @ASCO data (see post below), response data by RECIST and mRECST presented today

#ESMOAmbassadors

[Dr Amol Akhade @SuyogCancer]

Systemic therapy for advanced pancreatic NET and newer targets in pNET . From excellent talk by @OncoThor 🙂👍 @UGrewalMD @ASCO #asco26

[Jame Abraham, MD, FACP @jamecancerdoc]

Evaluation and Treatment of Iron Deficiency for the Practicing Oncologist | JCO Oncology Practice https://t.co/OlPqUor0xf @JCOOP_ASCO @ASCO @OncoAlert one of the most common consults in General HemOnc Clinics

[Dr Rishabh Jain @DrRishabhOnco]

🩺 THE 10 MOST IMPORTANT GI CANCER TRIALS OF #ASCO26

🌟 PLENARY & PRACTICE-CHANGERS

1️⃣ RASolute 302 (LBA5)
Daraxonrasib (RMC-6236) vs chemotherapy in metastatic pancreatic cancer
Can RAS finally become druggable in pancreatic cancer?

2️⃣ CIRCULATE (LBA3500)
ctDNA-guided adjuvant therapy in stage II colon cancer
Potentially the defining trial for escalation and de-escalation strategies.

3️⃣ EMERALD-3
Durvalumab + tremelimumab + lenvatinib + TACE in unresectable HCC
How aggressive should frontline liver cancer therapy become?

🧬 COLORECTAL CANCER PRECISION ERA

4️⃣ BREAKWATER Cohort 3 (LBA3503)
Encorafenib + cetuximab + FOLFIRI in BRAF V600E mCRC
Important real-world sequencing data beyond oxaliplatin-based therapy.

5️⃣ SWOG S2107
Sequencing optimization in BRAF V600E metastatic CRC
A major unmet-need clinical question.

6️⃣ STELLAR Update
Long-term survival update for TNT in rectal cancer
Do pCR gains translate into durable survival benefit?

🎯 GASTRIC, GEJ & RARE GI SUBTYPES

7️⃣ HERIZON-GEA-01 (4010)
Zanidatamab-based frontline therapy in HER2+ gastric/GEJ cancer
Could bispecific HER2 targeting redefine frontline care?

8️⃣ KEYNOTE-811 Mature OS
Final long-term OS update for pembrolizumab + trastuzumab + chemotherapy
Clinicians have been waiting for these mature survival curves.

9️⃣ ATTRACTION-6 Update
Checkpoint inhibitor strategies in advanced gastroesophageal cancers
The IO sequencing debate continues.

🔟 Bezuclastinib + Sunitinib (11500)
Phase III data in advanced GIST
A key resistance-targeting strategy in rare GI oncology.

Which GI abstract will change your clinic most?

#GIOnc #OncTwitter #ASCO26 #PanCan #ColorectalCancer #MedTwitter @ASCO @myesmo @esmo_open @OncoAlert

[Dr Rupam Manna MD @DrRupamOncology]

🚨 GIST TREATMENT MASTERCLASS – ULTIMATE EDITION 🔥
The most complete high-yield infographic you’ll ever need:
✅ Risk Stratification (Miettinen/AFIP table) – size, mitotic rate, site & rupture
✅ Choi Criteria (VERY HIGH YIELD) – why density drop beats RECIST in GIST
✅ Mutation-Based Algorithm (SUPER HIGH YIELD) – KIT exon 11/9, PDGFRA D842V → Avapritinib
✅ Complete Management Flow – Localized, Borderline, Metastatic & Special Cases
✅ Exam-critical pearls + Mutation & Treatment at a Glance table
Precision oncology prototype • NCCN-aligned • One-shot revision gold
Save this for rotations, boards & wards 📌
Tag a fellow/resident/fellow who lives on #MedTwitter 👇
RT if this just became your new GIST bible!
#GIST #Oncology #MedEd #HemeOnc #PrecisionOncology #TargetedTherapy #Cancer #MedTwitter

[Rohit Malde @roxboxfix]

2nd Line Treatment Options in Mets Breast Cancer

Post Progression after AI + Cdk 4/6 inhibitors use in 1st Line

Mandatory = Organise NGS testing

See the Wonderful options

Trial evidence and Efficacy snd Salient Toxicity

[Dr Amol Akhade @SuyogCancer]

Recording for this webinar is now available. Those who had registered and wish to have the same , kindly DM me 🙂.

[Hagen Kennecke @HKennecke]

Sharing the final publication and schema! @NANETS1 Guidelines for the diagnosis and management of stage I–III rectal neuroendocrine tumors https://t.co/UDLJ8ZI75f

[Dr. Foxpaws Fauxpas @foxpaws_onco]

Grades of #chemotherapy response across tumors

Higher is better in - Osteosarcoma Huvos, Ovarian CRS, Miller Payne Breast, Dvorak Rectum

Lower is better in - Ryan CAP/Mandard/Becker GI malignancies, #RCB in breast
#onctwitter #oncology #cancer #medtwitter #pathology

[Dr Rishabh Jain @DrRishabhOnco]

HIPEC finally shows a signal in T4 colon cancer.
But not where you expect.

It reduces peritoneal relapse…
Yet DFS and OS don’t improve.

Here’s HIPECT4 final analysis 👇

🧪 Trial
Resectable cT4N0-2M0 colon cancer
n = 184 randomized

⚔️ Arms
🔹 Surgery + adjuvant chemo
🔹 Surgery + HIPEC (mitomycin C 30 mg/m², 60 min) + adjuvant chemo 

📊 Primary endpoint
36-month locoregional control

🔥 Key result
HIPEC improved peritoneal control:
HR 0.19 (95% CI 0.04-0.86), P=0.031 

❗ But the reality check
No significant difference in:
• DFS
• OS 

🎯 Where benefit was strongest
• Definitive pT4: HR 0.08, P=0.017
• Per-protocol (received chemo): HR 0.18, P=0.028 

🧠 What changed biologically?
Less peritoneal relapse
More systemic pattern of recurrence
No added toxicity 

💡 Takeaway
This is NOT a survival-changing trial.

But it is a pattern-changing trial.

👉 HIPEC may matter in selected high-risk T4 patients
👉 Not ready for universal adoption

🔖 Save this before your next tumor board

📖 Full paper in comment ⬇️

#OncoTwitter #MedTwitter #ColorectalCancer #SurgicalOncology @OncoAlert @myesmo @esmo_open @asco @BJSurgery

[Nieves Martinez Lago MD PhD @DraMartinezLago]

🧬 MOONLIGHT: Not all IO strategies equal in GEA

📊 Ph II (HER2–)

❌ Dual ICI + FOLFOX: no benefit (mPFS 5.8 vs 6.6 | mOS 10.1 vs 12.5)
⚠️ ↑ tox (74% vs 45%)

❌ Seq IO: worse (mOS 7.6)

🚀 FLOT + nivo: best (mPFS 7.0 | mOS 14.6 | ORR 56%)

💡 IO combo strategy matters

🔗 https://t.co/DAMYF4aKHn
@OncoAlert

[Arndt Vogel @ArndtVogel]

Pembrolizumab and olaparib in HRD metastatic PDAC: the phase 2 POLAR trial
@NatureMedicine
https://t.co/Bh4jkcHWrc
👏great translational study
👉subset of HRD PDAC derive prolonged benefit from PARP-ICB maintenance
🧐We need biomarker
@myESMO @ASCO

[Nieves Martinez Lago MD PhD @DraMartinezLago]

🔥 HIPECT4: HIPEC in locally advanced colon cancer (pT4)

📊 Phase III RCT (n=184)

♨️ HIPEC (mitomycin C)
📉 ↓ locoregional/peritoneal relapse
• HR 0.19 (p=0.031)

⚠️ No benefit in DFS or OS

💡 Improves peritoneal control, not survival

🔗 https://t.co/U7J8AsbzDi
@OncoAlert

[Erman Akkus @Erman_Akkus]

📘Gastric cancer: French 🇫🇷 Intergroup clinical practice guidelines
@EORTC

👉https://t.co/WLqtvIvTEP

#cancer #oncology #MedX #gastric @OncoAlert

[Adriana Zucchiatti @zucchiatti_]

Cholangiocarcinoma 2026: status quo, unmet needs and priorities
https://t.co/k8ZYUVKHAI
#liverpath

[Dr. Foxpaws Fauxpas @foxpaws_onco]

Let's review taxanes in prostate cancers.

Evidence for
Weekly 25-30/m² - TAX327
2-weekly 50/m² - ARASAFE, PROSTY
3-weekly 75/m²- CHAARTED, STAMPEDE

What's your choice?

#gu #asco #gucsm #cancer #oncology