🫁 Another phase III trial is making the case for upfront treatment intensification in EGFR-mutated NSCLC.
AENEAS2 evaluated first-line aumolertinib ± platinum-pemetrexed in advanced EGFR-mutated NSCLC.
Study population:
EGFR Ex19del or L858R mutations
Treatment-naïve advanced NSCLC
ECOG 0-1
Stable brain metastases allowed
🔹 Aumolertinib
vs
🔸 Aumolertinib + platinum-pemetrexed → maintenance aumolertinib + pemetrexed
Results:
⏳ Median PFS
28.9 months vs 18.9 months
📉 53% lower risk of progression or death
HR 0.47 (95% CI 0.37-0.60)
🧠 Benefit seen in patients with brain metastases
🧬 Benefit seen in L858R-mutant disease
The trade-off?
⚠️ Grade 3-4 neutropenia
55% vs 1%
⚠️ Grade 3-4 thrombocytopenia
20% vs 1%
Clinical takeaway:
After FLAURA2, MARIPOSA, and now AENEAS2, the question is no longer whether intensification improves PFS.
The question is which patients should receive it upfront.
📖 Full paper in comment ⬇️
@asco@myesmo@oncoalert
#OncoTwitter #MedTwitter #NSCLC #LungCancer
Trastuzumab plus chemotherapy was associated with substantially longer progression-free and overall survival in HER2-positive biliary tract cancers, supporting routine HER2 testing and HER2-directed therapy @JCOOA_ASCO
https://t.co/Ih6MMFhVsX
ASCO 2026: Câncer de Mama Adjuvante | Dra Debora Gagliato
Como a #ASCO26 impactou na Adjuvância do Câncer de Mama?
Dra Debora Gagliato apresenta os estudos, com participação do Dr Antonio Buzaid e do Dr Carlos Barrios
#MOCnaASCO#breastcancer@DGagliato
https://t.co/oxj1pfTQjL
The OPTIMA trial addresses a huge unmet need, and the data, although with short follow up, are striking. Premenopausal patients with N+ tumors and PAM50 ROR<60 do not appear to benefit from chemo, in the setting of adequate OFS. A step forward toward sparing unnecessary chemo.
Benefit of adjuvant giredestrant over SoC endocrine treatment was observed irrespective of menopausal status, with a trend towards larger benefit in premenopausal patients. Comparable tox with giredestrant vs AI also seen irrespective of menopausal status (ie unrelated to OFS)
Interesting signal from #PRIMARY2. 🧵
Can we safely avoid prostate biopsy in men with PI-RADS 2-3 MRI but persistent clinical suspicion of prostate cancer?
🔬 PRIMARY2 (Phase III, Lancet Oncology)
660 biopsy-naïve men with:
• PI-RADS 2-3 MRI
• High clinical risk (PSA density, family history, abnormal DRE, etc.)
Randomized to:
➡️ Standard systematic biopsy
➡️ PSMA PET-guided strategy
📊 Key Results
✅ Clinically significant prostate cancer:
12% vs 16%
Non-inferior with PSMA PET strategy
(p=0.009 for non-inferiority)
✅ Biopsies avoided:
49%
✅ Clinically insignificant cancers:
14% vs 32%
Absolute reduction: 18%
✅ No increase in missed high-grade disease
💡 Takeaway
PSMA PET may become an important biopsy triage tool after equivocal or non-suspicious MRI.
Fewer biopsies.
Less overdiagnosis.
No apparent compromise in clinically significant cancer detection.
If validated globally and shown to be cost-effective, this could meaningfully reshape the prostate cancer diagnostic pathway.
📄 PRIMARY2
Lancet Oncology 2026
DOI: 10.1016/S1470-2045(26)00120-8
#ProstateCancer #PSMAPET #UroOnc #MedTwitter @TheLancetOncol @MSKHofman @LouiseEmmettMD @oncoalert
Belzutifan + Pembro now @US_FDA ✅ based off LITESPARK-022: PhIII (vs. Pembro) in adj RCC:
- 2.5yrs DFS: 75.8% vs. 68.6% (HR: 0.72)
- mOS NR
- 2.5yrs OS: 95.6% vs. 93.8% (HR: 0.78)
- AEs: 42.2% vs. 17.9% w/ Gr ≥ 3
#MedTwitter#gusm#KidneyCancer@OncoAlert
RTOG 0848: neg overall, but benefit in pN0 (adj chemoRT improved OS 5yr 48% v 29%).
Caveats: small N0 subgroup (N=91), gem chemo, pre neoadj era.
My main takeaway: RT has role in (select) resectable PDAC & future trials need to focus on biologically favorable subset. @OncoAlert
🔥#ASCO26 Concomitant Publication: CIRCULATE in ctDNA+ stage II pMMR/MSS colon ca. Academic tumor-informed ctDNA test, NGS-based, tracking up to 3 patient-specific mutations.
Read more: https://t.co/4IsniFwBqW
🚨 Should we still be giving upfront chemotherapy to most high-risk HR+/HER2− metastatic breast cancer patients?
The PADMA trial says probably not.
👩⚕️ 120 patients with HR+/HER2− mBC considered candidates for chemotherapy
⚖️ Palbociclib + endocrine therapy vs physician’s choice chemotherapy
📈 Median TTF:
17.2 vs 6.1 months
HR 0.46 (P<0.001)
📈 Median PFS:
18.7 vs 7.8 months
HR 0.45 (P<0.001)
🎯 Benefit was consistent across key subgroups, including patients with liver metastases and those with high disease burden.
⚠️ More hematologic toxicity with palbociclib, but no new safety signals.
💡 Takeaway:
Even in patients for whom clinicians were considering chemotherapy, first-line CDK4/6 inhibitor + endocrine therapy outperformed chemotherapy.
Another reminder that chemotherapy should remain the exception, not the default, in HR+/HER2− mBC.
Full paper link in comment
#bcsm #BreastCancer #MedTwitter #Oncology #ESMOOpen
@oncoalert
Scalp cooling outcomes in patients receiving trastuzumab deruxtecan for metastatic breast cancer in @ESMO_Open. No benefit of scalp cooling in terms of hair preservation or quality of life.G2 alopecia primary reason for scalp cooling discontinuation. https://t.co/uKW3G2S6gg
In a patient-level pooled analysis of ALEX and J-ALEX trials (alectinib vs crizotinib, 500 NSCLC), we found that tumor burden is not only prognostic but also predictive of ALK TKI efficacy.
Treatment escalation in high tumor burden? @BenjaminBesseMD
Link https://t.co/EF6oeRcb3s
🆕The addition of carboplatin to (neo)adjuvant chemotherapy (i.e., doxorubicin and cyclophosphamide followed by taxane) significantly ⬆️ event-free survival in patients with early TNBC
https://t.co/UGJo0sh930
In HER2-mutant NSCLC, this is a highly instructive case.
The target is not fixed; the tumor keeps evolving under treatment pressure.
When serial biopsies show how the phenotype has changed, treatment can sometimes be adapted accordingly, even within the same molecular axis.
Zongertinib → T-DXd → zongertinib rechallenge.
A single case report, but a sharp biology lesson.
The dynamic evolution of the ADC–TKI sequence 👇
https://t.co/8tOwyiYIPf
What did ASCO 2026 change?
Some standards of care have now moved by years.
That almost never happens.
BRAF colorectal, pancreatic KRAS, and DDLPS sarcoma
are three of oncology's hardest diseases
SOC moved by > 1yr:
▫️BRAF mCRC: 15.1 → 30.3 months OS
▪️Pancreatic KRAS: 6.7 → 13.2 months OS 🏆
▪️DDLPS sarcoma: 1.5 → 9.7 months PFS ⭐️
(sarcoma went from "nothing" to a win).
Myeloma, GIST, HR+/HER2- breast, uveal melanoma, bladder, prostate, and RET+ lung cancer moved too.
This is what decades of funded science look like when it compounds.
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Source: Jori (@jori_health)
𝘗𝘭𝘰𝘵 𝘱𝘦𝘦𝘳-𝘳𝘦𝘷𝘪𝘦𝘸𝘦𝘥 𝘣𝘺 𝘦𝘪𝘨𝘩𝘵 𝘰𝘯𝘤𝘰𝘭𝘰𝘨𝘺 𝘦𝘹𝘱𝘦𝘳𝘵𝘴. 𝘛𝘩𝘢𝘯𝘬 𝘺𝘰𝘶 <3
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Plenty of groups are racing to put AI pre-screening into trial workflows. Fewer are validating it this rigorously. Good to see it done in study format.
🎯 94.2% criterion-level agreement across 1,770 criteria
📈 Trial-level: 78.3% sensitivity, 98.5% specificity
🔍 40% of human-AI disagreements were overturned in favor of the AI on re-review
Why this matters: 💡 Pre-screening support, not autonomous enrollment, but adjustable thresholds could move accrual from passive referral to active outreach.
As more sites move toward AI pre-screen, is validation like this what earns your trust to deploy it? 🩺
Congrats to @JaiPatelPharmD@advocatehealth #ClinicalTrials #AIinMedicine #Oncology #AIinOncology
BREAKING: Ozempic / Wegovy linked to ~30% lower breast cancer risk in 111,000 women (new Penn Medicine study at ASCO 2026).
Even bigger: Women already diagnosed with breast cancer who took GLP-1s were 50% less likely to progress to Stage 4 (Cleveland Clinic data).
Prevention + slowed progression.
Here's what the studies actually show — and the caveats. 🧵
#GLP1 #Ozempic #Wegovy #BreastCancer #ASCO2026