Vinícius Lorandi

Ser humano. Médico. Oncologista. Gaúcho

[Erman Akkus @Erman_Akkus]

⭕️Cancer-associated VTE
NCCN guideline summary

#cancer #oncology #MedX #thrombosis #embolism @realbowtiedoc @crisbergerot

[Rami Manochakian MD, FASCO Cancer Education @RManochakian]

🔥🚨1/2 @OncoAlert Hot off the press.

⭐️My co-authors & I are excited & proud to share this, JUST PUBLISHED, #Manuscript in the 2026 #ASCOEdBook in conjunction with #EducationSession Presentation at #ASCO26 @ASCO@ASCO👇��

❇️“#Updates in #SmallCell #LungCancer-NO LONGER TOO SMAL to Ignore. A #Review of Recent #Therapeutic #Advances.”

👇🏻
https://t.co/5oSWHcTFlz

[Nieves Martinez Lago MD PhD @DraMartinezLago]

🚨 Review: MSI-H/dMMR mCRC

✔️ PD-1 ± CTLA-4: redefining 1L
📈 Dual ICI: ⬆️ efficacy, modest ⬆️ toxicity
⚠️ 10–30% primary resistance
⚠️ Optimal duration unknown
🧪 ctDNA may help treatment decisions

🎯 Next challenge: overcoming resistance and personalizing immunotherapy.

🔗 https://t.co/RlbAslqo3o
@OncoAlert

[Arndt Vogel @ArndtVogel]

Outcomes of Y90-radioembolization as downstaging to liver transplantation HCC and tumoral portal vein thrombosis
@HEP_Journal
https://t.co/RcHl1K7vxQ
👉25% sustained downstaging after TARE
👉15% eventually LTx with good outcome
🧐Downstaging is feasible in MVI pts
@myESMO @ILCAnews @EASLnews

[NEJM @NEJM]

Presented at #ASCO26:

Among patients with previously treated metastatic pancreatic ductal adenocarcinoma, the RAS(ON) inhibitor daraxonrasib led to significantly longer overall survival and progression-free survival than chemotherapy. Full phase 3 RASolute 302 trial results: https://t.co/xwLWBZYRzq

@ASCO

[Dr Rupam Manna MD @DrRupamOncology]

🧬 FAPI PET is redefining the future of cancer imaging.

Unlike FDG PET, which visualizes tumor glucose metabolism, FAPI PET maps the tumor microenvironment — especially cancer-associated fibroblasts (CAFs) and stromal activity.

Why this matters clinically 👇
✅ Better tumor-to-background contrast
✅ Superior detection of peritoneal disease
✅ Improved visualization of desmoplastic tumors
✅ Better assessment of low-FDG tumors
✅ Potential role in radiotherapy contouring
✅ Emerging theranostic applications (^177Lu-FAPI)

The shift in oncology imaging is happening:
➡️ From “tumor metabolism imaging”
➡️ To “tumor ecosystem imaging”

#FAPIPET #PETCT #NuclearMedicine #MedicalOncology #CancerImaging #Radiology #Oncology #PrecisionOncology #Theranostics #RadiationOncology #PancreaticCancer #GastricCancer #BreastCancer #HeadAndNeckCancer #CancerResearch #DrRupamManna #CancerConceptsExplained

[Dr Rupam Manna MD @DrRupamOncology]

🔬 MSI-High / dMMR Rectal Cancer After Neoadjuvant Immunotherapy with Complete Response: What Next?
In the rapidly evolving landscape of precision oncology, patients with localized MSI-High (MSI-H) or deficient mismatch repair (dMMR) rectal adenocarcinoma are benefiting from one of the most dramatic paradigm shifts in gastrointestinal cancer care.
Neoadjuvant immunotherapy — using agents such as dostarlimab, pembrolizumab, nivolumab ± ipilimumab — can produce extraordinarily deep and durable responses. Many patients achieve clinical complete response (cCR) or even pathologic complete response (pCR), raising a critical question:
“If the cancer is gone, do we still need surgery?”
The Key Principle
For MSI-H/dMMR rectal cancer, the goal is clear:
Avoid overtreatment while maintaining cure.
Immunotherapy-first strategies now allow selected patients to safely pursue organ preservation through non-operative “Watch-and-Wait” management when a sustained complete response is confirmed.
What the Infographic Breaks Down:
• Clinical scenario for neoadjuvant IO followed by cCR/pCR
• A. Non-operative management (“Watch-and-Wait”) – preferred when sustained cCR is achieved
→ No immediate surgery, no chemoradiation, no routine adjuvant chemotherapy
• B. Post-surgical true pCR (ypT0N0) → Observation + surveillance only
• Why this works
MSI-H tumors are highly immune-sensitive → exceptional pCR/cCR rates
Surgery carries real long-term risks: permanent colostomy, infertility, sexual dysfunction, bowel issues, neuropathy
• Evidence that changed the game
Dostarlimab MSKCC study (and supporting trials) → very high clinical complete response rates, many patients avoided surgery entirely, durable responses maintained on long-term follow-up
• Strict surveillance protocol (MRI pelvis, endoscopy, DRE, CEA, selective CT) — essential because cCR ≠ pCR (microscopic disease can still exist)
• 2025–2026 Practical Standards table: clear next steps for cCR without surgery, pCR after surgery, residual disease, or progression
• Unresolved questions still evolving: optimal IO duration, role of radiation omission, long-term regrowth risk, ctDNA, ideal patient selection
This approach represents one of the biggest modern advances in GI oncology: Immunotherapy-first organ preservation for MSI-H/dMMR localized rectal cancer — combining evidence, precision, and quality-of-life focus.
Designed as a quick, high-yield reference for oncologists, surgeons, radiation oncologists, fellows, residents, and anyone involved in rectal cancer care.
📌 Save • Share • Discuss
What are your experiences with IO-first strategies in MSI-H rectal cancer? Have you adopted Watch-and-Wait in your practice?
Follow for more visual, evidence-based explanations of complex oncology concepts.
Dr Rupam Manna, MD
Medical Oncologist
X: @DrRupamOncology
#RectalCancer #MSIHigh #dMMR #Immunotherapy #OrganPreservation #WatchAndWait #PrecisionOncology #CancerResearch #GIOncology #pCR #NeoadjuvantTherapy

[Mario Balsa @MarioBalsaMD]

🫁 Metastatic trajectories in NSCLC: redefining local + systemic therapy through disease evolution! @JCO_ASCO
https://t.co/XcpEhaGHML

▪️ Genomics + ctDNA + radiomics + functional imaging
▪️ Defines progression by pace, pattern, organotropism & resistance mechanisms
▪️ Adaptive strategies: escalate, switch, consolidate or locally ablate
▪️ Could reshape biomarker-driven platform trials in mNSCLC

Not all metastases follow the same road…some take very different “trajectories” 🚦

@OncoAlert @OncoReporte
@myESMO @_SEOM @LungCancerRx @Lung_Cancers @gecp_org

[Dr. Foxpaws Fauxpas @foxpaws_onco]

In Lt sided/KRASwt mCRC

1L EGFR mabs = SOC, but 4-5x 💵
1L Bev equivalent PFS, but ❌OS, ORR - Why?

🚨2L EGFR ORR 10%

•VEGF/R ⬆️
•Tumor prolif pathways diversify away from EGFR -> PI3K/MAPK/ERK
•HIF/EMT⬆️ in resistant subclones

Hit hard, hit first!

#cancer #crcsm

[Dr Rishabh Jain @DrRishabhOnco]

“HFS hurts.
HFSR frustrates.

One is collateral damage from chemotherapy.
The other is a pharmacodynamic footprint of VEGF inhibition.

But in clinic?

Both can decide whether treatment continues… or stops.

🔴 HFS (Hand-Foot Syndrome)
→ diffuse redness, swelling, burning
→ classically with capecitabine, 5-FU, liposomal doxorubicin

🔵 HFSR (Hand-Foot Skin Reaction)
→ painful hyperkeratotic lesions at pressure/friction points
→ classically with TKIs like regorafenib, sorafenib, cabozantinib

Same hands.
Very different biology.

And sometimes the toxicity tells you more about the drug than the scan does.

What’s the WORST HFS/HFSR case you’ve seen in practice? 👇

#OncoTwitter #MedTwitter #Oncology
@OncoAlert @myesmo @ESMO_Open

[Dr RP Singh, MD @rpsingh1894]

🩺 LFTs are more than just numbers — they reveal the story of liver injury, bile obstruction, and liver function.

Learn the easy approach:
🟡 Bilirubin → Jaundice type
🔴 AST/ALT → Liver cell injury
🟢 ALP/GGT → Cholestasis or obstruction
🔵 Albumin & INR → Liver synthetic function

Recognizing patterns early can help diagnose:
✔️ Viral hepatitis
✔️ Alcoholic liver disease
✔️ Fatty liver
✔️ Obstructive jaundice
✔️ Cirrhosis & liver failure

Interpret LFTs systematically — not randomly. 📋🧠

#LFT #LiverFunctionTest #Hepatology #Medicine #MedTwitter #FOAMed #MedicalEducation #Doctors #MedicalStudent #LiverDisease #ClinicalMedicine #Healthcare #MBBS #InternalMedicine

[Thor Halfdanarson @OncoThor]

This is an absolutely outstanding review on the management of patients with metastatic gastric cancer.

I may have posted about this review before but it is so good that it deserves another round of applause... Thanks @KlempnerSam @YJanjigianMD @amalsargsyan and all the other co-authors I could not find on X...

Sorry AI, I love you but you are just not there yet. True content experts writing a practical review still beat you easily.

This should be a required read for all who take care of patients with gastric cancer.

https://t.co/5eCIbBwK7G

[GBOT Alerta @GBOT_Alerta]

Porto Alegre será palco de mais uma importante edição do encontro que conecta especialistas, atualização científica e discussões multidisciplinares em oncologia torácica. 🫁

O VI Simpósio GBOT Sul já tem data marcada e reunirá grandes nomes da área para dois dias de troca de conhecimento, debate clínico e aprofundamento nos principais avanços da especialidade.

📍 Hilton Porto Alegre Hotel
📅 31 de julho e 01 de agosto de 2026

A programação contará com uma comissão científica formada por referências da oncologia torácica da região Sul, fortalecendo ainda mais a qualidade científica do evento.

As inscrições já estão abertas. Para mais informações e inscrições, entre em contato pelo e-mail [email protected] ou pelo WhatsApp [phone]

#gbot #oncologiatoracica #cancerdepulmao #educacaomedica #eventomedico

[Oscar Tahuahua @OscarTahuahua]

🚨 Up to 40% of rectal cancer patients may not need surgery.

In dMMR disease (with proper testing)
Immunotherapy → ~90-100% CR

In MSS
TNT: ~1 in 3 achieve cCR

With watch-and-wait:
~85% keep their rectum
>95% remain metastasis-free
Local regrowth ~15%, mostly detected early and successfully salvaged

It’s smarter upfront intensification then personalized decisions.

But this isn’t a simple algorithm.
It requires clinical judgment, proper testing, careful selection and intensive surveillance.

What once seemed unthinkable is now part of evolving clinical practice; the state of the art care
https://t.co/qM4gjtik8v

[Diego A. Díaz-García @diegoadiazg]

🫁 CHIO3: Chemo + Durvalumab in N2 NSCLC.

N2 clearance: 73.3%
pCR: 30%
R0: 93.3%
18-mo EFS: 60.6%
Feasible, low toxicity, strong nodal downstaging in N2+ disease.

📖 Lung Cancer
DOI 👉🏻 https://t.co/luJlQwU0br

#CánCare #NSCLC #Immunotherapy #lcsm

[ESMO Open @ESMO_Open]

Clinical outcomes of trifluridine/tipiracil plus bevacizumab versus trifluridine/tipiracil or regorafenib in metastatic colorectal cancer: a multicenter cohort study in @ESMO_Open.Improved PFS & DCR with FTD-TPI Bev, including KRAS p.G12C mCRC. https://t.co/HDrVKI40R1

[Grupo GETNE @GrupoGetne]

🧪 FOLFIRINOX in digestive NEC

📊 Retrospective (n=50), later lines (82%)
🔹 ORR 44% | DCR 72%
🔹 mPFS 5.6 mo
💥 Notable activity in: CRC NEC (52%), Ki67 <55% (50%), post PE (39%)

👉 Supports FOLFIRINOX as a potential option beyond 1L in aggressive NEC
🔗 https://t.co/Qj7JLAQ2Ae

[Daisuke Kotani, MD, Ph.D 小谷 大輔 @DaisukeKotani]

Japanese subgroup from RATIONALE-306:
1L tislelizumab + chemo showed consistent efficacy &amp; safety in Japanese patients with ESCC, aligning with global population with ≥3Y follow-up
🔗https://t.co/HTKCtFhNzH
@OncoAlert

[Stephen V Liu, MD @StephenVLiu]

Consensus definition on resectability of stage III NSCLC from @EORTC published @LancetRespirMed. Current consensus is that N3 or bulky N2 is unresectable but multi-station N2 remains potentially resectable. Does not lend itself perfectly to a flowchart given heterogeneity:

[Hagen Kennecke @HKennecke]

Here's the latest on repeat NGS testing for patients with #colorectalcancer. Well done by @OHSU Fellow Dr Nick Kendsersky!
The Evolving Role for Repeat Molecular Testing in Metastatic Colorectal Cancer https://t.co/zVtbrOYfjC #mdpicancers via @Cancers_MDPI