Mariana Lopez L.

Oncóloga médica, TX tumores gastrointestinales y melanoma. Christus Muguerza Altagracia **En esta cuenta no se apoyan remedios caseros**

[Toni Choueiri, MD @DrChoueiri]

"Armed with generative AI, a B student can produce A work while turning into a C student." -- Nicholas Carr @roughtype (https://t.co/Zx7ABm03m3)

[Mukund Iyengar @mukundiyngr]

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.

- - - - -
Source: Jori (@jori_health)
𝘗𝘭𝘰𝘵 𝘱𝘦𝘦𝘳-𝘳𝘦𝘷𝘪𝘦𝘸𝘦𝘥 𝘣𝘺 𝘦𝘪𝘨𝘩𝘵 𝘰𝘯𝘤𝘰𝘭𝘰𝘨𝘺 𝘦𝘹𝘱𝘦𝘳𝘵𝘴. 𝘛𝘩𝘢𝘯𝘬 𝘺𝘰𝘶 <3
- - - - -

[Allison Chang @aebchang]

You don’t have to be a GI oncologist to appreciate this moment. #ASCO2026

[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

[Carolina 🐾 @carolhsolis]

Ese ajolote morado y rosa con el que tapizó la CDMX es una mercancía visual alejada del ajolote real que sobrevive apenas entre agua contaminada y desinterés institucional.
Porque la 4T descubrió que convertir las causas en estética cuesta menos que resolverlas.

[Jose Ramos Vivas @joseramosvivas]

Especial médicos🩺⚕️🏥👨🏻‍⚕️👩🏻‍⚕️.
Os dejo esta carta en JAMA. Se la pondré a mis alumnos en la próxima clase:
He elegido estas frases :
👇🏻⏰
«La medicina puede tener un significado extraordinario. Pero no puede sustituir el estar presente en tu propia vida. El mundo puede necesitarnos como médicos. Pero las personas que nos aman nos necesitan como nosotros mismos. Y ese es el rol que nadie más puede llenar.»

«La residencia refuerza la lección de que las instituciones están diseñadas para perdurar más allá de los individuos. En cambio, las familias no.»

«Creo en formar a la próxima generación. Creo en el significado de este trabajo. Lo que ha cambiado es mi disposición a absorber el desgaste sin cuestionarlo.»

«Ya no estoy dispuesta a seguir posponiendo la vida. La medicina exige mucho. Y nosotros damos profundamente. Pero no puede tomarlo todo.»

«El significado de mi trabajo es profundo. El significado de mi presencia en casa es irremplazable.»

[Dr Rishabh Jain @DrRishabhOnco]

Claudins - The Next Big Solid Tumor Target?

A major 2026 review in Nature Reviews Cancer dissects why CLDN proteins are rapidly emerging as precision oncology targets

Here’s what every oncologist should know:

🧬 What are Claudins?
Tight junction transmembrane proteins maintaining epithelial polarity. Frequently dysregulated and overexpressed across solid tumors.

🔥 Why they matter in cancer
•Promote proliferation
•Drive EMT & stemness
•Modulate fibrosis
•Shape immune microenvironment
•Contribute to therapeutic resistance

🎯 Therapeutic breakthrough
CLDN18.2 targeting has achieved regulatory approval - validating claudins as druggable surface antigens

🚀 Therapeutic platforms in development
•Monoclonal antibodies
•ADCs
•Bispecific antibodies
•CAR-T cells
•Intracellular pathway targeting

🧠 Precision angle
Surface overexpression + subtype correlation + biomarker-enriched selection = scalable solid tumor strategy.

Claudins may follow the HER2 playbook.

From barrier proteins to immunotherapy targets.

📖 Full review: Nature Reviews Cancer 2026

#OncoTwitter #MedTwitter #PrecisionOncology #Immunotherapy #TargetedTherapy #GastricCancer #GIOncology #SolidTumors #ADC #CART

@NatureRevCancer @ASCO @myESMO @OncoAlert @ESMO_Open

[Nieves Martinez Lago MD PhD @DraMartinezLago]

🧬 CLDN18.2 in GEA

🔹 CLDN18.2-high in 48% GEA (↑ vs pivotal trials)
🔹 Major overlap w/ HER2, PD-L1, dMMR & EBV
🎯 ↑ outcomes w/ HER2-targeted Rx in HER2+/CLDN18.2-high
⚠️ Trend toward worse outcomes w/ IO-based Rx in CLDN18.2-high
➡️ Strong case for biomarker-guided Rx in GEA

🔗 https://t.co/mjJUCWZdje
@OncoAlert @EduardoTB94

[Mariana Lopez L. @lopezlemusmd]

See you next year #SFO

[Nieves Martinez Lago MD PhD @DraMartinezLago]

🟣 Gastric cancer in 2025 — essentials
🌍 ~1M new cases/year; high mortality
🦠 H. pylori remains a key, treatable risk factor
🎯 Localized: surgery ± perioperative chemo-IO
🧬 Metastatic: chemo + IO/targeted therapy
🤝 Early supportive care matters

🔗 https://t.co/IiSgIlIKvD

[Nieves Martinez Lago MD PhD @DraMartinezLago]

🧬🔬 Claudin 18.2 in cancer care — pathologist’s view
📘 Systematic review: biology, IHC assays, scoring & pre-analytics
🎯 Actionable/companion biomarker for T-T
⚠️ Membrane scoring, fixation & clone choice are critical
➡️ Standardisation is key for reliable patient seleccionó
🔗 https://t.co/Y0vQIzxULb
@OncoAlert

[Arndt Vogel @ArndtVogel]

🔥off the press🔥
Cholangiocarcinoma 2026: status quo, unmet needs and priorities
@NatRevGastroHep
https://t.co/bG6kCL3DSU
👉get the lastest, most comprehensive summary on cholangiocarcinoma
👏fantastic team effort!
@myESMO @EASLedu @ILCAnews

[Dr. Nina Niu Sanford @NiuSanford]

2 things stood out to me re: CRC in this AYA study.

1. CRC has HIGHEST lifetime metastatic burden of all cancers (~44%!)

2. AYA CRC w more late recurrences, steadily rising to yr 5.

&gt;&gt;implications re surveillance, survivorship, &amp; potential role of metastasis directed therapy.

[Yakup Ergün @dr_yakupergun]

Current landscape in oncology: ADCs are reshaping practice
#ESMO25

[Arndt Vogel @ArndtVogel]

PERISCOPE II trial: Systemic therapy, gastrectomy and CRS/HIPEC vs systemic therapy alone for gastric cancer with limited peritoneal dissemination
#ESMO25 #ESMOAmbassadors
👉 mOS: 16.6 vs 15.6 mo
🧐no benefit for CRS/HIPEC for pts with limited peritoneal metastasis, significant toxicity
@myesmo

[Nieves Martinez Lago MD PhD @DraMartinezLago]

Editorial on ESOPEC 🇩🇪:
📊 FLOT vs CROSS in resectable esophageal/GEJ ADC
🧬 FLOT → ↑OS (66 vs 37 mo) & 3y RFS (54.5% vs 39%)
⚕️ Similar locoregional control, ↓ distant relapse (31.5% vs 47.2%)
🧫 Calls for biomarkers & periop ICI (e.g. D-FLOT) to refine curative strategies
🔗 https://t.co/4uxk9shyUV

[Jash Datta, MD @DrJashDatta]

The RAS dam has broken! Current trials with KRAS inhibitors in progress from @DavidHongMD @MDAndersonNews #AACRpan25

[Sharlene Gill, MD, MPH, MBA, FASCO @GillSharlene]

Less than 4 weeks to #ESMO25 @myESMO
LBA titles dropped today...
🚨 #GI abstracts #GIUpper #GILower #NETs
My list below - notable mentions:
🌟FORTITUDE 101 - ph3 BEMA in FGFR2b+ G/GEJ
🌟DYNAMIC-III #ctDNA-guided adjuvant de-escalation in stage 3 CC @JeanneTie @GICancer @CDNCancerTrials
✴️STELLAR303 ph3 zanza/atezo in refractory mCRC @anwarsaeed3
✴️INTEGRATE IIb - ph3 rego/nivo in refractory G/GEJ
See you in #Berlin 👋
@OncoAlert

[Mariana Lopez L. @lopezlemusmd]

👀

[Dr Amol Akhade @SuyogCancer]

🚨 #ESMO25 | Lung Cancer Updates 🚨
Top 10 new molecules shaping the future of #NSCLC & #SCLC 👇
�� EGFR × HER3 bispecifics
🧬 DLL3 & T-cell engagers
🧬 Next-gen KRAS & EGFR TKIs
🧬 ADCs with intracranial activity
🧬 Novel IO combos (TLR7/8, KEYMAKER)
#OncoTwitter #ESMO2025 @@OncoAlertncoAlert @medicalwatchBC
@OncBrothers

[Arndt Vogel @ArndtVogel]

Nivolumab plus ipilimumab for potentially resectable hepatocellular carcinoma: longterm efficacy and biomarker exploration
@JHepatology
👉Neoadj. Nivo/Ipi is feasible
👉ICI-induced TLS formation associated with enhanced antitumor immunity &amp; OS
@myESMO @easledu @ILCAnews