Marshall Strother

urologic oncologist @OHSUurology he/him

[Marshall Strother @mcstroth]

I hereby submit my twitter petition for all journal article pdfs to automatically include the supplementary materials at the end. Extra clicks + pain of organizing extra PDFs >>> a few extra wasted KB of hard drive space @JUrology

[Adam B. Weiner, MD @Adam_Weiner535]

🚨 PROTEUS substudy (@EUplatinum): perioperative apalutamide + ADT improves event-free survival vs radical prostatectomy alone in high-risk/locally advanced #prostatecancer, 🧵 1/3 🚨

👥 408 pts, high-risk localized or locally advanced PCa, fit for surgery
📊 Open-label phase 3 substudy, randomized 1:3
💊 Perioperative (neoadj + adj) apalutamide + ADT (n=102) vs RP alone (n=306)
⏱️ Median f/u 37.4 mo
⭐️Event = BCR or imaging-based recurrence

✅ 3-yr EFS 63% vs 41%, HR 0.38 (0.26-0.55), p<0.001
✅ MFS by conventional or PSMA PET 87% vs 78%, HR 0.49 (0.26-0.90)
✅ But MFS by conventional imaging alone: similar, 94% vs 92% (p=0.5)

⚠️Caution in interpretation - See thread 👇

🔗 https://t.co/NZHC29O9v5

@PCFnews @PCF_Science @urotoday @UrologyTimes @TylerSbrt @renalandurology @Uroweb @JackAndrewsMD

[Kenrick Ng @Kenrickng1]

🧵 #ESMO26 prostate cancer highlights- my personal summary @urotoday:
1️⃣ Very high-risk localised: DASL-HiCaP &amp; the ARPI class question
2️⃣ mHSPC: PEACE-1, CAPItello-281 OS + PSA &gt;0.2: intensify or de-intensify? 
3️⃣ mCRPC: PROMPT, ctDNA vs tissue
4️⃣ NE PCa: KEYNOTE-365 1/5

[David H Aggen, MD PhD @Dr_Aggen]

With VOLGA results coming at #ESMO26, a summary of contemporary phase III perioperative trials in muscle-invasive bladder cancer.

⚠️ Different populations and designs—avoid cross-trial comparisons. VOLGA and EV-303 importantly include surgery-alone control arms without neoadjuvant therapy.

🔑 The next challenge: identifying who truly needs adjuvant ADC therapy—and who can safely avoid it.

#BladderCancer #GUOnc @OncoAlert @BladderCancerUS

[Tom Powles @tompowles1]

Darolutamide with ADT and locoregional
radiation therapy (RT) in high-risk prostate cancer (DASL) showed Darolutamide reduced the risk of relapse and time to CRPC. Tolerably was good. It’s imporant to identity which patients benefit, as mortality is low, and whether latest staging with PSMA-PET changes things #ESMO26 @Silke_Gillessen @ChrisSweens1

[Adam B. Weiner, MD @Adam_Weiner535]

🚨 VOLGA: chemo-free durvalumab + enfortumab vedotin beat surgery alone in muscle-invasive #bladdercancer 🚨

@NEJM today

🧵1/2

👥 n=695, cisplatin-ineligible or declined MIBC
📊 Phase 3 RCT, 1:1:1
💊 Perioperative durva + EV vs durva + tremelimumab + EV vs radical cystectomy alone
⏱️ Estimates at 24 mo

✅ Durva + EV EFS 63.5% vs 45.1%, HR 0.51 (0.38-0.67), p<0.001
✅ OS 78.4% vs 69.4%, HR 0.58 (0.40-0.83), p=0.003
✅ Durva + treme + EV EFS HR 0.61 (0.47-0.80), but grade ≥3 AEs 79.5% vs 71.1%

⚠️ The 2 durvalumab arms were not compared head-to-head, so the CTLA-4 add is not clearly worth the added toxicity

🎯 Another cisplatin-free ADC + IO backbone for cisplatin-ineligible MIBC

[Yu Guang Tan @YuGuangTan1]

First prospective multicentre cohort study on Gem doce for strictly BCG unresponsive NMIBC. 3m and 12mHGRFS at 89% and 68%. QOL measured comprehensively. Thank you to all authors. https://t.co/oQjfRKcvwG
@UroDocAsh @michaelabern @alirezaghoreifi @EurUrolFocus @IBCG_BladderCA

[Marshall Strother @mcstroth]

Love to see this. We need more discussion of men who are unlikely to benefit from salvage XRT. Such discussion is basically absent from AUA guidelines.

[Piet Ost @piet_ost]

Following RALP for pT2 R0, Gleason 4+4, iPSA of 25, PSMA N0M0, primary tumor PSMA avid: first PSA =4, 3mo later it is 10ng/ml. New PSMA PET is negative. Man is 73yo and fit.

What should we do?

[Marshall Strother @mcstroth]

@JorgeMena @CanesDavid Forever grateful to @ajskokan for correcting me on this one when I was a chief resident. I didn't believe him at first

[Marshall Strother @mcstroth]

@uretericbud Love it! Is just going to the front page a similar experience to signing up for the daily email? Id definitely put a link on my phones home screen but I'll never read an email newsletter.

[Journal of Urology @JUrology]

🚽 Is Gem/Doce the Future for Bladder Cancer Treatment?
Gem/Doce shows promise as a first-line treatment for BCG-naïve high-risk NMIBC, offering new hope during BCG shortages.

📈 Efficacy - 3-year high-grade recurrence-free survival is 80%
🔬 Tolerability - Only 8% stopped due to adverse reactions
📊 Future Potential - Phase 3 trials needed for standard care status

#BladderCancer #GemDoce #ClinicalTrials

https://t.co/W622xZfb0c

[Firas Abdollah @DrFAbdollah]

In a 10-yr follow-up of a randomized trial, Retzius-sparing RARP (better early continence) showed worse long-term cancer control than the anterior approach — 2.64x higher progression risk after adjustment. Post-hoc, hypothesis-generating. free link:https://t.co/WhcUr6NCkK

[Adam B. Weiner, MD @Adam_Weiner535]

🚨 MRI-first screening w/o contrast finds more ≥GG2 #ProstateCancer 🚨

@EurUrol

👥 759 pts randomized

📊 Biparametric MRI first vs MRI only if PSA ≥3
⏱️ 15 min scan, no contrast

✅ csPCa detected: 4.6% vs 1.8% (RR 2.6, 95% CI 1.1-6.1)
✅ Several csPCa found in pts w/ normal PSA

⚠️ More biopsies in MRI-first arm (10.8% vs 5.2%)

🎯 A FAST⚡️ contrast-free MRI up front catches significant PCa a PSA screen might miss

@PCF_Science @PCFnews @urotoday @UrologyTimes @UroOnc

🔗https://t.co/E8rXTQL1nW

[Sia Daneshmand, M.D. @siadaneshmand]

New in @JAMANetworkOpen: @SWOG S1600, a multicenter phase 3 RCT, found no reduction in 30- or 90-day complications w/ specialized immunonutrition vs standard nutrition after cystectomy. Exploratory DFS/OS favored immunonutrition. #BladderCancer
@JhamiltonReeves @DrJoeUnger @JMHolzbeierlein @FoxChaseCancer @BCM_Urology @JanetKukreja @eugenekanglee @URMCUrology @DrDawnHershman @fischmd @lynnhenrymd https://t.co/671sdA0D1y

[Tom Powles @tompowles1]

Enfortumab Vedotin & pembrolizumab beating platinum based neoadjuvant chemo (⬆️CR, ⬆️ EFS & ⬆️ OS) in muscle invasive bladder cancer @NEJM @mattgalsky @Uro_Oncologist . Every EV RIII study to date has ⬆️ OS vs SOC. Matt Galsky discontinues the Galsky criteria in MIBC, giving ⬆️ patients ⬆️ outcomes @OncoAlert https://t.co/sgPvwgT9BV

[Adam B. Weiner, MD @Adam_Weiner535]

🚨 JCOG1403: One dose. Within 24 hours. Meaningful benefit in RCT

@TheLancetOncol

👉 After nephroureterectomy for UTUC, a single intravesical chemo/pirarubicin instillation

⭐️Improved 3-year relapse-free survival:

💉 60% vs 47%
📉 HR 0.67
🎯 NNT = 12 to prevent one bladder recurrence
⚠️ Grade 3 hematuria: 3%
➖ No overall survival benefit

@SUO_YUO @UroOnc @renalandurology @urotoday @UrologyTimes

🔗https://t.co/g243nh6alh

[Marshall Strother @mcstroth]

@costplusdrugs the search feature "Browse medications" tab on your front page have been broken for weeks. no matter what you type or click it shows "no medications found". not inspiring confidence in my patients

[Toni Choueiri, MD @DrChoueiri]

🚨 Results from #LITESPARK022 (#LS022) are out in @NEJM!

1/This phase III trial evaluated whether adding the HIF-2α inhibitor Belzutifan (BEL) to adjuvant pembrolizumab (PEMBRO) could improve outcomes for patients with resected clear-cell RCC at increased risk for recurrence.

https://t.co/1BLAercj3p
@oncoalert @asco @myESMO

[Sia Daneshmand, M.D. @siadaneshmand]

Congratulations Domenique Escobar for completing the #SUO fellowship. We are so proud of you. Congratulations for your appointment as Assistant Professor at @OHSUurology especially meaningful for me that is where I started my academic career. @USC_Urology @UroOnc Welcome Anas Tresh from @StanfordUrology and welcome to your clinical year @MichaelBasinMD @domesypantsx3 @AnneSchuckmanMD Amir Lebastchi.

[UCSFUrology @UCSFUrology]

We are thrilled to announce our 2027AY Onc fellow - Wes Chou from OHSU - Welcome to the UCSF Urology family!

[Marshall Strother @mcstroth]

When looking at an axial CT series, when I push the mouse wheel away from me, I want to see slices that are...