Ji Hyun Kim

National Cancer Center Korea clinical assistant professor (2024.3~), fellow (2021.3~2024.2), tweets are on my own

[Ji Hyun Kim @writ__e]

Ifosfamide shortage alert.. 😡

[Dee Sparacio @womenofteal]

SHARE offers a new LGSOC Resource guide https://t.co/yO5yqfFJVr full of helpful information Check it out!
#gyncsm

[Ji Hyun Kim @writ__e]

#ASCO2026 Short-Term Fasting (STF) vs Free Diet in Advanced OC (Marchetti et al.)
🎯 Objective: Insulin reduction after 3 NACT cycles
🔬Method: Pilot RCT, N=36 HGSOC on carbo/paclitaxel NACT; STF (36h pre → 24h post each cycle) vs free diet
📊 Results: Insulin Δ: −1.12 vs +9.76 µIU/mL, p=0.01
CRS 3 at ICS: 58.8% vs 17.6%, p=0.03
mPFS: 38 vs 24 mo, p=0.045

[Dr Amol Akhade @SuyogCancer]

Short-term fasting during neoadjuvant chemotherapy for advanced ovarian cancer is one of the more intriguing non-drug interventions presented at #ASCO2026.

The study met its primary endpoint: fasting prevented the chemotherapy-associated rise in insulin levels and demonstrated a favorable metabolic shift.

The headline result was a PFS signal:
• mPFS 38 months with fasting vs 24 months with free diet •
HR 0.26 • Log-rank p=0.045

Before we get too excited, several important limitations deserve attention:

🔹 Only ~18 patients per arm after exclusions
🔹 Trial was powered for insulin changes, not PFS
🔹 Open-label design
🔹 Borderline statistics (95% CI 0.06–1.00; Cox p=0.056)
🔹 Multiple secondary and exploratory analyses increase the risk of false-positive findings
🔹 BRCA-mutated patients were more common in the fasting arm (50% vs 33%), which could influence outcomes
🔹 Median follow-up was only 16 months despite reporting a large difference in mPFS
🔹 Immune findings were hypothesis-generating with p-values around 0.06–0.07
🔹 Analysis appears vulnerable to selection bias from withdrawals and compliance-related exclusions

The most convincing finding is that short-term fasting is feasible and biologically active, affecting insulin and metabolic pathways.

The least convincing finding is a 14-month absolute PFS improvement from a dietary intervention in a 36-patient study.
Interesting study.
But extraordinary efficacy claims require validation in a larger multicenter randomized trial before fasting enters routine ovarian cancer practice.
@OncoAlert
@ASCO #asco26

[Ji Hyun Kim @writ__e]

That’s quite emotional. It’s making me think of my mentor professor who’s currently undergoing treatment for stage IV KRAS G12 mutant PDAC.

[Dr Rishabh Jain @DrRishabhOnco]

#ASCO26
📖 Concomitant publication in NEJM.

Pancreatic cancer may have just entered the RAS era. 🧬🔥

In the phase III RASolute 302 trial, daraxonrasib nearly doubled survival vs chemotherapy in previously treated metastatic PDAC. 🚨

👥 Study population:
500 patients with previously treated metastatic PDAC
91.8% had RAS G12 mutations

⚡ Daraxonrasib vs investigator’s choice chemotherapy

📈 Median OS: 13.2 vs 6.7 months
🎯 HR 0.40 (60% reduction in risk of death)
📉 Median PFS: 7.2 vs 3.6 months
🧪 ORR: 31.6% vs 11.2%

What stands out is not just the efficacy. It’s the magnitude.

An oral RAS(ON) inhibitor delivering median OS >13 months in second-line pancreatic cancer would have sounded impossible a few years ago. 👀

💬 QoL also improved:
🩹 Longer time to pain deterioration
❤️ Better global health status

🩺 Safety:
Mostly dermatologic/GI toxicities.
Grade ≥3 TRAEs were LOWER than chemotherapy (43.6% vs 57.5%).
Treatment discontinuation due to TRAEs: 1.2% vs 11.2%. ✅

Pancreatic cancer has long been the graveyard of targeted therapy.

This may finally be a turning point. 🌊

@NEJM @OncoAlert @myesmo @asco @esmo_open @AACR #OncoTwitter #MedTwitter #PancreaticCancer #RAS

[Ji Hyun Kim @writ__e]

The question isn’t PCS vs NACT, but who benefits from which TRUST gives us signals to sharpen that selection.
1. if redesigning the trial, exclud pts with pleural effusion/carcinomatosis from the PCS arm?
2. In truly resectable disease, PCS still shows a meaningful PFS advantage

[Ji Hyun Kim @writ__e]

GyneOnc Debate: NACT vs PCS #ASCO2026
💁🏻Exploratory analysis (TRUST) by pleural effusion/carcinomatosis:
Without (n=587): PCS wins — PFS HR 0.76, p=0.0075 ✅
With (n=101): NACT wins — PFS HR 1.43

[Ji Hyun Kim @writ__e]

#asco2026 #asco

[Ji Hyun Kim @writ__e]

MIROVA / AGO-OVAR 2.34
🎯 Objective: PFS
🔬 Method: Phase II RCT, N=145, FRα-high (PS2+)
📊 Results:
•mPFS 9.53 vs 9.79 mo, HR 1.00 ❌
•ORR 66% vs 33%
•↑ neuropathy, ocular tox 81%

[Ji Hyun Kim @writ__e]

💭 My take
67% had PFI >12mo, control mPFS 9.8mo (vs 7mo assumed).
ORR doubled but curves converged by 12mo → depth ≠ duration vs platinum + PARPi.
•PFI 6–12mo: HR 0.68 ✅
•PFI >12mo: HR 1.11 ❌
Hard to beat platinum in truly sensitive disease?

[Dee Sparacio @womenofteal]

#ASCO26 Gyn Oral Abstracts #gyncsm CHRONO: A randomized ph II trial of the chronology of surgery after neoadjuvant chemotherapy for ovarian cancer. ( 3 cycles of chemo then surgery vs 6 cycles chemo then surgery.) 10% each arm HIPEC. QOL no significant difference

[Ji Hyun Kim @writ__e]

핵심 질문은 메커니즘(열 vs 복강 내 경로 vs 추가 용량)이고, 이건 대조군을 다시 짜는 것보다 약동학·상관 연구로 답하는 게 좋지 않을까. HIPEC 시험 하시는 분들 생각이 궁금합니다.

[Ji Hyun Kim @writ__e]

코멘터리 공유 감사합니다 BatistaTP

Add-on 설계에서 “추가 노출”은 교란변수가 아니라 측정하려는 개입 그 자체지 않을까요.

진행성 난소암에서 6주기를 넘겨 백금을 연장해도 OS는 일관되게 개선되지 않았어요. 그러니 OVHIPEC의 생존 이득을 단일 추가 용량으로 돌리기는 어렵지 않을까.

[Thales P. Batista, MD, PhD @BatistaTP]

So, a new argument against #HIPEC… By that logic, should chemotherapy also be avoided when #Bev or #PARPi is planned?🤨 @PSOGI_EC @zivanovicmd @IJGConline @IJGCfellows @ESGO_society @ESSOnews

https://t.co/D6Agb9ISaj

[JCO Precision Oncology @JCOPO_ASCO]

BRCA1 Methylation in Circulating Free DNA: A Constitutional Matter?

Read the full article. https://t.co/e1IruaLgsd

[The Lancet @TheLancet]

Experts reach consensus to rename polycystic ovary syndrome (PCOS), better reflecting the condition’s full health impacts.

Find out more 👉 https://t.co/Azue7YDFcn @ESEndocrinology #ECE2026

[Nature Reviews Drug Discovery @NatRevDrugDisc]

The ovarian cancer drug market
https://t.co/Fj7xf8ekXY

This new article analyses the pipeline of drugs in development for ovarian cancer, such as antibody-drug conjugates, and their expected impact on the market

[Hidehito HORINOUCHI @HHorinouchi]

🔥Two decades of PARP inhibitor synthetic lethality in cancer
🆙 @Nature
🎯BRCA–PARPi synthetic lethality: from basic discovery to approved therapies for breast, ovarian, prostate & pancreatic cancer
🎙 @IcrLordLab @Ashworth_SF
@OncoAlert @Larvol
https://t.co/4EHfGJYGcf

[Philippe Aftimos, MD  @aftimosp]

Effects of ovarian ablation or suppression on breast cancer recurrence and survival: patient-level meta-analysis of 15 000 women in 23 randomised trials - The Lancet https://t.co/9nWVFxGIVT

[Ji Hyun Kim @writ__e]

주말에 다 읽었다! 좋은 글 공유 감사드립니다

[Bishal Gyawali, MD, PhD, FASCO @oncology_bg]

A MUST-READ!

This is probably one of my most important papers where I try to teach how to fish rather than offer fish.

How I Read a Clinical Trial Report?

BG’s primer for Busy Clinicians.

Thank you @JCOOP_ASCO @EthicsdoctorP for the kind invitation. I hope the readers will find this useful.

https://t.co/HJhZlsBpU2

[Khairallah AL-Awady @eng_khairallah1]

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