🚨 NEW CSCO–ASCO Guidelines for Recurrent/Metastatic Nasopharyngeal Cancer!
Key takeaways from JCO (2026):
🔹 1L: Gemcitabine/cisplatin + PD-1 inhibitor → PD-1 maintenance up to 2 years
🔹 Chemo-only responders: Capecitabine/S-1 maintenance
🔹 Selected de novo metastatic NPC: Consolidation IMRT
🔹 After ≥2 lines including platinum + PD-1: Izalontamab brengitecan ADC, where available
💡 Important: PD-L1 testing is NOT required before first-line PD-1 therapy. Evidence is insufficient to add oral chemotherapy to PD-1 maintenance.
A practical roadmap for a rapidly evolving disease!
@oncoalert
Full paper link in comment below ⬇️
Cancer drug resistance as a temporal process: cell plasticity, adaptive buffering, signaling pathways and therapeutic interception
https://t.co/6mn4UKkjGm
Analytical and clinical comparison of three PD-L1 antibody clones using Tumor Area Positivity (TAP) and Combined Positive Score (CPS) scoring in advanced gastric cancer
https://t.co/vJAuL4EVkv
🚨 ASCO 2026: PARP inhibitors in ovarian cancer. What has changed?
The new ASCO Living Guideline, published in @JCO_ASCO, reviewed 31 pivotal trials and 13 HRD assays.
1️⃣ First-line maintenance: The preferred window for PARPi
🔹 SOLO-1: Olaparib established durable benefit in BRCA-mutated disease.
🔹 PRIMA / PRIME: Niraparib improved PFS, with the greatest benefit in HRD-positive disease.
🔹 ATHENA-MONO: Rucaparib demonstrated PFS benefit, particularly in HRD-positive tumors.
🔹 PAOLA-1: Olaparib + bevacizumab benefits patients with HRD-positive disease following platinum + bevacizumab.
2️⃣ Biomarker selection is critical
✅ BRCA-mutated or HRD-positive: Offer first-line PARPi maintenance after platinum response.
❌ BRCA-wild-type / HRD-negative: Not routinely recommended, despite modest PFS signals in PRIMA and ATHENA-MONO.
3️⃣ Recurrent ovarian cancer: A major restriction
🔹 SOLO-2 / NOVA / ARIEL3: PFS benefits established, but mature OS findings raised concerns in some subgroups.
➡️ Recurrent maintenance is now primarily reserved for PARPi-naïve, BRCA-mutated patients responding to platinum.
4️�� PARPi as treatment, not maintenance?
🔹 SOLO-3 / ARIEL4: Concerning OS findings altered the risk-benefit assessment.
❌ PARPi monotherapy is NOT recommended for treatment of recurrent ovarian cancer outside clinical trials.
5️⃣ What about PARPi rechallenge?
🔹 OReO / ENGOT-ov38: Modest PFS benefit, but insufficient evidence for routine PARPi rechallenge.
The clinical takeaway:
PARPi treatment is moving from broad use across multiple lines toward earlier, biomarker-selected maintenance.
The question is no longer simply “Is the patient platinum-sensitive?”
It is “BRCA? HRD? Prior PARPi exposure? Which line of therapy?”
@ASCO @myesmo @ESMO_open
#OvarianCancer #PARPi #ESMO26
Full paper link in comment below ⬇️
Three HER2-targeting ADCs in HER2-low breast cancer.
Same target, same linker, same payload class (TOP1 inhibitors).
Three ADCs superior to chemotherapy. Three me-too ADCs???
Treatment of Advanced Biliary Tract Cancer: ASCO Living Guideline, Version 2026.1.0
DOI: 10.1200/JCO-26-02462
Summary of All Recommendations:
Biomarker Testing
First-line therapy for patients with
pMMR/MSS & dMMR/MSI-H Advanced
BTC
2nd Line Rx with/without Targeted Rx
🚨 NEW ASCO 2026 GUIDELINE: Recurrent Ovarian Cancer
A practical treatment algorithm worth saving 👇
PLATINUM-SENSITIVE recurrence
→ Platinum doublet remains backbone:
• Carboplatin + PLD
• Carboplatin + paclitaxel
• Carboplatin + gemcitabine
→ Bevacizumab may be added, followed by maintenance bevacizumab
→ Do NOT add trabectedin to PLD
PLATINUM-RESISTANT / REFRACTORY
⭐ FRα-high: Mirvetuximab soravtansine = strong recommendation
Other options:
• PLD
• Paclitaxel
• Bevacizumab + chemotherapy
• Relacorilant + nab-paclitaxel
• Gemcitabine
SURGERY
Secondary cytoreduction is not routinely recommended based on current evidence, but may be discussed when complete gross resection is highly achievable.
HIPEC
Evidence remains insufficient for a routine recommendation.
Key message:
Recurrent ovarian cancer is becoming increasingly biomarker-driven and patient-selected, especially in platinum-resistant disease.
@ASCO@JCO_ASCO@OncoAlert
#OvarianCancer #GynOnc #Oncology