Wonderful Murali! If you get a chance it’s worth looking at the algorithm on Daraxonrasib by @allysonfelix and @MPishvaian and our software team. If you click on the boxes you get extra info such as dose, toxicity, management, graphs re PFS/OS. This is an early version and will evolve and grow over time as a living version 🎋🌳 We have listened to the community and our wonderful ‘rising stars’ such as @kor_shah and @allisonoconn We feel there is a need for a platform that provides the knowledge and nuance of a clinician with the best of software/website design and AI Thanks for your interest myopenmedicine.com/algorithm…

Great question. I’d probably ask Toni or @DrRanaMcKay @brian_rini @HHammersMD @montypal I’d like to know grade, sarcomatoid differentiation etc Age is important IMO And most importantly what the patient wants… For this patient I’d be thinking Pembro alone if they wanted this after full explanation Reserving Pem/Bel for very high risk (T4, N etc) but we need better bio markers (as always) something I know many are making progress with. As @tompowles1has shown in urothelial carcinoma Great question and as we implement new drugs we need better guidance Something we are doing @OpenMedInsights Great episode on this combo on @uromigos post GU ASCO

I’ll update my relapsed myeloma algorithm on @OpenMedInsights @OpenMedicineHQ soon. myopenmedicine.com/algorithm… @scserendipity1

Two standing ovations. Two impossible moments. At #ASCO26, daraxonrasib delivered #pancreaticcancer survival data that nobody thought we’d ever see. @TheGarden the @nyknicks delivered a game-winner that nearly blew the roof off the building. Turns out there are only two ways to get a crowd on its feet in 2026: 1. Change the future of pancreatic cancer. 2. Beat the @spurs in the @NBA Finals. One advanced science. 💊 One advanced the Knicks. 🏀 Both gave us something priceless: #HOPE that what once seemed impossible might actually happen. 💊 🔬💜 🏀 💙🧡

Hi friends, it's #ProstateCancer Friday! Here are Top Posts of the Week 🧵 1/ @OncoAlert on integrating ARPIs into practice: x.com/OncoAlert/status/20643…

Wonderful and huge thanks to the the @TheIACH team. Mohamad, Amnon and all doing such great work! Thanks for all your support of @OpenMedInsights

Thank you! Already a lot of fun! And we are only just starting! Great work and energy from our GI group! @MPishvaian @GIMedOnc @YJanjigianMD @mgfakih @GlopesMd Great to see the algorithm on Daraxonrasib! @EileenMOReilly myopenmedicine.com/algorithm…

Hi friends, it's #AcuteMyeloidLeukemia Thursday! #EHA2026 edition 🎉🎉🎉 Here are Top Posts of the Week 🧵 1/ @Dr_AmerZeidan on a decade of progress in treating AML: x.com/Dr_AmerZeidan/status/2…

#ASCO26 through an algorithm lens @ASCO #PANKU-Breast02 / LBA1003 Official ASCO/JCO abstract: ascopubs.org/doi/pdf/10.1200… Clinical decision point: In pretreated metastatic TNBC, should a bispecific EGFR × HER3 ADC replace physician’s choice chemotherapy when available? PANKU-Breast02 tested izalontamab brengitecan, or iza-bren, versus physician’s choice chemotherapy in unresectable locally advanced or metastatic TNBC after 1–2 prior systemic lines for advanced disease. Key data: • randomized phase III trial • 418 patients • iza-bren vs eribulin, capecitabine, gemcitabine or vinorelbine • PFS: 8.5 vs 3.1 months • PFS HR: 0.29 • OS: 15.9 vs 12.5 months • OS HR: 0.60 • ORR: 51.7% vs 20.5% • hematologic toxicity common • investigational agent; global access pending Potential algorithm impact: PANKU-Breast02 adds a future ADC decision node in metastatic TNBC. The key question becomes: After taxane-containing therapy, which ADC should come next — and for whom? @DrRanaMcKay @mgfakih @drallysonocean @MPishvaian @GIMedOnc @YJanjigianMD @glopesmd @CaPsurvivorship @AzadOncology @amerseburger @brian_rini @neerajaiims @DrChoueiri @DrYukselUrun @DrMLChua @BraunMDPhD @OmidHamidMD @alisonbirtle @DrHBurstein @IlanaSchlam @PTarantinoMD @drsarahsam @hoperugo @sanamloghavi @montypal @allisonoconn @rajshekharucms @CharuAggarwalMD @jennifermarksmd @StephenVLiu @DrSapnaPatel @parthaskar @Rfonsi1 @VincentRK @VivekSubbiah @NiuSanford @TylerSbrt @UroDocAsh @ehlJAMA

⭐️ Open Medicine Algorithm Spotlight ⭐️ Sharing a practical @OpenMedicineHQ algorithm by @CharuAggarwalMD and @BenBleibergMD on STK11/KEAP1-altered advanced/metastatic non-squamous NSCLC. In this setting, molecular context matters — and STK11/KEAP1 alterations often make first-line treatment selection more nuanced. 🔹 Comprehensive NGS before treatment selection 🔹 Rule out actionable oncogenic drivers 🔹 PD-L1 expression still matters, but is not the whole story 🔹 Consider chemoimmunotherapy strategy and CTLA-4–containing approaches when appropriate 🔹 Reassess contraindications, comorbidities, toxicity, and clinical trial options A useful framework for a challenging NSCLC subgroup where biology, biomarkers, and treatment intensity intersect. How are you approaching 1L therapy selection in STK11/KEAP1-altered non-squamous NSCLC? #LCSM #NSCLC #MedOnc #OpenMedicine @DrRanaMcKay @mgfakih @drallysonocean @MPishvaian @GIMedOnc @YJanjigianMD @glopesmd @CaPsurvivorship @AzadOncology @amerseburger @brian_rini @neerajaiims @DrChoueiri @DrYukselUrun @DrMLChua @BraunMDPhD @nataliagandur @OmidHamidMD @alisonbirtle @DrHBurstein @IlanaSchlam @PTarantinoMD @drsarahsam @hoperugo @sanamloghavi @montypal @allisonoconn @rajshekharucms @CharuAggarwalMD @jennifermarksmd @StephenVLiu @DrSapnaPatel @parthaskar @Rfonsi1 @VincentRK @VivekSubbiah @NiuSanford @TylerSbrt @UroDocAsh @ehlJAMA Interactive, evidence-linked, open for discussion. Feedback welcome. #LivingAlgorithms myopenmedicine.com/algorithm…

Hi friends, it's #LungCancer Wednesday! Here are Top Posts of the Week 🧵 1/ @jennifermarksmd on neoadjuvant lorlatinib in stage 2 ALK NSCLC: x.com/jennifermarksmd/status…

#ASCO26 GU #PLUDO CCTG PR.21 @OncoAlert @ASCO Official ASCO abstract: asco.org/abstracts-presentat… annalsofoncology.org/article… Important sequencing question in PSMA mCRPC after ARPI: 177Lu-PSMA-617 first? Or docetaxel first? In the crossover analysis, among patients who received both therapies, there were no significant differences between LuPSMA→docetaxel and docetaxel→LuPSMA for rPFS2 or OS. Key data: • rPFS2: 18.5 vs 15.8 months • HR 0.91 • OS: 23.2 vs 20.0 months • HR 0.88 • PSA50 after crossover: 69% vs 40% My take: PLUDO does not create a single correct sequence. It reminds us that sequencing in mCRPC is clinical. PSMA PET status, symptoms, disease tempo, marrow reserve, taxane fitness, neuropathy risk, access to LuPSMA and patient preference all matter. This is exactly where algorithms need decision nodes, not rigid rules. @OncoAlert @rksayyid @DrChoueiri @neerajaiims @DrYukselUrun @Uromigos @NucMedDoc @ecancer @urotoday @UrologyTimes #ProstateCancer #GUonc #mCRPC #ASCO26

#ASCO26 through an algorithm lens BREAKWATER / LBA3503 Primary publication in Annals of Oncology: annalsofoncology.org/article… Official ASCO/JCO abstract: ascopubs.org/doi/10.1200/JCO… Clinical decision point: In newly diagnosed metastatic colorectal cancer, should BRAF V600E testing guide the first-line chemotherapy targeted therapy backbone? BREAKWATER Cohort 3 tested: • encorafenib cetuximab FOLFIRI versus • FOLFIRI ± bevacizumab Key data: • randomized phase III Cohort 3 • 147 patients with untreated BRAF V600E-mutant mCRC • PFS: 15.2 vs 8.3 months • PFS HR: 0.44 • OS: not estimable vs 20.3 months • OS HR: 0.56 • no new safety signals reported Potential algorithm impact: BREAKWATER reinforces that BRAF V600E is a first-line biomarker, not a later-line detail. @DrRanaMcKay @mgfakih @drallysonocean @MPishvaian @GIMedOnc @YJanjigianMD @glopesmd @CaPsurvivorship @AzadOncology @amerseburger @brian_rini @neerajaiims @DrChoueiri @DrYukselUrun @DrMLChua @BraunMDPhD @OmidHamidMD @alisonbirtle @DrHBurstein @IlanaSchlam @PTarantinoMD @drsarahsam @hoperugo @sanamloghavi @montypal @allisonoconn @rajshekharucms @CharuAggarwalMD @jennifermarksmd @StephenVLiu @DrSapnaPatel @parthaskar @Rfonsi1 @VincentRK @VivekSubbiah @NiuSanford @TylerSbrt @UroDocAsh @ehlJAMA

#ASCO26 through an algorithm lens HARMONi-6 / LBA4 Primary Lancet OS publication: thelancet.com/journals/lance… Official ASCO abstract: asco.org/abstracts-presentat… Clinical decision point: In untreated advanced squamous NSCLC, can PD-1/VEGF bispecific therapy plus chemotherapy improve outcomes over active PD-1 inhibitor plus chemotherapy? HARMONi-6 tested: • ivonescimab paclitaxel/carboplatin vs • tislelizumab paclitaxel/carboplatin Key data: • phase III randomized trial • 532 patients in China • active PD-1 comparator • median OS: 27.9 vs 23.7 months • OS HR: 0.66 • prior PFS benefit also reported • benefit across PD-L1 subgroups • safety generally comparable, but VEGF-related risks require attention Potential algorithm impact: HARMONi-6 creates a new question in first-line squamous NSCLC: If PD-1 chemotherapy is the standard backbone, can dual PD-1/VEGF targeting improve the first-line node? @DrRanaMcKay @mgfakih @drallysonocean @MPishvaian @GIMedOnc @YJanjigianMD @glopesmd @CaPsurvivorship @AzadOncology @amerseburger @brian_rini @neerajaiims @DrChoueiri @DrYukselUrun @DrMLChua @BraunMDPhD @OmidHamidMD @alisonbirtle @DrHBurstein @IlanaSchlam @PTarantinoMD @drsarahsam @hoperugo @sanamloghavi @montypal @allisonoconn @rajshekharucms @CharuAggarwalMD @jennifermarksmd @StephenVLiu @DrSapnaPatel @parthaskar @Rfonsi1 @VincentRK @VivekSubbiah @NiuSanford @TylerSbrt @UroDocAsh @ehlJAMA

Newly Diagnosed Myeloma from @VincentRK: myopenmedicine.com/algorithm…

Hi friends, it's #BreastCancer Tuesday! Here are Top Posts of the Week 🧵 1/ @DrHBurstein and @dr_yakupergun on the most important discussion at #ASCO26: x.com/DrHBurstein/status/206…

STK11/KEAP1 Advanced/Metastatic Squamous NSCLC from @CharuAggarwalMD @BenBleibergMD: myopenmedicine.com/algorithm…

Hi friends, it's #Myeloma Monday! Here are Top Posts of the Week 🧵 1/ @VincentRK on bispecifics in first relapse: x.com/VincentRK/status/20632…

#ASCO26 through an algorithm lens @ASCO RASolute-302 LBA5 Primary publication in NEJM: nejm.org/doi/full/10.1056/NE… Clinical decision point: In previously treated metastatic pancreatic ductal adenocarcinoma, should RAS-targeted therapy replace standard second-line chemotherapy when available? RASolute-302 tested daraxonrasib, an oral RAS(ON) multi-selective inhibitor, versus investigator’s choice chemotherapy. Key data: • randomized phase III trial • 500 patients in overall population • daraxonrasib 300 mg orally once daily • comparator: investigator’s choice standard chemotherapy • OS overall population: 13.2 vs 6.7 months • HR for death: 0.40 • PFS: 7.2 vs 3.6 months • ORR: 31.6% vs 11.2% • pain and global health/QoL deterioration delayed Potential algorithm impact: RASolute-302 creates a new post-progression decision node in metastatic PDAC. The key question becomes: After progression on first-line chemotherapy, is daraxonrasib available and appropriate? A future pathway may include: Confirm metastatic PDAC Document prior systemic therapy Assess RAS status and assay quality Confirm eligibility for daraxonrasib if approved/accessible Compare against chemotherapy options Monitor rash, diarrhea, stomatitis/mucositis, nausea and fatigue Plan resistance and next-line strategy Consider clinical trials for combinations or earlier-line use Bottom line: RASolute-302 may transform second-line metastatic PDAC. But implementation will require regulatory access, molecular testing, toxicity management and sequencing logic. @CathyEngMD @ronanhsieh @GillSharlene @ArndtVogel @coffman_kelley @ryanhuey

#ASCO26 through an algorithm lens @ASCO LIBRETTO-432 / LBA3 Primary publication in NEJM: nejm.org/doi/full/10.1056/NE… Clinical decision point: In early-stage NSCLC, should comprehensive molecular testing at diagnosis guide adjuvant targeted therapy after definitive local treatment? LIBRETTO-432 tested adjuvant selpercatinib vs placebo in early-stage RET fusion–positive NSCLC after definitive therapy. Key data: • global phase III randomized trial • 151 patients with stage IB–IIIA RET fusion–positive NSCLC • selpercatinib for up to 3 years • primary efficacy population: stage II–IIIA • median EFS: not reached vs 31.8 months • 2-year EFS: 91.5% vs 61.1% • EFS HR: 0.172 • OS immature @lungoncdoc @StephenVLiu @GlopesMd @ADesaiMD @M_Torasawa @Tony_Calles Potential algorithm impact: LIBRETTO-432 changes the early-stage NSCLC algorithm at the testing node. The key step is not only: “Which adjuvant treatment?” It is: “Was molecular testing done early enough to identify the adjuvant option?” A future pathway should include: Diagnose potentially curable NSCLC Stage accurately Preserve tissue for comprehensive molecular testing Test for actionable drivers, including RET fusions Complete surgery or definitive radiation ± systemic therapy when indicated If RET fusion-positive and eligible: consider adjuvant selpercatinib Monitor liver enzymes, blood pressure, diarrhea, dry mouth, QT/drug interactions and adherence Continue surveillance and long-term follow-up Bottom line: LIBRETTO-432 is not only an adjuvant RET-inhibitor trial. It is an early-stage molecular-testing trial in practice.