In comparison, what’s the relapse rate after radical Nephrectomy? What say you Open Evidence…? Maybe time for an RCT @_ShankarSiva ?

📌 Impact of Radionecrosis and Local Recurrence on Overall Survival After Stereotactic Radiosurgery for Brain Metastases 🧠 🔗 advancesradonc.org/article/S… @ASTRO_org @EJVaios @PeterFecci @MuzamilArshad18 🔹1383 pts 🔸 large, multi-institutional cohort 🔹 Patients diagnosed with LR were diagnosed sooner after SRS than RN (5.8 vs 8.3 months) 🔸 Local recurrence was associated with significantly worse OS than radionecrosis (15.2 vs 40.4 months) 🔹 Patients symptomatic from either LR or RN presented earlier after SRS than asymptomatic patients and had worse OS 🔸 On binomial logistic regression, RN was associated with single fraction SRS (odds ratio [OR] = 0.38, P = 0.012), receipt of immunotherapy after SRS (OR = 0.32, P < 0.014), and a longer interval from SRS (OR = 0.94, P = 0.028).

ASCO2026: Asymptomatic brain met EGFR/ALK NSCLC any benefit upfront cranial RT on this Randomized trial? - Upfront RT ↑↑ brain control, no benefit PFS, OS - Selection criteria high risk (e.g. larger size) for upfront RT is key ascopubs.org/doi/10.1200/JCO…

MIRACLE-2: RT to primary/mets -> chemo tislelizumab in MSS unresectable met rectal ca (N=50): 68% ORR & median OS 23 mo. Early, single-arm data, but ~1 in 5 pts reached NED. Suggests RT systemic PD1 blockade could overcome immune resistance in MSS mCRC. #ASCO26 @OncoAlert

Education - Metastatic #BreastCancer Stereotactic Body #Radiotherapy for Oligometastatic and Oligoprogressive Hormone Receptor-Positive Breast Cancer: When and Why? Steven J. Chmura #ASCO26 The story is not over @OncoAlert #OncoAlert

Neo-CRAG: Ph3 RCT (n=620, gastric/GEJ) - adding neoadj chemoRT to peri-op XELOX improved OS (68 v 38 mo). Limitation=non-FLOT, BUT still relevant IMO b/c: 1) DFS/OS benefit substantial. 2) Improvements in pCR, downstg, LRR supports plausible RT effect on OS. #ASCO26 @OncoAlert

#APCCC26 @APCCC_Lugano No one better to debate than @piet_ost Is early SRT "equivalent" to adjuvant RT in high risk/locally advanced disease? Statistically, absolutely not if you believe the RADICALS-RT data.

New @EurUrol! Pooled trials @PeterMacCC / @UTMDAnderson shows adding Pembrolizumab to MDT for oligometastatic #kidneycancer ⬆️ PFS (28 vs 17 mo; HR 0.57), esp. after prior therapy - shorturl.at/WWvBg - Correlative data confirm MDT ICI-evoked immune activation #Kcsm #RadOnc

Long-term survival for patients with newly-diagnosed metastatic cancer has more than doubled ⏫in the past 40 years. However, not all patients live longer. youtu.be/LMmFZRgWlCQ ascopubs.org/doi/10.1200/OP-… Work via @JCOOP_ASCO from team at @UHhospitals @CWRUSOM @MayoClinic

#APCCC26 Jochin Walz crushes his talk and makes the strong case why waiting until imaging is positive after RP is inappropriate and non-evidence based. Early is better!

Congreso @SochiraCl Turno de @SEBASOLE y el Rol de la RT en el escenario metastasico NSCLC @hletelier @DrewMoghanaki

@SEBASOLE @SochiraCl #XIXCongreso #OMD #NSCLC

I am thrilled to announce that Renaissance Institute completed the initial phase of its first course of LDRT for an #Alzheimers patient today. The patient began the treatment course with a MOCA of 15, complete anosmia & ageusia, and A&Ox1. By the end of Renaissance-modified treatment fractionation, the patient had recovered their sense of taste, was A&Ox4, able to remember my staff’s names, and MOCA improved to 19. We look forward to opening this new & innovative fractionation scheme in the upcoming LDRT-MIND trial. #radonc #neurology #dementia

Interesting that a review on TNT for LARC- w/ extensive discussion of RT toxicity & RT omission - has 0 rad onc authors, cites bowel tox data from 2005, and mischaracterizes PROSPECT data: no better QoL with chemo as they state, but different toxicity profile and no diff in HRQoL

Radiation is a powerful anti-cancer agent, but I considered it a weak immunomodulator. Our new study @CD_AACR changed my mind: in the right context, RT can incite potent systemic immune responses in patients (even rare irAEs). Which context? brnw.ch/21x1b6E A 🧵 /1

💬 Editorial: Stereotactic radiation offered modest symptom relief & better long-term neurocognitive outcomes than hippocampal-avoidance whole brain radiation, but was associated w/ higher rates of new brain metastases & salvage whole brain radiotherapy. ja.ma/4bEOp4E

More lesions ≠ WBRT anymore? 🤯 Phase 3 data just changed how we think about 5–20 brain metastases. 🧠 Trial: SRT vs HA-WBRT (JAMA 2026) 👥 Population: • 5–20 brain mets • Good PS, expected survival ≥4 months • Mean ~14 lesions ⚡ Arms: • 🎯 SRT (1–5 fractions) • 🧠 HA-WBRT (30 Gy/10 fx ± memantine) 📊 Key Results: • ↓ Symptom burden with SRT (MDASI-BT Δ −1.06, P<.001) • Better neurocognition at 12 months • Better performance status early & sustained • Similar survival & grade ≥3 toxicity ⚠️ Trade-offs: • ↑ New brain mets with SRT   45.4% vs 24.2% • ↑ Radiation necrosis (mostly asymptomatic) • More salvage WBRT needed 🎯 Takeaway: Even with up to 20 brain mets, SRT offers better QoL functional outcomes 👉 At the cost of higher intracranial relapse risk 🔖 Think beyond lesion count. Think patient-centered outcomes. 📖 Full paper in comment ⬇️ #OncoTwitter #MedTwitter #RadiationOncology #BrainMetastases @oncoalert

Check out our new @IJROBP SBRT special issue podcast! Highway to the Danger Zone - SBRT in difficult scenarios With practical tips to avoid toxicity in difficult situations! podcasts.apple.com/us/podcas…

‼️❓Is trusting only PSA reasonable in metastatic prostate cancer? 🚨Post hoc analysis of ARCHES PROSPER shows PSA can miss radiographic progression on enzalutamide. 🚨Among patients with radiological progression, 25% had no PSA rise and 60% did not meet PSA progression criteria. ‼️‼️Imaging-only progression also predicted worse OS. 👉doi.org/10.1200/JCO-24-02829 @JCO_ASCO @ASCO @OncoAlert @APCCC_Lugano @urotoday @DrYukselUrun

Huge congrats to Dr Saad Ashraf on his @FrontOncology case report! 👏 This unique case of OPD highlights 8 courses of SABR for 17 metastases over 5 years, delaying systemic therapy changes 8x to prioritize patient QOL in a HER2 breast cancer. Read: frontiersin.org/journals/onc…