💥NEOSUMMIT-01 trial in LA gastric/GEJ cancer: perioperative toripalimab ChT vs ChT alone (3-year follow-up, n=108) ascopubs.org/doi/full/10.120… ▪️ 3-year EFS: 74.7% vs 56.2% (HR 0.51) ▪️ 3-year OS: 81.3% vs 72.2% (HR 0.45) ▪️ Benefit maintained across most predefined subgroups Perioperative IO TORI-pal the survival curves in GC 🍜 @OncoAlert @OncoReporte @myESMO @_SEOM @GrupoTTD

🚨 RESET-C trial: single-cycle neoadjuvant pembrolizumab in stage I–III dMMR colon cancer (n=85) ascopubs.org/doi/full/10.120… 🎯 pCR 44% || MPR 57% 💥 DFS and OS rates: 96% and 98% at 18.4 months ▪️ Grade ≥3 AEs in 11%; only 1 recurrence reported One shot and the tumor may already be hitting the RESET button 🔄 @OncoAlert @OncoReporte @myESMO @_SEOM @GrupoTTD

Medicine is all about a lot of learning & then a lot of de-learning also! The very popular corrected serum calcium correction should no longer be used in the setting of abnormal albumin levels Corrected serum calcium = measured serum calcium 0.8 (4-Albumin) formula should no longer be used In the setting of low albumin levels, serum ionised calcium should be measured instead @iofbonehealth @isbmrindia @ISBMRTweets @iofbonehealth @Osteoporosis_NL @osteoporosisNI @TeamSESH @RheumPearls @RheumJnl @RheumResearch @IndianRheum @nihardesai7 @j_metb @EndoSocAus @EndoSocJournals @TheEndoSociety @TheAACE @IndiaESI

Premenopausal HR /HER2 eBC – Adjuvant ET • RD after NAT → OFS AI • pCR after NAT → risk-adapted  – Stage III → OFS AI  – Stage I–II → AI or TAM ± OFS • Upfront surgery → baseline stage-driven ET Principle: RD = ER-dependent, chemo-resistant → needs ET intensification Great editorial👇 thebreastonline.com/article/…

• Censoring = patient exits before event is observed • Non-informative = exit unrelated to event risk • Informative = exit linked to high event risk • Informative censoring → inflates estimated OS/PFS #Oncology #Biostats #KMcurve #SurvivalAnalysis #Trials #MVOnco

ESMO Clinical Practice Guideline: Local and locoregional prostate cancer! @myESMO @APCCC_Lugano @AttardLab @Ecastromarcos @stefanofanti4 @Silke_Gillessen @Prof_Nick_James @piet_ost @MarkARubin1 @ChrisSweens1 @Tilki_De @ZilliThomas @alison_tree @OncoAlert doi.org/10.1016/j.annonc.202…

Why Induction Should Be Performed With T-DXd Pertuzumab (IMO) The key distinction of DESTINY-Breast09 compared with HER2CLIMB-05 and PATINA is randomization at true treatment initiation. In both HER2CLIMB-05 and PATINA, only patients who did not progress during THP induction were randomized; early progressors were excluded by design. DESTINY-Breast09 therefore captures the full early-risk population. At 6 months—approximately the end of induction—12.2% of patients in the THP control arm had already experienced a PFS event, compared with 7.0% in the T-DXd pertuzumab arm, corresponding to an absolute 5.2% reduction in early progression within the first 6 months. Importantly, this separation is not transient. By 12 months, the absolute PFS difference widens to 13.5%, indicating that T-DXd pertuzumab not only prevents early progression but continues to deepen benefit over time. By contrast, PATINA and HER2CLIMB-05 never randomized the initial ~12% of patients who progressed during THP induction. Had induction been performed with T-DXd pertuzumab instead of THP, a substantial proportion of these early progressions—approximately 5% in absolute terms—might have been prevented. These patients would not have been lost upfront and could have proceeded to effective maintenance strategies rather than being excluded at the outset. At present, because maintenance trials have uniformly used THP as induction, there are no prospective data evaluating palbociclib- or tucatinib-based maintenance following T-DXd pertuzumab induction. Nevertheless, indirect inferences from DESTINY-Breast09 suggest a pragmatic clinical strategy: in patients who develop tolerability issues, treatment may reasonably be initiated with T-DXd pertuzumab, followed by maintenance tailored to hormone receptor subtype once maximal disease control is achieved. This approach leverages early disease suppression while preserving the opportunity for durable, subtype-specific maintenance therapy. Critically, in HR–positive disease, ET must remain an integral component of maintenance and should not be omitted.

🧬 PARP Maintenance After First-Line Chemo Huge PFS benefit… but still no OS signal? A 7-trial meta-analysis across 4013 pts. 🔍 Study Snapshot 🧪 7 RCTs 👩‍⚕️ Advanced-stage EOC (after response to platinum) 🧬 Subgroups: BRCA, HRD, BRCA-wt, HRP 🔪Surgery types: PCS vs NACT 💊 Agents: olaparib, niraparib, veliparib, senaparib, others 📈 Overall Results 🟢 PFS improved: HR 0.57 🔵 OS unchanged: HR 0.94 🔴 Grade 3 AEs ↑: RR 2.40 🧬 Molecular Breakdown 🔹 BRCA-mut ⭐ Strong PFS benefit (HR 0.40) ❌ No OS benefit 🔹 HRD ⭐ PFS HR 0.44 ❌ No OS advantage 🔹 BRCA-wt 👍 Moderate PFS benefit (HR 0.62) ❌ No OS benefit 🔹 HRP ⚪ Minimal PFS activity (HR 0.74) ❌ OS neutral 🧵 Treatment Context 🏥 After NACT: HR 0.51 🏥 After PCS: HR 0.54 ✔️ Works in both CR (HR 0.50) and PR (HR 0.57) 🔪 Across complete & incomplete cytoreduction ⚠️ Toxicity Landscape 🔥 Most toxicity: niraparib (RR 4.73) 🙂 Least toxicity: veliparib (RR 1.15) 🧩 Final Take PARP maintenance = robust PFS benefit, strongest in BRCA/HRD. But no OS benefit in any subgroup, and toxicity varies widely. ➡️ Use selectively, genotype-driven, toxicity-aware. 📖 Full paper in comment #OncoTwitter #MedTwitter #GYNOnc #parp @OncoAlert @myesmo @esmo_open @asco

💗 HER2CLIMB-05: TUKYSA takes the lead in HER2 MBC maintenance! 🚀 (PRESS RELEASE) 🧪 Phase 3 | n = 654 | 1st-line maintenance after chemo Arms: 🔹 Tucatinib trastuzumab pertuzumab 🔹 Placebo trastuzumab pertuzumab 🎯 Primary endpoint met: ✨ Statistically & clinically meaningful PFS improvement by investigator assessment 💪 Safety: Tolerable & consistent with known profiles of individual drugs 📊 Why it matters: • HER2 ≈ 15–20 % of breast cancers • 5-yr OS ~ 41–47 % • SOC unchanged since 2012 → most progress < 2 yrs ➡️ HER2CLIMB-05 offers a potential chemo-free maintenance path 🌈 💡 Takeaway: TUKYSA (tucatinib) may soon move from 3rd-line → 1st-line maintenance, shaping a new standard of care in HER2 MBC 💥 📖 Full release: businesswire.com/news/home/2… #OncoTwitter #MedTwitter #BreastCancer #HER2 #Tucatinib #ESMO #ASCO @OncoAlert @myesmo @esmo_open @Pfizer @JournalofOncology @ASCO @DFCI_BreastOnc

NEJM 2025 (ALASCCA): Low-dose aspirin (160 mg) in PI3K-altered stage I–III CRC ↓ 3-yr recurrence (7.7% vs 14.1%, HR 0.49). 🔎 6,397 pts screened → 2,980 sequenced → 1,103 (37%) had PI3K-pathway mutations Hotspot exon 9/20: 17% Other PI3K/PTEN: 20% 📊 NNT: Colon II → weak (42) Colon III → strong (9) Rectum III → best (6) ⚠️ Borderline stats, no OS yet, ↑ severe AEs.( 16.8 vs 11.6 % ) 👉 Signal clearest in stage III; stage II benefit marginal. Promising, not yet blanket SOC. Wait for longer follow-up @dr_yakupergun @GIMedOnc @NiuSanford @OncBrothers

The NCCN has included adjuvant atezolizumab (for 1 year) in the treatment of stage pT2c–III dMMR colon cancer. Given the positive trial results, its inclusion is certainly appropriate. However, the guideline adopts a somewhat conservative stance regarding neoadjuvant ICI use, limiting it only to cases with cT4b tumors or bulky positive lymph nodes. In the NICHE-2 study, however, 57% of patients were staged as cT3–cT4a. Achieving a 3-year DFS of 100% with just 4 weeks of neoadjuvant ICI suggests that restricting this approach to such a narrow population may not be entirely reasonable. We recognize the limitations of clinical staging, but these can be improved. In my view, neoadjuvant strategies that demonstrate a “less is more” effect deserve broader clinical adoption. Trials like NADINA, NICHE-2, and perhaps CheckMate-816( !?) point in this direction.

🧪 NAPOLI-3 Trial: First-Line Treatment in Metastatic Pancreatic Cancer Phase III, randomized, open-label trial 🧬 Study Arms 📌 NALIRIFOX (q2 weeks) Liposomal Irinotecan (nal-IRI) 50 mg/m² Oxaliplatin 60 mg/m² Leucovorin 400 mg/m² 5-FU 2400 mg/m² (46 hr infusion) 🆚 📌 Gemcitabine Nab-Paclitaxel (standard regimen) 📊 Key Outcomes NALIRIFOX VS Gem-NabPac OS 11.1 months VS 9.2 months PFS 7.4 months VS 5.6 months ORR 41.8% VS 36.2% Grade ≥3 AEs 70% VS 68% 🚨 Adverse Events NALIRIFOX: More diarrhea, nausea Gem-NabPac: More neuropathy 📌 Take-Home Message ✅ NALIRIFOX improves OS and PFS vs Gem-NabPac ✅ Suitable for fit patients (ECOG 0–1) ✅ Non-taxane option — helpful in neuropathy-prone patients

🥈 Secured 2nd prize at the Interdepartmental Quiz @ Aster MIMS! With 50 teams competing, it was a thrilling test of trivia covering health, business, and current affairs. Proud of the teamwork and quick thinking! 💡🧠🔥 #QuizTime #AsterMIMS #TriviaChampions #MedicalQuiz #Teamwork #HealthcareAndBeyond

🎓 Proud moment from #AsterMIMS! Two of our studies by final-year residents were published online at #ASCO25: 🧬 NSCLC study led by Dr. Sreedhar Cherulli highlights disparity in access to targeted therapy despite widespread NGS testing. 🩸 HCC study led by Dr. Sireesh Kumar Ch shares real-world insights on atezolizumab bevacizumab from South India. Kudos to both! 🙌 #GlobalOncology #LungCancer #LiverCancer #DNBResidents #MedicalOncology #CancerCare #RealWorldData #ASCO2025

1/n..Under the aegis of @CRSF_IN and guidance of @DrVijayPatil11, @VanitaNoronha, Dr. Kumar sir, our long-awaited study on Triple Metronomic therapy was published in @TheCancerLetter. Please read and comment. kwnsfk27.r.eu-west-1.awstrac…

Kudos to Dr Sanudev Sadanandan for organizing ONCOSCOPE 2025, a groundbreaking conference that raises awareness about Oncology among undergraduates.🎉🙌🎉 Honored to have represented medical oncology, highlighting the progress of cancer treatment over the ages 💉💊⚕️⚕️

🧬 MSI-H = hallmark of mismatch repair (MMR) deficiency. 🧵 Prevalence: ~30% endometrial, ~10% CRC, ~8% gastric. But not all MSI-H/dMMR tumors are alike: 1️⃣ MSH2/MSH6 loss → ↑ TMB, better ICI response 2️⃣ PTEN/AKT1 mutations → ICI resistance Checkpoint blockade is now 1L in CRC & endometrial. #MSI #Immunotherapy #Biomarkers 🔗 nature.com/articles/s41571-0…