Phase Ib results from the phase Ib/II study of [Lu]Lu-DOTA-TATE in combination with standard of care as a first-line treatment for pts with ES-SCLC. ☢️ Feasible but challenging combination. Hard to understand the contribution of Lu-DOTA-TATE in terms of efficacy. Ongoing phase II study no longer recruiting patients. #ASCO25 #SCLC #LCSM

Dr. @LuisPaz_Ares: biomarkers from phase III IMforte trial of maintenance lurbinectedin in SCLC #ASCO26. PFS & OS benefit of maintenance lurbinectedin seen across molecular subtypes and independent of SLFN11 expression. Suggestion that lurbi may overcome TAM-mediated resistance.

The #OncoAlertTopTweet 🚨Day Three #ASCO26 Post by @OncoAlert Faculty @CathyEngMD 🇺🇸 Daraxonrasib is the first RAS-targeted therapy to demonstrate a clinically meaningful survival advantage over standard chemotherapy in previously treated metastatic #PancreaticCancer Ping: OncoAlert ❤️Pulse @DrChoueiri 🇺🇸 @hoperugo 🇺🇸 @matteolambe 🇮🇹 @TiansterZhang 🇺🇸 @CathyEngMD 🇺🇸 @stolaney1 🇺🇸 @montypal 🇺🇸 @tompowles1 🇬🇧 @brian_rini 🇺🇸 @cdanicas 🇪🇸 @NiuSanford 🇺🇸 @amerseburger 🇩🇪 @GlopesMd 🇺🇸 @Icro_Meattini 🇮🇹 @PGrivasMDPhD 🇺🇸 @DrYukselUrun 🇹🇷 @nataliagandur 🇦🇷 @ElisaAgostinett 🇧🇪 @HHorinouchi 🇯🇵 @realbowtiedoc 🇺🇸 @to_be_elizabeth 🇮🇹 @UOzkerim 🇹🇷 @p_ciracimd 🇮🇹 @DrVilmaPBarcia 🇪🇸 @DraMartinezLago 🇪🇸 @DrMirallas 🇺🇸 @GaiaGriguolo 🇮🇹 @MarioBalsaMD 🇪🇸 @scocmem 🇬🇧 @AmandaNizamMD 🇺🇸 & @weoncologists 🇺🇸

🚨 PROTEUS: perioperative apalutamide moves into high-risk localized #prostatecancer Just out in @NEJM 🧬 2109 men w/ high-risk localized or locally advanced PCa randomized to ADT apalutamide vs ADT placebo around radical prostatectomy. 🎯 Both stated primary endpoints met. ⚠️ But the trial deserves nuance. Thread 🧵 #ASCO26 @ASCO @PCF_Science

Another major advance vs cancer! @ASCO #ASCO26 Personalized neoantigen mRNA vaccine 5 year follow-up vs metastatic melanoma reduced recurrence and death by 49% (on top of Keytruda) ascopubs.org/doi/10.1200/JCO…

Neoadjuvant sacituzumab govitecan in patients with #MIBC: Final results and biomarker analyses of the SURE-01 trial. Presentation by @BrigidaMaiorano @SanRaffaeleMI. #ASCO26 written coverage by @zklaassen_md @GACancerCenter > bit.ly/4x3aa6y @ASCO

Subgroup analyses by disease volume and de novo/recurrent #mHSPC in the #PSMAddition study of [177Lu]Lu-PSMA-617. Presentation by Fred Saad, CQ, MD, FRCS, FCAHS @chumontreal. #ASCO26 written coverage by @RKSayyid @UAUrology > bit.ly/4uLMKBp @ASCO

#ASCO26 GU Oncology Spotlight 🚨 🔬 Abstract 4521 | CaboNivo in non–clear cell RCC Final results of phase 2 cabozantinib nivolumab in patients with non–clear cell renal cell carcinoma Presented by Darren R. Feldman, MD @ASCO @OncoAlert Important final dataset in a difficult RCC space. Non–clear cell RCC represents a biologically diverse group of kidney cancers, often with fewer prospective data and historically poorer outcomes than clear cell RCC. 🔵 Study design Investigator-initiated phase 2 study: ➡️ cabozantinib 40 mg daily ➡️ nivolumab 240 mg q2w or 480 mg q4w Cohort 1 included: • papillary RCC • FH-deficient RCC • unclassified RCC • translocation-associated RCC Chromophobe RCC was evaluated separately and closed early for inefficacy. 🟢 Final efficacy signal With longer follow-up of ~50 months, CaboNivo reaffirmed antitumor activity in non–clear cell RCC. In cohort 1: • N = 53 • PR/CR: 43% • median PFS: 11 months • median OS: 28 months Responses were seen across several non–clear cell histologies, with a particularly notable signal in FH-deficient RCC: ➡️ 7/8 patients had an objective response. 🔵 Why it matters Non–clear cell RCC is not one disease. Histology matters. Biology matters. And prospective treatment data remain limited. This final analysis supports cabozantinib nivolumab as an active regimen for selected patients with non–clear cell RCC histologies, especially papillary, FH-deficient, unclassified, and translocation-associated disease. 🟠 Safety Toxicity was consistent with known cabozantinib nivolumab profiles. Grade 3/4 treatment-emergent AEs occurred in a substantial proportion of patients, and discontinuations due to AEs occurred with cabozantinib, nivolumab, or both. So this is active therapy — but not low-burden therapy. 🧠 My take CaboNivo is one of the more clinically useful prospective datasets in non–clear cell RCC. The key message is not “treat all non–clear cell RCC the same.” It is: ➡️ use histology ➡️ recognize biologic subgroups ➡️ avoid assuming clear-cell algorithms fully apply ➡️ consider CaboNivo as a treatment option where prospective evidence supports activity ➡️ continue building trials specific to rare RCC subtypes For non–clear cell RCC, better classification is the beginning of better treatment. #ASCO26 #GUOnc #KidneyCancer #RCC #NonClearCellRCC #PapillaryRCC #FHdeficientRCC #Cabozantinib #Nivolumab #PrecisionOncology @OncLive @TargetedOnc @CancerNetwrk @ASCOPost @ecancer @VJOncology @curetoday @JCO_ASCO

#ASCO26 GU Oncology Spotlight 🚨 🔬 Abstract 5017 | PROTRACT ctDNA-guided biomarker-directed therapy vs physician/patient choice in mCRPC progressing after abiraterone/prednisone Presented by Corinne Maurice-Dror, MD @ASCO @OncoAlert This is a very relevant precision-oncology question in prostate cancer: ➡️ Can ctDNA help guide whether a patient should receive docetaxel or enzalutamide after progression on abiraterone? PROTRACT tested a simple treatment-selection strategy: 🔵 Biomarker-directed arm • ctDNA ≥2% → docetaxel • ctDNA <2% → enzalutamide vs 🟠 Physician/patient choice • docetaxel or enzalutamide, based on clinical preference Primary endpoint: PFS Secondary endpoints included OS, PSA50 response, PFS2, safety, and ctDNA correlatives. 🔵 Why this matters This trial directly addresses a common real-world problem: After abiraterone progression in mCRPC, treatment choice is often based on clinical judgment, patient preference, fitness, access, and toxicity concerns. But biology may matter. A higher ctDNA fraction may reflect more aggressive disease biology and could potentially support moving toward chemotherapy rather than sequential AR pathway inhibition. 🔵 Feasibility signal The study randomized 42 patients before early termination due to slow accrual. Importantly: ➡️ 57% of patients had discordance between physician/patient preference and ctDNA-directed assignment. That is the key signal. ctDNA guidance would have changed the treatment direction for more than half of patients. 🟠 Important caveat This was underpowered and stopped early. So PROTRACT should not be read as a definitive efficacy trial. But it is still highly informative because it shows how often biomarker-directed treatment selection may differ from usual clinical choice. 🔵 My take PROTRACT is important not because it settles the sequencing question, but because it frames the next one: ➡️ Can ctDNA move from prognostic biomarker to treatment-selection tool in mCRPC? The future algorithm may not simply ask: “ARPI again or chemotherapy?” It may ask: What does the tumor biology suggest this patient needs next? #ASCO26 #GUOnc #ProstateCancer #mCRPC #ctDNA #PrecisionOncology #Biomarkers #ClinicalTrials #TreatmentSequencing @OncLive @TargetedOnc @CancerNetwork @ASCOPost @ecancer @VJOncology @curetoday

#ASCO26 GU highlight 🚨 LBA1 PROTEUS Perioperative apalutamide ADT in high-risk localized / locally advanced prostate cancer @ASCO @OncoAlert @NEJM Presented by @MaryEllenTaplin Published in @NEJM bit.ly/43lrZR3 This is a major perioperative prostate cancer dataset. #PROTEUS tested 6 cycles of neoadjuvant 6 cycles of adjuvant apalutamide added to ADT around radical prostatectomy. Key results: • pCR / minimal residual disease: 8.9% vs 1.0% • 5-year metastasis-free survival: 78.2% vs 73.5% • HR for distant metastasis or death: 0.80 • Event-free survival: 57.1 vs 38.4 months • Time to first subsequent therapy: 74.2 vs 41.5 months Why it matters: For years, systemic perioperative intensification around prostatectomy has been difficult to establish in high-risk localized prostate cancer. PROTEUS gives phase 3 evidence that deeper androgen-receptor pathway inhibition can improve pathologic response and delay clinically relevant recurrence events. Important caveats: This was not surgery alone vs systemic therapy. The control arm received perioperative ADT placebo. MFS by conventional imaging alone was not significantly different. Grade 3/4 AEs were higher with apalutamide, largely driven by rash. My take: This is practice-informing and potentially paradigm-shaping, but implementation will require careful patient selection, toxicity counseling, imaging context, and multidisciplinary discussion. @EAntonarakis @DanaFarber_GU @DrChoueiri @montypal @tompowles1 @brian_rini @PGrivasMDPhD @DrRanaMcKay @AliciaMorgans @amerseburger @NealShoreMD @DrYukselUrun @BraunMDPhD @DrSpratticus @EAntonarakis @KOSJ12 @LoebStacy @apolo_andrea @AndreaNecchi @DrDanielHeng @neerajaiims @OncLive @TargetedOnc @CancerNetwrk @ASCOPost @VJOncology @ecancer #ProstateCancer #GUonc #Oncology

Phase III MAIN-CAV: Maintenance #avelumab #cabozantinib did not improve OS (23 v 24.8)/PFS vs avelumab alone in #mUC after 1L platinum chemo, though very small numbers/early closure amid changing 1L landscape. Great efforts f/ investigators& research team! #ASCO26

Duravelo-2 reports encouraging activity of the Bicycle Drug Conjugate zelenectide pevedotin (BT8009) pembrolizumab in 1L mUC: ORR 55–58%,CR ~27%, low discontinuation rate (3%),no severe skin reactions and no hyperglycemia. A Future alternative?? @OncoAlert

POTOMAC 5-year OS update presented by Dr Maria De Santis: Durvalumab BCG (I M) continues to show no detriment to OS vs BCG alone in BCG-naive high-risk NMIBC (5-yr OS 87.6% vs 86.3%), with no major impact on quality of life. #ASCO26 #BladderCancer @OncoAlert @ASCO @OncBrothers

One of the most awaited presentations( at least by me) #ASCO26: HARMONi-6 shows that ivonescimab chemo significantly improves OS Vs tislelizumab chemo in first-line advanced Sq #NSCLC (HR 0.66). A positive phase III study with a clinically meaningful OS benefit and simultaneous publication in @TheLancet: thelancet.com/journals/lance… Caveat: this was a study conducted entirely in China. How these data will translate globally remains an important question? Let’s see what HARMONI 3 will show

Dr. Jun Gao presented a phase 1b/2 of Bulumtatug fuvedotin (BFv) toripalimab in la/mUC: ORR 83%, DCR 89.4%, mPFS 12.9 mo, and 18-mo OS rate 68.1%. All CRs remained on treatment. Impressive efficacy signal for this novel Nectin-4 ADC anti-PD-1 combo. #ASCO26 #BladderCancer @OncoAlert @ASCO @OncBrothers

When is NGS useful in the diagnosis of castration-resistant metastatic prostate cancer? @fizazi_karim #ASCO26 #mCRPC

Our #ASCO26 podcasts are now available in Spanish! Thanks to the magic of AI translation, @tompowles1 and @brian_rini speak fluent (sort of) Spanish. Listen to our podcast on PROTEUS here and all ASCO podcasts on all major podcast platforms. @_SEOM @OncoAlert spotifycreators-web.app.link…

Adjuvant nivolumab in high-risk muscle-invasive #UrothelialCarcinoma: Real-world evidence from the SOGUG-NIADY study of the Spanish Oncology Genitourinary Group (SOGUG). Presentation by Aurea Molina Diaz, MD. #ASCO26 written coverage by @RKSayyid > bit.ly/3Scl4XK @sogug1 @ASCO

CaboNivo final results in non-clear cell RCC presented by Dr Darren Feldman: ORR 43% in Cohort 1 (papillary, unclassified, tRCC), with a striking 88% ORR in FH-deficient RCC. mPFS 11 mo, mOS 28 mo. No responses in chromophobe RCC. CaboNivo confirmed as a standard 1L option for these rare subtypes. #ASCO26 #RCC @OncoAlert @ASCO @OncBrothers

Unsung hero poster award for RCC. @OncHahn discusses muscle and fat changes in patient receiving either Len/Ev or Cabo with some interesting findings that complement standard toxicity data.