Urologist | FEBU @UniklinikBonn - University Hospital Bonn, Germany
Bonn, Deutschland
Joined July 2022
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Very pleased to share our latest work: Molecular Urothelial Tumor Cell Subtypes Remain Stable During Metastatic Evolution published in @EUPlatinum - europeanurology.com/article/… - @niklas_kluemper @markuseckstein3. Follow our tweetorial about these clinically relevant data 1/9
Alexander Cox retweeted
Starting soon #EAU25 #BPH GAME CHANGER session - late breaking release of WATER3 RCT HOLEP vs @myaquablation @PROCEPTRobotics - 1015-1030am Green area. Is Aquablation as effective, efficient and safe for prostates 80-180cc? Come find out!
Alexander Cox retweeted
📹 How can artificial intelligence improve our understanding of tumour complexity?
Dr. @BenjaminPradere interviews Dr. @Markuseckstein3 on how AI is speeding up the process of diagnosis. But what next? And what about AI for #bladdercancer pathology? 👇
bladder.uroonco.uroweb.org/v…
Alexander Cox retweeted
Excited to be part of this exciting review @NatRevNeurol "Pre-treatment metastatic biopsy: a step towards precision oncology for urothelial cancer" with @niklas_kluemper @AlexanderCoxMD
@GottfridSjodahl
@roghmann
@ViktorGruenwald
@HolzelMichael
@Markuseckstein3
Thrilled to share our review published today in Nature Reviews Urology! @NatRevUrol: rdcu.be/dYuu1
"Pre-treatment metastatic biopsy: a step towards precision oncology for urothelial cancer"
Thanks to the amazing team of collaborators @AlexanderCoxMD @GottfridSjodahl @roghmann @ViktorGruenwald @FaltasLab @HolzelMichael @Markuseckstein3
We are exploring how real-time biopsies of metastases could capture the heterogeneity of met. UC, which could provide a clearer path to effective, targeted treatments for mUC!
#PrecisionOncology #UrothelialCancer #CancerResearch
@OncoAlert
#OncoAlertAF
@weoncologists @nataliagandur @acampsmalea @BiagioRicciutMD @yekeduz_emre @HHorinouchi
@FadiHaddad_MD @Dr_Ivanoncologo
@Abdallah81MD @FernandoOnco @ElisaAgostinett @to_be_elizabeth @lungoncdoc @bavilima @realbowtiedoc @Erman_Akkus @DrFMartinelli @Lucarecco
@matteolambe @Icro_Meattini @NarjustFlorezMD @double_whammied @JaniceTNBCmets @ARosen380 @kevinpunie @scserendipity1 @CathyEngMD @PGrivasMDPhD @tompowles1 @Uromigos @DrChoueiri @urotoday @DrYukselUrun @shilpaonc @PTarantinoMD
Alexander Cox retweeted
Are pre-treatment #biopsies the way to go in mUC?
☑️Response prediction to immunotherapy, anti-NECTIN4 ADC enfortumab vedotin, FGFR inhibitor erdafitinib
☑️Identification of druggable alterations and treatment selection
@Markuseckstein3 @niklas_kluemper @oncodaily #BladderCancer
Alexander Cox retweeted
Thrilled to share our review published today in Nature Reviews Urology! @NatRevUrol: rdcu.be/dYuu1
"Pre-treatment metastatic biopsy: a step towards precision oncology for urothelial cancer"
Thanks to the amazing team of collaborators @AlexanderCoxMD @GottfridSjodahl @roghmann @ViktorGruenwald @FaltasLab @HolzelMichael @Markuseckstein3
We are exploring how real-time biopsies of metastases could capture the heterogeneity of met. UC, which could provide a clearer path to effective, targeted treatments for mUC!
#PrecisionOncology #UrothelialCancer #CancerResearch
@OncoAlert
#OncoAlertAF
@weoncologists @nataliagandur @acampsmalea @BiagioRicciutMD @yekeduz_emre @HHorinouchi
@FadiHaddad_MD @Dr_Ivanoncologo
@Abdallah81MD @FernandoOnco @ElisaAgostinett @to_be_elizabeth @lungoncdoc @bavilima @realbowtiedoc @Erman_Akkus @DrFMartinelli @Lucarecco
@matteolambe @Icro_Meattini @NarjustFlorezMD @double_whammied @JaniceTNBCmets @ARosen380 @kevinpunie @scserendipity1 @CathyEngMD @PGrivasMDPhD @tompowles1 @Uromigos @DrChoueiri @urotoday @DrYukselUrun @shilpaonc @PTarantinoMD
Alexander Cox retweeted
Interesting work from @niklas_kluemper et al —Na levels may module ICB response. Still so much unknown in this area. Congrats for the elegant work Niklas!
We are happy to share our current manuscript: In an exploratory post-hoc analysis of IMmotion151 (mRCC, atezo + beva) and IMvigor211 (mUC, atezo), in which we correlated baseline electrolyte concentration with ICB response and outcome in an unbiased manner, we made an interesting observation:
ejcancer.com/article/S0959-8…
➡️High serum sodium predicts ICB response in mRCCl and mUC!
➡️Baseline sodium could serve as a valuable and cost-effective predictive biomarker for ICB (it outperforms PD-L1!)
➡️Sodium exhibits a linear correlation with survival in immunotherapy-treated patients
➡️This hypothesis-generating data suggests that more sodium might fuel an antitumor immune response!
➡️Consistent with this, there is growing evidence of a direct immune-modulating effect of sodium; e.g. High salt diet (HSD) inhibits tumor growth in mice by enhancing anti-tumor immunity
➡️ Maybe HSD could have a synergistic effect with ICB? Further research is needed!
Thanks to all collaborators @AlexanderCoxMD
@Markuseckstein3 @KuppeChristoph @HolzelMichael @IEO_HolzelLab @JohannesStein9 @saal_jonas @ImmunoSens and to the support from
@BMBF_Bund @ @Krebshilfe_Bonn
@EORTC @OncologyAdvance @myESMO @Uroweb
@UrowebESU @DrChoueiri @ASCO @JCOPO_ASCO
@OncoAlert @urotoday @PTarantinoMD @Erman_Akkus @drenriquegrande @PGrivasMDPhD @amerseburger
@DrYukselUrun @tompowles1 @Uromigos @montypal
@neerajaiims @shilpaonc @sonpavde
#Oncology #Cancer #Immunotherapy
Alexander Cox retweeted
We are happy to share our current manuscript: In an exploratory post-hoc analysis of IMmotion151 (mRCC, atezo + beva) and IMvigor211 (mUC, atezo), in which we correlated baseline electrolyte concentration with ICB response and outcome in an unbiased manner, we made an interesting observation:
ejcancer.com/article/S0959-8…
➡️High serum sodium predicts ICB response in mRCCl and mUC!
➡️Baseline sodium could serve as a valuable and cost-effective predictive biomarker for ICB (it outperforms PD-L1!)
➡️Sodium exhibits a linear correlation with survival in immunotherapy-treated patients
➡️This hypothesis-generating data suggests that more sodium might fuel an antitumor immune response!
➡️Consistent with this, there is growing evidence of a direct immune-modulating effect of sodium; e.g. High salt diet (HSD) inhibits tumor growth in mice by enhancing anti-tumor immunity
➡️ Maybe HSD could have a synergistic effect with ICB? Further research is needed!
Thanks to all collaborators @AlexanderCoxMD
@Markuseckstein3 @KuppeChristoph @HolzelMichael @IEO_HolzelLab @JohannesStein9 @saal_jonas @ImmunoSens and to the support from
@BMBF_Bund @ @Krebshilfe_Bonn
@EORTC @OncologyAdvance @myESMO @Uroweb
@UrowebESU @DrChoueiri @ASCO @JCOPO_ASCO
@OncoAlert @urotoday @PTarantinoMD @Erman_Akkus @drenriquegrande @PGrivasMDPhD @amerseburger
@DrYukselUrun @tompowles1 @Uromigos @montypal
@neerajaiims @shilpaonc @sonpavde
#Oncology #Cancer #Immunotherapy
Alexander Cox retweeted
💉🩸High serum sodium predicts response to IO in mUC and mRCC
@EORTC @OncologyAdvance
➡️Posthoc analyses of IMvigor211 (mUC, atezolizumab) and IMmotion151 (mRCC, atezolizumab+bevacizumab) trials
✅Baseline serum sodium levels of >140mmol/L : higher objective response⬆️
✅Serum sodium outperformed tumor PD-L1 expression
👉ejcancer.com/article/S0959-8…
@myESMO @Uroweb @UrowebESU @DrChoueiri @DrYukselUrun @yekeduz_emre @NazliDizman @Uromigos @OncoAlert
#Oncology #Cancer #immutheraphy #MedX
Alexander Cox retweeted
New data from EV302 Enfortumab Vedotin & pembrolizumab for upper tract disease (~25% of pts). UTUC has distinct biological features including more FGFR alterations. PFS & OS HR of 0.50 & 0.53 respectively in the subset is in line with the whole population (0.45 and 0.47) #EAU24
Alexander Cox retweeted
What a start at #EAU24 - OS Update of CheckMate274 Adjuvant Nivolumab demonstrates OS benefit for high-risk MIBC, especially in PD-L1+ population! (HR 0.56) @MattGalsky
But: Why did adjuvant Nivo perform better than Pembro (AMBASSADOR did not demonstrate OS benefit @ASCO #GU24)!
We need biomarkers! ctDNA guidance can help to identify the patients at highest-risk of recurrence with need for adjuvant IO @tompowles1 But also biomarkers to predict IO response are needed! @Markuseckstein3
Great discussion by Joost Boormans! @ErasmusMC
We also need to consider that SOC 1L mUC therapy has changed -> EV/PEM (EV-302) with mOS > 30month. Maybe even ctDNA+ patients would benefit more from surveillance and EV/P after disease recurrence?
@JoshMeeks @PGrivasMDPhD @urotoday @ViktorGruenwald @Uromigos @Uroweb
Alexander Cox retweeted
Nectin-4—drug conjugates (in metastatic urothelial carcinomas): The right drug for everyone?
Happy to talk about current evidence to use Nectin-4 status to predict Enfortumab vedotin response in met. UC at #EAU24 in Paris @Uroweb !
Very interesting Session on saturday about „Tumour and patient biology for optimised treatment“ 🎯
@LDyrskjot @JLinxweiler @Markuseckstein3 @ViktorGruenwald @imedverse @drenriquegrande @DrYukselUrun @amerseburger @urotoday
Alexander Cox retweeted
Happy to share or words of wisdom commentary @EUplatinum about ADC development for Penile squamous cell carcinoma (PSCC)! @JLinxweiler @Markuseckstein3 @Uroweb
➡️Targeting common antigens like TROP2 or NECTIN-4 is a promising avenue to develop tumor-agnostic ADC treatment in rare cancers like PSCC, which are often overlooked in clinical trials🎯
➡️Case report provides first evidence of EV response in a heavily pretreated patient with NECTIN4+ PSCC
➡️Phase II trial of EV in PSCC recently started recruiting patients (NCT06104618)
@ViktorGruenwald @SpiessPhilippe @amerseburger @drenriquegrande @PGrivasMDPhD @shilpaonc @PTarantinoMD @urotoday @OncoAlert @imedverse
authors.elsevier.com/a/1ilN-…
Alexander Cox retweeted
Excited to share our new paper just published @NatureComms @WCMGUcancer @WeillCornell nature.com/articles/s41467-0… Great collaboration between my lab with @ElementoLab @WCMEnglanderIPM and J.M. Mosquera @WCMCPathology 🔬 Full tweetorial below with more updates to come. Stay tuned!
Excited to share our new @biorxivpreprint: The evolution of genomic, transcriptomic, and immune features of metastatic upper tract urothelial carcinoma biorxiv.org/content/10.1101/…. A #Teamscience project spearheaded by K. Ohara and co-led by @FaltasLab and J.M. Mosquera
Alexander Cox retweeted
⚡️ On @nejm - Enfortumab Vedotin and Pembrolizumab — A New Perspective on Urothelial Cancer
#BladderCancer #Immunotherapy @tompowles1 @shilpaonc @cdanicas @OncoAlert
nejm.org/doi/full/10.1056/NE…
Alexander Cox retweeted
Great to see EV-302 data finally published @NEJM! Big step for patients with metastatic UC with doubling in OS!
➡️Open questions are which patients in particular benefit from EV/P and which patients only achieve short-term response or have primary EV/P resistance?
➡️Prediction of EV/P resistance is key to develop better treatment options for this population
NECTIN4 status 🔍
High membranous NECTIN4 expression or NECTIN4 amplification are promising predictive biomarkers! More biomarker work needed to better understand EV/P resistance!
@Markuseckstein3 @JCO_ASCO @Uroweb @urotoday @imedverse @ViktorGruenwald @amerseburger @drenriquegrande @shilpaonc @FaltasLab @tompowles1 @Uromigos
In a trial comparing enfortumab vedotin and a PD-1 inhibitor with chemotherapy in patients with untreated advanced or metastatic urothelial cancer, progression-free and overall survival nearly doubled with the experimental treatment. Full trial results: nej.md/49ViJEe
ALT Kaplan–Meier estimates of progression-free survival according to treatment group in the intention-to-treat population
Alexander Cox retweeted
Sacituzumab + Pembro is efficacious in metastic urothelial cancer following progress on platinum based chemotherapy !! Very interesting study by @PGrivasMDPhD and @y_loriot and team that unfortunately comes late. Is there still a place for this regimen after EV302 results ?
But underlines the performance of SG! ➡️options in the ADC 🏄♂️ space is clnstsntly expanding !
➡️ and TROP 2 is highly expressed in UC!
@DrYukselUrun @shilpaonc @niklas_kluemper @urotoday @OncoAlert @ViktorGruenwald
ascopubs.org/doi/10.1200/JCO…
Alexander Cox retweeted
Throwback Thursday: Different Responses to Neoadjuvant Chemotherapy in Urothelial Carcinoma Molecular Subtypes
buff.ly/3CqNcJr
@GottfridSjodahl @UroLiedberg
Alexander Cox retweeted
Prediction of therapy response based on RECIST criteria only has limitations for the immunotherapy era!
Longitudinal assessment of simple inflammatory 🔥blood biomarkers (CRP + albumin integrated into modified Glasgow Prognostic Score/ mGPS) provides complementary information to radiological staging for ICB-treated NSCLC, especially for heterogenous subgroup with stable disease! 🎯
We validated this simple new concept to improve therapy monitoring for ICB-treated
mRCC @JAMAOnc jamanetwork.com/journals/jam…
mUC @EurUrolOncol
sciencedirect.com/science/ar…
and now NSCLC! @myESMO
doi.org/10.1016/j.lungcan.20…
@Markuseckstein3 @urotoday @OncoAlert @OncBrothers @imedverse
Happy to share our work: Integrating On-Treatment Modified Glasgow Prognostic Score and Imaging to Predict Response and Outcomes in Metastatic Renal Cell Carcinoma @JAMAOnc. See our tweetorial and the terrific editorial by @ggebraelmd @GliceidaGalarza @neerajaiims @urotoday 1/7
Alexander Cox retweeted
Long Term results from PROFOUND out. Clearly showing the tremendous (🧪) predictive potential of deleterious BRCA alterations for PARP inhibitor Olaparib in metastatic castration resistant #prostatecancer!!
Although certainly not powered for that: ‼️ germline BRCA patients tend to have greater benefits ➡️ known for ovarian cancer!
🔬 these results should be an eye opener for everyone who believe in all comer efficacy of PARPi ➡️ biologically and clinically it makes no sense to apply targeted therapies without having a target 🎯 we need to test it - either in 🧪 or tissue.
@ASCO @Uroweb @Uromigos @imedverse @urotoday @OncoAlert @niklas_kluemper @VPrasadMDMPH
ascopubs.org/doi/10.1200/JCO…
Alexander Cox retweeted
Our latest paper ist out in @Histo_Journal ! We comprehensively studied the membranous protein expression of the two important #ADC targets TROP2 and NECTIN4 (surfaceome 🏄♂️). it is the first paper on protein expression in a large cohort of over 200 muscle-invasive and metastic carcinomas of the urinary bladder. 😊
➡️read below! @OncoAlert @Uroweb @onkowissen @ASCO @JAMA_current @JAMANetwork @urotoday @niklas_kluemper @IEO_HolzelLab @HolzelMichael
onlinelibrary.wiley.com/doi/…