Julio retweeted
5 years instead of 3 after high-risk adenoma removal?
The randomized EPoS trial challenges the current surveillance paradigm.
🔹 10,799 patients
🔹 First surveillance: 5 years vs 3 years
🔹 CRC at 5 years: 0.77% vs 0.82%
🔹 Risk difference: −0.05%
🔹 5-year strategy met noninferiority criteria
🔹 Cancer stage at diagnosis appeared similar
Clinical verdict: Extending first surveillance colonoscopy to 5 years may be reasonable after complete removal of high-risk adenomas, but these are interim results of a planned 10-year trial. NEJMoa2603816.pdf
@ASCO @OncoAlert
#ColorectalCancer #Colonoscopy #EPoS
Julio retweeted
For patients with esophageal cancer, 5-year survival has improved in recent decades but rarely exceeds 20%. A new review summarizes risk factors, screening, and treatment for the two main histologic types.
Read “Esophageal Cancer” by Shao-Hua Xie, MD, PhD, Elizabeth Smyth, MD, and Jesper Lagergren, MD, PhD: nej.md/3Tb2NuX
Julio retweeted
📝 #JAMAReview: #LiquidBiopsy using circulating #tumor #DNA can help guide care in #Cancer by identifying gene variants associated with treatment selection, monitoring treatment response, and detecting minimal residual disease after therapy.
Detectable circulating tumor DNA after curative-intent treatment was associated with recurrence and poorer survival across multiple cancer settings, often before progression was evident on imaging.
ja.ma/4dFgtVU
Julio retweeted
¿LA CREATINA CAUSA CÁNCER?
Hoy, con ustedes, el paper de moda en redes, recién publicado en Nature Communications, que nadie admite que no entendió.
Vamos a desmenuzarlo, mi pasión…
Spoiler: se va a poner científico, aguanten, en tiempos de AI está bueno poner atención e intentar entender.
Julio retweeted
Optimal indications for adj CDK4/6i in eBC remain debated, particularly regarding the unclear prognostic role of anatomic vs biologic features.
In @JNCI_Now we tried to refine the risk stratification according to #monarchE & #NATALEE criteria.
@OncoAlert
Main findings ⬇️
Julio retweeted
Systemic Therapy Considerations in Older Adults With Early-Stage Breast Cancer
Great review👇
jamanetwork.com/journals/jam…
Julio retweeted
📢 New ASCO Breast Cancer Surveillance Guideline
Not every breast cancer survivor needs the same intensity of follow-up.
Risk-stratify. De-escalate when appropriate. Intensify when risk is high.
❌ Routine tumor markers
❌ Routine metastatic imaging
❌ Routine ctDNA
✅ Appropriate mammography
✅ Selective MRI
✅ Shared decision-making
Less can be more—when evidence and risk support it.
#BreastCancer #ASCO #Oncology #Survivorship @drsarahsam @DFCI_BreastOnc @OncoDailyBreast
Julio retweeted
Prognostication in stage I TNBC remains challenging. Could gene signatures help? Here, we evaluated TNBC-DX (+TILs) in >100 pts with stage 1 TNBC, finding 100% 5y RFS in pts with high CIG (immune sig) and poor outcomes if low CIG or high proliferation sig. ejcancer.com/article/S0959-8…
Julio retweeted
Press Release: Trastuzumab Rezetecan, with or without pertuzumab, improved PFS in 1L HER2+ MBC vs THP 🎯
This ADC, currently approved in China, is very similar to T-DXd, yet with slightly lower DAR (6:1) and possibly less ILD.
hengrui.com/media/detail-102…
Julio retweeted
What just happened in Oncology? 5 new drugs/indications ✅ @FDADrugs in August 2026. As a #CommunityOncologists, we need to know them all:
1. #Rusfertide in Polycythemia Vera, improved phlebotomy (76.9% vs. 32.9%)
2. #Daraxonrasib in 2L metastatic pancreatic cancer, mOS 13.2 Vs 6.7mos
3. #Zanidatamab + Chemo ± Tislelizumab in 1L metastatic Her2+ GEA/Gastric adenocarcinoma, mOS 26.4mos Vs 19.2mos
4. #Iberdomide + Dara + Dex in 2L RRMM, improved MRD negativity (41% vs. 21%)
5. #Vusolimogene + Nivo in refractory Melanoma. ORR of 24.2% and mDOR: 14.1mos.
#pancsm #mpnsm #OncTwitter #HemeTwitter @OncoAlert @OncUpdates
Julio retweeted
1/6 Published today in @HEP_Journal @docamitgs
ovid.com/10.1097/HEP.0000000…
➡️BEACON-HCC, a new treatment allocation system for #HCC, developed by @HCCLIVEConf consortium
AASLD Statement: aasld.org/hepatology-publish…
Julio retweeted
With 6 FDA approvals in breast cancer already in 2026, it was time to update the breast cancer treatment algorithms. It's a great problem to have when innovation is moving so fast that it's hard to keep up #bcsm @OncoAlert @DFCI_BreastOnc
Julio retweeted
In this article @Annals_Oncology GLP1 receptor agonists reduce cancer incidence. The focus is on those cancers linked to obesity @AparnaKamatMD . A retrospective study with a large sample size in people looking to lose weight . A detailed case/control type method. 41%⬇️ in cancer with GLP1 injections. It’s not clear if the effects of wt loss or the agonists are having an effect. Validation needed. Great work!!
Julio retweeted
🔵Real-world HR+/HER2− early #BreastCancer (Flatiron EHR, n=7,481; 78-mo FU).
N0 with high-risk features had recurrence & mortality risk comparable to N1, indicating meaningful risk beyond nodal status.
🖋️@PTarantinoMD @DrSGraff
🔗 oxford.ly/4vMKrgV
Julio retweeted
In advanced #TNBC and #Her2+ breast cancer, for many it’s not an “if”brain metastases will occur, it’s a “when.” Catching brain disease early can preserve cognitive function and decrease rates of catastrophic complications (herniation/death). We have many effective therapies for breast cancer with CNS disease now and folks can live many many years we need to change with the times and screen!! #bcsm #brainmetastases #Breastcancer
Brain imaging screening in #MetastaticBreastCancer: Is it time to rethink clinical guidelines and practice?
In this recent editorial Drs. Sarah Sammons, Nayan Lamba and Nancy Lin present some compelling reasons:
🔦Screening for #BrainMetastasis (BM) is associated with clinically relevant rates of detection of asymptomatic disease
🔦Screening for #BrainMets leads to diagnosis of smaller and fewer lesions, prior to the development of neurologic symptoms
🔦Advanced radiation oncology techniques are safer and more effective for smaller #CNS system lesions
🔦Treating patients with asymptomatic/occult lesions may result in better outcomes
🔦Advances in systemic treatments have expanded treatment options and improved outcomes for patients with BM, particularly in HER2+ #MBC
🔦The identification of asymptomatic BM on brain imaging scans can lead to changes in treatment strategy. Read the full editorial ⬇️
🔓thebreastonline.com/article/… #BCBM
@drsarahsam @NayanLamba @nlinmd #BreastCancer
Julio retweeted
🚨 Can CDK4/6 inhibition replace chemotherapy even in visceral crisis?
DARVIN, a multicenter phase II trial, evaluated dalpiciclib + endocrine therapy in 53 women with HR+/HER2− advanced breast cancer and visceral crisis.
📌 6-month survival: 92.5%
📌 ORR: 26.4%
📌 DCR: 79.2%
📌 Median PFS: 11.2 months
📌 Median OS: Not reached
In an IPTW-adjusted external comparison:
Dalpiciclib + ET vs chemotherapy
🔹 Median PFS: 11.2 vs 4.6 months
🔹 HR 0.30, P<0.0001
⚠️ Grade ≥3 neutropenia: 77.4%
⚠️ Single-arm, nonrandomized study
⚠️ Nearly half had effusion-based visceral crisis
⚠️ External-control comparison remains hypothesis-generating
Verdict: Promising, not practice-changing yet.
This strengthens the case that selected patients with HR+/HER2− visceral crisis may not automatically require chemotherapy.
Would this change your first-line approach?
@oncoalert #BreastCancer #Oncology #CDK46
Julio retweeted
TROP2-Directed Antibody Drug Conjugates: New First-Line Treatment for All Patients with Advanced Triple-Negative Breast Cancer?
Great editorial👇
annalsofoncology.org/article…
Julio retweeted
When this article was published about a month ago, I outlined the main methodological concerns on X.
One month later, four comments have accumulated on the article’s online page. After reading them, it is hard not to ask a very simple question: how did this study pass editorial and peer review in its current form?
For those who have time, I would strongly recommend reading the comments under the article. My comment was probably the most superficial one; the more substantial and technically important critiques are in the other comments.
jamanetwork.com/journals/jam…
Survival and Recurrence With GLP-1 Receptor Agonists in Breast Cancer
A provocative signal, but not yet an anticancer effect
1. Retrospective EHR-based study; association does not prove causality.
2. High risk of residual confounding despite propensity score matching.
3. Possible healthy-user effect: GLP-1 RA users may have better follow-up, access, adherence, and metabolic care.
4. Strong calendar-time bias: GLP-1 RA use increased in more recent years, when breast cancer care also improved.
5. Weak exposure definition: ≥2 prescriptions do not prove sustained treatment.
6. No time-varying exposure model; immortal-time bias may persist.
7. Landmark analyses reduce bias but do not replace proper time-varying modeling.
8. The signal weakens against the active comparator SGLT2 inhibitors.
9. Insulin/metformin is a problematic comparator because it may represent a sicker diabetes population.
10. Limited tumor biology: ER/HER2 status, grade, nodal burden, tumor size, Ki-67, and genomic risk are inadequately captured.
11. ER-positive rates appear unrealistically low, suggesting incomplete EHR capture.
12. Cancer treatment data appear incomplete; surgery and radiotherapy rates look clinically implausible.
13. RFS is code-based, not a true clinical recurrence endpoint.
14. No breast cancer–specific survival; all-cause mortality may reflect cardiometabolic benefit rather than anticancer effect.
15. No competing-risk analysis despite substantial non-cancer mortality risk.
16. No weight-loss data; the actual metabolic effect is unknown.
17. Effective follow-up is short despite reporting 10-year estimates.
18. Few patients remain at risk beyond 5 years, weakening 10-year KM estimates.
19. High administrative censoring limits late outcome interpretation.
20. Mechanism remains unclear: anticancer effect, weight loss, metabolic control, or patient selection?
jamanetwork.com/journals/jam…
Julio retweeted
The tide is coming in. High tide of the X-tides, that is in the new GLP-1 family of peptide drugs. Today @NEJM survodutide, a GLP-1 and glucagon dual receptor agonist (no GIP, like tirzepatide) drug that achieved ~16% body weight loss at 2 different doses cf placebo
nejm.org/doi/full/10.1056/NE…
Julio retweeted
I wouldn't say that was my big takeaway of this paper or trial. The takeaway I got was there is a giant overall survival benefit for our youngest breast cancer patients to ovarian function suppression over tamoxifen. Sure, there are some low risk patients, where Tam alone is fine, but the majority of super young breast cancer patients present at later stage. If you’re going to give chemo then do not give tamoxifen alone, this needs to be more widely accepted in the community, as it’s been 15 years and the uptake is still too low. Too many oncologists do not give the youngest patients ovarian suppression, as they don't like dealing with how unpopular it is with patients, and difficult it is for patients. Yes it is hard, but it saves lives and it’s our duty to our patients to work with them on side effect management and not just abandon so easily when things get tough, as this is likely our most effective weapon in premenopausal ER+ breast cancer. We are failing our very young breast cancer patients who have the highest mortality from breast cancer when we do not strongly recommend this and then HELP patients with their side effects so they can stay compliant. This often take a lot of time and extra visits, but it really is so important. #Breastcancer #SOFT #TEXT
SOFT/TEXT 15-year final results: tamoxifen remains reasonable for low-risk premenopausal HR+ disease; in young, HER2−, high-risk patients, OFS—and especially exemestane+OFS—provides a stronger endocrine backbone.
annalsofoncology.org/article…
